Tenhunen R, Tokola O, Lindén I B
Department of Clinical Chemistry, University Central Hospital of Helsinki, Finland.
J Pharm Pharmacol. 1987 Oct;39(10):780-6. doi: 10.1111/j.2042-7158.1987.tb05119.x.
Intravenous administration of haem in acute hepatic porphyrias inhibits the induction of delta-aminolaevulinic acid synthase, reduces the formation of potentially harmful metabolites of porphyrin synthesis and corrects the haem deficiency. Typically, haem therapy has been given in the form of haematin--haem dissolved in alkali. Such haematin solutions are, however, extremely unstable. Thus, the rapid decomposition of this therapeutic agent may have been responsible for the ineffectiveness of treatment in some clinical states and adverse reactions may have been caused by haematin degradation products. There is, therefore, a need for a stable, effective and well-tolerated haem preparation. We have prepared certain highly soluble haem compounds of which haem arginate has proved to be the most promising. Pure haemin was isolated from HIV and hepatitis B negative human blood. The haem derivatives prepared were screened as substrates for haem oxygenase. Haem arginate and haem lysinate were found to be as good substrates as methaemalbumin. Stock solutions of haem arginate were stable for 2 years at +6 degrees C. After dilution with sterile isotonic saline the haem arginate infusion was clearly more stable than haematin solutions made in the laboratory or prepared by dissolving commercial lyophilized haematin. The antiporphyrogenic effect of haem arginate (even after storage for two years) in 2-allyl-2-isopropylacetamide-induced experimental porphyria of rats was equal to that of freshly prepared haematin. The acute oral toxicity of haem arginate was low compared with the parenterally administered drug, indicating poor oral bioavailability. The acute toxic effects after high intravenous or intraperitoneal doses were directed to the liver.(ABSTRACT TRUNCATED AT 250 WORDS)
在急性肝卟啉病中静脉注射血红素可抑制δ-氨基-γ-酮戊酸合酶的诱导,减少卟啉合成中潜在有害代谢产物的形成并纠正血红素缺乏。通常,血红素疗法一直以氯高铁血红素的形式给药——血红素溶解在碱中。然而,这种氯高铁血红素溶液极其不稳定。因此,这种治疗剂的快速分解可能是某些临床状态下治疗无效的原因,不良反应可能是由氯高铁血红素降解产物引起的。因此,需要一种稳定、有效且耐受性良好的血红素制剂。我们制备了某些高度可溶的血红素化合物,其中精氨酸血红素已被证明是最有前景的。纯氯高铁血红素从HIV和乙肝阴性的人血中分离出来。所制备的血红素衍生物作为血红素加氧酶的底物进行筛选。发现精氨酸血红素和赖氨酸血红素与高铁血红蛋白白蛋白一样是良好的底物。精氨酸血红素储备溶液在+6℃下可稳定保存2年。用无菌等渗盐水稀释后,精氨酸血红素输注液明显比实验室制备或通过溶解商业冻干氯高铁血红素制备的氯高铁血红素溶液更稳定。精氨酸血红素(即使储存两年后)在2-烯丙基-2-异丙基乙酰胺诱导的大鼠实验性卟啉病中的抗卟啉生成作用与新鲜制备的氯高铁血红素相同。与肠胃外给药的药物相比,精氨酸血红素的急性口服毒性较低,表明口服生物利用度差。高静脉或腹腔注射剂量后的急性毒性作用主要针对肝脏。(摘要截短于250字)