ES2562059T3 - Inhibidor de acción rápida de la secreción de ácido gástrico - Google Patents

Inhibidor de acción rápida de la secreción de ácido gástrico Download PDF

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ES2562059T3
ES2562059T3 ES07716990.2T ES07716990T ES2562059T3 ES 2562059 T3 ES2562059 T3 ES 2562059T3 ES 07716990 T ES07716990 T ES 07716990T ES 2562059 T3 ES2562059 T3 ES 2562059T3
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acid secretion
gastric acid
gastric
fast
glands
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John P. Geibel
Philipp Kirchhoff
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Yale University
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/28Compounds containing heavy metals
    • A61K31/315Zinc compounds
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/41641,3-Diazoles
    • A61K31/41681,3-Diazoles having a nitrogen attached in position 2, e.g. clonidine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/425Thiazoles
    • A61K31/429Thiazoles condensed with heterocyclic ring systems
    • A61K31/43Compounds containing 4-thia-1-azabicyclo [3.2.0] heptane ring systems, i.e. compounds containing a ring system of the formula, e.g. penicillins, penems
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/65Tetracyclines
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/70Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7042Compounds having saccharide radicals and heterocyclic rings
    • A61K31/7048Compounds having saccharide radicals and heterocyclic rings having oxygen as a ring hetero atom, e.g. leucoglucosan, hesperidin, erythromycin, nystatin, digitoxin or digoxin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K33/00Medicinal preparations containing inorganic active ingredients
    • A61K33/24Heavy metals; Compounds thereof
    • A61K33/30Zinc; Compounds thereof
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00Drugs for disorders of the alimentary tract or the digestive system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/04Drugs for disorders of the alimentary tract or the digestive system for ulcers, gastritis or reflux esophagitis, e.g. antacids, inhibitors of acid secretion, mucosal protectants
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/04Antibacterial agents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00Antineoplastic agents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

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  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
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  • Inorganic Chemistry (AREA)
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  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
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  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
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Abstract

Una composición farmacéutica para la administración al estómago de un paciente que comprende una cantidad eficaz de al menos una sal de cinc farmacéuticamente aceptable en combinación con un inhibidor de la bomba de protones, opcionalmente en combinación con un vehículo, aditivo o excipiente farmacéuticamente aceptable para su uso para incrementar rápidamente el pH de los jugos gástricos en el estómago de un paciente con dicha necesidad hasta al menos 3,0 dentro de un periodo no superior a una hora después de su administración.

Description

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de Sigma y Molecular Probes.
Resultados
Localización inmunohistoquímica de la ATPasa H+, K+
5 La inmunohistoquímica usando anticuerpos específicos dirigidos contra epítopos muy conservados dentro de las subunidades α o β de la ATPasa H+, K+ gástrica identificó tinción específica para ambas subunidades en las glándulas fúndicas (figura 7 A).
Microscopía electrónica
Después de la obtención de secciones en Epon de unión gastroesofágica de rata en ayunas, se realizó la microscopía electrónica sobre las glándulas gástricas que venían justo después de esta unión, y estas se llamaron F1 y se usaron en todos nuestros experimentos. Las figuras 7B, C muestran la localización de la etiqueta de oro de
15 la ATPasa H+, K+ en la célula parietal de la glándula fúndica. Percibimos una mayor densidad de tinción sobre el polo apical de la célula en los canalículos secretores o vacuolares. Esto podría correlacionarse con la alta extrusión basal de protones de las regiones del fondo en comparación con el cuerpo, debido al hecho de que la proteína está siempre en la membrana en la glándula fúndica, mientras que en el cuerpo el receptor está dentro del canalículo secretor hasta la estimulación.
Tinción del receptor de H2
La tinción del receptor de H2 se hizo tanto en el fondo como en el cuerpo para examinar la presencia y densidad del receptor en ambas áreas del estómago. Encontramos una clara tinción basolateral en las glándulas del cuerpo y no
25 pudimos detectar tinción en las glándulas fúndicas. Estos resultados se correlacionan con la falta de efecto de la histamina en la estimulación de la secreción de ácido en el fondo. Se vio claramente que el receptor H2 está ausente en las glándulas del fondo y presente en el cuerpo (datos no mostrados).
Secreción de ácido inducida por secretagogo
El pH intracelular se midió usando el colorante BCECF sensible a pH y se verificó continuamente usando un sistema de toma de imágenes de fluorescencia en tiempo real para identificar los cambios en el pH intracelular. Los índices de salida de protones se calcularon como ΔpHi/min usando una técnica que se desarrolló en nuestro laboratorio para las glándulas del cuerpo21a-25a. Medimos el cambio en el índice de salida en presencia y ausencia de secretagogos.
35
Efecto de la histamina sobre la ATPasa H+, K+ del fondo y del cuerpo
Incubamos glándulas individuales con histamina 100 µM durante 20 minutos. La histamina estuvo presente durante todo el protocolo de superfusión. En la glándula del cuerpo medimos una tasa de extrusión de protones estimulada por histamina de 0,056  0,008 ΔpHi/min, mientras que la secreción de ácido basal sin ningún secretagogo fue de 0,011  0,002 ΔpHi/min (figuras 8C, D). En comparación con el cuerpo, el fondo mostró un alto índice de extrusión de protones, incluso por debajo de las condiciones basales, (0,039  0,009 ΔpHi/ min). Éste es similar a la secreción de ácido inducida por histamina (0,040  0,0079 ΔpHi/min, figuras 8A, B). Estos datos muestran que no hay efecto de la histamina sobre las glándulas de la zona F1 en comparación con los controles.
45
Acetilcolina y secreción de ácido en el fondo
En la siguiente serie, investigamos las propiedades funcionales de las glándulas fúndicas de acuerdo con la estimulación neuronal por la vía de la ACh. Al contrario que con la histamina, hubo un cambio evidente en los índices de extrusión de protones después de la estimulación. Aunque los controles aún estaban bombeando hacia afuera protones de forma activa, las glándulas que se estimularon con acetilcolina 100 µM durante la carga de colorante y a lo largo de toda la perfusión. Determinamos que la acetilcolina causó un aumento del índice de alcalinización (0,075  0,0015 ΔpHi/min frente a los controles 0,039  0,009 ΔpHi/min), mostrando un efecto directo de la acetilcolina sobre la extrusión de ácido en el fondo (figura 9).
55
Efecto de la pentagastrina en la zona F1
Para determinar si la gastrina también podía activar la ATPasa H+,K+ del fondo, llevamos a cabo estudios usando pentagastrina, un péptido sintético que contiene los cinco aminoácidos terminales de la gastrina, el cual se sabe que causa una fuerte secreción de ácido en las glándulas del cuerpo. A una dosis de pentagastrina de 100 µM observamos índices de alcalinización que fueron de 0,062  0,007 ΔpHi/min, lo que fue similar a la acetilcolina en cuanto al aumento del índice de extrusión de protones desde las células del fondo (figura 9).
Inhibidores de la secreción de ácido gástrico
65 En la siguiente serie de estudios intentamos determinar si las glándulas fúndicas tenían perfiles de inhibición de la
17
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22a. Waisbren SJ, Geibel J, Boron WF, Modlin IM. Luminal perfusion of isolated gastric glands. Am J Physiol 1994;266:C1013-C1027.
23a. Waisbren SJ, Geibel JP, Modlin IM, Boron WF. Unusual permeability properties of gastric gland cells. 5 Nature 1994;368:332-335.
24a. Busque SM, Kerstetter JE, Geibel JP, Insogna K. L-type amino acids stimulate gastric acid secretion by activation of the calcium-sensing receptor in parietal cells. Am J Physiol Gastrointest Liver Physiol 2005;289:G664-G669.
10 25a. Geibel JP, Wagner CA, Caroppo R, Qureshi I, Gloeckner J, Manuelidis L, Kirchhoff P, Radebold K. The stomach divalent ion-sensing receptor scar is a modulator of gastric acid secretion. J Biol Chem 2001;276:3954939552.
15 26a. Sachs G, Scott D, Reuben M. Omeprazole and the gastric mucosa. Digestion 1990;47 Suppl 1:35-38.
27a. Sachs G, Wallmark B. The gastric H+,K+-ATPase: the site of action of omeprazole. Scand J Gastroenterol Suppl 1989;166:3-11.
20 28a. Alino SF, Garcia D, Uvnas-Moberg K. On the interaction between intragastric pH and electrical vagal stimulation in causing gastric acid secretion and intraluminal release of gastrin and somatostatin in anesthetized rats. Acta Physiol Scand 1983;117:491-495.
29a. Meulemans AL, Eelen JG, Schuurkes JA. NO mediates gastric relaxation after brief vagal stimulation in 25 anesthetized dogs. Am J Physiol 1995;269:G255-G261.
30a. Singh J. Prostaglandin release from rat stomach following vagal stimulation or administration of acetylcholine. Eur J Pharmacol 1980;65:39-48.
30 31a. Aarimaa M, Soderstrom KO, Kalimo H, Inberg M, Nevalainen T. Morphology and function of the parietal cells after proximal selective vagotomy in duodenal ulcer patients. Scand J Gastroenterol 1984;19:787-797.
32a. Amdrup E. The surgical treatment of duodenal ulcer. Schweiz Med Wochenschr 1979;109:583-585.
35 33a. Waisbren SJ, Modlin IM. The evolution of therapeutic vagotomy. Surg Gynecol Obstet 1990;170:261-272.
34a. Abelo A, Eriksson UG, Karlsson MO, Larsson H, Gabrielsson J. A turnover model of irreversible inhibition of gastric acid secretion by omeprazole in the dog. J Pharmacol Exp Ther 2000;295:662-669.
40 35a. Andersen JB, Andrade DV, Wang T. Effects of inhibition gastric acid secretion on arterial acid-base status during digestion in the toad Bufo marinus. Comp Biochem Physiol A Mol Integr Physiol 2003;135:425-433.
36a. Gedda K, Scott D, Besancon M, Lorentzon P, Sachs G. Turnover of the gastric H+,K(+)-adenosine triphosphatase alpha subunit and its effect on inhibition of rat gastric acid secretion. Gastroenterology 1995;109:113445 1141.
37a. Sachs G, Shin JM, Pratha V, Hogan D. Synthesis or rupture: duration of acid inhibition by proton pump inhibitors. Drugs Today (Barc) 2003;39 Suppl A:11-14.
50 38a. Shamburek RD, Schubert ML. Pharmacology of gastric acid inhibition. Baillieres Clin Gastroenterol 1993;7:23-54.
39a. Locke GR, III. Current medical management of gastroesophageal reflux disease. Thorac Surg Clin 2005;15:369-375. 55 40a. Geibel JP. Secretion and absorption by colonic crypts. Annu Rev Physiol 2005;67:471-490.
23

Claims (1)

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ES07716990.2T 2006-01-27 2007-01-25 Inhibidor de acción rápida de la secreción de ácido gástrico Active ES2562059T3 (es)

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US76259506P 2006-01-27 2006-01-27
US762595P 2006-01-27
US76483406P 2006-02-03 2006-02-03
US764834P 2006-02-03
US85089106P 2006-10-11 2006-10-11
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PCT/US2007/001950 WO2007089511A2 (en) 2006-01-27 2007-01-25 Fast acting inhibitor of gastric acid secretion

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ES13193624.7T Active ES2609976T3 (es) 2006-01-27 2007-01-25 Combinación de sal de cinc y agente anti-H. pylori como inhibidor de acción rápida de la secreción de ácido gástrico

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US (1) US11510894B2 (es)
EP (2) EP2705845B1 (es)
JP (3) JP5469865B2 (es)
CN (2) CN103463096B (es)
CA (1) CA2635272C (es)
DK (1) DK1976532T3 (es)
ES (2) ES2562059T3 (es)
HK (1) HK1191861A1 (es)
HR (1) HRP20151437T1 (es)
HU (1) HUE029222T2 (es)
PL (1) PL1976532T3 (es)
PT (1) PT1976532E (es)
RS (1) RS54543B1 (es)
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DK1976532T3 (en) 2006-01-27 2016-02-01 Univ Yale FAST-ACTING INHIBITOR of gastric acid secretion

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CN101374526B (zh) 2013-08-07
WO2007089511A3 (en) 2008-04-10
RS54543B1 (en) 2016-06-30
DK1976532T3 (en) 2016-02-01
EP1976532A2 (en) 2008-10-08
EP1976532B1 (en) 2015-11-11
EP2705845B1 (en) 2016-10-05
WO2007089511A2 (en) 2007-08-09
CA2635272C (en) 2016-11-29
JP6366548B2 (ja) 2018-08-01
PL1976532T3 (pl) 2016-05-31
PT1976532E (pt) 2016-02-11
JP2009524669A (ja) 2009-07-02
US11510894B2 (en) 2022-11-29
CN103463096B (zh) 2016-03-16
JP2013241457A (ja) 2013-12-05
JP2015232016A (ja) 2015-12-24
HUE029222T2 (en) 2017-02-28
JP5469865B2 (ja) 2014-04-16
EP1976532A4 (en) 2010-12-15
EP2705845A1 (en) 2014-03-12
HRP20151437T1 (hr) 2016-02-12
CA2635272A1 (en) 2007-08-09
HK1191861A1 (zh) 2014-08-08
CN103463096A (zh) 2013-12-25
ES2609976T3 (es) 2017-04-25
CN101374526A (zh) 2009-02-25
SI1976532T1 (sl) 2016-04-29
US20090035393A1 (en) 2009-02-05

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