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TW201615224A - 消化系統疾病用藥臨床新應用 - Google Patents

消化系統疾病用藥臨床新應用 Download PDF

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TW201615224A
TW201615224A TW104134963A TW104134963A TW201615224A TW 201615224 A TW201615224 A TW 201615224A TW 104134963 A TW104134963 A TW 104134963A TW 104134963 A TW104134963 A TW 104134963A TW 201615224 A TW201615224 A TW 201615224A
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cancer
drug
drugs
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digestive
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陳丘泓
莊秀美
蕭乃文
梁瑞岳
筱彤 陳
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朗齊生物醫學股份有限公司
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Abstract

本發明提供多種消化系統疾病用藥的新臨床之應用。該多種消化系統疾病用藥皆是經過衛生署通過核准上市的消化系統疾病用藥。本發明提供多種消化系統疾病用藥有效的抑制不同類型的癌細胞。

Description

消化系統疾病用藥臨床新應用
本發明係為多種消化系統疾病用藥的新適應症之應用，尤其該多種藥物為通過臨床實驗且具有抑制多種癌症之用途。
癌症長期高居全球死因之首，且罹患癌症人數更是逐年攀升，因此治療癌症儼然成為重要的課題。癌症的治療可區分為手術治療、放射線治療、化學治療及標靶治療。
一般來說，癌症藥物治療無論是化學治療或標靶治療，目的多是讓癌細胞無法複製、分裂，來阻斷腫瘤的蔓延擴張。在臨床治療選擇上，通常會結合一到數種化療藥物以及標靶治療，希望能藉由不同機制來殺死癌細胞以提高治療效果，但事實上，還是常遇到患者對於治療藥物的反應不佳。進一步，許多癌細胞相繼產生抗藥性，使藥物的使用成效大幅降低，最終導致癌症治療失敗。
消化系统是多細胞生物用以進食、消化食物、獲取能量和營養、排泄剩餘废物的一组器官，其主要功能為攝取、消化、吸收、同化和排泄。其中有關排泄的部分，也可歸類到排泄系統的一部分。下痢、腹瀉、乳糖不耐症、便祕、打隔、胃灼熱、食物中毒、嘔吐、噁心、脹氣、腸胃潰瘍、膽結石、B型肝炎、C型肝炎、胃食道 逆流、消化行潰瘍、大腸憩室症等皆屬於消化道疾病。
發明人依據長年的研究經驗，人類的癌症細胞常常有與正常細胞具有不同的表現性狀，型態上的差異或是作用機轉的變化或許也有可能被視為一種外來的侵入者，而每一種癌症細胞所在的位置不同，變異的狀態又與所處的環境有關，因此，第一個提出使用消化系統疾病用藥抑制癌症細胞的發明概念並且進行實驗。
相對的，在這些已經使用數十年消化系統疾病用藥，是早已被FDA所認可的用藥，具有大量藥物機轉及人體研究成果資料，因此，若應用在癌症方面，這項新發展會更省時、減少成本，也能和其他治療方式結合來提高效果。目前尚未有任何研究針對本發明所使用之藥物，進行癌症治療研究。
儘管如此，藥物開發依然是重要的醫學議題，必須經過繁複的臨床前試驗才能進入臨床試驗，根據統計，平均每一萬個新藥約只有五個能夠進入第一期臨床試驗。此外，除了藥物本身是否能大量製造的難題外，還需克服藥物安全性、病人篩選、試用劑量等問題，即便藥物已經通過FDA的核准並上市，亦有可能因上市後於人體發現不良反應而強制下架回收，由此可見藥物開發具有一定的困難程度。
為解決上述的問題，本發明係針對通過臨床實驗的多種藥物進行新適應症的研發，而達到老藥新用的目標。
經過實驗設計結果顯示消化系統疾病用藥對正常細胞沒有或僅有微小的毒性，但至於消化系統疾病用藥在正常細胞與腫 瘤細胞之間是否具有選擇性的影響，還待更多的研究釐清，而且並非所有的消化系統疾病用藥在相同的條件下均能有效的抑制腫瘤細胞，需要有許多的問題進行克服。
名詞定義
消化系統疾病用藥依據藥物的結構可以分為十二大類，包含止吐劑、止瀉劑整腸劑、抗痙攣劑、抗腹瀉劑、其他消化系統用藥、制酸劑、制酸劑抗發脹劑、呼吸興奮劑、消化性潰瘍治療劑、健胃消化劑利膽劑、催吐劑鎮吐劑鎮暈劑、瀉劑所組成群組與其他類。
抗痙攣劑，用於平滑肌收縮，尤其是在胃腸道的管狀器官。其效果是防止胃、腸或膀胱的痙攣。雙環錐林(Dicycloverine)、及天仙子胺這兩種是具有抗膽鹼劑作用的解痙藥。這兩種藥物具有一般的副作用，並且可能惡化胃食管反流病出。
制酸劑，英文名Antacids，內含鋁或(及)鎂之化合物為主，主要利用其中和胃酸的能力，用以緩解或預防因為胃酸過多所引起的心口灼熱感、胃脹氣或消化不良的症狀，也可用來治療或預防潰瘍的發生。制酸劑常見的藥物為內含鋁或(及)鎂之化合物為主，主要利用其中和胃酸的能力，用以緩解或預防因為胃酸過多所引起的心口灼熱感、胃脹氣或消化不良的症狀，也可用來治療或預防潰瘍的發生。制酸劑的主要藥理功效為：緩解或預防因為胃酸過多所引起的心口灼熱感、胃脹氣或消化不良的症狀，也可用來治療或預防潰瘍的發生，或中和胃酸。
呼吸興奮用藥，呼吸興奮屬於中樞興奮藥，主要通過直接興奮延髓呼吸中樞，也可通過刺激頸動脈體和主動脈體的化學感 受器反射性的興奮呼吸中樞，使呼吸加深加快，通氣量增加，提高了血中氧分壓，降低了血中二氧化碳分壓。提高呼吸中樞對二氧化碳的敏感性，在呼吸中樞處於抑制狀態時興奮作用尤為明顯。
消化性潰瘍是指一群由胃酸或蛋白畊等攻擊因子所造成上消化道形成潰瘍性變化的疾病總稱。目前學者們大多支持重要假說，就是攻擊因子與胃腸黏膜的防禦因子失衡所致。廣義而言，攻擊因子包括：(1)胃酸及蛋白，(2)藥物，(3)酒精，(4)抽煙，(5)膽汁逆流，(6)細菌，如幽門螺旋桿菌；防禦因子則包括：1黏膜表面黏液及碳酸氫離子的分泌，2.表面細胞的屏障，3.黏膜細胞的更新，4.黏膜層血流的供應，5.內因性前列腺的合成。其中攻擊因子亦會直接或間接影響防禦因子，而依發生的部位來分類，主要包括(1)十二指腸潰瘍和(2)胃潰瘍。
胃潰瘍好發年紀約比十二指腸潰瘍多出10-20歲，以60-70歲的年齡較常見，男女發生比率略同，相對於胃酸分泌過多為十二指腸潰瘍之致病主因，胃潰瘍患者的胃酸分泌大多數為正常或較少，而胃泌素則呈偏高的狀態，胃的排空速度較慢，且胃黏膜呈現不同程度的慢性胃炎及胃黏膜萎縮的現象。大多數學者都同意胃潰瘍的發生原因為多因性，偏重於一些黏膜防衛機轉的缺陷，至於幽門螺旋桿菌在胃潰瘍患者陽性率約65-80%，高於一般人，但低於十二指腸潰瘍患者的陽性率，相關性較低，目前治療方面仍建議作幽門螺旋桿菌之清除。臨床症狀方面，以上腹痛最為常見，但相較於十二指腸潰瘍的痛，則較不典型，若出現胃出血或穿孔的情況，其引起死亡率的機會，亦較十二指腸潰瘍為高。內視鏡用於胃潰瘍患者之診斷，除了可 直接觀查潰瘍之大小、形狀、部位及慢性炎症的變化，亦可作組織切片生檢，確定良性或惡性潰瘍，及檢查幽門螺旋桿菌之存在與否。至於治療方面，如同十二指腸潰瘍，包括個人及家族罹患惡性腫瘤的情形，建議病人避免使用加重潰瘍的食物及藥物；如煙、酒及止痛藥(NSAID)等，胃潰瘍治療仍以內科藥物為主，與十二指腸潰瘍之藥物相通，但似乎胃潰瘍的癒合較十二指腸潰瘍為慢，且較大的潰瘍也須花費較長的時間癒合，呈陽性之幽門螺旋桿菌檢驗結果，仍建議作幽門螺旋桿菌之清除。
一種制備抑制癌症之醫藥組合物之方法，其中該醫藥組合物係為一消化疾病藥物。
本發明一實施例中，其中該消化疾病藥物係選自由止吐劑、止瀉劑整腸劑、抗痙攣劑、抗腹瀉劑、其他消化系統用藥、制酸劑、制酸劑抗發脹劑、呼吸興奮劑、消化性潰瘍治療劑、健胃消化劑利膽劑、催吐劑鎮吐劑鎮暈劑、瀉劑所組成群組之消化疾病藥物。
本發明一實施例中，其中該抗痙攣劑係選自由Moxonidine、Moexipril HCl、Alverine Citrate及Camylofin Chlorhydrate所組成之藥物。
本發明一實施例中，其中該制酸劑係為Esomeprazole magnesium(Nexium)或/和Roxatidine acetate HCl藥物。
本發明一實施例中，其中該該呼吸興奮劑係Sorbitol(Glucitol)藥物。
本發明一實施例中，其中該消化性潰瘍治療劑係選自由Danofloxacin Mesylate和/或Bentiromide所組成之藥物。
本發明一實施例中，其中該胃潰瘍用藥系為Troxipide藥物。
本發明一實施例中，其中該急性腹痛藥物系為Rofecoxib之藥物。
本發明一實施例中，其中該癌症係選自由肺癌、腸道癌、大腸直腸癌、前列腺癌、肝癌、膀胱癌、子宮頸癌、乳癌及血癌所組成之群組。
本發明一實施例中，其中該藥物的有效劑量濃度為每日20mg/kg~500mg/kg。
現今癌症藥物費用動輒上萬至數百萬元，若未來更進一步證實消化系統疾病用藥對腫瘤的療效，對於無法負擔昂貴治療的患者們，這些便宜而歷史悠久的藥物，會是帶來健康的新希望。
第一圖顯示本發明消化系統疾病用藥應用於抑制癌細胞分析結果。
建立細胞株
請參考表一，將不同癌症類型的細胞株進行繼代培養，計算細胞數目後，回種2x106細胞數，然後加入培養該細胞株之培養液補至體積為10ml，繼續培養2-3天。之後將細胞計數，並分裝至96孔盤，其中每孔的細胞數目固定為3000顆，且體積為100ul。
IC50即半抑制濃度(或稱半抑制率)。在間接競爭ELISA標準曲線中是一個非常重要的資料，標準曲線是一個S型曲線。ICELISA中，不添加藥物的對照組的OD值定為B0，添加了藥物的實驗組的OD值為B，B/B0%就叫做結合率，在結合率為50%時所對應的藥物的濃度就叫做IC50。一般IC50的數值越小表示藥物的抑制效果越強。
細胞存活分析方法
將96孔盤中原有的培養液吸掉，每孔加入濃度10um、體積100ul的市售藥物，放置72小時後，每孔再加入100ul已稀釋的WST-1試劑，該稀釋比例為培養液與WST-1原液的體積比為9：1，最後每個孔盤的總體積為200ul，然後將96孔盤放置於37度30~90分鐘，利用elisa reader於OD450偵測吸光值，並計算各癌症細胞株之存活率。
消化系統疾病用藥應用於抑制癌細胞分析結果
消化系統疾病用藥分為九大類，分別為抗感染用藥、鎮咳用藥、祛痰用藥、平喘用藥、呼吸興奮用藥、感冒用藥、急性支氣管炎用藥、慢性支氣管炎用藥、支氣管哮喘用藥類抑制癌細胞生長的效果。
實驗結果明顯的顯示有許多的消化系統疾病用藥並無法有效的抑制癌症的細胞的生長(表二)。
而相對的各種的消化系統疾病用藥分子對於各種癌症細胞的抑制效果也不盡相同(圖一)，經過發明人實驗結果，證實消 化系統疾病用藥藥物Esomeprazole magnesium(Nexium)、Roxatidine acetate HCl、Moxonidine、Moexipril HCl、Sorbitol(Glucitol)、Rofecoxib(Vioxx)、Alverine Citrate、Danofloxacin Mesylate、Troxipide、Bentiromide、Camylofin Chlorhydrate等藥物對於不同的癌症細胞有明顯的抑制效果。(表三)
重複性實驗
依據表三所示結果，針對對癌症細胞株有效之藥物進行重覆性實驗，其結果如表四所示。
上列詳細說明係針對本發明之一可行實施例之具體說明，惟該實施例並非用以限制本發明之專利範圍，凡未脫離本發明技藝精神所為之等效實施或變更，均應包含於本發明之專利範圍中。

Claims (9)

  1. 一種製備抑制癌症之醫藥組合物之方法，其中該醫藥組合物係為有效濃度的一消化疾病藥物及一藥物可接受的鹽類所組成。
  2. 如申請專利範圍第1項所述之方法，其中該消化疾病藥物係選自由抗痙攣劑、抗腹瀉劑、制酸劑、呼吸興奮劑、胃潰瘍治療劑、急性腹痛所組成群組之消化疾病藥物。
  3. 如申請專利範圍第2項所述之方法，其中該抗痙攣劑係選自由Moxonidine、Moexipril HCl、Alverine Citrate及Camylofin Chlorhydrate所組成之藥物。
  4. 如申請專利範圍第2項所述之方法，其中該制酸劑係為Esomeprazole magnesium(Nexium)或/和Roxatidine acetate HCl藥物。
  5. 如申請專利範圍第2項所述之方法，其中該呼吸興奮劑係Sorbitol(Glucitol)藥物。
  6. 如申請專利範圍第2項所述之方法，其中該胃潰瘍治療劑係為Danofloxacin Mesylate和/或Bentiromide。
  7. 如申請專利範圍第2項所述之方法，其中該胃潰瘍用藥系為Troxipide藥物。
  8. 如申請專利範圍第2項所述之方法，其中該急性腹痛藥物系為Rofecoxib之藥物。
  9. 如申請專利範圍第1項所述之方法，其中該癌症係選自由肺癌、腸道癌、大腸直腸癌、前列腺癌、肝癌、膀胱癌、子宮頸癌、腎臟癌及乳癌所組成之群組。
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