CN112641786B - 川芎嗪硝酮化合物在制备预防和/或治疗肌营养不良性疾病中的应用 - Google Patents
川芎嗪硝酮化合物在制备预防和/或治疗肌营养不良性疾病中的应用 Download PDFInfo
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Abstract
本发明公开了一种川芎嗪硝酮化合物在制备预防和/或治疗肌营养不良性疾病药物中的应用,其中川芎嗪硝酮化合物为具有通式(I)所示结构的化合物或其在药学上可以接受的盐。实验结果显示本发明川芎嗪硝酮化合物能显著改善杜氏肌营养不良症(DMD)基因移码突变所致的杜氏肌营养不良症模型小鼠的运动功能障碍,提高运动能力,延缓疾病恶化过程;还能显著降低杜氏肌营养不良症模型小鼠腓肠肌、膈肌、心肌萎缩和纤维化程度。因此所述川芎嗪硝酮化合物可与药物载体制成各种剂型,用于肌营养不良性疾病的预防和治疗。
Description
本申请是申请日为2019年10月09日,申请号为:201910953423.8,发明名称为“川芎嗪硝酮化合物在制备预防和/或治疗肌营养不良性疾病中的应用”的中国发明专利申请的分案申请。
技术领域
本发明属于药物技术领域,具体涉及一种川芎嗪硝酮化合物在预防和治疗肌营养不良性疾病中的应用。
背景技术
杜氏肌营养不良(Duchenne muscular dystrophy,DMD)是肌营养不良症最常见的类型,是一种X连锁隐性遗传病。由于缺乏对肌纤维功能至关重要的dystrophin蛋白,患者的肌细胞无法保持完整,进而导致病变。本病的发病特征为进行性四肢近端骨骼肌萎缩无力、小腿腓肠肌假性肥大,同时累及心肌和呼吸肌。据统计,全球平均每3600个新生男婴中,就有一人罹患此病。患者在学龄前就会因骨骼肌不断退化出现肌肉无力或萎缩,导致不便行走。大部分DMD患者在3-5岁发病,表现为独立行走较迟,易跌倒,上楼、下蹲站起困难,逐渐出现步态异常,举臂无力,约1/3患儿智力低下;7-12岁彻底丧失行走能力,20岁左右会因为心肌、肺肌无力死亡(Int J Neurosci.2018Sep;128(9):854-864)。
抗肌萎缩蛋白是一个细胞骨架蛋白,主要位于骨骼肌和心肌的细胞浆面,少量表达于脑组织。DMD由抗肌萎缩蛋白基因突变所致,已证实人类抗肌萎缩蛋白基因定位于X染色体短臂上(Xp21.1-3),基因全长约2220kb,含79个外显子,cDNA长14kb,是迄今发现的最大的人类基因。该基因具有极高的突变频率,主要分为三种突变类型:缺失突变、重复突变、微小突变,这些突变改变了基因的阅读框架,影响抗肌萎缩蛋白的合成。抗肌萎缩蛋白与肌膜上的不同蛋白结合形成抗肌萎缩蛋白-糖蛋白复合体(DGC),其对于保护肌细胞膜的结构完整和维持肌细胞正常收缩功能有重要作用。当患者因DMD基因缺陷时,DGC功能丧失,机械完整性受损,重要的信号蛋白和途径被破坏,增加了肌肉细胞对炎症及氧化损伤的敏感度,导致肌细胞坏死、功能缺失以及肌肉组织纤维化(Hum Gene Ther Methods.2019Jun;30(3):71-80)。
活性氧自由基(ROS)产生和清除系统之间的不平衡引起的细胞损伤已经涉及多种人类疾病,包括DMD(JournaloftheNeurologicalSciences161(1998)77-84)。肌细胞异常膜结构引起细胞内钙稳态失衡,导致黄嘌呤脱氢酶/黄嘌呤氧化酶系统活化产生过量ROS,ROS(特别是羟基和超氧化物)是高反应性的瞬时化学物质,在正常的有氧细胞代谢过程中普遍形成(主要是通过线粒体呼吸链中的电子泄漏),可能引发对正常细胞功能所依赖核酸、脂质和蛋白质的损害。多种内源性ROS清除蛋白(如谷胱甘肽、金属硫蛋白、超氧化物歧化酶等)可保护细胞免受ROS诱导的损伤(HumanMolecularGenetics,2017,Vol.26,No.14.2781–2790)。
目前,FDA共批准2个DMD治疗药物。Sarepta Therapeutics公司的eteplirsen注射液是首个经FDA批准用于治疗DMD的新药,用于治疗DMD外显子51跳跃这一亚型。Eteplirsen是一种反义RNA,采用新颖的磷酰二胺吗啉代寡核苷酸和外显子跳跃技术,跳过外显子51表达,合成一些有一定功能形式的抗肌萎缩蛋白,修复mRNA的阅读框来纠正部分遗传缺陷,从而凭借这个较短形式的功能型抗肌萎缩蛋白来延缓DMD病人行走和运动能力的退化。外显子51跳跃的患者占全部患者的13%。另一个是治疗DMD的皮质类固醇药物Emflaza(deflazacort,地夫可特),其通过减少炎症和降低免疫系统活性而发挥作用,Emflaza片剂和口服混悬液,用于治疗5岁及以上DMD患者。但Emflaza副作用非常明显,与其它皮质类固醇药物相似,最常见的副作用包括面部浮肿、体重增加、食欲增加、上呼吸道感染、咳嗽、尿频、多毛症以及向心性肥胖等。
川芎嗪(Tetramethylpyrazine)是传统中药川芎的主要活性成分之一,临床上广泛用于治疗心脑血管、肾脏、视网膜、视神经缺血性眼病等疾病。既往研究证实,川芎嗪具有抗血栓、抗缺血再灌注、保护心脑血管系统、保肝、肾等多方面药理活性。川芎嗪可以通过抗细胞凋亡、抗炎、抗氧化等途径发挥细胞保护作用,从而减轻ROS引起的功能性损伤。
基于川芎嗪的部分抗氧化及硝酮类化合物强大的自由基清除作用,我们创造性的合成了川芎嗪硝酮化合物。川芎嗪硝酮化合物是一类具有强大自由基清除能力的化合物,对多种活性自由基均具有较强的清除作用,研究发现川芎嗪硝酮化合物对各种自由基导致疾病(如脑中风、帕金森病、糖尿病肾病、肌萎缩侧索硬化症等)具有一定的治疗作用。
治疗DMD药物价格昂贵,其中eteplirsen在美国每年治疗费用为892,000美元;Emflaza的供应价为62,900美元。这两个药的成本都超过了预定的成本效益比门槛。因此,开发能够预防或治疗DMD药物的化合物具有重要意义。
发明内容
本发明目的之一在于提供一种川芎嗪硝酮化合物在预防和/或治疗肌营养不良性疾病中的应用。或者,本发明提供一种川芎嗪硝酮化合物在制备用于预防和/或治疗肌营养不良性疾病药物中的应用。
一种川芎嗪硝酮化合物在制备用于预防和/或治疗肌营养不良性疾病药物中的应用,川芎嗪硝酮化合物为具有如下通式(I)所示结构的化合物或其在药学上可以接受的盐:
其中:
R2,R3相同或不同,各自独立选自氢或C1-C6烷基;
R4和R8各自独立的为仲丁基、异丁基、叔丁基、环戊基或环己基。
本发明还提供一种预防和/或治疗肌营养不良性疾病的方法,向罹患或易患肌营养不良的个体施用有效量的川芎嗪硝酮化合物,所述的川芎嗪硝酮化合物为具有如下通式(I)所示结构的化合物或其在药学上可以接受的盐:
其中:
R2,R3相同或不同,各自独立选自氢或C1-C6烷基;
R4和R8各自独立的为仲丁基、异丁基、叔丁基、环戊基或环己基。
在一种实施例中,本发明R2,R3相同或不同,各自独立选自氢、甲基、乙基、正丙基、异丙基、正丁基、异丁基、叔丁基或正戊基。
在一种实施例中,本发明所述的川芎嗪硝酮化合物选自如下结构式:
在申请的一些实施方案中,所述的肌营养不良性疾病,包括但不限于少年型近端型脊髓性肌萎缩症(Kugelberg-welander症),慢性多发性肌炎,强直性肌营养不良,重症肌无力,杜氏肌营养不良症(DMD),Becker型肌营养不良症(BMD),肢带型肌营养不良症,面肩肱型肌营养不良症(或称Landouzy-Dejerine型肌营养不良症),Emery-Dreifuss肌营养不良症,远端型肌营养不良症,眼咽型肌营养不良症,先天型肌营养不良症等。在一种具体的实施方式中,本发明所述的肌营养不良性疾病是指杜氏肌营养不良症(DMD)。
在一种实施例中,本发明所述的应用中的预防和/或治疗是指使肌营养不良的至少一种症状或特征在强度、严重性或频度方面得以降低,或延迟发作。
在一种实施例中,本发明所述的肌营养不良的至少一种症状或特征选自:肌肉萎缩、肌肉坏死、肌肉纤维化、dysferlin表达降低、肌肉消耗、肌肉无力、肌肉脆弱、关节挛缩、骨骼变形、心肌病、吞咽受损、肠和膀胱功能受损、肌肉缺血、认知损害、行为功能障碍、社交损害、脊柱侧凸或呼吸功能受损等。
本发明目的之二在于提供一种药用组合物,其包括有效剂量的本发明所述的川芎嗪硝酮化合物,以及药学上可接受的载体。
在本申请的一些实施方案中,所述的药物组合物可以以本发明所述的川芎嗪硝酮化合物作为唯一的药用活性成分,也可以与其他活性药物联合使用。
本发明所述的药用组合物,可通过多种途径给药,该途径包括但不限于选自以下的途径:口服、肠胃外、腹膜内、静脉内、动脉内、透皮、舌下、肌内、直肠、透颊、鼻内、吸入、阴道、眼内、局部、皮下、脂肪内、关节内、腹膜内和鞘内。在一个特定的实施方案中,通过口服给药。
本发明所述的药用组合物,可以为药学上可接受的各种剂型,所述剂型包括但不限于片剂、颗粒剂、针剂、粉剂、胶囊剂或悬浮剂。
本发明所述的药用组合物中所述的药学上可接受的载体包括但不限于药物赋形剂,添加剂,无毒的可相容的填料,粘合剂,崩解剂,缓冲剂,防腐剂,抗氧化剂,润滑剂,矫味剂,增稠剂,着色剂,乳化剂或稳定剂等。
给予本发明所述的川芎嗪硝酮化合物的量可根据疾病的严重程度、疾病的响应、任何治疗相关的毒性、受试者的年龄和健康状态来确定。在一个实施方案中,有效剂量为0.001~2g/kg。
在本申请的一些实施方案中,所述的其他活性药物可以为其他用于预防和/或治疗肌营养不良性疾病等的药物。在一种实施例中,优选为用于预防和/或治疗DMD的活性药物,包括但不限于糖皮质激素类药物、反义寡核苷酸。在一些具体的实施方案中,优选为糖皮质类固醇药物deflazacort。
本发明还提供上述组合物在用于制备用于预防和/或治疗肌营养不良性疾病药物中的应用。
本发明还提供一种预防和/或治疗肌营养不良性疾病的方法,向罹患或易患肌营养不良的个体施用有效量的本发明所述的组合物。
本发明组合物的应用或者预防和/或治疗方法中所述的“肌营养不良性疾病”、“预防和/或治疗”如前所述。
本文所用“联用”或“联合使用”意指两种或更多种活性物质可以在混合物中一起、作为单一制剂同时地或作为单一制剂以任何顺序依次地施用于受试者。
本发明所用“治疗有效量”是指当向罹患或易患疾病、病症和/或病状的受试者施用时,足以治疗、诊断、预防所述疾病、病症和/或病状的症状和/或延迟其发作的量。本领域普通技术人员应了解,治疗有效量通常是通过包含至少一个单位剂量的给药方案施用。
本发明所用“治疗(treat/treatment/treating)”是指用于部分或完全减轻、改善、缓和、抑制、预防特定疾病、病症和/或病状的一种或多种症状或特征、延迟其发作、减轻其严重性、和/或降低其发生率的任何方法。治疗可向不展现疾病的征象和/或仅展现所述疾病的早期征象的受试者施用以达成降低显现与所述疾病相关的病变的危险的目的。
本发明的技术优势:
1.本发明发现了川芎嗪硝酮化合物的新用途,即在制备预防和/或治疗DMD药物中的应用,可有效提高DMD小鼠运动能力,延缓疾病恶化过程;还能显著降低杜氏肌营养不良症模型小鼠腓肠肌、膈肌、心肌萎缩和纤维化程度,效果优于阳性对照药皮质类固醇药物deflazacort。
2.本发明提供的化合物是川芎嗪和硝酮基团的耦合物,兼有川芎嗪抗氧化、抗凋亡、抗炎等活性和硝酮基团的强自由基清除活性。越来越多的证据表明发生营养不良肌肉的退行性过程可能是由于氧化作用导致,川芎嗪硝酮可以明显提高血清中SOD的含量,减少氧化应激损伤。
3.本发明提供的川芎嗪硝酮化合物安全性高,而deflazacort副作用非常明显,与其它皮质类固醇药物相似,最常见的副作用包括面部浮肿、体重增加、骨质疏松、椎骨骨折、血压升高、食欲增加、上呼吸道感染、咳嗽、尿频、增加白内障风险、多毛症以及向心性肥胖等。
4.本发明提供的川芎嗪硝酮化合物还可与临床上现有的DMD治疗药物联合使用,通过协同作用提高疗效,降低现有临床药物的副作用,提高临床用药收益/风险比。
附图说明
图1TBN给药前后,各组小鼠爬杆时间变化趋势。##P<0.01,###P<0.001与野生组(WT)比较;*P<0.05,**P<0.01和***P<0.001与模型组(DMD)比较。其中,溶剂对照组:n=11只;模型组:n=12只;TBN 10mg/kg组:n=12只;TBN 30mg/kg组:n=10只;TBN 60mg/kg组:n=12只;Deflazacort 10mg/kg组:n=10只。
图2TBN给药后各组小鼠自主运动距离的变化趋势。##P<0.01,###P<0.001与野生组(WT)比较;***P<0.001,**P<0.01和*P<0.05与模型组(DMD)比较。其中,溶剂对照组:n=11只;模型组:n=12只;TBN 10mg/kg组:n=12只;TBN 30mg/kg组:n=10只;TBN 60mg/kg组:n=12只;Deflazacort 10mg/kg组:n=10只。
图3TBN增加DMD小鼠血清中SOD的含量。##P<0.01与野生组(WT)比较;*P<0.05,**P<0.01与模型组(DMD)比较。其中,溶剂对照组:n=11只;模型组:n=12只;TBN 10mg/kg组:n=12只;TBN 30mg/kg组:n=10只;TBN 60mg/kg组:n=12只;Deflazacort 10mg/kg组:n=10只。
图4TBN降低DMD小鼠腓肠肌萎缩。其中,溶剂对照组:n=8只;模型组:n=8只;TBN10mg/kg组:n=8只;TBN 30mg/kg组:n=8只;TBN 60mg/kg组:n=8只;Deflazacort 10mg/kg组:n=8只。
图5TBN降低DMD小鼠心肌萎缩。其中,溶剂对照组:n=8只;模型组:n=8只;TBN10mg/kg组:n=8只;TBN 30mg/kg组:n=8只;TBN 60mg/kg组:n=8只;Deflazacort 10mg/kg组:n=8只。
图6TBN降低DMD小鼠膈肌萎缩。其中,溶剂对照组:n=8只;模型组:n=8只;TBN10mg/kg组:n=8只;TBN 30mg/kg组:n=8只;TBN 60mg/kg组:n=8只;Deflazacort 10mg/kg组:n=8只。
图7TBN降低DMD小鼠腓肠肌纤维化程度。###P<0.001与野生组(WT)比较;**P<0.01与模型组(DMD)比较。其中,溶剂对照组:n=6只;模型组:n=6只;TBN 10mg/kg组:n=6只;TBN30mg/kg组:n=6只;TBN 60mg/kg组:n=6只;Deflazacort 10mg/kg组:n=6只。
图8TBN降低DMD小鼠心肌纤维化程度。*P<0.05与模型组(DMD)比较。其中,溶剂对照组:n=6只;模型组:n=6只;TBN 10mg/kg组:n=6只;TBN 30mg/kg组:n=6只;TBN 60mg/kg组:n=6只;Deflazacort 10mg/kg组:n=6只。
图9TBN降低DMD小鼠膈肌纤维化程度。##P<0.01与野生组(WT)比较;*P<0.05与模型组(DMD)比较。其中,溶剂对照组:n=6只;模型组:n=6只;TBN 10mg/kg组:n=6只;TBN30mg/kg组:n=6只;TBN 60mg/kg组:n=6只;Deflazacort10mg/kg组:n=6只。
图10TBN增加DMD小鼠腓肠肌dysferlin蛋白表达。*P<0.05与模型组(DMD)比较。其中,溶剂对照组:n=6只;模型组:n=6只;TBN 10mg/kg组:n=6只;TBN 30mg/kg组:n=6只;TBN 60mg/kg组:n=6只;Deflazacort 10mg/kg组:n=6只。
具体实施方式
下面将结合本发明具体实施例对本发明的技术方案进行清楚、完整地描述,显然,所描述的实施例只是本发明一部分实施例,而不是全部的实施例。本领域技术人员应当理解,对本发明的具体实施例进行修改或者对部分技术特征进行同等替换,而不脱离本发明技术方案的精神,均应涵盖在本发明保护的范围中。
实施例1.DMD模型小鼠的构建及分组
(1)杜氏肌营养不良症动物模型的建立
委托南京大学-南京生物医药研究院构建mouse Dmd基因的gRNA,利用CRISPR/Cas9技术和囊胚注射技术,针对mouse Dmd基因的Exon4进行打靶,筛选能够导致Dmd基因移码突变的小鼠模型。
(2)动物分组及给药
小鼠饲养于广州中医药大学三元里校区实验动物中心SPF级动物实验房,饲养在自然明/暗循环(12h/12h)环境中,温度20-26℃,湿度40-70%,小鼠自由进水和饮食。
给药方法:各组动物从8周龄开始连续灌胃给药24周,不同剂量TBN每天灌胃2次;阳性对照药deflazacort腹腔给药,一天一次。
实施例2.TBN对DMD小鼠四肢运动协调能力以及运动能力的影响。
为评价TBN对DMD小鼠运动行为功能的改善,给药开始后,每4周测定一次各组别小鼠的爬杆时间和旷场运动距离,连续测量24周。
爬杆测试可以评估小鼠四肢的运动及协调能力。自制长约50cm,直径约1cm的木杆,杆上缠有纱布以增加摩擦力。木杆竖直立置于水平桌面上,将小鼠头朝下轻轻置于杆顶,小鼠在不受外力的驱动下自主向下爬行,记录小鼠从杆顶爬到底部平台的时间(爬杆时间)。每次测量前连续训练3天,每天2次,测试结果以15s为分界值,超过15s按15s记录。重复测试3次,计算每只小鼠3次结果的平均爬杆时间作为评估值。结果如图1所示,DMD小鼠在发病后出现明显的运动迟缓现象,表现为爬杆时间明显长于野生型小鼠,并且随着年龄增加其运动迟缓现象愈发严重,而给予不同剂量TBN治疗后,均能显著改善其运动迟缓症状,且治疗效果显著优于阳性药deflazacort。
旷场试验又称自发活动分析、开放场实验,用于探索实验动物在新环境的自主行为、探索行为和紧张度的一种实验方法。将各组别小鼠轻轻放置于长50cm、宽50cm、高40cm的敞箱中,由自主摄影系统自动记录小鼠的自主活动,连续记录5min,并用相关软件分析处理数据,测定小鼠的自主运动总距离。实验结果如图2所示,DMD小鼠出现明显的自主行为下降,表现为小鼠自主运动的总距离明显低于野生型小鼠,并且随着年龄增长,其自主运动行为下降现象愈发严重,而给予不同剂量的TBN治疗后,能显著改善其运动迟缓症状,且治疗效果显著优于阳性药deflazacort。
实施例3.TBN明显提高DMD小鼠血清中SOD的含量
实验终点,麻醉小鼠后腹主动脉取血,静置1h后,3000rmp离心10min收集上清,按照SOD试剂盒说明书采用全自动生化分析仪测定含量。研究结果如图3所示,相对于DMD模型组,30mg/kg TBN组显著增加血清中SOD的含量,且治疗效果优于阳性药deflazacort。
实施例4.TBN对DMD小鼠腓肠肌、心肌和膈肌萎缩程度的影响
实验终点,小鼠用1%的戊巴比妥钠麻醉后,取小鼠双侧腓肠肌、心肌和膈肌,经4%多聚甲醛固定和石蜡包埋,连续组织切片,每片5μm,37℃烘干1h,然后进行苏木精-伊红(HE)染色,简要步骤如下:石蜡切片从65℃烘箱中取出后立即放入二甲苯中脱蜡和梯度酒精复水后,用苏木精染液染色10min,镜检控制1%盐酸酒精分化,直至细胞核及核内染色质清晰为止;1%氨水-乙醇溶液蓝化;0.5%曙红Y-乙醇溶液染色3min,最后常规脱水,封片,光镜下观察组织形态改变。实验结果如图4、5和6所示:相比于野生型小鼠,DMD小鼠肌纤维数目减少、排列稀疏、肌纤维融合、胞体完整性丧失,而给予TBN治疗后,能明显改善其肌细胞萎缩程度。
实施例5.TBN降低DMD小鼠腓肠肌、心肌和膈肌纤维化程度
实验动物麻醉处死后,分别取小鼠腓肠肌、心肌和膈肌,经4%多聚甲醛固定和石蜡包埋,连续组织切片,每片5μm,37℃烘干1h,然后进行Masson染色。简要步骤如下:石蜡切片从65℃烘箱中取出后立即放入二甲苯中脱蜡和梯度酒精复水后,按照试剂盒说明书加入试剂A(A1和A2等量混合液)染色8min;接着利用试剂B分化和试剂C返蓝;试剂D染色7min;试剂E洗1min;试剂F洗1min;试剂G染色1min;95%乙醇和无水乙醇脱水,二甲苯透明,中性树胶封片。扫片后通过MIPAR v2.1.8软件进行统计分析。实验结果如图7、图8和图9所示:相比于野生型小鼠,DMD组小鼠纤维化程度明显加重,给予TBN治疗后,不同剂量TBN能明显降低腓肠肌、心肌和膈肌纤维化,效果明显优于阳性药deflazacort。
实施例6.TBN增加DMD小鼠腓肠肌抗萎缩蛋白表达
将腓肠肌石蜡切片烘烤后,经二甲苯脱蜡,梯度乙醇复水,放入0.01M的枸橼酸缓冲液中,高火7min加热至沸腾,再用中低火维持15min后,自然冷却至室温。然后将切片放入含3%H2O2的PBS溶液中避光孵育15min,去除脑组织切片中的过氧化物酶,PBS洗涤3次,每次5min,然后加入10%的HS室温封闭90min,吸走HS,加入一抗,4℃孵育过夜,PBS洗涤3次,每次5min,加入GTVsion III抗鼠/兔通用二抗孵育1.5h,DAB显色后梯度乙醇脱水、二甲苯透明后中性树脂封片,置于倒置荧光显微镜下观察。实验结果如图10所示:相比于野生组,DMD组小鼠dysferlin表达降低,TBN治疗后能明显增加dysferlin表达。
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