WO2011024973A1 - 鼻炎治療剤 - Google Patents
鼻炎治療剤 Download PDFInfo
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- WO2011024973A1 WO2011024973A1 PCT/JP2010/064644 JP2010064644W WO2011024973A1 WO 2011024973 A1 WO2011024973 A1 WO 2011024973A1 JP 2010064644 W JP2010064644 W JP 2010064644W WO 2011024973 A1 WO2011024973 A1 WO 2011024973A1
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- rhinitis
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- therapeutic agent
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
- A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- A61K38/22—Hormones
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
- A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- A61K38/22—Hormones
- A61K38/2242—Atrial natriuretic factor complex: Atriopeptins, atrial natriuretic protein [ANP]; Cardionatrin, Cardiodilatin
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0043—Nose
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P11/00—Drugs for disorders of the respiratory system
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P11/00—Drugs for disorders of the respiratory system
- A61P11/02—Nasal agents, e.g. decongestants
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P37/00—Drugs for immunological or allergic disorders
- A61P37/08—Antiallergic agents
Definitions
- the present invention relates to a rhinitis therapeutic agent comprising C-type natriuretic peptide (CNP) or B-type natriuretic peptide (BNP) as an active ingredient.
- CNP C-type natriuretic peptide
- BNP B-type natriuretic peptide
- Rhinitis means inflammation of the so-called nasal mucous membrane, and is pathologically exudative inflammation, especially suppurative inflammation and allergic inflammation. In any case, it is characterized by leaching of humoral components from blood vessels, edema, cell leaching and enhanced secretion.
- rhinitis various types depending on the cause and symptoms, such as acute rhinitis (so-called rhinitis), chronic rhinitis, and allergic rhinitis.
- infectious rhinitis and hypersensitivity are as follows. It is classified into four types: non-infectious rhinitis, irritant rhinitis and others.
- Infectious rhinitis can be divided into acute rhinitis that changes over a short period of time (so-called nasal cold) and chronic rhinitis that lasts for a long time. Infectious rhinitis also includes infectious chronic paranasal sinusitis, which has lesions in the nasal cavity centering on the ethmoid sinus and the middle nasal passage.
- acute rhinitis is mainly nasal cold caused by infections such as viral infections, but simple acute rhinitis is also common.
- Acute viral rhinitis (cold) is characterized by symptoms such as runny nose, nasal congestion, nasal discharge and nasal discharge, coughing, and slight fever.
- vasoconstrictors such as phenylephrine spray nasal spray or pseudoephedrine oral medicine are used.
- the spray should be used within 3-4 days. If it is used for a longer time, the effect of the drug is diminished, and a rebound phenomenon occurs in which the mucous membrane of the nose is swollen more than before the drug is used.
- Antihistamines have the effect of suppressing runny nose, but have side effects such as sleepiness.
- the causes of simple acute rhinitis include inflammation of adjacent organs such as sinusitis, tonsillitis, adenoids, dust, smoke, tobacco, air pollution, extreme temperature changes, excessive drying and wetting. It is done. Symptoms start with sneezing, excessive rhinorrhea (nasal discharge), nasal congestion (nasal congestion), and olfactory disturbance, resembling nasal cold but without systemic symptoms such as fever. The nasal mucosa is congested and swollen. Usually healed within 10 days, but sometimes bacterial infection causes symptoms to worsen and fever. If the course is prolonged, it becomes sinusitis and chronic rhinitis. In addition to rest and warming, symptomatic antipyretics, analgesics, antitussives, anti-inflammatory agents are used, and antibiotics are used if bacterial infection occurs.
- Chronic rhinitis is a long-lasting infectious rhinitis that shifts to chronic rhinitis when the trigger for acute rhinitis is not improved. Chronic rhinitis is often often accompanied by chronic sinusitis. Chronic rhinitis has three conditions, called chronic simple rhinitis, chronic hypertrophic rhinitis, and atrophic rhinitis.
- Chronic simple rhinitis is a condition in which nasal mucosa is chronically swollen due to repeated acute rhinitis. Symptoms of chronic simple rhinitis are similar to those of chronic hypertrophic rhinitis, including nasal congestion, nasal discharge, olfactory disturbance, and headache. However, it differs from chronic hypertrophic rhinitis in that the vasoconstrictor improves the swelling of the nasal mucosa. The most important treatment is removal of triggers, and conservative treatments such as drug application and use of anti-inflammatory agents are also performed.
- Chronic hypertrophic rhinitis is caused by a long period of severe inflammation.
- Chronic hypertrophic rhinitis is the most common pathological condition among chronic rhinitis and refers to a condition in which the swelling of the nasal mucosa is significant and the mucosa is thickened.
- Chronic atrophic rhinitis refers to a condition in which the nasal mucosa and bone tissue of the nose are atrophyed and the nasal cavity is widened. Nasal congestion is on both sides and purulent nasal discharge is produced. The nasal secretions form a scab on the walls of the nasal cavity, causing a stench.
- Hypersensitivity non-infectious rhinitis is a rhinitis in which the mucous membrane of the nasal cavity becomes sensitive due to constitution or for some reason and causes inflammation, and is caused by a stimulus other than a virus or bacterial infection.
- hypersensitivity non-infectious rhinitis can be classified into complex (nasal hypersensitivity) rhinitis, rhinorrhea rhinitis, congestive rhinitis, and dry rhinitis.
- complex (nasal hypersensitivity) rhinitis can be classified into allergic rhinitis and non-allergic rhinitis.
- allergic rhinitis is classified into perennial allergic rhinitis and seasonal allergic rhinitis from the most common period.
- Non-allergic rhinitis can be classified into vasomotor rhinitis (essential rhinitis, vasomotor rhinitis, idiopathic rhinitis) and eosinophilic rhinitis (non-allergic rhinitis with eosinophilia syndrome).
- vasomotor rhinitis essential rhinitis, vasomotor rhinitis, idiopathic rhinitis
- eosinophilic rhinitis non-allergic rhinitis with eosinophilia syndrome
- rhinorrhea can be classified into taste rhinitis, cold inhalation rhinitis, and senile rhinitis
- congestive rhinitis can be classified into drug rhinitis, psychogenic rhinitis, gestational rhinitis, and cold rhinitis.
- rhinitis usually involves some of the symptoms of sneezing, aqueous rhinorrhea, nasal congestion (nasal congestion), for example, sneezing and aqueous rhinorrhea, sneezing and aqueous rhinorrhea and nasal congestion. ing.
- Allergic rhinitis among complex (nasal hypersensitivity) rhinitis is caused by the body's immune system reacting to causative substances in the external environment. Common substances causing allergic rhinitis are house dust, house dust mite mold, pollen, grass, trees, animals, and the like. More specifically, allergic rhinitis is a type I allergic disease of the nasal mucosa, which is characterized in principle by recurrent sneezing, aqueous rhinorrhea and nasal congestion.
- Allergic rhinitis is a type I allergic disease and therefore often has an allergic predisposition (history of allergies, complications, family history), elevated serum-specific IgE antibody levels, local mast cells, and local and blood eosinophils And increased non-specific hypersensitivity of the mucosa.
- allergic rhinitis perennial allergic rhinitis is mostly caused by house dust and mites, and seasonal allergic rhinitis is often caused by pollen.
- vasomotor rhinitis is a type of chronic rhinitis, and allergic rhinitis and symptoms such as nasal congestion (nasal congestion), sneezing, and aqueous rhinorrhea (nasal runny nose).
- nasal congestion nasal congestion
- sneezing sneezing
- aqueous rhinorrhea aqueous runny nose
- Symptoms include nasal congestion and swelling of the mucous membrane, and the colors vary from red to purple. Minor inflammation may be seen in the sinuses.
- Antihistamines or antiallergic agents are used for treatment.
- Eosinophilic rhinitis among non-allergic rhinitis refers to a disease in which allergic tests are negative, but only nasal eosinophils are significantly increased.
- rhinorrhea is mainly rhinorrhea, and three types are known, gustatory rhinitis, cold inhalation rhinitis, and senile rhinitis.
- taste rhinitis often occurs during eating of highly irritating or extremely hot food.
- Cold inhalation rhinitis is a rhinorrhea caused by inhalation of cold air, and is famous as skier's nose.
- Senile rhinitis is also a disease mainly caused by aqueous rhinorrhea, but the specific cause is unknown.
- Congestive rhinitis is a major symptom of hypersensitivity non-infectious rhinitis and is further subdivided into drug-induced rhinitis, psychogenic rhinitis, gestational rhinitis, endocrine rhinitis, and cold rhinitis. As for rhinitis, the mucosal congestion is mainly observed, and nasal congestion is often observed.
- drug-induced rhinitis mainly consists of nasal congestion, such as sympathetic blocking antihypertensives, vasodilatory antihypertensives, beta-stimulating hypotensives, bronchodilators, antidepressants, contraceptive pills It has been reported that it may be expressed as a side effect by long-term continuous use. However, the most frequent of these is the abuse of nasal vasoconstrictors for nasal congestion.
- Psychogenic rhinitis is seen in chronic stress, depression, neurosis, etc., and is mainly nasal congestion.
- Gestational rhinitis occurs after the second trimester of pregnancy, and its onset is thought to involve the action of female hormones, especially estrogen, on nasal mucosal blood vessels and autonomic receptors. In endocrine rhinitis, hypothyroidism is emphasized, but there are few cases. Cold rhinitis is thought to be due to reflex nasal mucosal volume vasodilation via cold stimulation of the body, particularly the limbs.
- dry rhinitis occurs when the room humidity drops below 20% due to winter air drying and heating. It is said that dryness of the skin increases irritation sensitivity, causing nasal dryness and nasal congestion.
- Irritant rhinitis is often caused by occupational work environment, and is classified into physical rhinitis, chemical rhinitis and radiation rhinitis depending on the cause. These physical rhinitis and chemical rhinitis are caused by physical or chemical acute or chronic irritation of the mucous membrane. Occasionally, inflammation is caused by irradiation of the nasal mucosa, which is called radiation rhinitis.
- rhinitis includes atrophic rhinitis and specific granulomatous rhinitis. Symptoms of atrophic rhinitis (or rhinorrhea) are thin and hard in the nasal mucosa and spread through the nasal cavity, but are rare in Japan. Specific granulomatous rhinitis is rhinitis associated with granulomas and includes specific rhinitis (tuberculosis, syphilis, etc.), sarcoidosis, and Wegener granulomatosis, but the number of cases is extremely small.
- rhinitis is a troublesome disease characterized by symptoms such as runny nose and stuffy nose, nasal mucosa inflamed and swollen, stuffy and disturbing daily life.
- rhinitis treatment methods are generally selected based on a combination of severity and disease type, and the choice is not uniform. According to “Guidelines for Clinical Practice 2009” (edited by the Committee for Preparation of Guidelines for Nasal Allergy), the treatment method is as follows.
- the second-generation antihistamine or chemical mediator release inhibitor is the first choice regardless of the disease type. If there are no side effects such as drowsiness and dry mouth, a first-generation antihistamine that is effective immediately may be used.
- Second generation antihistamines Select either (2) chemical mediator release inhibitor, or (3) nasal spray steroid, (3) is used in combination with (1) or (2) as necessary.
- nasal spray steroids In severe cases where sneezing and rhinorrhea are particularly severe, use nasal spray steroids in combination with second-generation antihistamines.
- nasal spray type steroid drugs are used in combination with anti-leukotriene drugs or anti-prostaglandin D2 / thromboxane A2 drugs in cases with severe nasal congestion among severe nasal congestion or fullness.
- Antigen removal and avoidance efforts are necessary for all cases. In cases where continuous treatment is possible, indication of specific immunotherapy is an option, and long-term remission can be expected. Surgical treatment is also an option for patients with obvious morphological abnormalities such as nasal septum folds or cases where drug therapy is inadequate for nasal congestion. Although the effects of antihistamines for nasal sprays have been reported, they are inferior to nasal spray steroids.
- allergic rhinitis treatment methods include antigen removal and avoidance, drug therapy, specific immunotherapy, and surgical therapy.
- Drugs used in drug therapy are based on their mechanism of action. Based on steroid drugs, histamine receptor antagonists, chemical mediator release inhibitors, thromboxane A2 receptor antagonists, thromboxane A2 synthesis inhibitors, leukotriene antagonists, Th2 cytokine inhibitors, etc. it can.
- beclomethasone (trade names: beconase, aldesine, renocoat, salcoat), fluticasone (trade name: fullnase) and the like are used as steroid drugs.
- histamine receptor antagonists include ketotifen (trade name: Zaditen), mequitazine (trade name: Zeslan), fexofenadine (trade name: Allegra), ebastine (trade name: Ebastel), bepotastine (trade name: Talion), Olopatadine (trade name: Allelock), loratadine (trade name: Claritin) and the like are used.
- cromoglycic acid (trade name: Intal), tranilast (trade name: Rizaben), or the like is used.
- thromboxane A2 receptor antagonists include seratrodast (trade name: Bronica), ramatroban (trade name: Binath), and the like.
- ozagrel (trade name: domesticane or trade name: Vega) and the like are used.
- montelukast (trade names: Singrea, Kipress), pranlukast (trade name: onon), and the like are used.
- Th2 cytokine inhibitor suplatast (trade name: IPD) or the like is used.
- nasal spray steroid drugs have local side effects such as nasal irritation, dryness, nasal burning, and nasal bleeding.
- care must be taken not to cause difficulty in withdrawal of steroids, and there is an unavoidable risk of concurrent infections.
- rhinitis that is resistant to treatment with steroids.
- the duration of the effect is not long, and in the case of an adult, it is necessary to use it at a frequency of about 4 times a day. For this reason, there are many patients who show resistance to the use of nasal spray steroids, and it has been reported that more than half of the patients did not take as prescribed.
- antihistamines suppress allergic reactions and symptoms caused by them, but have drawbacks such as drying the nasal mucosa and causing drowsiness.
- allergen injection leads to long-term immune tolerance to a specific causative agent, but has a weak point that it takes months to years before it can be fully effective.
- rhinitis therapeutic agent that is not only effective and safe for rhinitis patients, particularly allergic rhinitis patients, but also has no local side effects and does not cause the complication of infection. Furthermore, the development of an effective rhinitis therapeutic agent is desired for patients with severe cases who are resistant to treatment with steroid drugs.
- natriuretic peptides As natriuretic peptides (NP; natriuretic peptide), three kinds of natriuretic peptide families are known. Specifically, atrial natriuretic peptide (ANP), B-type natriuretic peptide (BNP) B-type natriuretic peptide) and C-type natriuretic peptide (CNP), which are mainly known as amino acid residues of 28, 32 and 22 residues, respectively.
- ANP atrial natriuretic peptide
- BNP B-type natriuretic peptide
- CNP C-type natriuretic peptide
- ANP and BNP ANP and BNP; ANP is synthesized primarily in the atria and BNP is synthesized primarily in the ventricle and is secreted from the heart to the whole body. It is said that ANP and BNP circulating in the blood are almost 100% derived from the heart. It has been reported that these ANP and BNP are deeply involved in pathological conditions such as hypertension, cardiac hypertrophy, heart failure, myocardial infarction, valvular disease, arrhythmia, and pulmonary hypertension.
- Human ANP is a peptide consisting of 28 amino acids that are produced and secreted by atrial cells.
- the 7th cysteine and the 23rd cysteine form a cyclic structure by disulfide bonds in the molecule.
- ANP exhibits diuretic action in the kidney and relaxes / expands vascular smooth muscle in blood vessels.
- human BNP is a peptide consisting of 32 amino acids produced and secreted by ventricular cells.
- the 10th cysteine and the 26th cysteine form a cyclic structure by disulfide bonds in the molecule.
- BNP also has diuretic and vasodilatory effects.
- BNP is a peptide isolated and identified from pig brain in Japan in 1988, and is also called brain natriuretic peptide.
- Both ANP and BNP bind to the receptor NPR-A (also known as GC-A) having a guanylate cyclase domain, and promote the production of cGMP to express the above action.
- NPR-A also known as GC-A
- ANP promotes secretion with increasing atrial fullness pressure in congestive heart failure or the like, and functions to reduce symptoms such as congestive heart failure by the above action.
- BNP also promotes secretion during myocardial infarction and functions to relieve various symptoms associated with myocardial infarction by the above-described action (see Non-Patent Document 1).
- the origin of blood sputum BNP sputum is mostly from the ventricle, but part is also secreted from the atria.
- ANP hANP
- BNP is clinically applied in the United States.
- CNP Since CNP was first discovered in the brain, it was thought that it functions as a neuropeptide, but it was later found to exist in the periphery. In particular, in the vascular wall, smooth muscle cells have many CNP-specific receptors, monocytes / macrophage cells and endothelial cells produce CNP. It is thought to be involved in the growth inhibition of From this, it is possible to prevent intravascular restenosis that occurs at a certain frequency and is a clinical problem after a patient with ischemic heart disease undergoes percutaneous coronary angioplasty (PTCA) by administration of CNP. The possibility of clinical application is currently being investigated.
- PTCA percutaneous coronary angioplasty
- CNP cardiac hypertrophy and fibrosis after myocardial infarction are markedly improved and cardiac function is improved.
- fibrosis of the heart is known to cause diastolic dysfunction and arrhythmia
- CNP has an action of strongly suppressing the proliferation of fibroblasts
- research as a therapeutic agent for cardiac fibrosis is also conducted. It has been broken.
- CNP is a hormone provided in the body, there is little concern about side effects, and it is expected to be applied as a clinical therapeutic agent for arteriosclerotic diseases and heart diseases.
- CNP-22 having 22 amino acids, CNP-53 having 53 amino acids with 31 amino acid residues added to the N-terminal thereof, and the like are known.
- NP receptors include NPR-A receptor having a guanylate cyclase domain (also known as GC-A), NPR-B receptor having a guanylate cyclase domain (also known as GC-B), guanylate Three types of receptors, NPR-C receptors, that do not have a cyclase domain are known: ANP for NPR-A and NPR-C receptors, and BNP for NPR-A and NPR-C receptors It is known that CNP can bind to NPR-B receptor and NPR-C receptor, respectively.
- NPR-A receptor results in vasodilatory action, diuretic action and cell growth inhibitory action.
- NPR-B receptors are abundant in vascular smooth muscle cells and are thought to bring about an inhibitory effect on the proliferation of vascular smooth muscle cells.
- ANP was first discovered as a peptide secreted by the atrium and its vasodilatory action and diuretic action attracted attention. Later, BNP and CNP were found as peptides similar to ANP. From such historical background, attention has been focused on the relationship between the natriuretic peptide and immunity related to the cardiovascular system. Moreover, since it was found that CNP knockout mice exhibited a dwarfism-like phenotype due to poor cartilage growth (see Non-Patent Document 2), they are also interested in the relationship between arthritis and natriuretic peptides. Is leaning.
- ANP suppresses the secretion of tumor necrosis factor ⁇ (TNF- ⁇ ) and interleukin 1 ⁇ (IL1 ⁇ ), which are inflammatory cytokines, suggesting a role in arthritis and sepsis (non-patent literature) 3).
- TNF- ⁇ tumor necrosis factor ⁇
- IL1 ⁇ interleukin 1 ⁇
- Non-patent Document 4 Non-patent Document 4
- BNP is an inflammatory cytokine, arachidonic acid, prostaglandin E2 (PGE2), leukotriene B4 ( LTB4) and interleukin 10 (IL10), which is an anti-inflammatory cytokine, both promote the release of macrophages, indicating that it has some inflammation-regulating action, but overall it acts to suppress inflammation It was not possible to conclude whether it works for promotion (see Non-Patent Document 6). This document also does not describe the relationship between BNP and rhinitis.
- CNP CNP-derived neuropeptides
- Non-Patent Document 7 it has been reported that macrophages secrete CNP (see Non-Patent Document 7), and Scotland et al studied the role of CNP in myocardial injury after cardiac ischemia and reperfusion. It has been reported that platelet aggregation and leukocyte migration were suppressed (see Non-Patent Document 8).
- this document does not describe the relationship between CNP and rhinitis.
- Obata et al examined the effects of CNP in myocarditis, and when CNP was continuously administered to a rat myocarditis model injected with porcine myosin for 1 week, it suppressed necrosis and inflammation of heart tissue. At the same time, it has been reported that angiogenesis was promoted to suppress a decrease in cardiac function (see Non-Patent Document 9). However, this document does not describe the relationship between CNP and rhinitis.
- CNP knockout mice exhibit a dwarf-like phenotype
- CNP is also interested in the relationship with cartilage growth
- Agoston et al is a primary cultured cartilage isolated from the fetal tibia of mice. It has been found that dexamethasone increases the expression of the CNP gene in cells (see Non-Patent Document 10). However, this document does not describe the relationship between CNP and rhinitis.
- CNP CNP
- BNP BNP
- ANP ANP
- CNP is used as a smooth muscle cell inhibitor and does not suggest application of CNP or BNP to a therapeutic agent for rhinitis.
- Katsuhiko Nakata et al. Proposed an eye drop for promoting lacrimal secretion or treating keratoconjunctive disorder using a natriuretic peptide as an active ingredient, and listed ANP, BNP and CNP as usable natriuretic peptides (see Patent Document 3). ).
- Kazukazu Nakao et al. Has proposed a composition for increasing height which is administered to an individual having no FGFR3 abnormality, comprising a guanylcyclase B (GC-B) activator such as CNP as an active ingredient (see Patent Document 4). ).
- GC-B guanylcyclase B
- CNP is used as a composition for increasing the height of CNP or BNP based on the finding that the nasal anal length was larger than that of normal littermates in transgenic mice overexpressing CNP. It does not suggest the application to the therapeutic agent for rhinitis.
- Kazukazu Nakao et al. Has proposed a therapeutic or preventive agent for joint inflammation containing a guanyl cyclase B (GC-B) activator such as CNP as an active ingredient (see Patent Document 5).
- GC-B guanyl cyclase B
- CNP is used as a therapeutic or preventive agent for joint inflammation, and does not suggest application of CNP or BNP to a rhinitis therapeutic agent.
- ANP and BNP both act as hormones secreted from the heart into the blood and act as neurotransmitters and are thought to play an important role in maintaining body fluid volume and blood pressure homeostasis (Omitted)
- CNP has a similar primary amino acid sequence to ANP and BNP, and natriuretic action and blood pressure lowering when administered in vivo.
- CNP is an NP family It occupies a specific position, and its physiological role is more than maintaining fluid volume and blood pressure homeostasis. (Omitted) Comparing the structure of CNP with those of ANP and BNP reveals that CNP differs from ANP or BNP in the following points ( That is, the primary amino acid sequence of CNP is completely different from ANP or BNP in the exocyclic N-terminal domain, and in the endocyclic domain, 5 residues are ANP and 4 residues are BNP out of 17 amino acid residues.
- the structure of the exocyclic C-terminal domain of CNP is very different from that of ANP or BNP, and CNP does not have the tail structure that exists in ANP or BNP (in the case of ANP / BNP, it is cyclic) (5 ANP and 6 BNP amino acid residues are added to the C-terminal side of the structure, and this structure is called tail structure for convenience) It is clear that the structural differences between CNP and ANP or BNP described above are involved in the above-described expression of the characteristic pharmacological action of CNP. "
- JP 2008-162987 A Japanese Patent Laid-Open No. 6-9688 JP 2000-169387 A WO2005 / 094890 pamphlet WO2005 / 094889 pamphlet
- rhinitis especially allergic rhinitis
- nasal spray steroids have a small amount of local effects, but local side effects include nasal irritation, dryness, nasal burning, and nasal bleeding, as well as long-term use.
- Antihistamines also suppress allergic reactions and symptoms associated with them, but have drawbacks such as drying the nasal mucosa and causing drowsiness. Therefore, the object of the present invention is not only effective and safe for rhinitis patients, particularly allergic rhinitis patients, but also has no side effects such as nasal irritation, dryness, nasal burning, nasal bleeding, and sleepiness. Provision of a therapeutic agent for rhinitis.
- CNP C-type natriuretic peptide
- BNP B-type natriuretic peptide
- C-type natriuretic peptide (CNP) has CNP-22, CNP-53, or any amino acid deleted, substituted or added in the amino acid sequence of CNP-22 or CNP-53, and has CNP activity
- the rhinitis therapeutic agent according to [1] which is a CNP derivative.
- B-type natriuretic peptide has BNP-26, BNP-32, BNP-45, or any amino acid deleted or substituted in the amino acid sequence of BNP-26, BNP-32 or BNP-45
- the rhinitis therapeutic agent according to [1] which is a BNP derivative which is added and has BNP activity.
- C-type natriuretic peptide (CNP) or B-type natriuretic peptide (BNP) is a chimeric peptide of CNP and BNP in which a cyclic structure is formed by an intramolecular disulfide bond, CNP-22, CNP-53, a peptide comprising any continuous amino acid sequence of 5 or more amino acids in the amino acid sequence of CNP-22 in which any one to 5 amino acids are deleted, substituted or added, or A peptide selected from the group consisting of peptides comprising any continuous amino acid sequence of 5 or more amino acids in the amino acid sequence of CNP-53 in which 1 to 5 arbitrary amino acids are deleted, substituted or added;
- the BNP is BNP-26, BNP-32, BNP-45, or any continuous amino acid of 5 or more amino acids in the amino acid sequence of BNP-26 in which any 1 to 5 amino acids are deleted, substituted or added
- CNP C-type natriuretic peptide
- BNP B-type natriuretic peptide
- the rhinitis therapeutic agent according to [1] wherein the allergic rhinitis is allergic rhinitis against at least one allergen selected from the group consisting of house dust, mites, cedars, camogaya, ragweed, and cat hair.
- rhinitis therapeutic agent according to [10], wherein the irritant rhinitis is physical rhinitis, chemical rhinitis or radiation rhinitis.
- the rhinitis therapeutic agent according to [1], wherein the dosage form is a nasal drop comprising an ointment, a gel, a cream, a lotion, a liquid, a powder, or a spray.
- the rhinitis therapeutic agent according to [1], wherein the dosage form is a nasal drop comprising a gel, a liquid or a spray.
- the rhinitis therapeutic agent according to [1], wherein the rhinitis is rhinitis in a subject suffering from atopic dermatitis.
- the rhinitis therapeutic agent of the present invention not only has an excellent effect on improvement of rhinorrhea and nasal congestion, disappearance of sneezing and nasal itching, etc. Penetration (absorbability), excellent persistence, immediate effect, no irritation to patients with sensitive nasal mucosa, and no systemic side effects such as local side effects or sleepiness induced .
- the rhinitis therapeutic agent of the present invention comprises CNP or BNP as an active ingredient, and its effect is remarkable compared to conventional steroid drugs and antihistamines, and also in terms of sustainability once a day. It is an epoch-making thing that a symptom is relieved by use.
- the therapeutic agent for rhinitis of the present invention has a long duration, so it is recommended to use it twice in the morning and before going to bed for the first time, but it is often used once a day from the second day. Symptoms such as sneezing, rhinorrhea and nasal congestion can be remarkably improved.
- BNP and ANP not only have the same family but also have the same receptor, it was predicted that the BNP preparation and the ANP preparation have the same action and effect.
- the pharmacological effect of the BNP preparation was far superior to that of the ANP preparation when tested in patients with rhinitis, especially in patients with allergic rhinitis.
- the BNP preparation had an immediate effect as compared with the ANP preparation, the clinical symptoms were remarkably improved, and the effect was sustained.
- ANP preparations were unexpected, and nasal inflammation, rhinorrhea, and nasal congestion were much inferior to those of BNP, and in most cases, there were many cases where there was no effect or worsened. .
- BNP as a rhinitis therapeutic agent had an outstanding effect compared to ANP belonging to the same natriuretic peptide family.
- CNP and BNP which are the active ingredients of the present invention, are hormones originally provided in the body, have little worry about side effects, and are considered to have a minor effect on hemodynamics as long as they are used appropriately, and have low or unstable blood pressure. It can be used with confidence, so it can be used for a long time even for patients with chronic rhinitis.
- the effectiveness against rhinitis is more remarkable than conventional steroids and antihistamines, and it is immediate and has a large effect, and the effect is long-lasting. Use once a day can significantly improve the symptoms of sneezing, rhinorrhea and nasal congestion.
- the rhinitis therapeutic agent of the present invention is an unprecedented and extremely excellent therapeutic agent that has the merit of being effective for patients resistant to steroid treatment and patients with severe cases.
- the rhinitis therapeutic agent of the present invention is extremely effective for treating various rhinitis, particularly allergic rhinitis, and has no concern about side effects. Therefore, conventional nasal spray steroids and antihistamines are used. It can also be applied to patients who did not respond to the drug, patients who had to refrain from using these drugs due to concerns about side effects, and young people.
- the therapeutic agent for rhinitis of the present invention can be expected to be practically used as a new therapeutic agent for rhinitis in place of steroid drugs and antihistamines.
- 100 ⁇ g / ml CNP nasal drops improved symptoms to mildness. It is a figure which shows the therapeutic effect of the rhinitis before and after the treatment by the spray of a BNP nasal drop. Each point represents each case. In the two most severe cases and one moderate case, symptoms improved to mildness by spraying 50 ⁇ g / ml BNP nasal drops. In addition, the symptom of one of the most severe cases improved to a moderate level by spraying 50 ⁇ g / ml BNP nasal drops. Similarly, the symptoms of one of the most severe cases improved to mildness by spraying 100 ⁇ g / ml BNP nasal drops. Similarly, in one severe case, symptoms improved to mildness by spraying 200 ⁇ g / ml BNP nasal drops.
- the present invention is a therapeutic agent for rhinitis containing C-type natriuretic peptide (CNP) or B-type natriuretic peptide (BNP) as an active ingredient.
- CNP C-type natriuretic peptide
- BNP B-type natriuretic peptide
- CNP means CNP-22 having 22 amino acids, CNP-53 having 31 amino acid residues added to the N-terminal thereof, 53 CNP-53 or a derivative thereof, and the like, as long as it has CNP activity. It is not limited.
- CNP-22, CNP-53 and derivatives thereof are all known and can be prepared by chemical synthesis or genetic manipulation.
- CNP-22 and CNP-53 are not particularly limited as long as it has CNP activity, but preferably CNP derived from mammals or birds including humans, more preferably humans, monkeys, mice, rats Alternatively, it is CNP derived from pig, and particularly preferably CNP derived from human.
- the CNP derivative preferably has 1 to 5, more preferably 1 to 3, more preferably 1 or 2 amino acids deleted, substituted or added in the amino acid sequence of CNP-22 or CNP-53. And having CNP activity, or having a sequence homology of 85% or more, preferably 90% or more, and more preferably 95% or more with the amino acid sequence of CNP-22 or CNP-53, and CNP It means what has activity.
- ⁇ Conservative amino acid substitution is desirable for substitutable amino acids.
- Conservative amino acids are classified according to polarity and charge type. For example, glycine, alanine, valine, leucine, isoleucine, proline, etc. for nonpolar uncharged amino acids, phenylalanine, tyrosine, tryptophan for aromatic amino acids, serine, threonine, cysteine, methionine for polar uncharged amino acids
- Negatively charged amino acids such as asparagine and glutamine include aspartic acid and glutamic acid, and positively charged amino acids include lysine, arginine and histidine, respectively.
- amino acid substitution is performed between conservative amino acids belonging to the same class.
- proline when substituting proline with another nonpolar uncharged amino acid, or when substituting a nonpolar noncharged amino acid other than proline with proline, proline is not a three-dimensionally flexible structure. It is necessary to pay attention to.
- cysteine when cysteine is replaced with another polar uncharged amino acid, or when a polar other than cysteine is replaced with cysteine, cysteine can form a disulfide bond with other cysteine. It is necessary to pay attention to.
- the CNP derivative has CNP activity
- the CNP C-terminal is amidated
- the CNP C-terminal is methoxylated
- the CNP is added with polyethylene glycol
- the sugar chain is added to the CNP.
- any known CNP can be used on the condition that it has CNP activity.
- it may be a CNP derivative disclosed in JP-A-6-9688, a CNP derivative disclosed in US Pat. No. 5,583,108, or a CD-NP disclosed in US Pat. No. 6,818,619.
- the presence or absence of CNP activity can be easily confirmed by known means.
- the inhibitory effect on clot smooth muscle cell proliferation or cGMP production activity in NPR-B receptor-expressing cells can be tested. This can be confirmed.
- CNP-22 As the active ingredient of the present invention, any of CNP-22, CNP-53 or derivatives thereof can be used, but CNP-22 having a lower molecular weight is preferable from the viewpoint of absorbability.
- CNP-22 can be prepared by chemical synthesis or genetic manipulation using a human CNP gene, and is obtained as, for example, CNP-22 (human) from PEPTIDE INSTITUTE, INC. be able to.
- CNP that can be used in the present invention is produced by purified CNP from nature, genetically modified CNP produced by a known genetic engineering technique, or a known chemical synthesis method (for example, solid phase synthesis using a peptide synthesizer).
- Basic techniques such as gene recombination techniques, site-directed mutagenesis methods, PCR techniques and the like are known or well-known, and are described in, for example, Current-Protocols-In-Molecular-Biology; John Wiley & Sons (1998), Japanese Patent Laid-Open No. Hei 5-207789, etc. Yes.
- BNP means 26 BNP-26, 32 BNP-32, 45 BNP-45 or a derivative thereof, respectively, as long as the amino acid has BNP activity. is not.
- the BNP may be a high molecular weight ⁇ -BNP having a molecular weight of about 13,000, in which a signal peptide is cleaved from a BNP precursor. Particularly preferred is BNP-32 or a derivative thereof.
- BNP-26, BNP-32, BNP-45 and derivatives thereof are all known and can be prepared by chemical synthesis or genetic manipulation.
- BNP-26, BNP-32 and BNP-45 is not particularly limited as long as it has BNP activity, but preferably CNP derived from mammals or birds including human, more preferably human, monkey CNP derived from mouse, rat or pig, particularly preferably BNP derived from human.
- the BNP derivative is preferably a deletion of 1 to 5, more preferably 1 to 3, more preferably 1 or 2 amino acids in the amino acid sequence of BNP-26, BNP-32 or BNP-45. Substituted or added and has BNP activity, or homology of 85% or more, preferably 90% or more, more preferably 95% or more with the amino acid sequence of these BNP-26, BNP-32 or BNP-45 It means having a sequence having and having BNP activity.
- the amino acid that can be substituted in the BNP derivative is the same as the amino acid that can be substituted for the CNP derivative.
- BNP derivatives have BNP C-terminal amidated, BNP C-terminal methoxylated, BNP polyethylene glycol added, BNP sugar chain added Those having an alkyl chain added to BNP, and those having a fatty acid added to BNP.
- any known BNP can be used on the condition that it has BNP activity.
- a BNP derivative disclosed in JP-T-2007-525213 a BNP derivative disclosed in US Pat. No. 6,280,855, a BNP derivative disclosed in US Pat. No. 5,114,923, a BD-NP disclosed in US Pat. No. 6,618,619, or It may be a diuretic polypeptide or a natriuretic polypeptide disclosed in JP-T-2010-500032.
- BNP activity can be easily confirmed by known means, for example, by testing cGMP production activity in NPR-A receptor-expressing cells.
- any of BNP-26, BNP-32, BNP-45 or derivatives thereof can be used, but BNP-32 is preferred from the viewpoint of medicinal efficacy and availability.
- the BNP of the present invention can be prepared by chemical synthesis or genetic manipulation using a human BNP gene (for example, JP-A-5-207891, JP-T2007-525957, JP-T2007-525213).
- BNP is already on the market and can be obtained from the market. Further, for example, it can be obtained as BNP-32 (human) from Peptide Institute, Inc. (PEPTIDE INSTITUTE, INC.).
- BNP that can be used in the present invention includes purified BNP from nature, recombinant BNP produced by a known genetic engineering technique, known chemical synthesis methods (for example, solid phase synthesis using a peptide synthesizer) BNP produced by the above method).
- Basic techniques such as gene recombination techniques, site-directed mutagenesis methods, PCR techniques and the like are known or well-known, and are described in, for example, Current-Protocols-In-Molecular-Biology; John Wiley & Sons (1998), Japanese Patent Laid-Open No. Hei 5-207789, etc. Yes.
- CNP or BNP includes not only the meaning of either CNP or BNP, but also a chimeric peptide of CNP and BNP. That is, in this specification, in the case of CNP or BNP, C-type natriuretic peptide (CNP) or B-type natriuretic peptide (BNP) is a chimeric peptide of CNP and BNP that forms a cyclic structure by intramolecular disulfide bonds, CNP-22, CNP-53, a peptide comprising any continuous amino acid sequence of 5 or more amino acids in the amino acid sequence of CNP-22 in which any one to 5 amino acids are deleted, substituted or added, or A peptide selected from the group consisting of peptides comprising any continuous amino acid sequence of 5 or more amino acids in the amino acid sequence of CNP-53 in which 1 to 5 arbitrary amino acids are deleted, substituted or added;
- the BNP is BNP-26, BNP-32, BNP-45, or any
- CNP-22 and CNP-53 is not particularly limited as long as it has CNP activity, but preferably CNP derived from mammals or birds including humans, more preferably human, monkey, mouse CNP derived from rat or pig, particularly preferably CNP derived from human.
- origin of BNP-26, BNP-32, and BNP-45 is not particularly limited as long as it has BNP activity, but it is preferably BNP derived from mammals or birds including humans, more preferably Is BNP derived from human, monkey, mouse, rat or pig, particularly preferably BNP derived from human.
- the derivative of a chimeric peptide of CNP and BNP is preferably 1 to 5, more preferably 1 to 3, more preferably 1 or 2 amino acids in the amino acid sequence of the chimeric peptide of CNP and BNP. Means deleted, substituted or added and having CNP activity or BNP activity.
- the amino acid that can be substituted in the derivative of the chimeric peptide of CNP and BNP is the same as the amino acid that can be substituted for the CNP derivative.
- the derivative of the chimeric peptide of CNP and BNP includes an amidated C-terminal of the chimeric peptide of CNP and BNP, as long as it has CNP activity or BNP activity, and the C-terminal of the chimeric peptide of CNP and BNP.
- those obtained by adding a fatty acid to a chimeric peptide of CNP and BNP are obtained by adding polyethylene glycol to a chimeric peptide of CNP and BNP.
- amino acid sequence of the human CNP peptide represented by SEQ ID NO: 1 and the amino acid sequence of the human BNP peptide represented by SEQ ID NO: 2 are “CFG”, “DRI”, “SGLGC”, respectively, as shown in FIG. It has four mutually different sequences delimited by three common sequences represented by the amino acid sequence. Therefore, as a chimeric peptide of CNP and BNP, at least 14 kinds of chimeric peptides represented by SEQ ID NOs: 3 to 16 are exemplified by combinations of these four mutually different sequences. These chimeric peptides and derivatives thereof are considered to have properties common to CNP and BNP. That is, these chimeric peptides and derivatives thereof can be used as an active ingredient of the rhinitis therapeutic agent of the present invention.
- any known chimeric peptide of CNP and BNP, or a derivative thereof can be used on the condition that it has CNP activity or BNP activity.
- it may be a water diuretic polypeptide or a natriuretic polypeptide disclosed as ABC-NP, ABC-NP1, BC-NP or the like in JP-T-2010-502231.
- These polypeptides are exemplified as amino acid sequences of SEQ ID NOs: 17-20.
- CNP activity or BNP activity can be easily confirmed by known means, for example, by testing cGMP production activity in NPR-A receptor-expressing cells or NPR-B-expressing cells. be able to.
- the chimeric peptide of CNP and BNP and its derivative of the present invention can also be prepared by chemical synthesis or genetic manipulation.
- the applicable disease of the rhinitis therapeutic agent of the present invention is not particularly limited as long as it is so-called rhinitis that causes inflammation of the nasal mucosa and has symptoms such as sneezing, runny nose and nasal congestion.
- the therapeutic agent for rhinitis of the present invention can be applied to various types of rhinitis. *
- the rhinitis to which the therapeutic agent for rhinitis of the present invention can be applied is infectious rhinitis, irritable non-infectious rhinitis, irritant rhinitis, atrophic rhinitis or specific granulomatous rhinitis, from the viewpoint of curative effect.
- infectious rhinitis and hypersensitivity noninfectious rhinitis are particularly preferred, and particularly preferred is hypersensitivity noninfectious rhinitis.
- Infectious rhinitis may be either acute rhinitis or chronic rhinitis, preferably acute rhinitis.
- rhinitis therapeutic agent of the present invention it is possible to effectively and quickly cure sneezing, nasal discharge (nasal discharge), nasal congestion (nasal congestion), olfactory disturbance, and the like.
- rhinitis for hypersensitivity non-infectious rhinitis, combined rhinitis including allergic rhinitis and non-allergic rhinitis (nasal hypersensitivity) rhinitis, gustatory rhinitis, cold inhalation rhinitis and senile rhinitis, drug-related rhinitis It may be any of congestive rhinitis selected from rhinitis, psychogenic rhinitis, gestational rhinitis and endocrine rhinitis and cold rhinitis, or dry rhinitis.
- allergic rhinitis or non-allergic rhinitis is preferable, and the allergic rhinitis may be perennial allergic rhinitis or seasonal allergic rhinitis.
- the rhinitis therapeutic agent of the present invention exhibits extremely excellent efficacy and safety as a therapeutic agent for allergic rhinitis, particularly perennial allergic rhinitis caused by house dust and mites, which is difficult to cure or relieve long-term, It is effective.
- this drug is a symptom caused by irritating rhinitis such as physical rhinitis, chemical rhinitis, radiation rhinitis, atrophic rhinitis, idiopathic granulomatous rhinitis, sneezing, runny nose, nasal congestion, etc. It is also effective as a therapeutic agent for rhinitis.
- rhinitis therapeutic agent if the applicable diseases of the rhinitis therapeutic agent are classified from the viewpoint of symptoms, full rhinitis and nasal congestion rhinitis are classified according to the "Rhinoallergy Medical Care Guidelines 2009 Edition" (edited by the Rhinocertic Medical Care Guidelines Guidelines). Or it can be effectively used for sneezing / nasal rhinitis.
- the rhinitis therapeutic agent of the present invention contains C-type natriuretic peptide (CNP) or B-type natriuretic peptide (BNP) as an active ingredient, and the administration route and dosage form are not particularly limited.
- the administration route can be an injection, an internal medicine or an external preparation depending on the patient and symptoms.
- Agents, emulsions, injections, tablets, pills, capsules, granules, powders and the like can be exemplified, and can also be used as a liquid by selecting an appropriate solvent. Any of the preparations can be produced according to known or known methods.
- nasal sprays such as nasal sprays, liquids, gels, sprays, ointments, creams, or lotions, powders, more preferably nasal sprays, liquids, gels, powders, Aerosols or sprays, particularly preferably liquids.
- the nasal drops of the present invention can be dried products such as liquids or powders, and can include carriers or excipients, surfactants, suspending agents, mucoadhesive bases and isotonic agents.
- an isotonic agent sodium chloride, glycerin, sodium bisulfite, benzalkonium chloride, fructose, citric acid, sodium citrate, crystalline sodium dihydrogen phosphate, sodium hydroxide, D-sorbitol solution, nicotinamide, concentrated Glycerin, propylene glycol, benzyl alcohol, boric acid, borax, macrogol 4000, sodium phosphate hydroxide, potassium dihydrogen phosphate, and sodium dihydrogen phosphate can be suitably used.
- the suspending agent crystalline cellulose / carmellose sodium and hydroxypropyl cellulose can be used.
- the gel agent may be any of a water-containing gel, an anhydrous gel, or a low water content gel made of a swellable gel-forming material. Further, it may be either a hydrogel base or a liogel base, but is preferably a transparent hydrogel based on an inorganic or organic polymer. As with formulations containing oils and fats, the gel itself is not absorbed by the nasal mucosa.
- the hydrogel base is non-fat and has a consistency like an ointment, and aims to increase the transdermal absorbability of the drug.
- the liogel base is made by suspending stearyl alcohol or the like in propylene glycol. It is gelled and has excellent nasal mucosal absorbability and hygroscopicity.
- the gel agent of the present invention is an active ingredient in a hydrophilic gel base containing carboxyl vinyl polymer, sodium polyacrylate, sodium polyacrylate, (vinyl methyl ether / ethyl maleate) copolymer, polymethacrylate, propylene glycol and the like.
- a gel agent in which CNP or BNP is uniformly dispersed may be used.
- the liquid is prepared by dissolving an active ingredient composed of CNP or BNP in an alcohol, propylene glycol, polyethylene glycol, water or the like as a base, preferably a liquid composed of an aqueous solution in which CNP or BNP is dissolved in physiological saline. is there.
- the aqueous solution may be mixed with a small amount of an organic base such as alcohol, propylene glycol, or polyethylene glycol in addition to physiological saline.
- the ointment may be either an oleaginous base or a water-soluble base, and both can be easily obtained according to known methods.
- Oily bases such as petrolatum are less irritating and odorless, and are excellent in protecting the nasal mucosa.
- the water-soluble base is an ointment mainly composed of a macrogol base, and has a strong action of absorbing and removing aqueous secretions.
- the cream (emulsion base) may be an oil-in-water base (O / W) (burnishing cream) or a water-in-oil base (W / O) (cold cream).
- Oil-in-water bases have the advantage that the oil-soluble component is less than the water-soluble component, and the whiteness of the cream appears to disappear when applied.
- the lotion agent means a liquid external preparation in which CNP or BNP is dissolved or evenly dispersed in the liquid.
- Lotion is suitable for use on the mucous membrane in the nasal cavity because the agent is liquid.
- Lotion forms include suspension lotion base, emulsion lotion,
- the spray agent is a solution in which CNP or BNP is used and sprayed at the gas pressure. This is convenient when used over a wide range.
- liquid agent for example, an aqueous solution in which an appropriate amount of CNP or BNP is mixed with physiological saline can be used.
- an aqueous solution in which CNP or BNP is dissolved in a buffer that can keep CNP or BNP stable can be used as the liquid agent.
- CNP or BNP can be administered in a pure dosage form or a dosage form diluted with an inert carrier.
- an inert carrier calcium carbonate or lactose can be used.
- povidone or lactose can be used as a hydrophilic auxiliary. Since the nose has a strong excretion mechanism, administration as a dry powder is advantageous in that the action time is extended compared to a liquid form.
- the powder can be produced by recrystallization, granulation, drying, or pulverization to a specific particle size to produce a fine powder.
- the aerosol can be prepared by pulverizing CNP or BNP to preferably 5 ⁇ m or less, adding a dispersing agent if necessary, and filling it in a spray container together with a propellant under cooling.
- Preferred dispersants include nonionic surfactants marketed under registered trade names such as Span 80 and Span 85, amphoteric surfactants such as soybean lecithin, and naturals such as oleyl alcohol. Examples include alcohol.
- Preferable propellants include CFC (chlorofluorocarbon) 11, CFC12, CFC114, and mixtures thereof, which are fluorinated and chlorinated lower alkanes.
- various bases moisturizers, ultraviolet absorbers, alcohols, chelates, pH adjusters, preservatives, thickeners, colorants, fragrances , Fillers, excipients, disintegrants, bulking agents, binders, film agents, solubilizers, suspending agents, buffers, stabilizers, preservatives, surfactants, antioxidants, dispersants, An emulsifier, a solubilizer, a solubilizing agent and the like can be combined in any combination.
- various drugs such as analgesic anti-inflammatory agents, bactericidal antiseptics, vitamins and the like may be appropriately blended as necessary.
- excipients include lactose, corn starch, calcium phosphate and the like.
- binder examples include crystalline cellulose, mannitol, hydroxypropylcellulose, hydroxypropylmethylcellulose, macrogol and the like.
- a preferable solution is a CNP or BNP aqueous solution prepared by dissolving an appropriate amount of CNP or BNP in physiological saline. It is also possible to use the liquid agent in a spray container.
- These solutions include conventional additives such as sorbitol, syrup, methyl cellulose, gelatin, hydroxyethyl cellulose, carboxymethyl cellulose, aluminum stearate gel or precipitation inhibitors such as hydrogenated edible fat, lecithin, sorbitan monooleate, gum arabic Emulsifiers such as, almond oil, rectified coconut oil, oily esters such as glycerin esters, non-aqueous media such as propylene glycol and ethyl alcohol (which may also include edible oils), methyl esters of p-hydroxybenzoic acid, ethyl Preservatives such as esters or propyl esters, or sorbic acid, and usual flavoring agents or coloring agents can be blended as necessary.
- the present rhinitis therapeutic agent when used as an oral preparation, in order to prevent the peptide CNP or BNP from being decomposed by gastric acid, an enteric coating agent is coated on the surface of the tablet or granule, or It is preferable to use an enteric preparation using a soluble capsule.
- the liquid may be an aqueous or oily suspension formulation or an emulsion formulation. Alternatively, it may be provided as a dry pharmaceutical composition that can be redissolved with water or a suitable medium prior to use.
- the rhinitis therapeutic agent of the present invention is a preparation comprising an appropriate amount of CNP or BNP, various bases, and additives as necessary.
- the dosage form and the base can be appropriately selected according to symptoms and patients.
- one of the preferred nasal drops is an aqueous solution.
- an aqueous solution is prepared by, for example, dissolving 0.1 mg to 1 mg of human CNP-22 (manufactured by Peptide Laboratories, Inc.) as a main agent in 10 ml of physiological saline to obtain a CNP concentration of 10 to 100 ⁇ g / ml.
- Aqueous solutions can be prepared. Since the specific gravity of water is 1, the CNP concentration in this case is 10 to 100 ⁇ g / g by weight.
- a preferable CNP concentration of the aqueous solution is 10 to 500 ⁇ g / g, more preferably 20 to 200 ⁇ g / g, still more preferably 50 to 200 ⁇ g / ml, and particularly preferably 50 to 100 ⁇ g / ml.
- the BNP aqueous solution can be produced in the same manner as the CNP aqueous solution, and the preferred concentration is the same as that of the CNP aqueous solution.
- the gel is obtained by dissolving an appropriate amount of CNP in distilled water or physiological saline to form an aqueous solution according to a known or well-known method, and further mixing this with a known or well-known or commercially available gelling agent and stirring. be able to.
- the preferred CNP concentration of the gel is 10 to 500 ⁇ g / g, more preferably 20 to 200 ⁇ g / g, still more preferably 50 to 200 ⁇ g / ml, particularly preferably 10 to 100 ⁇ g / g, more preferably 50 to 100 ⁇ g / ml, Most preferably, it is 30 to 100 ⁇ g / g.
- the gelling agent comprising a polymer inorganic component examples include water-containing or water-absorbing silicates such as aluminum silicate such as bentonite, magnesium silicate-aluminum, or colloidal silica.
- a natural, semi-synthetic or synthetic polymer can be used as the gelling agent comprising a high-molecular organic substance.
- Natural and semisynthetic polymers include, for example, polysaccharides such as cellulose, starch, tragacanth, gum arabic, xanthan gum, agar, gelatin, alginic acid and its salts such as sodium alginate and its derivatives, lower alkyl cellulose such as methylcellulose or ethylcellulose Carboxy- or hydroxy-lower-alkyl celluloses such as carboxymethyl cellulose or hydroxypropyl cellulose.
- Examples of the synthetic gelling agent include polyvinyl alcohol, polyvinyl pyrrolidone, polyacrylic acid, and polymethacrylic acid. These gelling agents may be one kind or a mixture of two or more kinds of gelling agents.
- transdermal absorption aid examples include limonene, menthol, salicylic acid, hyaluronic acid, oleic acid, N, N-diethyl-m-toluamide, n-butyl stearate, benzyl alcohol, isopropyl myristate, isopropyl palmitate, polypropylene Examples include glycol, crotamiton, diethyl sebacate, N-methylpyrrolidone, N-ethylpyrrolidone, and lauryl alcohol. Furthermore, antiseptics and antioxidants may be added as desired.
- the CNP or BNP concentration in the rhinitis therapeutic agent can be appropriately selected in consideration of symptoms, age, dosage form and the like.
- the preferred CNP or BNP concentration is 10 to 500 ⁇ g / g, more preferably 20 to 200 ⁇ g / g, for nasal drops such as liquids, gels, lotions and aerosols. For younger patients and patients with weak skin, it is preferable to use those having a concentration of 20 to 100 ⁇ g / g.
- the preferred CNP or BNP concentration in the gel is 10 to 100 ⁇ g / g, particularly preferably 30 to 100 ⁇ g / g.
- the preferred CNP or BNP concentration in the liquid is 20 to 200 ⁇ g / ml, particularly preferably 50 to 200 ⁇ g / ml.
- this rhinitis therapeutic agent vary depending on symptoms, age, dosage form, etc., but it is sufficient to use 1 to 2 times a day and 2 to 7 days as a standard.
- CNP nasal drops 3 mg of human CNP-22 (manufactured by Peptide Institute, Inc.) as the main agent was dissolved in 3 ml of physiological saline to prepare a 1000 ⁇ g / ml CNP solution.
- 100 ⁇ l of the obtained 1000 ⁇ g / ml CNP solution was diluted with 900 ⁇ l of physiological saline to prepare a CNP nasal solution having a CNP concentration of 100 ⁇ g / ml.
- 50 ⁇ l of a 1000 ⁇ g / ml CNP solution was diluted with 950 ⁇ l of physiological saline to prepare a CNP nasal solution having a CNP concentration of 50 ⁇ g / ml.
- 200 ⁇ l of a 1000 ⁇ g / ml CNP solution was diluted with 800 ⁇ l of physiological saline to prepare a CNP nasal solution having a CNP concentration of 200 ⁇ g / ml.
- BNP nasal drops 3 mg of human BNP-32 (manufactured by Peptide Institute, Inc.) as the main agent was dissolved in 3 ml of physiological saline to prepare a 1000 ⁇ g / ml BNP solution.
- 100 ⁇ l of the obtained 1000 ⁇ g / ml BNP solution was diluted with 900 ⁇ l of physiological saline to prepare a BNP nasal solution having a BNP concentration of 100 ⁇ g / ml.
- 50 ⁇ l of a 1000 ⁇ g / ml BNP solution was diluted with 950 ⁇ l of physiological saline to prepare a BNP nasal solution having a BNP concentration of 50 ⁇ g / ml.
- 200 ⁇ l of a 1000 ⁇ g / ml BNP solution was diluted with 800 ⁇ l of physiological saline to prepare a BNP nasal solution having a BNP concentration of 200 ⁇ g / ml.
- ANP nasal drops For comparative tests, 0.5 mg of human ANP-28 (Peptide Institute, Inc.) was dissolved in 1 ml of physiological saline to prepare a 500 ⁇ g / ml ANP solution. 1 ml of the obtained 500 ⁇ g / ml ANP solution was diluted with 9 ml of physiological saline to prepare an ANP nasal drop having an ANP concentration of 50 ⁇ g / ml.
- ANP nasal drops consisting of ANP nasal drops ;
- Three types of ANP nasal drops having an ANP concentration of 50 ⁇ g / ml obtained as described above are quantitative nasal spray containers (manufactured by Astellas Pharma Inc .; Used to prepare a spray amount of 130 ⁇ l. Therefore, the amount of ANP contained in one injection liquid is 6.5 ⁇ g.
- the test of the subject and diagnosis, evaluation of symptoms, CNP nasal drops, BNP nasal drops, and ANP nasal drops were performed as follows. 1. Both subjects and diagnosed subjects are patients who are not sufficiently effective using existing topical drugs such as steroids, or have local nasal irritation and dryness as side effects, and refrain from using steroids. A patient who must be. The diagnosis and treatment of these subjects were carried out by the inventor as doctors.
- the administration test of the nasal solution formulation of the present invention is carried out by using a CNP nasal solution, BNP nasal solution or ANP nasal solution in a nasal spray container at the time of waking up and at bedtime. It was performed by inhaling one spray into each nasal cavity once a day twice a day before. Therefore, the nasal amount of CNP, BNP or ANP per spray is equivalent to 13 ⁇ g in the case of 100 ⁇ g / ml CNP nasal fluid, BNP nasal fluid or ANP nasal fluid.
- the nasal volume of CNP, BNP or ANP per dose of CNP nasal, BNP or ANP nasal drops corresponds to 6.5 ⁇ g at a concentration of 50 ⁇ g / ml, In the case of a concentration of 200 ⁇ g / ml, all correspond to 26 ⁇ g.
- CNP dose setting test CNP nasal solution with a concentration of 100 ⁇ g / ml was used once a day for 7 consecutive days, then suspended for 14 days, and then the concentration was 50 ⁇ g / ml.
- the test was conducted with CNP nasal drops.
- the time until the effect is exhibited is about 20 minutes, and it takes about twice the time until the effect is exhibited, and the degree of improvement of nasal congestion is slightly reduced. It became clear to do.
- the CNP nasal solution at a concentration of 200 ⁇ g / ml was still non-irritating and the effect on rhinitis was remarkable, but the effect was not particularly doubled compared to the case of 100 ⁇ g / ml.
- BNP dose setting test BNP was also subjected to a dose setting test, and the same results as CNP were obtained.
- Test Example 1 (Case 1) The subject is a 48-year-old woman who is a full-blown severe patient. She has a history of atopic dermatitis, and her child also has atopic dermatitis and allergic rhinitis. The results of the scratch test are house dust 3+ and tick 3+. The subject has very strong nasal congestion, mouth breathing for a significant amount of time during the day, and severe nasal discharge. Nasal spray steroids cannot be used because they have nasal irritation.
- the CNP nasal solution having a concentration of 100 ⁇ g / ml obtained in Example 1 was sprayed and inhaled once into both nasal cavities of the subject (the dose of CNP into one nasal cavity was 13 ⁇ g).
- Test Example 2 (Case 2) The test subject was a 39-year-old woman who was a severe patient with sneezing and rhinorrhea. She has a history of atopic dermatitis, and her child also has atopic dermatitis. The results of the scratch test are house dust 2+, mite 2+, cedar 2+, camouflage 3+, and ragweed 1+. This test subject is a severe case with both symptoms of nasal congestion, sneezing and aqueous nasal discharge enough to pile up tissues, and is a patient who regularly uses second generation antihistamines. Spray steroids exacerbate nasal irritation, nasal itching, sneezing, and rhinorrhea, and have no subjective improvement effect.
- Example 1 the CNP nasal solution having a concentration of 100 ⁇ g / ml obtained in Example 1 was sprayed and inhaled once into both nasal cavities of this subject (the dose of CNP in one nasal cavity was 13 ⁇ g).
- the dose of CNP in one nasal cavity was 13 ⁇ g.
- Penetration was good, no irritation, and no local side effects were observed.
- No nasal discharge was observed at all once a day without nose sag. The effect lasted for 1 day. No nasal discharge was observed at all in the next morning.
- this CNP nasal drop was sprayed and inhaled once into both nasal cavities. As a result, there was no stuffiness on the day and no rhinorrhea was observed.
- the CNP nasal solution of the present invention is excellent in sustainability, absorbability, and immediate effect, and a sufficient effect can be obtained by spraying once a day.
- Test Example 3 (Case 3) The test subject is a 32-year-old woman who is a full-blown severe patient. She has a history of atopic dermatitis and her mother also has atopic dermatitis. The results of the scratch test are house dust 1+, mite 1+, cedar 1+, camogaya 2+, and ragweed 1+. This subject has a very strong nasal congestion and does not know the smell. There are also severe aqueous rhinorrhea. The nasal spray steroid had a feeling of irritation in the nose and a dry feeling that the back of the nose stuck together, and after a while after use, the runny nose was reduced to a certain extent and was not satisfactory.
- Example 1 the CNP nasal solution having a concentration of 100 ⁇ g / ml obtained in Example 1 was sprayed and inhaled once into both nasal cavities of this subject (the dose of CNP in one nasal cavity was 13 ⁇ g). As a result, the nasal congestion disappeared after 5 minutes and the rhinorrhea subsided. There were no local irritation symptoms. Thereafter, when spraying once a day in the morning was continued, the feeling of nasal congestion disappeared, the olfactory sensation was restored, the aqueous nasal discharge was improved, and nasal discharge was completely cured after 3 days. Neither local side effects such as irritation nor systemic side effects such as sleepiness were observed.
- Test Example 4 (Case 4) The test subject was a 23-year-old male and a severe patient with nasal congestion. She has a history of childhood asthma and her mother has atopic dermatitis. The results of the scratch test are house dust 3+ and tick 3+. This subject has a significant amount of mouth breathing during the day and has a very strong tendency to close the nose. The subject also had to refrain from using steroids due to symptoms of difficulty in withdrawal due to long-term use of systemic steroids. As in Test Example 1, the CNP nasal solution having a concentration of 100 ⁇ g / ml obtained in Example 1 was sprayed and inhaled once into both nasal cavities of this subject (the dose of CNP in one nasal cavity was 13 ⁇ g).
- Test Example 5 (Case 5) The test subject is a 24-year-old woman who is a full-blown severe patient. She has a history of atopic dermatitis, and her sister also has atopic dermatitis. The results of the scratch test are house dust 3+, mite 3+, cedar 3+, camogaya 2+, and ragweed 2+. The subject has mouth breathing for a significant amount of time during the day, has a very strong tendency to close the nose, and has severe nasal discharge. Nasal spray steroids are not used due to intranasal irritation and dryness.
- Example 2 In the same manner as in Test Example 1, the CNP nasal solution having a concentration of 100 ⁇ g / ml obtained in Example 1 was sprayed into both nasal cavities of this subject once (the dose of CNP into one nasal cavity was 13 ⁇ g). After 20 minutes, nasal congestion improved and rhinorrhea was cured. The effect lasted for 1 day, and sedation was maintained for both nasal congestion and rhinorrhea from the next day.
- Test Example 6 (Case 6) The test subject is a 37 year old female and is a full-blown severe patient. She has a history of atopic dermatitis, and her mother and sister also have atopic dermatitis. The results of the scratch test are house dust 3+ and tick 3+. In this subject, as in Case 5, mouth breathing has a considerable amount of time in a day, the tendency to close the nose is very strong, and nasal discharge is severe. The subject had severe nasal congestion and sneezing at night, and was also troubled by a nasal itching sensation. Nasal spray steroids are not used due to dryness in the nose.
- the CNP nasal solution having a concentration of 100 ⁇ g / ml obtained in Example 1 was inhaled once in both nasal cavities before going to bed (the dose of CNP in one nasal cavity was 13 ⁇ g), and after 1 hour He received a report that his nasal obstruction was significantly improved and his breathing was easier. Further, following the administration of the previous night, the CNP nasal solution of the present invention was sprayed and inhaled once into both nasal cavities the next morning, and the nasal itching and nasal congestion were resolved throughout the day. The aqueous nasal discharge was improved to the extent that it was not necessary to blow the nose. There was no local irritation. After that, use was stopped twice a day for 5 days in the morning and before going to bed. The effect continued for 4 to 5 days after discontinuation of use, and improved nasal itching, nasal congestion and rhinorrhea were maintained.
- Test Example 7 (Case 7)
- the test subject is a 39-year-old female and is a full-blown severe patient. She has a history of atopic dermatitis, and her child also has atopic dermatitis.
- the results of the scratch test are house dust, mite 2+, cedar, camogaya 3+, and ragweed.
- mouth breathing has a considerable amount of time during the day, the tendency to close the nose is very strong, and the nasal discharge is severe.
- morning rhinorrhea, nasal congestion and sneezing were severe, and he suffered from nasal itching.
- this subject has a nasal irritation to steroids for nasal spray, and sneezes and nasal discharge, so steroids cannot be used, and when taking second-generation antihistamines
- antihistamines had to be avoided as much as possible because of the tendency to develop palliative symptoms.
- the subject was inhaled once by spraying the CNP nasal solution with a concentration of 100 ⁇ g / ml obtained in Example 1 into both nasal cavities (the dose of CNP into one nasal cavity was 13 ⁇ g).
- the nasal congestion was remarkably improved 10 minutes after the nose was covered. He also received reports that breathing became easier. If I don't keep my tissue, the watery nasal discharge will stop.
- the CNP nasal drops of the present invention are gospel for rhinitis patients who cannot use or have to refrain from conventional steroids or antihistamines.
- Test Example 8 (Case 8) The test subject is a 39-year-old woman who is a full-fledged moderate patient. Although there is a history of atopic dermatitis, childhood asthma, sinusitis, the family is not affected by these diseases or allergic rhinitis. The results of the scratch test are house dust 2+, mite 3+, cedar 2+, camogaya 1+, ragweed, and cat hair 3+. This subject has mouth breathing occasionally during the day and has a strong tendency to close the nose. Steroids were not used because they suffered from sinusitis a year and a half ago.
- the subject was inhaled once by spraying the CNP nasal solution with a concentration of 100 ⁇ g / ml obtained in Example 1 into both nasal cavities (the dose of CNP into one nasal cavity was 13 ⁇ g). After 10 minutes, the nasal congestion was remarkably improved and breathing became easier. After 20 minutes, the aqueous nasal discharge also stopped. He also received reports that breathing became easier. Use once a day lasted for 1 day and improved to the extent that both nasal congestion and rhinorrhea were not bothered.
- Test Example 9 (Case 9) The test subject was a 21-year-old male and a severe patient with nasal congestion. She has a history of atopic dermatitis and allergic conjunctivitis, and her mother also has atopic dermatitis. The results of the scratch test are house dust 2+, mite 3+, cedar 2+, camouflage 3+, and ragweed 1+. In this test subject, as in Case 7, mouth breathing has a considerable time in one day, and the tendency to close the nose is observed very strongly. In the past, steroids were used, but nasal congestion was not improved sufficiently. The nasal discharge was not so bad.
- the subject was inhaled once by spraying the CNP nasal solution with a concentration of 100 ⁇ g / ml obtained in Example 1 into both nasal cavities (the dose of CNP into one nasal cavity was 13 ⁇ g).
- the nasal passage improved, and no symptoms of irritation were observed.
- the symptoms improved remarkably after 25 minutes, and rhinorrhea also subsided.
- the effect lasted for one day in the evening and once in the evening, the nasal mucus stayed unaffected even though it was not treated for the next three days. During this time, there was no need to take antihistamines.
- Test Example 10 (Case 10) The test subject is a 55-year-old woman who is a full-blown severe patient. She has a history of atopic dermatitis, and her child also has atopic dermatitis. The results of the scratch test are house dust 1+, mite 2+, cedar 2+, camogaya 3+ and ragweed 2+. This subject has a strong nasal congestion and always has a feeling of obstruction in the ear. In this patient, oral steroids and steroid sprays were used three times a day, but the effect on nasal congestion was not sufficient, persistence was low, and nasal discharge was not sufficiently improved. When using steroid sprays, the head becomes severe from the back of the nose to the head, and the consciousness is blurred.
- Test Example 11 The test subject was a 42-year-old woman who was the most severe patient with sneezing and rhinorrhea. A history of atopic dermatitis and allergic conjunctivitis. Her child has allergic rhinitis and atopic dermatitis. The results of the scratch test are house dust 2+, mite 2+, cedar-, camogaya 3+, ragweed 2+. This subject becomes mouth breathing due to nasal congestion only at night. The subject had been suffering from atopic dermatitis since childhood, but complications of hay fever from around 22-23 years old. Symptoms worsen from May to early July every year. During this period, sneezing, it never stops out endlessly runny nose.
- Nasal spray steroids have never been effective, and as a local irritation symptom, the dryness is strong and painful.
- the subject was inhaled once by spraying the BNP nasal solution with a concentration of 50 ⁇ g / ml obtained in Example 1 into both nasal cavities only once (the dose of BNP to one nasal cavity was 6.5 ⁇ g). ) After 10 minutes, the nasal mucosa penetrated and the symptoms settled, and the aqueous nasal discharge was improved. Since the effect was confirmed, I sprayed in the morning in the morning of the second day and went out in fine weather, but the symptoms of hay fever were improved to the extent that I did not mind, and the symptoms of runny nose and sneezing were not seen until the evening.
- Test Example 12 The test subject is a 21-year-old woman who is a full-fledged moderate patient. She has a history of atopic dermatitis and her father has allergic rhinitis. The results of the scratch test are house dust 1+, mite 2+, cedar 3+, camogaya 1+, ragweed 1+. The subject had been suffering from atopic dermatitis since childhood, but had hay fever two years ago, and had itchiness, nasal discharge, and nasal congestion, especially during fatigue. The nasal congestion is strong, and sometimes mouth breathing occurs during the day.
- This subject did not have a sufficient effect with steroid nasal drop at the time of exacerbation, and in particular, did not have a sufficient effect on rhinorrhea.
- the subject was inhaled once by spraying the BNP nasal solution with a concentration of 50 ⁇ g / ml obtained in Example 1 into both nasal cavities only once (the dose of BNP to one nasal cavity was 6.5 ⁇ g). ) After 10 minutes, the aqueous rhinorrhea ceased, the passage of the nose improved a little, and after 20 minutes the nasal congestion was improved.
- Test Example 13 The test subject was a 28-year-old female and the most severe patient with rhinorrhea. If you have a history of atopic dermatitis. Her sister has allergic rhinitis and atopic dermatitis. The results of the scratch test are house dust 1+, mite 2+, cedar 3+, camogaya 3+, and ragweed 2+. This test subject suffered from atopic dermatitis since childhood, but hay fever symptoms appeared from the age of 20. In particular, from around June the runny nose and sneezing became severe, and the nose was dripping when the nose was squeezed all day long and then peeled down. This subject has little mouth breathing but has nasal congestion.
- Test Example 14 The test subject is a 46 year old female and is the most severe patient with fullness. She has a history of atopic dermatitis and allergic conjunctivitis, but her child also has allergic rhinitis.
- the results of the scratch test are house dust 2+, tick 2+, cedar 3+, camogaya 3+, and ragweed 2+. This subject is, from the 10-year-old around, runny nose, nasal congestion, there were itchy eyes, from the 20-year-old, rhinitis is severe, runny nose If you do not stuffed to the nose began to ooze out endlessly. This subject has a fairly strong nasal congestion and a significant amount of mouth breathing during the day.
- Test Example 15 The test subject was a 45-year-old woman who was a severe patient with sneezing and rhinorrhea. She has a history of atopic dermatitis, and her child also has atopic dermatitis and allergic rhinitis.
- the results of the scratch test are house dust 2+, mite 3+, cedar 1+, camogaya 2+, and ragweed 1+.
- This subject has a persistent nasal discharge like perennial water, but almost no nasal congestion. Even when the steroid was instilled, the irritation in the nose was strong, and the aqueous nasal discharge increased compared to that before instillation.
- Test Example 16 (Case 16) The test subject was a 35-year-old male and the most severe patient with fullness. Allergic conjunctivitis is also complicated. Her father, older sister, and child have allergic rhinitis. The results of the scratch test are house dust, mite 1+, cedar 2+, camogaya 3+ and ragweed 1+. Aqueous nasal discharge is persistent, and you have to squeeze about two tissue boxes. There is also a nasal congestion and the nose is completely clogged up all day. This symptom lasted from late May to September. Even if the steroid is instilled, steroid resistance is likely to occur, the effect is lost after the second use of the steroid, and the use of the steroid is accompanied by a strong irritation.
- Comparative Example 1 (Case 17) The subject is a 28-year-old male and full-blown severe patient. He has a history of atopic dermatitis, and his father has atopic dermatitis and allergic rhinitis. The results of the scratch test are Huff Dust 2+, Tick 3+, Sugi-, Camogaya 3+, Ragweed 2+. This test subject suffered from atopic dermatitis from an early age, but developed hay fever symptoms after becoming a member of society. Especially, around June, the nasal congestion became strong and mouth breathing occurred. The runny nose and sneezing are severe, and the number of times of sniffing is about 20 times a day.
- Example 2 When the subject was inhaled once by spraying the ANP nasal solution having a concentration of 50 ⁇ g / ml obtained in Example 1 into both nasal cavities twice a day (the dose of ANP into one nasal cavity was 6.5 ⁇ g). The runny nose and sneezing still did not stop, and the nasal congestion was not improved. Although it was used twice a day for 7 days, there was no change in both nasal discharge and nasal congestion before and after use, and there was no improvement. The degree of symptom improvement was severe after ANP use, but remained severe after ANP use.
- Comparative Example 2 (Case 18) The test subject is a 28-year-old female who is a full-blown severe patient. She has a history of atopic dermatitis and her mother also has allergic rhinitis. The results of the scratch test are house dust 2+, mite 2+, cedar 2+, camogaya 3+, and ragweed 2+. This subject has perennial persistent rhinitis, which worsens particularly from early summer to the beginning of autumn, stops sneezing and nasal discharge, and is accompanied by strong nasal congestion at night. Steroids were not used because of intranasal irritation.
- Example 2 When the subject was inhaled by spraying one ANP nasal solution with a concentration of 50 ⁇ g / ml obtained in Example 1 into both nasal cavities (the dose of ANP into one nasal cavity was 6.5 ⁇ g), 15 minutes later Although the rhinorrhea did not stop, after 20 minutes, I felt that my nose passed through compared to before use. However, nasal congestion recurred again after 20 minutes, and itchy. It was sprayed again at night on the same day, but it seemed that the nose passed through in about 20 minutes. However, 15 minutes later, the nasal congestion recurred and it became difficult. The next morning, the nasal congestion was strong enough to wake up, and one spray was applied again, but the nasal congestion recurred 20 minutes later. Severity and improvement remained from severe to severe, and no satisfactory improvement was observed.
- Comparative Example 3 (Case 2)
- the test subject is the same test subject as the test subject in Case 2 who tested the effect of 100 ⁇ g / ml CNP nasal fluid.
- the effect of ANP nasal drops was tested after 11 months from using CNP nasal drops for 3 days, he was 40 years old when using ANP nasal drops.
- the background information possessed by the subject such as past history, family history, scratch test results, and effects of steroids, is as described in Test Example 2 and Table 4.
- the subject inhaled one spray of the ANP nasal solution with a concentration of 50 ⁇ g / ml obtained in Example 1 into both nasal cavities (the dose of ANP into one nasal cavity was 6.5 ⁇ g). There was no effect at all.
- the nasal drops of the present invention are remarkable for nasal congestion, sneezing attacks and rhinorrhea, which are typical symptoms of rhinitis, in about 10 to 20 minutes after inhalation. The effect was exhibited and it was effective for all of the full type, nasal congestion type, sneezing / nasal drip type. Moreover, the nasal drops of the present invention are not only CNP nasal drops and BNP nasal drops have a remarkable rhinitis improving effect, but also have an extremely rapid onset of drug effects, immediate effects, local side effects such as irritation, and sleepiness. It has ideal characteristics as a nasal spray that does not cause systemic side effects, has a sufficiently long duration, and is used once or twice a day for good compliance. Furthermore, in some cases of continuous use, the improvement rate tended to increase due to continuous use.
- nasal drops of the present invention are more effective than conventional steroids and antihistamines, and in terms of sustainability, the symptom is alleviated even if used once a day. Is something.
- ANP and BNP have the same receptor, it seemed that they would have the same effect. Surprisingly, contrary to expectation, only ANP and BNP were effective. .
- the rhinitis therapeutic agent of the present invention is extremely effective in treating various types of rhinitis, particularly allergic rhinitis, and has no concern about side effects. Therefore, it is effective with conventional nasal spray steroids and antihistamines. It can also be applied to patients who have not had these drugs or who have had to refrain from using these drugs due to concerns about side effects.
- the frequency of use of conventional nasal spray steroids is required 2 to 4 times a day for adults, and the duration of the effect is short, and the period until the onset of effect is 1 to 3 days or more. It takes 2 to 4 weeks for the effect to reach its peak. The satisfaction with the effect is low.
- there are side effects such as irritation in the nose and dryness, throat and laryngeal irritation, headache, and the risk of complications of infections due to long-term use.
- Mometasone furan carboxylate hydrate which has the merit of spraying once a day, has recently become available in Japan, but the effect of using it for 2 weeks for hay fever cases in Europe and the United States is an improvement in total symptoms.
- the degree of nasal obstruction is only 40 to 50% and the degree of improvement of nasal congestion is only 30 to 40%.
- the rhinitis therapeutic agent of the present invention can remarkably improve severe nasal inflammation without taking steroid drugs or antihistamines once a day.
- the rhinitis therapeutic agent of the present invention is superior to existing nasal drops in terms of immediate effect and sustainability, has no side effects, has good compliance, and has ideal characteristics as a therapeutic agent for allergic rhinitis. .
- the therapeutic agent for rhinitis of the present invention can be expected to be practically used as a new therapeutic agent for rhinitis in place of steroid drugs and antihistamines.
Abstract
Description
鼻炎は、いわゆる鼻粘膜の炎症を意味し、病理組織的には浸出性炎症であって、中でも化膿性炎症、アレルギー性炎症が多くみられる。いずれの場合も、血管からの液性成分の浸出、浮腫、細胞浸出および分泌亢進を特徴としている。
鼻炎は、急性鼻炎(いわゆる鼻かぜ)、慢性鼻炎、アレルギー性鼻炎などその原因や症状に応じて様々なものがあるが、通常はその原因や症状に応じて、下記のとおり、感染性鼻炎、過敏性非感染性鼻炎、刺激性鼻炎、その他の4つに分類される。
感染性鼻炎は、短期間に推移する急性鼻炎(いわゆる鼻かぜ)と長期にわたる慢性鼻炎に分けることができる。篩骨洞、中鼻道を中心に鼻腔に病変をもつ感染性慢性副鼻腔炎(infective chronic paranasal sinusitis)も感染性鼻炎に包含される。
急性のウイルス性鼻炎(かぜ)は、鼻水、鼻づまり、鼻汁が喉に回る後鼻漏、せき、微熱等の症状を特徴とする。鼻づまりを和らげるには、フェニレフリンのスプレー式点鼻薬かプソイドエフェドリンの内服薬などの血管収縮剤が用いられる。しかし、スプレー剤の使用は3~4日以内にとどめる必要がある。それ以上長く使用した場合には、薬の効果が薄れ、鼻の粘膜が薬を使う前よりも腫れてしまうリバウンド現象が起こるためである。また、抗ヒスタミン薬には鼻水を抑える効果があるが、眠気などの副作用がある。
アレルギー性鼻炎のうち通年性アレルギー性鼻炎は、多くはハウスダストやダニが原因であり、季節性アレルギー性鼻炎は、花粉が原因である場合が多い。
これらの鼻炎、特にアレルギー性鼻炎の治療法は、重症度と病型の組み合わせで選択するのが一般的であり、その選択は画一的なものではないが、「鼻アレルギー診療ガイドライン2009年版」(鼻アレルギー診療ガイドライン作成委員会編)によれば、その治療方法は以下のとおりである。
(1)第2世代抗ヒスタミン薬、
(2)ケミカルメディエター遊離抑制薬、または
(3)鼻噴霧用ステロイド薬のいずれか1つを選択し、
必要に応じて(1)または(2)に(3)を併用する。
(1)抗ロイコトリエン薬、
(2)抗プロスタグランジンD2・トロンボキサンA2薬、または
(3)鼻噴霧用ステロイド薬のいずれか1つを選択し、
必要に応じて(1)または(2)に(3)を併用する。
ナトリウム利尿ペプチド(NP;natriuretic peptide)としては、3種類のナトリウム利尿ペプチドファミリーが知られており、具体的には、心房性ナトリウム利尿ペプチド(ANP;atrial natriuretic peptide)、B型ナトリウム利尿ペプチド(BNP;B-type natriuretic peptide)、C型ナトリウム利尿ペプチド(CNP;C-type natriuretic peptide)であり、それぞれ28残基、32残基、22残基のアミノ酸からなる物が主として知られている。
ANPは主として心房で合成され、BNPは主として心室で合成され、心臓から全身へ分泌される。血中を循環しているANP、BNPはほぼ100%心臓由来であるといわれている。これらANP、BNPは、高血圧、心肥大、心不全、心筋梗塞、弁膜症、不整脈、肺高血圧などの病態に深く関与しているとの報告もなされている。
CNPは最初に脳内より発見されたことから、脳神経ペプチドとして機能していると考えられていたが、その後末梢にも存在することが明らかになった。特に、血管壁においては、平滑筋細胞にCNP特異的受容体が多いこと、単球/マクロファージ系細胞および内皮細胞がCNPを産生すること、などから、CNPは血管壁の局所因子として平滑筋細胞の増殖抑制に関与するものと考えられている。このことから、虚血性心疾患の患者が経皮的冠動脈形成術(PTCA)を受けた後に一定の頻度で発生し臨床的に問題となっている血管内再狭窄を、CNPの投与によって予防できる可能性について、現在臨床応用が検討されている。
NPの受容体としては、グアニレートシクラーゼドメインを有するNPR-A受容体(別名、GC-A)、グアニレートシクラーゼドメインを有するNPR-B受容体(別名、GC-B)、グアニレートシクラーゼドメインを有さないNPR-C受容体の3種類の受容体が知られており、ANPはNPR-A受容体およびNPR-C受容体に、BNPはNPR-A受容体およびNPR-C受容体に、CNPはNPR-B受容体およびNPR-C受容体に、それぞれ結合しうることが知られている。
ナトリウム利尿ペプチドは、歴史的には、まず、心房が分泌するペプチドとしてANPが発見されるとともにその血管拡張作用および利尿作用が注目を集めた。その後、ANPに類似するペプチドとしてBNPおよびCNPが見出された。このような歴史的経緯から、ナトリウム利尿ペプチドと免疫との関連については、心血管系に関連したものに関心が注がれてきた。また、その後、CNPノックアウトマウスは軟骨の成長が悪いために小人症のような表現型を示すことがわかったことから(非特許文献2参照)、関節炎とナトリウム利尿ペプチドとの関連にも関心がもたれている。
したがって、本発明の目的は、鼻炎患者、特にアレルギー性鼻炎患者に対して有効かつ安全であるばかりでなく、鼻内刺激感、乾燥感、鼻灼熱感、鼻出血、眠気等の副作用のない新たな鼻炎治療剤の提供である。
本発明は、具体的には下記のとおりである。
[2] C型ナトリウム利尿ペプチド(CNP)が、CNP-22、CNP-53、または、CNP-22若しくはCNP-53のアミノ酸配列において任意のアミノ酸が欠失、置換若しくは付加し、かつCNP活性を有するCNP誘導体である、 [1]に記載の鼻炎治療剤。
[3] C型ナトリウム利尿ペプチド(CNP)がCNP-22である、[1]に記載の鼻炎治療剤。
[4] B型ナトリウム利尿ペプチド(BNP)が、BNP-26、BNP-32、BNP-45、または、BNP-26、BNP-32若しくはBNP-45のアミノ酸配列において任意のアミノ酸が欠失、置換若しくは付加し、かつBNP活性を有するBNP誘導体である、[1]に記載の鼻炎治療剤。
[5] B型ナトリウム利尿ペプチド(BNP)がBNP-32である、[1]に記載の鼻炎治療剤。
[6] C型ナトリウム利尿ペプチド(CNP)またはB型ナトリウム利尿ペプチド(BNP)が、分子内ジスルフィド結合によって環状構造を形成する、CNPとBNPのキメラペプチドであって、
前記CNPがCNP-22、CNP-53、1~5個の任意のアミノ酸が欠失、置換若しくは付加したCNP-22のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチド、または、1~5個の任意のアミノ酸が欠失、置換若しくは付加したCNP-53のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチドからなる群より選択されるペプチドであり、
前記BNPがBNP-26、BNP-32、BNP-45、または、1~5個の任意のアミノ酸が欠失、置換若しくは付加したBNP-26のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチド、1~5個の任意のアミノ酸が欠失、置換若しくは付加したBNP-32のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチド、1~5個の任意のアミノ酸が欠失、置換若しくは付加したBNP-45のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチドからなる群より選択されるペプチドであり、
かつ、CNP活性またはBNP活性を有するキメラペプチド、あるいは、その誘導体である、[1]に記載の鼻炎治療剤。
[7] C型ナトリウム利尿ペプチド(CNP)またはB型ナトリウム利尿ペプチド(BNP)の含有量が、20~200μg/gである、[1]に記載の鼻炎治療剤。
[8] C型ナトリウム利尿ペプチド(CNP)またはB型ナトリウム利尿ペプチド(BNP)の含有量が、50~200μg/gである、[1]に記載の鼻炎治療剤。
[9] C型ナトリウム利尿ペプチド(CNP)またはB型ナトリウム利尿ペプチド(BNP)の含有量が、50~100μg/gである、[1]に記載の鼻炎治療剤。
[10] 鼻炎が、感染性鼻炎、過敏性非感染性鼻炎、刺激性鼻炎、萎縮性鼻炎または特異性肉芽腫性鼻炎である、[1]に記載の鼻炎治療剤。
[11] 感染性鼻炎が、急性鼻炎または慢性鼻炎である、[10]に記載の鼻炎治療剤。
[12] 過敏性非感染性鼻炎が、複合型(鼻過敏症)鼻炎、鼻漏型鼻炎、うっ血型鼻炎または乾燥型鼻炎である、[10]に記載の鼻炎治療剤。
[13] 複合型(鼻過敏症)鼻炎が、アレルギー性鼻炎である、[12]に記載の鼻炎治療剤。
[14] アレルギー性鼻炎が、ハウスダスト、ダニ、スギ、カモガヤ、ブタクサ、および猫毛からなる群から選択される少なくとも1つのアレルゲンに対するアレルギー性鼻炎である、[1]に記載の鼻炎治療剤。
[15] 刺激性鼻炎が、物理性鼻炎、化学性鼻炎または放射線性鼻炎である、[10]に記載の鼻炎治療剤。
[16] 鼻炎が、萎縮性鼻炎または特異性肉芽腫性鼻炎である、[1]に記載の鼻炎治療剤。
[17] 鼻炎が、充全型鼻炎、くしゃみ・鼻漏型鼻炎または鼻閉型鼻炎である、[1]に記載の鼻炎治療剤。
[18 剤形が、軟膏剤、ゲル剤、クリーム剤、ローション剤、液剤、粉末剤またはスプレー剤からなる点鼻剤である、[1]に記載の鼻炎治療剤。
[19] 剤形が、ゲル剤、液剤またはスプレー剤からなる点鼻剤である、[1]に記載の鼻炎治療剤。
[20] 鼻炎が、アトピー性皮膚炎を罹患している対象における鼻炎である、[1]に記載の鼻炎治療剤。
[21] 鼻炎が、ステロイド薬に治療抵抗性を示す鼻炎である、[1]に記載の鼻炎治療剤。
[22] 鼻炎が、ステロイド離脱困難状態に至った対象の鼻炎である、[1]に記載の鼻炎治療剤。
[23] 鼻炎が、抗ヒスタミン薬に治療抵抗性を示す鼻炎である、[1]に記載の鼻炎治療剤。
C型ナトリウム利尿ペプチド(CNP)またはB型ナトリウム利尿ペプチド(BNP)が、分子内ジスルフィド結合によって環状構造を形成する、CNPとBNPのキメラペプチドであって、
前記CNPがCNP-22、CNP-53、1~5個の任意のアミノ酸が欠失、置換若しくは付加したCNP-22のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチド、または、1~5個の任意のアミノ酸が欠失、置換若しくは付加したCNP-53のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチドからなる群より選択されるペプチドであり、
前記BNPがBNP-26、BNP-32、BNP-45、または、1~5個の任意のアミノ酸が欠失、置換若しくは付加したBNP-26のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチド、1~5個の任意のアミノ酸が欠失、置換若しくは付加したBNP-32のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチド、1~5個の任意のアミノ酸が欠失、置換若しくは付加したBNP-45のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチドからなる群より選択されるペプチドであり、
かつ、CNP活性またはBNP活性を有するキメラペプチド、あるいは、その誘導体をも意味する。
また、液剤は、上記の水溶液剤の他、水性または油性の懸濁液製剤、エマルジョン製剤としてもよい。あるいは使用前に水または適当な媒体により再溶解され得る乾燥医薬組成物として提供してもよい。
主剤としての3mgのヒトCNP-22(株式会社ペプチド研究所製)を3mlの生理食塩水に溶解して1000μg/mlのCNP溶液を調製した。得られた1000μg/mlのCNP溶液100μlを900μlの生理食塩水で希釈し、CNP濃度が100μg/mlのCNP点鼻液を調製した。同様に、1000μg/mlのCNP溶液50μlを950μlの生理食塩水で希釈し、CNP濃度が50μg/mlのCNP点鼻液を調製した。さらに、同様に、1000μg/mlのCNP溶液200μlを800μlの生理食塩水で希釈し、CNP濃度が200μg/mlのCNP点鼻液を調製した。
前記で得られたCNP濃度が100μg/ml、50μg/mlおよび200μg/mlである3種類のCNP点鼻液を定量式の点鼻用噴霧容器(アステラス製薬株式会社製;インタール点鼻液で使用する鼻用定量噴霧容器を使用した)に充填して1回の噴霧量を130μlとなるように調製した。従って、1回の噴射液中に含まれるCNP量は、100μg/ml、50μg/mlおよび200μg/mlのCNP点鼻液のそれぞれについて、順に13μg、6.5μg、26μgである。
主剤としての3mgのヒトBNP-32(株式会社ペプチド研究所製)を3mlの生理食塩水に溶解して1000μg/mlのBNP溶液を調製した。得られた1000μg/mlのBNP溶液100μlを900μlの生理食塩水で希釈し、BNP濃度が100μg/mlのBNP点鼻液を調製した。同様に、1000μg/mlのBNP溶液50μlを950μlの生理食塩水で希釈し、BNP濃度が50μg/mlのBNP点鼻液を調製した。さらに、同様に、1000μg/mlのBNP溶液200μlを800μlの生理食塩水で希釈し、BNP濃度が200μg/mlのBNP点鼻液を調製した。
前記で得られたBNP濃度が100μg/ml、50μg/mlおよび200μg/mlである3種類のBNP点鼻液を定量式の点鼻用噴霧容器(アステラス製薬株式会社製;インタール点鼻液で使用する鼻用定量噴霧容器を使用した)に充填して1回の噴霧量を130μlとなるように調製した。従って、1回の噴射液中に含まれるBNP量は、100μg/ml、50μg/mlおよび200μg/mlのBNP点鼻液のそれぞれについて、順に13μg、6.5μg、26μgである。
比較試験のために、ヒトANP-28(株式会社ペプチド研究所製)0.5mgを1mlの生理食塩水に溶解して500μg/mlのANP溶液を調製した。得られた500μg/mlのANP溶液1mlを9mlの生理食塩水で希釈し、ANP濃度が50μg/mlのANP点鼻液を調製した。
前記で得られたANP濃度が50μg/mlである3種類のANP点鼻液を定量式の点鼻用噴霧容器(アステラス製薬株式会社製;インタール点鼻液で使用する鼻用定量噴霧容器を使用した)に充填して1回の噴霧量を130μlとなるように調製した。従って、1回の噴射液中に含まれるANP量は6.5μgである。
1.被験者と診断
被験者は、いずれも、ステロイド等の既存の外用薬を使用しても効果が十分認められない患者、あるいは局所的副作用として、鼻内刺激感、乾燥感があり、ステロイドの使用を控えなければならない患者である。これら被験者の診断と処置は、本発明者が医師として実施したものである。
アレルギー性鼻炎の症状の重症度の評価は、原則的に「鼻アレルギー診療ガイドライン 2009年版」(鼻アレルギー診療ガイドライン作成委員会編)に従って下記の通り、鼻5段階に分類して行った。充全型とは、くしゃみ発作または鼻漏と鼻閉が同程度に表れた場合をいう。
本発明の点鼻液製剤の投与試験は、原則的に、点鼻用噴霧容器に入れたCNP点鼻液、BNP点鼻液またはANP点鼻液を起床時と就寝前の1日2回、1回当たり各鼻腔に1噴霧ずつ噴霧吸入することによって行った。したがって、1回の噴霧あたりのCNP、BNPまたはANPの点鼻量は100μg/mlのCNP点鼻液、BNP点鼻液またはANP点鼻液の場合で、いずれも13μgに相当する。同様に、CNP点鼻液、BNP点鼻液またはANP点鼻液の1回当たりのCNP、BNPまたはANPの点鼻量は、50μg/mlの濃度の場合はいずれも6.5μgに相当し、200μg/mlの濃度の場合はいずれも26μgに相当する。
CNP製剤、BNP製剤またはANP製剤の使用に先だって、被験者への問診、アレルゲンに対するScratch試験、診断を行った。表4~表7に、それら被験者への問診、診断結果、即ち、各症例における被験者の性別、年齢、病歴、家族歴、Scratch試験結果、診断所見、症状の評価を示す。
後述する症例10の被験者を対象として、濃度100μg/mlのCNP点鼻液を1日1回、連続7日間使用した後、14日間使用を中断し、その後に、濃度50μg/mlのCNP点鼻液で試験を行った。その結果、濃度100μg/mlのものに比べるとその効果の発現までの時間は20分程度であって、薬効発現まで約2倍の時間を要し、かつ、鼻閉の改善の程度もやや低下することが明らかとなった。尚、濃度200μg/mlのCNP点鼻液では、依然として刺激もなく、鼻炎に対する効果は顕著であったが、100μg/mlの場合に比べて特に効果が倍増するということはなかった。
BNP用量設定試験
BNPについても、用量設定試験を行い、CNPと同様の結果が得られた。
被験者は48歳の女性であり、充全型の重症患者である。アトピー性皮膚炎の既往歴があり、本人の子供もアトピー性皮膚炎とアレルギー性鼻炎に罹患している。スクラッチテストの結果は、ハウスダスト3+、ダニ3+である。この被験者は、鼻閉が非常に強く、口呼吸が1日のうちにかなりの時間あり、ひどい水性鼻汁症状もある。鼻噴霧用ステロイド剤は鼻内刺激感があるため、使用できない。
先ず、予備試験として、実施例1で得た濃度100μg/mlのCNP点鼻液を被験者の両鼻腔に1回ずつ噴霧吸入した(片方の鼻腔へのCNPの投与量は13μg)。その結果、15分後には鼻漏が治まり、鼻閉も改善された。浸透性もよく、刺激感もなく、局所刺激症状等の副作用も観察されなかった。
そこで、翌日の朝、就寝前の2回、本CNP点鼻液を両鼻腔に1回ずつ噴霧吸入したところ、翌々日には、症状が軽快し、鼻漏、鼻閉も顕著に改善され、1日中症状は出なかった。点鼻を中止後も2~3日は効果が持続し症状がでなかった。
被験者は39歳の女性であり、くしゃみ・鼻漏型の重症患者である。アトピー性皮膚炎の既往歴があり、本人の子供もアトピー性皮膚炎に罹患している。スクラッチテストの結果は、ハウスダスト2+、ダニ2+、スギ2+、カモガヤ3+、ブタクサ1+である。この被験者は、鼻閉とくしゃみ、ティッシュが山積みになるほどの水性鼻汁の両症状を有する重症例であり、第2世代抗ヒスタミン薬を常用している患者である。噴霧用ステロイド剤は鼻内刺激感、鼻掻痒感、くしゃみ、鼻漏がかえって増悪し、自覚的な改善効果はない。試験例1と同様に、実施例1で得た濃度100μg/mlのCNP点鼻液をこの被験者の両鼻腔に1回ずつ噴霧吸入した(片方の鼻腔へのCNPの投与量は13μg)。その結果、噴霧直後から鼻掻痒感が消失し10分後には鼻漏が治まった。浸透性もよく、刺激感もなく、局所副作用も観察されなかった。1日1回の使用で、鼻がぐずぐずすることもなく、鼻漏は全くみられなかった。効果は1日持続した。
翌朝も鼻漏は全く観察されなかった、念のため、朝1回、本CNP点鼻液を両鼻腔に1回ずつ噴霧吸入した。その結果、その日は鼻がぐずぐずすることもなく、鼻漏は全くみられなかった。鼻炎のことを忘れるほどであり、第2世代抗ヒスタミン薬も必要なかったというのが被験者の感想である。
このことから、本発明のCNP点鼻液剤は、持続性、吸収性、即効性に優れており、1日1回の噴霧で十分な効果が得られることが明らかになった。
被験者は32歳の女性であり、充全型の重症患者である。アトピー性皮膚炎の既往歴があり、本人の母もアトピー性皮膚炎に罹患している。スクラッチテストの結果は、ハウスダスト1+、ダニ1+、スギ1+、カモガヤ2+、ブタクサ1+である。この被験者は、鼻閉が非常に強く、臭いがわからない。ひどい水性鼻漏もある。鼻噴霧用ステロイド剤は鼻内刺激感と鼻とのどの奥がくっつくような乾燥感があり、使用後しばらくしてから少しは鼻水が減る程度で満足のいく効果はなかった。
試験例1と同様に、実施例1で得た濃度100μg/mlのCNP点鼻液をこの被験者の両鼻腔に1回ずつ噴霧吸入した(片方の鼻腔へのCNPの投与量は13μg)。その結果、5分後には鼻閉感が消失し、鼻漏も治まった。局所刺激症状はまったくなかった。その後、朝1日1回の噴霧を継続したところ、鼻閉感が消失し、嗅覚が回復するとともに、水性鼻汁も改善され、3日後には鼻漏も完全に治まった。刺激感等の局所副作用も眠気などの全身副作用も認められなかった。1週間の間、朝1回使用で効果は1日持続し、抗アレルギー剤の内服を1日目だけ併用したが2日目からはその必要はなくなった。1週間後使用を中止したがその後も効果は2週間以上維持された。 このことから、本発明のCNP点鼻液剤は、即効性、吸収性、持続性に優れており、1日1回の噴霧で十分であることが明らかになった。
被験者は23歳の男性であり、鼻閉型の重症患者である。小児喘息の既往歴があり、本人の母はアトピー性皮膚炎に罹患している。スクラッチテストの結果は、ハウスダスト3+、ダニ3+である。この被験者は、口呼吸が1日のうちにかなりの時間あり、鼻閉傾向が非常に強い。また、この被験者は、全身ステロイド薬の長期使用による離脱困難症状のため、ステロイド薬の使用は控えなければならなかった。
試験例1と同様に、実施例1で得た濃度100μg/mlのCNP点鼻液をこの被験者の両鼻腔に1回ずつ噴霧吸入した(片方の鼻腔へのCNPの投与量は13μg)。その結果、5分から10分後には鼻閉感が消失した。効果は1日持続し鼻の通りが良くなって呼吸が楽になった。1日1回、4日間使用した後に使用を中止してからも3日程度、効果は持続した。
上記各試験例の場合と同様、浸透性もよく、刺激感もなく、局所副作用も観察されなかった。この事実は以下の試験例においても同様であった。
このように、本発明のCNP点鼻剤は効果が絶大であり、ステロイド製剤の使用を避けなければならない鼻炎患者に対して大いなる福音である。
被験者は24歳の女性であり、充全型の重症患者である。アトピー性皮膚炎の既往歴があり、本人の妹もアトピー性皮膚炎に罹患している。スクラッチテストの結果は、ハウスダスト3+、ダニ3+、スギ3+、カモガヤ2+、ブタクサ2+である。この被験者は、口呼吸が1日のうちにかなりの時間あり、鼻閉傾向が非常に強く観察され、かつ、鼻汁がひどい。鼻噴霧用ステロイド剤は鼻内刺激と乾燥感のため使用していない。
試験例1と同様に、実施例1で得た濃度100μg/mlのCNP点鼻液をこの被験者の両鼻腔に1回ずつ噴霧吸入(片方の鼻腔へのCNPの投与量は13μg)したところ、20分後には鼻閉感が改善され、鼻漏も治まった。効果は1日持続し、翌日以降も鼻閉、鼻漏とも鎮静状態が維持された。
被験者は37歳の女性であり、充全型の重症患者である。アトピー性皮膚炎の既往歴があり、本人の母と姉もアトピー性皮膚炎に罹患している。スクラッチテストの結果は、ハウスダスト3+、ダニ3+である。この被験者は、症例5と同様、口呼吸が1日のうちにかなりの時間あり、鼻閉傾向が非常に強く観察され、かつ、鼻汁がひどい。被験者は、夜間の鼻閉とくしゃみがひどく、鼻掻痒感にも悩まされていた。鼻噴霧用ステロイド剤は鼻内乾燥感のため使用していない。
そこで、就寝前に実施例1で得た濃度100μg/mlのCNP点鼻液を両鼻腔に1回ずつ噴霧吸入(片方の鼻腔へのCNPの投与量は13μg投与)したところ、1時間後には鼻閉が顕著に改善されて呼吸も楽となり、明け方においても両鼻の通りが良く熟睡できたとの報告を受けた。
更に、前夜の投与に引き続き、翌朝、再度、本発明のCNP点鼻液を両鼻腔に1回ずつ噴霧吸入したところ、1日中鼻掻痒感および鼻閉感も解消された。水性鼻汁は鼻をかまなくても良いほどに改善された。局所刺激症状もまったくなかった。その後、朝と就寝前に1日2回5日間使用して症状が落ち着いたので、使用を中止した。使用を中止したあとも4~5日間効果が持続し鼻掻痒感、鼻閉、鼻漏とも改善状態が維持された。
被験者は39歳の女性であり、充全型の重症患者である。アトピー性皮膚炎の既往歴があり、本人の子供もアトピー性皮膚炎に罹患している。スクラッチテストの結果は、ハウスダスト-、ダニ2+、スギ-、カモガヤ3+、ブタクサ-である。この被験者は、症例6と同様、口呼吸が1日のうちにかなりの時間あり、鼻閉傾向が非常に強く観察され、かつ、鼻汁のひどい。とりわけ朝方の鼻漏、鼻閉およびくしゃみがひどく、鼻掻痒感に悩まされていた。また、この被験者は、鼻噴霧用ステロイド薬に対して鼻内刺激感があり、かえってくしゃみ、鼻水が出るためステロイド薬を使用することができず、また、第2世代抗ヒスタミン薬を内服した場合はだるくなる症状を呈する傾向があるため、抗ヒスタミン薬の使用を極力避けなければならなかった。
そこで、被験者に対して、実施例1で得た濃度100μg/mlのCNP点鼻液を両鼻腔に1回ずつ噴霧吸入(片方の鼻腔へのCNPの投与量は13μg)したところ、使用直後に鼻がとおるようになり10分後には鼻閉が顕著に改善された。また、呼吸が楽になったとの報告を受けた。ティッシュをつめておかないと落ちてくるほどの水性鼻汁も止まった。1日1回の使用で翌日まで効果は持続し、鼻閉、鼻漏とも改善が維持された。
したがって、本発明のCNP点鼻液は、従来のステロイド薬や抗ヒスタミン薬を使用できない、または控えなければならない鼻炎患者には福音である。
被験者は39歳の女性であり、充全型の中等症患者である。アトピー性皮膚炎、小児喘息、副鼻腔炎の既往歴があるが、家族はこれらの疾患にもアレルギー性鼻炎にも罹患していない。スクラッチテストの結果は、ハウスダスト2+、ダニ3+、スギ2+、カモガヤ1+、ブタクサ-、猫毛3+である。この被験者は、口呼吸が1日のうちに時々あり、鼻閉傾向が強い。ステロイド剤は、1年半前に副鼻腔炎に罹患したため使用していない。
この被験者に対して、実施例1で得た濃度100μg/mlのCNP点鼻液を両鼻腔に1回ずつ噴霧吸入(片方の鼻腔へのCNPの投与量は13μg)したところ、使用直後に鼻の通りが良くなり、10分後には鼻閉が顕著に改善されて呼吸が楽になり、20分後には水性鼻汁も止まった。また、呼吸が楽になったとの報告を受けた。
1日1回の使用で効果は1日持続し、鼻閉、鼻漏とも気にならない程度にまで改善された。
被験者は21歳の男性であり、鼻閉型の重症患者である。アトピー性皮膚炎とアレルギー性結膜炎の既往歴があり、本人の母もアトピー性皮膚炎に罹患している。スクラッチテストの結果は、ハウスダスト2+、ダニ3+、スギ2+、カモガヤ3+、ブタクサ1+である。この被験者は、症例7と同様、口呼吸が1日のうちにかなりの時間あり、鼻閉傾向が非常に強く観察される。過去にステロイド薬を使用したが、鼻閉が十分に改善されなかった。鼻汁はそれ程ひどくなかった。
この被験者に対して、実施例1で得た濃度100μg/mlのCNP点鼻液を両鼻腔に1回ずつ噴霧吸入(片方の鼻腔へのCNPの投与量は13μg投与)したところ、点鼻直後から鼻の通りが良くなり刺激症状を全く伴うことなく症状は25分後には鼻閉顕著に改善され、鼻漏もおさまった。夕方1回の点鼻で効果は1日持続し、翌日から3日間、治療していないにもかかわらず鼻水は気にならない程度におさまり、ほとんどかまずにすんだ。この間、抗ヒスタミン剤内服の必要はなかった。
被験者は55歳の女性であり、充全型の重症患者である。アトピー性皮膚炎の既往歴があり、本人の子供もアトピー性皮膚炎に罹患している。スクラッチテストの結果は、ハウスダスト1+、ダニ2+、スギ2+、カモガヤ3+、ブタクサ2+である。この被験者は、鼻閉が強く、常に耳に閉塞感がある。なお、この患者に対して1日3回のステロイド内服薬とステロイド噴霧薬を使用したが、鼻閉に対する効果は十分ではなく、持続性も低く、鼻漏も十分には改善されなかった。ステロイド噴霧薬使用時に鼻の奥から頭にかけて重苦しくなって頭痛があり、意識がぼうっとしてしまう。
この被験者に対して、実施例1で得た濃度100μg/mlのCNP点鼻液を両鼻腔に1回ずつ噴霧吸入(片方の鼻腔へのCNPの投与量は13μg投与)したところ、刺激症状を伴うことなく、10分後には鼻閉症状も、鼻水も完全に止まった。その後、ステロイド薬を内服することなく、朝と就寝前の2回、本CNP点鼻液を噴霧吸入した結果、鼻閉、鼻漏とも顕著に改善され、併せて耳の閉塞感も解消された。その後は1日1回の使用で丸一日効果は持続し、鼻の症状はすこぶる良く、水性鼻汁は止まり、鼻閉感もぬけたような感じがして自然な感じで症状が抑えられる。常に使用していたステロイドの内服や注射の必要はなかった。7日間の濃度100μg/mlのCNP点鼻液の使用中止後も1週間程度効果は持続し、鼻閉、鼻漏とも鎮静状態が維持され続けた。投与中止後14日後から50μg/mlのCNP点鼻液を1日1回5日間使用した場合にも、鼻噴霧後、20分で鼻閉が治まり、鼻漏も1日3~4回鼻をかむ程度に改善した。更に耳閉塞感からも解放された。これらの効果は使用中止後も3~4日間効果が持続した。
被験者は42歳の女性であり、くしゃみ・鼻漏型の最重症患者である。アトピー性皮膚炎とアレルギー性結膜炎の既往歴がある。本人の子供がアレルギー性鼻炎とアトピー性皮膚炎に罹患している。スクラッチテストの結果は、ハウスダスト2+、ダニ2+、スギ-、カモガヤ3+、ブタクサ2+である。この被験者は、夜だけ鼻閉のため口呼吸になる。この被験者は、幼小時からアトピー性皮膚炎に罹患していたが、22歳~23歳頃から花粉症を併発した。毎年5月から7月初旬にかけて症状が悪化する。この時期は、くしゃみ、鼻水がとめどなく出て止まることがない。鼻噴霧用ステロイド薬では効果を実感したことがなく、局所刺激症状として乾燥感が強く痛みを伴う。
この被験者に対して、実施例1で得た濃度50μg/mlのBNP点鼻液を試みに1回だけ両鼻腔にそれぞれ1噴霧吸入したところ(片方の鼻腔へのBNPの投与量は6.5μg)、10分経過後には、鼻粘膜に浸透して症状が落ち着き、水性鼻汁が改善された。効果が確認されたので、2日目の朝方1噴霧して晴天のなか外出したが、花粉症の症状は気にならない程度にまで改善され、鼻水、くしゃみの症状が夕方まで見られなかった。その後5日間、50μg/mlのBNP点鼻液を使用したところ、朝1回の噴霧で一日中鼻水、くしゃみの症状が出ないこともあれば、午後から鼻水がでることもあった。この場合も1日2回使用することで症状をおさえることができた。抗ヒスタミン剤併用の必要はなかった。さらに、局所刺激症状もなかった。
被験者は21歳の女性であり、充全型の中等症患者である。アトピー性皮膚炎の既往歴があり、本人の父がアレルギー性鼻炎に罹患している。スクラッチテストの結果は、ハウスダスト1+、ダニ2+、スギ3+、カモガヤ1+、ブタクサ1+である。この被験者は、幼小時からアトピー性皮膚炎に罹患していたが、2年前に花粉症を併発し、ムズムズしたかゆみと鼻漏、鼻閉があり、特に疲労時には増悪した。鼻閉が強く、1日のうち、ときどき口呼吸となる。この被験者は、増悪時はステロイド点鼻では十分な効果が得られず、特に鼻漏に対し十分な効果が得られていなかった。
この被験者に対して、実施例1で得た濃度50μg/mlのBNP点鼻液を試みに1回だけ両鼻腔にそれぞれ1噴霧吸入したところ(片方の鼻腔へのBNPの投与量は6.5μg)、10分経過後、水性鼻漏はとまり、少し鼻の通りが良くなって、20分後には鼻閉感が改善された。翌朝、1噴霧したところ、いつもは朝、鼻がムズムズかゆくなり鼻水が出るが、10分から20分程でおさまり、鼻閉感も楽になり夕食時まで効果は持続した。1週間1日2回朝晩使用した結果、水性鼻漏、鼻閉とも症状が改善したので7日間で使用を中止した。その後も効果は持続し、点鼻中止後も4~5日間鼻漏、鼻閉の再発はなく、鎮静状態が維持された。1日2回のBNP点鼻液使用で中等症から軽症に改善された。
被験者は28歳の女性であり、鼻漏型の最重症患者である。アトピー性皮膚炎の既往歴がある。本人の妹がアレルギー性鼻炎とアトピー性皮膚炎に罹患している。スクラッチテストの結果は、ハウスダスト1+、ダニ2+、スギ3+、カモガヤ3+、ブタクサ2+である。この被験者は、幼小時からアトピー性皮膚炎に罹患していたが、20歳から花粉症症状が出現した。特に6月ごろから鼻水、くしゃみがひどくなり、一日中鼻をかんでいて、下をむくと鼻水が垂れてくるという状態であった。この被験者は、口呼吸はあまりないが、鼻閉がある。
この被験者に対して、実施例1で得た濃度100μg/mlのBNP点鼻液を両鼻腔にそれぞれ1噴霧吸入したところ(片方の鼻腔へのBNPの投与量は13μg)、30分で鼻水が止まった。くしゃみも投与1時間後に治まった。その後、半日間は本点鼻液の効果が持続し、再び鼻水が出てきたのは夜9時ごろであった。BNP点鼻液使用時の症状改善度は重症から軽症であった。
この被験者は、ステロイド点鼻液の使用時やステロイド内服時には、副作用として鼻粘膜の表面がつっぱるような刺激感や、乾燥感があり、満足のゆく治療効果は得られていなかった。これに対し、本BNP点鼻液は、ステロイドに勝る効果があるにもかかわらず、そのような副作用は観察されなかった。
被験者は46歳の女性であり、充全型の最重症患者である。アトピー性皮膚炎とアレルギー性結膜炎の既往歴があるが、本人の子供もアレルギー性鼻炎に罹患している。スクラッチテストの結果は、ハウスダスト2+、ダニ2+、スギ3+、カモガヤ3+、ブタクサ2+である。この被験者は、10歳ころから、鼻水、鼻閉、目のかゆみがあったが、20歳からは、鼻炎が重症化し、鼻に詰め物をしないと鼻水が止めどなくだらだら出るようになった。この被験者は、鼻閉がかなり強く、口呼吸が一1日のうちかなりの時間ある。
この被験者に対して、実施例1で得た濃度50μg/mlのBNP点鼻液を両鼻腔にそれぞれ1噴霧吸入したところ(片方の鼻腔へのBNPの投与量は6.5μg)、5分後には鼻が軽くなったような感じがし、15分後には鼻が通る感じがして鼻漏の改善が顕著に認められ、30分後には鼻閉感が顕著に改善され、喉の痒みも治まった。被験者も本点鼻液の効果の素晴らしさに感動していた。
また、被験者の報告によれば、ステロイドの点鼻液は、鼻の中が乾燥した感じがして刺激症状があるだけでなく、効果としても全く効かなかった。本点鼻液の場合は、むしろしっとりした感じがするとのことであった。
就寝前に1回噴霧すると、抗ヒスタミン剤を内服しなくても鼻汁がでないので熟睡できた。就寝前に使用しただけで翌日の日中も鼻漏症状が気にならない程度におさまっていて、1時間に1回鼻をかむ程度まで改善し、抗ヒスタミン剤内服の併用は必要なかった。就寝前1回の使用で3~4日効果が持続し、その後は3~4日毎に就寝前に1回ずつ、計4回の使用で鼻漏、鼻閉、目のかゆみが中等症レベルに鎮静された状態が維持され続けた。BNP点鼻液の症状改善度は最重症から中等症にまで改善された。
被験者は45歳の女性であり、くしゃみ・鼻漏型の重症患者である。アトピー性皮膚炎の既往歴があり、本人の子供もアトピー性皮膚炎とアレルギー性鼻炎に罹患している。スクラッチテストの結果は、ハウスダスト2+、ダニ3+、スギ1+、カモガヤ2+、ブタクサ1+である。この被験者は、通年性の水のような鼻汁が持続的に出ているが、鼻閉はほとんどない。ステロイド剤を点鼻しても、鼻内刺激感が強く、点鼻前よりも水性鼻汁が増加した。
この被験者に対して、実施例1で得た濃度200μg/mlのBNP点鼻液を両鼻腔にそれぞれ1噴霧吸入したところ(片方の鼻腔へのBNPの投与量は26μg)、10分後に鼻汁が止まった。その際、局所刺激症状や違和感は全くなかったとのことである。抗ヒスタミン剤の内服の併用なしでも、鼻汁が止まる効果は一日持続した。翌日も1日1回の使用で水性鼻汁はおさえられた。2日間のBNP点鼻液使用により、重症から軽症に症状が改善された。
被験者は35歳の男性であり、充全型の最重症患者である。アレルギー性結膜炎も合併している。本人の父、姉、子供がアレルギー性鼻炎に罹患している。スクラッチテストの結果は、ハウスダスト‐、ダニ1+、スギ2+、カモガヤ3+、ブタクサ1+である。水性鼻汁が持続的に出ていて、ティッシュ箱を2箱使うくらいこう鼻しなければならない。鼻閉もあり、一日中完全に鼻が詰まっている状態にある。この症状は5月後半から9月まで続いていた。ステロイド剤を点鼻しても、ステロイドレジスタンスが起こりやすく、2回目のステロイド剤使用からは効果が無くなり、更にはステロイド剤の使用により強い刺激感を伴う。
この被験者に対して、実施例1で得た濃度50μg/mlのBNP点鼻液を両鼻腔にそれぞれ1噴霧したところ(片方の鼻腔へのBNPの投与量は6.5μg)、10分後に水性鼻汁、鼻掻痒感、鼻閉感がおさまった。その際、刺激症状はまったくなかった。その後も5日間にわたって朝1回噴霧すると、10分から15分で鼻掻痒感が消え、水性鼻汁が止まって、効果は一日持続し、一日中鼻水が出なかった。朝晩2回使用すると、鼻閉も改善して、抗ヒスタミン剤の内服は必要なくなった。使用期間は5日間で、使用時の症状改善度は最重症から軽症に改善した。使用中止後、鼻漏、鼻閉の鎮静効果は7日間維持された。
被験者は、28歳の男性であり、充全型の重症患者である。アトピー性皮膚炎の既往歴があり、本人の父はアトピー性皮膚炎とアレルギー性鼻炎に罹患している。スクラッチテストの結果は、ハフスダスト2+、ダニ3+、スギ-、カモガヤ3+、ブタクサ2+である。この被験者は、幼小時からアトピー性皮膚炎に罹患していたが、社会人になってから花粉症症状を発現し、特に6月頃には鼻閉感が強くなり、口呼吸になる。鼻水、くしゃみがひどく、鼻をかむ回数は1日20回程である。
この被験者に対して、実施例1で得た濃度50μg/mlのANP点鼻液を1日2回両鼻腔にそれぞれ1噴霧吸入したところ(片方の鼻腔へのANPの投与量は6.5μg)、依然として鼻水、くしゃみが止まらず、鼻閉感は改善されなかった。7日間、1日2回使用したが、使用前と使用後で鼻漏、鼻閉とも変化がなく改善されなかった。症状改善度は、ANP使用前に重症であった症状が、ANP使用後も重症のままであった。
被験者は28歳の女性であり、充全型の重症患者である。アトピー性皮膚炎の既往歴があり、本人の母もアレルギー性鼻炎に罹患している。スクラッチテストの結果は、ハウスダスト2+、ダニ2+、スギ2+、カモガヤ3+、ブタクサ2+である。この被験者は、通年性の持続性鼻炎であり、初夏から秋口にかけて特に悪化し、くしゃみ、水性鼻汁がとまらなくなり、夜間には強い鼻閉もともなう。ステロイド剤は鼻内刺激があるので使用していないとのことであった。
この被験者に対して、実施例1で得た濃度50μg/mlのANP点鼻液を両鼻腔にそれぞれ1噴霧吸入したところ(片方の鼻腔へのANPの投与量は6.5μg)、15経過後も鼻漏は止まらなかったが、20分後には使用前と比べて自覚的には鼻が通っている感じがした。しかしその後20分で再度鼻閉が再発し、むずむずした。同日の夜間にもまた一噴霧したが、20分ぐらいで自覚的には鼻が通った感じがしたが、その15分後には鼻閉が再発し、むずむずしてきたとのことである。翌日の朝は目が覚めるほど鼻閉が強く、再度1噴霧したが、20分後には鼻閉が再発した。重症度および改善度は重症から重症のままであり満足のいく改善効果はみられなかった。
被験者は100μg/mlのCNP点鼻液の効果を試験した症例2の被験者と同一の被験者である。ただし、CNP点鼻液を3日間使用してから11月経過後にANP点鼻液の効果を試験しているので、ANP点鼻液の使用時には40歳になっていた。既往歴、家族歴、スクラッチテストの結果、ステロイド剤の効果等、被験者の有する背景情報は、試験例2および表4に記載したとおりである。
この被験者に対して、実施例1で得た濃度50μg/mlのANP点鼻液を両鼻腔にそれぞれ1噴霧吸入したが(片方の鼻腔へのANPの投与量は6.5μg)、すぐには全く効果がみられなかった。1時間後に鼻内掻痒感に多少の改善の兆しが見られたが明瞭ではなく、鼻漏は改善されなかった。同じ日の晩、翌日の朝と晩、翌々日の朝と晩に上記と同じようにANP点鼻液を使用したところ、3日後には鼻内掻痒感のみにおいて軽度の改善が見られたが、持続性が低く、朝に使用した場合午後には再発した。3日間使用しても鼻漏に改善は見られず、1日計20回程度は鼻をかむ必要があった。重症度および改善度は重症から重症のままであり、明らかな改善効果は見られなかった。
上記試験例から明らかなとおり、本発明の点鼻薬は、吸入後10分から20分程度で、鼻炎の代表的な症状である鼻閉、くしゃみ発作、鼻漏に対して顕著な効果を発現し、かつ、充全型、鼻閉型、くしゃみ・鼻漏型のいずれに対しても有効であった。しかも、本発明の点鼻薬は、CNP点鼻薬もBNP点鼻薬も、顕著な鼻炎改善効果を有するのみならず、薬効発現が極めて早く、即効性であり、刺激感等の局所副作用、眠気などの全身副作用もみられず、薬効持続時間も十分に長く、使用回数が1日1~2回でコンプライアンスがよいといった点鼻薬として理想的な特性を備えている。さらに、連用したいくつかの症例では、連用により改善率が上昇する傾向が見られた。
それに対して、本発明の鼻炎治療剤は1日1回の投与でステロイド薬や抗ヒスタミン薬の内服をしなくても、重症の鼻炎症状を顕著に改善することが可能である。更に即効性があり、効果が持続する。すなわち、使用直後から効果の発現が認められ、ほとんどの場合10~20分後には、鼻閉、鼻漏とも著明に改善する。そして全例において、1日1回1噴霧ないし1日2回の噴霧で、鼻閉、鼻漏ともに顕著な改善効果が1日中維持される。
Claims (23)
- C型ナトリウム利尿ペプチド(CNP)またはB型ナトリウム利尿ペプチド(BNP)を有効成分として含有する鼻炎治療剤。
- C型ナトリウム利尿ペプチド(CNP)が、CNP-22、CNP-53、または、CNP-22若しくはCNP-53のアミノ酸配列において任意のアミノ酸が欠失、置換若しくは付加し、かつCNP活性を有するCNP誘導体である、請求項1に記載の鼻炎治療剤。
- C型ナトリウム利尿ペプチド(CNP)がCNP-22である、請求項1に記載の鼻炎治療剤。
- B型ナトリウム利尿ペプチド(BNP)が、BNP-26、BNP-32、BNP-45、または、BNP-26、BNP-32若しくはBNP-45のアミノ酸配列において任意のアミノ酸が欠失、置換若しくは付加し、かつBNP活性を有するBNP誘導体である、請求項1に記載の鼻炎治療剤。
- B型ナトリウム利尿ペプチド(BNP)がBNP-32である、請求項1に記載の鼻炎治療剤。
- C型ナトリウム利尿ペプチド(CNP)またはB型ナトリウム利尿ペプチド(BNP)が、分子内ジスルフィド結合によって環状構造を形成する、CNPとBNPのキメラペプチドであって、
前記CNPがCNP-22、CNP-53、1~5個の任意のアミノ酸が欠失、置換若しくは付加したCNP-22のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチド、または、1~5個の任意のアミノ酸が欠失、置換若しくは付加したCNP-53のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチドからなる群より選択されるペプチドであり、
前記BNPがBNP-26、BNP-32、BNP-45、または、1~5個の任意のアミノ酸が欠失、置換若しくは付加したBNP-26のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチド、1~5個の任意のアミノ酸が欠失、置換若しくは付加したBNP-32のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチド、1~5個の任意のアミノ酸が欠失、置換若しくは付加したBNP-45のアミノ酸配列中の5アミノ酸以上の連続する任意のアミノ酸配列を含むペプチドからなる群より選択されるペプチドであり、
かつ、CNP活性またはBNP活性を有するキメラペプチド、あるいは、その誘導体である、請求項1に記載の鼻炎治療剤。 - C型ナトリウム利尿ペプチド(CNP)またはB型ナトリウム利尿ペプチド(BNP)の含有量が、20~200μg/gである、請求項1に記載の鼻炎治療剤。
- C型ナトリウム利尿ペプチド(CNP)またはB型ナトリウム利尿ペプチド(BNP)の含有量が、50~200μg/gである、請求項1に記載の鼻炎治療剤。
- C型ナトリウム利尿ペプチド(CNP)またはB型ナトリウム利尿ペプチド(BNP)の含有量が、50~100μg/gである、請求項1に記載の鼻炎治療剤。
- 鼻炎が、感染性鼻炎、過敏性非感染性鼻炎、刺激性鼻炎、萎縮性鼻炎または特異性肉芽腫性鼻炎である、請求項1に記載の鼻炎治療剤。
- 感染性鼻炎が、急性鼻炎または慢性鼻炎である、請求項10に記載の鼻炎治療剤。
- 過敏性非感染性鼻炎が、複合型(鼻過敏症)鼻炎、鼻漏型鼻炎、うっ血型鼻炎または乾燥型鼻炎である、請求項10に記載の鼻炎治療剤。
- 複合型(鼻過敏症)鼻炎が、アレルギー性鼻炎である、請求項12に記載の鼻炎治療剤。
- アレルギー性鼻炎が、ハウスダスト、ダニ、スギ、カモガヤ、ブタクサ、および猫毛からなる群から選択される少なくとも1つのアレルゲンに対するアレルギー性鼻炎である、請求項1に記載の鼻炎治療剤。
- 刺激性鼻炎が、物理性鼻炎、化学性鼻炎または放射線性鼻炎である、請求項10に記載の鼻炎治療剤。
- 鼻炎が、萎縮性鼻炎または特異性肉芽腫性鼻炎である、請求項1に記載の鼻炎治療剤。
- 鼻炎が、充全型鼻炎、くしゃみ・鼻漏型鼻炎または鼻閉型鼻炎である、請求項1に記載の鼻炎治療剤。
- 剤形が、軟膏剤、ゲル剤、クリーム剤、ローション剤、液剤、粉末剤またはスプレー剤からなる点鼻剤である、請求項1に記載の鼻炎治療剤。
- 剤形が、ゲル剤、液剤またはスプレー剤からなる点鼻剤である、請求項1に記載の鼻炎治療剤。
- 鼻炎が、アトピー性皮膚炎を罹患している対象における鼻炎である、請求項1に記載の鼻炎治療剤。
- 鼻炎が、ステロイド薬に治療抵抗性を示す鼻炎である、請求項1に記載の鼻炎治療剤。
- 鼻炎が、ステロイド離脱困難状態に至った対象の鼻炎である、請求項1に記載の鼻炎治療剤。
- 鼻炎が、抗ヒスタミン薬に治療抵抗性を示す鼻炎である、請求項1に記載の鼻炎治療剤。
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Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP2666475A1 (en) * | 2011-01-21 | 2013-11-27 | Igisu Co., Ltd. | Therapeutic agent for alopecia |
EP3088416A1 (en) * | 2011-12-23 | 2016-11-02 | Mayo Foundation for Medical Education and Research | Assessing renal structural alterations and outcomes |
WO2016194855A1 (ja) * | 2015-05-29 | 2016-12-08 | 株式会社イギス | 環状ペプチド並びに該環状ペプチドを含む医薬、外用剤および化粧料 |
WO2017022728A1 (ja) * | 2015-07-31 | 2017-02-09 | 株式会社イギス | Cnp環状ペプチド並びに該環状ペプチドを含む医薬品、外用剤および化粧料 |
US9968654B2 (en) | 2009-07-23 | 2018-05-15 | Igisu Co., Ltd. | Method of treatment dermatitis with c-type natriuretic peptide derivatives |
JP2018522050A (ja) * | 2015-08-04 | 2018-08-09 | インキューファーム グループ エスディーエヌ ビーエイチディー | 経鼻組成物 |
Families Citing this family (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN102596216B (zh) | 2009-08-27 | 2016-04-20 | 远藤京子 | 鼻炎治疗剂 |
CN105617360B (zh) * | 2015-12-04 | 2018-12-21 | 中国农业大学 | C-型钠肽在制备外用避孕药和精子功能检测试剂中的应用 |
US11077152B2 (en) | 2017-03-21 | 2021-08-03 | Well Stone Co. | Method of producing nasal drop composition by mixing earthworm castings with water |
US20200268734A1 (en) * | 2019-02-22 | 2020-08-27 | Bridge Pharma, Inc. | Methods of treatment of respiratory disorders |
US10959992B2 (en) | 2019-02-22 | 2021-03-30 | Bridge Pharma Inc. | Methods of treatment of asthma and COPD |
CN112057478A (zh) * | 2020-10-16 | 2020-12-11 | 常州市艾斯康生物医药有限公司 | 一种用于舒缓和预防过敏性鼻炎的药物制剂 |
Citations (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5114923A (en) | 1988-05-31 | 1992-05-19 | California Biotechnology Inc. | Recombinant techniques for production of novel natriuretic and vasodilator peptides |
JPH05207891A (ja) | 1991-03-08 | 1993-08-20 | Shionogi & Co Ltd | 脳性ナトリウム利尿ペプチドの製造方法 |
JPH069688A (ja) | 1991-01-31 | 1994-01-18 | Toshiyuki Matsuo | Cnp類似体ペプチド及びその用途 |
US5583108A (en) | 1993-03-03 | 1996-12-10 | Mayo Foundation For Medical Education And Research | Vasonatrin peptide and analogs thereof |
US6028055A (en) | 1996-10-22 | 2000-02-22 | Genetech, Inc. | Receptor selective BNP |
JP2000169387A (ja) | 1998-09-28 | 2000-06-20 | Santen Pharmaceut Co Ltd | ナトリウム利尿ペプチドを有効成分とする涙液分泌促進または角結膜障害治療用点眼剤 |
US6818619B2 (en) | 1999-12-17 | 2004-11-16 | Mayo Foundation For Medical Education And Research | Chimeric natriuretic peptides |
WO2005094890A1 (ja) | 2004-03-31 | 2005-10-13 | Kazuwa Nakao | 身長増加用組成物 |
WO2005094889A1 (ja) | 2004-03-31 | 2005-10-13 | Chugai Seiyaku Kabushiki Kaisha | 関節炎症治療剤又は予防剤 |
JP2007525213A (ja) | 2004-01-27 | 2007-09-06 | コンピュゲン ユーエスエイ,インク. | 新規の脳性ナトリウム利尿ペプチドの変異体及びその利用方法 |
JP2007525957A (ja) | 2003-06-20 | 2007-09-13 | メイヨ・ファウンデーション・フォー・メディカル・エデュケーション・アンド・リサーチ | 脳性ナトリウム利尿ペプチドのアイソフォーム |
JP2008162987A (ja) | 2006-12-31 | 2008-07-17 | Toshiko Koide | 心房利尿ホルモンファミリー分子を活性物質として含有する組織再生製剤また該製剤をもちいる組織再生方法、および心房利尿ホルモンファミリー分子を活性物質として含有する発毛、増毛、育毛剤および皮膚組織修復改善剤また該製剤を用いる発毛、増毛、育毛促進方法および皮膚組織修復改善方法 |
WO2009046861A1 (en) * | 2007-09-11 | 2009-04-16 | Mondobiotech Laboratories Ag | Use of cnp-22, alone1 or in combination with physalemin, as a therapeutic agent |
JP2010500032A (ja) | 2006-08-08 | 2010-01-07 | メイヨ・ファウンデーション・フォー・メディカル・エデュケーション・アンド・リサーチ | 利尿ポリペプチドおよびナトリウム利尿ポリペプチド |
JP2010502231A (ja) | 2006-09-08 | 2010-01-28 | メイヨ・ファウンデーション・フォー・メディカル・エデュケーション・アンド・リサーチ | 血管拡張作用を欠く水利尿およびナトリウム利尿ポリペプチド |
Family Cites Families (21)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CA1339210C (en) * | 1988-05-31 | 1997-08-05 | John Lewicki | Recombinant techniques for production of novel natriuretic and vasodilator peptides |
US5965533A (en) | 1997-05-23 | 1999-10-12 | Baxter International Inc. | Atrial natriuretic peptide (ANP) as an additive to peritoneal dialysis solutions |
US6833358B1 (en) | 1998-09-28 | 2004-12-21 | Santen Pharmaceutical Co., Ltd. | Lacrimal secretion promoters or eye drops for treating keratoconjunctival failure containing as the active ingredient natriuretic peptides |
JP3676707B2 (ja) * | 2001-07-18 | 2005-07-27 | 三菱電機株式会社 | 車両用交流発電機の固定子およびその製造方法 |
AU2003268531A1 (en) * | 2002-09-06 | 2004-03-29 | University Of South Florida | Materials and methods for treatment of allergic diseases |
US20050271596A1 (en) | 2002-10-25 | 2005-12-08 | Foamix Ltd. | Vasoactive kit and composition and uses thereof |
EP1637162A4 (en) | 2003-06-13 | 2009-07-15 | Asubio Pharma Co Ltd | MEDICAL COMPOSITION FOR THE PREVENTION OR TREATMENT OF IMMUNOLOGICAL ILLNESSES TH1 TYPE |
CA2554599A1 (en) | 2004-01-27 | 2005-08-11 | Compugen Usa, Inc. | Novel brain natriuretic peptide variants and methods of use thereof |
CA2576852A1 (en) | 2004-08-11 | 2006-02-23 | Alza Corporation | Apparatus and method for transdermal delivery of natriuretic peptides |
EP1810716A1 (de) | 2005-12-23 | 2007-07-25 | Deutsches Zentrum für Luft- und Raumfahrt e.V. | Verfahren zur Bräunung der Haut |
DE102004048576A1 (de) | 2004-10-04 | 2006-04-13 | Deutsches Zentrum für Luft- und Raumfahrt e.V. | Methode zur Bräunung der Haut |
EP2051585A4 (en) * | 2006-04-28 | 2010-06-02 | Univ South Florida | MATERIALS AND METHODS OF SUPPRESSING INFLAMMATION THROUGH INHIBITION OF THE VORHOF RECEPTOR FOR NATRIURETIC PEPTIDES |
WO2008032450A1 (fr) | 2006-09-15 | 2008-03-20 | Kyoto University | Agent prophylactique et/ou thérapeutique pour une stéatose hépatique |
JP2010168283A (ja) | 2007-04-24 | 2010-08-05 | Yamaguchi Univ | ナトリウム利尿ペプチドを有効成分とする肝硬変・前癌病変の抑制剤 |
JP5207316B2 (ja) | 2007-05-10 | 2013-06-12 | 国立大学法人名古屋大学 | 腹膜線維化抑制用医薬組成物 |
AU2008297411A1 (en) * | 2007-09-11 | 2009-03-19 | Mondobiotech Laboratories Ag | Use of a peptide as a therapeutic agent |
JP2011504506A (ja) | 2007-11-21 | 2011-02-10 | バイオマリン ファーマシューティカル インコーポレイテッド | C型ナトリウム利尿ペプチドの変異体 |
US8642550B2 (en) * | 2008-10-24 | 2014-02-04 | Mayo Foundation For Medical Education And Research | Chimeric natriuretic peptides without hypotensive inducing capability |
WO2010078325A2 (en) * | 2008-12-29 | 2010-07-08 | Mayo Foundation For Medical Education And Research | Natriuretic polypeptides for reducing or preventing restenosis |
CA2758581C (en) * | 2009-05-20 | 2022-06-14 | Biomarin Pharmaceutical Inc. | Variants of c-type natriuretic peptide |
CN102596216B (zh) | 2009-08-27 | 2016-04-20 | 远藤京子 | 鼻炎治疗剂 |
-
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Patent Citations (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5114923A (en) | 1988-05-31 | 1992-05-19 | California Biotechnology Inc. | Recombinant techniques for production of novel natriuretic and vasodilator peptides |
JPH069688A (ja) | 1991-01-31 | 1994-01-18 | Toshiyuki Matsuo | Cnp類似体ペプチド及びその用途 |
JPH05207891A (ja) | 1991-03-08 | 1993-08-20 | Shionogi & Co Ltd | 脳性ナトリウム利尿ペプチドの製造方法 |
US5583108A (en) | 1993-03-03 | 1996-12-10 | Mayo Foundation For Medical Education And Research | Vasonatrin peptide and analogs thereof |
US6028055A (en) | 1996-10-22 | 2000-02-22 | Genetech, Inc. | Receptor selective BNP |
JP2000169387A (ja) | 1998-09-28 | 2000-06-20 | Santen Pharmaceut Co Ltd | ナトリウム利尿ペプチドを有効成分とする涙液分泌促進または角結膜障害治療用点眼剤 |
US6818619B2 (en) | 1999-12-17 | 2004-11-16 | Mayo Foundation For Medical Education And Research | Chimeric natriuretic peptides |
JP2007525957A (ja) | 2003-06-20 | 2007-09-13 | メイヨ・ファウンデーション・フォー・メディカル・エデュケーション・アンド・リサーチ | 脳性ナトリウム利尿ペプチドのアイソフォーム |
JP2007525213A (ja) | 2004-01-27 | 2007-09-06 | コンピュゲン ユーエスエイ,インク. | 新規の脳性ナトリウム利尿ペプチドの変異体及びその利用方法 |
WO2005094890A1 (ja) | 2004-03-31 | 2005-10-13 | Kazuwa Nakao | 身長増加用組成物 |
WO2005094889A1 (ja) | 2004-03-31 | 2005-10-13 | Chugai Seiyaku Kabushiki Kaisha | 関節炎症治療剤又は予防剤 |
JP2010500032A (ja) | 2006-08-08 | 2010-01-07 | メイヨ・ファウンデーション・フォー・メディカル・エデュケーション・アンド・リサーチ | 利尿ポリペプチドおよびナトリウム利尿ポリペプチド |
JP2010502231A (ja) | 2006-09-08 | 2010-01-28 | メイヨ・ファウンデーション・フォー・メディカル・エデュケーション・アンド・リサーチ | 血管拡張作用を欠く水利尿およびナトリウム利尿ポリペプチド |
JP2008162987A (ja) | 2006-12-31 | 2008-07-17 | Toshiko Koide | 心房利尿ホルモンファミリー分子を活性物質として含有する組織再生製剤また該製剤をもちいる組織再生方法、および心房利尿ホルモンファミリー分子を活性物質として含有する発毛、増毛、育毛剤および皮膚組織修復改善剤また該製剤を用いる発毛、増毛、育毛促進方法および皮膚組織修復改善方法 |
WO2009046861A1 (en) * | 2007-09-11 | 2009-04-16 | Mondobiotech Laboratories Ag | Use of cnp-22, alone1 or in combination with physalemin, as a therapeutic agent |
Non-Patent Citations (16)
Title |
---|
"Current Protocols In Molecular Biology", 1998, JOHN WILEY & SONS |
"Guidelines for medical care of nasal allergies", 2009 |
ANNALS OF THE RHEUMATIC DISEASE, vol. 60, no. 3, 2001, pages 68 |
BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS, vol. 356, 2007, pages 60 |
BMC MUSCULOSKELETAL DISORDERS, vol. 7, 2006, pages 87 |
CHIUECHIU V. ET AL, REGULATORY PEPTIDES, vol. 148, 2008, pages 26 - 32, XP022695427 * |
EUROPEAN J. ENDOCRINOLOGY, vol. 135, 1996, pages 265 |
EXPERIMENTAL HEMATOLOGY, vol. 29, 2001, pages 609 |
OBATA H. ET AL, BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS, vol. 356, 2007, pages 60 - 66, XP005926983 * |
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, vol. 98, no. 7, 2001, pages 4016 |
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES, vol. 102, no. 40, 2005, pages 14452 |
REGULATORY PEPTIDES, vol. 148, 2008, pages 26 |
REICHERT S. ET AL, THE CANADIAN JOURNAL OF CARDIOLOGY, vol. 24, no. SUPP.B, 2008, pages 15B - 18B, XP008152393 * |
See also references of EP2471546A4 |
THE JOURNAL OF HEART AND LUNG TRANSPLANTATION, vol. 27, 2008, pages 31 |
THE JOURNAL OF HEART AND LUNG TRANSPLANTATION, vol. 29, no. 3, 2010, pages 323 |
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Also Published As
Publication number | Publication date |
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EP2471546A1 (en) | 2012-07-04 |
US20170007673A1 (en) | 2017-01-12 |
KR20120060219A (ko) | 2012-06-11 |
RU2012105046A (ru) | 2013-10-10 |
DK2471546T3 (en) | 2016-01-25 |
JP4790096B2 (ja) | 2011-10-12 |
CN102596216A (zh) | 2012-07-18 |
US20180318395A1 (en) | 2018-11-08 |
KR101229546B1 (ko) | 2013-02-05 |
EP2471546A4 (en) | 2013-02-20 |
CA2771215C (en) | 2013-01-22 |
CA2771215A1 (en) | 2011-03-03 |
AU2010287421B2 (en) | 2013-06-13 |
RU2502519C2 (ru) | 2013-12-27 |
US9962429B2 (en) | 2018-05-08 |
CN102596216B (zh) | 2016-04-20 |
US20140243271A1 (en) | 2014-08-28 |
KR20130001337A (ko) | 2013-01-03 |
US11452762B2 (en) | 2022-09-27 |
ES2556336T3 (es) | 2016-01-15 |
AU2010287421A1 (en) | 2012-04-05 |
MX2012002175A (es) | 2012-06-27 |
US20130045921A1 (en) | 2013-02-21 |
HK1171682A1 (en) | 2013-04-05 |
JPWO2011024973A1 (ja) | 2013-01-31 |
EP2471546B1 (en) | 2015-11-25 |
NZ598600A (en) | 2014-03-28 |
BR112012004058A2 (pt) | 2021-08-17 |
US9358270B2 (en) | 2016-06-07 |
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