CN113318231A - Application of 4-aminoquinoline compound - Google Patents

Application of 4-aminoquinoline compound Download PDF

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CN113318231A
CN113318231A CN202110204726.7A CN202110204726A CN113318231A CN 113318231 A CN113318231 A CN 113318231A CN 202110204726 A CN202110204726 A CN 202110204726A CN 113318231 A CN113318231 A CN 113318231A
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acute
pneumonia
exudative
inflammation
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左敏
柯樱
牛锐
刘妍珺
夏广新
王雪松
杜丽莎
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Shanghai Phaarmaceuticals Holding Co ltd
Shanghai Pharmaceuticals Holding Co Ltd
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Abstract

The invention discloses an application of a 4-aminoquinoline compound in preparing a medicament for inhibiting exudative inflammation. The invention provides an application of a 4-aminoquinoline compound or a pharmaceutically acceptable salt thereof in preparing a medicament or a medicinal composition for treating and/or preventing exudative inflammation; the pharmaceutical composition comprises: the 4-aminoquinoline compound or the pharmaceutically acceptable salt thereof and one or more pharmaceutically acceptable pharmaceutical auxiliary materials and/or one or more other active ingredients. The 4-aminoquinoline compounds provided by the invention, such as chloroquine and hydroxychloroquine, have good treatment effects on cell swelling and blood vessel and intercellular fluid exudation in an inflammatory state.

Description

Application of 4-aminoquinoline compound
Technical Field
The invention relates to an application of a 4-aminoquinoline compound or a pharmaceutically acceptable salt thereof in preparing a medicament or a medicinal composition for treating and/or preventing exudative inflammation.
Background
Extravasation, which refers to the process of fluid and cellular components within the blood vessels of inflamed local tissues, through the vessel wall into the interstitial tissues, body cavities, mucosal surfaces and body surfaces. In the case of inflammation in the body, exudation of fluids is usually accompanied, which is manifested in different stages of development of the disease, as well as in widely different pathological and clinical manifestations.
Acute exudative inflammation is common in acute infectious inflammation. Patients with acute bacterial, viral infections of the lungs, for example, are rapidly transformed from a plaque-like exudative infiltration of the lungs to severe or critical illness in the short term after attack by a large number of microorganisms and thus progress to respiratory failure and multiple organ failure, whereby it is believed that the disease is associated not only with microbial replication but also with exudation and attack by a large number of cytokines. At present, in clinical treatment, glucocorticoid is generally used to resist the reaction of body exudative inflammation, however, glucocorticoid cannot be regarded as an ideal treatment strategy, but the immunosuppression may affect the clearance rate of virus, so that the death rate of acute exudative inflammation and acute multiple organ failure caused by acute exudative inflammation is high, and the use of large dose of glucocorticoid has serious adverse reactions such as osteoporosis, and the clinical requirement cannot be well met.
Therefore, there is an urgent need in the art to develop a drug that can be effectively and safely used for acute exudative inflammation that spreads locally and rapidly throughout the body.
Disclosure of Invention
The invention aims to solve the technical problem of overcoming the defect of side effect of a medicament for inhibiting acute exudative inflammation in the prior art, and provides an application of a 4-aminoquinoline compound or a pharmaceutically acceptable salt thereof in preparing a medicament or a pharmaceutical composition for treating and/or preventing exudative inflammation.
Hydroxychloroquine (HCQ) belongs to 4-aminoquinoline antimalarials, and in 1944, the hydroxychloroquine is artificially synthesized on the basis of chloroquine, and the difference between the hydroxychloroquine and the chloroquine is that one ethyl group in the chloroquine is replaced by hydroxyethyl group, so that the hydroxychloroquine is absorbed more quickly in the gastrointestinal tract of a human body and is distributed more widely in the human body. The toxicity is obviously reduced while the original drug effect of chloroquine is kept. Hydroxychloroquine was originally used for antimalarial therapy, beginning in 1955 for the treatment of Systemic Lupus Erythematosus (SLE) and in 1988 for the treatment of rheumatoid arthritis.
Figure BDA0002949375950000021
After a large amount of experimental researches and drug screening, the inventor discovers that the 4-aminoquinoline compounds, particularly chloroquine and hydroxychloroquine, have good treatment effects on cell swelling and blood vessel and intercellular fluid exudation in the acute inflammatory state. On the basis of this, the present invention has been completed.
The present invention solves the above-mentioned problems by the following technical means.
The invention provides an application of a 4-aminoquinoline compound or a pharmaceutically acceptable salt thereof in preparing a medicament or a medicinal composition for treating and/or preventing exudative inflammation; wherein, the pharmaceutical composition comprises: the 4-aminoquinoline compound or the pharmaceutically acceptable salt thereof and one or more pharmaceutically acceptable pharmaceutical auxiliary materials and/or one or more other active ingredients.
In one embodiment of the present invention, the 4-aminoquinoline compound may be a 4-aminoquinoline antimalarial drug conventional in the art. Such as piperaquine
Figure BDA0002949375950000022
Or a compound of formula I:
Figure BDA0002949375950000023
wherein R is1H, OH or halogen;
Figure BDA0002949375950000031
is composed of
Figure BDA0002949375950000032
Phenyl or phenyl substituted with one or more of the following substituents: OH or halogen.
In a certain embodiment of the invention, the 4-aminoquinoline compound is amonoquinol
Figure BDA0002949375950000033
Chloroquine
Figure BDA0002949375950000034
Or hydroxychloroquine
Figure BDA0002949375950000035
Preferably chloroquine orHydroxychloroquine, more preferably hydroxychloroquine.
In one embodiment of the present invention, the pharmaceutically acceptable salt is hydrochloride, phosphate, sulfate, mesylate, citrate or fumarate; preferably a phosphate or sulphate.
In a certain scheme of the invention, the pharmaceutically acceptable salt of the 4-aminoquinoline compound can be chloroquine phosphate (diphosphate) or hydroxychloroquine sulfate; preferably hydroxychloroquine sulfate.
In one embodiment of the invention, the active ingredient is selected from the group consisting of antiviral agents, antibiotics, antifungal agents, antitumor agents, and autophagy inhibiting agents.
In one embodiment of the present invention, the pharmaceutical composition is in the form of an oral preparation or a parenteral preparation.
In one embodiment of the present invention, the dosage form of the pharmaceutical composition includes tablets, capsules, intravenous injection, intraperitoneal injection, inhalant, aerosol, lyophilized preparation, patch, gel, spray, or suppository.
In one embodiment of the present invention, the pharmaceutical composition is in unit dosage form.
In a certain embodiment of the invention, the pharmaceutical composition comprises 50mg to 2000mg of the 4-aminoquinoline compound or the pharmaceutically acceptable salt thereof, such as 100mg, 200mg, 300mg, 400mg, 1000mg, 1200mg, 1600mg, 1800mg of the 4-aminoquinoline compound or the pharmaceutically acceptable salt thereof.
In one embodiment of the present invention, the pharmaceutical composition comprises at least 50 wt% (e.g., 60 wt%, 70 wt%, 80 wt%, 90 wt%, 95 wt%, 98 wt%, 99 wt%) of the 4-aminoquinoline compound or the pharmaceutically acceptable salt thereof.
The inflammatory exudate of exudative inflammation has one or more of the following characteristics:
(1) abnormal specific gravity;
(2) abnormal IL-2 levels;
(3) abnormal IL-6 levels;
(4) abnormal IL-8 levels;
(5) abnormal IL-17 levels;
(6) an abnormal IP-10 level;
(7) abnormal Colony Stimulating Factor (CSF) levels; or
(8) Abnormal levels of Tumor Necrosis Factor (TNF).
In one embodiment of the invention, the exudative inflammation is further characterized by one or more of the following:
(9) abnormal serum Interferon (IFN) levels; or
(10) Abnormal levels of serum Erythropoietin (EPO).
In the present invention, the abnormality is an abnormal value having clinical significance obtained by a standard measurement method with reference to a normal population index or a self-measured normal value A0 of a subject in a normal period.
In one embodiment of the present invention, the abnormality is an abnormally increased or abnormally decreased level.
In one embodiment of the present invention, the abnormality is an abnormally high.
In one embodiment of the invention, the abnormality is at least 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100%, 120%, 150%, 180%, 200%, 300%, 500%, or 1000% above or below the normal value A0 for the measured value of the index of inflammatory exudate A1.
In one embodiment of the invention, the Colony Stimulating Factor (CSF) comprises G-CSF, M-CSF, GM-CSF, multi-CSF, or a combination thereof.
In one embodiment of the invention, the Tumor Necrosis Factor (TNF) comprises TNF- α, TNF- β, or a combination thereof, preferably TNF- α.
In one embodiment of the invention, the Interferon (IFN) comprises a type I interferon, a type II interferon, or a combination thereof, such as IFN- α, IFN- β, IFN- γ, or a combination thereof.
In one embodiment of the present invention, the inflammatory exudate comprises serous exudate, purulent exudate, catarrhal exudate, cellulosic exudate, hemorrhagic exudate or a combination thereof.
In one embodiment of the invention, the abnormal specific gravity comprises a specific gravity of > 1.018 inflammatory exudate.
In the present invention, the term "clinically significant" refers to a measurement value that can be used in conjunction with pathogen detection, imaging detection, and/or pathology detection to determine that a subject is suffering from exudative inflammation.
In one embodiment of the invention, the inflammatory exudate comprises an exudate derived from one or more of sputum, nasopharyngeal secretions, interstitial fluid of the lung, alveolar lavage fluid, interstitial fluid of the tissue, and synovial fluid.
In one embodiment of the invention, the exudative inflammation is characterized by one or more of the following:
(i) the permeability of tissue blood vessels is increased, so that leukocyte infiltration, edema and fibrosis are caused, the tissue fluid is filled, and the specific gravity of inflammatory exudate is higher than a normal value;
(ii) inflammatory exudate and/or serum IL-6 levels above normal;
(iii) inflammatory exudate and/or serum TNF-a levels above normal;
(iv) inflammatory exudate and/or serum IFN levels are below normal;
(v) inflammatory exudate and/or serum CSF levels above normal;
(vi) serum EPO levels were below normal.
In one embodiment of the present invention, the exudative inflammation comprises local exudative inflammation and/or systemic exudative inflammation.
In one embodiment of the present invention, the exudative inflammation comprises acute exudative inflammation and/or chronic exudative inflammation.
In one embodiment of the present invention, the exudative inflammation is acute exudative inflammation.
In a certain embodiment of the invention, the acute exudative inflammation is a disease with a time of onset of less than 6 months, 5 months, 4 months, 3 months, 2 months, 1 month, 20 days, 15 days, 7 days, or 3 days.
In one aspect of the invention, the time of onset refers to the occurrence of clinical symptoms and/or imaging symptoms, and/or laboratory examinations.
In one embodiment of the invention, the local exudative inflammation comprises exudative inflammation occurring in one or more of the lung, bronchi, kidney, heart, liver, skin and joints.
In one embodiment of the present invention, the local exudative inflammation is exudative pneumonia.
In one embodiment of the present invention, the local exudative inflammation is acute exudative pneumonia. In one embodiment of the present invention, the local exudative inflammation comprises infectious or non-infectious pneumonia.
In one aspect of the invention, the non-infectious pneumonia comprises cancerous pneumonia.
In one embodiment of the present invention, the acute exudative pneumonia comprises acute bacterial infectious pneumonia, acute viral infectious pneumonia, acute fungal pneumonia, acute parasitic infectious pneumonia, acute rickettsial infectious pneumonia, and acute mycoplasma/chlamydia infectious pneumonia.
In one embodiment of the present invention, the acute exudative pneumonia comprises community-acquired pneumonia or nosocomial infectious pneumonia.
In one embodiment of the invention, the acute bacterial pneumonia comprises acute exudative pneumonia caused by one or more pathogens selected from the group consisting of streptococcus pneumoniae, staphylococcus aureus, klebsiella pneumoniae, haemophilus influenzae, legionella and pseudomonas aeruginosa.
In one embodiment of the invention, the acute viral pneumonia comprises acute exudative pneumonia caused by one or more of influenza a virus, influenza b virus, avian influenza virus, SARS virus, MERS virus, zika virus, ebola virus and covi-19 virus.
In one embodiment of the present invention, the acute fungal pneumonia comprises acute exudative pneumonia caused by one or more of cryptococcus, aspergillus, mucor and candida.
In one embodiment of the invention, the exudative inflammation also includes the accompanying acute multiple organ failure.
The present invention also provides a method of treating exudative inflammation, particularly acute exudative inflammation, comprising the steps of: administering to a subject in need thereof an effective dose of a medicament or pharmaceutical composition comprising a 4-aminoquinoline compound or a pharmaceutically acceptable salt thereof as described above.
In one aspect of the present invention, the method further includes the steps of:
(I) determining one or more of the following: specific gravity of local exudate, interleukin in local focus or serum, interferon, colony stimulating factor, tumor necrosis factor;
(II) administering an effective dose of a drug or pharmaceutical composition comprising a 4-aminoquinoline compound or a pharmaceutically acceptable salt thereof as described above to the subject of (I) who is detected as having an abnormal index.
The present invention provides a method for treating exudative inflammation, in particular a product and method for treating acute exudative inflammation. Acute exudative inflammation refers to an inflammatory reaction that rapidly progresses to exudative fluid in a relatively short time, for example, acute exudative inflammation within 6 months, preferably within 3 months, or within 1 month. Generally, acute exudative inflammation within 15 days, preferably within 7 days, of the invention is more suitable for the active ingredient (e.g. hydroxychloroquine) and the pharmaceutical composition of the invention, with administration times varying from 1 to 30 days.
The above preferred conditions can be arbitrarily combined to obtain preferred embodiments of the present invention without departing from the common general knowledge in the art.
The reagents and starting materials used in the present invention are commercially available.
The positive progress effects of the invention are as follows: the 4-aminoquinoline compounds provided by the invention, such as chloroquine and hydroxychloroquine, have good treatment effects on improving cell swelling and exudation of blood vessels and intercellular fluid under an acute inflammatory state. Specifically, based on cells and animals, chloroquine, hydroxychloroquine and other drugs can obviously improve acute exudative inflammation of different parts, such as obviously reducing interstitial fluid, reducing local vascular permeability and reducing pulmonary mucus exudation, and obvious reduction of cytokines can be observed in an experimental group using the drugs, so that the drugs can be used for improving exudative inflammation, particularly acute exudative inflammation of the lung and the kidney, and have excellent effect on preventing or treating acute immune inflammatory response. In addition, the inventor also finds that when a large dose of hydroxychloroquine is used in a short period (converted to a dose far exceeding the recommended dose), no obvious drug-related toxic and side effects are found. The medicine has good inhibition effect on the novel coronavirus in vitro and in vivo under the condition of effectively reducing inflammatory exudation, and the minimum inhibition effective concentration reaches the mu M level.
Drawings
FIG. 1 shows the inhibition effect of HCQ treatment for 24h on viral RNA amplification, and when the concentration of the local hydroxychloroquine reaches 20. mu.M, the copy number of the virus has been reduced to 102
FIG. 2 shows the virus inhibition rate of HCQ treatment for 24h, and it can be seen that the virus inhibition rate in vitro of hydroxychloroquine reaches more than 95% at lower concentration (more than 4. mu.M).
FIG. 3 shows the inhibitory effect of HCQ on cytokines in serum of mice with inflammation.
Detailed Description
To better understand the invention, certain terms are defined.
The term "treatment" as used herein refers to therapeutic treatment. Where specific conditions are involved, treatment refers to: (1) relieving one or more biological manifestations of a disease or disorder, (2) interfering with (a) one or more points in a biological cascade that causes or leads to a disorder or (b) one or more biological manifestations of a disorder, (3) ameliorating one or more symptoms, effects, or side effects associated with a disorder, or one or more symptoms, effects, or side effects associated with a disorder or treatment thereof, or (4) slowing the progression of one or more biological manifestations of a disorder or disorder.
The term "effective dose" as used herein refers to an amount of a compound that, when administered to a patient, is sufficient to effectively treat a disease or condition described herein. The amount of a compound that constitutes an "effective dose" will vary depending on the compound, the condition and its severity, and the age of the patient to be treated, but can be adjusted as desired by one of skill in the art. The preferable effective dose of the invention is far higher than the instruction dose of the existing medicine, for example, the dose of the hydroxychloroquine for acute exudative inflammation is extremely high and can reach 1200 mg/day (calculated by hydroxychloroquine sulfate tablets (dispute)) in a human body, and can also be adjusted to 1000mg/d, 800mg/d, 500mg/d, 400mg/d, 200mg/d and the like according to the improvement degree of the exudative inflammation.
The term "patient" as used herein refers to any animal, preferably a mammal, most preferably a human, who is about to, or has received administration of the compound or composition according to the embodiments of the present invention. As used herein, the term "mammal" includes any mammal. Examples of mammals include, but are not limited to, cows, horses, sheep, pigs, cats, dogs, mice, rats, rabbits, guinea pigs, monkeys, humans, and the like, with humans being most preferred.
The term "pharmaceutical excipient" as used herein refers to excipients and additives used in the manufacture of pharmaceutical products and in the formulation of pharmaceutical formulations, and is intended to include all substances contained in pharmaceutical formulations, except for the active ingredient. See the pharmacopoeia of the people's republic of China (2015 Edition), or Handbook of Pharmaceutical Excipients (Raymond C Rowe,2009Sixth Edition).
The term "pharmaceutically acceptable" as used herein means that the acid or base, solvent, adjuvant, etc. used in preparing the salt is generally non-toxic, safe, and suitable for patient use. The "patient" is preferably a mammal, more preferably a human.
The term "pharmaceutically acceptable salt" as used herein refers to a salt of a compound prepared with a relatively non-toxic, pharmaceutically acceptable acid or base. When compounds contain relatively acidic functional groups, base addition salts can be obtained by contacting the neutral forms of such compounds with a sufficient amount of a pharmaceutically acceptable base in neat solution or in a suitable inert solvent. Pharmaceutically acceptable base addition salts include, but are not limited to: lithium salt, sodium salt, potassium salt, calcium salt, aluminum salt, magnesium salt, zinc salt, bismuth salt, ammonium salt, and diethanolamine salt. When compounds contain relatively basic functional groups, acid addition salts can be obtained by contacting the neutral form of such compounds with a sufficient amount of a pharmaceutically acceptable acid in neat solution or in a suitable inert solvent. The pharmaceutically acceptable acids include inorganic acids including, but not limited to: hydrochloric acid, hydrobromic acid, hydroiodic acid, nitric acid, carbonic acid, bicarbonate, phosphoric acid, monohydrogen phosphate, dihydrogen phosphate, phosphorous acid, sulfuric acid, hydrogen sulfate, and the like. The pharmaceutically acceptable acids include organic acids including, but not limited to: acetic acid, propionic acid, oxalic acid, isobutyric acid, maleic acid, malonic acid, benzoic acid, succinic acid, suberic acid, fumaric acid, lactic acid, mandelic acid, phthalic acid, benzenesulfonic acid, p-toluenesulfonic acid, citric acid, salicylic acid, tartaric acid, methanesulfonic acid, isonicotinic acid, acid citric acid, oleic acid, tannic acid, pantothenic acid, hydrogen tartrate, ascorbic acid, gentisic acid, fumaric acid, gluconic acid, saccharic acid, formic acid, ethanesulfonic acid, pamoic acid (i.e. 4, 4' -methylene-bis (3-hydroxy-2-naphthoic acid)), amino acids (e.g. glutamic acid, arginine), and the like. When compounds contain relatively acidic and relatively basic functional groups, they may be converted to base addition salts or acid addition salts. See in particular Berge et al, "Pharmaceutical Salts", Journal of Pharmaceutical Science 66:1-19(1977), or, Handbook of Pharmaceutical Salts: Properties, Selection, and Use (P.Heinrich Stahl and Camile G.Wermuth, ed., Wiley-VCH, 2002).
Exudative inflammation "
As used herein, the term "exudative inflammation" refers to an inflammatory disease occurring locally or systemically, characterized primarily by fluid exudation. The exudative inflammation of the present invention may occur in one or more sites, and usually, it is preferably occurred in the lung, joints of gastrointestinal tract containing cavities, etc., and may also occur in the liver, kidney, spleen, heart, etc., parenchymal organs. One skilled in the art understands that diagnosis of exudative inflammation can be performed according to a variety of methods: for example, with clinical symptoms, exudative inflammation may manifest in the lungs as cough, expectoration, dyspnea; through laboratory examination, a large number of blood cells, inflammatory factors and the like can be found in secretions, wherein the appearance of learning parts, inflammatory cells (such as neutrophils, monocytes, eosinophils, macrophages and the like) and inflammatory factors has different expressions based on different diseases; through the imaging examination, symptoms such as lung macular shading, ground glass changes, pleural effusion, pericardial effusion, joint cavity effusion, parenchymal organ density reduction and the like can be found; by endoscopic or histological examination, swelling, congestion, exudation of fluid, and widening of the interstitium of the organ, such as lung foam-like fluid, pink secretion, etc., can be observed.
As used herein, the singular forms "a", "an" and "the" include plural references unless the context clearly dictates otherwise.
The invention is further illustrated by the following examples, which are not intended to limit the scope of the invention. The experimental methods without specifying specific conditions in the following examples were selected according to the conventional methods and conditions, or according to the commercial instructions.
EXAMPLE 1 treatment of LPS-induced acute Systemic Inflammatory Response (SIRS) in mice with hydroxychloroquine improves survival
A systemic inflammatory exudation mouse model is prepared by a method of intraperitoneal injection of Lipopolysaccharide (LPS), and the specific method comprises the following steps:
1. grouping mice: 8-12 weeks old female C57 mice (weight is about 22-25 g) are adaptively fed for one week, and then are randomly divided into 5 groups, namely a control group, a model group and a low-medium dose hydroxychloroquine group according to the weight of the mice, wherein each group comprises 10 mice.
2. Preparing a SIRS mouse model by intraperitoneal injection of lipopolysaccharide: after dissolving lipopolysaccharide powder in Phosphate Buffered Saline (PBS), the solution was intraperitoneally injected into mice at a ratio of 6 mg/kg (mg/kg) of body weight to obtain an inflammation mouse model, and a control group was intraperitoneally injected with PBS of the same volume as the control group. General conditions observed in animals include mental state, respiratory rate, defecation, death, etc. The successfully modeled mice are obviously reduced in respiratory rate, body temperature, mental weariness and activity and are in a coiled state.
3. Oral gavage administration: for the low dose group (10mg/kg), the medium dose group (50mg/kg) and the high dose group (100mg/kg) of the hydroxychloroquine-added inflammatory mice, the corresponding dose of hydroxychloroquine solution is administered by oral gavage, and the blank control group (normal mice) and the model group are administered with PBS of equal volume.
4. Then, the survival state of the mice was continuously observed for one week, and a survival curve was plotted.
The experimental results are as follows: in each administration group of hydroxychloroquine, the mental state of the mice is better than that of the model group, the survival rate of the mice is higher than that of the model group, and particularly, the survival rate of inflammatory mice with medium dose and high dose is obviously improved: the mice in the model group all died within 3 days, 1/10 in the low dose group survived for one week, 5/10 in the medium dose group survived for one week, 6/10 in the high dose group survived for one week, and the medium and high dose groups have significant differences compared with the model group, so that hydroxychloroquine significantly improves the prognosis of the model mice.
Example 2 treatment of multiple organ injury in mice with inflammation Using Hydroxychloroquine significantly prevented and reduced organ exudative inflammation
The method comprises the following steps of adopting an oral gavage administration mode to administer hydroxychloroquine with medium and high doses to inflammatory mice, carrying out sacrifice dissection on a model group and a treatment group which are normal, dead and end of an observation period, taking lung, kidney, spleen, liver and intestinal tissue organs of the mice, observing a specimen in general, and then carrying out HE staining pathological detection, wherein the specific steps are as follows:
1. grouping mice: female C57 mice (the weight is about 22-25 g) with the age of 8-12 weeks are adaptively fed in an SPF-level animal room for one week, and then are randomly divided into 5 groups according to the weight of the mice, namely a blank control (normal mice) group, an inflammation mouse model group, a hydroxychloroquine medium dose, a high dose preventive and inflammation mouse model group (hereinafter collectively referred to as a prevention group, 50mg/kg of medicine is applied one week earlier and then modeling is performed), an inflammation mouse hydroxychloroquine medium dose group (50mg/kg) and a high dose group (100mg/kg) (hereinafter collectively referred to as a dry pre-group), wherein the number of each group is 10.
2. Intraperitoneal injection of Lipopolysaccharide (LPS): LPS is injected into the abdominal cavity of a prevention group (after medicine application), a dry pre-treatment group and an inflammation mouse model group according to the proportion of 6 milligrams/kilogram (mg/kg) of body weight, and PBS with the same volume is injected into the abdominal cavity of a blank control group as a control.
3. Intragastric administration: for the prevention group and the intervention group, hydroxychloroquine is administered at the corresponding dose by oral gavage, and PBS with the same volume is administered to the blank control group and the inflammation mouse model group.
4. Continuously observing the survival state of the mouse, after 24 hours, euthanizing the mouse, collecting right lung leaves, right kidneys, spleens, middle liver leaves and intestinal tract jejunum segments, carrying out morphological observation on one part, respectively adding 4% paraformaldehyde tissue fixative with the volume being 10 times of that of the other part, standing and fixing for 24 hours at room temperature, dehydrating by using gradient alcohol, embedding into tissue blocks by using paraffin, cutting paraffin sections with the thickness of 0.5mm by using a paraffin slicer, carrying out the steps of dewaxing, hydrating, dyeing, washing off excessive variegated colors, sealing and the like, and finally observing the pathological change of the intestinal tract tissue under a microscope.
The experimental results are as follows: general specimen: compared with the blank group, the lung volume of the model group mouse is obviously increased, and a foam fluid is reserved on the section; the liver, kidney and spleen envelopes are slightly tense; microscopic examination: in the lung section, exudates appear in the alveolar cavity, the exudates are wide in edema and widened in pulmonary interstitium, are infiltrated by inflammatory cells and mainly take mononuclear cells; edema vacuoles can be seen in the liver, kidney and spleen, and glomerular capillary wall thickening, mesangial hyperplasia and mesangial area widening can be seen in microscopic examination.
The viscera of the drug for preventing hydroxychloroquine do not have obvious swelling, wherein the pulmonary interstitial microscopic examination does not have obvious broadening, a small amount of inflammatory cell infiltration exists, and the medium-dose and high-dose groups have certain effect on improving edema and have less inflammatory cell infiltration; no obvious exudation of fluid was observed in the other parenchymal organs, and the tissue structure was almost normal. Therefore, the hydroxychloroquine has a certain effect on treating and protecting the injury of multiple organs of an inflammatory mouse, and has a better multiple organ injury protection effect when being used prophylactically.
Example 3 amelioration of abnormal inflammatory response in inflammatory mice by Hydroxychloroquine
3.1 adopting the administration mode of gastric perfusion, hydroxychloroquine is administered to the inflammatory mice, peripheral blood is taken for detecting the level of conventional blood cells (including lymphocytes, neutrophils and the like), and the level of relevant inflammatory factors in the peripheral blood of the mice is determined by utilizing an Elisa method, and the specific steps are as follows:
1. grouping mice: 8-12 week-old female C57 mice (weight is about 22-25 g) are adaptively fed in an SPF animal room for one week, and then are randomly divided into 4 groups according to the weight of the mice, namely a blank control (normal mice) group, an inflammation mouse model group and an inflammation mouse hydroxychloroquine group (medium dose and high dose groups), wherein the number of each group is 10.
2. Intraperitoneal injection of Lipopolysaccharide (LPS): LPS is injected into the abdominal cavity of an inflammation mouse and hydroxychloroquine middle dose group, a high dose group and an inflammation mouse model group according to the proportion of 6 milligrams/kilogram (mg/kg) of body weight, and PBS with the same volume is injected into the abdominal cavity of a blank control group as a control.
3. Intragastric administration: for the medium-dose group and the high-dose group of the inflammatory mice and the hydroxychloroquine, the corresponding dose of hydroxychloroquine is given in an oral gavage mode, and the blank control group and the inflammatory mouse model group are given with PBS (phosphate buffer solution) with the same volume.
4. Continuously observing the survival state of the mouse, after 24 hours, collecting peripheral blood of the mouse by an eyeball taking-off method, immediately taking 10 microliters of whole blood and utilizing a full-automatic blood cell analyzer to detect the blood routine.
5. Collecting peripheral blood by using a heparin anticoagulation tube containing a small amount of liquid, fully and uniformly mixing the obtained whole blood with the anticoagulant, obtaining an upper plasma sample by centrifugal force of 3000rpm for 10 minutes, and detecting the level of the cell factor in the plasma by using an Elisa kit according to an operation instruction.
And (3) displaying a detection result: compared with a blank control group, the proportion of the lymphocytes of the mice with inflammation is obviously reduced, and the proportion of the neutral particles is obviously increased; the application of hydroxychloroquine effectively improves the level of lymphocytes and reduces the level of neutrophils, which shows that the inflammatory response caused by inflammation is relieved, the immune balance in acute inflammation is restored, and cytokine detection shows that IL-6, TNF-a, GM-CSF and the like are obviously reduced compared with a model group.
The experimental results show that hydroxychloroquine can reduce abnormal inflammatory reaction caused by inflammation.
3.2 adopting the administration mode of intraperitoneal injection, hydroxychloroquine is administered to the inflammatory mice, and the peripheral blood is taken to determine the level of relevant inflammatory factors in the peripheral blood of the mice by an Elisa method, and the specific steps are as follows:
1. grouping mice: after 8-week-old female C57 mice (the weight is about 20 g) are adaptively fed in an SPF-grade animal room for one week, the mice are randomly divided into 3 groups according to the weight of the mice, wherein the groups are a blank control (normal mice) group, an inflammation mouse model group and an inflammation mouse hydroxychloroquine group (50mg/kg), and the number of each group is 5.
2. And (3) intraperitoneal injection administration: for the hydroxychloroquine-added group of the inflammatory mice, 50mg/kg of hydroxychloroquine is administered by means of intraperitoneal injection, and equal volume of PBS is administered to the blank control group and the inflammatory mouse model group.
3. Intraperitoneal injection of Lipopolysaccharide (LPS): after the administration of hydroxychloroquine by intraperitoneal injection for 2 hours, LPS is intraperitoneally injected into an inflammation mouse and an inflammation mouse model group according to the proportion of 2 milligrams/kilogram (mg/kg) of body weight, and PBS with the same volume as that of a blank control group is intraperitoneally injected as a control.
4. The state of the mice was observed, and peripheral blood of the mice was collected by an eyeball-picking method 4 hours after LPS injection.
5. Collecting peripheral blood by using a heparin anticoagulation tube containing a small amount of liquid, fully and uniformly mixing the obtained whole blood with the anticoagulant, centrifuging at 3000rpm for 10 minutes to obtain an upper plasma sample, and detecting the level of the cell factor in the plasma by using an Elisa kit according to an operation instruction.
And (3) displaying a detection result: as shown in figure 3, compared with a blank control group, the cytokines IL-6, TNF-a and IL-1 beta in the model group are obviously increased, and the cytokines IL-6, TNF-a and IL-1 beta in the mouse subjected to hydroxychloroquine treatment are obviously reduced compared with the cytokines IL-6, TNF-a and IL-1 beta in the model group, and the result shows that hydroxychloroquine can reduce abnormal inflammatory response caused by inflammation. (Control: blank Control group, Model: inflammatory mouse Model, HCQ: inflammatory mouse hydroxychloroquine group; values of each group are expressed as mean. + -. standard error, (N ═ 5); statistics were performed by one-way ANOVA (one-way ANOVA); P < 0.0001; P < 0.001; P < 0.01; P < 0.05.)
Cytokine Control Inflammation model group Hydroxychloroquine (HCQ)
TNF-a(pg/mL) 55.19±27.45 746.43±221.47 582.41±123.10
IL-6(pg/mL) 47.53±19.29 17894.46±703.00 14562.83±2305.89
IL-1β(pg/mL) 47.50±20.39 207.63±32.81 130.61±20.13
Example 4 Hydroxychloroquine in vitro prevention of Virus
Cells were grown to 80% plates and treated with hydroxychloroquine at various concentrations in the medium for 20 hours. The collected cells were washed with Phosphate Buffered Saline (PBS) and incubated for 1 hour with the isolated 2019-nCoV (from Wuhan virus institute in Chinese academy of sciences) virus. Then, the virus was removed, and after further culturing for 16 hours, the cells were collected, the viral RNA copy number was measured, and the virus inhibition rate was calculated. The results are shown in FIG. 1.
Example 5 inhibition of Virus amplification by Hydroxychloroquine in vitro
Cells were grown to 80% plates, collected, washed with Phosphate Buffered Saline (PBS), and incubated with 2019-nCoV virus for 1 hour. The virus was then removed and hydroxychloroquine was added at various concentrations after 3 hours of culture in medium. After further incubation for 24 hours, cells were harvested, viral RNA copy number was measured, and viral inhibition was calculated, and the results are shown in FIG. 2.
As can be seen in fig. 1 and 2, hydroxychloroquine, based on its antiviral activity, is expected to reduce the response to acute exudative inflammation while further inhibiting viral replication, and thus is superior to other immunosuppressive agents (e.g., glucocorticoids) in responding to acute exudative inflammation.

Claims (10)

1. The use of a 4-aminoquinoline compound or a pharmaceutically acceptable salt thereof in the manufacture of a medicament or pharmaceutical composition for the treatment and/or prevention of exudative inflammation; wherein, the pharmaceutical composition comprises: the 4-aminoquinoline compound or the pharmaceutically acceptable salt thereof and one or more pharmaceutically acceptable pharmaceutical auxiliary materials and/or one or more other active ingredients.
2. The use according to claim 1, wherein the 4-aminoquinoline is a 4-aminoquinoline antimalarial; for example
Figure FDA0002949375940000011
Or a compound of formula I:
Figure FDA0002949375940000012
wherein R is1H, OH or halogen;
Figure FDA0002949375940000013
is composed of
Figure FDA0002949375940000014
Phenyl or phenyl substituted with one or more of the following substituents: OH or halogen;
and/or the pharmaceutically acceptable salt is hydrochloride, phosphate, sulfate, methanesulfonate, citrate or fumarate; preferably a phosphate or sulphate;
and/or, the active ingredient is selected from antiviral agents, antibiotics, antifungal agents, antitumor agents, and autophagy inhibiting agents;
and/or, the dosage form of the pharmaceutical composition is oral preparation or parenteral preparation; such as tablets, capsules, intravenous injections, intraperitoneal injections, inhalants, nebulizers, lyophilizates, patches, gels, sprays, or suppositories;
and/or, the pharmaceutical composition is a unit dose, for example, containing 50mg-2000mg of the 4-aminoquinoline compound or the pharmaceutically acceptable salt thereof;
and/or, the pharmaceutical composition at least contains 50 wt% of the 4-aminoquinoline compound or the pharmaceutically acceptable salt thereof.
3. The use according to claim 1 or 2, wherein the 4-aminoquinoline is amodiaquine, chloroquine or hydroxychloroquine; preferably chloroquine and/or hydroxychloroquine, more preferably hydroxychloroquine;
and/or the pharmaceutically acceptable salt of the 4-aminoquinoline compound is chloroquine phosphate or hydroxychloroquine sulfate; preferably hydroxychloroquine sulfate.
4. The use according to claim 1, wherein the inflammatory exudate from exudative inflammation is characterized by one or more of the following:
(1) abnormal specific gravity;
(2) abnormal IL-2 levels;
(3) abnormal IL-6 levels;
(4) abnormal IL-8 levels;
(5) abnormal IL-17 levels;
(6) an abnormal IP-10 level;
(7) abnormal CSF levels of colony stimulating factor; or
(8) Abnormal levels of tumor necrosis factor TNF;
preferably, the exudative inflammation is further characterized by one or more of the following:
(9) abnormal serum interferon IFN levels; or
(10) Abnormal levels of serum erythropoietin EPO.
5. The use according to claim 4, wherein the colony stimulating factor comprises G-CSF, M-CSF, GM-CSF, multi-CSF, or a combination thereof;
and/or, the tumor necrosis factor comprises TNF-alpha, TNF-beta or a combination thereof, preferably TNF-alpha;
and/or, the interferon includes type I interferon, type II interferon or their combination, such as IFN-alpha, IFN-beta, IFN-gamma or their combination;
and/or the inflammatory exudate comprises serous exudate, purulent exudate, catarrhal exudate, cellulosic exudate, hemorrhagic exudate or a combination thereof; alternatively, the inflammatory exudate comprises one or more of sputum, nasopharyngeal secretions, interstitial lung fluid, alveolar lavage fluid, interstitial fluid and synovial fluid;
and/or, said abnormal specific gravity comprises a specific gravity of inflammatory exudate > 1.018;
and/or, the exudative inflammation has one or more of the following characteristics:
(i) the permeability of tissue blood vessels is increased, so that leukocyte infiltration, edema and fibrosis are caused, the tissue fluid is filled, and the specific gravity of inflammatory exudate is higher than a normal value;
(ii) inflammatory exudate and/or serum IL-6 levels above normal;
(iii) inflammatory exudate and/or serum TNF-a levels above normal;
(iv) inflammatory exudate and/or serum IFN levels are below normal;
(v) inflammatory exudate and/or serum CSF levels above normal;
(vi) serum EPO levels were below normal.
6. The use of claim 4, wherein said exudative inflammation comprises topical exudative inflammation and/or systemic exudative inflammation; alternatively, the exudative inflammation comprises acute and/or chronic exudative inflammation, such as acute exudative inflammation; alternatively, the exudative inflammation also includes acute multiple organ failure that accompanies it.
7. The use of claim 6, wherein the local exudative inflammation comprises an exudative inflammation occurring in one or more of the lung, bronchi, kidney, heart, liver, skin and joints, or wherein the local exudative inflammation comprises infectious or non-infectious pneumonia;
and/or the acute exudative inflammation is a disease with a time of onset of less than 6 months, 5 months, 4 months, 3 months, 2 months, 1 month, 20 days, 15 days, 7 days, or 3 days.
8. The use according to claim 7, wherein the local exudative inflammation is exudative pneumonia, such as acute exudative pneumonia;
and/or, the non-infectious pneumonia comprises cancerous pneumonia.
9. The use of claim 8, wherein the acute exudative pneumonia comprises acute bacterial infectious pneumonia, acute viral infectious pneumonia, acute fungal pneumonia, acute parasitic infectious pneumonia, acute rickettsial infectious pneumonia, acute mycoplasma/chlamydia infectious pneumonia; alternatively, the acute exudative pneumonia comprises community-acquired pneumonia or nosocomial infectious pneumonia.
10. The use of claim 9, wherein said acute bacterial pneumonia comprises acute exudative pneumonia caused by one or more pathogens selected from the group consisting of streptococcus pneumoniae, staphylococcus aureus, klebsiella pneumoniae, haemophilus influenzae, legionella and pseudomonas aeruginosa;
and/or, the acute viral pneumonia comprises acute exudative pneumonia caused by one or more of influenza a virus, influenza b virus, avian influenza virus, SARS virus, MERS virus, zika virus, ebola virus and COVID-19 virus;
and/or the acute fungal pneumonia comprises acute exudative pneumonia caused by one or more of cryptococcus, aspergillus, mucor and candida.
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