CN108354914A - 包含植物大麻素次大麻二酚(cbdv)和大麻二酚(cbd)的药物组合物 - Google Patents
包含植物大麻素次大麻二酚(cbdv)和大麻二酚(cbd)的药物组合物 Download PDFInfo
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- CN108354914A CN108354914A CN201810149043.4A CN201810149043A CN108354914A CN 108354914 A CN108354914 A CN 108354914A CN 201810149043 A CN201810149043 A CN 201810149043A CN 108354914 A CN108354914 A CN 108354914A
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Abstract
本发明涉及包含或基本上由植物大麻素次大麻二酚(CBDV)和大麻二酚(CBD)组成的药物组合物。该组合物用于神经病症的治疗是特别安全和有效的,所述神经病症以中枢神经系统的过度兴奋、惊厥或癫痫发作例如发生在癫痫中的中枢神经系统的过度兴奋、惊厥或癫痫发作为特征。优选地,CBDV和CBD与大麻的至少一种非大麻素组分例如一种或多种萜类或萜部分(terpene fraction)一起存在。更具体地,该组合物还包含一种或多种大麻色烯类化合物(cannabichromene type compound)。特别地,大麻色烯丙基变体(CBCV)和/或大麻色烯(CBC)。更具体地,该组合物还不存在或基本上不存在其他大麻素,包括特别是通常大量存在于培育为含有大量CBDV和/或CBD的大麻化学型中的四氢大麻酚(THC)和四氢次大麻酚(THCV)。
Description
本申请是申请日为2012年09月14日,申请号为201280047000.6,发明名称为“包含植物大麻素次大麻二酚(CBDV)和大麻二酚(CBD)的药物组合物”的申请的分案申请。
技术领域
本发明涉及包含或基本上由植物大麻素(phytocannabinoid)次大麻二酚(cannabidivarin,CBDV)和大麻二酚(cannabidiol,CBD)组成的药物组合物。
该组合物用于神经病症的治疗是特别安全和有效的,所述神经病症以中枢神经系统的过度兴奋、惊厥或癫痫发作例如发生在癫痫中的中枢神经系统的过度兴奋、惊厥或癫痫发作为特征。
优选地,CBDV和CBD与大麻的至少一种非大麻素组分例如一种或多种萜类或萜部分(terpene fraction)一起存在。
更具体地,组合物还包含一种或多种大麻色烯类化合物(cannabichromene typecompound)。特别地,大麻色烯丙基变体(cannabichromene propyl variant,CBCV)和/或大麻色烯(cannabichromene,CBC)。
更具体地,组合物还不存在或基本上不存在其他大麻素,包括特别是通常大量存在于培育为含有大量CBDV和/或CBD的大麻化学型(chemotype)中的四氢大麻酚(THC)和四氢次大麻酚(THCV)。
背景技术
癫痫是一种呈现宽范围疾病的慢性神经疾患,影响世界范围内约5000万人(Sander,2003)。对身体内的“内源性大麻素”系统的了解的进步已导致基于大麻的药物可能具有治疗这种中枢神经系统的过度兴奋的疾患的潜力的建议(Mackie,2006,Wingerchuk,2004,Alger,2006)。
已将大麻归为促惊厥(Brust等人,1992)及抗惊厥两方面的效果。因此,大麻素是代表一个未被人所知的治疗抗惊厥剂或,相反地,是大麻的消遣和药用的使用者的潜在的风险因素还有待确定(Ferdinand等人,2005)。
1975年,Consroe等人描述了标准的治疗(苯巴比妥和苯妥英)没有控制住其癫痫发作的青年的病例。当他在社交中开始抽大麻时,他没有癫痫发作。然而,当他仅吃大麻时,癫痫发作复发。他们推断“大麻在人癫痫中可能具有抗惊厥的效果”。
Ng(1990)的一项研究涉及在其首次癫痫发作后已住院的308名癫痫患者的较大的群体。将他们与还没有过癫痫发作的294名患者的对照群体相比,并发现使用大麻似乎减少癫痫发作的可能性。然而此项研究被医学研究所(Institute of Medicine)报告(1999)批评,声称其是“无说服力的”,因为“该研究没有包括在住院之前的健康状况测量且他们健康状况的差异可能已经影响了他们的药物使用”而不是反过来。
三个对照试验已经研究了大麻二酚的抗癫痫潜力。在每一个中,大麻二酚以口服方式被给予全身性大发作或局灶性癫痫发作的患者。
Cunha等人(1980)报道了16名对常规药物治疗症状没有改善的大发作患者的一项研究。患者接受他们的常规药物治疗及200-300mg的大麻二酚或安慰剂。在接受CBD的患者中,3名显示完全的改善、2名部分的、2名较小的,而1名保持不变。唯一的不利作用是轻度镇静。在接受安慰剂的患者中,1名改善且7名保持不变。
Ames(1986)报道了在标准抗癫痫药物之外,每天给予12名癫痫患者200-300mg大麻二酚的不够成功的研究。在癫痫发作频率上似乎没有显著改善。
Trembly等人(1990)持续10个月,在每天被给予900-1200mg的大麻二酚的单一的患者身上进行开放试验。此单一患者的癫痫发作频率明显地减少。
除了表明CBD可能是有益的公开文献之外,有一份报道(Davis&Romsey),对5名教养院儿童施用四氢大麻酚(THC),所述儿童对其标准治疗(苯巴比妥和苯妥英)没有响应。一名变得彻底无癫痫发作,一名变得几乎完全没有癫痫发作,且另外三名没比之前更差。
在WO 2006/054057中,表明大麻素四氢次大麻酚(THCV)可能起抗癫痫的作用。然而,此文件中的主要教导是确定THCV充当CB1拮抗剂。
申请WO 2007/138322表明CBD是CB1和CB2受体的反向激动剂,并表明该化合物和结构上相关的化合物包括CBDV,可在涉及此类受体的宽范围的病症中具有治疗的益处。更特别地,此数据证明了大麻素CBD减少了大鼠体重。
然而,对大麻素的其他研究已表明,尽管THCV的结构与THC相似,这两种化合物对CB1受体的表现完全不同,并因此,由此可见丙基大麻素类似物将不会表现得像其戊基等同物一样。
此外,Deshpande等人在2007年的研究确定了CB1拮抗剂利莫那班是促惊厥剂;此项研究证明了CB1受体的拮抗作用引起了癫痫活跃。从此项研究的推论,充当该CB1受体拮抗剂的大麻素作为抗惊厥剂可能是没用的;事实上,其可能会加剧该病症。
申请WO 2007/083098描述了具有神经保护特性的大麻植物提取物的用途。在该医学领域中,含有THC和CBD的大麻素提取物被证明比其纯的对应物更有效。
申请WO 02/064109描述了使用大麻素THC和CBD的药物制剂。该申请继续声明这些大麻素的丙基类似物也可被用于所述制剂。从撰写该申请以来,已经显示THCV以与THC非常不同的方式起作用,并因此大麻素的丙基类似物可能以与其戊基对应物相似的方式起作用的假设现在是无效的。
申请GB2471565描述了THCV用于全身性癫痫发作治疗的用途;其还描述了CBD与THCV组合的用途。
申请GB1005364.3(未公布)描述了CBDV用于癫痫治疗的用途。
癫痫病症是非常难治的疾病,存在多于四十种可识别的癫痫综合征类型,部分归因于患者之间癫痫发作敏感性的不同(McCormick和Contreras,2001,Lutz,2004),且挑战是找到有效对抗这些不同类型的药物。
神经元活动是正常的大脑功能的先决条件。然而,扰乱神经元活动的兴奋-抑制平衡可引起癫痫发作。这些癫痫发作可被分成两个基本类别:
a)局部的,和
b)全身性癫痫发作。
局部癫痫发作起源于特定的大脑区域且保持局部的—最常见的是颞叶(包括海马),而全身性癫痫发作作为局部癫痫发作的继发普遍化出现于整个前脑(McCormick和Contreras,2001,Lutz,2004)。直到国际抗癫痫联盟(International League AgainstEpilepsy)于1969年出版了癫痫发作的分类方案,局部和全身性癫痫发作分类的这一概念才变成惯例(Merlis,1970,Gastaut,1970,Dreifuss等人,1981)。
国际抗癫痫联盟进一步分类局部癫痫发作,基于意识状态的存在或损害将其分为单纯的和复杂的(Dreifuss等人,1981)。
联盟还将全身性癫痫发作分类为很多种临床癫痫发作类型,其中的一些例子在下面概述:
失神癫痫发作经常发生,具有突然发病且中断正在进行的活动。另外,语言减慢或受阻且癫痫发作持续仅几秒钟(Dreifuss等人,1981)。
强直阵挛性癫痫发作,通常称为“大发作”,是最经常遇到的全身性癫痫发作(Dreifuss等人,1981)。此全身性癫痫发作类型具有两个阶段:强直性肌肉收缩,随后改变为阵挛性抽搐运动阶段。患者在整个癫痫发作期间及之后可变的时间段保持昏迷。
失张力癫痫发作,被称为“跌倒发作”,是身体内特定肌肉、肌群或所有肌肉的肌力的突发丧失的结果(Dreifuss等人,1981)。
癫痫发作的发病可危及生命,且患者还经历长期的健康隐患(Lutz,2004)。此类隐患可有多种形式:
精神健康问题(例如,阻碍在儿童时期的正常的谷氨酸能突触发育);
认知缺陷(例如,海马中神经元回路学习和储存记忆的能力减退);及
形态学改变(例如,兴奋性中毒引起的中生颞叶癫痫患者海马的CA1和CA3区选择性神经元丧失)(Swann,2004,Avoli等人2005)。
值得注意的是癫痫还极大影响患者的生活方式—潜在地生活在癫痫发作的大发作导致的间接伤害(例如头部伤害)的恐惧中,或没有进行日常事务的能力或没有开车的能力,除非有漫长的无癫痫发作期(Fisher等人,2000)。
尽管在二十世纪八十年代/九十年代对CBD在癫痫中的作用的历史性工作,抗惊厥领域中的研究已专注于许多其他的候选物,其中的许多目前被批准用于癫痫治疗。此类药物包括:乙酰唑胺、卡马西平、氧异安定、氯硝西泮、乙琥胺、醋酸艾司利卡西平、加巴喷丁、拉科酰胺、拉莫三嗪、左乙拉西坦、奥卡西平、苯巴比妥、苯妥英、普瑞巴林、扑痫酮、卢非酰胺、丙戊酸钠、噻加宾、托吡酯、丙戊酸盐、氨己烯酸、和唑尼沙胺。
这些药物中的一些的作用模式是清楚的而其他的是未知的。一些作用模式列于以下表1中:(改编自:Schachter SC.Treatment of seizures.于:Schachter SC,SchomerDL,编著。The comprehensive evaluation and treatment of epilepsy.San Diego,CA:Academic Press;1997.第61-74页)
表1.
然而,尽管在过去20年内引入大约20种不同化合物用于癫痫治疗,但是因为以下几个原因仍然需要替代药物:
i)世界人口的1-2%患有癫痫
(http://www.ncbi.nlm.nih.gov/sites/ppmc/articles/PMC1808496/);
ii)这其中的30%对于现有治疗是顽固性的;及
iii)现有疗法中还存在明显的运动副作用
(http://en.wikipedia.org/wiki/Epilepsy)。
例如,在大鼠癫痫模型中,如同以大于250mg/kg的剂量给予的苯巴比妥一样,当以大于200mg/kg的剂量给予大鼠时,丙戊酸盐和乙琥胺二者都显示出明显的运动及其他副作用(包括镇静)。
三个充分建立的且广泛使用的体内癫痫模型是:
戊四唑诱导(PTZ)的全身性癫痫发作模型(Obay等人,2007,Rauca等人,2004);
匹罗卡品诱导的颞叶(即海马)癫痫发作模型(Pereira等人,2007);及
青霉素诱导的局部癫痫发作模型(Bostanci和Bagirici,2006)。
这些提供了对于人类的治疗性研究是必要的一系列癫痫发作和癫痫模型。
发明内容
在上述说明中使用了以下术语并预期具有以下含义/定义:
“大麻素”是一组化合物,包括内源性大麻素、植物大麻素和既不是内源性大麻素也不是植物大麻素、下文统称“合成大麻素(syntho-cannabinoid)”的那些。
“内源性大麻素”是内源性的大麻素,其是CB1和CB2受体的高亲和力配体。
“植物大麻素”是来源于天然的大麻素,并可在大麻植物中被发现。植物大麻素可以存在于分离的或合成重制的提取物包含植物药物物质中。
“合成大麻素”是那些能够与大麻素受体(CB1和/或CB2)相互作用但不是内源性或在大麻植物中发现的化合物。实例包括WIN 55212和利莫那班。
“分离的植物大麻素”是指已经从大麻植物中被提取,并纯化至所有另外的组分诸如次要和少数大麻素及非大麻素部分已被除去的程度的大麻素。
“合成的大麻素”(synthetic cannabinoid)是指已经通过化学合成产生的大麻素,该术语包括修饰分离的植物大麻素,例如通过形成其药学上可接受的盐。
“植物药物物质(botanical drug substance)”或“BDS”在Guidance forIndustry Botanical Drug Products Draft Guidance,2000年8月,US Department ofHealth and Human Services,Food and Drug Administration Centre for DrugEvaluation and Research中被定义为:“来源于一种或多种植物、藻类或显微真菌(microscopic fungi)的药物。其通过下列方法的一种或多种从植物原料制备而来:粉碎、煎煮、压榨、水提取、乙醇提取或其他类似方法。”。植物药物物质不包括来源于天然原料的高度纯化的或化学修饰的物质。因此,就大麻来说,来源于大麻植物的BDS不包括高度纯化的药典级的大麻素。
在本发明中,认为BDS具有两种组分:含植物大麻素的组分和含非植物大麻素的组分。优选含植物大麻素的组分是较大组分,其构成大于50%(w/w)的总BDS,而含非植物大麻素的组分是较小组分,其构成小于50%(w/w)的总BDS。
在BDS中含植物大麻素的组分的量可大于总提取物的55%、直到60%、65%、70%、75%、80%至85%或更多。实际量可取决于所用的起始材料和所用的提取方法。
在BDS中的“主要植物大麻素”是以大于其他植物大麻素的量存在的植物大麻素。优选地,主要植物大麻素以大于总提取物的40%(w/w)的量存在。更优选地,主要植物大麻素以大于总提取物的50%(w/w)的量存在。仍然更优选地,主要植物大麻素以大于总提取物的60%(w/w)的量存在。
在BDS中的主要植物大麻素的量优选大于含植物大麻素的部分的50%,仍然更优选大于含植物大麻素的部分的55%,且仍然更优选大于含植物大麻素的部分的60%直到65%、70%、75%、80%、85%、90%和95%。
在BDS中的“次要植物大麻素”是以显著比例存在的植物大麻素。次要植物大麻素优选以大于总提取物的5%(w/w)、更优选大于总提取物的10%(w/w)、仍然更优选大于总提取物的15%(w/w)的量存在。某些BDS将具有以显著量存在的两种或多种次要植物大麻素。然而,并非所有BDS都将具有次要植物大麻素。
在BDS中的“少数植物大麻素”可描述为所有植物大麻素组分中除去主要和次要植物大麻素后的剩余部分。优选地,少数植物大麻素总计以小于总提取物的5%(w/w)的量存在,且最优选地,少数植物大麻素以小于总提取物的2%(w/w)的量存在。
术语“不存在”或“基本上不存在”指的是总提取物的小于1%、优选小于0.5%、仍然更优选小于0.3%、最优选小于0.1%(w/w)。
术语“基本上由......组成”被限定于指定的植物大麻素,其不排除也可能存在的非大麻素组分。
通常,BDS中的含非植物大麻素的组分包括萜类、甾醇类、甘油三酯类、烷烃类、鲨烯类、生育酚类和类胡萝卜素类。
这些化合物,无论是单独还是与植物大麻素组合,可在BDS的药理学中起到重要作用。
“萜部分”可能是重要的并且可分为两类萜:单萜或倍半萜。这些萜组分还可以以与大麻素类似的方式被定义。
在BDS中含非植物大麻素的组分的量可小于总提取物的45%、直到40%、35%、30%、25%、20%至15%或更少。实际量可取决于所用的起始材料和所用的提取方法。
在BDS中的“主要单萜”是以高于其他单萜的量存在的单萜。优选主要单萜以大于总萜含量的20%(w/w)的量存在。更优选主要单萜以大于总萜含量的30%(w/w)、仍然更优选大于总萜含量的40%(w/w)、及仍然更优选大于总萜含量的50%(w/w)的量存在。主要单萜优选是月桂烯或蒎烯。在某些情况下可存在两种主要单萜。在这样的情况下,主要单萜优选是蒎烯和/或月桂烯。
在BDS中的“主要倍半萜”是以高于所有其他倍半萜的量存在的倍半萜。优选主要倍半萜以大于总萜含量的20%(w/w)、仍然更优选大于总萜含量的30%(w/w)的量存在。主要倍半萜优选是石竹烯和/或蛇麻烯。
单萜组分可具有“次要单萜”。次要单萜优选是蒎烯,其优选以大于总萜含量的5%(w/w)的量存在,更优选地,次要单萜以大于总萜含量的10%(w/w)的量存在。
次要倍半萜优选是蛇麻烯,其优选以大于总萜含量的5%(w/w)的量存在,更优选地,次要倍半萜以大于总萜含量的10%(w/w)的量存在。
可选择地,植物提取物可通过将分离的植物大麻素或其合成等价物引入非大麻素植物部分而制备,所述非大麻素植物部分可获自零大麻素植物或从大麻植物中发现的一种或多种非大麻素组分例如萜类。
植物大麻素CBDV、CBD、CBCV、CBC、THCV和THC的结构如下所示:
取决于用于提取大麻素的方法,植物大麻素可以以中性(脱羧形式)或羧酸形式被发现。例如已知对羧酸形式加热将会引起大部分羧酸形式脱羧而变成中性形式。
其中,使用的术语合成的植物大麻素旨在包括化合物、其代谢物或衍生物,以及此类化合物的药学上可接受的盐。
术语“药学上可接受的盐”是指由药学上可接受的无毒的碱或酸,包括无机碱或酸及有机碱或酸制备的盐或酯,如本领域的技术人员熟知的。许多适当的无机和有机碱是本领域已知的。
植物大麻素也可以以戊基(5碳原子)或丙基(3碳原子)的变体存在。起初认为丙基和戊基的变体具有类似特性,然而最近的研究却表明并非如此。例如已知植物大麻素THC是CBl受体激动剂,而发现丙基变体THCV是CBl受体拮抗剂,意味着其具有几乎相反的作用。这由Pertwee(2000)在Cannabinoid receptor ligands:clinical andneuropharmacological considerations relevant to future drug discovery anddevelopment中证实。
本发明的目的是鉴定用于神经病症治疗的安全且有效的组合物,所述神经病症以中枢神经系统的过度兴奋、惊厥或癫痫发作例如发生在癫痫中的中枢神经系统的过度兴奋、惊厥或癫痫发作为特征。
事实上,现有的标准抗癫痫药物(SAED)的主要缺点是针对现有治疗30%是难治的,及现有疗法中也存在显著的运动副作用。因此,期望使用减少或不存在此类副作用的化合物或组合。
根据本发明的第一方面,提供了包含或基本上由植物大麻素次大麻二酚(CBDV)和大麻二酚(CBD)组成的组合物。
优选地,该组合物还包含一种或多种赋形剂。
优选地,该组合物还包含大麻的至少一种非大麻素组分。更优选地,所述大麻的至少一种非大麻素组分是萜或包括萜。
关于萜类应该注意的是,萜类可进一步分为单萜类或倍半萜类。大麻中发现的常见的单萜类包括月桂烯和蒎烯,且大麻中发现的常见的倍半萜类包括石竹烯和蛇麻烯。
优选地,所述植物大麻素包括,或基本上由CBDV、CBD和一种或多种大麻色烯类化合物组成。更优选地,该一种或多种大麻色烯类化合物是大麻色烯丙基变体(CBCV)和/或大麻色烯(CBC)。
优选地,该组合物包含或者基本上由CBDV、CBD和一种或多种大麻色烯类化合物组成。更优选地,该一种或多种大麻色烯类化合物是大麻色烯丙基变体(CBCV)和/或大麻色烯(CBC)。
优选地,该组合物不存在或基本上不存在任何其他大麻素。更优选地,该组合物不存在或基本上不存在大麻素四氢次大麻酚(THCV)和/或四氢大麻酚(THC)。
特别地,该组合物应包括小于0.3%(w/w)的THC。
优选地,该组合物包含或者基本上由以从7:1至1:2(CBDV:CBD)的比的大麻素CBDV和CBD组成。更优选地,CBDV和CBD以从5:1至1:1(CBDV:CBD)的比存在。仍然更优选地,CBDV和CBD以4.5:1至2:1(CBDV:CBD)的比存在。
优选地,该组合物以单位剂型被包装用于递送。更优选地,单位剂型包括从500mg至2000mg CBDV和从100mg至600mg CBD。
优选地,单位剂型包括从500mg至2000mg的CBDV。
优选地,单位剂型包括从100mg至600mg的CBD。
本文的“单位剂量”被定义为可在任一时间或在指定剂量时间段诸如例如4个小时内被服用的药物的最大剂量。
在本发明另外的实施方案中,该组合物还包含标准抗癫痫药物(SAED)。
标准抗癫痫药物是在癫痫治疗中被使用或已被使用的具有抗惊厥活性的药物。
根据本发明的第二方面,提供了包含植物大麻素CBDV和CBD但基本上不存在大麻素THCV和THC的提取物或BDS。
由于一些原因,大麻素THCV和THC可能不是用于癫痫治疗的组合物的期望的组分。在THCV的情况下,此植物大麻素是已知的CB1受体拮抗剂的事实,引发THCV用于癫痫治疗的适合性的质疑,特别是当有人考虑到由Deshpande等人提供的以下的证据:CB1拮抗剂可能是促惊厥剂且可能引起自杀倾向。在THC的情况下,THC是否是促惊厥剂或抗惊厥剂未被清楚地了解,但是广泛承认的是,由THC引起的某些副作用诸如精神病和焦虑,是特别不期望的。
优选地,提取物或BDS还包含一种或多种非大麻素组分。
根据本发明的第三方面,提供了由植物大麻素次大麻二酚(CBDV)和大麻二酚(CBD)的组合,用于治疗以中枢神经系统的过度兴奋、惊厥或癫痫发作为特征的神经病症。
优选地,该神经病症是癫痫。更优选地,待被治疗的癫痫的类型是全身性癫痫发作。
优选地,植物大麻素次大麻二酚(CBDV)和大麻二酚(CBD)的组合还包含标准抗癫痫药物(SAED)。
优选地,植物大麻素CBDV和CBD的组合不存在或基本上不存在任何其他大麻素。更优选地,该组合物不存在或基本上不存在大麻素四氢次大麻酚(THCV)和/或四氢大麻酚(THC)。
根据本发明的第四方面,提供了植物大麻素次大麻二酚(CBDV)和大麻二酚(CBD)的组合在制造用于治疗神经病症的药剂中的用途,该神经病症以中枢神经系统的过度兴奋、惊厥或癫痫发作为特征。
优选地,该药剂不存在或基本上不存在任何其他大麻素。更优选地,该组合物不存在或基本上不存在大麻素四氢次大麻酚(THCV)和/或四氢大麻酚(THC)。
根据本发明的第五方面,提供了用于治疗以中枢神经系统的过度兴奋、惊厥或癫痫发作为特征的神经病症的方法,所述方法包括向需要其的受试者施用治疗有效量的植物大麻素次大麻二酚(CBDV)和大麻二酚(CBD)的组合。
优选地,该治疗有效量的植物大麻素次大麻二酚(CBDV)和大麻二酚(CBD)的组合不存在或基本上不存在任何其他大麻素。更优选地,该组合物不存在或基本上不存在大麻素四氢次大麻酚(THCV)和/或四氢大麻酚(THC)。
附图说明
参考附图,下文进一步描述了本发明的实施方案,其中
图1显示在癫痫的PTZ模型中,CBDV(-/-)BDS的最大癫痫发作严重程度;
图2显示在癫痫的PTZ模型中,CBDV(-/-)BDS的死亡率百分数;
图3显示在癫痫的PTZ模型中,CBDV(-/-)BDS中无癫痫发作的动物的百分数;
图4显示在癫痫的PTZ模型中,CBDV(-/-)BDS中癫痫发作开始的潜伏期;及
图5显示在癫痫的PTZ模型中,CBDV(-/-)BDS中经历强直阵挛性癫痫发作的动物的百分数。
CBDV(-/-)BDS被用于指定THCV和THC已被从其中选择性去除的CBDV BDS。
具体实施方式
下文实施例1描述了其中大麻素THCV和THC已被选择性去除的CBDV植物药物物质(BDS),下文称为CBDV(-/-)BDS的用途。癫痫中全身性癫痫发作的PTZ模型被用于确定测试物(test article)的抗惊厥活性。
实施例1
包含CBDV和CBD的组合物在全身性癫痫发作的PTZ模型中的用途
方法:
动物:
雄性Wistar大鼠(P24-29;75-110g)被用于评价包含植物大麻素CBDV和CBD的组合物在全身性癫痫发作的PTZ模型中的组合效果。在实验之前,使动物习惯于测试环境、笼子、注射方案及操作。将动物置于21℃、12小时光:暗周期(0900开灯)、50%湿度的房间中,自由摄入食物和水。
人体等效剂量(HED)可使用以下的公式评价:
HED=动物剂量(mg/kg)乘以动物Km/人Km
大鼠的Km是6且人的Km是37。
因此,对于约60Kg的人,大鼠中200mg/Kg的剂量将等同于约2000mg的人的每日剂量。
组合物
使用CBDV植物药物物质(BDS)制备的组合物已通过离心分配色谱法被进一步制备以去除大麻素THCV和THC,使得大麻素基本上由CBDV和CBD以及较少量的CBCV和CBC组成。用于本申请目的的此BDS被称为CBDV(-/-)BDS。
实验设置:
将五个6L的带有盖的彼此之间有分隔物的Perspex槽置于单个实验台上。在分隔物上安装闭路电视(CCTV)摄像机以观察大鼠的行为。通过Brooktree数字捕捉卡(Bluecherry,USA)经BNC导线连接Sony Topica CCD相机(Bluecherry,USA)至低噪音的PC。使用Zoneminder(http://www.zoneminder.com)软件监测大鼠、开始和结束记录及管理视频文件。为了使用The Observer(Noldus Technologies)进一步脱机分析,使用内部Linux脚本编码视频文件为合适的格式。
PTZ模型:
使用一系列PTZ剂量(50-100mg/kg体重)以确定诱导癫痫发作的最佳剂量。结果,使用85mg/kg的剂量的腹腔注射(IP;储存溶液50mg/ml于0.9%盐水中)以筛选CBDV(-/-)BDS测试物。
实验方案:
在测试的当天,CBDV(-/-)BDS以50、100、200、275和346mg/kg的剂量经腹腔(i.p.)注射被施用,被注射匹配体积的大麻素媒介物(2:1:17乙醇:Cremophor:盐水)的并行进行的动物用作阴性对照组,(给予如下表1.1中列出的确定剂量的CBDV和CBD)。随后观察动物1小时,在观察时间之后它们接受85mg/kg PTZ的IP注射。与大麻素给药受试者同时进行阴性媒介物对照。在接受PTZ剂量之后,观察动物并录像以确定癫痫发作的严重程度和几种癫痫发作行为类型的潜伏期(见下文的体内分析)。在最后一次癫痫发作病征之后拍摄动物半小时,且随后送回它们的笼子。
剂量组:
下列表1.1说明了大麻素CBDV和CBD在CBDV(-/-)BDS的不同剂量组中的各自含量。
表1.1:
体内分析:
在实验过程中观察动物,但所有的分析使用观察行为分析软件(The Observerbehavioural analysis software,Noldus,Netherlands)对记录的视频文件脱机进行。使用癫痫发作严重程度评分系统以确定受试者经历的癫痫发作水平(Pohl&Mares,1987)。详述所有动物的所有癫痫发作病征。
表1.2癫痫发作严重程度评分等级,改编自Pohl&Mares,1987。
癫痫发作评分 | 行为表示 | 翻正反射 |
0 | 行为没有改变 | 保留 |
0.5 | 异常行为(嗅探、过度清洗、定向) | 保留 |
1 | 孤立性的肌阵挛抽搐 | 保留 |
2 | 非典型性阵挛性癫痫发作 | 保留 |
3 | 完全发展的双侧前肢阵挛 | 保留 |
3.5 | 具有强直成分和身体扭曲的前肢阵挛 | 保留 |
4 | 强直阶段被抑制的强直阵挛性癫痫发作 | 丧失 |
5 | 完全发展的强直阵挛性癫痫发作 | 丧失 |
6 | 死亡 |
从PTZ注射至癫痫发作形成的特定指征(indicator)的潜伏期:
记录了从PTZ注射至首次肌阵挛抽搐(FMJ;评分为1)及至动物达到“具有强直成分和身体扭曲的前肢阵挛”(评分为3.5)的潜伏期(以秒计)。FMJ是癫痫发作活动开始的指征,同时>90%的动物发展的评分为3.5,并因此是更严重癫痫发作形成的好的标志物。数据以实验组内的平均值±S.E.M.表示。
最大癫痫发作严重程度:
基于下文评分等级,对于每一个实验组将其以中值给出。
死亡率百分数:
由于PTZ诱导的癫痫发作导致的实验组内的动物死亡的百分数。注意形成强直阵挛性癫痫发作(评分为4和5)的大多数动物因此死亡,且评分为6(死亡)自动表示动物也经历了强直阵挛性癫痫发作。
癫痫发作持续时间:
从首次癫痫发作病征(典型地FMJ)至最后一次癫痫发作病征或,在受试者死亡情况下,死亡时间的时间(以秒计)—分为存活动物和未存活动物。对于每一个实验组将其以平均值±S.E.M.给出。
统计:
对于潜伏期和严重程度的量度,对所有测试组一起进行单因素方差分析(ANOVA)以检测测试物的总效果(p≤0.05认为显著),并在图中以‘*’标出。
对显著性ANOVA结果进行事后检验以检验媒介物组和药物组之间的差异(Tukey’s检验,p≤0.05认为显著),并在图中以‘*’标出。
结果:
图1说明了最大癫痫发作严重程度,在CBDV(-/-)BDS的275mg/kg的剂量下观察到CBDV(-/-)BDS对最大癫痫发作严重程度的显著作用。
图2说明了CBDV(-/-)BDS给药的动物的死亡率百分数。如可以观察到的,给予200和275mg/kg的CBDV(-/-)BDS的动物具有强的统计学显著性,且给予最高剂量(346mg/kgCBDV(-/-)BDS)的动物具有较少的统计显著性,但仍导致死亡率百分数的下降。
图3说明了虽然未观察到CBDV(-/-)BDS对无癫痫发作的动物百分数的显著作用,但275mg/kg剂量导致20%的动物变成无癫痫发作。
图4说明了在CBDV(-/-)BDS的所有高剂量组(200、275和346mg/kg)中,癫痫发作开始的潜伏期统计学上增加。
图5说明了在CBDV(-/-)BDS的较高剂量组(200、275和346mg/kg)中,经历了严重的强直阵挛性癫痫发作的动物百分数下降;但该下降无统计学显著性。
结论:
从以上数据可以看出CBDV(-/-)BDS组合物会降低癫痫发作的严重程度和死亡率,并增加癫痫发作开始的潜伏期,使其成为用于癫痫治疗的理想组合物。
大麻素THCV和THC从BDS的去除进一步避免了与CB1拮抗作用和精神病相关的担忧。
实施例2
CBDV(-/-)BDS的分析
上文实施例1中使用的CBDV(-/-)BDS可使用对CBDV(+/+)BDS的离心分配色谱法获得。
已制备并分析了CBDV(-/-)BDS,如下文表2.1中描述的:
表2.1 CBDV(-/-)BDS的总量和范围
CBDV(-/-)BDS的包含总植物大麻素的部分构成总BDS的约41%。根据变差,此部分可从±10%至±50%间变化。
表2.2次大麻二酚(-/-)BDS占大麻素的百分数
在CBDV(-/-)BDS中主要植物大麻素的量占含有植物大麻素的部分的百分数为约61%。根据变差,此部分可从±10%至±50%间变化。
在本实施例中,意图独立于“其他”大麻素提及主要或次要组分。
对比实施例3
CBDV(+/+)BDS分析
下列实施例被包括以提供CBDV(+/+)BDS的组分的详细说明。CBDV(+/+)BDS通过亚临界CO2萃取获得。与CBDV相同,其也包括大量的大麻素CBD、THCV和THC(每种都大于总大麻素含量的重量百分数的1%)。THC已经被归于促惊厥剂,并且,除了其他副作用诸如焦虑之外,THC也可以具有明显的不期望的精神作用。同时显示对癫痫中全身性癫痫发作特定的抗惊厥剂活性的THCV是CB1拮抗剂且以下证据表明CB1拮抗剂利莫那班可能会引起癫痫和其他不期望的效果,从BDS去除这些大麻素同时仍保留可能有助于BDS活性的非大麻素组分可以是期望的。
CBDV(+/+)BDS可以从富含CBDV的植物中提取获得。此类化学变型(chemovar)被专门培育以生产其大麻素的显著比例为CBDV。
CBDV化学型是由培育同时携带推定的BD和APR基因的植物产生。
BD基因指导植物合成CBD分子的环部分,而APR基因指导植物合成该分子的丙基侧链,与CBD中常见的戊基链不同。
培育CBDV化学变型并分析BDS,如下表3.1中描述的:
表3.1 CBDV(+/+)BDS总量和范围
CBDV(+/+)BDS的包含总植物大麻素的部分构成总BDS的约41%。根据变差,此部分可从±10%至±50%间变化。
表3.2 CBDV(+/+)BDS占大麻素百分数
CBDV(+/+)BDS | 量(总大麻素的%) |
CBDVA | 0.20 |
CBDV | 57.92 |
CBDA | 0.10 |
CBG | 0.83 |
CBD | 24.89 |
THCV | 4.30 |
CBCV | 6.12 |
THC | 1.24 |
CBDV(相关物质) | 3.09 |
CBC | 1.31 |
在CBDV(+/+)BDS中主要植物大麻素的量占含有植物大麻素的部分的百分数为约58%。根据变差,此部分可从±10%至±50%间变化。
在本实施例中,意图独立于“其他”大麻素提及主要或次要组分。
对比实施例4
含有高植物大麻素的植物的非大麻素概况(profile)
本对比实施例被包含以显示从已经培育以产生高产大麻素的大麻植物获得的典型萜概况。
植物大麻素BDS的非大麻素组分可在BDS药理学中起到重要作用。如此,萜概况分类如下。下表说明代表性的含有高植物大麻素的植物的CBD化学变型的萜概况。新鲜收获5株植株并用蒸汽蒸馏提取。主要单萜和倍半萜用粗体突出。
表4.1单萜量占总萜部分的百分数和范围
含单萜部分构成总萜部分的约52-64%(w/w)。
表4.2单萜量占单萜类的百分数
单萜部分中主要单萜月桂烯的量占单萜部分的百分数为约61-75%(w/w)。单萜部分还具有次要单萜蒎烯,其以单萜部分的约16.3-20%(w/w)存在。
表4.3倍半萜量占总萜部分的百分数和范围
含有倍半萜的部分构成总萜部分的约27-32%(w/w)。
表4.4倍半萜量占倍半萜的百分率
对比实施例5
“零大麻素”植物的非大麻素概况
本对比实施例描述了与上文实施例4中描述的不同的大麻素植物的萜概况,且此处再现用于对比的目的。
专利申请号PCT/GB2008/001837描述了“零大麻素”植物的产生。这些植物通过选择性培育而产生,以产生含有与产生大麻素的大麻(Cannabis sativa L)植物总体品质上类似的萜概况的大麻植物,但其却没有任何大麻素。此类植物可用于生产无大麻素的植物提取物,所述植物在实验和临床试验中是有用的对照植物。该植物中产生的萜概况的明细可参见下表。主要单萜类和倍半萜用粗体突出显示。
表5.1单萜量占总萜部分的百分数和范围
含有单萜的部分构成总萜部分的约65-79%(w/w)。
表5.2单萜量占单萜类的百分数
表5.3倍半萜量占总萜部分的百分数和范围
含有倍半萜的部分构成总萜部分的约25-31%(w/w)。
表5.4倍半萜量占倍半萜类的百分数
倍半萜部分中主要倍半萜石竹烯的量占倍半萜部分的百分数为约35-43%(w/w)。倍半萜部分还具有次要倍半萜蛇麻烯,其以倍半萜部分的约16-20%(w/w)存在。
对比实施例6
CBDV(+/+)BDS在全身性癫痫发作的PTZ模型中的用途
本对比实施例先前呈现在GB1005364.3(未公布)专利申请中,并在此被包括用于代表性目的。
方法如实施例1所述。
CBDV(+/+)BDS以产生50和100mg/kg的CBDV剂量的4种剂量被施用。下列表6.1详述了获得的数据。
表6.1
如可以看出的,CBDV(+/+)BDS显示了降低癫痫发作相关的死亡率的趋势。
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Claims (10)
1.一种组合物,所述组合物包含或基本上由植物大麻素次大麻二酚(CBDV)和大麻二酚(CBD)组成。
2.如权利要求1所述的组合物,所述组合物还包含一种或多种赋形剂。
3.如权利要求1或2所述的组合物,所述组合物还包含大麻的至少一种非大麻素组分。
4.如权利要求3所述的组合物,其中所述大麻的至少一种非大麻素组分是萜或包括萜。
5.如前述权利要求中任一项所述的组合物,其中所述植物大麻素包括,或基本上由CBDV、CBD和一种或多种大麻色烯类化合物组成。
6.如权利要求5所述的组合物,其中所述一种或多种大麻色烯类化合物是大麻色烯丙基变体(CBCV)和/或大麻色烯(CBC)。
7.如前述权利要求中任一项所述的组合物,所述组合物不存在或基本上不存在任何其他大麻素。
8.如权利要求7所述的组合物,其中所述任何其他大麻素是四氢次大麻酚(THCV)和/或四氢大麻酚(THC)。
9.如前述权利要求中任一项所述的组合物,其中所述CBDV和CBD以从7:1至1:2(CBDV:CBD)的比存在。
10.如权利要求9所述的组合物,其中所述CBDV和CBD以从5:1至1:1(CBDV:CBD)的比存在。
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