WO2013123824A1 - 聚乙二醇与纳洛酮的结合物及其药物组合物和应用 - Google Patents

聚乙二醇与纳洛酮的结合物及其药物组合物和应用 Download PDF

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WO2013123824A1
WO2013123824A1 PCT/CN2013/000166 CN2013000166W WO2013123824A1 WO 2013123824 A1 WO2013123824 A1 WO 2013123824A1 CN 2013000166 W CN2013000166 W CN 2013000166W WO 2013123824 A1 WO2013123824 A1 WO 2013123824A1
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naloxone
conjugate
polyethylene glycol
pharmaceutically acceptable
acceptable salt
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PCT/CN2013/000166
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English (en)
French (fr)
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郭志雄
冯泽旺
徐立华
赵宣
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天津键凯科技有限公司
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Priority to EP13752217.3A priority Critical patent/EP2818169B1/en
Priority to US14/376,680 priority patent/US8962647B1/en
Publication of WO2013123824A1 publication Critical patent/WO2013123824A1/zh

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    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07DHETEROCYCLIC COMPOUNDS
    • C07D519/00Heterocyclic compounds containing more than one system of two or more relevant hetero rings condensed among themselves or condensed with a common carbocyclic ring system not provided for in groups C07D453/00 or C07D455/00
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47Quinolines; Isoquinolines
    • A61K31/485Morphinan derivatives, e.g. morphine, codeine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/51Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
    • A61K47/54Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound
    • A61K47/55Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound the modifying agent being also a pharmacologically or therapeutically active agent, i.e. the entire conjugate being a codrug, i.e. a dimer, oligomer or polymer of pharmacologically or therapeutically active compounds
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/51Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
    • A61K47/56Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic macromolecular compound, e.g. an oligomeric, polymeric or dendrimeric molecule
    • A61K47/59Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic macromolecular compound, e.g. an oligomeric, polymeric or dendrimeric molecule obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyureas or polyurethanes
    • A61K47/60Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic macromolecular compound, e.g. an oligomeric, polymeric or dendrimeric molecule obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyureas or polyurethanes the organic macromolecular compound being a polyoxyalkylene oligomer, polymer or dendrimer, e.g. PEG, PPG, PEO or polyglycerol
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00Drugs for disorders of the alimentary tract or the digestive system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/10Laxatives
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • A61P25/30Drugs for disorders of the nervous system for treating abuse or dependence
    • A61P25/36Opioid-abuse

Definitions

  • the present invention relates to a hydrophilic polymer-naloxone conjugate, especially a combination of a small molecule oligoethylene glycol and naloxone And pharmaceutical compositions thereof.
  • Opioid analgesic drugs such as morphine
  • Opioids mainly act on opioid receptors.
  • Opioid receptors include three receptors, ⁇ , ⁇ , and ⁇ . Each receptor has a different subtype.
  • opioid analgesic drugs have side effects on peripheral opioid receptors.
  • One of the main side effects is intestinal dysfunction and constipation caused by opioids. Especially for patients with chronic pain, this side effect has always affected the quality of life of patients because of the long-term use of opioids to relieve pain.
  • Naloxone structural formula 1
  • a derivative of hydroxydihydromorphone is an opioid receptor-specific antagonist, and has competitive antagonism to various types of opioid receptors in the body, and can interact with opioid receptors in vivo.
  • ⁇ -endorphin Combined to prevent the release of excessive ⁇ -endorphin, it is rapidly absorbed in the body, fast in metabolism, strong in antagonism, easy to penetrate the blood-brain barrier, and replaces morphine-like substances to bind to receptors, relieves central inhibition, and rapidly recovers.
  • the normal function of the brain, heart, lungs and other organs does not produce morphine-like dependence, withdrawal symptoms and respiratory depression.
  • Naloxone is a special antidote to morphine overdose. It is also a diagnostic drug for morphine and heroin dependent patients. In recent years, clinicians at home and abroad have also applied it to the treatment of acute alcohol, diazepam, cerebral infarction, acute and chronic respiratory failure and various critically ill shocks, and have achieved good results.
  • naloxone is currently the most widely used opioid receptor antagonist in clinical practice, the first-pass effect of naloxone in liver is large, and oral administration of tablets is basically ineffective.
  • the clinically used dosage forms are only injection and sublingual tablets. Dosage form.
  • PEG polyethylene glycol
  • Polyethylene glycol (PEG) modification technology is a new drug delivery technology that has been rapidly developed in recent years and is mainly used in injection drug delivery systems. It is a technique that activates polyethylene glycol to link to drug molecules or surfaces.
  • the drug After modification of polyethylene glycol, the drug has the following advantages: 1. Increase the water solubility of the drug; 2. Reduce the toxicity; 3. Prolong the cycle half-life of the drug, reduce the number of medications, improve patient compliance, improve quality of life, and reduce Treatment costs; 4, reduce enzyme degradation, improve bioavailability; 5, reduce blood-brain barrier permeability, reduce central side effects.
  • the pharmacokinetics of the drug After linking with polyethylene glycol, the pharmacokinetics of the drug changed, which in turn changed the pharmacodynamics.
  • polyethylene glycol can prolong the time when the blood concentration is maintained at or near the target concentration, and the drug efficacy can be fully exerted.
  • the invention adopts the PEG technology to structurally modify naloxone, and uses low molecular weight polyethylene glycol to link with naloxone to improve the pharmacokinetic properties of the drug, increase the water solubility of naloxone itself, and improve
  • the distribution of drugs in the body reduces the toxic side effects of naloxone on the central nervous system, reduces intestinal dysfunction and constipation caused by long-term use of opioids, and develops them into injections or preparations suitable for oral administration.
  • the experimental group used its own advantages to synthesize and screen several polyethylene glycol-naloxone derivatives.
  • the compounds of the invention are linked to two or more reactive groups per polyethylene glycol structure. Therefore, the opioid receptor antagonistic activity of these compounds is superior to that of the same molecular weight.
  • the present invention provides a polyethylene glycol-naloxone conjugate of the formula ( ⁇ ) or a pharmaceutically acceptable salt thereof:
  • n is an integer from 1 to 20; preferably, n is an integer from 1 to 15; more preferably, n is an integer from 2 to 15. More preferably, n may be an integer of 2-14, an integer of 3-13 or an integer of 4-12.
  • the configuration of the conjugate is ( ⁇ , ⁇ ), ( ⁇ , ⁇ ), ( ⁇ , ⁇ ) or a mixture thereof; a preferred configuration is ( ⁇ , ⁇ ) or ( ⁇ , ⁇ ) .
  • Another aspect of the invention provides a polyethylene glycol-naloxone conjugate of the formula (U1) or a pharmaceutically acceptable salt thereof:
  • x, y, and w are the same or different and are each an integer from 0 to 20; preferably, x, y, and w are the same or different, and are each an integer of 0-15: More preferably, x, y, and w are the same. And is an integer from 0-10. More preferably, x, y, w may be the same or different and are each an integer of 0-9, 0-8, 0-7 or 0-6.
  • the configuration of the conjugate is ( ⁇ , ⁇ , ⁇ ), ( ⁇ , ⁇ , ⁇ ), ( ⁇ , ⁇ , ⁇ ), ( ⁇ , ⁇ , ⁇ ) or a mixture thereof;
  • the preferred configuration is ( ⁇ , ⁇ , ⁇ ) or ( ⁇ , ⁇ , ⁇ ).
  • Another aspect of the invention provides a polyethylene glycol-naloxone conjugate of the formula (IV) or a pharmaceutically acceptable salt thereof:
  • a, b, c, d are the same or different and are each an integer of 0-20; preferably, a, b, c, d are the same or different, respectively an integer of 0-15; more preferably, a, b , c, d are the same, and are integers from 0-10. More preferably, a, b, c, d may be the same or different and are each an integer of 0-8, 0-7, 0-6 or 0-5.
  • the configuration of the conjugate is ( ⁇ , ⁇ , ⁇ , ⁇ ), ( ⁇ , ⁇ , ⁇ , ⁇ ), ( ⁇ , ⁇ , ⁇ , ⁇ ), ( ⁇ , ⁇ , ⁇ , ⁇ ), ( ⁇ , ⁇ , ⁇ , ⁇ ) , ( ⁇ , ⁇ , ⁇ , ⁇ ) or a mixture thereof; preferred configuration is ( ⁇ , a, a, ⁇ ) or ( ⁇ , ⁇ , ⁇ , ⁇ ).
  • the above pharmaceutically acceptable salts may be hydrochlorides, hydrobromides, sulfates, nitrates, phosphates, citrates, tartrates, fumarates, maleates, lactates, A besylate, a pantothenate, an ascorbate or the like may also be a combination of these salts.
  • Another aspect of the invention provides a pharmaceutical composition comprising a polyethylene glycol-naloxone conjugate or a pharmaceutically acceptable salt thereof.
  • the pharmaceutical composition may further comprise a pharmaceutically acceptable carrier or excipient.
  • the pharmaceutical composition can constitute a tablet, an injection, a suppository, a pill, a soft and a hard Gelatin capsules, powders, solutions, suspensions or aerosols.
  • Another aspect of the present invention provides the use of a polyethylene glycol-naloxone conjugate or a pharmaceutically acceptable salt thereof for the preparation of a medicament for the treatment of intestinal dysfunction and constipation caused by long-term use of opioids.
  • the invention has the advantages that the modification of the hydrophilic polymer polyethylene glycol can protect naloxone, improve drug absorption, change the distribution of the drug body, reduce the blood-brain barrier permeability and avoid toxic side effects.
  • a low molecular weight polyethylene glycol is introduced into a naloxone molecule by a polyethylene glycol modification technique to increase its hydrophilicity, improve drug distribution in vivo, and reduce its blood-brain barrier permeability, thereby reducing its toxicity.
  • the conjugate of the present invention is prepared as follows: The hydrophilic oligoethylene glycol is modified to introduce a halogen or a methanesulfonyl group, a p-toluenesulfonyl group, etc., and then a nano-alloy Ketone binding.
  • oligoethylene glycol By introducing oligoethylene glycol, the distribution of drugs in the body is changed, the blood-brain barrier is improved, and intestinal dysfunction and constipation caused by long-term use of opioid receptor drugs are improved.
  • oligoethylene glycol it is represented by a ffl ethylene glycol polymerization unit, generally expressed by the number of ethylene glycol units, and the number of ethylene glycol units is in the range of 0-20, preferably 0-10.
  • the polyethylene glycol of the present invention also includes derivatives and analogs of polyethylene glycol, which may also be replaced by a hydrophilic polymer selected from the group consisting of ruthenium polyethylene glycol and polyglycol.
  • the combination of the present invention can be administered in the form of a pure compound or a suitable pharmaceutical composition, and can be carried out by any acceptable mode of administration or an agent for a similar use.
  • the mode of administration may be selected by oral, intranasal, parenteral, topical, transdermal or rectal administration in the form of a solid, semi-solid or liquid pharmaceutical form, for example, tablets, suppositories, pills, Soft and hard gelatin capsules, powders, solutions, suspensions or aerosols, and the like, are preferably employed in unit dosage forms for simple administration of precise dosages.
  • the composition may comprise a conventional pharmaceutical carrier or excipient and a combination of the invention as the active ingredient(s), and may further comprise other agents, carriers, adjuvants and the like.
  • a pharmaceutically acceptable composition will comprise from about 1 to about 99% by weight of a combination of the invention, and from 99 to 1% by weight of a suitable pharmaceutical excipient, depending on the mode of administration desired.
  • the compositions comprise from about 5 to 75% by weight of a combination of the invention, the balance being a suitable pharmaceutical excipient.
  • the pharmaceutical composition which can be administered in a liquid form can be, for example, dissolved or dispersed, and the conjugate of the present invention (about 0.5 to about 20%) and the selectively present pharmaceutical adjuvant can be dissolved and dispersed in a carrier. Examples are water, saline, aqueous dextrose, glycerol, ethanol, and the like to form a solution or suspension.
  • compositions of the present invention may also contain minor amounts of auxiliary substances such as wetting or emulsifying agents, pH buffering agents, antioxidants, and the like, for example: citric acid, sorbitan monolaurate, triethanolamine oil Acid ester, butylated hydroxytoluene, and the like.
  • auxiliary substances such as wetting or emulsifying agents, pH buffering agents, antioxidants, and the like, for example: citric acid, sorbitan monolaurate, triethanolamine oil Acid ester, butylated hydroxytoluene, and the like.
  • auxiliary substances such as wetting or emulsifying agents, pH buffering agents, antioxidants, and the like, for example: citric acid, sorbitan monolaurate, triethanolamine oil Acid ester, butylated hydroxytoluene, and the like.
  • MEMCL methoxyethoxymethyl chloride
  • Example 2 Synthesis of a double-terminated substituted tetraethylene glycol-naloxone (a, a)-NAL24 (compound E2, wherein ⁇ 4)
  • the tetraethylene glycol was used in place of hexaethylene glycol, and the hydrazine of Example 1 was repeated.
  • the double-substituted tetraethylene glycol-naloxone (a, a)-NAL24 was obtained. m/z [MH]+817.
  • Example 2 The procedure of Example 1 was repeated to give the di-terminated substituted dodecaethylene glycol-naloxone (a, a)-NAL212. Mlz [MH]+1169.
  • Example 8 Antagonism of PEG receptors by polyethylene glycol-naloxone conjugates.
  • Test substance double-substituted hexaethylene glycol-naloxone (a, a)-NAL26 and ( ⁇ , p)-NAL26), double-substituted tetraethylene glycol-naloxone (a, a) -NAL24, single-end substituted pentaethylene glycol-naloxone am-NAL5 and P_m-NAL5 (Beijing Key Kai Technology The company provided a total of six samples of naloxone as the test substance.
  • Naloxone hydrochloride is supplied by Beijing Jidong Bojie Technology Co., Ltd., and is formulated with calcium buffer to achieve the desired concentration.
  • Experimental principle By establishing a cell line that co-transfects MOR and Gal6, the receptor can be activated to activate Gal6 protein, which activates phospholipase C (PLC) to produce IP3 and DAG, and IP3 can interact with intracellular endoplasmic reticulum and The IP3 receptor on the mitochondria binds, causing the release of intracellular calcium. Therefore, the measurement of changes in intracellular calcium can be used as a method for detecting the activation state of MOR.
  • Fluo-4/AM is a calcium fluorescent probe indicator used to measure calcium ions.
  • CHO cells stably expressing MOR/Gal6 were seeded in 96-well plates and cultured overnight.
  • the instrument automatically adds 25 ⁇ l of calcium buffer dissolved in MOR receptor-known agonist in the 15th second, and finally reads the fluorescence at 525 nm.
  • D is the peak of calcium flow caused by the drug to be tested
  • B is the peak of calcium flow caused by the blank calcium buffer
  • S is the peak of calcium flow caused by the known agonist DAMGO.

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Abstract

提供如通式(II)的聚乙二醇一纳洛酮结合物以及包含该结合物的药物组合物。在所述结合物中,n是1-20的整数。还提供了三分支或四分支聚乙二醇与纳洛酮的结合物。通过亲水性聚合物对纳洛酮进行结构改造,改善了药物的药代动力学性质,增加纳洛酮本身的水溶性,改善药物在体内的分布,减低纳洛酮对中枢系统的毒副作用,减轻由于长期使用阿片类药物引起的肠功能紊乱及便秘。还提供了包含本发明结合物的药物组合物以及该结合物的应用。

Description

聚乙二醇与纳洛酮的结合物及其药物组合物和应用 技术领域 本发明涉及亲水性聚合物-纳络酮结合物, 尤其是小分子低聚乙二醇与纳洛酮的结合 物及其药物组合物。 背景技术 阿片类镇痛药物, 如吗啡等, 己广泛应用于临床, 是目前不可替代的强力止痛药物。 数据显示, 仅 2007年一年, 关国共有 2亿 3千力'阿片类药物处方。 阿片类药物主要作用 于阿片受体。 阿片受体包括 μ、 δ、 κ三种受体, 每种受体分别还有不同的亚型, 除中枢神 经系统外, 脊髓, 外周如胃、 小肠、 外分泌腺等都有阿片受体。 所以, 阿片类镇痛药物, 除了其中枢神经系统的强力止痛效果以外, 其作用于外周的阿片受体则产生副作用。 主要 副作用之一是阿片类药物引起的肠功能紊乱及便秘。 尤其对于慢性疼痛患者, 因为长期使 用阿片类药物缓解疼痛, 这一副作用一直影响着患者的生活质量。 纳洛酮 (结构式如 1 ), 为羟二氢吗啡酮的衍生物, 为阿片受体特异性拮抗剂, 对机 体内各类型阿片受体均有竞争性拮抗作用, 能与体内的阿片受体结合, 以对抗释放过多的 β内啡肽, 在体内吸收迅速、 代谢快、 拮抗作用也强, 易透过血脑屏障, 并取代吗啡样物 质与受体结合, 解除中枢抑制作用, 迅速恢复脑、 心、 肺等脏器的正常功能, 而且不产生 吗啡样物质的依赖性、戒断症状和呼吸抑制作用。纳洛酮是吗啡类药物过量的特效解毒剂. 也是吗啡、 海洛因依赖者的诊断用药。 近年来, 国内外临床医生也将它试用于急性酒精、 安定中毒, 脑梗塞、 急慢性呼吸衰竭及各种危重症休克的治疗, 己取得了较好的效果。 自 2002年至今, SFDA批准的纳洛酮生产批文有近百条, 2008-2009年期间, 共有 18家生产 企业为北京、 浙江、 吉林、 云南四个地区供应纳洛酮产品, 产量很大。
Figure imgf000002_0001
尽管纳洛酮已是目前临床应用最广的阿片受体拮抗剂, 但纳洛酮肝脏首过效应大, 片 剂口服基本无效, 目前临床上使用的剂型仅有注射液和舌下片两种剂型。 同时, 由于纳洛 酮血脑屏障透过率高,在减少慢性疼痛患者长期使用阿片类药物引起的肠功能紊乱及阿片 类药物引起的便秘的同时, 也抵消了阿片类药物的止痛作用。 聚乙二醇(PEG)修饰技术是近年来迅速发展起来的一项新型给药技术, 主要应用于 注射给药系统。它是一种将聚乙二醇活化后链接到药物分子或表面的技术。 药物小分子经 过聚乙二醇修饰后, 主要具有以下优点: 1、 增加药物的水溶性; 2、 降低毒性; 3、 延长 药物循环半衰期, 减少用药次数, 提高病人依从性, 提高生活质量, 降低治疗费用; 4、 减少酶降解作用, 提高生物利用度; 5、 降低血脑屏障透过率, 减少中枢副作用。 与聚乙 二醇链接后, 药物的药代动力学发生了改变, 进而改变药效学。 特别是聚乙二醇能使血药 浓度维持或接近目标浓度的时间延长, 保持药物的药效得以充分地发挥。 目前, 在国际市 场上聚乙二醇修饰的药物产品的代表有: PEG-intron®、 PEGasys®、 Neulasta®, Macugen®, Neulasta®, MICERA。 目前, 聚乙二醇修饰的小分子药物在国际市场还没有批准上市, 但 是几个产品已经进入二、 三期临床, 代表有 Nektar的 NKTE-102 和 NKTR-118。 本实验组一直致力于聚乙二醇化修饰小分子药物的研究 (ZL03 8 01109.3, ZL 2004 1 0029615.3 , ZL 2004 8 0005763.X, ZL 2008 1 0093688.7, ZL 02 1 07842.4, ZL 02 1 08778.4)。 主要是采用聚乙二醇与小分子药物进行链接, 得到的产物在增溶减毒方面有很好的改善。 采用聚乙二醇化技术对纳洛酮进行结构改造的产品(NKTR-118 ) 巳于 2011年 3月进 入三期临床 (参见 http:〃 www.nektar.com/pdf/pipeline/NKTR-l 18/pr_201 10315.pdf )。 在 NKTR-118中, 聚乙二醇只与一个活性基团连接。 本发明的目的在于克服现有技术的缺陷, 实现每个聚乙二醇与多个纳洛酮结合的问 题。本发明采用聚乙二醇化技术对纳洛酮进行结构改造, 利用低分子量的聚乙二醇与纳洛 酮进行链接, 改善药物的药代动力学性质, 增加纳洛酮本身的水溶性, 改善药物在体内的 分布, 减低纳洛酮对中枢系统的毒副作用, 减轻由于长期使用阿片类药物引起的肠功能紊 乱及便秘, 并将其开发成针剂或适合口服的制剂。 本实验组利用自身优势, 合成并筛选出 数个聚乙二醇-纳洛酮衍生物。 与 NKTR-118 不同, 本发明中的化合物每个聚乙二醇结构 与两个或多个活性基团连接。 所以, 这些化合物的阿片受体拮抗活性要优于同等分子量的
发明内容 本发明提供一种如通式 (Π) 的聚乙二醇一纳洛酮结合物或其药学上可接受的盐:
Figure imgf000003_0001
(II)
其中, n是 1-20的整数; 优选地, n是 1-15的整数; 更优选地, n是 2-15的整数。 更优 选地, n可以是 2-14的整数、 3-13的整数或 4-12的整数。 在一些实施方案中, 结合物的构型为 (α, α) 、 (β, β) 、 (α, β)或它们的混合物; 优选的构型为 (α, α) 或 (β, β) 。 本发明的另一个方面提供一种如通式(U1)的聚乙二醇一纳洛酮结合物或其药学上可 接受的盐:
Figure imgf000004_0001
(III)
其中, x、 y、 w相同或不同, 分别是 0-20的整数; 优选地, x、 y、 w相同或不同, 分别 是 0-15的整数: 更优选地, x、 y、 w相同, 且是 0-10的整数。 更优选地, x、 y、 w可以 相同或不同, 分别是 0-9、 0-8、 0-7或 0-6的整数。 在一些实施方案中, 其中, 结合物的构型为 (α, α, α) 、 (β, β, β) 、 (α, β, β) 、 (α, α, β) 或者它们的混合物; 优选的构型为 (α, α, α) 或 (β, β, β) 。 本发明的另一个方面提供一种如通式 (IV) 的聚乙二醇-纳洛酮结合物或其药学上可 接受的盐:
Figure imgf000005_0001
( IV )
其中, a、 b、 c、 d相同或不同, 分别是 0-20的整数; 优选地, a、 b、 c、 d相同或不同, 分别是 0-15的整数; 更优选地, a、 b、 c、 d相同, 且是 0-10的整数。 更优选地, a、 b、 c、 d可以相同或不同, 分别是 0-8、 0-7、 0-6或 0-5的整数。 在一些实施方案中, 其中, 结合物的构型为 (α, α, α, α ) 、 (β, β, β, β ) 、 (α, β, β, β ) 、 (α, α, β , β ) 、 (α, α, α, β ) 或者它们的混合物; 优选的构型为 (α, a, a, α) 或 (β, β, β, β ) 。 上述药学上可接受的盐, 可以是盐酸盐, 氢溴酸盐、 硫酸盐, 硝酸盐、 磷酸盐、 枸櫞 酸盐、 酒石酸盐、 富马酸盐、 马来酸盐、 乳酸盐、 苯磺酸盐、 泛酸盐、 抗坏血酸盐等, 也 可以是这些盐的组合。 本发明的另一个方面提供包含聚乙二醇-纳洛酮结合物或其药学上可接受的盐的药物 组合物。 所述的药物组合物可以进一歩包括药学上可接受的载体或赋形剂。 在一些实施方案中, 其中, 药物组合物可以构成片剂、 注射剂、 栓剂、 丸剂、 软和硬 明胶胶囊剂、 散剂、 溶液剂、 混悬剂或气雾剂。 本发明的另一个方面提供聚乙二醇-纳洛酮结合物或其药学上可接受的盐在制备用于 治疗由于长期使用阿片类药物引起的肠功能紊乱及便秘的药物中的应用。 本发明的优点是通过亲水性聚合物聚乙二醇的改性可对纳洛酮提供保护,改善药物吸 收, 改变药物体内分布, 降低血脑屏障透过率及避免毒副作用。 具体实施方式 通过聚乙二醇修饰技术在纳洛酮分子中引入低分子量聚乙二醇, 增加其亲水性, 改善 药物体内分布, 降低其血脑屏障透过率, 从而降低其毒性的目的。 本发明的结合物按如下方法制备: 对亲水性低聚乙二醇进行改性, 引入卤素或者甲磺 酰基、对苯甲磺酰基等易离去基团,然后碱性条件下与纳洛酮结合。通过引入低聚乙二醇, 改变药物在体内的分布, 改善血脑屏障透过, 改善由于长期服用阿片受体药物引起的肠功 能紊乱及便秘。 对低聚乙二醇而言, 采 ffl乙二醇聚合单元予以表示, 一般采用含有乙二醇单元的数目 来表示, 乙二醇单元数目范围为 0-20, 优选为 0-10。 本发明的聚乙二醇也包括聚乙二醇的衍生物和类似物,也可以被下述亲水性聚合物替 换, 所述的亲水性聚合物选自 ώ聚乙二醇、 聚谷氨酸、 聚天门冬氨酸、 聚丙二醇、 聚乙烯 醇、 聚丙烯吗啉、 聚噁唑啉以及它们的共聚物所组成的组。 本发明的结合物可以纯化合物形式或适宜的药物组合物形式进行给药,可采用任何可 接受的给药方式或用于类似的用途的试剂进行。 因此, 采用的给药方式可选择通过口、 鼻 内、 非肠道、 局部、 透皮或直肠方式, 其形式为固体、 半固体或液体药剂形式给药, 例如, 片剂、 栓剂、 丸剂、 软和硬明胶胶囊剂、 散剂、 溶液剂、 混悬剂或气雾剂等, 优选采用适 用于精确剂量的简单给药的单元剂量形式。组合物可包含常规药用载体或赋形剂和作为活 性成分 (一种或多种) 的本发明的结合物, 此外, 还可包含其它药剂、 载体、 辅剂等。 通常, 根据所需给药方式, 药学上可接受的组合物将包含约 1至约 99 重量%的本发 明结合物、 以及 99至 1重量%的适宜的药用赋形剂。优选组合物包含约 5至 75重量%的 本发明结合物, 其余为适宜的药用赋形剂。 可采用液体形式给药的药物组合物例如可通过溶解、 分散等手段将本发明的结合物 (约 0.5至约 20% )和选择性存在的药用辅剂溶解、 分散于载体中, 载体的实例为水、 盐 水、 含水葡萄糖、 甘油、 乙醇等, 从而形成溶液剂或混悬剂。 如果需要的话, 本发明的药物组合物还可包含少量的辅助物质, 如润湿剂或乳化剂、 pH缓冲剂、 抗氧化剂等, 例如: 柠檬酸、 脱水山梨醇单月桂酸酯、 三乙醇胺油酸酯、 丁 基化羟基甲苯等。 以下实施例用来说明本发明, 但不用来限制本发明。 实施例 实施例中所用的盐酸纳洛酮 ώ北京屹东博杰科技有限责任公司提供, 甲氧基乙氧基甲 基氯(MEMCL)从 alfa Aesar购得, 对甲苯磺酰氯从山东亿龙实业有限公司购得, 氢化钠 从梯希爱 (上海) 化成工业发展有限公司购得, H(OCH2CH2)4-OH、 H(OCH2CH2)6-OH 以及 H(OCH2CH2)12-OH从嘉兴博美生物技术有限公司购得。本发明实施例中所用的其他 试剂均为商业化学纯试剂。 实施例 1 双端取代的六乙二醇-纳洛酮 (a, O -NAL26和 (β, p)-NAL26(化合物 Ε2和 El, 其 中 f^6)的合成
Figure imgf000008_0001
Figure imgf000008_0002
Figure imgf000008_0003
D1 (β ,β )
Figure imgf000008_0004
D2 (α ,α)
Figure imgf000009_0001
Figure imgf000009_0002
E2 (α , α 化合物 B 的合成: 圆底烧瓶中加入盐酸纳洛酮 A 6g, 溶于二氯甲垸 30mL中, 全部溶解后, 加入二异丙 基乙胺 (DIPEA) 11.7g, 氮气保护下搅拌 15min, 缓慢递加 MEMCL 7.6g, 滴毕后室温 反应 24h。 TLC检测反应完全后, 停止搅拌, 加入水萃取三次(30 mL*3 ), 有机相用饱和 氯化钠溶液洗一次后, 加入无水硫酸钠干燥。 浓缩, 柱层析得到化合物 B 531%, 收率为 87%。 化合物 Cl(a构型)和 C2(p构型)的合成: 圆底烧瓶中加入化合物 B 5.37g,乙醇 180 mL, 0.2N 氢氧化钠溶液 90 mL,搅拌 15min。 分批加入硼氢化钠 2.3g, 室温搅拌过夜。 TLC检测反应完全后, 停止搅拌, 浓缩后, 用二 氯甲垸萃取三次 (100 mL*3 ), 有机相用饱和氯化钠溶液洗一次后, 加入无水硫酸钠干燥 2h。浓缩得粗品 4.7g。柱层析得到化合物 Cl(a构型) 1.66g, 收率为 31%, C2(p构型) 1.80g, 收率为 33%。 化合物 Dl(p, β)和 D2(a, a)的合成:
500mL 三口瓶中加入 22.9g 对甲苯磺酰氯, 80mL 吡啶, 冷却至 0。C。 将 14.1g H-(OCH2C¾)6-OH与 40mL吡啶混匀, 滴加到三口瓶中, 控制温度为 0-10°C。继续在此温 度下搅拌反应两小时。 TLC监测反应完全。向反应液中加入 300mL冷水及 120mL浓盐酸, 缓慢搅拌半小时, 将反应液转移入 lOOOmL 分液漏斗中, 加入乙酸乙酯萃取两次 ( 300mL+200mL 有机层合并, 用水洗至中性, 无水硫酸钠干燥两小时。 旋转蒸发仪蒸 出溶剂。 得到粘稠状液体 (Ms-(OCH2CH2)6-OMs ) 共 28.7g, 直接用于下一歩反应。 取柱层析得到的化合物 C I 801mg置于圆底烧瓶中,加入二甲基甲酰胺(DMF ) 3 mL 全部溶解后, 加入 Ms-(OCH2CH2)6-OMs 421mg,分批加入氢化钠 384mg, 30°C反应过夜。 TLC检测反应完全后, 停止搅拌, 加入 lOOmL水, 用二氯甲烷萃取三次( 100 mL*3 ), 有 机相用饱和氯化钠溶液洗一次后, 加入无水硫酸钠干燥。 浓缩得粗品, 经柱层析得到化合 物 Dl(P,P) 335mg, 收率为 23.2%。 化合物 D2(a, a)的合成同 Dl。 化合物 ΕΙ (β, β)和 E2(a,a)的合成: 将化合物 Dl(p, p)150mg溶解在 5ml无水甲醇中, 通入氯化氢气体, TLC监测反应完 成后,停止搅拌,浓缩后,缓慢加入碳酸钾水溶液调节 pH为 9,用乙酸乙酯萃取三次(100 mL*3 ) , 有机相用饱和氯化钠溶液洗一次后, 加入无水硫酸钠干燥 2h。 浓缩得粗品, 经柱 层析得到化合物 Ε1 (β, β) 98mg, 收率为 91%。 m/z [MH]+907.2。 Ή-NMR (DMSO-d6): 1.25-1.35(m, 4H), 1.45(d, 2H), 1.55- 1.60(m, 2H), 1.75-1.88(m, 4H), 2.1-2.2(m, 4H),
2.49- 2.59(m, 4H), 2.88(d, 2H), 3.00-3.10(m, 6H), 3.22(m, 2H), 3.62-3.77(m, 24H), 4.52(d, 2H), 5.12-5.20(m, 4H), 5.77(m, 2H), 6.53(d, J-8.16 Hz, 2H), 6.70(d, J=8.1 Hz,2H)。 化合物 E2(a, a)的合成同 Ε1 (β, β)。^/ζ [MH]+907.2。1H-NMR (CDC13): 1. 15-1.25(m, 4H),
1.45-1.59(m, 8H), 2.1 -2.26(m, 4H), 2.52-2.6 l (m, 4H), 2.88(d, 2H), 3.00-3.10(m, 6H), 3.55-3.77(m, 24H), 3.86-3.88(m, 2H), 4.7 l (d, 2H), 5.14-5.22(m, 4H), 5.76-5.84(m, 2H), 6.49(d, J=8.16 Hz, 2H), 6.70(d, J=8.1 Hz, 2H)。 实施例 2双端取代的四乙二醇-纳洛酮 (a, a)-NAL24(化合物 E2, 其中 ί^4)的合成 用四乙二醇代替六乙二醇, 重复实施例 1 的歩骤得到双端取代的四乙二醇-纳洛酮 (a, a)-NAL24。 m/z [MH]+817。 1H-NMR (CDC13): 1. 14-1.24(m, 4H), 1.46-1.58(m, 8H), 2.1-2.23(m, 4H), 2.52-2.62(m, 4H), 2.89(d, 2H), 3.00-3. l l(m, 6H), 3.55-3.78(m, 16H), 3.86-3.89(m, 2H), 4.72(d, 2H), 5.15-5.21(m, 4H), 5.77-5.85(m, 2H), 6.50(d, J=8.16 Hz, 2H), 6.71(d,J=8.1 Hz, 2H)。 实施例 3 双端取代的十二乙二醇-纳洛酮 (a, a)-NAL212(化合物 E2, 其中 f=12)的合成 用 H(OCH2CH2)12-OH代替六乙二醇, 重复实施例 1的歩骤得到双端取代的十二乙二 醇-纳洛酮(a, a)-NAL212。 mlz [MH]+1169。 1H-NMR (CDC13): 1. 12-1.24(m, 4H), 1.45-1.589(m, 8H), 2.11-2.24(m, 4H), 2.50-2.61(m, 4H), 2.89(d, 2H), 3.02-3. l l (m, 6H),
3.50- 3.78(m, 48H), 3.86-3.90(m, 2H), 4.7 l(d, 2H), 5.14-5.20(m, 411), 5.75-5.85(m, 2H), 6.5 l(d, J=8.17 Hz, 2H), 6.70(d, J=8.1 Hz, 2H)。
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实施例 5 三分支的乙二醇-纳洛酮结合物 (NAL37)(化合物 N)的合成
Figure imgf000013_0001
Figure imgf000013_0002
化合物 L的合成: 参考文献: J Org.Cfew. 2006, 71 , 9884-9886. 化合物 M的合成与实施例 4中化合物 I的合成相似, 其中用化合物 L代替化合物 H。 化合物 N(NAL37)的合成: 用化合物 L代替化合物 H, 重复实施例 4的歩骤得到三分支取代的乙二醇-纳洛酮 (α, α,α)- NAL37。 m/z [ΜΗ] 963.60 Ή-NMR (DMSO-d6) : 1.22-1.35(m, 6H), 1.47(d, 3H), 1.57-1.64(m, 3H), 1.74-1.88(m, 6H), 2.0-2.22(m, 6H), 2.50-2.57(m, 6H), 2.68(m, 1H), 2.88(d, 3H), 3.01-3.08(m, 9H), 3.24(m, 3H), 3.55-3.78(m, 90H), 4.52(d, 3H), 5.1 1-5.18(m, 6H), 5.77(m, 3H), 6.54(d, J=8.16 Hz, 3H), 6.71 (d, J=8.1 Hz,3H)。 实施例 6 四分支乙二醇与纳洛酮结合物 (NAL41)(化合物 Q)的合成 四分支乙二醇 (M,)的合成: 参考 Bulletin of Academy of Sciences of the USSR, Division of Chemical Science (English Translation); vol. 38; nb. 10; (1989); p. 2207。 化合物 ^的合成: 250mL三口瓶中加入 19.06g对甲苯磺酰氯, 40mL吡啶, 冷却至 0°C。 将 7.8g化合 物 ^ll与20mL吡啶混匀, 滴加到三口瓶中, 控制温度为 0-10°C。 继续在此温度下搅拌反 应两小时。 TLC监测反应完全。 向反应液中加入 lOOmL冷水及 60mL浓盐酸, 缓慢搅拌 半小时, 将反应液转移入 lOOOmL分液漏斗中, 加入乙酸乙酯萃取两次(300mL+200mL)。 有机层合并, 用水洗至中性, 无水硫酸钠干燥两小时。 旋转蒸发仪蒸出溶剂。 得到粘稠状 液体共 14.7g, 直接用于下一步反应。 化合物 P的合成: 取柱层析得到的化合物 CI 834mg置于圆底烧瓶中, 加入 DMF 3 mL全部溶解后, 加 入化合物 N^ Umg, 分批加入氢化钠 389mg, 30Γ反应过夜。 TLC检测反应完全后, 停 止搅拌, 加入 lOOmL水, 用二氯甲垸萃取三次(100 mL*3 ), 有机相用饱和氯化钠溶液洗 一次后,加入无水硫酸钠干燥。浓縮得粗品,经柱层析得到化合物 P 136mg,收率为 16.3%。 化合物 Q 的合成: 将化合物 P 136mg溶解在 5ml无水甲醇中, 通入氯化氢气体, TLC监测反应完成后, 停止搅拌,浓缩后,缓慢加入碳酸钾水溶液调节 pH为 9,用乙酸乙酯萃取三次( 100 mL*3 ), 有机相用饱和氯化钠溶液洗一次后, 加入无水硫酸钠干燥。 浓缩得粗品. 经柱层析得到化 合物 Q 85mg, 收率为 76.6%。 [MH]+1556.7。 Ή-NMR (DMSO-d6): 1.24-1.33(m, 8H), 1.47(d, 4H), 1.55-1.60(m, 4H), 1.74-1.89(m, 8H), 2.1-2.22(m, 8H), 2.47-2.61(m, 8H), 2.89(d, 4H), 3.01-3. l l(m, 12H), 3.23(m, 4H), 3.61-3.79(m, 24H), 4.54(d, 4H), 5.11-5.18(m, 8H), 5.79(m, 4H), 6.54(d, J=8.16 Hz, 4H), 6.70(d, J=8.1 Hz,4H)。
Figure imgf000015_0001
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实施例 8 聚乙二醇-纳洛酮结合物对 MOR受体的拮抗作用。 受试物: 双端取代的六乙二醇-纳洛酮 (a, a)-NAL26和 (β, p)-NAL26)、 双端取代的四乙二醇-纳 洛酮 (a, a)-NAL24、 单端取代的五乙二醇-纳洛酮 a-m-NAL5和 P_m-NAL5 (北京键凯科技 有限公司提供) 及纳洛酮共六个样品作为受试物。 阳性对照物: Beta-FNA, 是由国家新药筛选中心提供, 临用时用钙缓冲液配制成所需浓度。
盐酸纳洛酮 ώ北京屹东博杰科技有限责任公司提供,临用时用钙缓冲液配制成所需浓 度。 实验原理: 通过建立了共转 MOR和 Gal6的细胞系, 使得受体被激活后能引起 Gal6蛋白的活 化, 进而激活磷脂酶 C (PLC)产生 IP3和 DAG, IP3可与细胞内内质网和线粒体上的 IP3 受体结合, 从而引起胞内钙的释放。 因此, 测定胞内钙的变化可以作为检测 MOR活化状 态的方法。 Fluo-4/AM是一种钙荧光探针指示剂用来测量钙离子, 作为非极性脂溶性的化 合物, 进入细胞后在细胞脂解酶的作用下, AM基团解离, 释出 Fluo-4; 由于 Fluo-4是极 性分子, 不易通过脂质双分子膜, 它可使 Fluo-4长时问保留在细胞内。最终可以通过测量 被激发的荧光强度来反映 Get蛋白被激活的水平。如果筛选的化合物能够拮抗 MOR受体, 则可以使钙流反应大大降低。 实验歩骤:
1. 将稳定表达 MOR/Gal6的 CHO细胞种于 96孔板, 培养过夜。
2. 吸去种有细胞的孔内的培液, 加入新鲜配制的染料 40 μΐ/孔, 37°C培养箱内恒温孵育 40 分钟。
3. 用钙缓冲液将待测的药物稀释并混匀。
4. 将染料吸尽弃去, 用新鲜配制的钙缓冲液洗一遍后, 换上 50 μΐ溶解有待测药物的钙缓 冲液。
5. 用 FlexStation II仪检测, 第 15秒幵始由仪器自动加入 25 μΐ溶解有 MOR受体己知激动剂 的钙缓冲液, 最终读取 525 nm处荧光值。
6. 数据处理:
% response = (D-B)/(S-B)* 100%;
其中 D为待测药物引起的钙流峰值, B为空白的钙缓冲液引起的钙流峰值, S为已知激动剂 DAMGO引起的钙流峰值。 实验结果: 六个受试物在 MOR受体上都有拮抗效应; 化合物 Mw IC50 (M) 95 %可信限 (M)
Beta-FNA 2.619e-009 1.370e-009 至 5.008e-009
NAL 365.85 1.524e-008 8.488e-009 至 2.737e-008
(a, a)-NAL26 905.08 9.555e-009 4.225e-009 至 2.161e-008
(β, p)-NAL26 905.08 2.344e-008 1.289e-008 至 4.186e-008
(a, a)-NAL24 816.98 7.156e-009 3.799e-009 至 1.348e-008 a-m-NAL5 579.72 3.369e-009 8.702e-009 至 1.305e-007 p-m-NAL5 579.72 7.814e-008 3.140e-008 至 1.945e-007

Claims

权利要求 一种如通式 (II ) 的聚乙二醇一纳洛酮结合物或其药学上可接受的盐:
Figure imgf000020_0001
其中, I 是 1 -20的整数。
2. 如权利要求 1所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 其中, n是 15的整数。
3. 如权利要求 1所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 其中, η是 2-15的整数。
4. 如权利要求 1 所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 其中, 所 述结合物的构型为 (α, α) 、 (β, β ) 、 (α, β ) 或它们的混合物。
5. 如权利要求 4 所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 其中, 所 述结合物的构型为 (α, ) 。
6. 如权利要求 4所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 其中, 所 述结合物的构型为 (β, β ) 。
7. 如权利要求 1 所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 所述结合 物选自具有如下结构的结合物:
Figure imgf000020_0002
E1 (β , β ) 或
Figure imgf000021_0001
E2 (a , a )
其中, f为 4 、 6或 12。
8. —种如通式 (III) 的聚乙二醇一纳洛酮结合物或其药学上可接受的盐:
Figure imgf000021_0002
(III)
其中, x、 y、 w相同或不同, 分别是 0-20的整数。
9. 如权利要求 8所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 其中, X .. y、 w相同或不同, 分别是 0-15的整数。
10. 如权利要求 8所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 其中, X, y、 w相同, 且是 0-10的整数。
11. 如权利要求 8所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 其中, 所 述结合物的构型为 (α, α, α) 、 (β, β, β) 、 (α, β, β) 、 (α, α, β) 或者它们的混 合物。
12. 如权利要求 11 所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 其中, 所述结合物构型为 (α, α, α) 。
13. 如权利要求 11 所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 其中, 所述结合物构型为 (β, β, β) 。
14. 如权利要求 8所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 所述结合 物选自具有如下结构的结合物
Figure imgf000022_0001
Figure imgf000023_0001
15. 一种如通式 (IV ) 的聚乙二醇 -纳洛酮结合物或其药学上可接受的盐:
Figure imgf000024_0001
( IV )
其中, a、 b、 c, d相同或不同, 分别是 0-20的整数。
16. 如权利要求 14所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐,其中, a、 b、 c、 d相同或不同, 分别是 0-15的整数。
17. 如权利要求 14所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐,其中, a、 b、 c、 d相同, 且是 0-10的整数。
18. 如权利要求 14 所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 其中, 所述结合物的构型为 (α, α, α, α) 、 (β, β, β, β ) 、 (α, β, β, β) 、 (α, α, β, β ) 、 ( α, α, α, β ) 或者它们的混合物。
19. 如权利要求 18 所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 其中, 所述结合物的构型为 (α, α, α, α) 。
20. 如权利要求 18 所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 其中, 所述结合物的构型为 (β, β, β, β )
21. 如权利要求 15 所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 所述结 合物选自具有如下结构的结合物:
Figure imgf000025_0001
Figure imgf000026_0001
22. 如前述任一项权利要求所述的聚乙二醇一纳洛酮结合物或其药学上可接受的盐, 其中所述的盐选自由盐酸盐, 氢溴酸盐、硫酸盐, 硝酸盐、 磷酸盐、 枸櫞酸盐、酒石酸盐、 富马酸盐、 马来酸盐、 乳酸盐、 苯磺酸盐、 泛酸盐、 抗坏血酸盐或其组合组成的组。
23. 包含如权利要求 1 至 22之任一项所述的结合物或其药学上可接受的盐的药物组 合物。
24. 如权利要求 23 所述的药物组合物, 其中, 所述药物组合物构成片剂、 注射剂、 栓剂、 丸剂、 软和硬明胶胶囊剂、 散剂、 溶液剂、 混悬剂或气雾剂。
25. 如权利要求 1 至 22之任一项所述的结合物或其药学上可接受的盐在制备用于治 疗由于长期使用阿片类药物引起的肠功能紊乱及便秘的药物中的应用。
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CN103289075B (zh) 2016-01-20
CN103289075A (zh) 2013-09-11
US8962647B1 (en) 2015-02-24

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