CN1194681C - 用于抗血栓形成的甘氨酸甜菜碱 - Google Patents
用于抗血栓形成的甘氨酸甜菜碱 Download PDFInfo
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- A—HUMAN NECESSITIES
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- A61P9/00—Drugs for disorders of the cardiovascular system
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Abstract
本发明涉及甘氨酸甜菜碱消除病理生理性血管疾病的用途。本发明涉及甘氨酸甜菜碱在动脉或静脉起源的血栓栓塞和止血疾病的发病中的治疗和预防活性。甘氨酸甜菜碱具有通过抑制血栓形成实现的预防活性和通过消除血栓而抑制其增殖的治疗活性。本发明的特征在于甘氨酸甜菜碱与目前所用的分子和治疗相比不存在任何出血或变态反应的危险。本发明还涉及甘氨酸甜菜碱作为抗凝剂用于血液保存的用途。
Description
本发明涉及甘氨酸甜菜碱消除病理生理性血管疾病的用途。本发明涉及甘氨酸甜菜碱在动脉或静脉起源的血栓栓塞和止血疾病的发病中的治疗和预防活性。
甘氨酸甜菜碱在阻止血栓形成时显示出预防活性,并在消灭血栓时显示出阻止血栓增殖的治疗活性。本发明的有效性是基于这样的事实:甘氨酸甜菜碱的应用由于对抗了目前所用的分子和治疗而没有导致任何出血或变态反应的危险。
在先技术
血管形成血栓是生物体面临对血管壁及其细胞和血浆内容物的攻击时作出的响应。血栓形成是伴有血栓形成的凝结物的局限性激活。
近年来对这种病变的关注已确定了其的几种成因:
-血管、血管壁和内皮细胞,
-血液中存在的各种成分的作用
-凝结和纤维蛋白溶解系统,及其抑制剂。
有若干种类型的血栓形成可发生于动脉、静脉、器官的微循环、心脏腔中和与血液接触的人造表面上。血管形成血栓是对血管壁及其细胞和血浆内容物攻击的响应。血栓形成是血液成分(血小板、红细胞和白细胞)、纤维蛋白和其他血浆蛋白质的组织团块,它们沉积于血管系统的表面或阻塞血管系统的自由通道。
血栓形成的机理与止血的机理类似,但由于它们在血管内异常定位,因而是病理性的。
血栓形成和栓塞是与心血管疾病和动脉粥样硬化有关的临床并发症的主要原因。
根据Virchow的研究,至少有三种类型的血栓形成因素决定血栓形成的位置、程度和消退:
-血液动力学和流变因素;
-内皮损害;
-血液构成物特别是血小板的活化,以及血凝固的激活导致血栓形成。
动脉或静脉起源的血栓栓塞疾病一直是发达国家死亡的主要原因之一。
动脉血栓形成经常是由于动脉粥样硬化斑的破裂引起的,而静脉血栓形成由凝固抑制剂(AT III)的不足或纤维蛋白溶解活化剂(S蛋白和/或C蛋白)的不足引起,或者更经常是由淤滞引起。事实上,这些都是由血液和血管壁之间的相互作用、静脉血栓形成和/或止血异常引起的。动脉血栓形成更常继发于周壁的异常,并且主要涉及血小板。它根据在血管形成中涉及的动脉层而导致各种各样的临床图象。血栓形成主要能影响心动脉(冠状动脉),以及下部、脑或消化器官的动脉。因此,动脉疾病有助于血栓本身的形成,这是大多数末端血管阻塞的原因。另外,止血紊乱和在其他血管损害处形成的血栓的参与是明显的:血管壁的损害、局部缺血和微循环中的问题加重。
有三种治疗策略可以用于防止与血栓形成有关的伤害:
抗凝剂。它们在对显示出血栓栓塞疾病的患者的治疗中构成了主要成分。目前使用的是肝素及其衍生物。但是,肝素类的应用可能产生两种主要的并发症,即出血或血小板减少。
K抗维生素(KAV)。可用于长期治疗,它们不能用于紧急情况,并且不能与其他抗聚集剂同时使用,因为它们会加强其出血作用。
血小板抗聚集剂。可用于预防与动脉粥样硬化有关的动脉血栓形成。目前使用的主要的血小板机能抑制剂是:阿斯匹林、噻氯匹定、潘生丁、以及某些非类固醇抗炎剂诸如氟比洛芬和前列腺环素。这些治疗确实是有效的,但对患者有不期望的使其经受变态反应或出血的作用。
尽管有功效,但所有这些治疗在使用时都需要特定的预防措施,诸如给予解毒剂、配药过量问题和不希望的副作用。这些治疗使得必需对患者进行监控,特别是由于可能在药物治疗过程中或之后产生的与出血相关的问题,以及与其他药物的可能的不相容性。因此,令人感兴趣的是确定具有高抗血栓形成潜力而没有不期望的作用的分子。非常令人惊讶的是,甘氨酸甜菜碱已确定在血栓形成的治疗中具有高治疗潜力。
分子式为(CH3)3N-----CH2-----COOR的甘氨酸甜菜碱(Glycinebetaine),或甜菜碱(betaine),是一种已知其具有渗透保护性能的分子,并已知其美容和药物用途。甜菜碱的各种药物用途是已知的,特别是甜菜碱用于治疗会引起心血管问题的高胱氨酸尿的用途(L.& B.Wilken,J.Inher.Metab.Dis.1997)。因此,患有高胱氨酸尿(是一种遗传异常)的病人显示出早期动脉粥样硬化和血栓栓塞疾病(S.H.Mudd等,遗传病的代谢和分子基础,1995)和心血管疾病(McCully,动脉粥样硬化评论11,1983)。高胱氨酸尿是一种遗传缺陷,其纯合形式非常罕见。据估计,这种纯合形式的流行相当于在总人口中200人中出现1人。
高胱氨酸尿是由于受影响患者血浆中高半胱氨酸的浓度升高引起的。给药甜菜碱能降低血液中高半胱氨酸的浓度。
出版物WO 951 157 50提出了使用包含甜菜碱的成分来预防高胱氨酸尿患者的血管疾病。
出版物WO 98/19690也涉及患有血液中高半胱氨酸浓度升高的患者。除了其他成分以外,甜菜碱的应用是为了降低血液中高半胱氨酸的浓度,它已确定高半胱氨酸是发生心血管疾病以及早老性痴呆的正危险因素。
出版物EP 0 347 864描述了甜菜碱与其他成分一起用于对抗人血浆中因半胱氨酸和高半胱氨酸引起的巯基的增加,并由此用于抑制动脉粥样硬化斑的形成。
这种抗动脉粥样硬化作用是已知的,并且得到了充分证明。这些出版物涉及甜菜碱对脂质代谢的作用(Zapadnyuk等,Biol.Med.1987),和对胆固醇代谢的作用(Panteleimonova等,Farmakol.Toksikol,Moscow 1983)。
出版物WO 97 38685描述了甜菜碱和牛磺酸用于治疗某些器官中因局部缺血导致的并发症的用途。局部缺血是血流的局部停滞,并且只代表因血栓导致的病变之一。
出版物EP 0 781 554包括的实施例描述了有关摘出心脏的实验,即:有关已从血管系统中取出并分离的心脏。使用甜菜碱的已知的渗透保护和抗辐射性能使得发明人请求保护其对心肌的保护作用。
甜菜碱的其他形式已被提出过(WO 97/06795),但迄今没有能比得上甘氨酸甜菜碱的效力和性能的。
这些出版物中没有一篇公开过甘氨酸甜菜碱关于静脉和/或动脉血栓形成的效力,也没有公开过其抗聚集剂和抗凝剂的效力。
在本发明中,甘氨酸甜菜碱可以用于各种临床适应症,诸如:
-冠脉血栓形成和静脉血栓形成
-梗死,心绞痛,动脉瘤,肺栓塞,静脉炎
-脑栓塞
-创伤后休克,无论是否外科来源的
-预防下列病况中的微循环伤害:血友病,化学治疗,老化,使用雌激素口服避孕,肥胖,烟草成瘾,修复术。
-预防与离子和非离子造影剂给药有关的危险。
仪器和方法
A/激光诱导血栓形成的原理
(Seiffge D.等,1989年;Weichter W.等,1983年)
在这个模型中,血管壁的损害是利用激光束导致的。这种激光束引起血管内皮的有限损害(只有1-2个细胞被破坏)。这种敷设露出内皮下膜,其是形成血栓的表面,由此经糖蛋白II导致血小板粘着。血小板的这种粘着接下来导致其活化。它们形成伪足并分泌它们的颗粒内容物。这种活化导致糖蛋白IIb-IIIa出现,它们是血小板之间聚集所必需的。这种损害是在大鼠的肠系膜微循环中诱导的。之后立即有血栓形成(在几秒钟内)。此血栓在血液流动的影响下迅速扩大,在被再次形成之前成为栓子。
通过这种方式,对甘氨酸甜菜碱的药理学作用进行评定,连带着研究两种用作参照的活性分子,即乙酰水杨酸和肝素(低分子量的)。该评定还涉及甘氨酸甜菜碱与由造影剂导致的促血栓形成作用有关的活性。
B/淤滞诱导的血栓形成
实行剖腹术打开下腔静脉,在T0时放置结扎线,接着在T0+2小时的时候皮下注射甘氨酸甜菜碱,在T0+6小时的时候取消凝结。
C/实验步骤
雄性Wistar大鼠用于这些试验。它们的重量在200和250g之间。经过8天的稳定期后,将这些大鼠禁食12小时。然后将它们麻醉,皮下注射甘氨酸甜菜碱,并在实验结束时打开肠系膜(激光)或腔静脉(淤滞)。
实施例:
实施例1:评估由激光灼烧导致血管变化后栓子的数量和栓塞的持续时间。
栓子的数量 | 栓塞的持续时间(分钟) | |
阴性对照NaCl 0.9% | 5.33±0.58 | 2±0 |
甘氨酸甜菜碱5mg/kg | 2±0 | 1±0 |
乙酰水杨酸100mg/kg | 1±1 | 0.33±0.58 |
肝素2mg/kg | 2.67±0.52 | 1±0 |
甘氨酸甜菜碱大大减少了由激光灼烧导致血管变化后栓子的数量和栓塞的持续时间。结果证明了其强大的抗血栓形成活性。
实施例2:评估所引起的出血时间
(E.Dejana.大鼠的出血时间。血栓形成研究,1982年)
出血时间(秒) | |
阴性对照NaCl 0.9% | 101.52±5.7 |
甘氨酸甜菜碱5mg/kg | 95±5 |
乙酰水杨酸100mg/kg | 276.67±20.82 |
肝素2mg/kg | 313.33±20 |
这些结果显示,甘氨酸甜菜碱将所引起的出血时间维持在了阴性对照的数值范围内。除了其抗血栓形成活性外,甘氨酸甜菜碱与阳性对照相比没有产生任何出血危险。
实施例3:评估因激光灼烧导致血管变化后血小板的聚集
(Cardinal & Flower.药理学方法,1980年)
幅度(欧姆数) | 速率(欧姆数/分钟) | |
阴性对照NaCl 0.9% | 13±1 | 9±1 |
甘氨酸甜菜碱5mg/kg | 0.66±1.15 | 1.66±1.15 |
乙酰水杨酸100mg/kg | 2.33±2.08 | 2±1 |
肝素2mg/kg | 4.33±0.57 | 2.66±0.50 |
这些结果证明了甘氨酸甜菜碱的抗聚集作用。
实施例4:评估对血细胞的作用
a/血小板计数
血小板数(109) | |
阴性对照NaCl 0.9% | 788±30.14 |
甘氨酸甜菜碱5mg/kg | 804.67±20.03 |
乙酰水杨酸100mg/kg | 855.33±63.17 |
肝素2mg/kg | 777.33±6.43 |
b/白细胞计数
白细胞数(109) | |
阴性对照NaCl 0.9% | 5.03±1 |
甘氨酸甜菜碱5mg/kg | 4.43±0.32 |
乙酰水杨酸100mg/kg | 4.33±1.00 |
肝素2mg/kg | 5.80±0.10 |
c/红细胞计数
红细胞数(109) | |
阴性对照NaCl 0.9% | 6.56±0.15 |
甘氨酸甜菜碱5mg/kg | 6.19±0.25 |
乙酰水杨酸100mg/kg | 6.15±0.31 |
肝素2mg/kg | 6.20±0.20 |
血液中存在的各种成分的计数维持在阴性对照的数值范围内,这证明了甘氨酸甜菜碱的无害性。
实施例5:生态平衡
a/Quick时间
QT(秒) | |
阴性对照NaCl 0.9% | 17±1 |
甘氨酸甜菜碱5mg/kg | 16.9±1.05 |
乙酰水杨酸100mg/kg | 18.33±2.08 |
肝素2mg/kg | 29.50±0.52 |
b/活化脑磷脂时间(ACT)
ATT(秒) | |
阴性对照NaCl 0.9% | 20.5±0.5 |
甘氨酸甜菜碱5mg/kg | 39.9±1.05 |
乙酰水杨酸100mg/kg | 27.26±1.1 |
肝素2mg/kg | 39.46±1.36 |
c/纤维蛋白原分析
纤维蛋白原(g/l) | |
阴性对照NaCl 0.9% | 2.45±0.19 |
甘氨酸甜菜碱5mg/kg | 1.7±0.1 |
乙酰水杨酸100mg/kg | 2.19±0.33 |
肝素2mg/kg | 2.13±0.25 |
d/α,2-抗纤维蛋白溶酶分析(α2AP)
α2AP(%) | |
阴性对照NaCl 0.9% | 30.16±0.85 |
甘氨酸甜菜碱5mg/kg | 29.7±0.68 |
乙酰水杨酸100mg/kg | 29.36±0.92 |
肝素2mg/kg | 29.4±1.01 |
e/抗凝血酶III分析(AT III)
AT III(%) | |
阴性对照NaCl 0.9% | 86±3 |
甘氨酸甜菜碱5mg/kg | 89.5±1.37 |
乙酰水杨酸100mg/kg | 85.33±3.51 |
肝素2mg/kg | 77.66±1.52 |
实施例6:甘氨酸甜菜碱活性作为时间函数的评估
实验组:产品以5mg/kg激光诱导的血栓形成的浓度进行测试
对照 NaCl 0.9%
组I 产品于实验前1小时注射
组II 产品于实验前2小时注射
组III 产品于实验前3小时注射
组IV 产品于实验前4小时注射
a)测试产品(5mg/ml/kg)对所引起的出血时间的作用。
组 | B.T.C.(秒) |
NaCl 0.9% | 110±21.2 |
I | 105±26.2 |
II | 145±15.52 |
III | 115.5±14.2 |
IV | 120±10.13 |
b)测试产品(5mg/ml/kg)对由激光束导致的动脉血栓形成的作用
组 | 灼烧数 | 栓子数 | 栓塞的持续时间(分钟) |
NaCl 0.9% | 2.5±0.84 | 5.7±1.5 | 2.1±0.69 |
I | 3.49±1.07 | 1.8±1.44 | 0.51±0.5 |
II | 3.0±1.5 | 1.4±1.18 | 0.3±0.23 |
III | 2.50±1.25 | 1.99±0.4 | 1.00±0.5 |
IV | 2.7±1.0 | 2.2±0.69 | 1.5±0.6 |
c)测试产品(5mg/kg)对来自体内诱导的血小板聚集的作用。
组 | 幅度(欧姆数) | 速率(欧姆数/分钟) |
NaCl 0.9% | 24.23±0.5 | 14.4±2.3 |
I | 11.33±3.08 | 8.2±0.2 |
II | 13.2±3.5 | 9.3±1.8 |
III | 12.7±4.1 | 8.7±1.3 |
IV | 13±2.8 | 8.7±1.15 |
d)反复给药后于治疗的第5天评估甘氨酸甜菜碱对凝血因子的作用
ACT(秒) | Quick时间(秒) | 纤维蛋白原g/l | |
未治疗的对照 | 21.25±2.3 | 16.1±1.0 | 3.03±0.45 |
甘氨酸甜菜碱(5mg/kg/天) | 39.3±2.3 | 19.8±1.2 | 2.2±0.1 |
实施例7:评估甘氨酸甜菜碱对由淤滞诱导的静脉血栓形成的作用。
a)甘氨酸甜菜碱对血凝块重量的作用
血凝块重量(mg) | |
未治疗的对照 | 4.033±2 |
甘氨酸甜菜碱(1mg/kg) | 3.1±0.4 |
甘氨酸甜菜碱(2.5mg/kg) | 1.63±0.76 |
甘氨酸甜菜碱(5mg/kg) | 0.76±0.4 |
b)评估甘氨酸甜菜碱对纤维蛋白溶酶原形成的作用
纤维蛋白溶酶原形成% | |
NaCl 0.9% | 2.7±0.33 |
甘氨酸甜菜碱(5mg/kg) | 1.66±0.58 |
甘氨酸甜菜碱(2.5mg/kg) | 2±0.15 |
甘氨酸甜菜碱(1mg/kg) | 2.44±0.58 |
c)评估甘氨酸甜菜碱对血凝固的作用
ACT(秒) | Quick时间(秒) | 纤维蛋白原g/l | |
未治疗的对照 | 30.2±2.7 | 16.1±1.0 | 3.03±0.45 |
甘氨酸甜菜碱(1mg/kg) | 29.1±2.3 | 16.2±1.2 | 2.63±0.3 |
甘氨酸甜菜碱(2.5mg/kg) | 31.2±2.6 | 16.6±0.7 | 2.2±0.17 |
甘氨酸甜菜碱(5mg/kg) | 33.5±1.9 | 15.6±0.4 | 2.32±0.33 |
d)评估甘氨酸甜菜碱对凝血因子的作用
抗Xa单位/ml | 抗IIa单位/ml | |
甘氨酸甜菜碱(5mg/kg) | 0.35±0.15 | - |
甘氨酸甜菜碱(2.5mg/kg) | 0.14±0.10 | - |
甘氨酸甜菜碱(1mg/kg) | 0.08±0.1 | - |
用甘氨酸甜菜碱治疗抑制了由激光灼烧引起的血栓栓塞并发症。事实上,在激光灼烧之前用甘氨酸甜菜碱治疗减少了血小板的血管粘着及其聚集。
用甘氨酸甜菜碱治疗抑制了血栓栓塞并发症。事实上,在诱导血栓形成之前用甘氨酸甜菜碱治疗显示出了关于在血栓形成过程中开始活动的所有参数的高抗血栓形成潜力。另外,有关生物学参数的结果证明甘氨酸甜菜碱是完全无害的,与所用的参照产品(阿司匹林和肝素)形成对照,它没有导致任何出血作用或不期望的副作用。这些特性意味着:甘氨酸甜菜碱除了其已经证明的效力外,可以对有出血危险的人给药,以及对如果给予常规抗血栓形成治疗可能发生过敏或变态反应危险的人(血友病的,变态反应的)给药。甘氨酸甜菜碱没有引起血小板减少或出血性疾病(实施例2和4)。实施例5c的实验结果表明有纤维蛋白原的消耗。
应当注意,在有关血液保存的相同实验条件下,甘氨酸甜菜碱与含有肝素或EDTA的试管相比似乎具有高抗凝剂能力。甘氨酸甜菜碱的有效剂量似乎在3和5mg/溶血管之间。该实验结果证明了甘氨酸甜菜碱的高抗凝剂潜力。由此可以断言,甘氨酸甜菜碱可用作抗凝剂,用于人体的体内治疗和来自体内的血液的保存。
甘氨酸甜菜碱的活性与造影剂的活性的对比评估
在我们的有关抗血栓形成作用的研究中,为了补充我们有关甘氨酸甜菜碱效能的初步工作,我们评估了甘氨酸甜菜碱对于与使用已知具有促血栓形成能力的造影剂有关的血栓栓塞危险增加的作用。此模型的有效性在于它使得能直接观察血管损害部位血栓的形成。这些结果解释了血管成形术过程中血栓形成性闭塞的发生,尤其是发生于内皮已被破坏或受损的那些病人中的。冠脉血管成形术引起内皮剥离,循环血液的胶原、弹性蛋白和平滑肌细胞露置,这类似于所用的实验性血栓形成模型。因此,在近期发生过冠脉血栓形成的病人中或具有偏心性冠脉斑的病人当中,新血栓的发生率更高。
给药造影剂减少了白细胞、红细胞和血小板的数量。造影剂与白细胞相互作用,诱导了白三烯的释放,增加了血管的渗透性并产生了趋化作用。另外,造影剂的作用可控制P-选择蛋白的表达,并引起白细胞对血管内皮的粘着。据显示,使用造影剂与出现可变量的血栓有关,这取决于所用的产品。
研究两种造影剂Hexabrix(离子的)和Iopamidol(非离子的)。
实施例8:通过激光灼烧和给药造影剂引起血管变化后评估栓子的数量和栓塞的持续时间
栓子数 | 栓塞的持续时间(分) | |
阴性对照NaCl 0.9% | 5.33±0.58 | 2±0 |
Hexabrix | 8±1 | 3.67±0.58 |
Iopamidol | 11.67±0.50 | 6.33±0.52 |
甘氨酸甜菜碱5mg/kg+Hexabrix | 4±1 | 2±0 |
甘氨酸甜菜碱5mg/kg+Iopamidol | 5.33±0.58 | 2.33±0.48 |
实施例9:评估诱导的出血时间(IBD)
IBD(秒) | |
阴性对照NaCl 0.9% | 101.52±5.7 |
Hexabrix | 195±13.23 |
Iopamidol | 128±7.64 |
甘氨酸甜菜碱5mg/kg+Hexabrix | 150±5 |
甘氨酸甜菜碱5mg/kg+Iopamidol | 111±6.60 |
实施例10:评估因激光灼烧导致血管变化后的血小板聚集
幅度(欧姆数) | 速率(欧姆数/分钟) | |
阴性对照NaCl 0.9% | 13±1 | 9±1 |
Hexabrix | 6±1 | 5.66±0.57 |
Iopamidol | 15±2.64 | 12.33±0.50 |
甘氨酸甜菜碱5mg/kg+Hexabrix | 2±1 | 5±0 |
甘氨酸甜菜碱5mg/kg+Iopamidol | 4.66±0.52 | 9.33±0.8 |
实施例11:评估甘氨酸甜菜碱对血细胞的作用
a/血小板计数
血小板数(109) | |
阴性对照NaCl 0.9% | 788.33±30.14 |
Hexabrix | 620±10 |
Iopamidol | 585.67±23.54 |
甘氨酸甜菜碱5mg/kg+Hexabrix | 669.67±7.37 |
甘氨酸甜菜碱5mg/kg+Iopamidol | 704.33±92.33 |
b/白细胞计数
白细胞数(1012) | |
阴性对照NaCl 0.9% | 5.03±0.20 |
Hexabrix | 2.96±0.21 |
Iopamidol | 3.06±0.35 |
甘氨酸甜菜碱5mg/kg+Hexabrix | 4.20±0.1 |
甘氨酸甜菜碱5mg/kg+Iopamidol | 3.9±0.3 |
c/红细胞计数
红细胞数(109) | |
阴性对照NaCl 0.9% | 6.56±0.15 |
Hexabrix | 5.43±0.47 |
Iopamidol | 5.5±0.36 |
甘氨酸甜菜碱5mg/kg+Hexabrix | 6.5±0.15 |
甘氨酸甜菜碱5mg/kg+Iopamidol | 6.6±0.19 |
实施例12:生态平衡
a/Quick时间
QT(秒) | |
阴性对照NaCl 0.9% | 17±1 |
Hexabrix | 24.13±1 |
Iopamidol | 28.1±0.75 |
甘氨酸甜菜碱5mg/kg+Hexabrix | 16.36±0.56 |
甘氨酸甜菜碱5mg/kg+Iopamidol | 17.83±1.2 |
b/活化脑磷脂时间(ACT)
ACT(秒) | |
阴性对照NaCl 0.9% | 20.5±0.5 |
Hexabrix | 49.3±1.85 |
Iopamidol | 41.33±0.8 |
甘氨酸甜菜碱5mg/kg+Hexabrix | 25.4±0.61 |
甘氨酸甜菜碱5mg/kg+Iopamidol | 22.4±0.7 |
c/纤维蛋白原分析
纤维蛋白原(g/l) | |
阴性对照NaCl 0.9% | 2.45±0.19 |
Hexabrix | 1.49±0.18 |
Iopamidol | 1.5±0.8 |
甘氨酸甜菜碱5mg/kg+Hexabrix | 1.7±0.09 |
甘氨酸甜菜碱5mg/kg+Iopamidol | 1.9±0.1 |
d/α,2-抗纤维蛋白溶酶分析(α2AP)
α2AP(%) | |
阴性对照NaCl 0.9% | 30.16±0.85 |
Hexabrix | 23.26±1.06 |
Iopamidol | 25.23±0.95 |
甘氨酸甜菜碱5mg/kg+Hexabrix | 25.66±0.09 |
甘氨酸甜菜碱5mg/kg+Iopamidol | 28.13±0.8 |
e/抗凝血酶III分析(AT III)
AT III(%) | |
阴性对照NaCl 0.9% | 86.3±3 |
Hexabrix | 81.63±0.66 |
Iopamidol | 70.6±1.51 |
甘氨酸甜菜碱5mg/kg+Hexabrix | 79.1±1.05 |
甘氨酸甜菜碱5mg/kg+Iopamidol | 87.26±0.98 |
用甘氨酸甜菜碱治疗抑制了与使用造影剂有关的血栓栓塞并发症。事实上,在注射造影剂之前或当中用甘氨酸甜菜碱治疗,减少了血小板的粘着及其在血管水平上的聚集。这些结果证明了甘氨酸甜菜碱的抗血栓形成和溶解血栓的作用。应当注意,造影剂可能因其自身的给药过程而导致其他副作用诸如导致导管和内皮损害中止血。甘氨酸甜菜碱改善了这些不期望的作用。
结论
甘氨酸甜菜碱具有与所研究的抗凝剂和抗聚集剂(乙酰水杨酸和肝素)相同或者甚至更好的治疗特性,同时没有显示出不期望的作用。
至于甘氨酸甜菜碱的优于这两种分子(乙酰水杨酸和肝素)的治疗功效的卓越性能对于配制含有甘氨酸甜菜碱作为治疗活性成分的药物是一种激励,所述药物打算用于治疗血栓形成和血栓栓塞疾病。
根据上面给出的结果,这种药物也显示出抗凝剂、抗聚集剂和纤维蛋白溶解性能。已证明的这种分子的无害性使得可以考虑长期治疗而不需要进行生物学监控。
使用甘氨酸甜菜碱的利益是基于这样的事实:它以若干种止血水平起作用,即:它作用于血小板聚集、凝结和纤维蛋白溶解。这种活性是持久的并防止了反复给药,这对现有的治疗来说是相当大的进步。给药甘氨酸甜菜碱没有引起任何出血危险或其他副作用(例如肝素诱导的血小板减少),这是抗血栓形成治疗中的主要进展。
Claims (10)
1、甘氨酸甜菜碱作为抗血栓活性剂用于制备治疗不是由高胱氨酸尿导致的血栓形成的组合物的用途。
2、甘氨酸甜菜碱作为抗血栓栓塞活性剂用于制备治疗不是由高胱氨酸尿导致的血栓栓塞疾病的组合物的用途。
3、甘氨酸甜菜碱作为抗血凝疾病活性剂用于制备治疗患者血液凝结疾病的组合物的用途。
4、甘氨酸甜菜碱作为抗血小板凝集活性剂用于制备治疗患者血小板聚集疾病的组合物的用途。
5、甘氨酸甜菜碱作为血栓溶解活性剂用于制备溶解血栓的组合物的用途。
6、甘氨酸甜菜碱作为抗血栓活性剂用于制备治疗患者有出血危险的血栓形成的组合物的用途。
7、甘氨酸甜菜碱作为抗凝剂用于保存来自体内的血液的用途。
8、甘氨酸甜菜碱作为抗血栓栓塞活性剂用于制备抵消由造影剂引起的血栓栓塞作用的组合物的用途。
9、按照权利要求8的用途,其特征在于所述组合物包括造影剂和甘氨酸甜菜碱。
10、按照权利要求1-6和8-9任一项所述的用途,其特征在于所述组合物包括有效量的甘氨酸甜菜碱与药学上可接受的支持物、载体或赋形剂。
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HUP9900213A1 (hu) * | 1999-02-01 | 2000-12-28 | Gábor Bogye | Gyógykompozíció(k) gesztagén tipusú hormon tartalmú gyógyszerek thromb-embóliás mellékhatásainak mérséklésére |
US7608640B2 (en) | 1999-03-02 | 2009-10-27 | Jallal Messadek | Glycine betaine and its use |
EP1408949B1 (en) * | 2001-02-05 | 2007-12-19 | Jallal Messadek | Glycine betaine and its use as anti-hemorrhagic agent |
BE1015608A6 (fr) | 2003-07-15 | 2005-06-07 | Messadek Jallal | Traitement des arterites. |
US20060160896A1 (en) * | 2002-02-04 | 2006-07-20 | Jallal Messadek | Therapeutic treatment |
UA83341C2 (uk) * | 2002-02-25 | 2008-07-10 | Дифьюжен Фармасьютикалз Ллк | Біополярні солі транс-каротиноїдів та їх використання |
US7759506B2 (en) | 2002-02-25 | 2010-07-20 | Diffusion Pharmaceuticals Llc | Bipolar trans carotenoid salts and their uses |
WO2004049095A2 (en) * | 2002-11-25 | 2004-06-10 | Jallal Messadek | Betaine and salicylic acid compositions |
US8697679B2 (en) | 2003-03-07 | 2014-04-15 | N.V. Nutricia | Method and composition for treating or preventing catabolism or stimulating anabolism in a mammal undergoing metabolic stress |
EP1615632B1 (fr) * | 2003-04-17 | 2006-12-06 | Jallal Messadek | Formulations orales flottantes pour la liberation controlee de la betaine |
WO2005011645A2 (en) * | 2003-08-04 | 2005-02-10 | Jallal Messadek | Selected betaines and their uses |
BE1016128A6 (fr) * | 2004-07-22 | 2006-03-07 | Messadek Jallal | Combinaisons therapeutiques |
WO2006050581A2 (en) * | 2004-11-10 | 2006-05-18 | Jallal Messadek | Betaine as agent against arthropod - or mosquito -borne diseases |
WO2006086856A1 (en) | 2005-02-15 | 2006-08-24 | Messadek, Jallal | Combination therapeutic compositions and method of use |
KR101315904B1 (ko) | 2005-02-24 | 2013-10-08 | 디퓨젼 파마슈티컬즈 엘엘씨 | 트랜스 카로티노이드, 이들의 합성, 제제화 및 용도 |
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US8557863B2 (en) * | 2005-09-27 | 2013-10-15 | Robert Benson Aylor | Suppression and prevention of tumors |
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US8293804B2 (en) | 2007-04-13 | 2012-10-23 | Diffusion Pharmaceuticals Llc | Use of bipolar trans carotenoids as a pretreatment and in the treatment of peripheral vascular disease |
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DE60024415T2 (de) | 2006-09-21 |
HUP0105397A3 (en) | 2003-03-28 |
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KR20020021369A (ko) | 2002-03-20 |
ATE311226T1 (de) | 2005-12-15 |
US6855734B2 (en) | 2005-02-15 |
CN1342071A (zh) | 2002-03-27 |
HK1044276B (zh) | 2006-12-22 |
WO2000051596A1 (fr) | 2000-09-08 |
JP2002538113A (ja) | 2002-11-12 |
ES2254144T3 (es) | 2006-06-16 |
CA2362558A1 (fr) | 2000-09-08 |
NZ513905A (en) | 2001-09-28 |
BE1012495A3 (fr) | 2000-11-07 |
HK1044276A1 (en) | 2002-10-18 |
WO2000051596A9 (fr) | 2001-10-11 |
EP1156796B1 (fr) | 2005-11-30 |
US20020065320A1 (en) | 2002-05-30 |
DE60024415D1 (de) | 2006-01-05 |
MXPA01008426A (es) | 2003-06-06 |
HUP0105397A2 (hu) | 2002-05-29 |
PL350408A1 (en) | 2002-12-02 |
BR0008631A (pt) | 2002-02-13 |
PL204560B1 (pl) | 2010-01-29 |
EP1156796A1 (fr) | 2001-11-28 |
EA200100925A1 (ru) | 2002-04-25 |
IL145068A0 (en) | 2002-06-30 |
CA2362558C (fr) | 2009-06-02 |
EA004047B1 (ru) | 2003-12-25 |
AU2897900A (en) | 2000-09-21 |
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