WO2007000234A1 - Moxifloxacin therapeutic use for treating immune system functional disturbances - Google Patents

Moxifloxacin therapeutic use for treating immune system functional disturbances Download PDF

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Publication number
WO2007000234A1
WO2007000234A1 PCT/EP2006/005569 EP2006005569W WO2007000234A1 WO 2007000234 A1 WO2007000234 A1 WO 2007000234A1 EP 2006005569 W EP2006005569 W EP 2006005569W WO 2007000234 A1 WO2007000234 A1 WO 2007000234A1
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use according
fluoroquinolones
moxifloxacin
fluoroquinolone
treatment
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PCT/EP2006/005569
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German (de)
French (fr)
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Olaf Weber
Peter Seiler
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Bayer Healthcare Ag
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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
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/496Non-condensed piperazines containing further heterocyclic rings, e.g. rifampin, thiothixene
    • 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
    • A61K31/435Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47Quinolines; Isoquinolines
    • A61K31/4709Non-condensed quinolines and containing further heterocyclic rings
    • 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
    • A61P37/00Drugs for immunological or allergic disorders
    • A61P37/02Immunomodulators
    • A61P37/04Immunostimulants

Definitions

  • the invention relates to the use of fluoroquinolones for the preparation of medicaments for the reconstruction of disorders of the immune system, such as e.g. the therapy and / or prophylaxis of immunosuppressions.
  • the fluoroquinolones may be antibacterially active or antibacterially inactive fluoroquinolones.
  • the invention relates to the use of moxifloxacin, ciprofloxacin, gatifloxacin ,, enrofloxacin, sparfloxacin, clinafloxacin, Grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, fleroxacin, danofloxacin, sarafloxacin, marbofloxacin, Orbifloxacin, pradofloxacin or levofloxacin for the manufacture of a medicament for Treatment of immunosuppressants.
  • Immunosuppressants may be caused by disease states or induced by certain drugs. On the one hand, it is possible to induce immunosuppression specifically in the therapy (eg in the treatment of inflammatory diseases or in organ transplants to prevent rejection of the transplant, on the other hand, immunosuppressants may appear as undesirable side effects of certain medications, the latter being of particular importance in the chemotherapy of tumor diseases ,
  • Immunevasion mechanisms have been described e.g. of viruses, bacteria and parasites, or tumor cells designed as strategies to escape detection by the immune system or even actively suppress the immune system (11-20).
  • Neutropenic fever is a serious complication in cancer patients who have or have been treated with chemotherapy (21-24). There is a risk of generalized infection with a significant mortality rate in these patients. In recently published reports, the use of moxifloxacin and gatifloxacin in neutropenic cancer patients with fever has been advocated for the treatment of bacterial infections (25-30).
  • colony-stimulating factors can not rule out the possibility that, despite an improved blood count and different immunological parameters (TNF- ⁇ , bone marrow colony-forming units-cell counts, total neutrophil counts, IL-1, IL-6, IL-1). 8, Fas, FasL, TNFRl), a promoting influence on further resident in the patient tumor cells in terms of recurrence of the tumor disease or activation of metastasis developed (8, 34).
  • the administration of colony-stimulating factors may be associated with significant side effects such as acute respiratory distress syndrome, deaths have been described here ([285702] Iddb). The reference is cited in the following reports: filgrastim. Updated on 23 rd June 2004.
  • Originator lenograstim Amgen Ine. Updated on 24 lh March 2004. Originator: Chugai Pharmaceutical Co Ltd nartograstim. Updated on 28 " 1 January 2003. Originator: Kyowa Hakko Kogyo Co Ltd, SCRIP World Pharmaceutical News 1998, 2324).
  • the therapy should be at the same time more favorable side effect profile than the use of colony-stimulating factors both physically and functionally reconstitute the immune response as well as to completely reconstitute before rationalnism, hospital-associated, bacterial infections.
  • the invention relates to a first object.
  • Immunosuppressed patients are people and other warm-blooded animals for whom the reduction of the number of immunologically important cells such as monocytes / macrophages, neutrophils, basophils and eosinophils, mast cells, dendritic cells, natural killer cells, T- and B-cells as well as an impairment of the Functions of these cells, such as phagocytosis, oxidative burst, cytokine and chemokine secretion, antigen presentation, T-killer cell activity, T helper cell activity, T suppressor cell activity, unconventional T cell activity, conventional B2 and unconventional Bl activity B cells are at increased risk of infection or tumor disease.
  • immunologically important cells such as monocytes / macrophages, neutrophils, basophils and eosinophils, mast cells, dendritic cells, natural killer cells, T- and B-cells as well as an impairment of the Functions of these cells, such as phagocytosis, oxidative burst, cytokin
  • Immunosuppression may have been medically induced (eg chemotherapy) or caused by other causes (hereditary, infectious diseases).
  • Immunosuppressive conditions are understood to mean conditions in which the number of immunologically important cells such as monocytes / macrophages, neutrophilic, basophilic and eosinophilic granulocytes, mast cells, dendritic cells, natural killer cells, T cells and B cells is reduced and their functions impaired Cells, such as phagocytosis, oxidative burst, cytokine and
  • Immunosuppression may have been medically induced (e.g., chemotherapy) or due to other causes (hereditary, infectious diseases).
  • the flourchinolone is a compound selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin , Fleroxacin, danofloxacin, sarafloxacin, marbofloxacin, orbifloxacin, pradofloxacin and
  • Levofloxacin acts.
  • the flourchinolone is a compound selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, fleroxacin, levofloxacin, Danofloxacin, sarafloxacin, marbofloxacin, orbifloxacin and pradofloxacin.
  • the fluoroquinolone is a fluoroquinolone selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, fleroxacin, levofloxacin, Danofloxacin, sarafloxacin, marbofloxacin, orbifloxacin and pradofloxacin.
  • the antitumor agent is an agent selected from the group consisting of asparaginase, bleomycin, carboplatin, carmustine, chlorambucil, cisplatin, colaspase, cyclophosphamide, cytarabine, dacarbazine, Dactinomycin, daunorubicin, doxorubicin (adriamycin), epirubicin, etoposide, 5-fluorouracil, hexamethylmelamine, hydroxyurea,
  • Ethinyl estradiol 5-fluorodeoxyuridine, 5-fluorodeoxyuridine monophosphate, fludarabine phosphate, fluoxymesterone, flutamide, hydroxyprogesterone caproate, idarubicin, interferon, medroxyprogesterone acetate, megestrol acetate, melphalan, mitotane, paclitaxel, pentstatin, PALA, plicamycin, semustine, teniposide, testosterone propionate, thiotepa, trimethylmelamine, Uridine, and vinorelbine, oxaliplatin, gemcitabine, capecitabine,
  • fluoroquinolone is a fluoroquinolone selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin,
  • Enrofloxacin sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, fleroxacin, levofloxacin, danofloxacin, sarafloxacin, marbofloxacin, orbifloxacin and pradofloxacin.
  • the antiviral agent is an agent selected from the group consisting of interferon- ⁇ , interferon alfacon-1, interferon- ⁇ or pegylated interferon- ⁇ , 3TC (lamivudine), adevovir , Adevovir dipivoxil, entecavir, emtricitabine, Clevudine, L-dT, L-Fd4C acyclovir, valacyclovir, penciclovir, famciclovir foscarnet, brivudine, ganciclpvir, cidofovir, inhibitors of
  • Helicase-primase complex ribavirin, lopinavir-ritonavir (Kaletra), AG7088, hexapeptidyl CMK, ruprin trivir (AG7088), 3C protease inhibitors, pirodavir, pleconaril, soluble ICAM-I, amantidine, Symmetrel, flumadine, oseltamvir, zanamivir, tenofovir disproxil Fumarate (TDF), emtricitabine (FTC), didanosine (ddl), stavudine (d4T), zidovudine (AZT), zalcitabine (ddC), efavirenz (EFV), nivirapine (NVP), delaviridine
  • DLV atazanavir
  • ATV atazanavir
  • RTV ritonavir
  • ATV amprenavir
  • ADV amprenavir
  • LUV lopinavir / rironavir
  • NFV nelfinavir
  • IDV indinavir
  • SQV-SGC saquinavir
  • T-20 Etravirine
  • TMC-125 capravirine
  • PMPA tenovovir
  • Kit containing containers separated from each other, in each of which the active ingredients mentioned under point 15, 16, or 17 are included. Such a kit is suitable for the
  • Kit containing separate containers, in each of which the active ingredients mentioned under point 18, 19, or 20 are included.
  • viral infections are infections by viruses selected from the group consisting of the virus families Adenoviridae, Caliciviridae, Picornaviridae, Paramyxoviridae, Coronaviridae, Orthomyxoviridae, Retroviridae, Reoviridae, Bunyaviridae, Togaviridae, Herpesviridae, Parvoviridae and / or
  • Papovaviridae acts. 26. Use according to items 24 or 25, which are diseases of the respiratory tract (eg SARS, influenza), the digestive tract and / or the skin with its appendages and the connective tissue.
  • diseases of the respiratory tract eg SARS, influenza
  • Orbifloxacin, pradofloxacin and levofloxacin and / or non-antibacterial fluoquinolones are included in Orbifloxacin, pradofloxacin and levofloxacin and / or non-antibacterial fluoquinolones.
  • the invention also relates to medicaments containing one or more flourchinolones, in particular antibacterially active fluoroquinolones, preferably a flourchinolone selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, Fleroxacin, danofloxacin, sarafloxacin, marbofloxacin, orbifloxacin, pradofloxacin and levofloxacin, more preferably moxifloxacin for the treatment of immunosuppressive activity.
  • a flourchinolone selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparflox
  • the invention also relates to the use of one or more flourchinolones, in particular antibacterially active fluoroquinolones, preferably a flourchinolone selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, Grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, fleroxacin, danofloxacin, sarafloxacin, marbofloxacin, Orbifloxacin, pradofloxacin or levofloxacin, particularly preferably Moxifloxacin for the manufacture of a medicament for Treatment of immunosuppressants.
  • a flourchinolone selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin,
  • a combination preparation may contain the active ingredients separately in separate containers. However, the active ingredients may also be present together in a dosage form, e.g. together with suitable accompanying substances pressed in a tablet.
  • the invention also relates to treatment methods in which the drug preparations prepared as described are used for the treatment of immunosuppressants.
  • These treatments may also be combination therapies.
  • Preference is given to combination therapies comprising one or more fluoroquinolone and one or more agents used in the treatment of tumors, or one or more fluoroquinolones and one or more antiviral agents.
  • Particularly preferred are combination therapies using the specifically disclosed fluoroquinolones with the specifically disclosed drugs used in tumor therapy or with the specifically disclosed antiviral agents.
  • the administration of the active ingredients can be carried out simultaneously or sequentially in combination therapy, even at longer intervals.
  • the active substance can act systemically and / or locally.
  • it can be applied in a suitable manner, e.g. oral, parenteral, pulmonary, nasal, sublingual, lingual, buccal, rectal, transdermal, conjunctivae otic or implant.
  • the active ingredient can be administered in suitable administration forms.
  • Tablets uncoated and coated tablets, for example enteric coated tablets or film-coated tablets
  • capsules dragees, granules, pellets, powders, emulsions, suspensions, solutions and aerosols.
  • Parenteral administration can be carried out bypassing a resorption step (intravenously, intraarterially, intracardially, intraspinally or intralumbarly) or using absorption (intramuscular, subcutaneous, intracutaneous, percutaneous, or intraperitoneal).
  • suitable application forms include injection and infusion. preparations in the form of solutions, suspensions, emulsions, lyophilisates and sterile powders.
  • Inhalation medicaments including powder inhalers, nebulizers
  • nasal drops / solutions, sprays lingual, sublingual or buccal tablets or capsules to be applied
  • suppositories e.g., suppositories
  • ear and ophthalmic preparations vaginal capsules
  • vaginal capsules aqueous suspensions (lotions, shake mixtures)
  • lipophilic suspensions ointments, creams, milk, pastes, scattering powders or implants.
  • the active compounds can be converted in a manner known per se into the stated administration forms. This is done using inert non-toxic, pharmaceutically suitable excipients.
  • excipients include u.a. Carriers (eg, microcrystalline cellulose), solvents (eg, liquid polyethylene glycols), emulsifiers (eg, sodium dodecyl sulfate), dispersants (eg, polyvinylpyrrolidone), synthetic and natural biopolymers (eg, albumin), stabilizers (eg, antioxidants such as ascorbic acid), dyes (eg, inorganic pigments such as iron oxides ) or flavor and / or odor remedies.
  • Carriers eg, microcrystalline cellulose
  • solvents eg, liquid polyethylene glycols
  • emulsifiers eg, sodium dodecyl sulfate
  • dispersants eg, polyvinylpyrrolidone
  • synthetic and natural biopolymers eg, albumin
  • parenterally administered amounts of about 0.001 to 10 mg / kg, preferably about 0.01 to 5 mg / kg of body weight to achieve effective results.
  • the amount is about 0.01 to 25 mg / kg, preferably about 0.1 to 10 mg / kg of body weight.
  • mice Female C57BL / 6 mice were treated with 57 mg / kg carboplatin intravenously (i.v.) on days 1, 5 and 9 of the experiment. On days 10, 11 and 12, the mice were treated with moxifloxacin intraperitoneally (i.p.). One group of mice received 22.5 mg / kg / day divided into three doses of 7.5 mg / kg, and a second group of mice 67.5 mg / kg / day divided into three doses a 21.5 mg / kg. A third group was used as a control in place of moxifloxacin with dH2O i.p. treated. A fourth group was administered as a control in place of carboplatin 0.9% saline i.v. treated and instead of moxifloxacin with dH2O i.p. treated.
  • mice On day 9 and day 15 of the experiment, the mice were bled.
  • the peripheral blood leukocytes were subjected to a FACS analysis (FACScalibur, BD, Heidelberg, D), as well as a phagocytosis and a burst test (Orpegen, Heidelberg, D).
  • CD3- ⁇ / CD4 / CD8- ⁇ for the characterization of the T-cell subtypes
  • CD3- ⁇ / CD25 / CD69 for the characterization of the T-cell activation states
  • CD19 / CD25 / CD69 for the characterization of B-cell activation states.
  • Phagocytosis of FITC-labeled, serum-opsonized, heat-inactivated E. coli (Phagoassay, Orpegen, Heidelberg, D)
  • the phagocytic activities of peripheral blood neutrophil granulocytes were not affected at any time and by any treatment.
  • mice treated with carboplatin alone was reduced by over 90% compared to the T-cell population of placebo-treated mice.
  • Immunocompetent mice were transplanted with syngeneic melanoma cells.
  • Treatment of the melanoma with carboplatin was alternately supplemented by treatment with moxifloxacin (Experiment 1) or moxifloxacin, levofloxacin and clarithromycin (Experiment 2).
  • the resulting immune suppression by carboplatin or the subsequent immune restoration by moxifloxacin was measured indirectly by the influence on the control of melanoma growth.
  • mice Male C57BL / 6 mice were transplanted under the right flank with 10 6 B16F10 melanoma cells subcutaneously (sc). After 3 days, mice were monitored for melanoma growth and randomized. On days 3, 6 and 9, 75 mg / kg carboplatin was intravenously (iv) treated. On days 4, 5, 7, 8, 10 and 11 the mice were treated with 20 mg / kg moxifloxacin (experiment 1) or with 20 mg / kg moxifloxacin, levofloxacin or clarithromycin (experiment 2) intraperitoneally (ip). A control group was replaced with dH 2 O instead of antibiotics treated ip. Another group was treated iv with 0.9% saline as a control instead of carboplatin and ip treated with dH 2 O instead of moxifloxacin.
  • FIG. 1 phagocytosis of peripheral blood monocytes.
  • Peripheral mouse leukocytes from 6 mice per group were combined in equal volumes and incubated with FITC-labeled E. coli.
  • Phagocytosis was quantified by FACS analysis focused on monocytes. The analyzes took place on day 8, ie before the third carboplatin treatment (A, see treatment scheme below) and on day 14, ie after the third carboplatin and after three moxifloxacin treatments (B). Shown are percent phagocytic monocytes per total population of live monocytes. Phagocytosis was measured after incubation at 37 ° C (filled symbols). Control samples for measuring nonspecific fluorescence were incubated at 0 ° C (open symbols). The fluorescence of FITC non-phagocytosed extracellular E. coli was quenched with trypan blue.
  • peripheral leukocytes were from mice treated according to the following scheme:
  • FIG. 2 Characterization of lymphocyte subpopulations. Peripheral mouse leukocytes from 6 mice per group were combined in equal volumes and stained for the following surface antigens:
  • CD3- ⁇ / CD4 / CD8- ⁇ for the characterization of the T-cell subtypes.
  • slgM / CD23 / CD45R to characterize the B-cell subtypes.
  • the surface staining was quantified by FACS analysis focused on lymphocytes according to the manufacturer's instructions (BD Biosciences, Heidelberg, D). The analyzes took place on day 14, ie after the third carboplatin and after three moxifloxacin treatments. Shown are percent of positively stained cells per total population of live lymphocytes.
  • peripheral leukocytes were from mice treated according to the following scheme:
  • FIG. 3 Characterization of lymphocyte activation states. Peripheral mouse leukocytes from 6 mice per group were combined in equal volumes and stained for the following surface antigens:
  • CD19 negative / CD25 / CD69 to characterize the T-cell activation states.
  • CD19 / CD25 / CD69 for the characterization of B-cell activation states.
  • FIG. 4 Course of melanoma growth to 13 days post transplantation.
  • C57BL / 6 male mice were transplanted under the right flank with 10 6 Bl 6F10 mouse melanoma cells sc.
  • the tumor growth was measured with a caliper gauge (Plexx, NL) and calculated according to the formula according to the formula (axb 2 ) x 0.5, where a represents the longer and b the shorter side of the measured ellipsoid. Shown are the medians of the calculated tumor volumes per group in mm 3 ⁇ standard deviation experiment 1) or the medians (experiment 2).
  • the following treatment groups were examined for tumor growth: Experiment 1:
  • Figure 5 Calculated final volumes of melanoma 13 days post-transplantation.
  • mice C57BL / 6 male mice were transplanted under the right flank with 10 6 B16F10 mouse melanoma cells sc.
  • the tumor growth was measured with a caliper gauge (Plexx, NL) and calculated according to the formula according to the formula (axb 2 ) x 0.5, where a represents the longer and b the shorter side of the measured ellipsoid. Shown are the medians of the calculated tumor volumes per group in mm 3 .
  • the following treatment groups were examined for tumor growth: Experiment 1
  • Latent tuberculosis mechanisms of host and bacillus that contribute to persistent infection. Lancet Infect Dis 3: 578-590.

Abstract

The invention relates to using fluoroquinolones for producing drugs for treating immune system functional disturbances, for example, for treating and/or preventing immunosuppresions.

Description

Therapeutischer Einsatz von Moxifloxacin zur Rekonstitution von Funktionsstörungen des ImmunsvstemsTherapeutic use of moxifloxacin to reconstitute dysfunction of the immune system
Die Erfindung betrifft die Verwendung von Fluorchinolonen zur Herstellung von Arzneimitteln zur Rekonstruktion von Funktionsstörungen des Immunsystems, wie z.B. die Therapie und/oder Prophylaxe von Immunosuppressionen. Bei den Fluorchinolonen kann es sich um antibakteriell wirksame oder um antibakteriell unwirksame Fluorchinolone handeln. Insbesondere betrifft die Erfindung die Verwendung von Moxifloxacin, Ciprofloxacin, Gatifloxacin,, Enrofloxacin, Sparfloxacin, Clinafloxacin, Grepafloxacin, Trovafloxacin, Tosufloxacin, Temafloxacin, Norfloxacin, Rufloxacin, Fleroxacin, Danofloxacin, Sarafloxacin, Marbofloxacin, Orbifloxacin, Pradofloxacin oder Levofloxacin zur Herstellung eines Arzneimittels zur Behandlung von Immunsuppressionen.The invention relates to the use of fluoroquinolones for the preparation of medicaments for the reconstruction of disorders of the immune system, such as e.g. the therapy and / or prophylaxis of immunosuppressions. The fluoroquinolones may be antibacterially active or antibacterially inactive fluoroquinolones. In particular, the invention relates to the use of moxifloxacin, ciprofloxacin, gatifloxacin ,, enrofloxacin, sparfloxacin, clinafloxacin, Grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, fleroxacin, danofloxacin, sarafloxacin, marbofloxacin, Orbifloxacin, pradofloxacin or levofloxacin for the manufacture of a medicament for Treatment of immunosuppressants.
Immunsuppressionen können durch Krankheitszustände hervorgerufen werden oder mittels bestimmter Medikamente induziert werden. Hierbei kann man einerseits gezielt im Sinne der Therapie eine Immunsuppression hervorrufen (z.B. bei der Behandlung entzündlicher Erkrankungen oder bei Organtransplantationen zur Verhinderung einer Abstoßung des Transplantates, andererseits können Immunsuppressionen als unerwünschte Nebenwirkungen bestimmter Medikamente auftreten. Letzteres ist vor allem bei der Chemotherapie von Tumorerkrankungen von Bedeutung.Immunosuppressants may be caused by disease states or induced by certain drugs. On the one hand, it is possible to induce immunosuppression specifically in the therapy (eg in the treatment of inflammatory diseases or in organ transplants to prevent rejection of the transplant, on the other hand, immunosuppressants may appear as undesirable side effects of certain medications, the latter being of particular importance in the chemotherapy of tumor diseases ,
Bei immunsupprimierten Patienten laufen die für Abwehr von Infektionserregern oder entarteter Zellen (z.B. Tumorzellen und deren Vorstufen) zuständigen Reaktionen gar nicht mehr oder nur noch in abgeschwächter Form ab. So können ansonsten harmlose Infektionskrankheiten für diese Patienten lebensbedrohlich sein, oder bestimmte Tumoren häufiger auftreten (1-7).In immunosuppressed patients, the reactions responsible for defense against infectious agents or degenerate cells (for example, tumor cells and their precursors) no longer take place or only to a lesser extent. Otherwise, harmless infectious diseases can be life-threatening for these patients, or certain tumors can occur more frequently (1-7).
Während einer Chemotherapie ist die Immunsuppression eine schwere, oft die Behandlung begrenzende, unerwünschte Wirkung. Durch hämatopoetische Wachstumsfaktoren wird derzeit versucht, Ausmaß und Dauer der durch die Chemotherapie induzierten Immunsuppression zu verkürzen (8-10).During chemotherapy, immunosuppression is a severe, often treatment-limiting, undesirable effect. Hematopoietic growth factors are currently attempting to reduce the extent and duration of chemotherapy-induced immunosuppression (8-10).
Eine weitere Form der Immunsuppression kann aus der Immunevasion verschiedener Erreger hervorgehen. Immunevasionsmechanismen wurden z.B. von Viren, Bakterien und Parasiten, oder Tumorzellen als Strategien entwickelt, um einer Erkennung durch das Immunsystem zu entgehen oder das Immunsystem sogar aktiv zu unterdrücken (11-20).Another form of immunosuppression may result from the immune evasion of various pathogens. Immunevasion mechanisms have been described e.g. of viruses, bacteria and parasites, or tumor cells designed as strategies to escape detection by the immune system or even actively suppress the immune system (11-20).
Neutropenisches Fieber ist eine ernste Komplikation bei Krebspatienten, die mit Chemotherapeutika behandelt wurden oder werden (21-24). Es besteht bei diesen Patienten die Gefahr einer generalisierten Infektion mit erheblicher Mortalitätsrate. In kürzlich publizierten Berichten wurde die Anwendung von Moxifloxacin und Gatifloxacin bei neutropenischen Krebspatienten mit Fieber zur Behandlung von bakteriellen Infektionen propagiert (25-30).Neutropenic fever is a serious complication in cancer patients who have or have been treated with chemotherapy (21-24). There is a risk of generalized infection with a significant mortality rate in these patients. In recently published reports, the use of moxifloxacin and gatifloxacin in neutropenic cancer patients with fever has been advocated for the treatment of bacterial infections (25-30).
Patienten, bei denen durch eine Chemotherapie eine Immunsuppression induziert wird, werden zur Zeit mit z.B. mit Kolonie stimulierenden Faktoren (z.B. G-CSF) behandelt. Eine ausreichende antibakterielle Wirkkomponente ist bei dieser Therapie nicht gegeben, so dass im Falle einer Infektion mit Antibiotika erweitert werden oder auf diese ausgewichen werden muss. In diesem Falle erfolgt die Therapie jedoch mitunter zu spät (8, 31-35).Patients in whom immunosuppression is induced by chemotherapy are currently being treated with e.g. treated with colony stimulating factors (e.g., G-CSF). A sufficient antibacterial active component is not given in this therapy, so that in case of infection with antibiotics to be extended or evaded. In this case, however, the therapy may be too late (8, 31-35).
Außerdem kann bei der Therapie mit koloniestimulierenden Faktoren nicht ausgeschlossen werden, dass sich trotz eines verbesserten Blutbildes und verschiedener immunologischer Parameter (TNF-α, bone marrow colony forming units-cell counts, total neutrophil counts, IL-I, IL-6, IL-8, Fas, FasL, TNFRl) ein fördernder Einfluss auf weiter im Patienten residierende Tumorzellen im Sinne einer Rezidivierung der Tumorerkrankung oder Aktivierung der Metastasierung entwickelt (8, 34). Außerdem kann die Gabe von koloniestimulierenden Faktoren mit beträchtlichen Nebenwirkungen, wie akutem Respiratory distress Syndrome einhergehen, Todesfalle wurden hier beschrieben ([285702]Iddb). The reference is cited in the following reports: filgrastim. Updated on 23rd June 2004. Originator: Amgen Ine lenograstim. Updated on 24lh March 2004. Originator: Chugai Pharmaceutical Co Ltd nartograstim. Updated on 28"1 January 2003. Originator: Kyowa Hakko Kogyo Co Ltd, SCRIP World Pharmaceutical News 1998, 2324).In addition, therapy with colony-stimulating factors can not rule out the possibility that, despite an improved blood count and different immunological parameters (TNF-α, bone marrow colony-forming units-cell counts, total neutrophil counts, IL-1, IL-6, IL-1). 8, Fas, FasL, TNFRl), a promoting influence on further resident in the patient tumor cells in terms of recurrence of the tumor disease or activation of metastasis developed (8, 34). In addition, the administration of colony-stimulating factors may be associated with significant side effects such as acute respiratory distress syndrome, deaths have been described here ([285702] Iddb). The reference is cited in the following reports: filgrastim. Updated on 23 rd June 2004. Originator: lenograstim Amgen Ine. Updated on 24 lh March 2004. Originator: Chugai Pharmaceutical Co Ltd nartograstim. Updated on 28 " 1 January 2003. Originator: Kyowa Hakko Kogyo Co Ltd, SCRIP World Pharmaceutical News 1998, 2324).
Folglich ist es Aufgabe der vorliegenden Erfindung, eine neue Therapie für immunsupprimierte Patienten zu entwickeln, bei denen eine manifeste Neutropenie nicht nachgewiesen werden kann und die nicht mit der potentiellen Gefahr einer Induktion von Rezidiven bei Tumorpatienten assoziiert ist. Außerdem soll die Therapie bei möglichst günstigerem Nebenwirkungsprofil als beim Einsatz von koloniestimulierenden Faktoren gleichzeitig sowohl die Immunantwort physisch und funktionell rekonstituieren als auch bis zur vollständigen Rekonstitution effektiv vor oportunistischen, Krankenhaus-assoziierten, bakteriellen Infektionen abschirmen.Accordingly, it is an object of the present invention to develop a new therapy for immunosuppressed patients in whom manifest neutropenia can not be detected and which is not associated with the potential danger of inducing recurrences in tumor patients. In addition, the therapy should be at the same time more favorable side effect profile than the use of colony-stimulating factors both physically and functionally reconstitute the immune response as well as to completely reconstitute before oportunistischen, hospital-associated, bacterial infections.
Diese Aufgabe wird - wie in Beispielen 1 und 2 dargelegt - gelöst durch die Bereitstellung Fluorchinolon-haltiger Arzneimittel, insbesondere Moxifloxacin-beinhaltender Arzneimittel zur Behandlung und/oder Prophylaxe von Immunsuppressionen.This object is achieved - as set forth in Examples 1 and 2 - by providing fluoroquinolone-containing drugs, in particular moxifloxacin-containing drugs for the treatment and / or prophylaxis of immunosuppressants.
Die Erfindung betrifftThe invention relates
1. Verwendung von einem oder mehreren Fluorchinolonen in einem Verfahren zur Herstellung eines Arzneimittels zur Behandlung und/oder Prophylaxe von Immun- suppressionen. Unter immunsupprimierten Patienten versteht man Menschen und andere Warmblüter, für die durch eine Reduktion der Anzahl immunologisch wichtiger Zellen wie Monozyten / Makrophagen, neutrophilen, basophilen und eosinophilen Granulozyten, Mastzellen, Dendritischer Zellen, Natürlichen Killerzellen, T- und B-Zellen sowie eine Beeinträchtigung der Funktionen dieser Zellen, wie Phagozytose, oxidative burst, Zytokin- und Chemokin-Ausschüttung, Antigenpräsentation, T-Killerzell-Aktivität, T-Helferzell- Aktivität, T-Suppressorzell-Aktiviät, Aktivität unkonventioneller T-Zellen, Aktivität konventioneller B2- und unkonventioneller Bl -B-Zellen eine erhöhte Gefahr von Infektionen oder Tumorerkrankungen besteht. Die Immunsuppression kann dabei medikamentös ausgelöst worden sein (z.B. Chemotherapie) oder durch andere Ursachen (erblich, Infektionskrankheiten) bedingt sein. Unter Immunsuppressionen versteht man Zustände, bei denen durch eine Reduktion der Anzahl immunologisch wichtiger Zellen wie Monozyten / Makrophagen, neutrophilen, basophilen und eosinophilen Granulozyten, Mastzellen, Dendritischer Zellen, Natürlichen Killerzellen, T- und B-Zellen sowie eine Beeinträch- tigung der Funktionen dieser Zellen, wie Phagozytose, oxidative burst, Zytokin- und1. Use of one or more fluoroquinolones in a process for the preparation of a medicament for the treatment and / or prophylaxis of immune suppressions. Immunosuppressed patients are people and other warm-blooded animals for whom the reduction of the number of immunologically important cells such as monocytes / macrophages, neutrophils, basophils and eosinophils, mast cells, dendritic cells, natural killer cells, T- and B-cells as well as an impairment of the Functions of these cells, such as phagocytosis, oxidative burst, cytokine and chemokine secretion, antigen presentation, T-killer cell activity, T helper cell activity, T suppressor cell activity, unconventional T cell activity, conventional B2 and unconventional Bl activity B cells are at increased risk of infection or tumor disease. Immunosuppression may have been medically induced (eg chemotherapy) or caused by other causes (hereditary, infectious diseases). Immunosuppressive conditions are understood to mean conditions in which the number of immunologically important cells such as monocytes / macrophages, neutrophilic, basophilic and eosinophilic granulocytes, mast cells, dendritic cells, natural killer cells, T cells and B cells is reduced and their functions impaired Cells, such as phagocytosis, oxidative burst, cytokine and
Chemokin-Ausschüttung, Antigenpräsentation, T-Killerzell-Aktivität, T-Helferzell-Aktivi- tät, T-Suppressorzell-Aktiviät, Aktivität unkonventioneller T-Zellen, Aktivität konventioneller B2- und unkonventioneller Bl -B-Zellen eine erhöhte Gefahr von Infektionen oder Tumorerkrankungen besteht. Die Immunsuppression kann dabei medikamentös ausgelöst worden sein (z.B. Chemotherapie) oder durch andere Ursachen (erblich, Infektionskrankheiten) bedingt sein.Chemokine release, antigen presentation, T-killer cell activity, T-helper cell activity, T-suppressor cell activity, unconventional T-cell activity, activity of conventional B2 and unconventional Bl-B cells increase the risk of infection or tumor disease consists. Immunosuppression may have been medically induced (e.g., chemotherapy) or due to other causes (hereditary, infectious diseases).
2. Verwendung gemäß Punkt 1, wobei es sich bei den Fluorchinolonen um antibakteriell wirksame Fluorchinolone handelt.2. Use according to item 1, wherein the fluoroquinolones are antibacterially active fluoroquinolones.
3. Verwendung gemäß Punkt 1, wobei es sich bei mindestens einem Fluorchinolon um Moxifloxacin handelt.3. Use according to item 1, wherein at least one fluoroquinolone is moxifloxacin.
4. Verwendung gemäß Punkt 1, wobei es sich bei mindestens einem Fluorchinolon um Ciprofloxacin handelt.4. Use according to item 1, wherein at least one fluoroquinolone is ciprofloxacin.
5. Verwendung gemäß Punkt 1, wobei es sich bei mindestens einem Fluorchinolon um Gatifloxacin handelt.5. Use according to item 1, wherein at least one fluoroquinolone is gatifloxacin.
6. Verwendung gemäß Punkt 1, wobei es sich bei mindestens einem Fluorchinolon um Levofloxacin handelt. 7. Die Erfindung bertrifft auch eine Verwendung gemäß Punkt 1, wobei es sich bei dem Flourchinolon um eine Verbindung ausgewählt aus der Gruppe bestehend aus Moxifloxacin, Ciprofloxacin, Gatifloxacin, Enrofloxacin, Sparfloxacin, Clinafloxacin, Grepafloxacin, Trovafloxacin, Tosufloxacin, Temafloxacin, Norfloxacin, Rufloxacin, Fleroxacin, Danofloxacin, Sarafloxacin, Marbofloxacin, Orbifloxacin, Pradofloxacin und6. Use according to item 1, wherein at least one fluoroquinolone is levofloxacin. 7. The invention also surpasses use according to item 1, wherein the flourchinolone is a compound selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin , Fleroxacin, danofloxacin, sarafloxacin, marbofloxacin, orbifloxacin, pradofloxacin and
Levofloxacin handelt.Levofloxacin acts.
8. Verwendung gemäß Punkt 1, wobei es sich bei den Fluorchinolonen um antibakteriell unwirksame Fluorchinolone handelt.8. Use according to item 1, wherein the fluoroquinolones are antibacterially inactive fluoroquinolones.
9. Verwendung gemäß Punkt 1, wobei es sich bei den Fluorchinolonen um eine Mischung aus antibakteriell wirksamen und unwirksamen Fluorchinolone handelt.9. Use according to item 1, wherein the fluoroquinolones is a mixture of antibacterially active and inactive fluoroquinolones.
10. Verwendung gemäß Punkt 1, wobei es sich bei den Immunsuppressionen um Zustände handelt, die durch Funktionsstörungen der Monozyten/Makrophagen hervorgerufen werden.10. Use according to item 1, wherein the immunosuppressants are states which are caused by disorders of the monocytes / macrophages.
11. Verwendung gemäß Punkt 10, wobei es sich bei mindestens einem Fluorchinolon um Moxifloxacin handelt.11. Use according to item 10, wherein at least one fluoroquinolone is moxifloxacin.
12. Verwendung gemäß Punkt 10, wobei es sich bei mindestens einem Fluorchinolon um Gatifloxacin handelt.12. Use according to item 10, wherein at least one fluoroquinolone is gatifloxacin.
13. Verwendung gemäß Punkt 10, wobei es sich bei mindestens einem Fluorchinolon um Levofloxacin handelt.13. Use according to item 10, wherein at least one fluoroquinolone is levofloxacin.
14. Verwendung gemäß Punkt 10, wobei es sich bei dem Flourchinolon um eine Verbindung ausgewählt aus der Gruppe bestehend aus Moxifloxacin, Ciprofloxacin, Gatifloxacin, Enrofloxacin, Sparfloxacin, Clinafloxacin, Grepafloxacin, Trovafloxacin, Tosufloxacin, Temafloxacin, Norfloxacin, Rufloxacin, Fleroxacin, Levofloxacin, Danofloxacin, Sarafloxacin, Marbofloxacin, Orbifloxacin und Pradofloxacin handelt.14. Use according to item 10, wherein the flourchinolone is a compound selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, fleroxacin, levofloxacin, Danofloxacin, sarafloxacin, marbofloxacin, orbifloxacin and pradofloxacin.
15. Verwendung von einem oder mehrerer Fluorchinolone in einem Verfahren zur Herstellung eines Arzneimittels zur Behandlung und/oder Prophylaxe von Immunsuppressionen, wobei es sich um ein Kombinationspräparat mit Arzneimitteln handelt, die zur antitumoralen Therapie, wie zum Beispiel Chemotherapeutika oder cytostatisch wirkende Mittel, eingesetzt werden. 16. Verwendung gemäß Punkt 15, wobei es sich bei dem Fluorchinolon um ein Fluorchinolon ausgewählt aus der Gruppe bestehend aus Moxifloxacin, Ciprofloxacin, Gatifloxacin, Enrofloxacin, Sparfloxacin, Clinafloxacin, Grepafloxacin, Trovafloxacin, Tosufloxacin, Temafloxacin, Norfloxacin, Rufloxacin, Fleroxacin, Levofloxacin, Danofloxacin, Sarafloxacin, Marbofloxacin, Orbifloxacin und Pradofloxacin handelt.15. Use of one or more fluoroquinolones in a process for the preparation of a medicament for the treatment and / or prophylaxis of immunosuppressive, which is a combination preparation with medicaments, which are used for antitumoral therapy, such as chemotherapeutic agents or cytostatic agents , 16. Use according to item 15, wherein the fluoroquinolone is a fluoroquinolone selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, fleroxacin, levofloxacin, Danofloxacin, sarafloxacin, marbofloxacin, orbifloxacin and pradofloxacin.
17. Verwendung gemäß Punkt 15 oder 16, wobei es sich bei dem antitumoral wirksamenden Mittel um ein Mittel handelt, welches ausgewählt wird aus der Gruppe bestehend aus Asparaginase, Bleomycin, Carboplatin, Carmustin, Chlorambucil, Cisplatin, Colaspase, Cyclophosphamid, Cytarabin, Dacarbazin, Dactinomycin, Daunorubicin, Doxorubicin (Adriamycin), Epirubicin, Etoposid, 5-Fluorouracil, Hexamethylmelamin, Hydroxyurea,17. Use according to item 15 or 16, wherein the antitumor agent is an agent selected from the group consisting of asparaginase, bleomycin, carboplatin, carmustine, chlorambucil, cisplatin, colaspase, cyclophosphamide, cytarabine, dacarbazine, Dactinomycin, daunorubicin, doxorubicin (adriamycin), epirubicin, etoposide, 5-fluorouracil, hexamethylmelamine, hydroxyurea,
Ifosfamid, Irinotecan, Leucovorin, Lomustin, Mechlorethamin, 6-Mercaptopurin, Mesna, Methothrexat, MitomycinC, Mitoxantron, Prednisolon, Prednison, Precarbazin, Raloxifen, Streptozocin, Tamoxifen, Thioguanin, Topotecan, Vinblastin, Vincristin, Vindesin, Aminogluthethimid, L-Asparaginase, Azathioprin, 5-Azacytidin Cladribin, Busulfan, Diethylstilbestrol, 2',2'-Difluorodeoxycytidine, Docetaxel, Erythrohydroxynonyladenin,Ifosfamide, irinotecan, leucovorin, lomustine, mechlorethamine, 6-mercaptopurine, mesna, methothrexate, mitomycin C, mitoxantrone, prednisolone, prednisone, precarbazine, raloxifene, streptozocin, tamoxifen, thioguanine, topotecan, vinblastine, vincristine, vindesine, aminogluthethimide, L-asparaginase, Azathioprine, 5-azacytidine, cladribine, busulfan, diethylstilbestrol, 2 ', 2'-difluorodeoxycytidines, docetaxel, erythrohydroxynonyladenine,
Ethinylestradiol, 5-Fluorodeoxyuridin, 5-Fluorodeoxyuridinmonophosphat, Fludarabin- phosphat, Fluoxymesteron, Flutamid, Hydroxyprogesteroncaproat, Idarubicin, Interferon, Medroxyprogesteronacetat, Megestrolacetat, Melphalan, Mitotan, Paclitaxel, Pentstatin, PALA, Plicamycin, Semustin, Teniposid, Testosteronpropionat, Thiotepa, Trimethylmelamin, Uridin, und Vinorelbin, Oxaliplatin, Gemcitabin, Capecitabin,Ethinyl estradiol, 5-fluorodeoxyuridine, 5-fluorodeoxyuridine monophosphate, fludarabine phosphate, fluoxymesterone, flutamide, hydroxyprogesterone caproate, idarubicin, interferon, medroxyprogesterone acetate, megestrol acetate, melphalan, mitotane, paclitaxel, pentstatin, PALA, plicamycin, semustine, teniposide, testosterone propionate, thiotepa, trimethylmelamine, Uridine, and vinorelbine, oxaliplatin, gemcitabine, capecitabine,
Epothilon und natürliche oder synthetische Derivate, Tositumomab, Trabedectin, und Temozolomid, Trastuzumab, Cetuximab, Bevacizumab, Pertuzumab, ZD-1839 (Iressa), OSI-774 Tarceva), CI-1033, GW-2016, CP-724,714, HKI-272, EKB-569, STI- 571(Gleevec), PTK-787, SU-11248, ZD-6474, AG-13736, KRN-951, CP-547, 632, CP- 673,451 und Sorafenib.Epothilone and natural or synthetic derivatives, toositumomab, trabedectin, and temozolomide, trastuzumab, cetuximab, bevacizumab, pertuzumab, ZD-1839 (Iressa), OSI-774 Tarceva), CI-1033, GW-2016, CP-724,714, HKI-272 , EKB-569, STI-571 (Gleevec), PTK-787, SU-11248, ZD-6474, AG-13736, KRN-951, CP-547, 632, CP-673,451 and sorafenib.
18. Verwendung von Fluorchinolonen in einem Verfahren zur Herstellung eines Arzneimittels zur Behandlung und/oder Prophylaxe von Immunsuppressionen, wobei es sich um ein Kombinationspräparat mit antiviralen Arzneimitteln handelt.18. The use of fluoroquinolones in a process for the preparation of a medicament for the treatment and / or prophylaxis of immunosuppressants, which is a combination preparation with antiviral medicaments.
19. Verwendung gemäß Punkt 18, sich bei dem Fluorchinolon um ein Fluorchinolon ausgewählt aus der Gruppe bestehend aus Moxifloxacin, Ciprofloxacin, Gatifloxacin,19. Use according to item 18, wherein the fluoroquinolone is a fluoroquinolone selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin,
Enrofloxacin, Sparfloxacin, Clinafloxacin, Grepafloxacin, Trovafloxacin, Tosufloxacin, Temafloxacin, Norfloxacin, Rufloxacin, Fleroxacin, Levofloxacin, Danofloxacin, Sarafloxacin, Marbofloxacin, Orbifloxacin und Pradofloxacin handelt. 20. Verwendung gemäß Punkt 18 oder 19, wobei es sich bei dem antiviral wirksamen Mittel um ein Mittel ausgewählt aus der Gruppe bestehend aus Interferon-ß, Interferon alfacon-1, Interferon-α oder pegyliertes Interferon-ß, 3TC (Lamivudin), Adevovir, Adevovir Dipivoxil, Entecavir, Emtricitabine, Clevudine, L-dT, L-Fd4C Acyclovir, Valacyclovir, Penciclovir, Famciclovir Foscarnet, Brivudin, Ganciclpvir, Cidofovir, Inhibitoren desEnrofloxacin, sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, fleroxacin, levofloxacin, danofloxacin, sarafloxacin, marbofloxacin, orbifloxacin and pradofloxacin. 20. Use according to item 18 or 19, wherein the antiviral agent is an agent selected from the group consisting of interferon-β, interferon alfacon-1, interferon-α or pegylated interferon-β, 3TC (lamivudine), adevovir , Adevovir dipivoxil, entecavir, emtricitabine, Clevudine, L-dT, L-Fd4C acyclovir, valacyclovir, penciclovir, famciclovir foscarnet, brivudine, ganciclpvir, cidofovir, inhibitors of
Helikase-Primase-Komplexes, Ribavirin, Lopinavir-ritonavir (Kaletra), AG7088, hexapeptidyl CMK, Ruprintrivir (AG7088), 3C Protease Inhibitoren, Pirodavir, Pleconaril, lösliches ICAM-I, Amantidin, Symmetrel, Flumadine, Oseltamvir, Zanamivir, Tenofovir Disproxil Fumarat (TDF), Emtricitabine (FTC), Didanosine (ddl), Stavudine (d4T), Zidovudine (AZT), Zalcitabine (ddC), Efavirenz (EFV), Nivirapine (NVP), DelaviridineHelicase-primase complex, ribavirin, lopinavir-ritonavir (Kaletra), AG7088, hexapeptidyl CMK, ruprin trivir (AG7088), 3C protease inhibitors, pirodavir, pleconaril, soluble ICAM-I, amantidine, Symmetrel, flumadine, oseltamvir, zanamivir, tenofovir disproxil Fumarate (TDF), emtricitabine (FTC), didanosine (ddl), stavudine (d4T), zidovudine (AZT), zalcitabine (ddC), efavirenz (EFV), nivirapine (NVP), delaviridine
(DLV), Atazanavir (ATV), Ritonavir (RTV), Amprenavir (APV), Lopinavir/Rironavir (LPV/RTV), Nelfinavir (NFV), Indinavir (IDV), Saquinavir (SQV-SGC), Enfuvirtide (T- 20), Etravirine (TMC- 125), Capravirine, Tenovovir (PMPA) handelt.(DLV), atazanavir (ATV), ritonavir (RTV), amprenavir (APV), lopinavir / rironavir (LPV / RTV), nelfinavir (NFV), indinavir (IDV), saquinavir (SQV-SGC), enfuvirtide (T-20 ), Etravirine (TMC-125), capravirine, tenovovir (PMPA).
21. Kit, beinhaltend voneinander getrennte Behältnisse, in denen jeweils die unter Punkt 15, 16, oder 17 genannten Wirkstoffe enthalten sind. Ein solcher Kit ist geeignet für die21. Kit, containing containers separated from each other, in each of which the active ingredients mentioned under point 15, 16, or 17 are included. Such a kit is suitable for the
Behandlung von Immunsuppressionen, die auf eine Chemotherapeutika-Tumortherapie zurückzuführen sind.Treatment of immunosuppressive reactions due to chemotherapeutic tumor therapy.
22. Kit, beinhaltend voneinander getrennte Behältnisse, in denen jeweils die unter Punkt 18, 19, oder 20 genannten Wirkstoffe enthalten sind.22. Kit, containing separate containers, in each of which the active ingredients mentioned under point 18, 19, or 20 are included.
23. Verwendung gemäß Punkten 10, 15, 16, 17, 18, 19, 20, 21, oder 22, wobei es sich bei mindestens einem Fluorchinolon um ein antibakteriell unwirksames Fluorchinolon handelt.23. Use according to items 10, 15, 16, 17, 18, 19, 20, 21 or 22, wherein at least one fluoroquinolone is an antibacterially inactive fluoroquinolone.
24. Verwendung von einem oder mehreren Fluorchinolonen in einem Verfahren zur Herstellung eines Arzneimittels zur Behandlung und/oder Prophylaxe von viralen und bakteriellen Mischinfektionen mit Substanzen aus Punkten 1-9, wobei es sich bei der bakteriellen Infektion um eine Sekundärinfektion in einem immunsupprimierten Patienten handelt.24. Use of one or more fluoroquinolones in a process for the preparation of a medicament for the treatment and / or prophylaxis of viral and bacterial mixed infections with substances from items 1-9, wherein the bacterial infection is a secondary infection in an immunosuppressed patient.
25. Verwendung gemäß Punkt 24, wobei es sich bei den viralen Infektionen um Infektionen durch Viren ausgewählt aus der Gruppe bestehend aus den Virusfamilien Adenoviridae, Caliciviridae, Picornaviridae, Paramyxoviridae, Coronaviridae, Orthomyxoviridae, Retro- viridae, Reoviridae, Bunyaviridae, Togaviridae, Herpesviridae, Parvoviridae und/oder25. Use according to item 24, wherein the viral infections are infections by viruses selected from the group consisting of the virus families Adenoviridae, Caliciviridae, Picornaviridae, Paramyxoviridae, Coronaviridae, Orthomyxoviridae, Retroviridae, Reoviridae, Bunyaviridae, Togaviridae, Herpesviridae, Parvoviridae and / or
Papovaviridae handelt. 26. Verwendung gemäß Punkten 24 oder 25, wobei es sich um Erkrankungen des Respirationstraktes (z.B. SARS, Influenza), des Verdauungstraktes und/oder der Haut mit ihren Anhangsorganen sowie des Bindegewebes handelt.Papovaviridae acts. 26. Use according to items 24 or 25, which are diseases of the respiratory tract (eg SARS, influenza), the digestive tract and / or the skin with its appendages and the connective tissue.
27. Verwendung gemäß Punkt 26, wobei es sich bei den Erkrankungen um SARS oder Influenza handelt.27. Use according to item 26, wherein the diseases are SARS or influenza.
28. Verwendung gemäß Punkten 1-16, wobei es sich um Immunsuppressionen handelt, die sich unter dem Einfluss einer Behandlung mit zytotoxischen Chemotherapeutika befinden.28. Use according to items 1-16, which are immunosuppressants that are under the influence of a treatment with cytotoxic chemotherapeutic agents.
29. Verwendung gemäß Punkt 28, wobei es sich um Immunsuppressionen in Krebspatienten handelt.29. Use according to item 28, which is immunosuppressants in cancer patients.
30. Verwendung gemäß Punkten 1-16, wobei es sich um Immunsuppressionen handelt, die durch eine Radiotherapie oder einer Bestrahlung bedingt sind.30. Use according to items 1-16, which are immunosuppressive conditions caused by radiotherapy or radiation.
31. Verwendung gemäß Punkt 30, wobei es sich um Immunsuppressionen bei Krebspatienten handelt.31. Use according to item 30, which is immunosuppressants in cancer patients.
32. Verwendung von einem oder mehreren Fluorchinolonen in einem Verfahren zur Herstellung eines Arzneimittels zur Behandlung und/oder Prophylaxe der Strahlenkrankheit nach Exposition mit radioaktivem Material.32. Use of one or more fluoroquinolones in a process for the preparation of a medicament for the treatment and / or prophylaxis of radiation sickness after exposure to radioactive material.
33. Verwendung gemäß Punkt 32, wobei es sich um Fluorochinolone ausgewählt aus der Gruppe bestehend aus Moxifloxacin, Ciprofloxacin, Gatifloxacin, Enrofloxacin, Sparfloxacin, Clinafloxacin, Grepafloxacin, Trovafloxacin, Tosufloxacin, Temafloxacin, Norfloxacin, Rufloxacin, Fleroxacin, Danofloxacin, Sarafloxacin, Marbofloxacin,33. Use according to item 32, which is fluoroquinolones selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, fleroxacin, danofloxacin, sarafloxacin, marbofloxacin,
Orbifloxacin, Pradofloxacin und Levofloxacin und/oder nicht antibakteriell wirksamen Fluochinolonen handelt.Orbifloxacin, pradofloxacin and levofloxacin and / or non-antibacterial fluoquinolones.
Die Erfindung betrifft auch Arzneimittel, beinhaltend ein oder mehrere Flourchinolone, insbesondere antibakteriell wirksame Fluorchinolone, bevorzugt ein Flourchinolon ausgewählt aus der Gruppe bestehend aus Moxifloxacin, Ciprofloxacin, Gatifloxacin, Enrofloxacin, Sparfloxacin, Clinafloxacin, Grepafloxacin, Trovafloxacin, Tosufloxacin, Temafloxacin, Norfloxacin, Rufloxacin, Fleroxacin, Danofloxacin, Sarafloxacin, Marbofloxacin, Orbifloxacin, Pradofloxacin und Levofloxacin, besonders bevorzugt Moxifloxacin zur Behandlung von Immunsuppressionen.The invention also relates to medicaments containing one or more flourchinolones, in particular antibacterially active fluoroquinolones, preferably a flourchinolone selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, Fleroxacin, danofloxacin, sarafloxacin, marbofloxacin, orbifloxacin, pradofloxacin and levofloxacin, more preferably moxifloxacin for the treatment of immunosuppressive activity.
Die Erfindung betrifft ebenfalls die Verwendung von einem oder mehreren Flourchinolonen, insbesondere antibakteriell wirksame Fluorchinolone, bevorzugt ein Flourchinolon ausgewählt aus der Gruppe bestehend aus Moxifloxacin, Ciprofloxacin, Gatifloxacin, Enrofloxacin, Sparfloxacin, Clinafloxacin, Grepafloxacin, Trovafloxacin, Tosufloxacin, Temafloxacin, Norfloxacin, Rufloxacin, Fleroxacin, Danofloxacin, Sarafloxacin, Marbofloxacin, Orbifloxacin, Pradofloxacin oder Levofloxacin, besonders bevorzugt Moxifloxacin zur Herstellung eines Arzneimittels zur Behandlung von Immunsuppressionen.The invention also relates to the use of one or more flourchinolones, in particular antibacterially active fluoroquinolones, preferably a flourchinolone selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, Grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, fleroxacin, danofloxacin, sarafloxacin, marbofloxacin, Orbifloxacin, pradofloxacin or levofloxacin, particularly preferably Moxifloxacin for the manufacture of a medicament for Treatment of immunosuppressants.
Ein Kombinationspräparat kann die Wirkstoffe separat in getrennten Behältnissen enthalten. Die Wirkstoffe können aber auch zusammen in einer Darreichungsform vorliegen, z.B. gemeinsam mit geeigneten Begleitstoffen gepresst in einer Tablette.A combination preparation may contain the active ingredients separately in separate containers. However, the active ingredients may also be present together in a dosage form, e.g. together with suitable accompanying substances pressed in a tablet.
Die Erfindung betrifft auch Behandlungsmethoden, in denen die wie geschildert hergestellten Wirkstoffpräparate eingesetzt werden zur Behandlung von Immunsuppressionen. Bei diesen Behandlungsmethoden kann es sich auch um Kombinationstherapien handeln. Bevorzugt sind dabei Kombinationstherapien umfassend ein oder mehrere Fluorchinolon und ein oder mehrere in der Tumorbekämpfung eingesetzte Wirkstoffe, oder ein oder mehrere Fluorchinolone und ein oder mehrere antivirale Wirkstoffe. Besonders bevorzugt sind Kombinationstherapien unter Verwendung der spezifisch offenbarten Fluorchinolone mit den spezifisch offenbarten in der Tumortherapie eingesetzten Wirkstoffen oder mit den spezifisch offenbarten antiviralen Wirkstoffen. Die Verabreichung der Wirkstoffe kann bei einer Kombinationstherapie gleichzeitig, aber auch sequenziell nacheinander, auch in größeren Zeitabständen, erfolgen.The invention also relates to treatment methods in which the drug preparations prepared as described are used for the treatment of immunosuppressants. These treatments may also be combination therapies. Preference is given to combination therapies comprising one or more fluoroquinolone and one or more agents used in the treatment of tumors, or one or more fluoroquinolones and one or more antiviral agents. Particularly preferred are combination therapies using the specifically disclosed fluoroquinolones with the specifically disclosed drugs used in tumor therapy or with the specifically disclosed antiviral agents. The administration of the active ingredients can be carried out simultaneously or sequentially in combination therapy, even at longer intervals.
Der Wirkstoff kann systemisch und/oder lokal wirken. Zu diesem Zweck kann er auf geeignete Weise appliziert werden, wie z.B. oral, parenteral, pulmonal, nasal, sublingual, lingual, buccal, rektal, transdermal, conjunctivae otisch oder als Implantat.The active substance can act systemically and / or locally. For this purpose it can be applied in a suitable manner, e.g. oral, parenteral, pulmonary, nasal, sublingual, lingual, buccal, rectal, transdermal, conjunctivae otic or implant.
Für diese Applikationswege kann der Wirkstoff in geeigneten Applikationsformen verabreicht werden.For these administration routes, the active ingredient can be administered in suitable administration forms.
Für die orale Applikation eignen sich bekannte, den Wirkstoff schnell und/oder modifiziert abgebende Applikationsformen, wie z.B. Tabletten (nicht überzogene sowie überzogene Tabletten, z.B. mit magensaftresistenten Überzüge versehene Tabletten oder Filmtabletten), Kapseln, Dragees, Granulate, Pellets, Pulver, Emulsionen, Suspensionen, Lösungen und Aerosole.For oral administration are known, the drug rapidly and / or modified donating application forms, such. Tablets (uncoated and coated tablets, for example enteric coated tablets or film-coated tablets), capsules, dragees, granules, pellets, powders, emulsions, suspensions, solutions and aerosols.
Die parenterale Applikation kann unter Umgehung eines Resorptionsschrittes geschehen (intravenös, intraarteriell, intrakardial, intraspinal oder intralumbal) oder unter Einschaltung einer Resorption (intramuskulär, subcutan, intracutan, percutan, oder intraperitoneal). Für die parenterale Applikation eignen sich als Applikationsformen u.a. Injektions- und Infusionszu- bereitungen in Form von Lösungen, Suspensionen, Emulsionen, Lyophilisaten und sterilen Pulvern.Parenteral administration can be carried out bypassing a resorption step (intravenously, intraarterially, intracardially, intraspinally or intralumbarly) or using absorption (intramuscular, subcutaneous, intracutaneous, percutaneous, or intraperitoneal). For parenteral administration, suitable application forms include injection and infusion. preparations in the form of solutions, suspensions, emulsions, lyophilisates and sterile powders.
Für die sonstigen Applikationswege eignen sich z.B. Inhalationsarzneifbrmen (u.a. Pulverinhalatoren, Nebulizer), Nasentropfen / -lösungen, Sprays; lingual, sublingual oder buccal zu applizie- rende Tabletten oder Kapseln, Suppositorien, Ohren- und Augen-präparationen, Vaginalkapseln, wässrige Suspensionen (Lotionen, Schüttelmixturen), lipophile Suspensionen, Salben, Cremes, Milch, Pasten, Streupuder oder Implantate.For the other routes of administration are suitable, for example Inhalation medicaments (including powder inhalers, nebulizers), nasal drops / solutions, sprays; lingual, sublingual or buccal tablets or capsules to be applied, suppositories, ear and ophthalmic preparations, vaginal capsules, aqueous suspensions (lotions, shake mixtures), lipophilic suspensions, ointments, creams, milk, pastes, scattering powders or implants.
Die Wirkstoffe können in an sich bekannter Weise in die angeführten Applikationsformen überführt werden. Dies geschieht unter Verwendung inerter nichttoxischer, pharmazeutisch ge- eigneter Hilfsstoffe. Hierzu zählen u.a. Trägerstoffe (z.B. mikrokristalline Cellulose), Lösungsmittel (z.B. flüssige Polyethylenglycole), Emulgatoren (z.B. Natriumdodecylsulfat), Dispergiermittel (z.B. Polyvinylpyrrolidon), synthetische und natürliche Biopolymere (z.B. Albumin), Stabilisatoren (z.B. Antioxidantien wie Ascorbinsäure), Farbstoffe (z.B. anorganische Pigmente wie Eisenoxide) oder Geschmacks- und / oder Geruchskorrigentien.The active compounds can be converted in a manner known per se into the stated administration forms. This is done using inert non-toxic, pharmaceutically suitable excipients. These include u.a. Carriers (eg, microcrystalline cellulose), solvents (eg, liquid polyethylene glycols), emulsifiers (eg, sodium dodecyl sulfate), dispersants (eg, polyvinylpyrrolidone), synthetic and natural biopolymers (eg, albumin), stabilizers (eg, antioxidants such as ascorbic acid), dyes (eg, inorganic pigments such as iron oxides ) or flavor and / or odor remedies.
Im Allgemeinen hat es sich als vorteilhaft erwiesen, bei parenteraler Applikation Mengen von etwa 0.001 bis 10 mg/kg, vorzugsweise etwa 0.01 bis 5 mg/kg Körpergewicht zur Erzielung wirksamer Ergebnisse zu verabreichen. Bei oraler Applikation beträgt die Menge etwa 0.01 bis 25 mg/kg, vorzugsweise etwa 0.1 bis 10 mg/kg Körpergewicht.In general, it has been found to be beneficial to administer parenterally administered amounts of about 0.001 to 10 mg / kg, preferably about 0.01 to 5 mg / kg of body weight to achieve effective results. When administered orally, the amount is about 0.01 to 25 mg / kg, preferably about 0.1 to 10 mg / kg of body weight.
Trotzdem kann es gegebenenfalls erforderlich sein, von den genannten Mengen abzuweichen, und zwar in Abhängigkeit von Körpergewicht, Applikationsweg, individuellem Verhalten gegenüber dem Wirkstoff, Art der Zubereitung und Zeitpunkt bzw. Intervall, zu welchem die Applikation erfolgt. So kann es in einigen Fällen ausreichend sein, mit weniger als der vorgenannten Mindestmenge auszukommen, während in anderen Fällen die genannte obere Grenze überschritten werden muss. Im Falle der Applikation größerer Mengen kann es empfehlenswert sein, diese in mehreren Einzelgaben über den Tag zu verteilen. BeispieleNevertheless, it may be necessary to deviate from the stated amounts, depending on body weight, route of administration, individual behavior towards the active ingredient, type of preparation and time or interval at which the application is carried out. Thus, in some cases it may be sufficient to manage with less than the aforementioned minimum amount, while in other cases, the said upper limit must be exceeded. In the case of the application of larger quantities, it may be advisable to distribute these in several single doses throughout the day. Examples
Beispiel 1example 1
In immunkompetenten Mäusen wurde eine funktionelle Immunsuppression durch die Applikation eines zytotoxischen Medikamentes (Carboplatin) ausgelöst. Dabei wurde die Dosis so gewählt, dass eine Verminderung der Anzahl der neutrophilen Granulozyten (Neutropenie) nicht bestand. Dieser Zustand wurde mittels FACS kontrolliert.In immunocompetent mice, functional immunosuppression was induced by the application of a cytotoxic drug (carboplatin). The dose was chosen so that a reduction in the number of neutrophils (neutropenia) did not exist. This condition was controlled by FACS.
Weibliche C57BL/6 Mäuse wurden mit 57mg/kg Carboplatin intravenös (i.v.) behandelt an den Tagen 1, 5 und 9 des Experiments. An den Tagen 10, 11 und 12 wurden die Mäuse mit Moxifloxacin intraperitoneal (i.p.) behandelt. Dabei erhielt eine Gruppe Mäuse 22,5 mg/kg/Tag, verteilt auf drei Dosen ä 7,5 mg/kg, und eine zweite Gruppe Mäuse 67,5 mg/kg/Tag, verteilt auf drei Dosen a 21,5 mg/kg. Eine dritte Gruppe wurde als Kontrolle anstelle von Moxifloxacin mit dH2O i.p. behandelt. Eine vierte Gruppe wurde als Kontrolle anstelle von Carboplatin 0,9% Kochsalzlösung i.v. behandelt und anstelle von Moxifloxacin mit dH2O i.p. behandelt.Female C57BL / 6 mice were treated with 57 mg / kg carboplatin intravenously (i.v.) on days 1, 5 and 9 of the experiment. On days 10, 11 and 12, the mice were treated with moxifloxacin intraperitoneally (i.p.). One group of mice received 22.5 mg / kg / day divided into three doses of 7.5 mg / kg, and a second group of mice 67.5 mg / kg / day divided into three doses a 21.5 mg / kg. A third group was used as a control in place of moxifloxacin with dH2O i.p. treated. A fourth group was administered as a control in place of carboplatin 0.9% saline i.v. treated and instead of moxifloxacin with dH2O i.p. treated.
Am Tag 9 und Tag 15 des Experiments wurde den Mäusen Blut entnommen. Die peripheren Blutleukozyten wurden einer FACS-Analyse (FACScalibur, BD, Heidelberg, D), sowie einem Phagozytose- und einem Burst-Test (Orpegen, Heidelberg, D) unterzogen.On day 9 and day 15 of the experiment, the mice were bled. The peripheral blood leukocytes were subjected to a FACS analysis (FACScalibur, BD, Heidelberg, D), as well as a phagocytosis and a burst test (Orpegen, Heidelberg, D).
Folgende Oberflächenmoleküle wurden analysiert:The following surface molecules were analyzed:
CD3-ε / CD4 / CD8-α zur Charakterisierung der T-ZeIl SubtypenCD3-ε / CD4 / CD8-α for the characterization of the T-cell subtypes
slgM / CD23 / CD45R zur Charakterisierung der B-ZeIl SubtypenslgM / CD23 / CD45R to characterize the B-cell subtypes
CD3-ε / CD25 / CD69 zur Charakterisierung der T-ZeIl AktivierungszuständeCD3-ε / CD25 / CD69 for the characterization of the T-cell activation states
CDl 9 / CD25 / CD69 zur Charakterisierung der B-ZeIl Aktivierungszustände.CD19 / CD25 / CD69 for the characterization of B-cell activation states.
Folgende Myelozyten-Funktionen wurden analysiert:The following myelocyte functions were analyzed:
Phagozytose von FITC-markierten, Serum-opsonisierten, Hitze-inaktivierten E. coli (Phagoassay, Orpegen, Heidelberg, D)Phagocytosis of FITC-labeled, serum-opsonized, heat-inactivated E. coli (Phagoassay, Orpegen, Heidelberg, D)
Induktion von reaktiven Sauerstoff- und Stickstoff-Radikalen (Phagoburstassay, Orpegen, Heidelberg, D) Überraschenderweise wurde gefunden, dass durch Gabe von verschiedenen Dosen Moxifloxacin an diese Mäuse eine funktionelle Rekonstitution verschiedener Funktionen des Immunsystemes erzielt werden konnte. Dies sind im Einzelnen:Induction of Reactive Oxygen and Nitrogen Radicals (Phagoburstassay, Orpegen, Heidelberg, D) Surprisingly, it was found that by administering various doses of moxifloxacin to these mice a functional reconstitution of various functions of the immune system could be achieved. These are in detail:
1. Am Tag 15 nach Behandlungsbeginn, das entspricht Tag 3 nach letzter Moxifloxacin- Behandlung, war die Phagozytose-Aktivität der Blut-Monozyten von Carboplatin plus1. On day 15 after initiation of treatment, equivalent to day 3 after the last moxifloxacin treatment, the phagocytosis activity of the blood monocytes of carboplatin plus was
Moxifloxacin behandelter Mäuse vollständig rekonstituiert und vergleichbar zu derjenigen von Blut-Monozyten Placebo-behandelter Mäuse. Zum gleichen Zeitpunkt war die Phagozytose-Aktivität von Blut-Monozyten aus Mäusen, welche nur mit Carboplatin behandelt waren, um einen Faktor 3 - 5 reduziert im Vergleich zu derjenigen von Blut- Monozyten Placebo-behandelter Mäuse. Die Ergebnisse sind in Fig. 1 dargestellt.Moxifloxacin treated mice completely reconstituted and comparable to that of blood monocytes placebo-treated mice. At the same time, the phagocytic activity of blood monocytes from mice treated with carboplatin alone was reduced by a factor of 3-5 as compared to that of blood monocytes of placebo-treated mice. The results are shown in FIG.
2. Die Phagozytose-Aktivitäten von neutrophilen Granulozyten aus peripherem Blut waren zu keinem Zeitpunkt und durch keine Behandlung beeinflusst.2. The phagocytic activities of peripheral blood neutrophil granulocytes were not affected at any time and by any treatment.
3. Am Tag 15 nach Behandlungsbeginn, i.e. am Tag 3 nach letzter Moxifloxacin- Behandlung, war die oxidative burst-Aktivität der Blut-Monozyten von Carboplatin plus Moxifloxacin behandelter Mäuse vollständig rekonstituiert und vergleichbar zu derjenigen von Blut-Monozyten Placebo-behandelter Mäuse. Zum gleichen Zeitpunkt war die oxidative burst-Aktivität von Blut-Monozyten aus Mäusen, welche nur mit Carboplatin behandelt waren, um einen Faktor 3 - 5 reduziert im Vergleich zu derjenigen von Blut- Monozyten Placebo-behandelter Mäuse.3. On day 15 after initiation of treatment, i.e. on day 3 after the last moxifloxacin treatment, the oxidative burst activity of blood monocytes of carboplatin plus moxifloxacin-treated mice was completely reconstituted and comparable to that of blood monocytes of placebo-treated mice. At the same time, the oxidative burst activity of blood monocytes from mice treated with carboplatin alone was reduced by a factor 3-5 as compared to that of blood monocytes from placebo-treated mice.
4. Die oxidative burst-Aktivitäten von neutrophilen Granulozyten aus peripherem Blut waren zu keinem Zeitpunkt und durch keine Behandlung beeinflusst.4. The oxidative burst activities of peripheral blood neutrophil granulocytes were not affected at any time and by any treatment.
5. Am Tag 15 nach Behandlungsbeginn, i.e. am Tag 3 nach letzter Moxifloxacin-Behand- lung, war die pan T-ZeIl Population (CD3+, CD4+ und CD8+ T-Zellen) von Carboplatin plus Moxifloxacin behandelter Mäuse partiell rekonstituiert und erreichte 30 - 50% der T- Zell Population Placebo-behandelter Mäuse. Zum gleichen Zeitpunkt war die T-ZeIl5. On day 15 after start of treatment, i.e. on day 3 after the last moxifloxacin treatment, the pan T cell population (CD3 +, CD4 + and CD8 + T cells) of carboplatin plus moxifloxacin treated mice was partially reconstituted and reached 30-50% of the T cell population placebo-treated mice. At the same time, the T-cell was
Population aus Mäusen, welche nur mit Carboplatin behandelt waren, um über 90 % reduziert im Vergleich zu der T-ZeIl Population Placebo-behandelter Mäuse. Diese Ergebnisse sind in Figur 2 dargestellt.Population from mice treated with carboplatin alone was reduced by over 90% compared to the T-cell population of placebo-treated mice. These results are shown in FIG.
6. Am Tag 15 nach Behandlungsbeginn, i.e. am Tag 3 nach letzter Moxifloxacin-Behand- lung, war die pan B-ZeIl Population (sIgM+ / CD23+ / CD45R+ B-Zellen) von Carboplatin plus Moxifloxacin behandelter Mäuse partiell rekonstituiert und erreichte 30 - 50% der B-ZeIl Population Placebo-behandelter Mäuse. Zum gleichen Zeitpunkt war die B-ZeIl Population aus Mäusen, welche nur mit Carboplatin behandelt waren, um über 90 % reduziert im Vergleich zu der B-ZeIl Population Placebo-behandelter Mäuse. Diese Ergebnisse sind in Figur 2 dargestellt.6. On day 15 post treatment initiation, ie on day 3 after the last moxifloxacin treatment, the pan B cell population (sIgM + / CD23 + / CD45R + B cells) of carboplatin plus moxifloxacin treated mice was partially reconstituted, reaching 30-50 % of the B-cell population of placebo-treated mice. At the same time the B-cell was Population from mice treated with carboplatin reduced by over 90% compared to the B-cell population of placebo-treated mice. These results are shown in FIG.
7. Am Tag 15 nach Behandlungsbeginn, i.e. am Tag 3 nach letzter Moxifloxacin- Behandlung, war der Aktivierungszustand der T-ZeIl Population (CD 19- / CD25+ / CD69+7. On day 15 after initiation of treatment, i.e. on day 3 after the last moxifloxacin treatment, the activation state of the T-cell population (CD19 / CD25 + / CD69 +
T-Zellen) von Carboplatin plus Moxifloxacin behandelter Mäuse vollständig rekonstituiert und erreichte höhere Werte als diejenigen der T-ZeIl Population Placebo-behandelter Mäuse. Zum gleichen Zeitpunkt war der Aktivierungszustand der T-ZeIl Population aus Mäusen, welche nur mit Carboplatin behandelt waren, um über 70 % reduziert im Vergleich zu der T-ZeIl Population Placebo-behandelter Mäuse. Diese Ergebnisse sind inT cells) of carboplatin plus moxifloxacin-treated mice was completely reconstituted and reached higher levels than those of the T-cell population of placebo-treated mice. At the same time, the activation state of the T-cell population from mice treated with carboplatin alone was reduced by over 70% compared to the T-cell population of placebo-treated mice. These results are in
Figur 3 dargestellt.Figure 3 shown.
8. Am Tag 15 nach Behandlungsbeginn, i.e. am Tag 3 nach letzter Moxifloxacin- Behandlung, war der Aktivierungszustand der B-ZeIl Population (CD 19+ / CD25+ / CD69+ B-Zellen) von Carboplatin plus Moxifloxacin behandelter Mäuse vollständig rekonstituiert und erreichte höhere Werte als diejenigen der B-ZeIl Population Placebo- behandelter Mäuse. Zum gleichen Zeitpunkt war der Aktivierungszustand der B-ZeIl Population aus Mäusen, welche nur mit Carboplatin behandelt waren, um über 70 % reduziert im Vergleich zu der B-ZeIl Population Placebo-behandelter Mäuse. Diese Ergebnisse sind in Figur 3 dargestellt.8. On day 15 after initiation of treatment, i.e. on day 3 after the last moxifloxacin treatment, the activation state of the B-cell population (CD19 + / CD25 + / CD69 + B cells) of carboplatin plus moxifloxacin-treated mice was completely reconstituted and reached higher levels than those of the B-cell population placebo. treated mice. At the same time, the activation state of the B-cell population from mice treated with carboplatin alone was reduced by over 70% compared to the B-cell population of placebo-treated mice. These results are shown in FIG.
Beispiel 2Example 2
Immunkompetente Mäuse wurden mit syngenen Melanomzellen transplantiert. Die Behandlung des Melanoms mit Carboplatin wurde alternierend durch die Behandlung mit Moxifloxacin (Experiment 1 ) oder Moxifloxacin, Levofloxacin und Clarithromycin (Experiment 2) ergänzt. Die daraus resultierende Immun-Suppression durch Carboplatin bzw. die anschliessende Immun- Restauration durch Moxifloxacin wurde indirekt gemessen durch den Einfluss auf die Kontrolle des Melanom-Wachstums.Immunocompetent mice were transplanted with syngeneic melanoma cells. Treatment of the melanoma with carboplatin was alternately supplemented by treatment with moxifloxacin (Experiment 1) or moxifloxacin, levofloxacin and clarithromycin (Experiment 2). The resulting immune suppression by carboplatin or the subsequent immune restoration by moxifloxacin was measured indirectly by the influence on the control of melanoma growth.
Männliche C57BL/6 Mäuse wurden mit 106 B16F10 Melanomzellen sub cutan (s.c.) unter die rechte Flanke transplantiert. Nach 3 Tagen wurden die Mäuse auf ihr Melanomwachstum kontrolliert und randomisiert. An den Tagen 3, 6 und 9 wurde mit 75 mg/kg Carboplatin intravenös (i.v.) behandelt. An den Tagen 4, 5, 7, 8, 10 und 11 wurden die Mäuse mit 20 mg/kg Moxifloxacin (Experiment 1) bzw. mit 20 mg/kg Moxifloxacin, Levofloxacin oder Clarithromycin (Experiment 2) intraperitoneal (i.p.) behandelt. Eine Kontrollgruppe wurde anstelle von Antibiotika mit dH2O i.p. behandelt. Eine weitere Gruppe wurde als Kontrolle anstelle von Carboplatin mit 0,9% Kochsalzlösung i.v. behandelt und anstelle von Moxifloxacin mit dH2O i.p. behandelt.Male C57BL / 6 mice were transplanted under the right flank with 10 6 B16F10 melanoma cells subcutaneously (sc). After 3 days, mice were monitored for melanoma growth and randomized. On days 3, 6 and 9, 75 mg / kg carboplatin was intravenously (iv) treated. On days 4, 5, 7, 8, 10 and 11 the mice were treated with 20 mg / kg moxifloxacin (experiment 1) or with 20 mg / kg moxifloxacin, levofloxacin or clarithromycin (experiment 2) intraperitoneally (ip). A control group was replaced with dH 2 O instead of antibiotics treated ip. Another group was treated iv with 0.9% saline as a control instead of carboplatin and ip treated with dH 2 O instead of moxifloxacin.
Überraschenderweise wurde gefunden, dass durch Gabe von Moxifloxacin eine funktionelle Restauration des Immunsystemes erzielt werden konnte, welche die Kontrolle des Tumorwachstums durch Carboplatin syriergistisch verstärkte. Ein ähnlicher, wenn auch geringerer Synergismus wurde durch die Behandlung mit Levofloxacin erreicht. Die Resultate sind im einzelnen:Surprisingly, it was found that by administration of moxifloxacin, a functional restoration of the immune system could be achieved, which increased the control of tumor growth by carboplatin syriergistisch. Similar, albeit lesser, synergism was achieved by treatment with levofloxacin. The results are in detail:
Experiment 1Experiment 1
1. Die Melanome wuchsen in Saline / dH2O-behandelten Tieren innerhalb von 14 Tagen exponentiell an und erreichten ein errechnetes Volumen von 2000 mm3 (Fig. 4 und 5,1. The melanomas grew exponentially in saline / dH 2 O-treated animals within 14 days and reached a calculated volume of 2000 mm 3 (FIGS. 4 and 5, FIG.
Experiment 1).Experiment 1).
2. Die Melanome in Saline / Moxifloxacin-behandelter Tiere wuchsen vergleichbar zu Melanomen in Saline / dH2O-behandelter Tiere (Fig. 4 und 5, Experiment 1). Dies bedeutet, dass Moxifloxacin keine Anti-Tumor-Wirkung hat.2. The melanomas in saline / moxifloxacin-treated animals grew comparable to melanomas in saline / dH 2 O-treated animals (Figures 4 and 5, Experiment 1). This means that moxifloxacin has no anti-tumor effect.
3. Die Melanome in Carboplatin / dH2O-behandelter Tiere wuchsen deutlich verlangsamt und zu geringerem errechneten Endvolumen im Vergleich zu Melanomen in Saline / dH2O- behandelter Tiere (Fig. 4 und 5 Experiment 1).3. The melanomas in carboplatin / dH 2 O-treated animals grew significantly slowed and at lower final calculated volume compared to melanomas in saline / dH 2 O-treated animals (Figures 4 and 5 Experiment 1).
4. Die Melanome in Carboplatin / Moxifloxacin-behandelter Tiere wuchsen deutlich verlangsamt und zu geringerem errechneten Endvolumen im Vergleich zu Melanomen in Carboplatin / dH2O-behandelter Tiere (Fig. 4 und 5 Experiment 1). Dies bedeutet, dass die4. The melanomas in carboplatin / moxifloxacin-treated animals grew significantly slower and at lower final calculated volume compared to melanomas in carboplatin / dH 2 O-treated animals (Figures 4 and 5 Experiment 1). This means that the
Immun-Restauration hervorgerufen durch die Moxifloxacin-Behandlung die Anti-Tumor- Behandlung mit Carboplatin synergistisch unterstützt.Immune restoration induced by the moxifloxacin treatment synergistically supports the anti-tumor treatment with carboplatin.
Experiment 2Experiment 2
1. Die Melanome wuchsen in Saline / dH2O-behandelten Tieren innerhalb von 14 Tagen exponentiell an und erreichten ein errechnetes Volumen von 2000 mm3 (Fig. 4 und 5,1. The melanomas grew exponentially in saline / dH 2 O-treated animals within 14 days and reached a calculated volume of 2000 mm 3 (FIGS. 4 and 5, FIG.
Experiment 2).Experiment 2).
2. Die Melanome in Carboplatin / dH2O-behandelter Tiere wuchsen deutlich verlangsamt und zu geringerem errechneten Endvolumen im Vergleich zu Melanomen in Saline / dH2O- behandelter Tiere (Fig. 4 und 5, Experiment 2). 3. Die Melanome in Carboplatin / Moxifloxacin-behandelter Tiere wuchsen deutlich verlangsamt und zu geringerem errechneten Endvolumen im Vergleich zu Melanomen in Carboplatin / dt^O-behandelter Tiere (Fig. 4 und 5, Experiment T). Dies bedeutet, dass die Immun-Restauration hervorgerufen durch die Moxifloxacin-Behandlung die Anti-Tumor- Behandlung mit Carboplatin synergistisch unterstützt, analog zu Experiment 1.2. The melanomas in carboplatin / dH 2 O-treated animals grew significantly slower and at lower final calculated volume compared to melanomas in saline / dH 2 O-treated animals (Figures 4 and 5, Experiment 2). 3. The melanomas in carboplatin / moxifloxacin-treated animals grew significantly slower and at a lower final calculated volume compared to melanomas in carboplatin / dt ^ O-treated animals (Figures 4 and 5, experiment T). This means that the immune restoration caused by the moxifloxacin treatment synergistically supports the anti-tumor treatment with carboplatin, analogously to Experiment 1.
4. Ein geringerer, analoger Effekt wurde durch die Behandlung mit Levofloxacin erreicht (Fig. 4 und 5, Experiment 2). 4. A lesser analogous effect was achieved by treatment with levofloxacin (Figures 4 and 5, Experiment 2).
Beschreibung der FigurenDescription of the figures
Figur 1: Phagozytose von peripheren Blut-Monozyten. Periphere Maus-Leukozyten von 6 Mäusen per Gruppe wurden zu gleichen Volumina vereint und mit FITC-markierten E. coli inkubiert. Phagozytose wurde quantifiziert durch FACS-Analyse fokussiert auf Monozyten. Die Analysen fanden statt am Tag 8, d.h. vor der dritten Carboplatin-Behandlung (A; vgl. Behandlungsschema unten) und am Tag 14, d.h. nach der dritten Carboplatin- und nach drei Moxifloxacin-Behandlungen (B). Dargestellt sind Prozent phagozytierende Monozyten pro Totalpopulation lebender Monozyten. Phagozytose wurde gemessen nach Inkubation bei 37°C (gefüllte Symbole). Kontrollproben zur Messung unspezifischer Fluoreszent wurden bei 00C inkubiert (offene Symbole). Die Fluoreszenz von FITC nicht-phagozytierter, extrazellulärer E. coli wurde gequentscht mit Trypanblau.Figure 1: phagocytosis of peripheral blood monocytes. Peripheral mouse leukocytes from 6 mice per group were combined in equal volumes and incubated with FITC-labeled E. coli. Phagocytosis was quantified by FACS analysis focused on monocytes. The analyzes took place on day 8, ie before the third carboplatin treatment (A, see treatment scheme below) and on day 14, ie after the third carboplatin and after three moxifloxacin treatments (B). Shown are percent phagocytic monocytes per total population of live monocytes. Phagocytosis was measured after incubation at 37 ° C (filled symbols). Control samples for measuring nonspecific fluorescence were incubated at 0 ° C (open symbols). The fluorescence of FITC non-phagocytosed extracellular E. coli was quenched with trypan blue.
Die peripheren Leukozyten stammten aus Mäusen, die nach folgendem Schema behandelt worden waren:The peripheral leukocytes were from mice treated according to the following scheme:
1) 0.9% NaCl intra venös (i.v.) an den Tagen 0, 4 und 8; dH2O intra peritoneal (i.p.) an den Tagen 9, 10 und 11 , dreimal pro Tag (Kreise)1) 0.9% NaCl intra venous (iv) on days 0, 4 and 8; dH 2 O intraperitoneally (ip) on days 9, 10 and 11, three times a day (circles)
2) Carboplatin 57mg/kg in 0.9% NaCl i.v. an den Tagen 0, 4 und 8; dH2O i.p. an den Tagen 9, 10 und 11 , dreimal pro Tag (Quadrate)2) carboplatin 57mg / kg in 0.9% NaCl iv on days 0, 4 and 8; dH 2 O ip on days 9, 10 and 11, three times a day (squares)
3) Carboplatin 57mg/kg in 0.9% NaCl i.v. an den Tagen 0, 4 und 8; Moxifloxacin 22.5 mg/kg in dH2O i.p. an den Tagen 9, 10 und 11, aufgeteilt auf drei Dosen pro Tag (aufrechte Dreiecke)3) carboplatin 57mg / kg in 0.9% NaCl iv on days 0, 4 and 8; Moxifloxacin 22.5 mg / kg in dH 2 O ip on days 9, 10 and 11, divided into three doses per day (upright triangles)
4) Carboplatin 57mg/kg in 0.9% NaCl i.v. an denTagen 0, 4 und 8; Moxifloxacin 67.5 mg/kg in dH2O i.p. an den Tagen 9, 10 und 11, aufgeteilt auf drei Dosen pro Tag (abrechte Dreiecke)4) carboplatin 57 mg / kg in 0.9% NaCl iv on days 0, 4 and 8; Moxifloxacin 67.5 mg / kg in dH 2 O ip on days 9, 10 and 11, divided into three doses per day (triangles on the right)
5) 0.9% NaCl i.v. an den Tagen 0, 4 und 8; Moxifloxacin 67.5 mg/kg in dH2O i.p. an den Tagen 9, 10 und 11, aufgeteilt auf drei Dosen pro Tag (Diamanten).5) 0.9% NaCl iv on days 0, 4 and 8; Moxifloxacin 67.5 mg / kg in dH 2 O ip on days 9, 10 and 11 divided into three doses per day (diamonds).
Figur 2: Charakterisierung von Lymphozyten-Subpopulationen. Periphere Maus-Leukozyten von 6 Mäusen per Gruppe wurden zu gleichen Volumina vereint und für folgende Oberflächenantigene gefärbt:FIG. 2: Characterization of lymphocyte subpopulations. Peripheral mouse leukocytes from 6 mice per group were combined in equal volumes and stained for the following surface antigens:
CD3-ε / CD4 / CD8-α zur Charakterisierung der T-ZeIl Subtypen.CD3-ε / CD4 / CD8-α for the characterization of the T-cell subtypes.
slgM / CD23 / CD45R zur Charakterisierung der B-ZeIl Subtypen. Die Oberflächenfärbung wurde quantifiziert durch FACS-Analyse fokussiert auf Lymphozyten gemäß Angaben des Herstellers (BD Biosciences, Heidelberg, D). Die Analysen fanden statt am Tag 14, d.h. nach der dritten Carboplatin- und nach drei Moxifloxacin-Behandlungen. Dargestellt sind Prozent positiv gefärbter Zellen pro Totalpopulation lebender Lymphozyten.slgM / CD23 / CD45R to characterize the B-cell subtypes. The surface staining was quantified by FACS analysis focused on lymphocytes according to the manufacturer's instructions (BD Biosciences, Heidelberg, D). The analyzes took place on day 14, ie after the third carboplatin and after three moxifloxacin treatments. Shown are percent of positively stained cells per total population of live lymphocytes.
Die peripheren Leukozyten stammten aus Mäusen, die nach folgendem Schema behandelt worden waren:The peripheral leukocytes were from mice treated according to the following scheme:
1) 0.9% NaCl intra venös (i.v.) an den Tagen 0, 4 und 8; dH2O intra peritoneal (i.p.) an den Tagen 9, 10 und 11 , dreimal pro Tag (offener Balken)1) 0.9% NaCl intra venous (iv) on days 0, 4 and 8; dH 2 O intraperitoneally (ip) on days 9, 10 and 11, three times a day (open bar)
2) 0.9% NaCl i.v. an den Tagen 0, 4 und 8; Moxifloxacin 67.5 mg/kg in dH2O i.p. an den Tagen 9, 10 und 11, aufgeteilt auf drei Dosen pro Tag (gestreifter Balken)2) 0.9% NaCl iv on days 0, 4 and 8; Moxifloxacin 67.5 mg / kg in dH 2 O ip on days 9, 10 and 11, divided into three doses per day (striped bar)
3) Carboplatin 57mg/kg in 0.9% NaCl i.v. an den Tagen 0, 4 und 8; dH2O i.p. an den Tagen 9, 10 und 11, dreimal pro Tag (gefüllter Balken)3) carboplatin 57mg / kg in 0.9% NaCl iv on days 0, 4 and 8; dH 2 O ip on days 9, 10 and 11, three times a day (filled bar)
4) Carboplatin 57mg/kg in 0.9% NaCl i.v. an den Tagen 0, 4 und 8; Moxifloxacin 67.5 mg/kg in dH2O i.p. an den Tagen 9, 10 und 11, aufgeteilt auf drei Dosen pro Tag (karrierter Balken)4) Carboplatin 57 mg / kg in 0.9% NaCl iv on days 0, 4 and 8; Moxifloxacin 67.5 mg / kg in dH 2 O ip on days 9, 10 and 11, divided into three doses per day (checked bar)
Figur 3: Charakterisierung von Lymphozyten -Aktivierungszuständen. Periphere Maus- Leukozyten von 6 Mäusen per Gruppe wurden zu gleichen Volumina vereint und für folgende Oberflächenantigene gefärbt:FIG. 3: Characterization of lymphocyte activation states. Peripheral mouse leukocytes from 6 mice per group were combined in equal volumes and stained for the following surface antigens:
CD19 negativ / CD25 / CD69 zur Charakterisierung der T-ZeIl Aktivierungszustände.CD19 negative / CD25 / CD69 to characterize the T-cell activation states.
CDl 9 / CD25 / CD69 zur Charakterisierung der B-ZeIl Aktivierungszustände.CD19 / CD25 / CD69 for the characterization of B-cell activation states.
Die Behandlung der Mäuse und Auswertung der FACS-Färbungen fand analog der Beschreibung zu Figur 2 statt.The treatment of the mice and evaluation of the FACS staining took place analogously to the description of FIG.
Figur 4: Verlauf des Melanomwachstums bis 13 Tage post Transplantation. C57BL/6 männliche Mäuse wurden mit 106 Bl 6F10 Maus-Melanomzellen s.c. unter die rechte Flanke transplantiert. Das Tumorwachstum wurde mit einer Schieblehre (Plexx, NL) vermessen und zum Tumorvolumen errechnet gemäss der Formel (a x b2) x 0.5, wobei a die längere und b die kürzere Seite des vermessenen Elipsoids repräsentiert. Dargestellt sind die Mediane der errechneten Tumorvolumina pro Gruppe in mm3 ±Standardabweichung Experiment 1) oder die Mediane (Experiment 2). Folgende Behandlungsgruppen wurden auf Tumorwachstum untersucht: Experiment 1:Figure 4: Course of melanoma growth to 13 days post transplantation. C57BL / 6 male mice were transplanted under the right flank with 10 6 Bl 6F10 mouse melanoma cells sc. The tumor growth was measured with a caliper gauge (Plexx, NL) and calculated according to the formula according to the formula (axb 2 ) x 0.5, where a represents the longer and b the shorter side of the measured ellipsoid. Shown are the medians of the calculated tumor volumes per group in mm 3 ± standard deviation experiment 1) or the medians (experiment 2). The following treatment groups were examined for tumor growth: Experiment 1:
1) Unbehandelt (offenes Quadrat)1) Untreated (open square)
2) 0.9% NaCl intra venös (i.v.) an den Tagen 3, 6 und 9; dH2O intra peritoneal (i.p.) an den Tagen 4, 5, 7, 8, 10 und 11 (offener Kreis)2) 0.9% NaCl intra venous (iv) on days 3, 6 and 9; dH 2 O intraperitoneally (ip) on days 4, 5, 7, 8, 10 and 11 (open circle)
3) 0.9% NaCl i.v. an den Tagen 3, 6 und 9; Moxifloxacin [20 mg/kg] i.p. an den Tagen 4, 5,3) 0.9% NaCl i.v. on days 3, 6 and 9; Moxifloxacin [20 mg / kg] i.p. on days 4, 5,
7, 8, 10 und 11 (offenes Dreieck)7, 8, 10 and 11 (open triangle)
4) Carboplatin 75 mg/kg in 0.9% NaCl i.v. an den Tagen 3, 6 und 9; dH2O i.p. an den Tagen 4, 5, 7, 8, 10 und 11 (gefülltes Quadrat)4) Carboplatin 75 mg / kg in 0.9% NaCl iv on days 3, 6 and 9; dH 2 O ip on days 4, 5, 7, 8, 10 and 11 (filled square)
5) Carboplatin 75 mg/kg in 0.9% NaCl i.v. an den Tagen 3, 6 und 9; Moxifloxacin [20 mg/kg] i.p. an den Tagen 4, 5, 7, 8, 10 und 11 (gefüllter Kreis)5) Carboplatin 75 mg / kg in 0.9% NaCl i.v. on days 3, 6 and 9; Moxifloxacin [20 mg / kg] i.p. on days 4, 5, 7, 8, 10 and 11 (filled circle)
Experiment 2Experiment 2
1) 0.9% NaCl intra venös (i.v.) an den Tagen 3, 6 und 9; dH2O intra peritoneal (i.p.) an den Tagen 4, 5, 7, 8, 10 und 11 (offener Kreis)1) 0.9% NaCl intra venous (iv) on days 3, 6 and 9; dH 2 O intraperitoneally (ip) on days 4, 5, 7, 8, 10 and 11 (open circle)
2) Carboplatin 75 mg/kg in 0.9% NaCl i.v. an den Tagen 3, 6 und 9; dH2O i.p. an den Tagen 4, 5, 7, 8, 10 und 11 (gefülltes Quadrat)2) Carboplatin 75 mg / kg in 0.9% NaCl iv on days 3, 6 and 9; dH 2 O ip on days 4, 5, 7, 8, 10 and 11 (filled square)
3) Carboplatin 75 mg/kg in 0.9% NaCl i.v. an den Tagen 3, 6 und 9; Moxifloxacin [20 mg/kg] i.p. an den Tagen 4, 5, 7, 8, 10 und 11 (gefüllter Kreis)3) Carboplatin 75 mg / kg in 0.9% NaCl i.v. on days 3, 6 and 9; Moxifloxacin [20 mg / kg] i.p. on days 4, 5, 7, 8, 10 and 11 (filled circle)
4) Carboplatin 75 mg/kg in 0.9% NaCl i.v. an den Tagen 3, 6 und 9; Levofloxacin [20 mg/kg] i.p. an den Tagen 4, 5, 7, 8, 10 und 11 (offener Rhombus)4) Carboplatin 75 mg / kg in 0.9% NaCl i.v. on days 3, 6 and 9; Levofloxacin [20 mg / kg] i.p. on days 4, 5, 7, 8, 10 and 11 (open rhombus)
Figur 5: Errechnete Endvolumina der Melanome 13 Tage post Transplantation.Figure 5: Calculated final volumes of melanoma 13 days post-transplantation.
C57BL/6 männliche Mäuse wurden mit 106 B16F10 Maus-Melanomzellen s.c. unter die rechte Flanke transplantiert. Das Tumorwachstum wurde mit einer Schieblehre (Plexx, NL) vermessen und zum Tumorvolumen errechnet gemäss der Formel (a x b2) x 0.5, wobei a die längere und b die kürzere Seite des vermessenen Elipsoids repräsentiert. Dargestellt sind die Mediane der errechneten Tumorvolumina pro Gruppe in mm3. Folgende Behandlungsgruppen wurden auf Tumorwachstum untersucht: Experiment 1C57BL / 6 male mice were transplanted under the right flank with 10 6 B16F10 mouse melanoma cells sc. The tumor growth was measured with a caliper gauge (Plexx, NL) and calculated according to the formula according to the formula (axb 2 ) x 0.5, where a represents the longer and b the shorter side of the measured ellipsoid. Shown are the medians of the calculated tumor volumes per group in mm 3 . The following treatment groups were examined for tumor growth: Experiment 1
1) 0.9% NaCl intra venös (i.v.) an den Tagen 3, 6 und 9; dH2O intra peritoneal (i.p.) an den Tagen 4, 5, 7, 8, 10 und 11 (offener Kreis)1) 0.9% NaCl intra venous (iv) on days 3, 6 and 9; dH 2 O intraperitoneally (ip) on days 4, 5, 7, 8, 10 and 11 (open circle)
2) 0.9%. NaCl i.v. an den Tagen 3, 6 und 9; Moxifloxacin [20 mg/kg] i.p. an den Tagen 4, 5, 7, 8, 10 und 1 1 (offenes Dreieck)2) 0.9%. NaCl i.v. on days 3, 6 and 9; Moxifloxacin [20 mg / kg] i.p. on days 4, 5, 7, 8, 10 and 1 1 (open triangle)
3) Carboplatin 75 mg/kg in 0.9% NaCl i.v. an den Tagen 3, 6 und 9; dH2O i.p. an den Tagen3) Carboplatin 75 mg / kg in 0.9% NaCl iv on days 3, 6 and 9; dH 2 O ip in the days
4, 5, 7, 8, 10 und 1 1 (gefülltes Quadrat)4, 5, 7, 8, 10 and 1 1 (filled square)
4) Carboplatin 75 mg/kg in 0.9% NaCl i.v. an den Tagen 3, 6 und 9; Moxifloxacin [20 mg/kg] i.p. an den Tagen 4, 5, 7, 8, 10 und 11 (gefüllter Kreis)4) Carboplatin 75 mg / kg in 0.9% NaCl i.v. on days 3, 6 and 9; Moxifloxacin [20 mg / kg] i.p. on days 4, 5, 7, 8, 10 and 11 (filled circle)
Experiment 2Experiment 2
1) 0.9% NaCl intra venös (i.v.) an den Tagen 3, 6 und 9; dH2O intra peritoneal (i.p.) an den Tagen 4, 5, 7, 8, 10 und 11 (offener Kreis)1) 0.9% NaCl intra venous (iv) on days 3, 6 and 9; dH 2 O intraperitoneally (ip) on days 4, 5, 7, 8, 10 and 11 (open circle)
2) Carboplatin 75 mg/kg in 0.9% NaCl i.v. an den Tagen 3, 6 und 9; dH2O i.p. an den Tagen 4,2) Carboplatin 75 mg / kg in 0.9% NaCl iv on days 3, 6 and 9; dH 2 O ip on days 4,
5, 7, 8, 10 und 11 (gefülltes Quadrat)5, 7, 8, 10 and 11 (filled square)
3) Carboplatin 75 mg/kg in 0.9% NaCl i.v. an den Tagen 3, 6 und 9; Moxifloxacin [20 mg/kg] i.p. an den Tagen 4, 5, 7, 8, 10 und 11 (gefüllter Kreis)3) Carboplatin 75 mg / kg in 0.9% NaCl i.v. on days 3, 6 and 9; Moxifloxacin [20 mg / kg] i.p. on days 4, 5, 7, 8, 10 and 11 (filled circle)
4) Carboplatin 75 mg/kg in 0.9% NaCl i.v. an den Tagen 3, 6 und 9; Levofloxacin [20 mg/kg] i.p. an den Tagen 4, 5, 7, 8, 10 und 11 (offener Rhombus)4) Carboplatin 75 mg / kg in 0.9% NaCl i.v. on days 3, 6 and 9; Levofloxacin [20 mg / kg] i.p. on days 4, 5, 7, 8, 10 and 11 (open rhombus)
5) Carboplatin 75 mg/kg in 0.9% NaCl i.v. an den Tagen 3, 6 und 9; Clarithromycin [20 mg/kg] i.p. an den Tagen 4, 5, 7, 8, 10 und 11 (offenes Dreieck)5) Carboplatin 75 mg / kg in 0.9% NaCl i.v. on days 3, 6 and 9; Clarithromycin [20 mg / kg] i.p. on days 4, 5, 7, 8, 10 and 11 (open triangle)
Die statistische Signifikanz wurde ermittelt über eine Varianzanalyse nach Kruskall-Wallis und einem nachgestellten Signifikanz-Test nach Dünn für nicht-normal verteilte Werte (überprüft nach χ2- Anpassungstest). * = p<0.05). Ausreißer wurden ermittelt nach Dixons-Ausreißertest und eliminiert. * = p<0.05. Referenzen:The statistical significance was determined using a variance analysis according to Kruskall-Wallis and a postponed significance test according to Dünn for non-normally distributed values (verified after χ 2 - adaption test). * = p <0.05). Outliers were determined after Dixon's outlier test and eliminated. * = p <0.05. References:
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26. Freifeld, A., Marchigiani, D., Walsh, T., Chanock, S., Lewis, L., Hiemenz, J., Hiemenz, S., Hicks, J.E., GiIl, V., Steinberg, S.M., et al. 1999. A double-blind comparison of empirical oral and intravenous antibiotic therapy for low-risk febrile patients with neutropenia during Cancer chemotherapy. N Engl J Med 341 :305-311.26. Freifeld, A., Marchigiani, D., Walsh, T., Chanock, S., Lewis, L., Hiemenz, J., Hiemenz, S., Hicks, JE, GiIl, V., Steinberg, SM, et al. 1999. A double-blind comparison of empirical oral and intravenous antibiotic therapy for low-risk febrile patients with neutropenia during cancer chemotherapy. N Engl J Med 341: 305-311.
27. Rolston, K. V., Frisbee-Hume, S., LeBlanc, B., Streeter, H., and Ho, D.H. 2003. In vitro antimicrobial activity of moxifloxacin compared to other qυinolones against recent clinical bacterial isolates from hospitalized and community-based Cancer patients. Diagn Microbiol Infect Dis 47:441-449.27. Rolston, K.V., Frisbee-Hume, S., LeBlanc, B., Streeter, H., and Ho, D.H. 2003. In vitro antimicrobial activity of moxifloxacin compared to other qυinolones against recent clinical bacterial isolates from hospitalized and community-based cancer patients. Diagn Microbiol Infect Dis 47: 441-449.
28. Rolston, K.V., Kontoyiannis, D.P., Yadegarynia, D., and Raad, II. 2005. Νonfermentative gram-negative bacilli in Cancer patients: increasing frequency of infection and antimicrobial susceptibility of clinical isolates to fluoroquinolones. Diagn Microbiol Infect28. Rolston, K.V., Kontoyiannis, D.P., Yadegarynia, D., and Raad, II. 2005. feronfermentative gram-negative bacilli in cancer patients: increasing frequency of infection and antimicrobial susceptibility of clinical isolates to fluoroquinolones. Diagn Microbiol Infect
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29. Chamilos, G., Bamias, A., Efstathiou, E., Zorzou, P.M., Kastritis, E., Kostis, E., Papadimitriou, C, and Dimopoulos, M.A. 2005. Outpatient treatment of low-risk neutropenic fever in cancer patients using oral moxifloxacin. Cancer 103:2629-2635.29. Chamilos, G., Bamias, A., Efstathiou, E., Zorzou, P.M., Kastritis, E., Kostis, E., Papadimitriou, C, and Dimopoulos, M.A. 2005. Outpatient treatment of low-risk neutropenic fever in cancer patients using oral moxifloxacin. Cancer 103: 2629-2635.
30. Rolston, K.V., Vaziri, L, Frisbee-Hume, S., Streeter, H., and LeBlanc, B. 2004. In vitro antimicrobial activity of gatifloxacin compared with other quinolones against clinical isolates from cancer patients. Chemotherapy 50:214-220.30. Rolston, K.V., Vaziri, L, Frisbee-Hume, S., Streeter, H., and LeBlanc, B. 2004. In vitro antimicrobial activity of gatifloxacin compared with other quinolones against clinical isolates from cancer patients. Chemotherapy 50: 214-220.
31. Dombret, H., Chastang, C, Fenaux, P., Reiffers, J., Bordessoule, D., Bouabdallah, R., Mandelli, F., Ferrant, A., Auzanneau, G., Tilly, H., et al. 1995. A controlled study of recombinant human granulocyte colony-stimulating factor in elderly patients after treatment for acute myelogenous leukemia. AML Cooperative Study Group. N Engl J Med 332:1678-1683.31. Dombret, H., Chastang, C, Fenaux, P., Reiffers, J., Bordessoule, D., Bouabdallah, R., Mandelli, F., Ferrant, A., Auzanneau, G., Tilly, H. , et al. 1995. A controlled study of recombinant human granulocyte colony-stimulating factor in elderly patients after treatment for acute myelogenous leukemia. AML Cooperative Study Group. N Engl J Med 332: 1678-1683.
32. Godwin, J.E., Kopecky, K.J., Head, D.R., Willman, C.L., Leith, C.P., Hynes, H.E., Balcerzak, S.P., and Appelbaum, F.R. 1998. A double-blind placebo-controlled trial of granulocyte colony-stimulating factor in elderly patients with previously untreated acute myeloid leukemia: a Southwest oncology group study (9031). Blood 91 :3607-3615. 33. Heil, G., Hoelzer, D., Sanz, M.A., Lechner, K., Liu Yin, J.A., Papa, G., Noens, L., Szer, J., Ganser, A., O'Brien, C, et al. 1997. A randomized, double-blind, placebo-controlled, phase III study of fϊlgrastim in remission induction and consolidation therapy for adυlts with de novo acute myeloid leukemia. The International Acute Myeloid Leukemia Study Group. Blood 90:4710-4718.32. Godwin, JE, Kopecky, KJ, Head, DR, Willman, CL, Leith, CP, Hynes, HE, Balcerzak, SP, and Appelbaum, FR 1998. A double-blind placebo-controlled trial of granulocyte colony-stimulating factor in patients with previously untreated acute myeloid leukemia: a Southwest oncology group study (9031). Blood 91: 3607-3615. 33. Heil, G., Hoelzer, D., Sanz, MA, Lechner, K., Liu Yin, JA, Papa, G., Noens, L., Szer, J., Ganser, A., O'Brien, C, et al. 1997. A randomized, double-blind, placebo-controlled, phase III study of fulgrim in remission induction and consolidation therapy for adoles with acute myeloid leukemia. The International Acute Myeloid Leukemia Study Group. Blood 90: 4710-4718.
34. Goldstone, A.H., Burnett, A.K., Milligan, D.W., Prentice, A.G., and Wheatley, K. 1997. Lack of benefit of G-CSF on complete remission and possible increased relapse risk in AML: An MRC study of 800 patients. Blood 90 (Suppl. l):583a.34. Goldstone, A.H., Burnett, A.K., Milligan, D.W., Prentice, A.G., and Wheatley, K. 1997. Lack of benefit of G-CSF on complete remission and possible increased relapse risk in AML: at MRC study of 800 patients. Blood 90 (Suppl. L): 583a.
35. Stone, R.M., Berg, D.T., George, S.L., Dodge, R.K., Paciucci, P.A., Schulman, P., Lee, EJ., Moore, J.O., Powell, B.L., and Schiffer, CA. 1995. Granulocyte-macrophage colony- stimulating factor after initial chemotherapy for elderly patients with primary acute myelogenous leukemia. Cancer and Leukemia Group B. N EnglJ Med 332:1671-1677. 35. Stone, R.M., Berg, D.T., George, S.L., Dodge, R.K., Paciucci, P.A., Schulman, P., Lee, E.J., Moore, J.O., Powell, B.L., and Schiffer, CA. 1995. Granulocyte-macrophage colony-stimulating factor after initial chemotherapy for elderly patients with acute myelogenous leukemia. Cancer and Leukemia Group B.N EnglJ Med 332: 1671-1677.

Claims

Patentansprüche: claims:
1. Verwendung von einem oder mehreren Fluorchinolonen in einem Verfahren zur Herstellung eines Arzneimittels zur Behandlung und/oder Prophylaxe von Immunsuppressionen.Use of one or more fluoroquinolones in a process for the preparation of a medicament for the treatment and / or prophylaxis of immunosuppressants.
2. Verwendung gemäß Anspruch 1, wobei es sich bei den Fluorchinolonen um antibakteriell wirksame Fluorchinolone handelt.2. Use according to claim 1, wherein the fluoroquinolones are antibacterially active fluoroquinolones.
3. Verwendung gemäß Anspruch 1, wobei es sich bei einem oder mehreren Fluorchinolonen um ein oder mehrere Fluorchinolone ausgewählt aus der Gruppe bestehend aus Moxifloxacin, Ciprofloxacin, Gatifloxacin, Enrofloxacin, Sparfloxacin, Clinafloxacin, Grepa- floxacin, Trovafloxacin, Tosufloxacin, Temafloxacin, Norfloxacin, Rufloxacin,3. Use according to claim 1, wherein one or more fluoroquinolones is one or more fluoroquinolones selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, grepaflexacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin,
Fleroxacin, Levofloxacin, Danofloxacin, Sarafloxacin, Marbofloxacin, Orbifloxacin und Pradofloxacin handelt.Fleroxacin, levofloxacin, danofloxacin, sarafloxacin, marbofloxacin, orbifloxacin and pradofloxacin.
4. Verwendung gemäß Anspruch 1, wobei es sich bei dem Fluorchinolon um Moxifloxacin handelt.4. Use according to claim 1, wherein the fluoroquinolone is moxifloxacin.
5. Verwendung gemäß Anspruch 1, wobei es sich bei den Fluorchinolonen um antibakteriell unwirksame Fluorchinolone handelt.5. Use according to claim 1, wherein the fluoroquinolones are antibacterially inactive fluoroquinolones.
6. Verwendung gemäß Anspruch 1, wobei es sich bei den Fluorchinolonen um eine Mischung aus antibakteriell wirksamen und unwirksamen Fluorchinolone handelt.6. Use according to claim 1, wherein the fluoroquinolones is a mixture of antibacterially active and inactive fluoroquinolones.
7. Verwendung gemäß Anspruch 1, wobei es sich bei den Immunsuppressionen um Zustände handelt, die durch Funktionsstörungen der Monozyten/Makrophagen hervorgerufen werden.7. Use according to claim 1, wherein the immunosuppressive conditions are caused by disorders of monocytes / macrophages.
8. Verwendung gemäß Anspruch 7, wobei es sich bei einem oder mehreren Fluorchinolonen um ein oder mehrere Flourchinolone ausgewählt aus der Gruppe bestehend aus Moxifloxacin, Ciprofloxacin, Gatifloxacin Enrofloxacin, Sparfloxacin, Clinafloxacin, Grepafloxacin, Trovafloxacin, Tosufloxacin, Temafloxacin, Norfloxacin, Rufloxacin,8. Use according to claim 7, wherein one or more fluoroquinolones are one or more flourchinolones selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin enrofloxacin, sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin,
Fleroxacin, Levofloxacin, Danofloxacin, Sarafloxacin, Marbofloxacin, Orbifloxacin und Pradofloxacin handelt.Fleroxacin, levofloxacin, danofloxacin, sarafloxacin, marbofloxacin, orbifloxacin and pradofloxacin.
9. Verwendung gemäß Anspruch 7, wobei es sich bei dem Fluorchinolon um Moxifloxacin handelt. 9. Use according to claim 7, wherein the fluoroquinolone is moxifloxacin.
10. Verwendung gemäß Anspruch 7, wobei es sich bei mindestens einem Fluorchinolon um ein antibakteriell wirksames Fluorchinolon handelt.10. Use according to claim 7, wherein at least one fluoroquinolone is an antibacterially active fluoroquinolone.
11. Verwendung gemäß Anspruch 7, wobei es sich bei mindestens einem Fluorchinolon um ein antibakteriell unwirksames Fluorchinolon handelt.11. Use according to claim 7, wherein at least one fluoroquinolone is an antibacterially inactive fluoroquinolone.
12. Verwendung von einem oder mehreren Fluorchinolonen in einem Verfahren zur Herstellung eines Arzneimittels zur Behandlung und/oder Prophylaxe von viralen und bakteriellen Mischinfektionen mit Substanzen aus Ansprüchen 1-6, wobei es sich bei der bakteriellen Infektion um eine Sekundärinfektion in einem immunsuppremierten Patienten handelt.12. The use of one or more fluoroquinolones in a process for the preparation of a medicament for the treatment and / or prophylaxis of viral and bacterial mixed infections with substances from claims 1-6, wherein the bacterial infection is a secondary infection in a immunosuppremed patient.
13. Verwendung gemäß Anspruch 12, wobei es sich bei den viralen Infektionen um Infektionen durch Viren ausgewählt aus der Gruppe bestehend aus den Virusfamilien Adenoviridae, Caliciviridae, Picornaviridae, Paramyxoviridae, Coronaviridae, Orthomyxoviridae, Retroviridae, Reoviridae, Bunyaviridae, Togaviridae, Herpesviridae, Parvoviridae und/oder Papovaviridae handelt.13. Use according to claim 12, wherein the viral infections are infections by viruses selected from the group consisting of the virus families Adenoviridae, Caliciviridae, Picornaviridae, Paramyxoviridae, Coronaviridae, Orthomyxoviridae, Retroviridae, Reoviridae, Bunyaviridae, Togaviridae, Herpesviridae, Parvoviridae and / or Papovaviridae.
14. Verwendung gemäß Ansprüchen 12 und 13, wobei es sich um Erkrankungen des Respirationstraktes, des Verdauungstraktes und/oder der Haut mit ihren Anhangsorganen sowie des Bindegewebes handlet.14. Use according to claims 12 and 13, wherein it handlet diseases of the respiratory tract, the digestive tract and / or the skin with its appendages and the connective tissue.
15. Verwendung gemäß Anspruch 14, wobei es sich bei den Erkrankungen um SARS oder Influenza handelt.Use according to claim 14, wherein the diseases are SARS or influenza.
16. Verwendung gemäß Ansprüchen 1-12, wobei es sich um Immunsuppressionen handelt, die sich unter dem Einfluß einer Behandlung mit zytotoxischen Chemotherapeutika befinden.Use according to claims 1-12, which are immunosuppressants which are under the influence of a treatment with cytotoxic chemotherapeutic agents.
17. Verwendung gemäß Anspruch 16, wobei es sich um Immunsuppressionen in Krebspatienten handelt.17. Use according to claim 16, which is immunosuppressants in cancer patients.
18. Verwendung gemäß Ansprüchen 1-12 oder 16, wobei es sich um Immunsuppressionen handelt, die durch eine Radiotherapie oder einer Bestrahlung bedingt sind.Use according to claims 1-12 or 16, which are immunosuppressive conditions caused by radiotherapy or radiation.
19. Verwendung gemäß Anspruch 18, wobei es sich um Immunsuppressionen bei Krebspatienten handelt.19. Use according to claim 18, which is immunosuppressants in cancer patients.
20. Verwendung von einem oder mehreren Fluorchinolonen in einem Verfahren zur Herstellung eines Arzneimittels zur Behandlung und/oder Prophylaxe der Strahlen- krankheit nach Exposition mit radioaktivem Material. 20. Use of one or more fluoroquinolones in a process for the preparation of a medicament for the treatment and / or prophylaxis of the radiation disease after exposure to radioactive material.
21. Verwendung gemäß Anspruch 20, wobei es sich um Fluorochinolone ausgewählt aus der Gruppe bestehend aus Moxifloxacin, Ciprofloxacin, Gatifloxacin, Enrofloxacin, Sparfloxacin, Clinafloxacin, Grepafloxacin, Trovafloxacin, Tosufloxacin, Temafloxacin, Norfloxacin, Rufloxacin, Fleroxacin, Levofloxacin, Danofloxacin, Sarafloxacin, Marbofloxacin, Orbifloxacin und Pradofloxacin und/oder nicht antibakteriell wirksamen21. Use according to claim 20 which is fluoroquinolones selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, fleroxacin, levofloxacin, danofloxacin, sarafloxacin, Marbofloxacin, orbifloxacin and pradofloxacin and / or non-antibacterial
Fluochinolonen handelt.Fluoquinolones act.
22. Verwendung von einem oder mehrerer Fluorchinolone in einem Verfahren zur Herstellung eines Arzneimittels zur Behandlung und/oder Prophylaxe von Immunsuppressionen, wobei es sich um ein Kombinationspräparat mit Arzneimitteln handelt, die zur antitumoralen Therapie, wie zum Beispiel Chemotherapeutika oder cytostatisch wirkende Mittel, eingesetzt werden.22. Use of one or more fluoroquinolones in a process for the preparation of a medicament for the treatment and / or prophylaxis of immunosuppressive, which is a combination preparation with medicaments, which are used for antitumoral therapy, such as chemotherapeutic agents or cytostatic agents ,
23. Verwendung gemäß Anspruch 22, wobei es sich bei dem Fluorchinolon um ein Fluorchinolon ausgewählt aus der Gruppe bestehend aus Moxifloxacin, Ciprofloxacin, Gatifloxacin, Enrofloxacin, Sparfloxacin, Clinafloxacin, Grepafloxacin, Trovafloxacin, Tosufloxacin, Temafloxacin, Norfloxacin, Rufloxacin, Fleroxacin, Levofloxacin,23. Use according to claim 22, wherein the fluoroquinolone is a fluoroquinolone selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, fleroxacin, levofloxacin,
Danofloxacin, Sarafloxacin, Marbofloxacin, Orbifloxacin und Pradofloxacin handelt.Danofloxacin, sarafloxacin, marbofloxacin, orbifloxacin and pradofloxacin.
24. Verwendung gemäß Anspruch 22 oder 23, wobei es sich bei dem antitumoral wirksamenden Mittel um ein Mittel handelt, welches ausgewählt wird aus der Gruppe bestehend aus Asparaginase, Bleomycin, Carboplatin, Carmustin, Chlorambucil, Cisplatin, Colaspase, Cyclophosphamid, Cytarabin, Dacarbazin, Dactinomycin, Daunorubicin,24. Use according to claim 22 or 23, wherein the antitumor agent is an agent selected from the group consisting of asparaginase, bleomycin, carboplatin, carmustine, chlorambucil, cisplatin, colaspase, cyclophosphamide, cytarabine, dacarbazine, Dactinomycin, daunorubicin,
Doxorubicin (Adriamycin), Epirubicin, Etoposid, 5-Fluorouracil, Hexamethylmelamin, Hydroxyurea, Ifosfamid, Irinotecan, Leucovorin, Lomustin, Mechlorethamin, 6-Mercapto- purin, Mesna, Methothrexat, MitomycinC, Mitoxantron, Prednisolon, Prednison, Precarbazin, Raloxifen, Streptozocin, Tamoxifen, Thioguanin, Topotecan, Vinblastin, Vincristin, Vindesin, Aminogluthethimid, L-Asparaginase, Azathioprin, 5-AzacytidinDoxorubicin (adriamycin), epirubicin, etoposide, 5-fluorouracil, hexamethylmelamine, hydroxyurea, ifosfamide, irinotecan, leucovorin, lomustine, mechlorethamine, 6-mercapto-purine, mesna, methothrexate, mitomycin C, mitoxantrone, prednisolone, prednisone, precarbazine, raloxifene, streptozocin , Tamoxifen, thioguanine, topotecan, vinblastine, vincristine, vindesine, aminogluthethimide, L-asparaginase, azathioprine, 5-azacytidine
Cladribin, Busulfan, Diethylstilbestrol, 2',2'-Difluorodeoxycytidine, Docetaxel, Erythro- hydroxynonyladenin, Ethinylestradiol, 5-Fluorodeoxyuridin, 5-Fluorodeoxyuridinmono- phosphat, Fludarabinphosphat, Fluoxymesteron, Flutamid, Hydroxyprogesteroncaproat, Idarubicin, Interferon, Medroxyprogesteronacetat, Megestrolacetat, Melphalan, Mitotan, Paclitaxel, Pentstatin, PALA, Plicamycin, Semustin, Teniposid, Testosteronpropionat,Cladribine, busulfan, diethylstilbestrol, 2 ', 2'-difluorodeoxycytidine, docetaxel, erythrohydroxynonyladenine, ethinylestradiol, 5-fluorodeoxyuridine, 5-fluorodeoxyuridine monophosphate, fludarabine phosphate, fluoxymesterone, flutamide, hydroxyprogesterone caproate, idarubicin, interferon, medroxyprogesterone acetate, megestrol acetate, melphalan, Mitotane, paclitaxel, pentstatin, PALA, plicamycin, semustin, teniposide, testosterone propionate,
Thiotepa, Trimethylmelamin, Uridin, und Vinorelbin, Oxaliplatin, Gemcitabin, Capecitabin, Epothilon und natürliche oder synthetische Derivate, Tositumomab, Trabedectin, und Temozolomid, Trastuzumab, Cetuximab, Bevacizumab, Pertuzumab, ZD- 1839 (Iressa), OSI-774 Tarceva), CI-1033, GW-2016, CP-724,714, HKI-272, EKB-569, STI-571(Gleevec), PTK-787, SU-11248, ZD-6474, AG-13736, KRN-951, CP-547, 632, CP-673,451 und Sorafenib.Thiotepa, trimethylmelamine, uridine, and vinorelbine, oxaliplatin, gemcitabine, capecitabine, epothilone and natural or synthetic derivatives, toositumomab, trabedectin, and temozolomide, trastuzumab, cetuximab, bevacizumab, pertuzumab, ZD-1839 (Iressa), OSI-774 tarceva), CI-1033, GW-2016, CP-724,714, HKI-272, EKB-569, STI-571 (Gleevec), PTK-787, SU-11248, ZD-6474, AG-13736, KRN-951, CP-547, 632, CP-673,451 and sorafenib.
25. Verwendung von Fluorchino Ionen in einem Verfahren zur Herstellung eines Arzneimittels zur Behandlung und/oder Prophylaxe von Immunsuppressionen, wobei es sich um ein Kombinationspräparat mit antiviralen Arzneimitteln handelt.25. Use of fluoroquinolones in a process for the preparation of a medicament for the treatment and / or prophylaxis of immunosuppressants, which is a combination preparation with antiviral medicaments.
26. Verwendung gemäß Anspruch 25, sich bei dem Fluorchinolon um ein Fluorchinolon ausgewählt aus der Gruppe bestehend aus Moxifloxacin, Ciprofloxacin, Gatifloxacin, Enrofloxacin, Sparfloxacin, Clinafloxacin, Grepafloxacin, Trovafloxacin, Tosufloxacin, Temafloxacin, Norfloxacin, Rufloxacin, Fleroxacin, Levofloxacin, Danofloxacin, Sarafloxacin, Marbofloxacin, Orbifloxacin und Pradofloxacin handelt.26. Use according to claim 25, wherein the fluoroquinolone is a fluoroquinolone selected from the group consisting of moxifloxacin, ciprofloxacin, gatifloxacin, enrofloxacin, sparfloxacin, clinafloxacin, grepafloxacin, trovafloxacin, tosufloxacin, temafloxacin, norfloxacin, rufloxacin, fleroxacin, levofloxacin, danofloxacin, Sarafloxacin, marbofloxacin, orbifloxacin and pradofloxacin.
27. Verwendung gemäß Anspruch 25 oder 26, wobei es sich bei dem antiviral wirksamen Mittel um ein Mittel ausgewählt aus der Gruppe bestehend aus Interferon-ß, Interferon alfacon-1, Interferon-α oder pegyliertes Interferon-ß, 3TC (Lamivudin), Adevovir, Adevovir Dipivoxil, Entecavir, Emtricitabine, Clevudine, L-dT, L-Fd4C Acyclovir, Valacyclovir, Penciclovir, Famciclovir Foscarnet, Brivudin, Ganciclovir, Cidofovir,Use according to claim 25 or 26, wherein the antiviral agent is an agent selected from the group consisting of interferon-β, interferon alfacon-1, interferon-α or pegylated interferon-β, 3TC (lamivudine), adevovir , Adevovir dipivoxil, entecavir, emtricitabine, Clevudine, L-dT, L-Fd4C acyclovir, valacyclovir, penciclovir, famciclovir foscarnet, brivudine, ganciclovir, cidofovir,
Inhibitoren des Helikase-Primase-Komplexes, Ribavirin, Lopinavir-ritonavir (Kaletra), AG7088, hexapeptidyl CMK, Ruprintrivir (AG7088), 3C Protease Inhibitoren, Pirodavir, Pleconaril, lösliches ICAM-I, Amantidin, Symmetrel, Flumadine, Oseltamvir, Zanamivir, Tenofovir Disproxil Fumarat (TDF), Emtricitabine (FTC), Didanosine (ddl), Stavudine (d4T), Zidovudine (AZT), Zalcitabine (ddC), Efavirenz (EFV), Nivirapine (NVP),Inhibitors of the helicase-primase complex, ribavirin, lopinavir-ritonavir (Kaletra), AG7088, hexapeptidyl CMK, ruprin trivir (AG7088), 3C protease inhibitors, pirodavir, pleconaril, soluble ICAM-I, amantidine, Symmetrel, flumadine, oseltamvir, zanamivir, Tenofovir disproxil fumarate (TDF), emtricitabine (FTC), didanosine (ddl), stavudine (d4T), zidovudine (AZT), zalcitabine (ddC), efavirenz (EFV), nivirapine (NVP),
Delaviridine (DLV), Atazanavir (ATV), Ritonavir (RTV), Amprenavir (APV), Lopinavir/Rironavir (LPV/RTV), Nelfinavir (NFV), Indinavir (IDV), Saquinavir (SQV- SGC), Enfuvirtide (T-20), Etravirine (TMC-125), Capravirine, Tenovovir (PMPA) handelt.Delaviridine (DLV), atazanavir (ATV), ritonavir (RTV), amprenavir (APV), lopinavir / rironavir (LPV / RTV), nelfinavir (NFV), indinavir (IDV), saquinavir (SQV-SGC), enfuvirtide (T- 20), etravirine (TMC-125), capravirine, tenovovir (PMPA).
28. Kit, beinhaltend voneinander getrennte Behältnisse, in denen jeweils die unter Anspruch 22, 23, oder 24 genannten Wirkstoffe enthalten sind.28. Kit, containing separate containers, in each of which the active ingredients mentioned in claim 22, 23, or 24 are included.
29. Kit, beinhaltend voneinander getrennte Behältnisse, in denen jeweils die unter Anspruch 25, 26, oder 27 genannten Wirkstoffe enthalten sind. 29. Kit, containing separate containers, in each of which the active ingredients mentioned in claim 25, 26, or 27 are included.
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WO2011076721A1 (en) 2009-12-22 2011-06-30 Deutsches Krebsforschungszentrum Fluoroquinolones for the treatment and/or prophylaxis of inflammatory diseases
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US9211291B2 (en) 2009-04-06 2015-12-15 Wyeth Llc Treatment regimen utilizing neratinib for breast cancer
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US9511063B2 (en) 2008-06-17 2016-12-06 Wyeth Llc Antineoplastic combinations containing HKI-272 and vinorelbine
US10596162B2 (en) 2005-02-03 2020-03-24 Wyeth Llc Method for treating gefitinib resistant cancer
US10729672B2 (en) 2005-11-04 2020-08-04 Wyeth Llc Antineoplastic combinations with mTOR inhibitor, trastuzumab and/or HKI-272

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US10596162B2 (en) 2005-02-03 2020-03-24 Wyeth Llc Method for treating gefitinib resistant cancer
US10603314B2 (en) 2005-02-03 2020-03-31 The General Hospital Corporation Method for treating gefitinib resistant cancer
US10729672B2 (en) 2005-11-04 2020-08-04 Wyeth Llc Antineoplastic combinations with mTOR inhibitor, trastuzumab and/or HKI-272
US9139558B2 (en) 2007-10-17 2015-09-22 Wyeth Llc Maleate salts of (E)-N-{4-[3-Chloro-4-(2-pyridinylmethoxy)anilino]-3-cyano-7-ethoxy-6-quinolinyl}-4-(dimethylamino)-2-butenamide and crystalline forms thereof
US9630946B2 (en) 2007-10-17 2017-04-25 Wyeth Llc Maleate salts of (E)-N-{4-[3-chloro-4-(2-pyridinylmethoxy)anilino]-3-cyano-7-ethoxy-6-quinolinyl}-4-(dimethylamino)-2-butenamide and crystalline forms thereof
US10035788B2 (en) 2007-10-17 2018-07-31 Wyeth Llc Maleate salts of (E)-N-{4[3-chloro-4-(2-pyridinylmethoxy)anilino]-3-cyano-7-ethoxy-6-quinolinyl}-4-(dimethylamino)-2-butenamide and crystalline forms thereof
US9511063B2 (en) 2008-06-17 2016-12-06 Wyeth Llc Antineoplastic combinations containing HKI-272 and vinorelbine
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US9265784B2 (en) 2008-08-04 2016-02-23 Wyeth Llc Antineoplastic combinations of 4-anilino-3-cyanoquinolines and capecitabine
US9211291B2 (en) 2009-04-06 2015-12-15 Wyeth Llc Treatment regimen utilizing neratinib for breast cancer
WO2011076721A1 (en) 2009-12-22 2011-06-30 Deutsches Krebsforschungszentrum Fluoroquinolones for the treatment and/or prophylaxis of inflammatory diseases

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