WO2012081713A1 - 血液脳関門障害症候群治療薬 - Google Patents
血液脳関門障害症候群治療薬 Download PDFInfo
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- A61K38/46—Hydrolases (3)
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- A61P9/00—Drugs for disorders of the cardiovascular system
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Definitions
- the present invention relates to a therapeutic agent for blood brain barrier disorder syndrome. More particularly, the present invention relates to a blood brain barrier disorder syndrome comprising a biguanide drug or a pharmaceutically acceptable salt thereof as an active ingredient for treating or preventing various diseases by enhancing blood brain barrier function. It relates to therapeutic drugs.
- the Blood-Brain Barrier is a barrier that separates the circulating blood and the brain parenchyma, which are cerebral vascular endothelial cells, and restricts the transfer of substances such as drugs to the brain. Furthermore, the blood-brain barrier, which is composed of cerebral vascular endothelial cells together with cerebral pericytes and glial cells, forms a “brain neurovascular mechanism” composed of advanced network functions together with cerebral neurons and maintains higher brain functions. This disorder of blood-brain barrier function is involved in the pathogenesis of various brain dysfunctions (Non-Patent Document 1).
- pathological conditions caused by blood-brain barrier dysfunction such as decreased blood-brain barrier function include (i) increased drug transfer into the brain, (ii) brain edema due to brain infiltration of blood albumin, (iii) leukocyte Encephalopathy due to infiltration in the brain, (iv) abnormal brain clearance of physiologically active peptides such as amyloid beta protein (A ⁇ ), and the like.
- a ⁇ amyloid beta protein
- pathological conditions (1) occurrence of adverse drug events (side effects), (2) cerebral infarction, brain trauma, (3) cranial neurodegenerative diseases, (4) Alzheimer's disease, etc. The onset or worsening of the disease (blood-brain barrier disorder syndrome) occurs.
- Non-patent Document 2 It is known that imatinib, which is a therapeutic agent for chronic myelogenous leukemia, suppresses cerebral infarction by suppressing blood-brain barrier permeability (Non-patent Document 2).
- pranlukast which is a therapeutic agent for bronchial asthma, acts as a vascular permeability enhancement agent on vascular endothelial cells constituting the lumen and structure of capillaries, and plasma components and blood cells in capillaries Is known to prevent leakage into the tissue (Patent Document 1).
- An object of the present invention is to provide a pharmaceutical composition for treating or preventing various diseases by enhancing blood brain barrier function.
- a drug containing a biguanide drug or a pharmaceutically acceptable salt thereof or a pharmaceutical composition containing the drug is a tight binding ability or transcellular transport of cerebrovascular endothelial cells.
- the present inventors completed the present invention by finding out that leakage of albumin present in brain capillaries and sodium fluorescein, which is a tight binding ability marker, to the brain tissue side is suppressed by enhancing blood-brain barrier functions including ability and the like.
- the term “enhancement” used in the present specification and claims means enhancement of normal functions as well as enhancement of functions that are reduced innately or acquiredly. It also means enhancement of the function by “reconstruction”, which improves the function that is deteriorated in or after. Furthermore, it also means “suppression” that the function is reduced. In addition, it means “promotion” that the function is strengthened by external or internal factors. Therefore, strengthening the blood brain barrier function, including tight junction capacity and transcellular transport ability, not only strengthens the blood brain barrier function, but also reconstructs the blood brain barrier function and suppresses the decrease in the blood brain barrier function. It is also interpreted to include enhancement of blood-brain barrier function, promotion of reconstruction, and suppression of decline.
- the present application provides a therapeutic agent for blood-brain barrier disorder syndrome, which is a pharmaceutical or pharmaceutical composition containing a biguanide drug or a pharmaceutically acceptable salt thereof for enhancing blood-brain barrier function as an active ingredient. More specifically, the present application provides the therapeutic agent for blood-brain barrier disorder syndrome according to the present invention for preventing deterioration or recurrence of cerebral infarction. The present application also provides a therapeutic agent for blood-brain barrier disorder syndrome according to the present invention for preventing, suppressing or improving cerebral edema associated with cerebral infarction. The present application also provides a therapeutic agent for blood-brain barrier disorder syndrome according to the present invention for preventing, suppressing or ameliorating encephalopathy associated with sepsis.
- the present application also provides a therapeutic agent for blood-brain barrier disorder syndrome according to the present invention for preventing, suppressing or improving leukocyte brain infiltration in multiple sclerosis.
- the present application also provides a therapeutic agent for blood-brain barrier disorder syndrome according to the present invention for preventing, suppressing or improving accumulation of amyloid beta protein (A ⁇ ) in the brain in Alzheimer's disease.
- the present application provides the therapeutic agent for blood-brain barrier disorder syndrome according to the present invention for preventing, suppressing, or improving central nervous system adverse symptoms of animals or humans by preventing or suppressing drug brain transfer. To do.
- invention 1 A pharmaceutical comprising a biguanide drug or a pharmaceutically acceptable salt thereof as an active ingredient for enhancing blood-brain barrier function.
- invention 2 The medicament according to any one of inventions 1, wherein the enhancement of the blood brain barrier function is prevention, suppression or promotion of suppression of a decrease in blood brain barrier function.
- invention 3 The decrease in blood-brain barrier function is caused by a disease selected from the group consisting of diabetes, obesity, hypertension, cerebral infarction, brain trauma, sepsis, multiple sclerosis, Alzheimer's disease or a combination thereof, or induction of central side effects
- the medicament according to invention 2 which is derived from a substance.
- invention 4 The medicament according to invention 3, wherein the central side effect inducer is an immunosuppressive drug or a thrombolytic drug.
- invention 5 The medicament according to the invention 1, which is used in combination with a drug for preventing, suppressing or improving brain edema associated with cerebral infarction or brain injury.
- invention 6) The medicament according to invention 5, wherein the drug is a thrombolytic drug.
- invention 7) The medicament according to invention 6, wherein the thrombolytic drug is tissue-type plasminogen activator (t-PA).
- t-PA tissue-type plasminogen activator
- invention 8 The medicament of invention 1, wherein the medicament prevents or inhibits drug brain transfer.
- invention 9 The medicament according to invention 8, wherein the drug is a drug that is not expected to act in the central nervous system of animals or humans.
- invention 10 The medicament according to invention 8 or 9, wherein the medicament prevents, suppresses or ameliorates an adverse symptom of a central nervous system action of an animal or a human by preventing or suppressing brain transfer of the drug.
- the adverse symptoms are selected from tremor, convulsions, leukoencephalopathy, headache, sleepiness, disturbance of consciousness, abnormal behavior, delirium, hallucinations, delusions, epilepsy and combinations thereof.
- invention 12 The medicament according to any one of inventions 1 to 11, wherein the biguanide drug is metformin or buformin.
- invention 13 The medicament according to invention 12, wherein the biguanide drug or a pharmaceutically acceptable salt thereof is metformin hydrochloride or buformin hydrochloride.
- invention 14 The medicament according to any one of Inventions 1 to 13, wherein the active ingredient dose is 125 to 3000 mg / person / day.
- invention 15 A method for preventing, suppressing or ameliorating a disease, comprising: The disease is selected from the group consisting of tremor, convulsions, leukoencephalopathy, headache, sleepiness, consciousness disorder, abnormal behavior, delirium, hallucinations, delusions, epilepsy, cerebral infarction, sepsis, Alzheimer's disease, and combinations thereof And The method comprises the step of administering the medicament of invention 1 to a person in need thereof; Method.
- invention 16 A method for treating blood brain barrier disorder syndrome, comprising: The method includes the step of administering a biguanide drug or a pharmaceutically acceptable salt thereof as an active ingredient to a person in need to enhance blood brain barrier function, Method.
- invention 1a A therapeutic agent for blood-brain barrier dysfunction syndrome comprising a biguanide drug or a pharmaceutically acceptable salt thereof as an active ingredient for preventing or suppressing drug transfer to the brain.
- invention 2a The therapeutic agent for blood-brain barrier dysfunction syndrome according to invention 1a, wherein the drug is a drug that is not expected to act in the central nervous system of animals or humans.
- invention 3a The therapeutic agent for blood-brain barrier disorder syndrome according to invention 1a or 2a for preventing, suppressing or ameliorating an adverse symptom of central nervous system action of an animal or human by preventing or suppressing brain transfer of the drug.
- invention 4a The therapeutic agent for blood-brain barrier disorder syndrome according to invention 3a, wherein the adverse symptoms are selected from tremor, convulsions, leukoencephalopathy, headache, sleepiness, disturbance of consciousness, abnormal behavior, delirium, hallucinations, delusions, epilepsy and combinations thereof .
- invention 5a A therapeutic agent for blood-brain barrier disorder syndrome comprising a biguanide drug or a pharmaceutically acceptable salt thereof as an active ingredient for preventing, suppressing or improving brain edema associated with cerebral infarction or brain injury.
- invention 6a A therapeutic agent for blood-brain barrier disorder syndrome comprising a biguanide drug or a pharmaceutically acceptable salt thereof as an active ingredient for preventing, suppressing or improving encephalopathy associated with sepsis.
- invention 7a A therapeutic agent for blood-brain barrier disorder syndrome comprising a biguanide drug or a pharmaceutically acceptable salt thereof as an active ingredient for preventing, suppressing or improving leukocyte brain infiltration in multiple sclerosis.
- Invention 8a A therapeutic agent for blood-brain barrier dysfunction syndrome comprising a biguanide drug or a pharmaceutically acceptable salt thereof as an active ingredient for preventing, suppressing or improving accumulation of amyloid beta protein (A ⁇ ) in the brain in Alzheimer's disease.
- a ⁇ amyloid beta protein
- invention 9a A therapeutic agent for blood-brain barrier disorder syndrome comprising a biguanide drug or a pharmaceutically acceptable salt thereof as an active ingredient for preventing or suppressing deterioration or recurrence of cerebral infarction.
- invention 10a A therapeutic agent for blood-brain barrier dysfunction syndrome comprising a biguanide drug or a pharmaceutically acceptable salt thereof as an active ingredient for enhancing the blood-brain barrier function.
- invention 11a The therapeutic agent for blood-brain barrier syndrome according to invention 10a, wherein the enhancement of blood-brain barrier function is prevention, suppression, or promotion of suppression of a decrease in blood-brain barrier function.
- invention 12a The therapeutic agent for blood-brain barrier disorder syndrome according to invention 11a, wherein the decrease in blood-brain barrier function is due to a disease selected from the group consisting of diabetes, obesity, hypertension or a combination thereof.
- invention 13a The therapeutic agent for blood-brain barrier disorder syndrome according to any one of inventions 1a to 12a, wherein the biguanide-based drug is metformin or buformin.
- invention 14a The therapeutic agent for blood-brain barrier disorder syndrome according to invention 13a, wherein the biguanide drug or a pharmaceutically acceptable salt thereof is metformin hydrochloride or buformin hydrochloride.
- invention 15a The therapeutic agent for blood-brain barrier disorder syndrome according to any one of inventions 1a to 14a, wherein an active ingredient dose is 125 to 3000 mg / person / day.
- the therapeutic agent for blood-brain barrier disorder syndrome prevents a disease or symptom predisposed to blood-brain barrier disorder by strengthening the blood-brain barrier function including the tight binding ability and transcellular transport ability of cerebrovascular endothelial cells. , Has the effect of suppressing or improving.
- the therapeutic agent for blood-brain barrier disorder syndrome enhances the blood-brain barrier function including the tight binding ability and transcellular transport ability of cerebrovascular endothelial cells.
- the medicament or pharmaceutical composition of the present invention prevents, suppresses or ameliorates the disease state caused by blood brain barrier dysfunction, thereby preventing a disease or symptom predisposed to blood brain barrier dysfunction such as the disease. Contribute to suppression or improvement.
- Examples of the active ingredient of the therapeutic agent for blood-brain barrier disorder syndrome according to the present invention include biguanide drugs such as metformin and buformin, or pharmaceutically acceptable salts thereof.
- the type of the salt is not limited. It may be an inorganic acid salt or an organic acid salt.
- the inorganic acid for the inorganic acid salt include hydrochloric acid, sulfuric acid, nitric acid, phosphoric acid, boric acid and the like.
- salts for organic acid salts for example, formic acid, acetic acid, propionic acid, lactic acid, benzoic acid, oxalic acid, succinic acid, fumaric acid, maleic acid, malic acid, tartaric acid, citric acid, methanesulfonic acid, benzenesulfonic acid Etc.
- Preferred salts include hydrochloride. Metformin hydrochloride and buformin hydrochloride are commercially available as hypoglycemic agents.
- the biguanide drug of the present invention or a pharmaceutically acceptable salt thereof is not limited to the production method, and can be produced by a known method. Moreover, it can be formulated according to a conventional method as it is or in combination with a known pharmaceutically acceptable pharmaceutical carrier.
- the administration method is not limited for the therapeutic agent for blood-brain barrier disorder syndrome according to the present invention.
- Examples include oral administration, intravenous injection, intramuscular injection, intraperitoneal injection, subcutaneous or intradermal injection, rectal administration, transmucosal administration, and respiratory tract administration.
- a preferred method of administration includes oral administration.
- the dosage form of the therapeutic agent for blood-brain barrier disorder syndrome according to the present invention is not limited.
- Examples of the dosage form for oral administration include tablets, granules, capsules, powders, solutions, suspensions, syrups and the like.
- Examples of dosage forms for parenteral administration include injections, instillations, suppositories, and transdermal absorption agents.
- a known pharmaceutically acceptable pharmaceutical carrier can be used.
- excipients examples include starch acrylate, gum arabic, lactose, corn starch, sucrose, glucose, sorbitol, crystalline cellulose, silicon dioxide calcium silicate, magnesium silicate and the like.
- binder examples include polyvinyl alcohol, calcium citrate, carboxyvinyl polymer, carboxymethyl ethyl cellulose, polyvinyl ether, methyl cellulose, gum arabic, tragacanth, gelatin, shellac, hydroxypropyl cellulose, hydroxypropyl methylcellulose, ethyl cellulose, dextrin, sodium polyphosphate And pectin.
- disintegrant examples include disintegrants called super disintegrants such as crospovidone, croscarmellose sodium, and carmellose calcium; hydroxypropyl cellulose; carboxymethyl starch sodium; corn starch and the like.
- Examples of the lubricant include magnesium stearate, talc, polyethylene glycol, aluminum stearate, lactose, magnesium carbonate, carmellose calcium, carmellose sodium, hydrogenated vegetable oil, and the like.
- Examples of the stabilizer include sodium edetate, sodium sulfite, butylhydroxyanisole, butylhydroxytoluene and the like.
- Examples of the colorant include caramel, edible yellow No. 5, edible red No. 2, and edible blue No. 2, etc., edible pigment, edible lake pigment, Bengala and the like.
- Examples of the flavoring agent include hydrochloric acid, orange oil, fennel, cocoa powder, mint brain, aromatic acid, mint oil, cinnamon oil and the like. Tablets and granules can be coated with sugar coating, gelatin coating, etc. if necessary.
- the pharmaceutical or pharmaceutical composition according to the present invention can be administered to humans at 125 to 3000 mg / person / day as metformin hydrochloride.
- 250 mg / person / day, 500 mg / person / day, 750 mg / person / day, 850 mg / person / day, 1500 mg / person / day, 1700 mg / person / day, 2250 mg / person / day 2550 mg / person / day can be administered.
- blood-brain barrier dysfunction causes the onset of various pathologies, pathological deterioration, and recurrence, and is a predisposing factor for the onset, worsening, or recurrence of diseases related to blood-brain barrier dysfunction.
- neurotoxin in the blood enters the brain and causes encephalopathy due to a decrease in blood-brain barrier function due to sepsis (Non-patent Document 3).
- the expression of adhesion molecules on the cerebral vascular endothelial cells constituting the blood-brain barrier increases, so that leukocytes easily penetrate the blood-brain barrier and multiple sclerosis progresses (Non-patent Document 3). And 4).
- the blood brain barrier function-enhancing drug of the present invention is useful for the prevention, suppression or improvement of the disease or symptom predisposed to blood brain barrier dysfunction.
- the therapeutic agent for blood-brain barrier disorder syndrome according to the present invention can be used in order to prevent or suppress the worsening or recurrence of cerebral infarction.
- the therapeutic agent for blood brain barrier disorder syndrome according to the present invention can be used in order to prevent, suppress or improve cerebral edema associated with cerebral infarction.
- the therapeutic agent for blood-brain barrier disorder syndrome according to the present invention can be used to prevent, suppress or ameliorate cerebral edema associated with brain injury.
- the therapeutic agent for blood-brain barrier disorder syndrome according to the present invention can be used in order to prevent, suppress or improve encephalopathy associated with sepsis.
- the therapeutic agent for blood-brain barrier disorder syndrome according to the present invention can be used to prevent, suppress or improve leukocyte infiltration in multiple sclerosis.
- the therapeutic agent for blood brain barrier disorder syndrome according to the present invention can be used.
- the therapeutic agent for blood-brain barrier disorder syndrome according to the present invention can be used for preventing or suppressing drug brain transfer.
- the drug may be a drug that is not expected to act on the central nervous system of animals or humans.
- the drug or pharmaceutical composition of the present invention may be used in order to suppress the brain migration exceeding the expectation, in which the drug is a drug that is expected to act in the central nervous system of animals or humans.
- the medicament or pharmaceutical composition of the present invention can be used to prevent, suppress or ameliorate adverse central nervous system symptoms of animals or humans by preventing or suppressing the brain migration of the drug.
- Non-Patent Documents 5 to 12 known adverse symptoms due to central side effects such as tremor, convulsions, leukoencephalopathy, headache, etc. caused by blood brain barrier function decline and associated blood brain barrier penetration due to immunosuppressive drugs such as cyclosporine and tacrolimus.
- the present invention can prevent, suppress or ameliorate the above-mentioned adverse symptoms by suppressing blood brain barrier function deterioration and strengthening or restructuring blood brain barrier function.
- the present invention can prevent, suppress or ameliorate blood-brain barrier function deterioration caused by thrombolytic agents such as tissue type plasminogen activator.
- the present invention can prevent, suppress or ameliorate hemorrhagic infarction associated with the decrease in blood brain barrier function.
- the present invention can be used to extend the therapeutic window during the use of the thrombolytic agent in the treatment of cerebral infarction. Therefore, the present invention can be used as a therapeutic agent for cerebral infarction in combination with the thrombolytic agent.
- the present invention relates to sleepiness due to antihistamines, disturbance of consciousness due to Tamiflu, abnormal behavior, delirium, hallucinations, delusions, convulsions, etc. ⁇ Prevents, suppresses or ameliorates leukoencephalopathy caused by tegafur and fluorouracil.
- the medicament or pharmaceutical composition of the present invention can be used for preventing, suppressing or improving the decrease in blood brain barrier function with the therapeutic agent for blood brain barrier disorder syndrome according to the present invention.
- blood-brain barrier function may decrease due to diabetes, obesity, high blood pressure, and the like (Non-Patent Documents 14 and 15). Therefore, the therapeutic agent for blood-brain barrier disorder syndrome according to the present invention can be used for preventing, suppressing or improving the decrease in blood-brain barrier function due to diabetes, obesity, hypertension and the like.
- Prevention, suppression, or improvement of the decrease in blood-brain barrier function leads to prevention of worsening or recurrence of cerebral infarction, prevention or suppression of drug transfer to the brain, and the like.
- the therapeutic agent for blood-brain barrier disorder syndrome according to the present invention can also be used to prevent, suppress or improve the above-mentioned diseases caused by a decrease in blood-brain barrier function.
- biguanide drugs or salts thereof, or substances or compositions containing them as active ingredients can also be used as animal test reagents for the above-mentioned actions or uses.
- animal test reagents for the above-mentioned actions or uses.
- the animal include medaka, frog, lizard, chicken, mouse, rat, guinea pig, hamster, rabbit, dog, cat, sheep, pig, goat, cow and monkey.
- Example 1 Cerebrovascular endothelial cells (RBEC) were isolated according to the following reference 1. Details are as follows. A 3-week-old Wistar rat was anesthetized with ether, then decapitated, and the cerebrum was removed and placed in a dish on ice. After peeling the meninges, the cerebral cortex is shredded in a dish on ice and shaken at 37 ° C. for 1.5 hours with collagenase (CLS2) (1 mg / ml; Worthington) and deoxyribonuclease I (50 units / ml; Sigma) ( 200 rpm) and the enzyme treatment was performed.
- CLS2 collagenase
- CLS2 collagenase
- deoxyribonuclease I 50 units / ml; Sigma
- bovine serum albumin (BSA) -DMEM was added to the resulting pellet, followed by centrifugation (1000 ⁇ g, 20 minutes) to remove neurons and glial cells. Thereafter, the enzyme treatment was carried out by shaking (200 rpm) at 37 ° C. for 30 minutes with collagenase / dispase (1 mg / ml; Boehringer Mannheim) and deoxyribonuclease I (50 units / ml; Sigma). After centrifugation, the obtained pellet is suspended in a small amount of DMEM, added to a 33% percoll (GE healthcare) solution that had been formed with a density gradient in advance at 4 ° C.
- BSA bovine serum albumin
- the brain capillary piece was isolated.
- the brain capillary piece isolated by the above method was treated with 10% plasma-derived serum (PDS) 10%, gentamicin 50 ⁇ g / 50 ⁇ g / 37% in a 5% CO 2 /95% atmosphere using a collagen and fibronectin-coated culture dish.
- PDS plasma-derived serum
- DMEM / F12 containing mL, L-glutamine 1 mM, heparin 1 mg / mL, bFGF 1.5 ng / mL, insulin 5 ⁇ g / mL, transferring 5 ⁇ g / mL, selenium 5 ng / mL, puromycin 4 ⁇ g / mL And cultured.
- RBEC medium I RBEC medium II
- RBEC medium II from which puromycin was removed was replaced and further cultured to obtain cerebral vascular endothelial cells (RBEC).
- An in vitro BBB model of monolayer which is an RBEC monolayer culture system, was prepared from the RBEC obtained by the above method. That is, a Transwell insert (12-well type, Costar, MA) coated with Polycarbonate membrane (0.4 ⁇ m pore size) with collagen and fibronectin was placed in a well of 24-well culture plate (Costar, MA), and RBEC (5). 0.0 ⁇ 10 4 cells / well) were seeded inside the insert (monolayer). The day after the seeding of RBEC, the RBEC culture medium II containing hydrocortisone (500 nM) was replaced, and the experiment was performed using the in vitro BBB model completed two days later.
- Transwell registered trademark
- Example 1-2 Transmission experiment— The effect of metformin on BBB function was as follows: sodium fluorescein (Na-F) (Sigma, St. Louis, MO) and Evans blue-albumin (albumin) ((Evans blue; Sigma, E2129) (Bovine serum albumin; 790, Sigma6A )) As the index.
- Adrenomedullin a vasorelaxant, suppresses permeation of fluorescein sodium in vitro and in vivo by enhancing the blood-brain barrier function (Non-Patent Document 16, unpublished data by the inventor). In other words, the in vitro test and the in vivo test regarding permeation of sodium fluorescein have a positive relationship.
- a test sample 0.1 mM metformin (metformin hydrochloride; Sigma, D15,095-9), 0.5 mM metformin (same), 1 mM metformin (same) dissolved in RBEC culture solution II from which PDS was removed was used.
- RBEC culture medium II from which PDS was removed was used. All of the culture solution in the in vitro BBB model completed above was removed and replaced with a test sample, and the permeability test was performed 24 hours later.
- the fluorescence intensity of fluorescein sodium was measured using a fluorescence plate reader (CytoFluor (registered trademark) Series 4000, PerSeptive Biosystems, Framingham, MA) (excitation wavelength: 485 nm, fluorescence wavelength: 530 nm), absorption plate reader (Sunrise (registered trademark)), The absorbance of albumin was measured using TECAN, Mannedorf, Switzerland (wavelength 630 nm), and the concentrations of sodium fluorescein and albumin were calculated from a calibration curve. The calculation of clearance and permeability coefficient (P) was according to References 1 and 2 below.
- 1 / PS app 1 / PS membrane + 1 / PS trans PS is a slope of a straight line plotting clearance against time, and represents (permeation coefficient) ⁇ (surface area of membrane).
- P app represents the apparent transmission coefficient
- P trans represents the true transmission coefficient.
- P membrane represents the transmission coefficient of the chamber membrane alone.
- FIG. 2 and 3 show the test results using metformin at each concentration (0.1 mM, 0.5 mM and 1 mM) when the test result (permeability coefficient) using the target group is 100%.
- FIG. 2 shows the measurement result of albumin permeability coefficient
- FIG. 3 shows the measurement result of sodium fluorescein permeability coefficient.
- the significance probability P in the one-way ANOVA method of the four groups was 0.0009, and there was a significant difference at a significance level of 0.05. Furthermore, as a result of performing a significant difference test using Dunnett's multiple comparison test with a significance level of 0.05 between the control group and each metformin group, there was a significant difference in the 1 mM metformin group. In FIG. 2, the group is marked with *.
- the significance probability P in the four-group one-way ANOVA method was less than 0.0001, and there was a significant difference with a significance level of 0.05. Furthermore, as a result of conducting a significant difference test using Dunnett's multiple comparison test with a significance level of 0.05 between the control group and each metformin group, there was a significant difference between the 0.5 mM metformin group and the 1 mM metformin group. In FIG. 3, those groups are marked with *.
- metformin significantly suppressed the leakage of albumin present in the brain capillaries and fluorescein sodium, which is a tight binding ability marker, to the brain tissue side as compared with the control group.
- Example 2 Protective effect of metformin on blood brain barrier function decline by central side effect-inducing drug (CsA)
- CsA central side effect-inducing drug
- the immunosuppressive drug cyclosporin A (CsA) is a beneficial drug that improves the success rate of transplantation.
- CsA central side effect-inducing drug
- Example 2-1 An in vitro BBB model was created according to Example 1-1.
- Example 2-2 A transmission experiment was conducted in the same manner as in Example 1-2. However, drug stimulation methods are different. As a test sample, 1 mM metformin (metformin hydrochloride; Sigma, D15, 095-9) dissolved in RBEC culture solution II from which CsA and PDS dissolved in ethanol were removed was used. As a control group, RBEC culture solution II from which ethanol and PDS were removed was used. All of the culture solution in the in vitro BBB model completed above was removed and replaced with a test sample, and the permeability test was performed 24 hours later.
- metformin metalformin hydrochloride
- Example 3 Effects of metformin on blood-brain barrier function decline by central side effect drug (t-PA) (in vitro)
- t-PA central side effect drug
- the thrombolytic drug “tissue-type plasminogen activator (t-PA)” for cerebral infarction has been shown to have a very good effect by intravenous administration from 3 to 4.5 hours after onset.
- t-PA tissue-type plasminogen activator
- Hemorrhagic infarction may be caused by blood-brain barrier disorder associated with t-PA use in ischemic pathogenesis (Non-patent Documents 17 and 18), so the therapeutic window is 3 hours after cerebral infarction
- Non-Patent Document 2 a “t-PA BBB injury model” in which ischemia and t-PA were loaded on the in vitro BBB model was prepared, and the blood brain barrier function protecting action of metformin was examined.
- Example 3-1 An in vitro BBB model was created according to Example 1-1.
- Example 3-2 A transmission experiment was conducted in the same manner as in Example 1-2. However, drug stimulation methods are different.
- t-PA injection activacin; Kyowa Hakko
- 1 mM metformin metalformin hydrochloride; Sigma, D15,095-9
- RBEC culture medium I from which PDS was removed were used.
- RBEC culture solution I from which PDS was removed was used. All of the culture solution in the in vitro BBB model completed above was removed, replaced with a test sample, and allowed to stand for 48 hours under N 2 95% / CO 2 5% (ischemia) conditions, and then a permeability test was performed. .
- Example 4-1 Preparation of in vivo BBB injury model by t-PA
- the common carotid artery on both sides of the ddy mouse was ligated (2VO) for 30 minutes to prepare a cerebral infarction model mouse.
- a mouse administered with t-PA (10 mg / kg) from the subclavian vein after reopening the blood vessel and allowed to stand for 24 hours was used as a model mouse for BBB injury by t-PA.
- Metformin was administered at 100 mg / kg simultaneously with t-PA.
- a cerebral infarction model mouse to which no drug was administered was used.
- Example 4-2 Evaluation of BBB function 24 hours after administration of t-PA or t-PA and metformin, mixing of sodium fluorescein (Na-F) (6 mg / mL) and Evans blue (EB) (20 mg / mL) After 200 ⁇ L of the solution was administered to the subclavian vein and left for 60 minutes, the whole brain was removed. BBB function was assessed using whole brain photographs and homogenized whole brain Na-F and EB concentrations.
- Na-F sodium fluorescein
- EB Evans blue
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Abstract
Description
その他、外的又は内的要因によって機能が強化することの「促進」も意味する。
したがって、密着結合能や経細胞輸送能などを含む血液脳関門機能の強化には、血液脳関門機能の強化ばかりではなく、血液脳関門機能の再構築も、血液脳関門機能の低下の抑制も、血液脳関門機能の強化・再構築・低下の抑制の促進も、含まれるものと解釈される。
より具体的には、本願は、脳梗塞の悪化又は再発を予防するための、本発明に係る血液脳関門障害症候群治療薬を提供する。また、本願は、脳梗塞に伴う脳浮腫を予防、抑制又は改善するための、本発明に係る血液脳関門障害症候群治療薬を提供する。また、本願は、敗血症に伴う脳症を予防、抑制又は改善するための、本発明に係る血液脳関門障害症候群治療薬を提供する。また、本願は、多発性硬化症における白血球脳内浸潤を予防、抑制又は改善するための、本発明に係る血液脳関門障害症候群治療薬を提供する。また、本願は、アルツハイマー病におけるアミロイドベータタンパク質(Aβ)の脳内での蓄積を予防、抑制又は改善するための、本発明に係る血液脳関門障害症候群治療薬を提供する。
さらにまた、本願は、薬物の脳移行を予防又は抑制することにより、動物又はヒトの中枢神経性有害症状を予防、抑制又は改善するための、本発明に係る血液脳関門障害症候群治療薬を提供する。
(発明1)
血液脳関門機能を強化するための、ビグアナイド系薬剤又はその医薬的に許容される塩を有効成分とする医薬。
(発明2)
前記血液脳関門機能の強化が血液脳関門機能の低下の予防、抑制又は抑制の促進である、発明1のいずれか一項に記載の医薬。
(発明3)
前記血液脳関門機能の低下が、糖尿病、肥満、高血圧、脳梗塞、脳外傷、敗血症、多発性硬化症、アルツハイマー病又はその組合せからなる群から選ばれる疾患によるものである、又は中枢性副作用誘発物質によるものである、発明2に記載の医薬。
(発明4)
前記中枢性副作用誘発物質が免疫抑制薬又は血栓溶解薬である、発明3に記載の医薬。
(発明5)
脳梗塞若しくは脳外傷に伴う脳浮腫を予防、抑制又は改善するための薬物と併用される、発明1に記載の医薬。
(発明6)
前記薬物が血栓溶解薬である、発明5に記載の医薬。
(発明7)
前記血栓溶解薬が組織型プラスミノゲン・アクチベーター(t−PA)である、発明6に記載の医薬。
(発明8)
前記医薬が薬物の脳移行を予防又は抑制する、発明1の医薬。
(発明9)
前記薬物が動物又はヒトの中枢神経での作用を期待しない薬物である、発明8に記載の医薬。
(発明10)
前記薬物の脳移行を予防又は抑制することにより、前記医薬が動物又はヒトの中枢神経性作用の有害症状を予防、抑制又は改善する、発明8又は9に記載の医薬。
(発明11)
前記有害症状が、振戦、痙攣、白質脳症、頭痛、眠気、意識障害、異常行動、せん妄、幻覚、妄想、てんかん及びそれらの組み合わせから選ばれる、発明10に記載の医薬。
(発明12)
前記ビグアナイド系薬剤がメトホルミン又はブホルミンである、発明1~11のいずれか一項に記載の医薬。
(発明13)
前記ビグアナイド系薬剤又はその医薬的に許容される塩がメトホルミン塩酸塩又はブホルミン塩酸塩である、発明12に記載の医薬。
(発明14)
有効成分投与量が125~3000mg/人/日である、発明1~13のいずれか一項に記載の医薬。
(発明15)
疾患を予防、抑制又は改善するための方法であって、
前記疾患が、振戦、痙攣、白質脳症、頭痛、眠気、意識障害、異常行動、せん妄、幻覚、妄想、てんかん、脳梗塞、脳外傷、敗血症、アルツハイマー病、及びそれらの組み合わせからなる群から選択され、
前記方法が、必要としている者に発明1に記載の医薬を投与する工程を含む、
方法。
(発明16)
血液脳関門障害症候群を治療するための方法であって、
前記方法が、必要としている者にビグアナイド系薬剤又はその医薬的に許容される塩を有効成分として含む医薬を投与して、血液脳関門機能を強化する工程を含む、
方法。
さらに、いくつかは上記と重複するが、本発明を以下に記す。
(発明1a)
薬物の脳移行を予防又は抑制するための、ビグアナイド系薬剤又はその医薬的に許容される塩を有効成分とする血液脳関門障害症候群治療薬。
(発明2a)
前記薬物が動物又はヒトの中枢神経での作用を期待しない薬物である、発明1aに記載の血液脳関門障害症候群治療薬。
(発明3a)
前記薬物の脳移行を予防又は抑制することにより、動物又はヒトの中枢神経性作用の有害症状を予防、抑制又は改善するための、発明1a又は2aに記載の血液脳関門障害症候群治療薬。
(発明4a)
前記有害症状が、振戦、痙攣、白質脳症、頭痛、眠気、意識障害、異常行動、せん妄、幻覚、妄想、てんかん及びそれらの組み合わせから選ばれる、発明3aに記載の血液脳関門障害症候群治療薬。
(発明5a)
脳梗塞若しくは脳外傷に伴う脳浮腫を予防、抑制又は改善するための、ビグアナイド系薬剤又はその医薬的に許容される塩を有効成分とする血液脳関門障害症候群治療薬。
(発明6a)
敗血症に伴う脳症を予防、抑制又は改善するための、ビグアナイド系薬剤又はその医薬的に許容される塩を有効成分とする血液脳関門障害症候群治療薬。
(発明7a)
多発性硬化症における白血球脳内浸潤を予防、抑制又は改善するための、ビグアナイド系薬剤又はその医薬的に許容される塩を有効成分とする血液脳関門障害症候群治療薬。
(発明8a)
アルツハイマー病におけるアミロイドベータタンパク質(Aβ)の脳内での蓄積を予防、抑制又は改善するための、ビグアナイド系薬剤又はその医薬的に許容される塩を有効成分とする血液脳関門障害症候群治療薬。
(発明9a)
脳梗塞の悪化又は再発を予防又は抑制するための、ビグアナイド系薬剤又はその医薬的に許容される塩を有効成分とする血液脳関門障害症候群治療薬。
(発明10a)
血液脳関門機能を強化するための、ビグアナイド系薬剤又はその医薬的に許容される塩を有効成分とする血液脳関門障害症候群治療薬。
(発明11a)
前記血液脳関門機能の強化が血液脳関門機能の低下の予防、抑制又は抑制の促進である、発明10aに記載の血液脳関門障害症候群治療薬。
(発明12a)
前記血液脳関門機能の低下が、糖尿病、肥満、高血圧又はその組合せからなる群から選ばれる疾患によるものである、発明11aに記載の血液脳関門障害症候群治療薬。
(発明13a)
前記ビグアナイド系薬剤がメトホルミン又はブホルミンである、発明1a~12aのいずれか一つに記載の血液脳関門障害症候群治療薬。
(発明14a)
前記ビグアナイド系薬剤又はその医薬的に許容される塩がメトホルミン塩酸塩又はブホルミン塩酸塩である、発明13aに記載の血液脳関門障害症候群治療薬。
(発明15a)
有効成分投与量が125~3000mg/人/日である、発明1a~14aのいずれか一つに記載の血液脳関門障害症候群治療薬。
また、そのまま、又は、公知の薬学的に許容される医薬用担体と組合せて常法に従って製剤化することが出来る。
賦形剤としては、例えばアクリル酸デンプン、アラビアゴム、乳糖、コーンスターチ、白糖、ブドウ糖、ソルビット、結晶セルロース、二酸化ケイ素ケイ酸カルシウム、ケイ酸マグネシウムなどが挙げられる。結合剤としては、例えばポリビニルアルコール、クエン酸カルシウム、カルボキシビニルポリマー、カルボキシメチルエチルセルロース、ポリビニルエーテル、メチルセルロース、アラビアゴム、トラガント、ゼラチン、シェラック、ヒドロキシプロピルセルロース、ヒドロキシプロピルメチルセルロース、エチルセルロース、デキストリン、ポリリン酸ナトリウム、ペクチンなどが挙げられる。崩壊剤としては、例えばクロスポビドン、クロスカルメロースナトリウム、カルメロースカルシウム等のスーパー崩壊剤と称される崩壊剤;ヒドロキシプロピルセルロース;カルボキシメチルスターチナトリウム;コーンスターチなどが挙げられる。滑沢剤としては、例えばステアリン酸マグネシウム、タルク、ポリエチレングリコール、ステアリン酸アルミニウム、乳糖、炭酸マグネシウム、カルメロースカルシウム、カルメロースナトリウム、硬化植物油などが挙げられる。安定化剤としては、例えばエデト酸ナトリウム、亜硫酸ナトリウム、ブチルヒドロキシアニソール、ブチルヒドロキシトルエンなどが挙げられる。着色剤としては、例えばカラメル、食用黄色5号、食用赤色2号、食用青色2号等の食用色素や食用レーキ色素、ベンガラなどが挙げられる。矯味矯臭剤としては、例えば塩酸、オレンジ油、ウイキョウ、ココア末、ハッカ脳、芳香酸、ハッカ油、ケイヒ油などが挙げられる。錠剤や顆粒剤には糖衣、ゼラチン衣、その他必要に応じてコーティングすることもできる。
したがって、本発明の血液脳関門機能強化薬は、血液脳関門機能障害を素因とする前記疾患又は症状の予防、抑制又は改善に有用である。
また、前記薬物の脳移行を予防又は抑制することにより、動物又はヒトの中枢神経性の有害症状を予防、抑制又は改善するために、本発明の医薬又は医薬組成物を使用出来る。
また、本発明は、組織型プラスミノゲン・アクチベーター等の血栓溶解薬による血液脳関門機能低下を予防、抑制又は改善することが出来る。また、本発明は、前記血液脳関門機能低下に伴う出血性梗塞を予防、抑制又は改善することが出来る。また、本発明は、脳梗塞の治療の際の前記血栓溶解薬の使用時における治療可能時間(therapeutic window)の拡張に用いることが出来る。そのため、本発明は、前記血栓溶解薬と併用して、脳梗塞治療薬として用いることが出来る。
その他、本発明は、抗ヒスタミン薬による眠気や、タミフルによる意識障害、異常行動、せん妄、幻覚、妄想、痙攣等や、インターフェロン・インフリキシマブ・抗うつ薬・ニューキノロン系抗菌薬による痙攣・てんかんや、カルモフール・テガフール・フルオロウラシルによる白質脳症を予防、抑制又は改善することが出来る。
例えば、糖尿病、肥満、高血圧等により血液脳関門機能が低下する可能性があることが知られている(非特許文献14、15)。そのため、本発明に係る血液脳関門障害症候群治療薬を、糖尿病、肥満、高血圧等による血液脳関門機能の低下を予防、抑制又は改善するために使用出来る。前記血液脳関門機能の低下を予防、抑制又は改善は、脳梗塞の悪化又は再発を予防すること、薬物の脳移行を予防又は抑制すること、等へつながる。
また逆に、血液脳関門機能の低下により糖尿病及び/又は肥満が発症又は悪化するとも考えられる。そのため、本発明に係る血液脳関門障害症候群治療薬を、血液脳関門機能の低下に起因する上記疾患の予防、抑制又は改善するためにも使用出来る。
(例1−1)
—in vitro BBBモデルの作成—
脳血管内皮細胞(RBEC)を下記参考文献1に従って単離した。詳細は下記の通りである。
3週齢のWistar系ラットをエーテル麻酔後、断頭し大脳を摘出し氷上のディッシュに入れた。髄膜を剥がした後に氷上のディッシュにて大脳皮質を細断し、collagenase(CLS2)(1mg/ml;Worthington)とdeoxyribonuclease I(50units/ml;Sigma)で37℃、1.5時間振とう(200rpm)し、酵素処理を行った。遠心分離後、得られたペレットに20% bovine serum albumin(BSA)−DMEMを加え、遠心分離(1000×g、20分)することでニューロンやグリア細胞を取り除いた。その後collagenase/dispase(1mg/ml;Boehringer Mannheim)とdeoxyribonuclease I(50units/ml;Sigma)で37℃、30分振とう(200rpm)して酵素処理をした。遠心分離後、得られたペレットを少量のDMEMで懸濁し、あらかじめ4℃、30000×g、1時間で密度勾配を形成させておいた、33% percoll(GE helthcare)溶液に加え、遠心分離することで脳毛細血管片を単離した。
上記の方法で単離した脳毛細血管片を、コラーゲン及びフィブロネクチンでコーティングしたculture dishを用いて37℃、5%CO2/95%大気下で、plasma derived serum(PDS) 10%、gentamicin 50μg/mL、L−glutamine 1mM、heparin 1mg/mL、bFGF 1.5ng/mL、insulin 5μg/mL、transferring 5μg/mL、selenium 5ng/mL、puromycin 4μg/mLを含むDMEM/F12(RBEC培養液I)にて培養した。48時間後に、puromycinを除去したRBEC培養液I(RBEC培養液II)に置換し、さらに培養することで脳血管内皮細胞(RBEC)を得た。
Transwell(登録商標)(24−well type、Costar、MA)を用いて、上記の方法で得られたRBECからRBEC単層培養系であるmonolayerのin vitro BBBモデルを作製した。
すなわち、Polycarbonate membrane(0.4μm pore size)をコラーゲン及びフィブロネクチンでコーティングしたTranswellインサート(12−well type、Costar、MA)を24−well culture plate(Costar、MA)のwellに設置し、RBEC(5.0×104cells/well)を前記インサートの内側に播種した(monolayer)。RBECを播種した翌日、hydrocortisone(500nM)を含むRBEC培養液IIに交換し、その2日後に完成したin vitro BBBモデルを用いて実験を行った。
—透過実験—
メトホルミンのBBB機能への影響は、フルオレセインナトリウム(Na−F)(Sigma、St.Louis、MO)及びEvans blue−albumin(アルブミン)((Evans blue;Sigma、E2129)(Bovine serum albumin;Sigma、A7906))の透過係数を指標として、確認された。
なお、血管弛緩因子であるadrenomedullinは血液脳関門機能を強化することにより、in vitro及びin vivoにおいてフルオレセインナトリウムの透過を抑制する(非特許文献16、発明者未発表データ)。つまりフルオレセインナトリウムの透過に関するin vitro試験とin vivo試験は正の関係である。
試験サンプルとして、PDSを除去したRBEC培養液IIに溶解した0.1mMメトホルミン(メトホルミン塩酸塩;Sigma、D15,095−9)、0.5mMメトホルミン(同)、1mMメトホルミン(同)を用いた。対照群として、PDSを除去したRBEC培養液IIを用いた。上記で完成したin vitro BBBモデル中の培養液を全て取り除き、試験サンプルで置換し、24時間後に透過性の試験を行った。
フルオレセインナトリウム(100μg/ml)又はアルブミン(0.04g/ml)を含んだphysiological buffer(0.1ml)をインサートの血管側に添加した後、10、20、30、60、120、180分後にwell(脳側)からサンプル(0.4ml)を採取し、新たにphysiological bufferを同量加えた。蛍光プレートリーダー(CytoFluor(登録商標) Series 4000,PerSeptive Biosystems、Framingham、MA)を用いてフルオレセインナトリウムの蛍光強度を測定し(励起波長485nm、蛍光波長530nm)、吸光プレートリーダー(Sunrise(登録商標)、TECAN、Mannedorf、Switzerland)を用いてアルブミンの吸光強度を測定し(波長630nm)、検量線よりフルオレセインナトリウム及びアルブミンの濃度を算出した。
クリアランスと透過係数(P)の算出は下記参考文献1及び2に従った。クリアランスは、血管側のchamberから脳実質側のchamberに移行したフルオレセインナトリウム及びアルブミンの量をμLで表し、血管側に入れたフルオレセインナトリウム及びアルブミンの初濃度[C]Lと脳実質側に移行したフルオレセインナトリウム及びアルブミンの最終濃度[C]Aから、以下の式より算出した。
Clearance(μl)=[C]A×VA/[C]L
(VA:脳実質側chamberの容積(1.5ml))
透過係数P(cm/min)は以下の式より求めた。
1/PSapp=1/PSmembrane+1/PStrans
PSは時間に対してクリアランスをプロットした直線の傾きで、(透過係数)×(membraneの表面積)を表している。Pappはみかけの透過係数、Ptransは真の透過係数を表す。Pmembraneは、チャンバーのmembraneのみの透過係数を表す。
[参考文献1]Isobe,I.,Watanabe,T.,Hazemoto,N.,Yamagata,K.,Ueki,T.,Nakanishi,K.,Asai,K.,Kato,T.、「Astrocytic contributions to blood−brain barrier (BBB) formation by endothelial cells: a possible use of aortic endothelial cell for in vitro model」、Neurochemistry International、1996、28、p.523−533
[参考文献2]Dehouck,M.−P.,Jolliet−Riant,P.,Bree,F.,Fruchart J.−C.,Cecchelli,R.,Tillement,J.−P.,「Drug transfer across the blood−brain barrier: correlation between in vitro and in vivo models」、Journal of Neurochemistry、1992、58、p.1790−1797
[参考文献3]Hayashi Y.,Nomura M.,Yamagishi S.,Harada S.,Yamashita J.,Yamamoto H.,「Induction of various blood−brain barrier properties in non−neural endothelial cells by close apposition to co−cultured astrocytes」、Glia、1997、19、p.13−26
[参考文献4]Takata F,Sumi N,Nishioku T,Harada E,Wakigawa T,Shuto H,Yamauchi A,Kataoka Y.、「Oncostatin M induces functional and structural impairment of blood−brain barriers comprised of rat brain capillary endothelial cells」、Neuroscience Letters、2008、441(2)、p.163−166
中枢性副作用誘発薬物(CsA)による血液脳関門機能低下に対するメトホルミンの保護作用
免疫抑制薬cyclosporin A(CsA)は、移植の成功率を向上させる有益な医薬品である。一方で副作用も多く、振戦・痙攣などの中枢性副作用が発現すると投与中止を余儀なくされる。これまでに我々は、中枢性副作用発現にCsAの血液脳関門機能低下作用に伴うCsAの脳移行増大が関与することを明らかにした。そこで、CsAによる血液脳関門機能低下に対するメトホルミンの作用について検討した。
例1−1にしたがって、in vitro BBBモデルを作成した。
例1−2と同様に、透過実験を行った。ただし、薬物の刺激方法が異なる。
試験サンプルとして、エタノールに溶解したCsA及びPDSを除去したRBEC培養液IIに溶解した1mMメトホルミン(メトホルミン塩酸塩;Sigma、D15,095−9)を用いた。対照群として、エタノール及びPDSを除去したRBEC培養液IIを用いた。上記で完成したin vitro BBBモデル中の培養液を全て取り除き、試験サンプルで置換し、24時間後に透過性の試験を行った。
中枢性副作用誘発薬物(t−PA)による血液脳関門機能低下に対するメトホルミンの作用(in vitro)
脳梗塞に対する血栓溶解薬「組織型プラスミノゲン・アクチベーター(t−PA)」は、発症から3~4.5時間までの静脈投与で極めて良好な効果が示されている。しかし、t−PAによる血栓溶解療法には問題点が存在する。虚血病態化でのt−PA使用に伴う血液脳関門障害により、出血性梗塞を合併することがあるため(非特許文献17及び18)、治療可能時間(therapeutic window)が脳梗塞後3時間と極めて短いことがその一つである(非特許文献2)。そこで、in vitro BBBモデルに虚血及びt−PAを負荷した、「t−PA BBB障害モデル」を作製し、メトホルミンの血液脳関門機能保護作用について検討した。
例1−1にしたがって、in vitro BBBモデルを作成した。
例1−2と同様に、透過実験を行った。ただし、薬物の刺激方法が異なる。
試験サンプルとして、t−PA注射剤(アクチバシン;協和発酵)及びPDSを除去したRBEC培養液Iに溶解した1mMメトホルミン(メトホルミン塩酸塩;Sigma、D15,095−9)を用いた。対照群として、PDSを除去したRBEC培養液Iを用いた。上記で完成したin vitro BBBモデル中の培養液を全て取り除き、試験サンプルで置換し、N295%/CO25%(虚血)条件下で48時間放置した後に透過性の試験を行った。
中枢性副作用誘発薬物(t−PA)による血液脳関門機能低下に対するメトホルミンの作用(in vivo)
t−PAによるin vivo BBB障害モデルの作製
ddyマウスの両側の総頸動脈を30分間結紮(2VO)して脳梗塞モデルマウスを作製した。血管を再開通した後に鎖骨下静脈よりt−PA(10mg/kg)を投与し24時間放置したマウスを、t−PAによるBBB障害モデルマウスとして用いた。
メトホルミンはt−PAと同時に100mg/kgを投与した。対照群として、薬物を投与していない脳梗塞モデルマウスを用いた。
BBB機能評価
t−PAを投与して、又はt−PA及びメトホルミンを投与して24時間後に、フルオレセインナトリウム(Na−F)(6mg/mL)及びEvans blue(EB)(20mg/mL)の混合液200μLを鎖骨下静脈に投与して60分放置した後に全脳を摘出した。BBB機能は全脳の写真及びホモジナイズした全脳のNa−F及びEB濃度を用いて評価した。
脳梗塞モデルマウスにt−PAを負荷すると脳が青く染まり、血管からEBが脳全体に漏れ出ているのが認められた(図7真ん中)。これにメトホルミンを併用すると脳の青色は薄くなったことから(図7右)、血管外へのEB漏出が抑制されたことがわかる。このことよりt−PA負荷によるBBB機能障害がメトホルミン併用により抑制されたと考えられる。
脳梗塞モデルマウスにt−PAを負荷するとNa−F及びEBの脳内移行量はそれぞれ16%及び20%上昇した(図8及び9)。メトホルミン併用によりNa−F及びEBの上昇は78%及び66%抑制された(図8及び9)。
Claims (16)
- 血液脳関門機能を強化するための、ビグアナイド系薬剤又はその医薬的に許容される塩を有効成分とする医薬。
- 前記血液脳関門機能の強化が血液脳関門機能の低下の予防、抑制又は抑制の促進である、請求項1のいずれか一項に記載の医薬。
- 前記血液脳関門機能の低下が、糖尿病、肥満、高血圧、脳梗塞、脳外傷、敗血症、多発性硬化症、アルツハイマー病又はその組合せからなる群から選ばれる疾患によるものである、又は中枢性副作用誘発物質によるものである、請求項2に記載の医薬。
- 前記中枢性副作用誘発物質が免疫抑制薬又は血栓溶解薬である、請求項3に記載の医薬。
- 脳梗塞若しくは脳外傷に伴う脳浮腫を予防、抑制又は改善するための薬物と併用される、請求項1に記載の医薬。
- 前記薬物が血栓溶解薬である、請求項5に記載の医薬。
- 前記血栓溶解薬が組織型プラスミノゲン・アクチベーター(t−PA)である、請求項6に記載の医薬。
- 前記医薬が薬物の脳移行を予防又は抑制する、請求項1の医薬。
- 前記薬物が動物又はヒトの中枢神経での作用を期待しない薬物である、請求項8に記載の医薬。
- 前記薬物の脳移行を予防又は抑制することにより、前記医薬が動物又はヒトの中枢神経性作用の有害症状を予防、抑制又は改善する、請求項8又は9に記載の医薬。
- 前記有害症状が、振戦、痙攣、白質脳症、頭痛、眠気、意識障害、異常行動、せん妄、幻覚、妄想、てんかん及びそれらの組み合わせから選ばれる、請求項10に記載の医薬。
- 前記ビグアナイド系薬剤がメトホルミン又はブホルミンである、請求項1~11のいずれか一項に記載の医薬。
- 前記ビグアナイド系薬剤又はその医薬的に許容される塩がメトホルミン塩酸塩又はブホルミン塩酸塩である、請求項12に記載の医薬。
- 有効成分投与量が125~3000mg/人/日である、請求項1~13のいずれか一項に記載の医薬。
- 疾患を予防、抑制又は改善するための方法であって、
前記疾患が、振戦、痙攣、白質脳症、頭痛、眠気、意識障害、異常行動、せん妄、幻覚、妄想、てんかん、脳梗塞、脳外傷、敗血症、アルツハイマー病、及びそれらの組み合わせからなる群から選択され、
前記方法が、必要としている者に請求項1に記載の医薬を投与する工程を含む、
方法。 - 血液脳関門障害症候群を治療するための方法であって、
前記方法が、必要としている者にビグアナイド系薬剤又はその医薬的に許容される塩を有効成分として含む医薬を投与して、血液脳関門機能を強化する工程を含む、
方法。
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
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WO2021261571A1 (ja) | 2020-06-24 | 2021-12-30 | 国立大学法人北海道大学 | 血液脳脊髄関門保護剤 |
Also Published As
Publication number | Publication date |
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US20140256820A1 (en) | 2014-09-11 |
JP5954843B2 (ja) | 2016-07-20 |
EP2653158A1 (en) | 2013-10-23 |
EP2653158B1 (en) | 2017-07-05 |
JP5674166B2 (ja) | 2015-02-25 |
EP2653158A4 (en) | 2014-07-09 |
JPWO2012081713A1 (ja) | 2014-05-22 |
JP2015078225A (ja) | 2015-04-23 |
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