WO2021218506A1 - 孕激素在制备抑制细胞因子风暴的药物中的应用 - Google Patents
孕激素在制备抑制细胞因子风暴的药物中的应用 Download PDFInfo
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- WO2021218506A1 WO2021218506A1 PCT/CN2021/082899 CN2021082899W WO2021218506A1 WO 2021218506 A1 WO2021218506 A1 WO 2021218506A1 CN 2021082899 W CN2021082899 W CN 2021082899W WO 2021218506 A1 WO2021218506 A1 WO 2021218506A1
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- Prior art keywords
- cytokine storm
- storm syndrome
- progestin
- syndrome
- coronavirus
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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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
- A61K31/57—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K39/395—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum
- A61K39/39533—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum against materials from animals
- A61K39/39541—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum against materials from animals against normal tissues, cells
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/04—Antibacterial agents
- A61P31/06—Antibacterial agents for tuberculosis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/12—Antivirals
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/12—Antivirals
- A61P31/14—Antivirals for RNA viruses
-
- 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
- A61P37/02—Immunomodulators
- A61P37/06—Immunosuppressants, e.g. drugs for graft rejection
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
- C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
- C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
- C07K16/2803—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily
- C07K16/2809—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily against the T-cell receptor (TcR)-CD3 complex
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/505—Medicinal preparations containing antigens or antibodies comprising antibodies
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K2317/00—Immunoglobulins specific features
- C07K2317/70—Immunoglobulins specific features characterized by effect upon binding to a cell or to an antigen
- C07K2317/75—Agonist effect on antigen
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
Definitions
- the present invention belongs to the field of treatment of immune diseases and infectious diseases. Specifically, this application provides the application of PR2005 in the preparation of drugs for suppressing cytokine storm, especially cytokine storm caused by diseases such as new coronavirus pneumonia.
- Cytokines are small molecules released by cells into the blood. They can make immune cells move to the site of infection, swallow damaged cells, and even penetrate blood vessel walls. At the same time, cytokines can also cause inflammation, causing the damaged body to swell, heat, and pain.
- Cytokine storm syndrome is a systemic inflammatory response caused by hypersensitivity activation of the immune system.
- the specific known symptoms include fever, headache, rash, arthralgia, muscle pain, hypotension, vascular leakage, diffuse intravascular coagulation and even more Organ failure, etc.
- related indicators also include lymphopenia, increased creatinine, disorder of coagulation parameters, and increased ferritin and protein C.
- cytokine storm Common clinical causes of cytokine storm include CART treatment, H5N1, H1N1, SARS, MERS, COVID-19, etc.
- cytokine storm syndrome the specific pathophysiological mechanism of cytokine storm syndrome is not clear (it is speculated to be related to cytolytic immune response), and there is no specific corresponding treatment drug.
- most of the clinical management experience of cytokine storm syndrome comes from immunotherapy In particular, the symptoms of CRS caused by adoptive cell therapy. In influenza virus and coronavirus infections, there is no clear treatment guideline.
- the drugs that have been tried to treat cytokine storm syndrome include peroxisome proliferation activated receptors. Body agonists, sphingosine-1-phosphate receptor agonists, cyclooxygenase inhibitors, antioxidants, anti-tumor necrosis factor therapy, intravenous immunoglobulin and other therapies.
- the new coronavirus pneumonia (COVID-19) caused by the new coronavirus (SARS-CoV-2) is a major threat to human health and socio-economic development.
- a large part of the deaths from new coronavirus pneumonia are related to cytokine storms (Mehta P, etc., COVID-19: consider cytokine storm syndromes and immunosuppression, Lancet, Volume 395, published online on March 16, 2020; Fu B, etc. , Pathogenic T cells and inflammatory monocytes incite inflammatory storm in several COVID-19 patients, J Transl Med, April 2004, Volume 18, Issue 1).
- Inhibiting cytokine storm syndrome is the same as inhibiting virus invasion/replication. It is one of the main ways to treat new coronavirus pneumonia and reduce the mortality rate of new coronavirus pneumonia.
- hydroxyprogesterone caproate which is in the development stage, is a drug candidate with high efficacy and low potential for side effects.
- the test results prove that hydroxyprogesterone caproate can suppress the cytokine storm that appears in animal models.
- PR2005 may become a clinical drug for the treatment of new coronavirus pneumonia.
- this application claims to protect the application of progesterone in the preparation of drugs for inhibiting cytokine storm syndrome.
- the present application claims a pharmaceutical composition for inhibiting cytokine storm syndrome, which is characterized in that it contains a progestin.
- the present application claims a method for treating coronavirus infections, which is characterized in that progesterone is administered.
- the progesterone can be selected from hydroxyprogesterone caproate, medroxyprogesterone acetate, progesterone, etc., preferably hydroxyprogesterone caproate.
- the cytokine storm syndrome can be cytokine storm syndrome caused by various viral infections, macromolecular antibody therapy, organ transplantation or CAR-T therapy.
- the infection can be coronavirus, influenza virus and other viral infections.
- the coronavirus infection disease may be new coronavirus pneumonia, Middle East respiratory syndrome, and severe acute respiratory syndrome, preferably new coronavirus pneumonia. These diseases can be treated by administering progesterone to suppress the cytokine storm in these diseases
- the new coronavirus described in this application has a variety of naming methods, including but not limited to new coronavirus, 2019-nCov, SARS-CoV-2 (officially named by the International Committee for Classification of Viruses); the disease caused by the virus infection can be called For the new type of coronavirus pneumonia, NCP, COVID-19 (officially named by the International Health Organization), etc.
- hydroxyprogesterone caproate is also called 17- ⁇ hydroxyprogesterone caproate, 17-HPC, 17-hydroxyprogesterone caproate, 17-hydroxyprogesterone, and its CAS number is 630-56-8.
- the code name of PR2005 is used in the experimental part.
- the drugs in this application can be in any clinically acceptable dosage form, and the drugs in the treatment of this application can be administered in any clinically acceptable dosage form.
- Specific dosage forms include, but are not limited to: tablets, capsules, oral liquids, injections, powder injections, etc.
- the medicine prepared by the present invention may also contain other known and unknown drugs for the treatment of related diseases.
- the treatment method of the present invention may also use other known and unknown drugs for the treatment of related diseases.
- These drugs include but are not limited to: Drugs used to treat autoimmune diseases, such as immunosuppressants, peroxisome proliferator-activated receptor agonists, sphingosine-1-phosphate receptor agonists, cyclooxygenase inhibitors, antioxidants, Anti-tumor necrosis factor therapy, intravenous immunoglobulin and other therapies.
- Drugs used to treat infections such as antibiotics, antifungal drugs, viral replication inhibitors, viral invasion inhibitors, and known and unknown drugs used to treat symptoms such as fever, vomiting, and skin problems in related diseases.
- various pharmaceutically acceptable excipients can be used in the medicine, including but not limited to coating materials, solvents, solubilizers, binders, stabilizers, antioxidants, pH regulators, and flavoring agents, These auxiliary ingredients can be selected by those skilled in the art according to common knowledge in pharmacy.
- mice bred under conditions without specific pathogens were used in the experiment. All experimental procedures were approved by the animal ethics committee. All antibodies used for flow cytometry were purchased from outside. The endotoxin level of these antibodies is less than 0.5IU/mg on average.
- PBMCs Human peripheral blood mononuclear cells
- PBMC peripheral blood mononuclear cells
- hu-SCID severe combined immunodeficiency mice
- mice with severe combined immunodeficiency mice mice with severe combined immunodeficiency mice
- the ratio of CD45 cells is 3:1 and 0.4:1, respectively. This equates to 1-2 ⁇ 10 7 cells in the spleen personal CD45, per milliliter of blood in 1 ⁇ 10 6 CD45 individual cells.
- Morolizumab-CD3 has serious adverse reactions after infusion.
- Ten days after adoptive transplantation of human PBMC human cells isolated from the spleen of hu-SCID mice can still bind to OKT3.
- IV intravenous
- IP intraperitoneal
- mice After administration of OKT3 and control IgG, blood was collected from the mice at 10 min, 20 min, and 60 min. The collected heparinized plasma is then applied to multiple immunoassay systems to analyze cytokines.
- the cytokines measured include human IL-1 ⁇ , IL-2, IL-4, IL-5, IL-6, IL-10, IL-12 (p70), IL-13, IL-17, IFN- ⁇ and TNF - ⁇ .
- the mice After the last blood collection (60 min), the mice were sacrificed. Then use flow cytometry to analyze its activation markers. The mouse spleen and human peripheral blood mononuclear cells were blocked with 2.4G2, and then stained with fluorescently labeled CD69, CD25, CD45 and CD3.
- Body temperature measurement The rectal temperature of the mice was measured before treatment, and the rectal temperature was measured again before each blood sampling point. The temperature is measured by inserting a rectal thermocouple probe and waiting for the number to stabilize ( ⁇ 10s) to obtain a reading. The mice with body temperature ⁇ 32°C were sacrificed.
- IP injection group In the low-dose 2 ⁇ g IP route administration, all hu-SCID mice were not affected. The clinical score of Hu-SCID mice that received 10 ⁇ g OKT3IP administration was moderate (back arched, too little activity), and 1 out of 5 mice appeared dying and was sacrificed at 2 h.
- hypothermia and hyperthermia will appear in the cytokine storm. To this end, we made observations.
- OKT3 group After 10 ⁇ g OKT3 was injected by IP or IV, the rectal temperature dropped severely from 37°C to below 32°C within 1 hour. At a lower dose of 2 ⁇ g, IV route administration resulted in transient hypothermia ( ⁇ 32°C) at 1h, which was partially recovered after 5h; the moderate change after IP administration was similar to that of control human IgG injection The results are similar.
- IgG control group No significant change in body temperature.
- cytokines in the plasma of hu-SCID mice human IL-1 ⁇ , IL-2, IL-4, IL-5, IL-6, IL -10, IL-12 (p70), IL-13, IL17, IFN- ⁇ and TNF- ⁇ .
- OKT3 group High-dose (10 ⁇ g) injection of OKT3-IP with IP can induce the production of a variety of cytokines, including IL-1 ⁇ , IL-2, IL-4, IL-5, IL-6, IL-10 and IFN- ⁇ , Its concentration gradually increased in the 5h test time course; in addition, it also induced the production of TNF- ⁇ , but its peak appeared earlier (at 1h).
- Hu-SCID mice that received a high-dose IV injection of OKT3 were sacrificed 1 hour later, so cytokines could not be detected after this time point. Regardless of whether 2 ⁇ g OKT3 was injected by IP or IV, induced cytokines were rarely detected at any point in time.
- IgG control group no cytokine changes were seen.
- Table 1 The rectal temperature of hu-SCID mice induced by OKT3 injection. The data is the mean of each group of animals. Compared with the control group at the same time point.
- Cytokines induced after OKT3 injection Hu-SCID mice were injected with 10 ⁇ g OKT3IP (black bar) or IgG control IP (gray bar). Blood was collected at 1h, 2h, and 5h to determine the concentration of circulating cytokines. The sensitivity (limit of detection) of the analytical method is 1 ng ml -1 . The data is expressed as the mean of each group of animals. Compared with the control group at the same time point.
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Abstract
Description
Claims (15)
- 孕激素在制备抑制细胞因子风暴综合征的药物中的应用。
- 根据权利要求1所述的应用,其中所述孕激素为己酸羟孕酮。
- 根据权利要求1或2的应用,其中所述细胞因子风暴综合征为各类病毒感染,大分子抗体治疗,器官移植或CAR-T治疗引起的细胞因子风暴综合征。
- 根据权利要求3的应用,其中所述细胞因子风暴综合征为冠状病毒,流感病毒和其他病毒感染引起的细胞因子风暴综合征。
- 根据权利要求4的应用,其中所述细胞因子风暴综合征为新型冠状病毒感染引起的细胞因子风暴综合征。
- 一种用于抑制细胞因子风暴综合征的药物组合物,其特征在于,包含孕激素。
- 根据权利要求6所述的药物组合物,其中所述孕激素为己酸羟孕酮。
- 根据权利要求6或7的药物组合物,其中所述细胞因子风暴综合征为各类病毒感染,大分子抗体治疗,器官移植或CAR-T治疗引起的细胞因子风暴综合征。
- 根据权利要求8的的药物组合物,其中所述细胞因子风暴综合征为冠状病毒感染引起的细胞因子风暴综合征。
- 根据权利要求9的的药物组合物,其中所述细胞因子风暴综合征为新型冠状病毒感染引起的细胞因子风暴综合征。
- 治疗冠状病毒感染疾病的方法,其特征在于,施用孕激素。
- 根据权利要求11的方法,其中所述孕激素为己酸羟孕酮。
- 根据权利要求11或12的方法,其中所述冠状病毒为新型冠状病毒。
- 根据权利要求11-13任一项的方法,其中冠状病毒感染疾病为新型冠状病毒肺炎。
- 根据权利要求11-14任一项的方法,其中施用孕激素抑制所述冠状病毒感染疾病中的细胞因子风暴综合征。
Priority Applications (7)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP21797288.4A EP3981411A4 (en) | 2020-04-28 | 2021-03-25 | APPLICATION OF PROGESTIN IN THE PREPARATION OF A DRUG INHIBITING CYTOKINE SHOCK |
CA3145350A CA3145350A1 (en) | 2020-04-28 | 2021-03-25 | Application of progestin in preparation of drug inhibiting cytokine storm |
KR1020217043443A KR20220016233A (ko) | 2020-04-28 | 2021-03-25 | 사이토카인 폭풍을 억제하는 약물의 제조에서 프로게스토겐의 응용 |
JP2021577948A JP2022538358A (ja) | 2020-04-28 | 2021-03-25 | サイトカインストームを抑制する医薬品の製造におけるプロゲストーゲンの使用 |
US17/623,331 US20230020546A1 (en) | 2020-04-28 | 2021-03-25 | Application of progestin in preparation of drug inhibiting cytokine storm |
BR112022000957A BR112022000957A2 (pt) | 2020-04-28 | 2021-03-25 | Uso de progestógeno para inibir tempestade de citocina e composição compreendendo progestógeno |
ZA2022/01174A ZA202201174B (en) | 2020-04-28 | 2022-01-25 | Application of progestin in preparation of drug inhibiting cytokine storm |
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CN202010350632.6 | 2020-04-28 | ||
CN202010350632.6A CN113559107B (zh) | 2020-04-28 | 2020-04-28 | 孕激素在制备抑制细胞因子风暴的药物中的应用 |
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US (1) | US20230020546A1 (zh) |
EP (1) | EP3981411A4 (zh) |
JP (1) | JP2022538358A (zh) |
KR (1) | KR20220016233A (zh) |
CN (1) | CN113559107B (zh) |
BR (1) | BR112022000957A2 (zh) |
CA (1) | CA3145350A1 (zh) |
WO (1) | WO2021218506A1 (zh) |
ZA (1) | ZA202201174B (zh) |
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CN114533741A (zh) * | 2020-11-25 | 2022-05-27 | 河南农业大学 | 孕酮的抗病毒用途 |
JP2023510054A (ja) * | 2020-12-17 | 2023-03-13 | シェンチェン エバーグリーン セラピューティクス カンパニー リミテッド | サイトカイン放出症候群の治療におけるプロゲストーゲンの使用 |
CN116077416A (zh) * | 2021-11-05 | 2023-05-09 | 深圳埃格林医药有限公司 | 一种包含孕激素的新型口服制剂及制备方法和应用 |
CN116355844B (zh) * | 2023-05-31 | 2023-08-18 | 吉林大学第一医院 | 一种SARS-CoV-2抗原诱发细胞因子风暴模型的建立及应用 |
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2020
- 2020-04-28 CN CN202010350632.6A patent/CN113559107B/zh active Active
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2021
- 2021-03-25 JP JP2021577948A patent/JP2022538358A/ja active Pending
- 2021-03-25 WO PCT/CN2021/082899 patent/WO2021218506A1/zh unknown
- 2021-03-25 BR BR112022000957A patent/BR112022000957A2/pt not_active IP Right Cessation
- 2021-03-25 CA CA3145350A patent/CA3145350A1/en active Pending
- 2021-03-25 KR KR1020217043443A patent/KR20220016233A/ko not_active Application Discontinuation
- 2021-03-25 US US17/623,331 patent/US20230020546A1/en active Pending
- 2021-03-25 EP EP21797288.4A patent/EP3981411A4/en not_active Withdrawn
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- 2022-01-25 ZA ZA2022/01174A patent/ZA202201174B/en unknown
Patent Citations (3)
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JP2022538358A (ja) | 2022-09-01 |
CA3145350A1 (en) | 2021-11-04 |
KR20220016233A (ko) | 2022-02-08 |
ZA202201174B (en) | 2023-04-26 |
US20230020546A1 (en) | 2023-01-19 |
BR112022000957A2 (pt) | 2022-04-05 |
EP3981411A4 (en) | 2022-09-14 |
CN113559107A (zh) | 2021-10-29 |
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EP3981411A1 (en) | 2022-04-13 |
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