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ÁÆÐ§¸ü³Ö¾ÃµÄÐÂÐÍ¿¹¹Ø½ÚÑ×Ò©Îï http://www.dxy.cn/bbs/post/view? ... 1&tpg=1&age New engineered drug may offer prolonged arthritis relief Ò»ÖÖÄܹ»¸ü³¤Ê±¼ä»º½â¹Ø½ÚÑ×ÌÛÍ´µÄÐÂÒ©. DURHAM, N.C. -- Researchers at Duke University have devised a new way to significantly prolong the effects of an anti-inflammatory drug, potentially making it useful for providing longer-lasting treatment for osteoarthritis, the most common form of arthritis. Duke UniversityµÄÑо¿ÈËÔ±·¢Ã÷ÁËÒ»ÖÖÐµĹ»ÏÔÖøÑÓ³¤¿¹Ñ×Ò©Îï×÷ÓõÄÒ©ÎÔڹǹؽÚÑ×£¨×îΪ³£¼ûµÄ¹Ø½ÚÑ×£©ÖÎÁÆ·½Ãæ¾ßÓÐDZÔÚÓÃ;¡£ The modified drug, which would be injected directly into arthritic joints, could last for several weeks rather than just the few hours the unmodified drug would last, the researchers said. Ñо¿ÈËÔ±³Æ¾¹ý¸ÄÁ¼µÄÒ©Îï¿ÉÒÔÖ±½Ó×¢ÉäÈ뻼²¡¹Ø½Ú£¬Ò©Ð§¿É³ÖÐøÊýÖÜ£¬¶øÔÐÍÒ©Îï½öÄÜά³Ö¼¸Ð¡Ê±¡£ In their study, the researchers modified a drug called interleukin-1 receptor antagonist (IL1RA). They found that the drug, which is a protein, could be improved by attaching a second protein that clumps together at normal body temperatures. The combined drug likewise would assemble into clumps in the body to serve as "drug depots" that gradually release active drug particles, the researchers said. ÔÚÑо¿ÖУ¬Ñо¿ÈËÔ±¸ÄÁ¼ÁËIL-1ÊÜÌåÞ׿¹¼Á¡£ËûÃÇÔÚIL-1ÊÜÌåÞ׿¹¼ÁÉÏÁ´½ÓÁËÒ»¸öÑǵ°°×£¬ÕâÖÖÑǵ°°×ÔÚÕý³£ÌåÎÂϳɴشæÔÚ¡£¡°ÕâÖÖ»ìºÏÒ©ÎïͬÑù½«»áÔÚÌåÄڳɴشæÔÚ£¬ÓÌÈç¡°Ò©Îï´¢²ØÊÒ¡±£¬Öð½¥ÊÍ·ÅҩЧ¡£¡±Ñо¿ÈËԱ˵¡£ "Although the conventional drug is being used for autoimmune diseases, no one yet knows how much of it would be needed to achieve a therapeutic effect for osteoarthritis," said Lori Setton, associate£¨¸±µÄ£© professor of biomedical engineering and surgery. "Current estimates suggest it would require perhaps two injections per week of the unmodified drug. ¡°¾¡¹ÜÔÐÍÒ©ÎïÒѾÔÚÓÃÓÚÖÎÁÆ×ÔÉíÃâÒßÐÔ¼²²¡£¬µ«ÊÇûÈËÖªµÀÖÎÁƹǹؽÚÑ×µÄ×î¼ÑÓÃÁ¿¡±Lori Setton£¨ÉúÎïҽѧ¹¤³ÌºÍÍâ¿Æ½ÌÊÚ£©Ëµ£¬¡°Ä¿Ç°½¨ÒéÿÖÜ×¢ÉäÁ½´Î¡£¡± "With this advance, we believe treatments could go from twice a week to perhaps twice a month, and that would be a huge clinical gain," she said. ¡°¾ÍÐÂÒ©À´Ëµ£¬ÎÒÃÇÏàÐÅÓ÷¨»á´ÓÿÖÜÁ½´Î¿ªÊ¼ÉõÖÁÄܴﵽÿÔÂÁ½´Î£¬ÕâÔÚÁÙ´²ÉÏÓкܴóµÄ¼ÛÖµ¡£¡±Ëý˵¡£ By remaining at the site of disease, the drug also might cause fewer negative side effects than the unmodified drug, the researchers added. ÕâÖÖÐÂÒ©³¤ÆÚʹÓñÈÔÐÍÒ©¸±×÷ÓøüС£¬Ñо¿Õ߳ơ£ The team reported an initial proof-of-concept study¼ÙÉè֤ʵÑо¿ on Saturday, Oct. 14, at the Biomedical Engineering Society annual meeting, in Chicago. The team also has reported related findings online in the Journal of Controlled Release. Ñо¿ÍŶÓÓÚÊ®ÔÂ14ÈÕÖÜÁùµÄÔÚÖ¥¼Ó¸çhe Biomedical Engineering SocietyÄê»áÉϹ«²¼ÁËËûÃǵÄÒ»Ïî×î³õµÄ¼ÙÉè֤ʵÑо¿£¬Í¬Ê±Ò²Áª»úÔÚ the Journal of Controlled Release.¹«²¼ÁËËûÃǵÄÏà¹ØÑо¿¡£ The work was supported by a Coulter Foundation Translational Research Partnership award to the biomedical engineering department at Duke's Pratt School of Engineering, and by the National Institutes of Health and a United Negro College Fund-Merck graduate dissertation fellowship. Ñо¿µÄÔÞÖúÕߣ¨Ê¡ÂÔδ·Ò룩¡£ Osteoarthritis is a degenerative joint disease that affects an estimated 21 million adults in the United States. It is the nation's most prevalent musculoskeletal disorder and the leading cause of disability, the researchers said, adding that as the average age of the population continues to rise, the incidence of osteoarthritis will increase. " ¹Ç¹Ø½ÚÑ×ÊÇÒ»ÖֹؽÚÍËÐб䣬ÔÚÃÀ¹ú¹À¼ÆÓÐ2.1ÒÚ»¼²¡£¬ÊÇ×îÆÕ±éµÄ¼¡Èâ¹Ç÷ÀÒì³£µÄÖ²ÐÔÒò£¬Ñо¿Õß˵£¬Ëæ×ÅÀÏÄêÈ˿ڵÄÔö¶à£¬¹Ç¹Ø½ÚÑ×ÒཫÔö¶à¡£ Osteoarthritis had been attributed primarily to the gradual wear and tear of joint surfaces. More recently, however, scientists have discovered that inflammation sparked by the immune system also plays an important role in the worsening of the disease. . ¹Ø½ÚÑ×Ò»Ö±±»ÈÏΪÓÉÓڹؽڱíÃæµÄÖð½¥Ä¥Ëð¶ÏÁÑÒýÆð¡£×î½ü£¬¿ÆÑ§¼Ò·¢ÏÖÃâÒßϵͳÒýÆðµÄÑ×Ö¢ÔÚ²¡Çé¶ñ»¯ÖÐÆðÖØÒª×÷ÓᣠSpecifically, scientists have linked a key molecule involved in inflammation, called interleukin-1 (IL-1), to osteoarthritis. IL-1 heightens the activity of enzymes that damage joints by breaking down their collagen "framework," Setton explained. She credits team member Virginia Kraus, professor of rheumatology and immunology at Duke University Medical Center, for focusing on IL-1 as a major mediator of osteoarthritis in the joint. ¿ÆÑ§¼ÒÃǽ«Ñ×Ö¢ÖеĹؼü·Ö×ÓIL-1Óë¹Ç¹Ø½ÚÑ×ÏàÁªÏµ¡£IL-1¿ÉÒÔͨ¹ýÆÆ»µ¹Ç½ºÔ¿ò¼ÜÀ´Ìá¸ßËðÉ˹ؽڵÄøµÄ×÷Óã¬Setton½âÊÍ¡£ËýÔÞͬÍŶӳÉÔ±Virginia Krau£¨ Duke University Medical Center·çʪ²¡ºÍÃâÒßѧ½ÌÊÚ£©¹Ø×¢IL-1×÷Ϊ¹Ç¹Ø½ÚÑ×ÖÐÖ÷Òª½éÖÊ¡£ Given the immune system's suspected role in osteoarthritis, scientists have suspected that the interleukin-1 receptor antagonist drug, which is known to block IL-1 activity, might have value in diminishing the severity of osteoarthritis, said Mohammed Shamji, a neurosurgery resident pursuing his Ph.D. in Setton's laboratory. ¼øÓÚÃâÒßϵͳÔڹǹؽÚÑ×ÖеÄÒÉËÆ×÷Ó㬿ÆÑ§¼ÒÃDzÂÏëIL-1ÊÜÌåÞ׿¹¼ÁÔÚ¼õÇá¹Ç¹Ø½ÚÑ×ÑÏÖØÐÔ·½Ãæ»áÓÐ×÷Óã¬Mohammed Shamj˵£¨Setton'sʵÑéÊÒ²©Ê¿Ñо¿Éú£© However, trials of IL1RA for osteoarthritis have had limited success, primarily because the drug tends to break down quickly, according to the researchers. È»¶øIL-1ÊÜÌåÞ׿¹¼ÁÖÎÁƹǹؽÚÑ×µÄÁÙ´²ÊµÑé½öÈ¡µÃÓÐÏ޳ɹ¦£¬Ñо¿ÈËÔ±ÈÏΪÖ÷ÒªÊÇÒòΪҩÎï´úл̫¿ì¡£ "Physicians can inject large amounts of this drug systemically, but it's cleared very rapidly and there is no evidence that it reaches the joint space," said Helawe Betre, who performed these studies for his doctoral work at Duke and now works at Zimmer Orthobiologics. "We set out to develop a modified version of the drug that when injected directly might stay in the joint long enough to be effective." ¡°Ò½ÉúÃǸø²¡ÈË´ó¼ÆÁ¿×¢ÉäIL-2ÊÜÌåÞ׿¹¼Á£¬È»¶øËü´úлºÜ¿ì²¢ÇÒÒ²²»ÖªÊÇ·ñÄܵ½´ï¹Ø½Ú£¬¡±Helawe Betre˵£¬¡°ÎÒÃÇ¿ªÊ¼Ñо¿Ò»ÖָĽøÐ͵ÄÒ©ÎÕâÖÖÒ©ÎïÄܹ»Ö±½Ó×¢ÉäÈë¹Ø½Ú²¢ÇÒ´æÔÚ×ã¹»³¤Ê±¼ä¡£ To build in such durability, Betre turned to a class of proteins called elastin-like polypeptides (ELPs). Once ELPs in solution reach a certain threshold temperature, they assemble into protein aggregates. Study collaborator Ashutosh Chilkoti, a professor of biomedical engineering at the Pratt School, previously had investigated the use of ELPs that clump at temperatures higher than normal body temperature for treating cancers. ΪÁË´ïµ½³Ö¾ÃÁÆÐ§£¬Beter¿ªÊ¼¹Ø×¢Ò»ÖÖ½Ð×öµ¯ÐÔ¶àëĵĵ°°×ÖÊ£¨ELPs£©¡£µ±ÕâÖÖµ°°×ÖÊ´ïµ½ãÐζÈʱ£¬±ã»á¾Û¼¯³É¾ÛºÏÌå¡£Ñо¿ºÏ×÷ÕßAshutosh Chilkoti£¨Pratt SchoolÉúÎïҽѧ¹¤³Ì½ÌÊÚ£©Ôø¾Ñо¿¹ýELPsÔÚ°©Ö¢ÖÎÁÆÖеÄÑо¿£¬ELPs¾Û¼¯µÄζȸßÓÚÕý³£ÌåΡ£ ELPs aren't recognized by the body's immune system as foreign substances, and thus they have some unique advantages for biomedical applications, according to the researchers. Also, ELPs can be joined directly to genes that control the production of various proteins in cells, with the combination forming "fusion proteins." As the proteins degrade, they yield simple amino acids, which are the building blocks of all proteins. ¾ÝÑо¿Õ߳ƣ¬ELPs²»ÒýÆðÃâÒß·´Ó¦ËùÒÔËüÔÚÉúÎïҽѧÖÐÓжÀÌØµÄÓŵ㡣ELPs¿ÉÒÔÖ±½ÓÓëϸ°ûÄÚ²úÉú¸÷ÖÖµ°°×²úÎïµÄ»ùÒòÏà½áºÏ£¬´Ó¶øÐγɡ°Èںϵ°°×¡±¡£ By experimenting with composition, molecular weight and concentration of various ELPs, Betre developed a protein for use in joints that would precipitate out of solution and clump at normal body temperature. ͨ¹ý¶Ô¸÷ÖÖELPsµÄ×é³É¡¢·Ö×ÓÁ¿ºÍŨ¶È£¬BetreÑÐÖÆ³öÒ»ÖÖÓÃÓڹؽڵĵ°°×£¬ËüÄÜÔÚÕý³£ÌåÎÂÏ´ÓÈÜÒºÖоۼ¯³Áµí¡£ When he injected the sticky ELP into the knees of rats, the protein proved to have a 25-fold longer half-life in the joint than a similar soluble protein, Betre reported in the journal article. Half-life is the time required for half the quantity of the protein to be broken down and eliminated from the joint space. µ±Ëû°ÑÕ³ÐÔELP×¢ÉäÈëСÊóÏ¥¹Ø½Ú£¬ÔڹؽÚÖÐÕâÖÖµ°°×µÄ°ëË¥ÆÚÊÇÏàËÆµÄ¿ÉÈÜÐÔµ°°×µÄ25±¶£¬Betre±¨µÀ˵¡£°ëË¥ÆÚÖ¸Ò»°ëµ°°×´Ó¹Ø½ÚÇ»ÖзֽâºÍÏûʧÓõÄʱ¼ä¡£ "At 12 hours, the soluble protein was already at a concentration in the joint below 10 percent of the injected dose," Setton said. Setton˵¡°12Сʱºó£¬¿ÉÈÜÐÔµ°°×ÔڹؽÚÖеÄŨ¶ÈµÍÓÚ×¢ÉäÁ¿µÄ10%¡£¡± In contrast, the sticky ELP took about two weeks to fall to the 10 percent level in the animals' joints -- a "really substantial increase," she said. Ïà±È֮ϣ¬Õ³ÐÔELPÔÚ¶¯Îï¹Ø½ÚÖдóÔ¼2Öܺó²Å½µÖÁ10%¡ª¡°ÏÔÖøÑÓ³¤¡±£¬Ëý˵¡£ Moreover, rats injected with the clumping ELP contained lower blood levels of the protein, suggesting that a protein drug paired to the ELP might also have the benefit of fewer side effects, Shamji said. This would be important, he said, because IL1RA can weaken the immune system and make patients more susceptible to infection. ¸üÖØÒªµÄÊÇ£¬×¢Éä¾Û¼¯ELPµÄСÊóѪÖк¬Óеĵ°°×¸üÉÙ£¬±íÃ÷ËüµÄ¸±×÷ÓøüÉÙ£¬Shamji˵¡£Õ⽫ºÜÖØÒª£¬Ëû˵£¬ÒòΪIL-1ÊÜÌåÞ׿¹¼Á»á½µµÍÃâÒß¹¦ÄÜʹµÃ²¡ÈËÒ×±»¸ÐȾ¡£ Such vulnerability to infection is a particular problem for patients treated for chronic diseases such as osteoarthritis, and this vulnerability suggests the need for a local treatment, Shamji added. ÕâÖÖ¸±×÷ÓÃÔÚÂýÐÔ¼²²¡Èç¹Ç¹Ø½ÚÑ×µÄÖÎÁÆÖиü¼ÓÃ÷ÏÔ£¬½ø¶øÐèÇó¾Ö²¿ÓÃÒ©£¬Shamji½øÒ»²½Ö¸³ö¡£ Based on the initial investigation, the team paired the ELP with the IL1RA drug in a second study, to test whether the fusion protein would retain the ability to suppress IL-1 activity and fight inflammation. »ùÓÚ³õ²½Ñо¿£¬¸ÃÍŶÓÔÚ½ÓÏÂÀ´µÄÑо¿ÖУ¬½«ELPºÍIL-1Þ׿¹¼ÁÏà±È½Ï£¬ÒÔÑéÖ¤Èںϵ°°×ÈÔÈ»¿ÉÒÔÒÖÖÆIL-1µÄ»îÐԺͿ¹Ñס£ The researchers treated human white blood cells with either the original or the modified drug. White blood cells are responsible for mounting the body's immune response and normally react to IL-1 by growing in numbers and releasing molecules that further activate the immune system. Active IL1RA therefore serves to dampen the immune cells' rate of proliferation, Shamji said. Ñо¿Õß·Ö±ðÓÃÔÐͺ͸ÄÁ¼ºóµÄÒ©Îï´¦ÀíÈ˰×ϸ°û¡£°×ϸ°ûÄܹ»·¢¶¯»úÌåÃâÒß·´Ó¦¶øÆðÒ»°ãͨ¹ýÊýÄ¿Ôö¼ÓºÍÊͷŽøÒ»²½¼¤»îÃâÒßϵͳµÄ·Ö×Ó¶ÔIL-1×ö³ö·´Ó¦¡£ White blood cells treated with the modified drug increased in number at a slower than normal pace, evidence of the drug's activity, Shamji reported at the Biomedical Engineering Society meeting. But its potency dropped by a factor of about 20£¨´óÔ¼20%µÄ±ÈÂÊ£© compared to the pure drug. ÓÃÐÂÒ©´¦Àí¹ýµÄ°×ϸ°ûÔö³¤ËٶȼõÂýÊÇÐÂÒ©ÓÐЧµÄÖ¤¾Ý£¬ShamjiÔÚthe Biomedical Engineering Society»áÒéÉϱ¨¸æ£¬µ«ÊÇÓëÔÐÍÒ©ÎïÏà±ÈDZÄÜϽµ´óÔ¼20%. Further studies, however, suggested the fusion protein might do better in an arthritic joint, Shamji said. The researchers were surprised to find that the same inflammatory enzymes that destroy joint collagen also chew ELP from the original drug protein, thereby restoring its activity. ¾¡¹ÜÈç´Ë£¬½øÒ»²½µÄÑо¿ÌáʾÈںϵ°°×ÔÚ²¡±ä¹Ø½ÚÄÚ¿ÉÄܸüÓÐЧShamji˵¡£Ñо¿ÈËÔ±¾ªÆæµØ·¢ÏÖÆÆ»µ¹Ø½ÚÖйǽºÔµÄøͬÑù»áʹÔÐÍÒ©Îï´ÓELPÖзÖÀë³öÀ´¶øÇÒ·ÖÀëºóÈÔÓÐ×÷Óᣠ"With the ELP tag gone, you get back yor originally active drug," Shamji said ¡°ELPÈ¥ÁË£¬ÔÐ͹éÀ´¡±Shamji˵ "That finding was pretty unexpected," Setton added. "We hadn't intentionally designe d it to have that feature at all. "ÕâÌ«ÒâÍâÁË£¬ÍêÈ«³öºõÎÒÃǵÄÒâÁÏ¡£ The researchers now plan to work with collaborators to test the modified drug's ability to interfere with the progression of disease in the joints Ñо¿ÈËÔ±½«½øÒ»²½²âÊÔÐÂÒ©ÔÚ²¡³ÌÖеÄ×÷Óᣠ|
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