JP6144873B2 - Ire1、src、及びabl活性を調節するための方法及び組成物 - Google Patents
Ire1、src、及びabl活性を調節するための方法及び組成物 Download PDFInfo
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- JP6144873B2 JP6144873B2 JP2011527045A JP2011527045A JP6144873B2 JP 6144873 B2 JP6144873 B2 JP 6144873B2 JP 2011527045 A JP2011527045 A JP 2011527045A JP 2011527045 A JP2011527045 A JP 2011527045A JP 6144873 B2 JP6144873 B2 JP 6144873B2
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Description
本出願は、2008年9月15日出願の米国仮特許出願第61/097,173号(本明細書中、その全体が参照として含まれる)に基づく優先権を主張する。
本発明は、国立衛生研究所のグラント(GM60641)及び国防総省グラント第W81XWH-06-1-0383号の援助を受けた。政府は本発明に一定の権利を有する。
本明細書中で使用した略号は、化学及び生物学の分野の通常の意味をもつ。
(A)-OH、-NH2、-SH、-CN、-CF3、-NO2、オキソ、ハロゲン、非置換アルキル、非置換へテロアルキル、非置換シクロアルキル、非置換ヘテロシクロアルキル、非置換アリール、非置換ヘテロアリール、並びに
(B)以下のものから選択される少なくとも一つの置換基で置換された、アルキル、ヘテロアルキル、シクロアルキル、ヘテロシクロアルキル、アリール及びヘテロアリール:
(i)オキソ、-OH、-NH2、-SH、-CN、-CF3、-NO2、ハロゲン、非置換アルキル、非置換へテロアルキル、非置換シクロアルキル、非置換ヘテロシクロアルキル、非置換アリール、非置換ヘテロアリール、及び
(ii)以下のものから選択される少なくとも一つの置換基で置換された、アルキル、ヘテロアルキル、シクロアルキル、ヘテロシクロアルキル、アリール及びヘテロアリール:
(a)オキソ、-OH、-NH2、-SH、-CN、-CF3、-NO2、ハロゲン、非置換アルキル、非置換へテロアルキル、非置換シクロアルキル、非置換ヘテロシクロアルキル、非置換アリール、非置換ヘテロアリール、並びに
(b)オキソ、-OH、-NH2、-SH、-CN、-CF3、-NO2、ハロゲン、非置換アルキル、非置換へテロアルキル、非置換シクロアルキル、非置換ヘテロシクロアルキル、非置換アリール、及び非置換ヘテロアリールから選択される少なくとも一つの置換基で置換された、アルキル、ヘテロアルキル、シクロアルキル、ヘテロシクロアルキル、アリールまたはヘテロアリール。
本明細書では、式:
別の側面では、細胞でのIre1活性を調節する方法を提供する。本方法は、細胞と有効量の上記Ire1モジュレータ(たとえば式I〜VIIIの化合物)または有効量のスニチニブとを接触させることを含む。ある態様では、細胞はヒト細胞などの哺乳細胞である。細胞はインビトロに単離されるか、インビトロ組織の一部を形成するか、または有機体の一部を形成してもよい。
Ire1活性の調節は、溶液中で試験化合物とIre1タンパク質とを接触させることにより特定することができる。
別の側面では、本発明は医薬的に許容可能なキャリヤと組み合わせた本発明の化合物(即ちIre1モジュレータ)を含む医薬組成物を提供する。医薬組成物は、本明細書中に開示された阻害剤の光学異性体、ジアステレオマー、または医薬的に許容可能な塩を含む。医薬組成物に含まれる化合物は、上記のようにキャリヤ部分に共有結合していてもよい。あるいは、医薬組成物に含まれる化合物は、キャリヤ部分に共有結合していない。
以下の実施例は、本発明の特定の態様を説明するためのものであり、本明細書に記載の本発明の範囲を限定するものではない。
タンパク質は大腸菌で発現させ、GST-アフィニティ精製及びサイズ除外クロマトグラフィーを使用して精製した。DNAオリゴヌクレオチドはPCRで製造し、IDTから購入した。RNAオリゴヌクレオチドは、Dharmacon Inc.より購入するか、T7 RNAポリメラーゼでインビトロ転写により製造した。全ての動態アッセイ及び分析超遠心は、30℃及び中性pHで実施した。回折データはビームライン8.3.1(Advanced Lignt Source,Berkeley National Laboratories)で冷凍保存された結晶から集めた。相は、PHASERでのサーチモデルとしてPDB座標2rioを使用して分子置換より決定した。最終モデルはIre1のアミノ酸665-864、892-1115を含み;N-末端の一部(641-664)及び高リン酸化ループ865-891(aF-aEF)が不規則になっている。最終解像度は3.9Åであり、R/Rfreeは良い形状で0.264/0.298であった。実験手順の詳細な記載を以下に示す。
本発明の特定の化合物は、以下に記載のスキームを使用して合成し、必要により好適な試薬選択を実施することができる。
2,4-ジクロロピリミジン(3.2g,21.6mmol)及び5-シクロプロピル-2H-ピラゾール-3-イルアミン(2.65g,21.5mmol)をTHFとH2Oの1:1混合物(140mL)中に溶解し、KOAc(30当量,64g)で処理し、55℃で48時間保持した。層を分離し、有機層を蒸発させ、CH2Cl2(30mL)に溶解し、−20℃で3時間保持した。沈殿したピリミジノ-アミノピラゾール塩化物塩を濾過により集めた。濾液を蒸発させ、CH2Cl2(25mL)に溶解し、−20℃でさらに3時間保持し、濾過した。合わせた固体をCHCl3:CH3OHが10:1(25mL)に溶解し、精製(CHCl3:CH3OH=100:0〜90:10)すると、ピリミジノ-アミノピラゾール中間体が得られた(収率46%,2.32g)。
ピリミジノ-アミノピラゾール一塩化物(0.2g,0.85mmol)及びp-アミノベンゾニトリル(0.112g,0.85mmol)をBuOH(8mL)に溶解し、続いて濃HCl(0.1mL)を添加した。得られた混合物を一晩100℃に保持した。固体沈殿物を濾過により集め、BuOH(8mL)で洗浄し、真空下で乾燥すると化合物APY24が得られた(0.23g,収率86%)。
N2-(4-アミノフェニル)-N4-(3-シクロプロピル-1H-ピラゾール-5-イル)ピリミジン-2,4-ジアミン(0.011g,0.035mmol;Shokat Lab:A.Statsyuk)のCH2Cl2(10mL)中の溶液を氷水浴中で冷却した。これに、CH2Cl2(10mL)中に希釈した3-(トリフルオロメチル)ベンゾイルクロリド(0.005mL,0.036mmol)を滴下添加した。反応物を放置して温め1時間攪拌したままにした。TLC及びLC-MSで反応が完了したことを判断するまで、反応を進行させた。反応混合物を真空下で濃縮し、50:50のH2O-CH3CN中に再び懸濁させ、CH3CN/H2O/0.1%TFA(1〜100%勾配液)中のC18カラムで精製すると、AD74が得られた。ESI-MS m/z [M+H]+、実測値480.5,計算値480.2。
N2-(4-アミノフェニル)-N4-(3-シクロプロピル-1H-ピラゾール-5-イル)ピリミジン-2,4-ジアミン(0.022g,0.07mmol)のCH2Cl2(10mL)中の溶液を氷水浴中で冷却した。これにCH2Cl2(5mL)中に希釈した3-(トリフルオロメチル)フェニルイソシアネート(0.030mL,0.2mmol)を滴下添加した。反応物を放置して室温に温め、1時間攪拌したままにした。TLC及びLC-MSで反応が完了したことを判断するまで、反応を進行させた。反応混合物を真空下で濃縮し、50:50のH2O-CH3CN中に再び懸濁させ、CH3CN/H2O/0.1%TFA(1〜100%勾配液)中のC18カラムで精製すると、AD75が得られた。ESI-MS m/z [M+H]+、実測値495.5,計算値495.2。
N2-(3-アミノフェニル)-N4-(3-シクロプロピル-1H-ピラゾール-5-イル)ピリミジン-2,4-ジアミン(0.014g,0.046mmol;Shokat Lat:A.Stasyuk)のCH2Cl2(10mL)中の溶液を氷水浴中で冷却した。これにCH2Cl2(5mL)中に希釈した3-(トリフルオロメチル)ベンゾイルクロリド(0.007mL,0.046mmol)を滴下添加した。反応物を放置して室温に温め、1時間攪拌したままにした。TLC及びLC-MSで反応が完了したことを判断するまで、反応を進行させた。反応混合物を真空下で濃縮し、50:50のH2O-CH3CN中に再び懸濁させ、CH3CN/H2O/0.1%TFA(1〜100%勾配液)中のC18カラムで精製すると、AD76が得られた。ESI-MS m/z [M+H]+、実測値480.4,計算値480.2。
N2-(3-アミノフェニル)-N4-(3-シクロプロピル-1H-ピラゾール-5-イル)ピリミジン-2,4-ジアミン(0.014g,0.046mmol)のCH2Cl2(10mL)中の溶液を氷水浴中で冷却した。これにCH2Cl2(5mL)中に希釈した3-(トリフルオロメチル)フェニルイソシアネート(0.006mL,0.046mmol)を滴下添加した。反応物を放置して室温に温め、12時間攪拌したままにした。TLC及びLC-MSで反応が完了したことを判断するまで、反応を進行させた。反応混合物を真空下で濃縮し、50:50のH2O-CH3CN中に再び懸濁させ、CH3CN/H2O/0.1%TFA(1〜100%勾配液)中のC18カラムで精製すると、AD77が得られた。ESI-MS m/z [M+H]+、実測値495.4,計算値495.2。
Ire1構築物の発現及び精製
Ire1発現用プラスミドは、Pfuポリメラーゼ及びIre1の細胞質ドメインをコードするpGEX-6P-2ベクターでPCRを使用して調製した(Sidrauski,C.ら、Cell 90巻:1031-9頁(1997年))。突然変異変性用のDNAプライマーは、Biochem Lab Solutions 3.5を使用して設計し、IDTより購入した。タンパク質はBL21 CodonPlus(RIPL)大腸菌細胞(Stratagene)上で発現させた。発現及び精製は先に記載のように実施した(Nock,S.ら、Methods Enzymol 342巻:3〜10頁(2001年))。バクテリアは22℃で成長させ、溶解及びEPLC緩衝液はIre1凝集を防ぐために少なくとも300mMのNaClを含んでいた。タンパク質濃度は、280nmでの吸収ピークを使用してUVスペクトルから測定し、吸光係数(Biochem Lab Solutions 3.5)を計算した。精製Ire1変異体は濃度10〜70mg/mlであり、クーマシーブルー染色及びFPLCトレースの定量により判断して純度99%を超えていた。
HP21 21-mer及びHAC1 28-merはDhrmacon Inc.より購入した。他のRNA基質はHAC1及びXBP1 mRNAをコードする制限(酵素)消化プラスミドから、またはPCR-増幅産生物から調製した。長鎖RNAの予備量(preparative amount)はMegashortScript kit(Ambion)を使用して調製した。使用前に、オリゴヌクレオチドは、変性(8M変性)5〜20%ポリアクリルアミドゲル電気泳動(PAGE)で精製し、29:1架橋させ(National diagnostics)、TE緩衝液中で溶離し、エタノール沈殿させた。5’-末端基質で32p-ラベルしたものは、NENによりT4 PNK(NEB)及びg-32pATPを使用して調製した。32p-ボデー-ラベル化基質は、a-32pUTP(NEN)の存在下、T7 RNAポリメラーゼ(Promega)で転写により調製した。32p-ラベル化基質は、変性5〜20%PAGEにより精製し、TE中で溶離し、エタノール沈殿させた。
RNA切断反応は、20mM HEPES(pH7.5)、70mM NaCl、2mM ADP(pH7.0)、2mM Mg(OAc)2、5mM DTT、5%グリセロール、1nM未満32p-ラベルRNA基質、及び3nM〜20μM Ire1を含む緩衝液中、30℃で実施した。反応溶液及び緩衝液は、Biochem Lab Solutions 3.5を使用して設計した。反応は、RNA以外の全ての成分を含む予め温めておいた反応混合物9μlにRNA 1μlを添加するように調製した。通常、最初の時間点に関して5秒から開始して、3〜10分の時間的経過を集めた。時間間隔で溶液1μlをそれぞれの反応物から取り出し、10M尿素、0.1%SDS、0.1mM EDTA、0.05%キシレンシアノール、及び0.05%ブロモフェノールブルーを含む6μl停止溶液と混合した。サンプルは、変性10%PAGEで分離し、ホスファーストレージスクリーン(phosphor strage screen)上に暴露した。スクリーンをStormまたはTyphoon装置上でスキャンし、ImageQuant 5.0またはGelQuant.NET 1.4プログラムを使用して定量した。データをプロットし、SigmaPlot 6.0で作成した。
Ire1サンプル(10μM)を、RNase切断活性用で使用する緩衝液中、400μl細胞に充填した。55,000rpm及び30℃でBeckmann XL-A分析超遠心分離機で遠心分離を実施した。1スキャン/2分の頻度で全部で60スキャンを集めた。沈殿した痕跡量を、平均軸比(average axial ratio)3:2のC(s)分布を使用してUltraScan 6.0で分析した。
金メッキプレートを100%メタノール及び水で洗浄した。溶液A(アセトニトリル0.7mL中10mg 4-HCCA、0.1%トリフルオロ酢酸)を迅速に層に塗布し、放置して乾燥した。残渣をティッシュでそっと除去した。次に1μl Ire1サンプル(0.1〜1mg/ml)及び5μl溶液B(300μl蟻酸、100μl H2O、200μlイソプロパノール及び10mg4-HCCA)を含む混合物0.5μlを乾燥表面上にスポットし、放置して乾燥した。サンプルを0.1%トリフルオロ酢酸2μlで2回洗浄し、Voyager質量分析計上でMALDI分析に使用した。スペクトルはMoverZで分析した。
最初に、Ire1KR32(10mg/ml)を1.0Mクエン酸ナトリウムからADP(2mM)との複合体(complex)として蒸気拡散により結晶化した。これらの共結晶は一方向で乱れており、回折実験での使用は中止した。別の結晶形は、ADPをキナーゼ阻害剤APY29で置換することによって得た。Ire1KR32・APY29結晶は、液滴をつるす際に蒸気拡散により得た。液滴は、貯蔵緩衝液(20mM HEPES pH7.0(20℃)、300mM NaCl、2mM DTT、及び5%グリセロール)中のIre1KR32(12mg/ml)とAPY29(1.2mM)1μlを、0.27M Na2SO4、8%PEG-3350、10mM EDTA及び2mM TCEPを含む溶液1μlとを混合することにより調製した。ウエル溶液は200μlの0.085M Na2SO4、2.33%3350、及び5%tert-アミルアルコールを含んでいた。単結晶は、室温で3〜4日間の間に最大サイズ0.1×0.4×0.2mmに成長した。本出願人は、TCEPが10mM L-システインで置換できたことを知見した。低温保護(cryo-protection)のために、結晶は、0.085M Na2SO4、3%tAm、5%PEG-3350及び30%エチレングリコールを含む溶液中でフラッシュ凍結した。
X-線回折データは、Berkeley National LaboratoryのAdvanced Light Source、ビームラインBL8.3.1で記録した。X-線波長1.11587Å及び1度の振動角で得られたデータセットは、XDSパッケージを使用してインデックスをつけ、積分し、目盛りを付けた(Kabsch,W.J.、J.Appl.Cryst.26巻:795-800頁(1993年))(図14)。精密化(refinment)の進行度をモニターするために5%の反射をテスト-セット(Rfree-set)反射としてマークした。分子置換溶液はPHASER(McCoy,A.J.、J Appl Cryst 40巻:658-674頁(2007年))を使用して見つけた。Ire1二量体の最近のX線構造由来のモノマーA14コピー(Lee,K.P.ら、Cell 132巻:89-100頁(2008年))を精密化用の出発モデルとして使用した。CNS(Brunger,A.T.ら、Acta Cystallogr D Biol Crystallogr 54巻:905-21頁(1998年))におけるシミュレーテッド-アニーリング及びグループ化B因子精密化ならびに最終段階では、PHENIX(Adams,P.D.ら、Acta Crystallogr D Biol Crystallogr 58巻:1948-54頁(2002年))を14-回(14-fold)NCSを使用して実施した。フーリエSA-秤量(Read,R.J.、Acta Cryst A42巻:140-149頁(1986年))Fobs-Fcalc差マップは、出発構造から見当たらないモデルの部分を説明するために使用した。リガンドモデルは、ChemSketch10.0(ACD labs)を使用して作成した。モデル構築及び実空間精密化はCoot(Emsley,P.ら、Acta Crystallogr D Biol Crystallogr 60巻:2126-32頁(2004年))、Pymol(W.DeLano)及びRSRef(Korostelev.A.ら、Acta Crystallogr D Biol Crystallogr 58巻:761-7頁(2002年))で実施した。得られたモデルは優れた立体化学パラメータ(図14)をもち、0.264/0.298という低い結晶学的R/Rfreeは、回折データとよく一致していることを示している。
Ire1活性におけるツニカマイシン、SU11248、DJM2005、APY24及びAPY29の効果は、モデルシステムとしてHEK293細胞を使用する哺乳類細胞で試験した。細胞は、Lin JHらのScience 318巻:944頁(2007年)に記載の方法に従って処理した。表示時間の間、対応する薬剤で処理した後、Xbp-1 mRNAスプライシングはRT-PCRにより測定した。スプライスされていない(unspliced:u)及びスプライスされた(spiliced:s)Xbp1-mRNA産生物は、Ire1を介するUPR活性化の尺度として表示され機能する。結果を図17に示す。
Ire1の活性化剤及び阻害剤を同定するために、具体的なインビトロアッセイを実施する。
活性化剤の同定のために、本アッセイでは溶液中でタンパク質凝集を検出するのに適した方法のいずれかを使用する。最も原始的な形態では、約300mM NaCl及び5〜100mg/ml Ire1を含む中性緩衝液中のIre1溶液を簡単に目視チェックする。活性化剤を添加すると、曇ってくる(図2A)。このスクリーニング(screen)は迅速で、処理能力が高く、且つ簡単な自動化に適している。あるいは溶液による光散乱は、動的光散乱(dynamic light scattering:DLS)または静的光散乱(static light scattering:SLS)アプローチを使用して測定することができる。スクリーニング条件は、ADPまたは公知活性化剤(APY29)を溶液に添加すると、DLSまたはSLSアプローチにより検出されるように重質種が発生するように選択する。うまくできた活性化剤ならばオリゴマーが形成する。当業者に公知のタンパク質凝集を検出する他の方法も同様に効果的である。
このアッセイの好都合な点は、非常に希薄なIre1濃度の分子の活性化及び測定を実施する能力に対して高感度であるということであり、ここでしっかりと結合している活性化剤及び阻害剤は、大量の弱く相互作用している活性化剤及び阻害剤からずっと容易に選択される。本アッセイで使用されるIre1は、ドナー蛍光色素団分子でラベルしたIre1(Ire1-FRET-D)と、アクセプター蛍光色素団(または消光性染料)でラベルしたIre1(Ire1-FRET-A/Q)との混合物である。
動的アッセイは、Lin JHら、Science 318巻:944頁(2007年)に記載の通りである。Ire1により切断される放射性標識または蛍光標識RNAオリゴヌクレオチドを基質として使用する。RNA切断反応のスクリーニングは、試験化合物(ADP及びAPY29)に対して最大活性応答を産生するIre1濃度で実施する。活性化剤及び阻害剤スクリーニングは、上記説明のように関連している。
キナーゼ及びRNaseドメイン(Ire1KR)及びN-末端に向かって24個または32個のアミノ酸で伸張したIre1KR(Ire1KR24またはIreKR32)を含むIre1の細胞質部分の変異体を調製した(図1A、図1C、図7)。これらの追加のアミノ酸伸張部分は、膜貫通領域にキナーゼ/RNaseドメインをつなぐ約100個のアミノ酸の長いリンカードメインの一部である。これら三つの構築物は、XBP1 mRNAから誘導された部位特異的5’-32p-標識化ステムループオリゴリボヌクレオチド14を切断した(図1B、図8)。21-merステムループHP21の切断に関して観察された速度定数は、酵素濃度において非ミカエリス依存性を示し、IreKR及びIre1KR24に関してHill係数n=2、そして意外にもIre1KR32に関してHill係数n=3.5-8と共同的に増加した(図1D)。この知見は、Ire1のRNase活性がIre1KR及びIre1KR24に関しては主に二量体、並びにIre1KR32に関してはオリゴマーの形成と共に自己会合から生じることを示唆する。ADP・Mg補因子はRNaseの共同的活性化に全く必要ではなかった。しかしながら、補因子は、特異的RNase活性を平均で二桁増加させ、このことは補因子が活性化遷移を刺激することを示している(機構的関係を参照されたい)。
Ire1KR32は、CDK2及びEGFRキナーゼを標的にするように設計された阻害剤と共に共結晶化した。特定のキナーゼ阻害剤は、Ire1のRNase機能を十分に活性化した(図3A)。これは、合成化合物による野生型Ire1活性化の最初の例である。
Claims (19)
- 式:
Lは−NH−C(O)−NH−であり;
Aはアリールまたはヘテロアリールであり;
R37は、ハロゲン、ハロゲン−置換若しくは非置換C1−C8アルキル、または非置換へテロアルキルであり、ここでヘテロアルキルは、少なくとも1つの炭素原子と、O、N、P、SiおよびSからなる群から選択される少なくとも1つのヘテロ原子とを含み、炭素原子とヘテロ原子との総数は2〜8であり;及び
wは0〜5の整数である}
をもつ化合物。 - R1はシクロプロピルである、請求項1に記載の化合物。
- Aはアリールである、請求項1または2に記載の化合物。
- Aはフェニルである、請求項1または2に記載の化合物。
- R37は−CF3である、請求項1〜4のいずれか一項に記載の化合物。
- wは0または1である、請求項1〜5のいずれか一項に記載の化合物。
- wは1である、請求項1〜5のいずれか一項に記載の化合物。
- 以下の式:
- 式:
- 請求項1〜9のいずれか一項に記載の化合物と医薬的に許容可能な賦形剤とを含む医薬組成物。
- 細胞中のIre1活性を活性化するための医薬組成物であって、請求項1〜9のいずれか一項に記載の化合物の有効量を含む医薬組成物。
- 通常レベルと比較して低下したIre1活性により生じる疾患を治療するための医薬組成物であって、請求項1〜9のいずれか一項に記載の化合物の有効量を含む医薬組成物。
- 疾患は、嚢胞性線維症、網膜色素変性病、糖尿病または神経変性病である、請求項12に記載の医薬組成物。
- 前記疾患は、アレキサンダー病、アルパース病、アルツハイマー病、筋萎縮性側索硬化症、毛細血管拡張性小脳失調症、バッテン病、ウシ海綿状脳症(BSE)、カナバン病、コケーン症候群、大脳皮質基底核変性症、クロイツフェルト・ヤコブ病、ハンチントン病、HIVに伴う認知症、ケネディ病、クラッベ病、レヴィー小体認知症、マシャド・ジョセフ病、多発性硬化症、多系統萎縮症、ナルコプシー、神経ボレリア症、パーキンソン病、ペリツェウス・メルツバッヘル病、ピック病、原発性側索硬化症、プリオン病、レフサム病、サンドホフ病、シルダー病、悪性貧血に続発する亜急性脊髄連合変性症、統合失調症、脊髄小脳失調、脊髄性筋萎縮症、スティール・リチャードソン・オルスゼフスキー病、または脊髄癆である、請求項13に記載の医薬組成物。
- Ire1活性を活性化させるための薬剤の製造における、請求項1〜9のいずれか一項に記載の化合物の使用。
- 細胞中のIre1活性を活性化するための薬剤の製造における、請求項1〜9のいずれか一項に記載の化合物の使用。
- 低下したIre1活性により生じる疾患の治療の必要な患者において、前記低下したIre1活性により生じる疾患を治療するための薬剤の製造における、請求項1〜9のいずれか一項に記載の化合物または請求項10に記載の組成物の使用。
- 疾患は、嚢胞性線維症、網膜色素変性病、糖尿病または神経変性病である、請求項17に記載の使用。
- 前記疾患は、アレキサンダー病、アルパース病、アルツハイマー病、筋萎縮性側索硬化症、毛細血管拡張性小脳失調症、バッテン病、ウシ海綿状脳症(BSE)、カナバン病、コケーン症候群、大脳皮質基底核変性症、クロイツフェルト・ヤコブ病、ハンチントン病、HIVに伴う認知症、ケネディ病、クラッベ病、レヴィー小体認知症、マシャド・ジョセフ病、多発性硬化症、多系統萎縮症、ナルコプシー、神経ボレリア症、パーキンソン病、ペリツェウス・メルツバッヘル病、ピック病、原発性側索硬化症、プリオン病、レフサム病、サンドホフ病、シルダー病、悪性貧血に続発する亜急性脊髄連合変性症、統合失調症、脊髄小脳失調、脊髄性筋萎縮症、スティール・リチャードソン・オルスゼフスキー病、または脊髄癆である、請求項17に記載の使用。
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