阅读说明：本技术 一种治疗及预防眼科疾病的药物及其应用 (Medicine for treating and preventing ophthalmic diseases and application thereof ) 是由 郭涛 范先群 范宇晨 郭丽 彭玉豪 魏嘉洪 于 2018-06-13 设计创作，主要内容包括：本发明涉及医药技术领域。一种治疗及预防眼科疾病的药物,其特征在于：所述药物中含有蛇床子素和/或蛇床子素的衍生物。本发明通过蛇床子素及其衍生物治疗部分眼科疾病,为眼科相关的纤维化等细胞外基质蛋白异常的疾病提供新的治疗思路。本发明的药物,可用于治疗及预防细胞外基质蛋白异常导致的眼科疾病。所述眼科疾病可以为青光眼。所述眼科疾病可以为结膜瘢痕化、假性上睑下垂、眼部皮肤疤痕、老年性黄斑变性、糖尿病视网膜病变或后发性白内障。所述眼科疾病可以为小梁网切除术后滤过道疤痕化导致的手术治疗失败及小梁网切除术后滤过道疤痕化。(The invention relates to the technical field of medicines. A medicament for the treatment and prevention of ophthalmic diseases, characterized by: the medicine contains osthole and/or osthole derivatives. The invention treats partial ophthalmic diseases through the osthole and the derivatives thereof, and provides a new treatment idea for diseases of extracellular matrix protein abnormality such as fibrosis related to ophthalmology. The medicine of the present invention may be used in preventing and treating eye diseases caused by extracellular matrix protein abnormality. The ophthalmic disease may be glaucoma. The ophthalmic disease may be conjunctival scarring, pseudoptosis, ocular skin scarring, age-related macular degeneration, diabetic retinopathy or secondary cataract. The ophthalmic disease can be surgical treatment failure caused by filter channel scarring after trabeculectomy and filter channel scarring after trabeculectomy.)

1. A medicament for the treatment and prevention of ophthalmic diseases, characterized by: the medicine contains osthole and/or osthole derivatives.

2. The agent for the treatment and prevention of ophthalmic diseases according to claim 1, characterized in that: the medicine is any one of tablets, capsules, pills, oral liquid, injection, eye drops, eye ointment and external ointment.

3. The agent for the treatment and prevention of ophthalmic diseases according to claim 1, characterized in that: the injection is prepared by intravenous injection, intramuscular injection, subcutaneous injection, periocular injection, retrobulbar injection, subconjunctival injection, scleral injection or intraocular injection.

4. The agent for the treatment and prevention of ophthalmic diseases according to claim 1, characterized in that: the medicine is eye ointment or eye drop, and the concentration of the osthole and/or osthole derivative is 10 mu mol/l-10 mmol/l.

5. The agent for the treatment and prevention of ophthalmic diseases according to claim 4, characterized in that: the concentration of the osthole and/or the osthole derivative is 20-100 mu mol/l.

6. The agent for the treatment and prevention of ophthalmic diseases according to claim 1, characterized in that: the medicine is intraocular injection, subconjunctival injection, scleral injection, intravitreal injection or intracameral injection, and the concentration of the osthole and/or osthole derivative is 20-100 mu mol/l.

7. The agent for the treatment and prevention of ophthalmic diseases according to claim 1, characterized in that: the medicine contains auxiliary materials.

8. Use of a medicament for the treatment and prevention of ophthalmic diseases according to claims 1 to 7, characterized in that it is used for the treatment and prevention of ophthalmic diseases caused by abnormalities of extracellular matrix proteins.

9. The use of a medicament for the treatment and prevention of ophthalmic diseases according to claim 8, wherein the ophthalmic diseases are glaucoma, conjunctival scarring, pseudoptosis, ocular skin scarring, age-related macular degeneration, diabetic retinopathy or secondary cataract.

10. The use of a medicament for the treatment and prevention of an ophthalmic disease according to claim 8, wherein the ophthalmic disease is surgical treatment failure due to scarring of the filter passage after trabeculectomy and scarring of the filter passage after trabeculectomy.

Technical Field

The invention relates to the technical field of medicines, in particular to an ophthalmic medicine.

Background

In various proliferative diseases common to ophthalmology, although the pathogenesis, treatment mode and prognosis are different, the common aspect is that the activation and stimulation of a plurality of cells and cytokines cause the abnormality of extracellular matrix proteins, so that the migration and proliferation of the cells cause great difficulty in clinical treatment and prognosis.

The diseases of primary open-angle glaucoma, scar formation of a filtering bleb after glaucoma operation, proliferative vitreoretinopathy, proliferative diabetic retinopathy, after-cataract and the like are common proliferative pathological changes in ophthalmology. Although their pathogenesis, treatment pattern and prognosis vary from one to another, they have in common that many cells and cytokines are involved together in the development and progression of lesions, and the activation and stimulation of inflammatory factors in lesion areas causes abnormalities in extracellular matrix proteins, resulting in the migration and proliferation of cells, which poses great challenges to the clinical work and surgical prognosis of ophthalmologists.

1. In primary open angle glaucoma, pathological changes in the aqueous humor outflow pathway, particularly changes in the trabecular meshwork, which are closely related to the fibrosis of the trabecular meshwork and thickening, narrowing or occlusion of the trabecular meshwork caused by abnormal accumulation of extracellular matrix proteins of trabecular meshwork cells, such as Fibronectin (FN) Laminin (LA), cause obstruction of aqueous humor outflow and increase in intraocular pressure. In addition, some cytokines secreted by trabecular meshwork, such as Transforming Growth Factor-beta 2 ((TGF-beta 2), etc., affect outflow of aqueous humor to varying degrees, current treatments for glaucoma are limited to relieving symptoms by lowering intraocular pressure, clinically commonly used ocular hypotensive drugs can be classified into two major categories by their mechanism of action, inhibiting aqueous humor formation and promoting aqueous outflow via the uveoscleral pathway, glaucoma surgery focuses on creating pathways to increase the rate of aqueous outflow, these treatments are characterized by their lack of direct treatment for the pathological mechanism of obstruction of aqueous outflow of the trabecular meshwork of glaucoma, which can be said to be temporary or permanent, and thus must be administered for life by the patient, and further, as pathological changes in the trabecular meshwork continue to worsen, these treatments generally decrease in efficacy over the years of treatment, thus, intraocular pressure cannot be effectively controlled, so that patients must be treated with a combination of various drugs and surgery.

2. The most common surgical mode for glaucoma is trabeculectomy, but at present, some problems still exist to influence the success rate of the surgery, most common is proliferation of fibers of the Tenon's capsule in a post-operative filtration area, and extracellular matrix protein is abnormal, so that scarring of a filtration passage is caused, normal circulation of aqueous humor through the filtration passage is blocked, and intraocular pressure cannot be reduced. It has been found that the main causes of scarring of the filter channel after glaucoma surgery are proliferation, contraction and migration of the Tenon's follicle fibroblasts in the filter region, increased extracellular matrix synthesis, and in addition, many cytokines are involved in and induce proliferation of fibroblasts. Therefore, antimetabolites such as mitomycin C, 5-fluorouracil, etc. are used to prevent scarring of the filter channel during surgery, but these drugs may still cause a series of complications such as post-operative bleb leakage, corneal edema, conjunctival, scleral necrosis, endophthalmitis, etc. Thus, drugs such as MMC and 5-FU remain deficient in preventing scarring of the filter corridor after glaucoma surgery.

3. The cataract patients obtain more obvious curative effect by ultrasonic emulsification and suction combined artificial lens implantation, and the vision of most patients is improved to different degrees compared with the vision before operation. However, the remaining part of the anterior lens capsule and the intact posterior lens capsule in the operation can cause the proliferation, migration and differentiation of the residual lens epithelial cells to generate fibrosis of the anterior lens capsule, and the fibrosis is transformed into fibroblasts, which can cause the formation of posterior cataract, and is one of the common complications after cataract operation. In the process, the balance between transforming growth factor beta (TG F-beta) and basic fibroblast growth factor is destroyed, the former regulates the epithelial-mesenchymal transdifferentiation of lens epithelial cells, makes extracellular matrix protein abnormal, and cystic fibrosis; the latter regulates the regeneration of lens structure and cell proliferation, and becomes the main reason for influencing the visual function of patients after cataract operation. YAG laser can treat the posterior cataract, but complications such as inflammation, increased intraocular pressure, intraocular lens injury, macular edema, retinal detachment and the like can still be caused. There is still a need to find more effective methods and drugs for preventing and treating the development of secondary cataract.

4. Proliferative Vitreoretinopathy (PVR) is a common proliferative disorder in ophthalmology, and can cause proliferative disorders after trauma, diabetes, retinal detachment, and the like. Its main pathological features are retinal pigment epithelial cell and glial cell proliferation, abnormalities in extracellular matrix proteins, and concomitant formation of subretinal and preretinal fibrocyte membranes. After the retina is damaged, Retinal Pigment Epithelial (RPE), glial cells, macrophages and the like migrate under the action of cytokines and gather in the vitreous cavity and under the retina, and in the process, the cells undergo phenotypic transformation to form a fibrous proliferation membrane with a contraction function, and finally the retina is detached. At present, the surgical excision of the proliferation membrane can obviously improve the success rate of the surgery, but the postoperative vision of many patients is not ideal. Especially, severe PVR is not ideal in both surgical mode and postoperative condition, and multiple operations are often needed. In recent years, many scholars research gene therapy of PVR, but the vector has not been completely applied to clinic due to the incomplete technology, poor targeting and tissue specificity of the vector, low transduction success rate and safety problems. As can be seen, the proliferation disorders after ophthalmic surgery pose a significant challenge to the clinical treatment of ophthalmologists, and therefore, many scholars have attempted to find safer and more effective drugs that can prevent and treat the proliferation disorders.

Disclosure of Invention

The object of the present invention is to provide a drug for the treatment and prevention of ophthalmic diseases, which is useful for the prevention or treatment of the above-mentioned ophthalmic diseases.

The present invention also provides the use of the above-mentioned medicament for the treatment and prevention of ophthalmic diseases.

The technical problem solved by the invention can be realized by adopting the following technical scheme:

a medicament for the treatment and prevention of ophthalmic diseases, characterized by: the medicine contains osthole and/or osthole derivatives.

Further, the medicine is any one of tablets, capsules, pills, oral liquid, injection, eye drops, eye ointment and external ointment. Furthermore, the injection is prepared by intravenous injection, intramuscular injection, subcutaneous injection, periocular injection, retrobulbar injection, subconjunctival injection, scleral injection or intraocular injection.

Further, the medicine is eye ointment or eye drop, and the concentration of the osthole and/or the osthole derivative is 10 mu mol/l to 10 mmol/l. Still further, the concentration of the osthole and/or the osthole derivative is 20-100 mu mol/l.

Furthermore, the medicine is intraocular injection, subconjunctival injection, scleral injection, intravitreal injection or intracameral injection, and the concentration of the osthole and/or the osthole derivative is 20-100 mu mol/l.

The medicine also contains auxiliary materials. The auxiliary materials are pharmaceutically acceptable auxiliary materials.

The medicine for treating and preventing ophthalmic diseases can be used for treating and preventing ophthalmic diseases caused by extracellular matrix protein abnormality.

The ophthalmic disease may be glaucoma.

The ophthalmic disease may be conjunctival scarring, pseudoptosis, ocular skin scarring, age-related macular degeneration, diabetic retinopathy or secondary cataract.

The ophthalmic disease can be surgical treatment failure caused by filter channel scarring after trabeculectomy and filter channel scarring after trabeculectomy.

Drawings

FIG. 1 is a bar graph of FN expression levels in different experimental groups in experiment 1;

FIG. 2 is a bar graph of the expression levels of Col-IV in different experimental groups in experiment 1;

FIG. 3 is a bar graph of LN expression levels for different experimental groups in experiment 1;

FIG. 4 is a graph showing the results of the experiment of the cell viability of the first day samples under the effect of different concentrations of osthole in experiment 1;

FIG. 5 is a graph showing the results of the experiment of the cell viability of the fourth day sample under the effect of different concentrations of osthole in experiment 1;

FIG. 6 is a graph showing the results of the experiment of cell viability of the seventh day sample under the effect of different concentrations of osthole in experiment 1;

FIG. 7 is a graph showing the results of the experiment 1 on the first day of cell survival when dexamethasone was added to the samples under the action of osthole with different concentrations;

FIG. 8 is a graph showing the results of the experiment 1 in which different concentrations of osthole were added to the samples for the survival rate on the fourth day;

FIG. 9 shows the results of the experiment of the cell viability of the sample at the seventh day when dexamethasone was added to the sample at different concentrations of osthole in experiment 1;

FIG. 10 shows the results of the intervention of osthole in experiment 2 on intraocular pressure in model mouse with high intraocular pressure;

FIG. 11 shows the results of the treatment of ocular hypertension in mice model with osthole of experiment 2.

Detailed Description

In order to make the technical means, the creation characteristics, the achievement purposes and the effects of the invention easy to understand, the invention is further described with the specific drawings.

A medicine for treating and preventing ophthalmology diseases contains osthole and/or osthole derivatives. The osthole and the derivatives thereof are used for treating partial ophthalmic diseases, and a new treatment idea is provided for diseases related to ophthalmic diseases such as fibrosis and other extracellular matrix protein abnormalities. The medicine can be used for treating and preventing ophthalmic diseases caused by extracellular matrix protein abnormality. The ophthalmic disease may be glaucoma. The ophthalmic disease can be conjunctival scarring, pseudoptosis, scar of eye skin, age-related macular degeneration, diabetic retinopathy or secondary cataract. The ophthalmic diseases can be surgical treatment failure caused by filter channel scarring after trabeculectomy and filter channel scarring after trabeculectomy.

Experiment 1

1. Cell plating: human Normal Trabecular mesh Cells (NTM) were cultured with F12 containing 10% Fetal Bovine Serum (FBS), and when the well-grown human Normal Trabecular mesh Cells fused to 75% -80%, the Cells were trypsinized and plated into 6-well plates with 2ml of culture medium.

2. Grouping experiments: the normal culture of human normal trabecular meshwork cells is used as a blank control group, the human normal trabecular meshwork cells are added with dexamethasone to be used as an experimental control group, and the human normal trabecular meshwork cells are added with the dexamethasone and the osthole with different concentrations to be used as an experimental group. (the concentration of dexamethasone in the culture solution of the experimental control group and the experimental group is 10-7mol/l, and the concentration of osthole is 1, 3, 10, 30 and 100 mu mol/l respectively), and culturing the trabecular meshwork cells to the 0 th, 3 th, 6 th, 12 th, 24 th and 48 th hours. Dexamethasone induces the increase of the expression levels of transforming growth factor beta (TGF beta), Fibronectin (FN), type IV collagen (COL-IV), Laminin (LN) and the like in cells, and causes the fibrosis of the cells. Fibrosis is induced by dexamethasone to mimic the development of ophthalmic disease.

3. And (3) detecting the extracellular matrix protein gene and protein secretion of the trabecular meshwork: designing primer sequences of Laminin (LN), collagen type IV (Col-IV) and Fibronectin (FN) genes, and detecting messenger RNA expression of LN, COL-IV and FN by RT-PCR; the expression level of extracellular matrix proteins of the trabecular meshwork was detected by ICC using Anti-LN, Anti-Col-IV, Anti-FN antibodies, as shown in FIG. 1, FIG. 2, FIG. 3, FIG. 4, FIG. 5, FIG. 6, FIG. 7, FIG. 8, and FIG. 9.

And (4) experimental conclusion: the expression level of TGF beta, FN, COL-IV and LN is reduced after osthole stem prognosis. Therefore, osthole and its derivatives can inhibit the fibrosis of trabecular meshwork cells, and can treat or prevent ophthalmic diseases caused by cell fibrosis.

Experiment 2

1. Dissolving osthole powder in physiological saline to obtain 30mg/kg solution;

2. selecting male Balb/cJ mice 8-12 weeks old and 10-15 g in weight, and all meeting the first-class animal standard. The breeding method is characterized in that the breeding room temperature is 15-20 ℃, the relative humidity is 55-75%, the illumination is maintained for 12 hours, and drinking water is freely taken. Inclusion criteria were: there is no eye disease. The direct light reflection and the indirect light reflection of the pupils of the two eyes are normal;

3. measuring the intraocular pressure of the left eye and the intraocular pressure of the right eye of each mouse in a waking state, and recording;

4. measuring the weight of each mouse, and anesthetizing the mouse by adopting a 4% chloral hydrate intraperitoneal injection mode, wherein the anesthetic dose is 10 mu l/g;

5. injecting TGF beta 2 over-expression adenovirus into the vitreous cavity of a model mouse, wherein the injection dose is 3 mu l, the concentration is 3 multiplied by 107 pfu/mu l, and injecting no-load adenovirus with the same dose and concentration into the vitreous cavity of the contralateral eye;

6. after modeling, the medicine is randomly divided into a model group (n is 6), a osthole pretreatment group (n is 10), an osthole treatment group (n is 10) and a normal control group (n is 6), wherein the osthole pretreatment group starts to administer the medicine immediately after the modeling, the osthole treatment group starts to administer the medicine immediately after the intraocular pressure of the model group is increased and is in a stable state, and the medicine is injected into the abdominal cavity according to 30mg/kg of osthole for 1 time per day.

7. Measure mouse intraocular pressure once on the molding day, measure mouse intraocular pressure once the second day after the molding, measure mouse intraocular pressure once every a period of time later, avoid causing the damage because of the too frequent mouse eye cornea that leads to of intraocular pressure measurement, in addition, the celiac injection osthole should be after measuring mouse intraocular pressure every day, avoid because the administration causes the influence to the intraocular pressure, measure the intraocular pressure every time and go on in same time quantum in addition, avoid changing round the clock to cause the influence to mouse intraocular pressure.

The results of the osthole intervention on the intraocular pressure of the mouse model with high intraocular pressure are shown in figure 10: on the 10 th day after osthole drying, the intraocular pressure of the intervention group is lower than that of the model group.

Results of osthole treatment on ocular hypertension model mice ocular pressure, see fig. 11: on day 8 after osthole treatment, the intraocular pressure in the treated group was lower than that in the model group.

As a preferable scheme, the medicine can be any one of tablets, capsules, pills, oral liquid, injection, eye drops, eye ointment and external ointment. The injection is preferably intravenous injection, intramuscular injection, subcutaneous injection, periocular injection, retrobulbar injection, subconjunctival injection, scleral injection or intraocular injection. When the medicine is eye ointment or eye drop, the concentration of osthole and/or osthole derivative is 10 mu mol/l-mmol/l. More preferably, the concentration of osthole and/or osthole derivative is 20 to 100. mu. mol/l. When the medicine is intraocular injection, subconjunctival injection, scleral injection, intravitreal injection or intracameral injection, the concentration of the osthole and/or osthole derivative is 20-100 mu mol/l. The medicine is tablet, capsule, pill, and the mass of osthole and/or osthole derivative is preferably above 0.3g/g, more preferably 0.4g/g-0.5 g/g.

As a preferable scheme, the medicine is eye drop, the eye drop comprises the following raw materials, 5 mmol/l-10 mmol/l osthole, 2 mmol/l-5 mmol/l cassia seed, 1 mmol/l-3 mmol/l ginkgo leaf, 0.5 mmol/l-1 mmol/l honeysuckle, 1 mmol/l-2 mmol/l pilocarpine, and the balance of selenium-enriched spring water, and the pH value is adjusted to 7.3-7.5 by sodium hydroxide or hydrochloric acid. The prescription of the eye drop is optimized, so that the treatment effect on eye diseases is realized. In the invention, cassia seed: is bitter, sweet and cool in nature, and has the functions of clearing liver fire, dispelling wind-damp, tonifying kidney, improving eyesight and the like; honeysuckle flower: clearing away heat and toxic material, and cooling and dispersing wind heat, and can be used for treating carbuncle, furuncle, and larynx arthralgia, erysipelas, and heat-toxin bloody dysentery, and has the following effects: has the effects of clearing away heat and toxic materials, dredging meridian passage, broad-spectrum antibacterial and antivirus, and has the functions of traditional Chinese medicine antibiotics and ginkgo leaf: sweet, bitter and astringent in nature and taste, and has the effects of benefiting the heart, astringing the lung, eliminating dampness, stopping diarrhea, relieving asthma, promoting blood circulation, removing blood stasis, relieving pain and the like; pilocarpine can lower intraocular pressure by dilating small blood vessels around the canal and contracting ciliary muscles, possibly followed by a change in trabecular meshwork structure, and can help alleviate or eliminate the symptoms of glaucoma. Selenium-rich mountain spring water protects cell membranes from oxidative damage; the selenium-P protein in the selenium-rich mountain spring water actually has a series of toxicants such as chelated heavy metals and the like, and can reduce the toxicity of the toxicants.

More preferably, the eye drop comprises the following raw materials, by mass, 8mmol/l of osthole, 3mmol/l of cassia seed, 1.5mmol/l of ginkgo leaf, 0.5mmol/l of honeysuckle, 2mmol/l of pilocarpine and the balance of selenium-enriched spring water, and the pH value of the eye drop is adjusted to 7.4 by using sodium hydroxide or hydrochloric acid. The medicines are reasonably compatible and complement each other, have the effects of supplementing qi and nourishing yin, and promoting blood circulation and diuresis, and have the properties of nature, taste and meridian tropism of four-qi and five-flavor medicines according to the dialectical traditional medical theory of treatment and the exterior-interior relationship of the collaterals of internal organs and meridians of human body, so that the medicines can directly conduct the efficacy and efficacy of medicines in eyes to treat glaucoma, dredge blood vessels of eyes in the body, dredge blood vessels, dredge meridians and collaterals, and automatically eliminate pain of diseases, so that the diseases are recovered, and the aim of treating both principal and secondary aspects of diseases is fulfilled.

As another preferable mode, the medicine is an eye drop, the eye drop comprises the following raw materials, by mass, 0.2% of disodium hydrogen phosphate, 0.75% of sodium chloride, 0.01% of disodium edetate, 0.01% of benzalkonium chloride, 0% -0.3% of hydroxypropyl methyl cellulose, 0.05% of polysorbate, 0.01% -1% of osthole or a derivative of osthole, and the balance of purified water, and the pH value of the solution is adjusted to 7.0-7.6, preferably 7.4 by using sodium hydroxide or hydrochloric acid. In the formula, disodium hydrogen phosphate is a buffering agent, sodium chloride is a penetrating agent, and disodium ethylene diamine tetraacetate is a preservative; polysorbates are surfactants. Since the osmotic pressure of the methylcellulose aqueous solution is the same as that of tears, it is less irritating to the eyes and is added to ophthalmic drugs as a lubricant for contact with the eye lens. Thus, hydroxypropyl methylcellulose is preferred, preferably in an amount of 0.1% to 0.3%.

The foregoing shows and describes the general principles and broad features of the present invention and advantages thereof. It will be understood by those skilled in the art that the present invention is not limited to the embodiments described above, which are described in the specification and illustrated only to illustrate the principle of the present invention, but that various changes and modifications may be made therein without departing from the spirit and scope of the present invention, which fall within the scope of the invention as claimed. The scope of the invention is defined by the appended claims and equivalents thereof.