JP4091860B2 - Drugs for the treatment of neurological disorders - Google Patents
Drugs for the treatment of neurological disorders Download PDFInfo
- Publication number
- JP4091860B2 JP4091860B2 JP2003062489A JP2003062489A JP4091860B2 JP 4091860 B2 JP4091860 B2 JP 4091860B2 JP 2003062489 A JP2003062489 A JP 2003062489A JP 2003062489 A JP2003062489 A JP 2003062489A JP 4091860 B2 JP4091860 B2 JP 4091860B2
- Authority
- JP
- Japan
- Prior art keywords
- vitamin
- acid
- sodium
- group
- nerve
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
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- 229940079593 drug Drugs 0.000 title description 7
- 208000012902 Nervous system disease Diseases 0.000 title description 3
- 208000025966 Neurological disease Diseases 0.000 title 1
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Description
【0001】
【発明の属する技術分野】
本発明は、神経障害予防治療用の医薬に関する。さらに詳しくは、ビタミン類複合剤による末梢神経障害予防治療用の医薬に関する。
【0002】
【従来の技術】
末梢神経障害は虚血、薬物中毒、外傷、ウイルス感染、栄養障害、遺伝、糖尿病、腫瘍、アレルギー、アルコールの多飲等、様々な原因から引き起こされることが知られている。障害の発生部位も局所的なものから、多発性のもの、全身性のものがある。その結果としておきる症状も、神経障害の発生部位によって、全身麻痺、筋肉萎縮、筋力低下、しびれ、疼痛、浮腫、難聴、視力低下、呼吸困難、皮膚潰瘍等多岐多様に渡っている。
【0003】
上記の様な末梢神経障害に対しては、ビタミンB12の投与が有効であることが報告されている(診療と新薬,22,219−223頁,1985年)。また、特開平2−22229号公報には、神経細胞及び神経線維の疾患及び予防に用いるイチョウ抽出物および、葉酸もしくはその誘導体、α−リポ酸、ビタミンBグループもしくはその誘導体のうち少なくとも1つを含有する組み合わせ調合剤が報告されている。特開平5−294968号公報および特開平7−18084号公報には、葉酸誘導体が癌治療、特定の貧血、自動免疫疾患、神経障害の治療に使用できることが開示されている。特開平10−218775号公報には、大量のメチルコバラミン投与が筋萎縮性側索硬化症の治療に有効であることが記載されている。
さらに、しびれや痛みを示した末梢神経障害患者に、ビタミンB12とビタミンEを併せて投与することによって、ビタミンB12単独のときよりも、神経障害の改善度が高くなり、これはビタミンEの末梢循環促進作用に基づくものであると報告されている(Suzuki,K.,et al.,Jpn.Pharmacol.Ther.,Vol.13,3061−3084,1985)。
【0004】
【発明が解決しようとする課題】
葉酸は抗貧血因子として古くから知られている必須ビタミン類であり、プリン、ピリミジンの代謝、グリシン、セリン、ヒスチジン等の代謝に関与している。特開2001−238640号公報には、貧血の改善に有効な葉酸及び/又はビタミンB12をラクトフェリン類に保持させた複合物が記載されているが、神経修復作用については、何ら記載されていない。
そこで、本発明の目的は、従来知られているものよりも、さらに有効性の高い神経修復剤を提供することにある。
【0005】
【課題を解決するための手段】
本発明者らは、上記事情に鑑みて鋭意研究を行った結果、特定のビタミン類を組み合わせた医薬が、従来知られている例えばビタミンB12や葉酸単独の神経修復剤よりも高い効果があることを見出し、本発明を完成させた。
【0006】
すなわち、本発明はビタミンB群の1種以上およびビタミンEを有効成分とする神経障害予防治療剤である。また、本発明はさらに葉酸を含む上記神経障害予防治療剤である。さらに本発明は、上記ビタミンBがB1、B2、B6およびB12からなる群から選ばれる1種以上である神経障害予防治療剤である。
【0007】
【発明の実施の形態】
本発明において,神経障害は器質的な障害または機能的な障害を意味する。すなわち、ニューロパチーや事故等による神経組織の損傷、腫瘍等の物理的圧迫による機能障害、ストレス等によって誘発される自律神経の失調、およびこれらに起因する痛み、しびれ、こり、倦怠感、筋力低下、眼精疲労、頭痛等の諸症状を意味する。
本発明に係る組成物は、食品、飲料、飼料、医薬品、医薬部外品、またはこれらの添加物として使用できる。
本発明に係る組成物の剤型は、錠剤、細粒剤、顆粒剤、粉剤、カプセル剤、カプレット、口腔内溶解型錠剤、注射剤、内服用液剤等であり、好ましくは錠剤またはカプセル剤である。
【0008】
本発明においてビタミンB群には誘導体も含まれる。例えばビタミンB1(チアミン、フルスルチアミン等)、ビタミンB2(リボフラビン、リン酸リボフラビン、リボフラビンモノヌクレオチド等)、ビタミンB3(ナイアシン)、ビタミンB5(パントテン酸)、ビタミンB6(ピリドキシン、ピリドキサール、ピリドキサミン等)およびビタミンB12(シアノコバラミン、メチルコバラミン、ヒドロキソコバラミン、アデノシルコバラミン)等である。好ましくはビタミンB1、ビタミンB6、ビタミンB12である。
【0009】
ビタミンB群の1日当たりの投与量は、経口投与する場合には、ビタミンB1およびB6では、通常0.05〜250mg/kg、好ましくは0.1〜125mg/kg、さらに好ましくは0.5〜5mg/kgである。また、ビタミンB12では、通常0.1〜5000μg/kg、好ましくは1〜500μg/kg、さらに好ましくは15〜45μg/kgである。
【0010】
本発明においてビタミンEとは、トコフェロール類およびトコトリエノール類を意味し、これらの塩および誘導体も含まれる。例えば、α−トコフェロール、β−トコフェロール、γ−トコフェロール、δ−トコフェロール、α−酢酸トコフェロール、α−コハク酸トコフェロール、コハク酸トコフェロールカルシウム、α−ニコチン酸トコフェロール、α−トコトリエノール、γ−トコトリエノール等を意味する。好ましくは酢酸d−α−トコフェロールである。
【0011】
ビタミンEの1日当たりの投与量は特に限定されないが、通常0.05〜250mg/kg、好ましくは0.1〜125mg/kg、さらに好ましくは0.5〜5mg/kgである。
【0012】
本発明において葉酸には、プテロイルモノグルタメートまたは活性体、これらの塩、誘導体も含まれる。例えばジヒドロ葉酸、テトラヒドロ葉酸、5−メチルテトラヒドロ葉酸、5,10−メチレンテトラヒドロ葉酸、10−ホルミルテトラヒドロ葉酸等である。
【0013】
葉酸の1日当たりの投与量は特に限定されないが、通常0.5〜62.5mg/kg、好ましくは1〜100mg/kg、さらに好ましくは2.5〜10mg/kgである。
【0014】
本発明に係る液剤組成物の製剤化には、通常用いられる種々の添加剤を配合することができる。添加剤としては例えば、安定化剤、界面活性剤、可溶化剤、緩衝剤、甘味剤、矯味剤、懸濁化剤、抗酸化剤、清涼化剤、着香剤・香料、乳化剤、pH調整剤、分散剤、芳香剤、防腐剤、保存剤等が挙げられる。
【0015】
安定化剤としては、例えばアジピン酸、アスコルビン酸、L−アスコルビン酸ナトリウム、L−アスパラギン酸、L−アスパラギン酸ナトリウム、亜硫酸ナトリウム、L−アルギニン、安息香酸ナトリウム、イノシトール、エデト酸ナトリウム、エリソルビン酸、エリソルビン酸ナトリウム、クエン酸ナトリウム、グリシン、グリセリン、グリセリン脂肪酸エステル、軽質無水ケイ酸、酢酸トコフェロール、ゼラチン、大豆油不けん化物、ポリオキシエチレンポリオキシプロピレングリコール、無水クエン酸ナトリウム、モノステアリン酸グリセリン、リン酸水素ナトリウム等が挙げられる。
【0016】
界面活性剤としては、コレステロール、ショ糖脂肪酸エステル、ステアリルアルコール、セスキオレイン酸ソルビタン、セタノール、ソルビタン脂肪酸エステル、ポリオキシエチレン硬化ヒマシ油、ポリオキシエチレンポリオキシプロピレングリコール、ポリソルベート、マクロゴール、モノオレイン酸ソルビタン、モノステアリン酸グリセリン、モノラウリン酸ソルビタン、ラウリル硫酸ナトリウム、ラウロマクロゴール等が挙げられる。
【0017】
可溶化剤としては、L−アスパラギン酸、L−アルギニン、安息香酸ナトリウム、エタノール、塩化ナトリウムソルビタン脂肪酸エステル、炭酸水素ナトリウム、ポリオキシエチレン硬化ヒマシ油、ポリオキシエチレンポリオキシプロピレングリコール、ポリソルベート、ポリビニルアルコール、D−マンニトール、無水エタノール等を例示することができる。
【0018】
緩衝剤としては、アスコルビン酸、L−アスパラギン酸マグネシウム、アミノエチルスルホン酸、L−アルギニン、安息香酸、安息香酸ナトリウム、クエン酸、クエン酸カルシウム、クエン酸ナトリウム、クエン酸二ナトリウム、グリシン、炭酸水素ナトリウム、乳酸、ブドウ糖、無水クエン酸、無水クエン酸ナトリウム、無水リン酸一水素ナトリウム、メタリン酸ナトリウム、リン酸水素ナトリウム、リン酸二カリウム、リン酸二水素カリウム、リン酸二水素ナトリウム等を使用することができる。
【0019】
甘味剤としては、アスパルテーム、アマチャ、カンゾウ、果糖、果糖ブドウ糖液、ブドウ糖果糖液糖、還元麦芽糖水アメ、グリチルリチン酸二カリウム、グリチルリチン酸モノアンモニウム、高果糖液糖、ブドウ糖、水アメ、乳糖、白糖、精製白糖、ハチミツ、サッカリン、サッカリンナトリウム、ステビア、スクラロース、エリスリトール、キシリトール、D−ソルビトール、マルチトール、マルトース、D−マンニトール、単シロップ等を挙げることができる。
【0020】
矯味剤としては、アスコルビン酸、L−アスパラギン酸、DL−アラニン、5′−イノシン酸二ナトリウム、ウイキョウ、塩化ナトリウム、オレンジ油、カカオ末、カンフル、グリシン、グリセリン、L−グルタミン酸、サフラン、酒石酸、ショウキョウ、D−ソルビトール、ハッカ、アジピン酸、フマル酸、ペパーミント、ボルネオール、メントール、リュウノウ、緑茶末、リンゴ果汁、リンゴ酢、レモン油、ローズ油、ローヤルゼリー等を使用することができる。
【0021】
懸濁化剤としては、例えばアラビアゴム、カラギーナン、カルボキシビニルポリマー、カンテン、キサンタンガム、グリセリン脂肪酸エステル、酸化チタン、ショ糖脂肪酸エステル、ステリアルアルコール、ステアリン酸アルミニウム、セタノール、精製ゼラチン、ソルビタン脂肪酸エステル、大豆レシチン、プロピレングリコール脂肪酸エステル、ペクチン、プロピレングリコール、ポリオキシエチレン硬化ヒマシ油、ポリエチレングリコール、メチルセルロース、モノステアリン酸グリセリン、流動パラフィン等を挙げることができる。
【0022】
抗酸化剤としては、アスコルビン酸、L−アスコルビン酸ステアリン酸エステル、亜硫酸水素ナトリウム、亜硫酸ナトリウム、エリソルビン酸、塩酸システイン、酢酸トコフェロール、大豆レシチン、ブチルヒドロキシアニソール、没食子酸プロピル等を例示することができる。
【0023】
清涼化剤としては、ゲラニオール、ハッカ水、ハッカ油、ボルネオール、メントール、ミント等が挙げられる。
【0024】
着香剤・香料としては、ウイキョウ、エチルバニリン、エチルマルトール、オレンジ、カンフル、ケイヒ、シュガーフレーバー、シンナムアルデヒド、チェリーフレーバー、トウヒチンキ、ハッカ、バニラフレーバー、バニリン、ビターエッセンス、フルーツフレーバー、フレーバーGI、ベルモットフレーバー、ミックスフレーバー、ミントフレーバー、メントール、ユーカリ油、リュウノウ、レモンパウダー、レモン油、ロジン、ローズ油等を例示することができる。
【0025】
乳化剤としては、カラギーナン、カルボキシビニルポリマー、カルメロースナトリウム、グァーガム、グリセリン脂肪酸エステル、ジステアリン酸ポリエチレングリコール、ショ糖脂肪酸エステル、ステアリルアルコール、ステアリン酸、セタノール、ゼラチン、ソルビタン脂肪酸エステル、大豆レシチン、ヒドロキシプロピルセルロース、プロピレングリコール、プロピレングリコール脂肪酸エステル、ポリオキシエチレンポリオキシプロピレングリコール、ポリソルベート、ミリスチルアルコール、モノステアリン酸グリセリン、モノラウリン酸ソルビタン、ラウリル硫酸ナトリウム等が挙げられる。
【0026】
pH調整剤としては、希塩酸、クエン酸ナトリウム、グリシン、コハク酸、酢酸、酒石酸、水酸化ナトリウム、炭酸水素ナトリウム、炭酸ナトリウム、フマル酸一ナトリウム、リン酸、リン酸三ナトリウム、リン酸水素ナトリウム、リン酸二カリウム、リン酸二水素ナトリウム等が挙げられる。
【0027】
分散剤としては、アミノアルキルメタクリレートポリマーRS、アラビアゴム、オレイン酸、カルボキシビニルポリマー、カルメロースナトリウム、グリセリン、結晶セルロース、コリンリン酸塩、レシチン、セスキオレイン酸ソルビタン、デキストリン、トウモロコシデンプン、トリオレイン酸ソルビタン、ヒドロキシエチルセルロース、ヒドロキシプロピルセルロース、メチルセルロース、モノステアリン酸グリセリン、ラウリル硫酸ナトリウム、流動パラフィン等を使用することができる。
【0028】
芳香剤としては、ウイキョウ、エチルバニリン、オレンジ油、カンフル、ケイヒ、ショウキョウ、ジンコウ、チョウジ、ハッカ、バニラ、バニリン、ボルネオール、マルトール、メントール、ユーカリ、リュウノウ、レモン、ローズ水等を挙げることができる。
【0029】
防腐剤としては、アミノエチルスルホン酸、安息香酸、安息香酸ナトリウム、エタノール、エデト酸ナトリウム、カンテン、クエン酸ナトリウム、サリチル酸ナトリウム、ソルビン酸、パラオキシ安息香酸イソプロピル、パラオキシ安息香酸エチル、メントール等が挙げられる。
【0030】
保存剤としては、安息香酸ナトリウム、エタノール、エデト酸ナトリウム、グリセリン、サリチル酸、サリチル酸ナトリウム、D−ソルビトール、ソルビン酸、パラオキシ安息香酸イソブチル、パラオキシ安息香酸エチル、パラオキシ安息香酸ブチル、パラオキシ安息香酸メチル、プロピレングリコール等を挙げることができる。
【0031】
【実施例】
以下に、実施例を示して本発明をさらに詳細に説明するが、本発明はこれらに限定されない。
【0032】
実施例1
各群10例の雄ラット(Crj:Wistar)を使って神経障害モデルを作成し、本発明の医薬組成物を投与して、その効果を調べた。
各ラットをペントバルビタールナトリウムで麻酔し、右側後肢の坐骨神経を露出させ、コッヘルで5秒間圧挫して神経障害モデルを作成した。
その後、6または8週間連続で、ビタミンB1(VB1)、ビタミンB6(VB6)、ビタミンB12(VB12)、ビタミンE(VE)、葉酸(FA)を1日1回、強制経口投与した(投与薬剤および投与量:表1)。対照群には媒体を投与した。
なお、飼料は低葉酸のもの(12μg/100g)を使用し、さらに腸内細菌の影響を無くするために、スルファサクジン250mg/headを毎日経口投与した。
【0033】
A:VB1 2mg/kg、VB6 2mg/kg、VB12 0.03mg/kg
およびVE 2mg/kgの混合液(媒体;Tween80)
B:葉酸0.02mg/kg(媒体注射用水)
C:葉酸0.1mg/kg(媒体注射用水)
VB1 塩酸フルスルチアミン
VB6 塩酸ピリドキシン
VB12メチルコバラミン
VE 酢酸d−α−トコフェロール
【0034】
投与開始6および8週後に、各群各10例のラットをエーテル麻酔下で放血致死させ、坐骨神経を採取し、常法に従って病理組織学的検査用のプレパラートを作成した。
そして画像解析装置(MacSCOPE:商品名、Mitani co.ltd.製)を使用して、各個体ごとに500本の神経線維について有髄神経の短径を測定した。
【0035】
図1は、6週後の、図2は、8週後の神経線維径の分布である。
VB1 2mg/kg、VB6 2mg/kg、VB12 0.03mg/kg、VE 2mg/kgを投与した第1群では、投与6週後には、径4.5μm以上の神経線維の割合が、また、8週後には、4.0μm以上の神経線維の割合が対照群より増加した。
したがって、ビタミンB群とビタミンEを投与することによって、末梢神経の修復作用が促進されることが明らかになった。
葉酸0.02mg/kgをさらに投与した第2群では、投与6週後と8週後共に4.5μm以上の大きい神経線維の割合が第1群よりもさらに増加していた。
また、葉酸0.1mg/kgを投与した第3群では、投与6週後に、3.5μm以上の大きい神経線維の割合が、8週後に4.0μm以上の割合が第2群よりもさらに増加していた。
このように、第1群よりも第2群および第3群の方が有効性が高かったことから、ビタミンB群、Eにさらに葉酸を配合することによって相乗的な効果が得られることが明らかとなった。また、葉酸の配合量と末梢神経の回復促進効果の間には、明らかなDose−Responseがあることが認められた。
【0036】
実施例2
整形外科的領域の神経疾患を持つ患者に本発明の医薬組成物を投与してその効果を調べた。
筋肉痛、関節痛(肩こり、腰痛、肩関節周囲炎、頚肩腕症候群など)、手足のしびれ、神経痛,肩や首筋のこりを有する患者50人に対し、表2の成分を有する治療剤を一日3回に別け、食後に経口投与し、4週継続後、有効性について検討した。
VB12 メチルコバラミン
VE 酢酸d−α−トコフェロール
VB1 塩酸フルスルチアミン
VB6 塩酸ピリドキシン
FA 葉酸
【0037】
自覚症状別改善度は次のとおりである。
自発腰痛 53.3%(8/15)
運動後の腰痛 50.0%(7/14)
しびれ(上肢) 69.2%(9/13)
こり(頚部) 54.5%(6/11)
こり(腰部、背部)80.0%(4/5)
筋肉痛 62.5%(5/8)
脱力感 66.7%(4/6)
疲労倦怠感 80.0%(8/10)
冷感 60.0%(3/5)
熱感 66.7%(2/3)
【0038】
他覚症状所見別の改善度は次のとおりである。
異常知覚(上肢) 62.5%(5/8)
知覚鈍麻(下肢) 50.0%(2/4)
脊柱運動制限 40.0%(2/5)
異常知覚(下肢) 37.5%(3/8)
【0039】
全般改善度は次のとおりである。
改善度 %(例数)
著明改善 20.5(9)
改善 20.5(9)
軽度改善 31.8(14)
不変 27.3(12)
悪化 0.0(0)
合計 (44)
有効性評価例での「軽度改善度」以上の改善率は72.7%(32/44)であった。
以上の成績から、本発明に係る医薬組成物は、筋肉痛(肩こり、腰痛症、五十肩など)、手足のしびれ、肩や首筋のこりなどの諸症状に対して有効であることが明らかになった。
【0040】
実施例3
眼精疲労の患者45人に対し、表2の成分を有する治療剤を1日3回に別け、食後に経口投与し、2週継続後と、4週継続後に、その有効性を評価した。
【0041】
自覚症状別改善度は投与4週後で次のとおりである。
目が疲れる 64.1%(25/39)
目が痛い 79.2%(19/24)
上記以外の眼症状 80.0%(20/25)
(涙が出る、まぶしい、まぶたがぴくぴくする)
頭が痛い、重い 63.0%(17/27)
筋症状 78.4%(29/37)
(腰が痛い、肩がこる、首が痛い)
視機能 64.3%(18/28)
(物が二重に見える、目の前がちらちらする、
物がはっきり見えない、ぼやけて見える)
疲労感 63.6%(21/33)
(全身倦怠感、あくびがでる・ねむい、根気がなくなる)
主評価項目である自覚症状総合改善度は、投与2週後の判定では76.7%(33/43)であった。投与4週後の判定では90.5%(38/42)のであった。
【0042】
全般改善度は次のとおりである。
改善度 %(例数)
著名改善 14.0(6)
改善 46.5(20)
軽度改善 30.2(13)
不変 2.3(1)
軽度悪化 7.0(3)
判定不能 0.0(0)
評価例数 (43)
有効性評価例での「軽度改善」以上の改善率は90.7%(39)であった。
【0043】
以上の成績から、本発明に係る医薬組成物は、眼精疲労の治療薬として有効であることが明らかとなった。
【0044】
実施例4
各群4例の雄ラット(SD、日本チャールスリバー)を使用して、異所性神経発火モデル(薬剤の鎮痛作用の検討モデル)を作製し、本発明に係る医薬組成物の効果を検討した。
各ラットをハロセンで麻酔し、左後肢を切開して、伏在神経を露出させた。伏在神経を約5mm切除し、術創を縫合した。その1週間後にラットをウレタン/α−クロラースで麻酔し、右頸静脈に薬物投与用のカテーテルを挿入した。さらに、切除した伏在神経の近位端を露出させて、白金製フック電極をかけ、メモリーオシロスコープを使用して神経発火を記録した。発火が安定したことを確認し、初期値として10秒間の発火を記録した。
その後、カテーテルからビタミンB1(VB1)、ビタミンB6(VB6)、ビタミンB12(VB12)、ビタミンE(VE)、葉酸(FA)を投与して、神経発火を記録して初期値と比較した(投与薬剤および投与量:表3)。
その結果、ビタミンB12を単独投与した第1群では効果は見られなかったが、ビタミンB1、B6、B12およびビタミンEを投与した第2群、ビタミンB1、B6、B12および葉酸を投与した弟3群では、神経発火がそれぞれ初期値の67%、79%と低下した。また、ビタミンB1、B6、B12、ビタミンEおよび葉酸の5剤を投与した第4群では31%にまで低下し、本発明に係る医薬組成物が大きな効果を発揮することが明らかになった。
【0045】
A:VB12(メチルコバラミン) 0.6mg/kg
B:VB1(塩酸チアミン)20mg/kg、VB6(塩酸ピリドキシン)20mg/kg
C:VE(酢酸トコフェロール) 20mg/kg
D:FA(葉酸)6mg/kg
【0046】
実施例5
PC12細胞を用いて、ロテノン添加による細胞障害に対する、本発明に係る医薬組成物の保護効果を検討した。
PC12細胞の培養には10%FCS、10%HS含有DMEM培地を用いた。PC12細胞を24孔コラーゲンコート培養プレート(Falkon社製)に播種(1.3×105/孔)し、CO2インキュベーター(37℃、5%CO2)中で3日間、コンフルエントに達するまで培養した。培養液を除去後、ビタミンB1(VB1)、ビタミンB6(VB6)、ビタミンB12(VB12)、ビタミンE(VE)、葉酸(FA)の各種複合剤(薬剤および用量:表4)を加えた5%FCS含有DMEM培地を添加し、培養6時間後に、ロテノン(10nM、シグマ社製)を加えた。培養1日(21時間)後に、生存細胞数の指標となるMTT assayを行った。各孔の培地に1/10量のMTT溶液(5mg/ml、シグマ社製)を添加し、CO2インキュベーター内に入れ、その3時間後に1.5倍量の40mM塩酸−イソプロパノール溶液を加え、一晩放置後、吸光度(OD550nm)を測定した。
その結果、VB1、VB6およびVB12を添加した第1群に対して、VB1、VB6、VB12およびVEを添加した第2群、並びに、VB1、VB6、VB12およびFAを添加した第3群では、第1群よりも吸光度値が上昇した。さらに、VB1、VB6、VB12、VEおよびFAを添加した第4群では最も高い吸光度値を示したことから、本発明に係る医薬組成物が大きな効果を発揮することが明らかになった。
【0047】
A:VB1(塩酸チアミン)25μg/ml+VB6(塩酸ピリドキシン)25μg/ml+VB12(メチルコバラミン)10μg/ml
B:VE(酢酸トコフェロール)25μg/ml
C:FA(葉酸)10μg/ml
【0048】
【発明の効果】
本発明に係る医薬は、末梢神経障害の予防治療に有効である。
神経挫滅等の器質的障害の修復を促進し、整形外科的領域の疾患である痛み、こり、痺れ等の自覚症状の改善および眼精疲労に伴う症状の改善が認められた。また、鎮痛作用や細胞障害に対する保護効果が認められた。
【図面の簡単な説明】
【図1】実施例1における対照群と、本発明治療剤投与6週後の各群の神経線維径分布を示す図
【図2】同上対照群と、本発明治療剤投与8週後の各群の神経線維径分布を示す図[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a medicament for preventing and treating neuropathy. More specifically, the present invention relates to a pharmaceutical for preventing or treating peripheral neuropathy with a vitamin complex.
[0002]
[Prior art]
Peripheral neuropathy is known to be caused by various causes such as ischemia, drug addiction, trauma, viral infection, nutritional disorders, heredity, diabetes, tumors, allergies, and excessive drinking of alcohol. The site of the disorder may be local, multiple, or systemic. The resulting symptoms also vary widely depending on the site of neuropathy, including general paralysis, muscle atrophy, muscle weakness, numbness, pain, edema, hearing loss, decreased visual acuity, dyspnea, and skin ulcers.
[0003]
It has been reported that the administration of vitamin B12 is effective for peripheral neuropathy as described above (clinical practice and new drugs, 22, 219-223, 1985). JP-A-2-22229 discloses at least one of ginkgo biloba extract used for diseases and prevention of nerve cells and nerve fibers and folic acid or a derivative thereof, α-lipoic acid, vitamin B group or a derivative thereof. Containing combination preparations have been reported. JP-A-5-294968 and JP-A-7-18084 disclose that a folic acid derivative can be used for cancer treatment, specific anemia, autoimmune disease, and neuropathy treatment. JP-A-10-218775 describes that administration of a large amount of methylcobalamin is effective for the treatment of amyotrophic lateral sclerosis.
In addition, administration of vitamin B12 and vitamin E to peripheral neuropathy patients who have shown numbness or pain increases the degree of improvement of neuropathy compared with vitamin B12 alone, It has been reported to be based on a circulation promoting action (Suzuki, K., et al., Jpn. Pharmacol. Ther., Vol. 13, 3061-3084, 1985).
[0004]
[Problems to be solved by the invention]
Folic acid is an essential vitamin that has long been known as an anti-anemic factor, and is involved in the metabolism of purines, pyrimidines, glycine, serine, histidine, and the like. Japanese Patent Application Laid-Open No. 2001-238640 describes a complex in which folic acid and / or vitamin B12 effective in improving anemia is retained in lactoferrin, but does not describe any nerve repair action.
Accordingly, an object of the present invention is to provide a nerve repair agent that is more effective than those conventionally known.
[0005]
[Means for Solving the Problems]
As a result of intensive studies in view of the above circumstances, the present inventors have found that a medicine combined with a specific vitamin is more effective than conventionally known nerve repair agents such as vitamin B12 or folic acid alone. The present invention was completed.
[0006]
That is, the present invention is a neuropathy preventive / therapeutic agent comprising at least one vitamin B group and vitamin E as active ingredients. Furthermore, the present invention is the above-mentioned neuropathy preventive / therapeutic agent further comprising folic acid. Furthermore, the present invention is a neuropathy preventive or therapeutic agent wherein the vitamin B is one or more selected from the group consisting of B1, B2, B6 and B12.
[0007]
DETAILED DESCRIPTION OF THE INVENTION
In the present invention, a neurological disorder means an organic disorder or a functional disorder. In other words, neuropathy and accidents, etc., damage to the nervous tissue, dysfunction due to physical compression such as tumors, autonomic ataxia induced by stress, etc., and pain, numbness, stiffness, malaise, muscle weakness caused by these, It means various symptoms such as eye strain and headache.
The composition according to the present invention can be used as foods, beverages, feeds, pharmaceuticals, quasi drugs, or additives thereof.
The dosage form of the composition according to the present invention is a tablet, fine granule, granule, powder, capsule, caplet, oral-dissolving tablet, injection, liquid for internal use, and preferably a tablet or capsule. is there.
[0008]
In the present invention, the vitamin B group includes derivatives. For example, vitamin B1 (thiamine, fursultiamine, etc.), vitamin B2 (riboflavin, riboflavin phosphate, riboflavin mononucleotide, etc.), vitamin B3 (niacin), vitamin B5 (pantothenic acid), vitamin B6 (pyridoxine, pyridoxal, pyridoxamine, etc.) And vitamin B12 (cyanocobalamin, methylcobalamin, hydroxocobalamin, adenosylcobalamin) and the like. Vitamin B1, vitamin B6, and vitamin B12 are preferred.
[0009]
When administered orally, the daily dose of vitamin B group is usually 0.05 to 250 mg / kg, preferably 0.1 to 125 mg / kg, more preferably 0.5 to 0.5 for vitamins B1 and B6. 5 mg / kg. Moreover, in vitamin B12, it is 0.1-5000 microgram / kg normally, Preferably it is 1-500 microgram / kg, More preferably, it is 15-45 microgram / kg.
[0010]
In the present invention, vitamin E means tocopherols and tocotrienols, and salts and derivatives thereof are also included. For example, α-tocopherol, β-tocopherol, γ-tocopherol, δ-tocopherol, α-tocopherol acetate, α-tocopherol succinate, tocopherol calcium succinate, α-tocopherol nicotinate, α-tocotrienol, γ-tocotrienol, etc. To do. Preferred is d-α-tocopherol acetate.
[0011]
The daily dose of vitamin E is not particularly limited, but is usually 0.05 to 250 mg / kg, preferably 0.1 to 125 mg / kg, more preferably 0.5 to 5 mg / kg.
[0012]
In the present invention, folic acid also includes pteroyl monoglutamate or active form, salts and derivatives thereof. For example, dihydrofolic acid, tetrahydrofolic acid, 5-methyltetrahydrofolic acid, 5,10-methylenetetrahydrofolic acid, 10-formyltetrahydrofolic acid and the like.
[0013]
The daily dose of folic acid is not particularly limited, but is usually 0.5 to 62.5 mg / kg, preferably 1 to 100 mg / kg, more preferably 2.5 to 10 mg / kg.
[0014]
In formulating the liquid composition according to the present invention, various commonly used additives can be blended. Examples of additives include stabilizers, surfactants, solubilizers, buffers, sweeteners, flavoring agents, suspending agents, antioxidants, cooling agents, flavoring agents / fragrances, emulsifiers, pH adjustments. Agents, dispersants, fragrances, preservatives, preservatives and the like.
[0015]
Examples of the stabilizer include adipic acid, ascorbic acid, sodium L-ascorbate, L-aspartic acid, sodium L-aspartate, sodium sulfite, L-arginine, sodium benzoate, inositol, sodium edetate, erythorbic acid, Sodium erythorbate, sodium citrate, glycine, glycerin, glycerin fatty acid ester, light anhydrous silicic acid, tocopherol acetate, gelatin, soybean oil unsaponifiable matter, polyoxyethylene polyoxypropylene glycol, anhydrous sodium citrate, glyceryl monostearate, Examples thereof include sodium hydrogen phosphate.
[0016]
Surfactants include cholesterol, sucrose fatty acid ester, stearyl alcohol, sorbitan sesquioleate, cetanol, sorbitan fatty acid ester, polyoxyethylene hydrogenated castor oil, polyoxyethylene polyoxypropylene glycol, polysorbate, macrogol, monooleic acid Examples include sorbitan, glyceryl monostearate, sorbitan monolaurate, sodium lauryl sulfate, lauromacrogol and the like.
[0017]
As solubilizers, L-aspartic acid, L-arginine, sodium benzoate, ethanol, sodium chloride sorbitan fatty acid ester, sodium hydrogen carbonate, polyoxyethylene hydrogenated castor oil, polyoxyethylene polyoxypropylene glycol, polysorbate, polyvinyl alcohol , D-mannitol, absolute ethanol and the like.
[0018]
Buffering agents include ascorbic acid, magnesium L-aspartate, aminoethylsulfonic acid, L-arginine, benzoic acid, sodium benzoate, citric acid, calcium citrate, sodium citrate, disodium citrate, glycine, hydrogen carbonate Use sodium, lactic acid, glucose, anhydrous citric acid, anhydrous sodium citrate, anhydrous sodium hydrogen phosphate, sodium metaphosphate, sodium hydrogen phosphate, dipotassium phosphate, potassium dihydrogen phosphate, sodium dihydrogen phosphate, etc. can do.
[0019]
Sweeteners include aspartame, achacha, licorice, fructose, fructose dextrose, glucose fructose dextrose, reduced maltose syrup, dipotassium glycyrrhizinate, monoammonium glycyrrhizinate, high fructose syrup, dextrose, water candy, lactose, sucrose And purified sucrose, honey, saccharin, sodium saccharin, stevia, sucralose, erythritol, xylitol, D-sorbitol, maltitol, maltose, D-mannitol, simple syrup and the like.
[0020]
As a corrigent, ascorbic acid, L-aspartic acid, DL-alanine, disodium 5'-inosinate, fennel, sodium chloride, orange oil, cacao powder, camphor, glycine, glycerin, L-glutamic acid, saffron, tartaric acid, For example, ginger, D-sorbitol, mint, adipic acid, fumaric acid, peppermint, borneol, menthol, agate, green tea powder, apple juice, apple vinegar, lemon oil, rose oil, royal jelly, and the like can be used.
[0021]
Examples of the suspending agent include gum arabic, carrageenan, carboxyvinyl polymer, agar, xanthan gum, glycerin fatty acid ester, titanium oxide, sucrose fatty acid ester, stearic alcohol, aluminum stearate, cetanol, purified gelatin, sorbitan fatty acid ester, Examples include soybean lecithin, propylene glycol fatty acid ester, pectin, propylene glycol, polyoxyethylene hydrogenated castor oil, polyethylene glycol, methyl cellulose, glyceryl monostearate, liquid paraffin, and the like.
[0022]
Examples of antioxidants include ascorbic acid, L-ascorbic acid stearate, sodium hydrogen sulfite, sodium sulfite, erythorbic acid, cysteine hydrochloride, tocopherol acetate, soybean lecithin, butylhydroxyanisole, propyl gallate and the like. .
[0023]
Examples of the refreshing agent include geraniol, mint water, mint oil, borneol, menthol, mint and the like.
[0024]
Flavoring agents and fragrances include fennel, ethyl vanillin, ethyl maltol, orange, camphor, keihi, sugar flavor, cinnamaldehyde, cherry flavor, spruce tincture, mint, vanilla flavor, vanillin, bitter essence, fruit flavor, flavor GI, vermouth Examples include flavor, mixed flavor, mint flavor, menthol, eucalyptus oil, agate, lemon powder, lemon oil, rosin, and rose oil.
[0025]
As an emulsifier, carrageenan, carboxyvinyl polymer, carmellose sodium, guar gum, glycerin fatty acid ester, polyethylene glycol distearate, sucrose fatty acid ester, stearyl alcohol, stearic acid, cetanol, gelatin, sorbitan fatty acid ester, soybean lecithin, hydroxypropyl cellulose , Propylene glycol, propylene glycol fatty acid ester, polyoxyethylene polyoxypropylene glycol, polysorbate, myristyl alcohol, glyceryl monostearate, sorbitan monolaurate, sodium lauryl sulfate and the like.
[0026]
Examples of pH adjusters include dilute hydrochloric acid, sodium citrate, glycine, succinic acid, acetic acid, tartaric acid, sodium hydroxide, sodium bicarbonate, sodium carbonate, monosodium fumarate, phosphoric acid, trisodium phosphate, sodium hydrogen phosphate, Examples include dipotassium phosphate and sodium dihydrogen phosphate.
[0027]
Dispersants include aminoalkyl methacrylate polymer RS, gum arabic, oleic acid, carboxyvinyl polymer, carmellose sodium, glycerin, crystalline cellulose, choline phosphate, lecithin, sorbitan sesquioleate, dextrin, corn starch, sorbitan trioleate Hydroxyethyl cellulose, hydroxypropyl cellulose, methyl cellulose, glyceryl monostearate, sodium lauryl sulfate, liquid paraffin and the like can be used.
[0028]
Examples of fragrances include fennel, ethyl vanillin, orange oil, camphor, cinnamon, ginger, ginkgo, clove, mint, vanilla, vanillin, borneol, maltol, menthol, eucalyptus, rhubarb, lemon, rose water, etc. .
[0029]
Examples of the preservative include aminoethyl sulfonic acid, benzoic acid, sodium benzoate, ethanol, sodium edetate, agar, sodium citrate, sodium salicylate, sorbic acid, isopropyl paraoxybenzoate, ethyl paraoxybenzoate, menthol, and the like. .
[0030]
Preservatives include sodium benzoate, ethanol, sodium edetate, glycerin, salicylic acid, sodium salicylate, D-sorbitol, sorbic acid, isobutyl paraoxybenzoate, ethyl paraoxybenzoate, butyl paraoxybenzoate, methyl paraoxybenzoate, propylene A glycol etc. can be mentioned.
[0031]
【Example】
Hereinafter, the present invention will be described in more detail with reference to examples, but the present invention is not limited thereto.
[0032]
Example 1
A neuropathy model was created using 10 male rats (Crj: Wistar) in each group, the pharmaceutical composition of the present invention was administered, and the effect was examined.
Each rat was anesthetized with sodium pentobarbital to expose the sciatic nerve in the right hind limb and squeezed with Kochel for 5 seconds to create a neuropathy model.
Thereafter, vitamin B1 (VB1), vitamin B6 (VB6), vitamin B12 (VB12), vitamin E (VE), and folic acid (FA) were orally administered by gavage once a day for 6 or 8 weeks (administered drug) And dose: Table 1). The control group received vehicle.
The feed used was low folic acid (12 μg / 100 g), and sulfasacdin 250 mg / head was orally administered daily in order to eliminate the effects of intestinal bacteria.
[0033]
A: VB1 2 mg / kg, VB6 2 mg / kg, VB12 0.03 mg / kg
And VE 2 mg / kg mixture (medium; Tween 80)
B: Folic acid 0.02 mg / kg (medium injection water)
C: Folic acid 0.1 mg / kg (medium injection water)
VB1 fursultiamine hydrochloride VB6 pyridoxine hydrochloride VB12 methylcobalamin VE acetic acid d-α-tocopherol
6 and 8 weeks after the start of administration, 10 rats in each group were exsanguinated under ether anesthesia, the sciatic nerve was collected, and a preparation for histopathological examination was prepared according to a conventional method.
Then, using an image analyzer (MacSCOPE: trade name, manufactured by Mitani co.ltd.), The minor axis of the myelinated nerve was measured for 500 nerve fibers for each individual.
[0035]
FIG. 1 shows the distribution of nerve fiber diameter after 6 weeks, and FIG. 2 shows the distribution of nerve fiber diameter after 8 weeks.
In the first group administered with 2 mg / kg of VB1, 2 mg / kg of VB6, 0.03 mg / kg of VB12, and 2 mg / kg of VE, the proportion of nerve fibers having a diameter of 4.5 μm or more after 6 weeks of administration, After a week, the proportion of nerve fibers of 4.0 μm or more increased from the control group.
Therefore, it was revealed that the peripheral nerve repair action is promoted by administering vitamin B group and vitamin E.
In the second group in which 0.02 mg / kg of folic acid was further administered, the ratio of large nerve fibers of 4.5 μm or more was further increased than in the first group at 6 weeks and 8 weeks after administration.
In the third group administered with 0.1 mg / kg of folic acid, the proportion of large nerve fibers of 3.5 μm or more increased 6 weeks after the administration, and the proportion of 4.0 μm or more increased further 8 weeks after the administration. Was.
Thus, since the effectiveness of the second group and the third group was higher than that of the first group, it is clear that a synergistic effect can be obtained by further adding folic acid to the vitamin B group and E. It became. In addition, it was recognized that there was a clear dose-response between the blended amount of folic acid and the peripheral nerve recovery promoting effect.
[0036]
Example 2
A pharmaceutical composition of the present invention was administered to a patient having a neurological disorder in the orthopedic region to examine its effect.
50 therapeutic patients with muscle pain, joint pain (shoulder stiffness, low back pain, shoulder periarthritis, neck-shoulder arm syndrome, etc.), numbness of the limbs, neuralgia, shoulder and neck stiffness, one therapeutic agent having the ingredients listed in Table 2 Divided into 3 times a day and administered orally after meals, and after 4 weeks, the effectiveness was examined.
VB12 Methylcobalamin VE Acetic acid d-α-tocopherol VB1 Fursultiamine hydrochloride VB6 Pyridoxine hydrochloride FA Folic acid
The degree of improvement by subjective symptoms is as follows.
Spontaneous back pain 53.3% (8/15)
Low back pain after exercise 50.0% (7/14)
Numbness (upper limb) 69.2% (9/13)
Litter (neck) 54.5% (6/11)
Litter (waist, back) 80.0% (4/5)
Myalgia 62.5% (5/8)
Sense of weakness 66.7% (4/6)
Fatigue fatigue 80.0% (8/10)
Cool feeling 60.0% (3/5)
Thermal sensation 66.7% (2/3)
[0038]
The degree of improvement by objective symptoms is as follows.
Abnormal perception (upper limb) 62.5% (5/8)
Perception dullness (lower limbs) 50.0% (2/4)
Spinal motion restriction 40.0% (2/5)
Abnormal perception (lower limbs) 37.5% (3/8)
[0039]
The overall improvement is as follows.
Improvement rate% (number of cases)
Significant improvement 20.5 (9)
Improvement 20.5 (9)
Mild improvement 31.8 (14)
Unchanged 27.3 (12)
Deterioration 0.0 (0)
Total (44)
The improvement rate of “mild improvement” or more in the effectiveness evaluation example was 72.7% (32/44).
From the above results, it was revealed that the pharmaceutical composition according to the present invention is effective for various symptoms such as muscle pain (shoulder stiffness, low back pain, fifty shoulders, etc.), numbness of limbs, stiffness of shoulders and neck muscles. .
[0040]
Example 3
Forty-five patients with eye strain, the therapeutic agents having the components shown in Table 2 were divided into three times a day, orally administered after meals, and the effectiveness was evaluated after 2 weeks and 4 weeks.
[0041]
The degree of improvement by subjective symptom is as follows 4 weeks after administration.
Eyes get tired 64.1% (25/39)
Eyes hurt 79.2% (19/24)
Eye symptoms other than the above 80.0% (20/25)
(Tears, dazzling, eyelids tingling)
Painful and heavy 63.0% (17/27)
Myopathy 78.4% (29/37)
(Back pain, shoulder stiffness, neck pain)
Visual function 64.3% (18/28)
(Things look double, the front flickers,
(I can't see things clearly, it looks blurry)
Fatigue 63.6% (21/33)
(Whole body fatigue, yawning / sneezing, patience)
The overall subjective symptom improvement degree, which is the main evaluation item, was 76.7% (33/43) as determined at 2 weeks after administration. The determination at 4 weeks after administration was 90.5% (38/42).
[0042]
The overall improvement is as follows.
Improvement rate% (number of cases)
Prominent improvement 14.0 (6)
Improvement 46.5 (20)
Mild improvement 30.2 (13)
Unchanged 2.3 (1)
Mild deterioration 7.0 (3)
Judgment impossible 0.0 (0)
Number of evaluation examples (43)
The improvement rate of “mild improvement” or more in the effectiveness evaluation example was 90.7% (39).
[0043]
From the above results, it was revealed that the pharmaceutical composition according to the present invention is effective as a therapeutic agent for eye strain.
[0044]
Example 4
Using 4 male rats (SD, Nippon Charles River) in each group, an ectopic nerve firing model (a study model for analgesic action of drugs) was prepared, and the effect of the pharmaceutical composition according to the present invention was examined. .
Each rat was anesthetized with halothane and the left hind limb was incised to expose the saphenous nerve. The saphenous nerve was excised approximately 5 mm, and the surgical wound was sutured. One week later, the rats were anesthetized with urethane / α-chlorase, and a drug administration catheter was inserted into the right jugular vein. In addition, the proximal end of the resected saphenous nerve was exposed, a platinum hook electrode was applied, and nerve firing was recorded using a memory oscilloscope. After confirming that the ignition was stable, the ignition for 10 seconds was recorded as an initial value.
Thereafter, vitamin B1 (VB1), vitamin B6 (VB6), vitamin B12 (VB12), vitamin E (VE), and folic acid (FA) were administered from the catheter, and nerve firing was recorded and compared with the initial value (administration) Drugs and doses: Table 3).
As a result, no effect was seen in the first group administered with vitamin B12 alone, but the second group administered with vitamins B1, B6, B12 and vitamin E, and brother 3 administered with vitamins B1, B6, B12 and folic acid. In the group, nerve firing decreased to 67% and 79% of the initial value, respectively. Moreover, in the 4th group which administered vitamin B1, B6, B12, the vitamin E, and the 5 drugs of folic acid, it fell to 31%, and it became clear that the pharmaceutical composition which concerns on this invention exhibits a big effect.
[0045]
A: VB12 (methylcobalamin) 0.6 mg / kg
B: VB1 (thiamine hydrochloride) 20 mg / kg, VB6 (pyridoxine hydrochloride) 20 mg / kg
C: VE (tocopherol acetate) 20 mg / kg
D: FA (folic acid) 6 mg / kg
[0046]
Example 5
Using PC12 cells, the protective effect of the pharmaceutical composition according to the present invention against cell damage caused by rotenone addition was examined.
For culturing PC12 cells, 10% FCS, 10% HS-containing DMEM medium was used. PC12 cells were seeded (1.3 × 10 5 / hole) in a 24-hole collagen-coated culture plate (Falkon) and cultured in a CO 2 incubator (37 ° C., 5% CO 2 ) for 3 days until reaching confluence. did. After removing the culture solution, vitamin B1 (VB1), vitamin B6 (VB6), vitamin B12 (VB12), vitamin E (VE), and various combinations of folic acid (FA) (drugs and doses: Table 4) were added 5 % FCS-containing DMEM medium was added, and rotenone (10 nM, manufactured by Sigma) was added after 6 hours of culture. After 1 day of culture (21 hours), MTT assay was performed as an index of the number of viable cells. 1/10 amount of MTT solution (5 mg / ml, manufactured by Sigma) was added to the medium in each pore, placed in a CO 2 incubator, and 3 hours later, 1.5 times the amount of 40 mM hydrochloric acid-isopropanol solution was added, After standing overnight, the absorbance (OD550 nm) was measured.
As a result, in the first group to which VB1, VB6 and VB12 were added, in the second group to which VB1, VB6, VB12 and VE were added, and in the third group to which VB1, VB6, VB12 and FA were added, Absorbance values were higher than in
[0047]
A: VB1 (thiamine hydrochloride) 25 μg / ml + VB6 (pyridoxine hydrochloride) 25 μg / ml + VB12 (methylcobalamin) 10 μg / ml
B: VE (tocopherol acetate) 25 μg / ml
C: FA (folic acid) 10 μg / ml
[0048]
【The invention's effect】
The medicament according to the present invention is effective for the prevention and treatment of peripheral neuropathy.
It promoted the repair of organic disorders such as nerve crush, improved subjective symptoms such as pain, stiffness and numbness, which were diseases in the orthopedic region, and improved symptoms associated with eye strain. In addition, analgesic action and protective effect against cell damage were observed.
[Brief description of the drawings]
FIG. 1 is a graph showing the distribution of nerve fiber diameters in a control group in Example 1 and each group 6 weeks after administration of the therapeutic agent of the present invention. FIG. Of nerve fiber diameter distribution of group
Claims (2)
ビタミンB1、B6、B12及び葉酸を含み、
前記ビタミンB12がメチルコバラミンである、
神経障害予防治療剤。One or more vitamin B group and vitamin E as active ingredients ,
Contains vitamins B1, B6, B12 and folic acid,
The vitamin B12 is methylcobalamin,
Neuropathic preventive and therapeutic agent.
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