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一项评估健康志愿者中犬尿氨酸安全性、耐受性、药代动力学和药效学的 1 期研究。

Phase 1 study to access safety, tolerability, pharmacokinetics, and pharmacodynamics of kynurenine in healthy volunteers.

机构信息

Danish Headache Center, Department of Neurology, University of Copenhagen, Denmark.

Danish Knowledge Center on Headache Disorders, Rigshospitalet-Glostrup, Denmark.

出版信息

Pharmacol Res Perspect. 2021 Apr;9(2):e00741. doi: 10.1002/prp2.741.

Abstract

The kynurenine pathway (KP) is the main path for tryptophan metabolism, and it represents a multitude of potential sites for drug discovery in neuroscience, including pain, stroke, and epilepsy. L-kynurenine (LKYN), the first active metabolite in the pathway, emerges to be a prodrug targeting glutamate receptors. The safety, tolerability, pharmacokinetics, and pharmacodynamics of LKYN in humans have not been previously investigated. In an open-label, single ascending dose study, six participants received an intravenous infusion of 50, 100, and 150 µg/kg LKYN and new six participants received an intravenous infusion of 0.3, 0.5, 1, and 5 mg/kg LKYN. To compare the pharmacological effects between species, we investigated in vivo the vascular effects of LKYN in rats. In humans, LKYN was safe and well-tolerated at all dose levels examined. After infusion, LKYN plasma concentration increased significantly over time 3.23 ± 1.12 µg/mL (after 50 µg/kg), 4.04 ± 1.1 µg/mL (after 100 µg/kg), and 5.25 ± 1.01 µg/mL (after 150 µg/kg) (p ≤ 0.001). We observed no vascular changes after infusion compared with baseline. In rats, LKYN had no effect on HR and MAP and caused no dilation of dural and pial arteries. This first-in-human study of LKYN showed that LKYN was safe and well-tolerated after intravenous infusion up to 5 mg/kg over 20 minutes. The lack of change in LKYN metabolites in plasma suggests a relatively slow metabolism of LKYN and no or little feed-back effect of LKYN on its synthesis. The therapeutic potential of LKYN in stroke and epilepsy should be explored in future studies in humans.

摘要

犬尿氨酸途径(KP)是色氨酸代谢的主要途径,它代表了神经科学中许多潜在的药物发现靶点,包括疼痛、中风和癫痫。KP 中的第一个活性代谢产物 L-犬尿氨酸(LKYN),作为一种靶向谷氨酸受体的前药出现。LKYN 在人体内的安全性、耐受性、药代动力学和药效学尚未被研究过。在一项开放标签、单剂量递增研究中,六名参与者接受了静脉输注 50、100 和 150μg/kg LKYN,另外六名参与者接受了静脉输注 0.3、0.5、1 和 5mg/kg LKYN。为了比较种间的药理作用,我们在大鼠体内研究了 LKYN 的血管作用。在人体内,所有检查剂量水平的 LKYN 均安全且耐受良好。输注后,LKYN 血浆浓度随时间显著增加,分别为 3.23±1.12μg/mL(50μg/kg 后)、4.04±1.1μg/mL(100μg/kg 后)和 5.25±1.01μg/mL(150μg/kg 后)(p≤0.001)。与基线相比,输注后我们没有观察到血管变化。在大鼠中,LKYN 对 HR 和 MAP 没有影响,也没有引起硬脑膜和软脑膜动脉扩张。这是 LKYN 在人体内的首次研究,表明 LKYN 在 20 分钟内静脉输注高达 5mg/kg 是安全且耐受良好的。血浆中 LKYN 代谢物无变化表明 LKYN 的代谢相对较慢,并且 LKYN 对其合成没有或几乎没有反馈作用。在未来的人类研究中,应该探索 LKYN 在中风和癫痫中的治疗潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8e0/7937944/ca927374ec28/PRP2-9-e00741-g004.jpg

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