WO2024046340A1 - 一种药物组合物及其应用 - Google Patents

一种药物组合物及其应用 Download PDF

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WO2024046340A1
WO2024046340A1 PCT/CN2023/115656 CN2023115656W WO2024046340A1 WO 2024046340 A1 WO2024046340 A1 WO 2024046340A1 CN 2023115656 W CN2023115656 W CN 2023115656W WO 2024046340 A1 WO2024046340 A1 WO 2024046340A1
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pharmaceutical composition
component
composition according
acid
citric acid
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PCT/CN2023/115656
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English (en)
French (fr)
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程先元
汤伟伟
李斯
龚俊波
冯颖
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安徽汤谷医药科技有限公司
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Publication of WO2024046340A1 publication Critical patent/WO2024046340A1/zh

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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
    • A61K31/335Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/365Lactones
    • A61K31/366Lactones having six-membered rings, e.g. delta-lactones
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/045Hydroxy compounds, e.g. alcohols; Salts thereof, e.g. alcoholates
    • A61K31/05Phenols
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/185Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19Carboxylic acids, e.g. valproic acid
    • A61K31/192Carboxylic acids, e.g. valproic acid having aromatic groups, e.g. sulindac, 2-aryl-propionic acids, ethacrynic acid 
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/185Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19Carboxylic acids, e.g. valproic acid
    • A61K31/194Carboxylic acids, e.g. valproic acid having two or more carboxyl groups, e.g. succinic, maleic or phthalic acid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/335Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/35Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom
    • A61K31/352Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom condensed with carbocyclic rings, e.g. methantheline 
    • A61K31/3533,4-Dihydrobenzopyrans, e.g. chroman, catechin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/70Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7024Esters of saccharides
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/70Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7042Compounds having saccharide radicals and heterocyclic rings
    • A61K31/7048Compounds having saccharide radicals and heterocyclic rings having oxygen as a ring hetero atom, e.g. leucoglucosan, hesperidin, erythromycin, nystatin, digitoxin or digoxin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00Drugs for disorders of the urinary system
    • A61P13/04Drugs for disorders of the urinary system for urolithiasis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00Drugs for disorders of the urinary system
    • A61P13/12Drugs for disorders of the urinary system of the kidneys

Definitions

  • the invention belongs to the fields of biomineralization and biomedicine, specifically relates to a pharmaceutical composition and its application, and in particular, to a combined pharmaceutical composition for treating kidney stones and its application.
  • Biomineralization is a ubiquitous phenomenon in nature, but it is divided into normal mineralization (such as teeth, shells, eggshells, etc.) and pathological mineralization (kidney stones, gallstones, gout, etc.). Because the process of pathological mineralization mainly involves a series of crystallization processes such as the accumulation of supersaturation of solute molecules, solute nucleation, crystal growth, and crystal coalescence, most current treatments for diseases related to pathological crystallization start from the perspective of crystallization, by inhibiting pathological The crystallization process enables the treatment and prevention of related diseases.
  • Kidney stones are a common disease in the urinary system.
  • the incidence rate of kidney stones in my country in 2016 was 7.54%, and the recurrence rate of stones in 5-10 years is as high as 50%. Therefore, the treatment and prevention of stones have received widespread clinical attention.
  • calcium oxalate is the main component of kidney stones
  • current treatments for kidney stones from a crystallization perspective mainly focus on inhibiting the crystallization of calcium oxalate stones.
  • Studies have found that calcium oxalate monohydrate (COM) and dihydrate (COD) exist in normal people and stone patients. COM crystals easily adhere to renal epithelial cells and macromolecules in urine, grow and aggregate to form large particles.
  • COM calcium oxalate monohydrate
  • CDOD dihydrate
  • COM crystal growth inhibitors include metal ions, organic small molecules, and macromolecules.
  • Na + , K + , Li + and Cs + can not only reduce the supersaturation of calcium oxalate, but also inhibit the macroscopic growth of COM crystals, with an inhibition rate of 50%; citric acid has an inhibitory effect of 60% on calcium oxalate crystals.
  • Polyphosphate substances can reduce the occurrence of COM by inducing the production of COD; urine proteins such as osteopontin, chondroitin sulfate, etc. have only a 30%-40% inhibitory effect on calcium oxalate crystals. Therefore, a type of COM crystal growth inhibitor is needed to completely inhibit the growth of COM crystals and reduce the formation of stones, thereby achieving the prevention of stones.
  • this application provides a pharmaceutical composition and its application to improve the therapeutic effect of the drug through synergy.
  • One of the objects of the present invention is to provide a pharmaceutical composition, which includes component A and component B;
  • component A includes polyphenols with a carbon number of 6-14 and/or can be metabolized into polyphenols with a carbon number of 6-14 (such as 6, 10, 12, 14, etc.) in the human body;
  • Component B includes any one or a combination of at least two of citric acid, citrate salts, citric acid derivatives or citric acid derivative salts.
  • the polyphenolic substance with a carbon number of 6-14 includes any one or a combination of at least two of ellagic acid, gallic acid, pyrogallol or protocatechuic acid.
  • the substances that can be metabolized into polyphenols with a carbon number of 6-14 in the human body include any one of tannic acid, punicalagin, galloylglucose or ester catechins. or a combination of at least two.
  • the citrate salt includes any one or a combination of at least two of potassium citrate salt, sodium citrate salt or magnesium citrate salt.
  • the citric acid derivative includes hydroxycitric acid, an ester compound derived from citric acid or a lactone compound derived from citric acid.
  • the citric acid derivative salt includes any one or a combination of at least two of hydroxycitrate potassium salt and/or hydroxycitrate sodium salt or hydroxycitrate magnesium salt.
  • the molar ratio of component A and component B is 0.0013 ⁇ 3.33:1.
  • the combined action concentration ratio of the A component and the B component is set according to the action mechanism of each component, and exemplarily includes:
  • the molar ratio of component A: component B is 0.0013 ⁇ 0.163:1, such as 0.005:1, 0.008:1, 0.01:1, 0.03:1, 0.05: 1, 0.08:1, 0.1:1, 0.12:1, 0.15:1, 0.16:1, etc.
  • the molar ratio of component A: component B is 0.0023 to 0.025:1, such as 0.003:1, 0.005:1, 0.008:1, 0.01:1, 0.012:1 , 0.015:1, 0.018:1, 0.02:1, 0.022:1, 0.025:1, etc.
  • the molar ratio of component A: component B is 1.77 to 3.33:1, such as 1.8:1, 1.9:1, 2:1, 2.1:1, 2.2: 1, 2.3:1, 2.4:1, 2.5:1, 2.6:1, 2.7:1, 2.8:1, 2.9:1, 3:1, 3.1:1, 3.2:1, 3.3:1, etc.
  • the pharmaceutical composition includes a molar addition amount of 0-2 ⁇ M (for example, 0.1 ⁇ M M, 0.3 ⁇ M, 0.5 ⁇ M, 0.7 ⁇ M, 1 ⁇ M, 1.2 ⁇ M, 1.5 ⁇ M, 1.8 ⁇ M, etc.) ellagic acid and molar addition amount of 0-0.5mM (such as 0.1mM, 0.2mM, 0.3mM, 0.4mM, etc.) ) of component B, and the added amounts of both ellagic acid and component B are not 0.
  • the pharmaceutical composition includes ellagic acid and citric acid or potassium citrate or hydroxycitric acid.
  • the pharmaceutical composition includes gallic acid and molar addition in a molar addition amount of 0-25 ⁇ M (for example, 1 ⁇ M, 3 ⁇ M, 5 ⁇ M, 7 ⁇ M, 10 ⁇ M, 12 ⁇ M, 15 ⁇ M, 18 ⁇ M, 20 ⁇ M, 22 ⁇ M, etc.)
  • the amount of component B is 0-0.5mM (such as 0.1mM, 0.2mM, 0.3mM, 0.4mM, etc.), and the added amounts of gallic acid and component B are not 0.
  • the pharmaceutical composition includes gallic acid and citric acid or potassium citrate or hydroxycitric acid.
  • the pharmaceutical composition includes pyrogallol in a molar addition amount of 0-15mM (such as 1mM, 3mM, 5mM, 7mM, 10mM, 12mM, 15mM, etc.) and a molar addition amount of 0-15mM.
  • 0-15mM such as 1mM, 3mM, 5mM, 7mM, 10mM, 12mM, 15mM, etc.
  • 0.5mM such as 0.1mM, 0.2mM, 0.3mM, 0.4mM, etc.
  • the pharmaceutical composition includes pyrogallol and citric acid.
  • the pharmaceutical composition includes a molar addition amount of 0-0.55mM (for example, 0.05mM, 0.1mM, 0.15mM, 0.2mM, 0.25mM, 0.3mM, 0.35mM, 0.4mM, 0.45mM , 0.5mM, etc.) protocatechuic acid and component B with a molar addition amount of 0-0.5mM (such as 0.1mM, 0.2mM, 0.3mM, 0.4mM, etc.), and the addition of protocatechuic acid and component B The quantity is not 0.
  • the pharmaceutical composition includes protocatechuic acid and citric acid.
  • the pharmaceutical composition further includes a pharmaceutically acceptable carrier or excipient.
  • the carrier includes any one or a combination of at least two of liposomes, micelles, dendrimers, microspheres or microcapsules.
  • This application does not limit the specific material of the carrier. , those skilled in the art can define it according to actual needs.
  • the excipients include any one or a combination of at least two of wetting agents, binders or disintegrants. This application does not limit the specific substances of the excipients. Those skilled in the art can make limitations according to actual needs.
  • the pharmaceutical composition is a compound preparation.
  • the preparation type of the pharmaceutical composition is a separate preparation of component A and a separate preparation of component B.
  • the administration mode of the separate preparations includes simultaneous administration, separate administration or sequential administration.
  • the form of the pharmaceutical composition includes any pharmaceutically acceptable dosage form.
  • the dosage forms include tablets, granules, granules, powders, capsules, injections Agents, etc.
  • the second object of the present invention is to provide an application of the pharmaceutical composition according to the first object in the preparation of drugs for preventing and/or treating kidney stones.
  • the third object of the present invention is to provide the use of the pharmaceutical composition as described in the first object in the preparation of calcium oxalate monohydrate crystal growth inhibitor.
  • the fourth object of the present invention is to provide the use of the pharmaceutical composition as described in one of the objects in preventing and/or treating kidney stones.
  • the fifth object of the present invention is to provide a method for preventing and/or treating kidney stones, including:
  • An effective amount of a pharmaceutical composition for one of the purposes is administered to a subject suffering from or suspected of suffering from kidney stones.
  • the present invention has the following beneficial effects:
  • the present invention has confirmed through experiments that the combined use of component A and component B can inhibit the growth of COM crystals, and the combined use of the two shows a synergistic effect compared to the separate use of component A or component B, especially ellagic acid and gallic acid.
  • the combined use of acid, pyrogallol or protocatechuic acid and citric acid can inhibit the growth of COM crystals, and the combination of the two is better than the use of ellagic acid, gallic acid, pyrogallol, protocatechuic acid or citric acid alone.
  • the present invention has confirmed through experiments that ellagic acid, pyrogallol and citric acid have the same mechanism in inhibiting the growth of COM crystals, which is a combined mechanism of step pinning and kink blocking.
  • Inhibitor molecules can exert synergistic effects.
  • the specific mechanism is that inhibitor molecules such as ellagic acid, pyrogallol or citric acid can be adsorbed on the step platform of the COM crystal crystal surface on the one hand, hindering the extension of the steps during growth.
  • the extended steps encounter the steps adsorbed on the step platform,
  • inhibitor molecules are added to the step, the edge of the step is bent.
  • the bent step has higher solubility, so the local supersaturation of the step is reduced, thereby reducing the step growth rate.
  • the step stops growing and the crystal plane is completely suppressed; on the other hand, it can be adsorbed at the crystal step kink points (kinks) to reduce the density of solute embedding growth nodes and reduce the steps. Growth kinetic coefficient, thereby reducing the step growth rate.
  • kinks crystal step kink points
  • the present invention confirms through experiments that gallic acid and citric acid have similar mechanisms in inhibiting the growth of COM crystals.
  • the mechanism of gallic acid is only step inhibition, but the combined use of the two inhibitor molecules exerts a synergistic effect.
  • the specific mechanism of action of gallic acid is that gallic acid molecules are adsorbed on the step platform of the crystal face of COM crystal, reducing the local supersaturation of the growth step, thereby reducing the step growth rate until the crystal face growth is completely inhibited.
  • gallic acid and citric acid are used together, the distance between different inhibitor molecules adsorbed on the step platform is smaller than the distance between the same inhibitor molecules, and the combined use of the two inhibitors shows a more potent inhibitory effect.
  • the present invention has confirmed through experiments that although protocatechuic acid and citric acid have different mechanisms in inhibiting the growth of COM crystals, and the mechanism of protocatechuic acid is step inhibition, the combined use of the two inhibitor molecules exerts synergy. effect.
  • the specific mechanism of action of protocatechuic acid is that protocatechuic acid molecules are adsorbed on the step growth kink points of the COM crystal face, thereby reducing the density of growth nodes for solute embedding and reducing the kinetic coefficient of step growth, thereby reducing The growth rate of the steps.
  • One of protocatechuic acid molecules and citric acid molecules is adsorbed at the kink point of step growth, and the other is adsorbed on the step platform. The two do not conflict, and when the distance between them is smaller than the distance between citric acid molecules, the combined use of the two inhibitors A synergistic effect can be achieved.
  • the combined use composition of ellagic acid, gallic acid, pyrogallol or protocatechuic acid and citric acid provided by the invention can improve the inhibitory effect of a single inhibitor molecule on COM crystals and reduce the formation and growth of COM crystals, thereby Improve the preventive effect of inhibitor drugs on kidney stones.
  • Figure 1 shows the inhibition of COM crystal growth when ellagic acid and citric acid are used in combination. isobologram;
  • Figure 2 is an isobologram showing the inhibition of COM crystal growth when gallic acid and citric acid are used together;
  • Figure 3 is an isobologram showing the inhibition of COM crystal growth when pyrogallol and citric acid are used together;
  • Figure 4 is an isobologram showing the inhibition of COM crystal growth when protocatechuic acid and citric acid are used in combination;
  • Figure 5 Colored diagram of human proximal tubule cell survival (green) and death (red), the scale bar is 50 ⁇ m;
  • Figure 7 Lactate dehydrogenase release percentage. Compared with the control group, *p ⁇ 0.05, **p ⁇ 0.01; compared with the CA group, #p ⁇ 0.05, ##p ⁇ 0.01;
  • Figure 8 Number of COM crystals adhered. Compared with the control group, *p ⁇ 0.05, **p ⁇ 0.01; compared with the CA group, #p ⁇ 0.05, ##p ⁇ 0.01.
  • first and second are only used for descriptive purposes and cannot be understood as indicating or implying relative importance or implicitly indicating the number of indicated technical features. Therefore, features defined as “first” and “second” may explicitly or implicitly include one or more of these features. Further, in the description of the present invention, unless otherwise It is explained that “multiple” means two or more.
  • the terms “optionally,” “optionally,” or “optionally” generally mean that the subsequently described event or condition may but need not occur, and that the description includes instances in which the event or condition occurs, and A situation in which the event or condition did not occur.
  • composition is in a form that is effective to permit the biological activity of the active ingredient and does not contain additional ingredients that would have unacceptable toxicity to the subject to whom the composition is to be administered.
  • treatment means to temporarily or permanently, partially or completely eliminate, reduce, inhibit or ameliorate the clinical symptoms, manifestations or progression of an event, disease or condition.
  • the terms “subject” and “patient” are used interchangeably, regardless of whether the subject has been or is currently receiving any form of treatment.
  • the term “subject” or “patient” refers to a mammalian subject or patient. Unless otherwise indicated, the terms “patient” or “subject” are used interchangeably herein. Exemplary subjects include, but are not limited to, humans, monkeys, dogs, cats, mice, rats, cattle, horses, camels, avian, goats, and sheep.
  • the subject is human.
  • the subject is a person suspected of having cancer, an autoimmune disease or condition, and/or an infection.
  • the effect of the combined use of inhibitors is plotted in an isobologram, as shown in Figure 1.
  • the open symbols in the figure indicate the concentration required for a single inhibitor to achieve a certain effect, and the same solid symbols indicate the concentration required for a combination of inhibitors to achieve the same effect. If the solid symbol falls on the lower left side of the line between open symbols, it indicates that the combination has a synergistic effect; if it falls on the line, it indicates that the combination effect is additive; if it falls on the upper right side of the line, it indicates that the combination effect is antagonistic.
  • Figure 1 clearly shows that the combined use of ellagic acid/citric acid shows a synergistic effect, and compared to the individual effects of inhibitor molecules, the combined use improves the performance of ellagic acid by nearly 8 times and citric acid by nearly 10 times respectively.
  • this example chose to directly expose An in vitro model of COM crystals to detect short-term cellular damage.
  • Mature human proximal tubule cells (HK-2) were exposed to COM crystal suspension medium in the presence and absence of inhibitors for the indicated times.
  • HK-2 cells in the control group cell membrane integrity was reduced and intracellular esterase activity was reduced after exposure to COM crystals for 24 hours ( Figure 5).
  • Figure 6 shows the synergistic effect of the pharmaceutical composition of four polyphenol molecules and citric acid in improving cell activity, and the order of synergistic enhancement is: GaA>PcA>PGA>EA.
  • Lactate dehydrogenase is a cytoplasmic enzyme released extracellularly when the cell membrane ruptures, so the amount of LDH released can be used as a marker of cell membrane integrity.
  • LDH release from cells directly exposed to COM crystals increased to 277.14% ( ⁇ 36.02%) and decreased to 195.17% ( ⁇ 2.46%) when 200 ⁇ M CA was present.
  • the combination of CA and GaA can reduce cellular LDH release to 110.87% ( ⁇ 8.67%), which further reveals the synergistic effect of the combination of CA and polyphenols in reducing crystal toxicity.
  • Crystal adhesion is not only a prerequisite for cell necrosis but also the key to triggering crystal aggregation. Therefore, this example quantified the number of crystal adhesion and examined the combined inhibitory effect of the pharmaceutical composition on COM crystal adhesion to HK-2 cells in vitro ( Figure 8). The results showed that compared with the blank group without inhibitor effect, the inhibitory effect of 200 ⁇ M CA on COM crystal adhesion reached 30%.
  • CA can reduce the number of crystal adhesion by up to 50%, and the EA/CA combination is the most effective inhibitor combination for crystal adhesion inhibition.
  • Example 1 The only difference from Example 1 is that ellagic acid is replaced by albumin, and other preparation methods are the same as Example 1.
  • Example 1 The only difference from Example 1 is that ellagic acid is replaced by o-hydroxybenzoic acid, and other preparation methods are the same as Example 1.
  • HCA hydroxycitric acid
  • EA ellagic acid
  • HCA hydroxycitric acid
  • GaA gallic acid
  • KCA potassium citrate
  • EA ellagic acid
  • references to the terms “one embodiment,” “some embodiments,” “an example,” “specific examples,” or “some examples” or the like means that specific features are described in connection with the embodiment or example. , structures, materials, or features are included in at least one embodiment or example of the present disclosure. In this specification, the schematic expressions of the above terms are not necessarily directed to the same embodiment or example. Furthermore, the specific features, structures, materials or characteristics described may be combined in any suitable manner in any one or more embodiments or examples. Furthermore, those skilled in the art may combine and combine different embodiments or examples and features of different embodiments or examples described in this specification unless they are inconsistent with each other.

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Abstract

一种药物组合物及其应用,所述药物组合物包括A组分和B组分;其中,A组分包括碳原子数为6-14的多酚物质和/或在人体内可代谢为碳原子数为6-14的多酚物质;B组分包括柠檬酸、柠檬酸盐、柠檬酸衍生物或柠檬酸衍生物盐中的任意一种或至少两种的组合。所述药物组合物不仅在抑制草酸钙晶体生长方面具有协同增强的效果,还可用于肾结石的协同治疗。

Description

一种药物组合物及其应用
优先权信息
本申请请求2022年08月30日向中国国家知识产权局提交的专利申请202211043899.6的优先权和权益,并且通过参照将其全文并入此处。
技术领域
本发明属于生物矿化、生物医药领域,具体涉及一种药物组合物及其应用,尤其涉及一种治疗肾结石的联合用药组合物及其应用。
背景技术
生物矿化是自然界普遍存在的现象,但是其分为正常矿化(如牙齿,贝壳,蛋壳等)和病态矿化(肾结石,胆结石,痛风等)。因为病态矿化过程主要涉及溶质分子过饱和度的积累、溶质成核、晶体生长、晶体聚结等一系列结晶过程,所以目前多数与病态结晶相关的疾病治疗开始从结晶角度出发,通过抑制病态结晶过程,实现与相关疾病的治疗和预防。
肾结石是泌尿***中一种常见的疾病,我国2016年的肾结石发病率为7.54%,且5-10年的结石复发率高达50%。因此结石的治疗和预防在临床上受到广泛的重视。因为草酸钙是肾结石的主要成分,所以目前肾结石从结晶角度的相关治疗主要聚焦在草酸钙结石的结晶抑制。研究发现,正常人和结石患者体内存在草酸钙一水合物(COM)和二水合物(COD),其中COM晶体易与肾上皮细胞和尿液中的大分子粘附,生长聚集形成大颗粒,最终无法***、滞留在肾脏中形成结石,所以COM为肾结石的主要成分。因此,从结晶的角度抑制COM晶体的生长,可有效预防结石的形成,降低结石复发率。
相关研究报道中指出,COM晶体生长抑制剂包括金属离子、有机小分子以及大分子等。其中,Na+、K+、Li+和Cs+不仅能降低草酸钙的过饱和度,也能抑制COM晶体的宏观生长,抑制率达50%;柠檬酸对草酸钙结晶的抑制效果达60%;多磷酸物质可通过诱导COD的产生的方式减少COM的出现;尿液蛋白如骨桥蛋白,硫酸软骨素等对草酸钙结晶的抑制效果仅为30%-40%。因此需要一类COM晶体生长抑制剂,完全抑制COM晶体生长,减少结石的形成,从而实现结石的预防。
近年来,联合用药逐渐成为疾病治疗的研究热点,联合用药可以发挥药物的协同作用,达到更好的疾病治疗效果。但药物联合使用时,药物间相互作用也可能产生相反的结果。因此,本领域一直致力于开发草酸钙结晶的抑制剂,并寻找药药联用具有协同增效的联合用药组合,以进一步增强结石的预防效果。
发明内容
在现有技术的基础上,为进一步增强结石治疗和预防效果,本申请提供了一种药物组合物及其应用,以通过协同增效的方式提高药物的治疗效果。
本发明的目的之一在于提供一种药物组合物,所述药物组合物包括A组分和B组分;
其中,A组分包括碳原子数为6-14的多酚物质和/或在人体内可代谢为碳原子数为6-14(例如6、10、12、14等)的多酚物质;
B组分包括柠檬酸、柠檬酸盐、柠檬酸衍生物或柠檬酸衍生物盐中的任意一种或至少两种的组合。
根据本发明的一个实施方案,所述碳原子数为6-14的多酚物质包括鞣花酸、没食子酸、邻苯三酚或原儿茶酸中的任意一种或至少两种的组合。
根据本发明的一个实施方案,所述在人体内可代谢为碳原子数为6-14的多酚的物质包括单宁酸、安石榴苷、没食子酰葡萄糖或酯型儿茶素中的任意一种或至少两种的组合。
根据本发明的一个实施方案,所述柠檬酸盐包括柠檬酸钾盐、柠檬酸钠盐或柠檬酸镁盐中的任意一种或至少两种的组合。
根据本发明的一个实施方案,所述柠檬酸衍生物包括羟基柠檬酸、柠檬酸衍生得到的酯类化合物或柠檬酸衍生得到的内酯化合物。
根据本发明的一个实施方案,所述柠檬酸衍生物盐包括羟基柠檬酸钾盐和/或羟基柠檬钠盐或羟基柠檬酸镁盐中的任意一种或至少两种的组合。
根据本发明的一个实施方案,在所述药物组合物中,所述A组分和B组分的摩尔比为0.0013~3.33:1。
根据本发明的一个实施方案,所述A组分和B组分的组合作用浓度配比根据各组分作用机理设定,示例性地包括:
当所述A组分与B组分作用机理相同时,A组分:B组分摩尔比为0.0013~0.163:1,例如0.005:1、0.008:1、0.01:1、0.03:1、0.05:1、0.08:1、0.1:1、0.12:1、0.15:1、0.16:1等。
当所述A组分与B组分作用机理相近时,A组分:B组分摩尔比为0.0023~0.025:1例如0.003:1、0.005:1、0.008:1、0.01:1、0.012:1、0.015:1、0.018:1、0.02:1、0.022:1、0.025:1等。
当所述A组分与B组分作用机理不同时,A组分:B组分摩尔比为1.77~3.33:1,例如1.8:1、1.9:1、2:1、2.1:1、2.2:1、2.3:1、2.4:1、2.5:1、2.6:1、2.7:1、2.8:1、2.9:1、3:1、3.1:1、3.2:1、3.3:1等。
根据本发明的一个实施方案,所述药物组合物包括摩尔添加量为0-2μM(例如0.1μ M、0.3μM、0.5μM、0.7μM、1μM、1.2μM、1.5μM、1.8μM等)的鞣花酸和摩尔添加量为0-0.5mM(例如0.1mM、0.2mM、0.3mM、0.4mM等)的B组分,且鞣花酸和B组分的添加量均不为0。优选地,所述药物组合物包括鞣花酸和柠檬酸或柠檬酸钾或或羟基柠檬酸。
根据本发明的一个实施方案,所述药物组合物包括摩尔添加量为0-25μM(例如1μM、3μM、5μM、7μM、10μM、12μM、15μM、18μM、20μM、22μM等)的没食子酸和摩尔添加量为0-0.5mM(例如0.1mM、0.2mM、0.3mM、0.4mM等)的B组分,且没食子酸和B组分的添加量均不为0。优选地,所述药物组合物包括没食子酸和柠檬酸或柠檬酸钾或羟基柠檬酸。
根据本发明的一个实施方案,所述药物组合物包括摩尔添加量为0-15mM(例如1mM、3mM、5mM、7mM、10mM、12mM、15mM等)的邻苯三酚和摩尔添加量为0-0.5mM(例如0.1mM、0.2mM、0.3mM、0.4mM等)的B组分,且邻苯三酚和B组分的添加量均不为0。优选地,所述药物组合物包括邻苯三酚和柠檬酸。
根据本发明的一个实施方案,所述药物组合物包括摩尔添加量为0-0.55mM(例如0.05mM、0.1mM、0.15mM、0.2mM、0.25mM、0.3mM、0.35mM、0.4mM、0.45mM、0.5mM等)的原儿茶酸和摩尔添加量为0-0.5mM(例如0.1mM、0.2mM、0.3mM、0.4mM等)的B组分,且原儿茶酸和B组分的添加量均不为0。优选地,所述药物组合物包括原儿茶酸和柠檬酸。
根据本发明的一个实施方案,所述药物组合物还包括药学上可接受的载体或赋形剂。
根据本发明的一个实施方案,所述载体包括脂质体、胶束、树枝状大分子、微球或微囊中的任意一种或至少两种的组合,本申请不对载体的具体物质进行限定,本领域技术人员可根据实际需要进行限定。
根据本发明的一个实施方案,所述赋形剂包括润湿剂、粘合剂或崩解剂中的任意一种或至少两种的组合,本申请不对赋形剂的具体物质进行限定,本领域技术人员可根据实际需要进行限定。
根据本发明的一个实施方案,所述药物组合物的制剂类型为复方制剂。
根据本发明的一个实施方案,所述药物组合物的制剂类型为A组分单独的制剂和B组分单独的制剂。
根据本发明的一个实施方案,所述单独的制剂的给药方式包括同时给药、分别给药或依次给药。
根据本发明的一个实施方案,所述药物组合物的型包括药剂学上可接受的任一剂型。
根据本发明的一个实施方案,所述剂型包括片剂、颗粒剂、冲剂、散剂、胶囊剂、注射 剂等。
本发明的目的之二在于提供一种如目的之一所述的药物组合物在制备预防和/或治疗肾结石药物中的应用。
本发明的目的之三在于提供如目的之一所述的药物组合物在制备草酸钙一水合物晶体生长抑制剂中的应用。
本发明的目的之四在于提供如目的之一所述的药物组合物在预防和/或治疗肾结石中的应用。
本发明的目的之五在于提供一种预防和/或治疗肾结石的方法,包括:
向患有或疑似患有肾结石的受试者施用有效量的目的之一所述的药物组合物。
相对于现有技术,本发明具有以下有益效果:
本发明通过实验证实A组分和B组分联合使用能够抑制COM晶体的生长,且两者联合使用比单独使用A组分或B组分表现出协同增效作用,尤其是鞣花酸、没食子酸、邻苯三酚或原儿茶酸与柠檬酸的联合使用能抑制COM晶体生长,且两者联合使用与单独使用鞣花酸、没食子酸、邻苯三酚、原儿茶酸或柠檬酸相比表现出更好的协同增效作用。更进一步地,当鞣花酸、没食子酸、邻苯三酚或原儿茶酸与柠檬酸联合使用时各自的剂量减半,对COM晶体生长的抑制效果比单一用药时更强。
本发明通过实验证实了鞣花酸、邻苯三酚和柠檬酸在抑制COM晶体生长方面具有相同的机制,为台阶阻宁(step pinning)和台阶阻结(kink blocking)的组合机制,两种抑制剂分子间可发挥协同作用。具体机制为,鞣花酸、邻苯三酚或柠檬酸等抑制剂分子一方面可吸附在COM晶体晶面台阶平台,阻碍生长中台阶的延展,当延展的台阶遇到吸附在台阶平台上的抑制剂分子时,台阶边缘发生弯曲,弯曲的台阶具有较高的溶解度,因此台阶局部过饱和度降低,从而降低台阶生长速率,当吸附在台阶平台上的抑制剂分子间的距离小于溶液过饱和度所对应的台阶生长临界直径时,台阶停止生长,晶面被完全抑制;另一方面,可吸附在晶体台阶扭结点(kinks),以减少用于溶质嵌入生长结点密度的方式,降低台阶生长动力学系数,从而减小台阶生长速率。当鞣花酸或邻苯三酚与柠檬酸联合使用时,吸附在台阶上的不同抑制剂分子间的距离小于相同抑制剂分子间的距离时,两种抑制剂的联合使用表现出更强效的抑制效果。
本发明通过实验证实没食子酸和柠檬酸在抑制COM晶体生长方面具有相似的机制,其中没食子酸的机制仅为台阶阻宁,但两种抑制剂分子间的联合使用发挥了协同作用效果。没食子酸的具体作用机制为,没食子酸分子吸附在COM晶体晶面台阶平台,降低生长台阶的局部过饱和度,从而降低台阶生长速率,直至晶面生长被完全抑制。当没食子酸和柠檬酸联合使用时,吸附在台阶平台上的不同抑制剂分子间的距离小于相同抑制剂分子间的距离时,两种抑制剂的联合使用表现出更强效的抑制效果。
本发明通过实验证实了虽然原儿茶酸和柠檬酸在抑制COM晶体生长方面具有不同的机制,其中原儿茶酸的机制为台阶阻结,但两种抑制剂分子间的联合使用发挥了协同的作用效果。原儿茶酸的具体作用机制为,原儿茶酸分子吸附在COM晶体晶面的台阶生长扭结点,以减少用于溶质嵌入生长结点密度的方式,降低台阶生长的动力学系数,从而减低台阶的生长速率。原儿茶酸分子和柠檬酸分子一个吸附在台阶生长扭结点,一个吸附在台阶平台,两种不冲突,且当两者的间距小于柠檬酸分子间的间距时,两种抑制剂的联合使用可达到协同的作用效果。
本发明提供的鞣花酸,没食子酸,邻苯三酚或原儿茶酸与柠檬酸的联合使用组合物可提高单个抑制剂分子对COM晶体的抑制效果,减少COM晶体的形成和生长,从而提升抑制剂药物对肾结石的预防效果。
本发明的附加方面和优点将在下面的描述中部分给出,部分将从下面的描述中变得明显,或通过本发明的实践了解到。
附图说明
本发明的上述和/或附加的方面和优点从结合下面附图对实施例的描述中将变得明显和容易理解,其中:图1是鞣花酸和柠檬酸联合使用时对COM晶体生长抑制的等效线图;
图2是没食子酸和柠檬酸联合使用时对COM晶体生长抑制的等效线图;
图3是邻苯三酚和柠檬酸联合使用时对COM晶体生长抑制的等效线图;
图4是原儿茶酸和柠檬酸联合使用时对COM晶体生长抑制的等效线图;
图5人类近端小管细胞存活(绿色)和死亡(红色)着色图,标尺为50μm;
图6细胞死亡/存活比统计分析。与控制组相比,*p<0.05,**p<0.01;与CA组相比,#p<0.05,##p<0.01;
图7乳酸脱氢酶释放百分数。与控制组相比,*p<0.05,**p<0.01;与CA组相比,#p<0.05,##p<0.01;
图8COM晶体粘附数量。与控制组相比,*p<0.05,**p<0.01;与CA组相比,#p<0.05,##p<0.01。
发明详细描述
下面通过具体实施方式来进一步说明本发明的技术方案。本领域技术人员应该明了,所述实施例仅仅是帮助理解本发明,不应视为对本发明的具体限制。
需要说明的是,术语“第一”、“第二”仅用于描述目的,而不能理解为指示或暗示相对重要性或者隐含指明所指示的技术特征的数量。由此,限定有“第一”、“第二”的特征可以明示或者隐含地包括一个或者更多个该特征。进一步地,在本发明的描述中,除非另 有说明,“多个”的含义是两个或两个以上。
在本文中所披露的范围的端点和任何值都不限于该精确的范围或值,这些范围或值应当理解为包含接近这些范围或值的值。对于数值范围来说,各个范围的端点值之间、各个范围的端点值和单独的点值之间,以及单独的点值之间可以彼此组合而得到一个或多个新的数值范围,这些数值范围应被视为在本文中具体公开。
为了更容易理解本发明,以下具体定义了某些技术和科学术语。除显而易见在本文件中的它处另有明确定义,否则本文中使用的所有其它技术和科学术语都具有本发明所属领域的一般技术人员通常理解的含义。
在本文中,术语“包含”或“包括”为开放式表达,即包括本发明所指明的内容,但并不排除其他方面的内容。
在本文中,术语“任选地”、“任选的”或“任选”通常是指随后所述的事件或状况可以但未必发生,并且该描述包括其中发生该事件或状况的情况,以及其中未发生该事件或状况的情况。
如本文所用,术语“组合物”是以允许活性成分的生物学活性有效的形式存在,并且不包含对将施用所述组合物的对象具有不可接受的毒性的另外的成分。
如本文所用,术语“治疗”是指暂时或永久地、部分或完全地消除、减少、抑制或改善事件、疾病或病状的临床症状、表现或进展。
如本文所用,术语“受试者”和“患者”可互换使用,而不管受试者是否已经或当前正在接受任何形式的治疗。如本文所用,术语“受试者”或“患者”是指哺乳动物受试者或患者。除非指出时,否则所述术语“患者”或“受试者”在本文中可互换地使用。示例性受试者包括但不限于人、猴、犬、猫、小鼠、大鼠、牛、马、骆驼、禽、山羊和绵羊。在某些实施方案,所述受试者是人。在一些实施方案,所述受试者是疑似患有癌症、自体免疫性疾病或病况、和/或感染的人。
下面将结合实施例对本公开的方案进行解释。本领域技术人员将会理解,下面的实施例仅用于说明本公开,而不应视为限定本公开的范围。实施例中未注明具体技术或条件的,按照本领域内的文献所描述的技术或条件或者按照产品说明书进行。所用试剂或仪器未注明生产厂商者,均为可以通过市购获得的常规产品。
实施例1
鞣花酸和柠檬酸的联合使用
在25ml的去离子水中,将溶液过饱和度控制在S=2.4,加入不同浓度的柠檬酸(CA)和鞣花酸(EA),监测晶体的生长过程,得到鞣花酸/柠檬酸联合使用在晶体生长的三个方向上的抑制百分比如表1所示。
表1鞣花酸/柠檬酸组合对浓度及其实现的晶体生长抑制剂百分比
*CA指柠檬酸,EA指鞣花酸。
根据表中数据,当CA单独作用时,其在0.0108mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;EA单独作用时,0.0105mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;但当CA与EA联合使用时,0.0009mM的CA和0.0012mM的EA联合作用,即可实现COM晶体[001]方向10%的生长抑制。CA与EA的联合使用分别将CA和EA的作用能力提升12和8.8倍。
将抑制剂联合使用效果绘制在等效线图中,如图1所示。图中空心符号表示的是单个抑制剂达到某一作用效果时所需要的浓度,相同的实心符号表示抑制剂组合得到相同作用效果所需要的浓度。如果实心符号落在空心符号间的连线左下方,表明此组合为协同效果;如果落在线上,表明组合作用效果为相加;如果落在线的右上方,表明组合作用效果为拮抗。
图1明确表示鞣花酸/柠檬酸联合使用表现出协同作用,且相比于抑制剂分子的单独作用,联合使用分别提升鞣花酸性能近8倍,提升柠檬酸性能近10倍。
实施例2
没食子酸和柠檬酸的联合使用
在25ml的去离子水中,加入不同浓度的柠檬酸(CA)和没食子酸(GaA),接着监测晶体的生长过程,得到三个生长方向上没食子酸/柠檬酸联合使用在晶体生长的三个方向上的抑制百分比如表2所示。
表2没食子酸和柠檬酸组合对浓度及其实现的晶体生长抑制剂百分比
根据表中数据,当CA单独作用时,其在0.0108mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;GaA单独作用时,0.4678mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;但当CA与GaA联合使用时,0.0013mM的CA和0.0311mM的GaA联合作用,即可实现COM晶体[001]方向10%的生长抑制。CA与GaA的联合使用分别将CA和GaA的作用能力提升8.3和15倍。
将抑制剂联合使用效果绘制在等效线图中,如图2所示。据图可知,没食子酸/柠檬酸联合使用表现出协同作用,且相比于抑制剂分子的单独作用,联合使用分别提升没食子酸性能近14倍,提升柠檬酸性能近7倍。
实施例3
邻苯三酚和柠檬酸的联合使用
在25ml的去离子水中,加入不同浓度的柠檬酸(CA)和邻苯三酚(PGA),接着监测晶体的生长过程,得到三个生长方向上邻苯三酚/柠檬酸联合使用在晶体生长的三个方向上的抑制百分比如表3所示。
表3邻苯三酚和柠檬酸组合对浓度及其实现的晶体生长抑制剂百分比
根据表中数据,当CA单独作用时,其在0.0108mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;PGA单独作用时,0.0021mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;但当CA与PGA联合使用时,0.0043mM的CA和0.0007mM的PGA联合作用,即可实现COM晶体[001]方向10%的生长抑制。CA与PGA的联合使用分别将CA和PGA的作用能力提升3和2.5倍。
将抑制剂联合使用效果绘制在等效线图中,如图3所示。据图可知,邻苯三酚/柠檬酸联合使用表现出协同作用,且相比于抑制剂分子的单独作用,联合使用分别提升邻苯三酚性能近3倍,提升柠檬酸性能近2.5倍。
实施例4
原儿茶酸和柠檬酸的联合使用
在25ml的去离子水中,加入不同浓度的柠檬酸(CA)和原儿茶酸(PrA),接着监测晶体的生长过程,得到三个生长方向上原儿茶酸/柠檬酸联合使用在晶体生长的三个方向上的抑制百分比如表4所示。
表4原儿茶酸和柠檬酸组合对浓度及其实现的晶体生长抑制剂百分比
根据表中数据,当CA单独作用时,其在0.0108mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;PrA单独作用时,0.0255mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;但当CA与PrA联合使用时,0.0006mM的CA和0.0020mM的PrA联合作用,即可实现COM晶体[001]方向10%的生长抑制。CA与PrA的联合使用分别将CA和PrA的作用能力提升12.8和18倍。
将抑制剂联合使用效果绘制在等效线图中,如图4所示。据图可知,原儿茶酸/柠檬酸联合使用表现出协同作用,且相比于抑制剂分子的单独作用,联合使用分别提升原儿茶酸性能近12倍,提升柠檬酸性能近17倍。
实施例5
药物组合物对CaOx结石形成的协同抑制
研究表明减少草酸钙结晶、晶体-细胞相互作用和细胞损伤在一定程度上可以防止结石的形成。在此基础上,本实施例进一步验证了柠檬酸(200μM)与多酚分子(20μM GaA,20μM EA,40μM PGA,200μM PrA)的药物组合物在减少细胞损伤和晶体粘附方面的联合作用效果。
为了探索药物组合物对减少晶体对细胞毒性的联合作用,本实施例选择直接暴露于 COM晶体的体外模型来检测细胞短期损伤。在有无抑制剂的培养液环境中,将成熟的人类近端小管细胞(HK-2)在指定时间内暴露在COM晶体悬浮培养基中。与对照组的HK-2细胞相比,暴露于COM晶体24小时后的细胞膜完整性降低,细胞内酯酶活性降低(图5)。但CA存在下,细胞死亡数量减少50%(图6)。此外,图6还表明了四种多酚分子与柠檬酸的药物组合物在提高细胞活性方面的协同作用,且协同增强顺序是:GaA>PcA>PGA>EA。
乳酸脱氢酶(LDH)是细胞膜破裂时向胞外释放的一种细胞质酶,因此LDH释放量可作为细胞膜完整性的标志。如图7所示,与对照组相比,直接暴露于COM晶体的细胞LDH释放增加到277.14%(±36.02%),当200μM CA存在时减少至195.17%(±2.46%)。而CA和GaA的组合物可使细胞LDH释放减少至110.87%(±8.67%),这也进一步揭示了CA与多酚组合在降低晶体毒性的协同作用效果。
晶体粘附不仅是细胞坏死的前提条件,也是触发晶体聚集的关键。因此,本实施例量化晶体粘附的数量考察了药物组合物对COM晶体体外粘附HK-2细胞的联合抑制作用(图8)。结果发现与没有抑制剂作用的空白组相比,200μM CA对COM晶体粘附的抑制效果达30%。而与多酚分子(GaA、EA、PGA或PrA)联用时,CA对晶体粘附数量的减少可达50%,并且EA/CA组合是对晶体粘附抑制最有效的抑制剂组合。
对比例1
与实施例1的区别仅在于,将鞣花酸替换为白蛋白,其他制备方法均与实施例1相同。
通过实验现象对比,发现白蛋白与柠檬酸的联合使用反而降低了柠檬酸的抑制性能。
对比例2
与实施例1的区别仅在于,将鞣花酸替换为邻羟基苯甲酸,其他制备方法均与实施例1相同。
通过实验现象对比,发现邻羟基苯甲酸与柠檬酸的联合使用反而降低了柠檬酸的抑制性能。
实施例6
鞣花酸和羟基柠檬酸的联合使用
在25ml的去离子水中,将溶液过饱和度控制在S=2.4,加入不同浓度的羟基柠檬酸(HCA)和鞣花酸(EA),监测晶体的生长过程,得到鞣花酸/羟基柠檬酸联合使用在晶体生长的三个方向上的抑制百分比如表5所示。
表5鞣花酸/羟基柠檬酸组合对浓度及其实现的晶体生长抑制剂百分比
*HCA指羟基柠檬酸,EA指鞣花酸。
根据表中数据,当HCA单独作用时,其在0.0088mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;EA单独作用时,0.0084mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;但当HCA与EA联合使用时,0.0007mM的HCA和0.0009mM的EA联合作用,即可实现COM晶体[001]方向10%的生长抑制。HCA与EA的联合使用分别将HCA和EA的作用能力提升12.6和9.3倍。
实施例7
没食子酸和羟基柠檬酸的联合使用
在25ml的去离子水中,加入不同浓度的羟基柠檬酸(HCA)和没食子酸(GaA),接着监测晶体的生长过程,得到三个生长方向上没食子酸/羟基柠檬酸联合使用在晶体生长的三个方向上的抑制百分比如表6所示。
表6没食子酸和羟基柠檬酸组合对浓度及其实现的晶体生长抑制剂百分比

根据表中数据,当HCA单独作用时,其在0.0088mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;GaA单独作用时,0.3716mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;但当HCA与GaA联合使用时,0.0010mM的HCA和0.0250mM的GaA联合作用,即可实现COM晶体[001]方向10%的生长抑制。HCA与GaA的联合使用分别将HCA和GaA的作用能力提升8.8和14.8倍。
实施例8
鞣花酸和柠檬酸钾的联合使用
在25ml的去离子水中,将溶液过饱和度控制在S=2.4,加入不同浓度的柠檬酸钾(KCA)和鞣花酸(EA),监测晶体的生长过程,得到鞣花酸/柠檬酸钾联合使用在晶体生长的三个方向上的抑制百分比如表7所示。
表7鞣花酸/柠檬酸钾组合对浓度及其实现的晶体生长抑制剂百分比

*KCA指柠檬酸钾,EA指鞣花酸。
根据表中数据,当KCA单独作用时,其在0.0106mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;EA单独作用时,0.0104mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;但当KCA与EA联合使用时,0.0008mM的KCA和0.0012mM的EA联合作用,即可实现COM晶体[001]方向10%的生长抑制。KCA与EA的联合使用分别将KCA和EA的作用能力提升13和8.8倍。
实施例9
没食子酸和柠檬酸钾的联合使用
在25ml的去离子水中,加入不同浓度的柠檬酸钾(KCA)和没食子酸(GaA),接着监测晶体的生长过程,得到三个生长方向上没食子酸/柠檬酸钾联合使用在晶体生长的三个方向上的抑制百分比如表8所示。
表8没食子酸和柠檬酸钾组合对浓度及其实现的晶体生长抑制剂百分比
根据表中数据,当KCA单独作用时,其在0.0106mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;GaA单独作用时,0.4677mM的浓度下,对晶体在[001]方向生长的抑制程度达到10%;但当KCA与GaA联合使用时,0.0012mM的KCA和0.0312mM的GaA联合作用,即可实现COM晶体[001]方向10%的生长抑制。KCA与GaA的联合使用分别将KCA和GaA的作用能力提升8.8和15倍。由此可见,柠檬酸钾与柠檬酸的作用效果几乎一致,柠檬酸盐的作用主要取决于柠檬酸根离子。
在本说明书的描述中,参考术语“一个实施例”、“一些实施例”、“示例”、“具体示例”、或“一些示例”等的描述意指结合该实施例或示例描述的具体特征、结构、材料或者特点包含于本公开的至少一个实施例或示例中。在本说明书中,对上述术语的示意性表述不必须针对的是相同的实施例或示例。而且,描述的具体特征、结构、材料或者特点可以在任一个或多个实施例或示例中以合适的方式结合。此外,在不相互矛盾的情况下,本领域的技术人员可以将本说明书中描述的不同实施例或示例以及不同实施例或示例的特征进行结合和组合。
申请人声明,以上所述仅为本发明的具体实施方式,但本发明的保护范围并不局限于此,所属技术领域的技术人员应该明了,任何属于本技术领域的技术人员在本发明揭露的技术范围内,可轻易想到的变化或替换,均落在本发明的保护范围和公开范围之内。

Claims (24)

  1. 一种药物组合物,其中,所述药物组合物包括A组分和B组分;
    其中,A组分包括碳原子数为6-14的多酚物质和/或在人体内可代谢为碳原子数为6-14的多酚物质;
    B组分包括柠檬酸、柠檬酸盐、柠檬酸衍生物或柠檬酸衍生物盐中的任意一种或至少两种的组合。
  2. 根据权利要求1所述的药物组合物,其中,所述碳原子数为6-14的多酚物质包括鞣花酸、没食子酸、邻苯三酚或原儿茶酸中的任意一种或至少两种的组合。
  3. 根据权利要求1所述的药物组合物,其中,所述在人体内可代谢为碳原子数为6-14的多酚的物质包括单宁酸、安石榴苷、没食子酰葡萄糖或酯型儿茶素中的任意一种或至少两种的组合。
  4. 根据权利要求1所述的药物组合物,其中,所述柠檬酸盐包括柠檬酸钾盐、柠檬酸钠盐或柠檬酸镁盐中的任意一种或至少两种的组合。
  5. 根据权利要求1所述的药物组合物,其中,所述柠檬酸衍生物包括羟基柠檬酸、柠檬酸衍生得到的酯类化合物或柠檬酸衍生得到的内酯化合物。
  6. 根据权利要求1所述的药物组合物,其中,所述柠檬酸衍生物盐包括羟基柠檬酸钾盐和/或羟基柠檬钠盐或羟基柠檬酸镁盐中的任意一种或至少两种的组合。
  7. 根据权利要求1所述的药物组合物,其中,在所述药物组合物中,所述A组分和B组分的摩尔比为0.0013~3.33:1。
  8. 根据权利要求1所述的药物组合物,其中,所述A组分和B组分的组合作用浓度配比根据各组分作用机理设定;
    所述A组分与B组分作用机理相同时,A组分:B组分摩尔比为0.0013~0.163:1;
    所述A组分与B组分作用机理相近时,A组分:B组分摩尔比为0.0023~0.025:1;
    所述A组分与B组分作用机理不同时,A组分:B组分摩尔比为1.77~3.33:1。
  9. 根据权利要求7或8所述的药物组合物,其中,所述药物组合物包括摩尔添加量为0-2μM的鞣花酸和摩尔添加量为0-0.5mM的B组分,且鞣花酸和B组分的添加量均不为0。
  10. 根据权利要求7或8所述的药物组合物,其中,所述药物组合物包括摩尔添加量为0-25μM的没食子酸和摩尔添加量为0-0.5mM的B组分,且没食子酸和B组分的添加量均不为0。
  11. 根据权利要求7或8所述的药物组合物,其中,所述药物组合物包括摩尔添加量为0-15mM的邻苯三酚和摩尔添加量为0-0.5mM的B组分,且邻苯三酚和B组分的添加量均不为0。
  12. 根据权利要求7或8所述的药物组合物,其中,所述药物组合物包括摩尔添加量为0-0.55mM的原儿茶酸和摩尔添加量为0-0.5mM的B组分,且原儿茶酸和B组分的添加量均不为0。
  13. 根据权利要求1所述的药物组合物,其中,所述药物组合物还包括药学上可接受的载体或赋形剂。
  14. 根据权利要求13所述的药物组合物,其中,所述载体包括脂质体、胶束、树枝状大分子、微球或微囊中的任意一种或至少两种的组合。
  15. 根据权利要求13所述的药物组合物,其中,所述赋形剂包括润湿剂、粘合剂或崩解剂中的任意一种或至少两种的组合。
  16. 根据权利要求1所述的药物组合物,其中,所述药物组合物的制剂类型为复方制剂。
  17. 根据权利要求1所述的药物组合物,其中,所述药物组合物的制剂类型为A组分单独的制剂和B组分单独的制剂。
  18. 根据权利要求17所述的药物组合物,其中,所述单独的制剂的给药方式包括同时给药、分别给药或依次给药。
  19. 根据权利要求1所述的药物组合物,其中,所述药物组合物的剂型包括药剂学上可接受的任一剂型。
  20. 根据权利要求1所述的药物组合物,其中,所述剂型包括片剂、颗粒剂、冲剂、散剂、胶囊剂或注射剂中的任意一种。
  21. 权利要求1-20任一项所述的药物组合物在制备预防和/或治疗肾结石药物中的应用。
  22. 权利要求1-20任一项所述的药物组合物在制备草酸钙一水合物晶体生长抑制剂中的应用。
  23. 权利要求1-20任一项所述的药物组合物在预防和/或治疗肾结石中的应用。
  24. 一种预防和/或治疗肾结石的方法,其中,所述方法包括:
    向患有或疑似患有肾结石的受试者施用有效量的权利要求1-20任一项所述的药物组合物。
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