US4429141
PHYSIOLOGICALLY
ACTIVE PTEROCARPAN-COMPOUNDS,METHODS FOR THE ISOLATION
THEREOF AND THERAPEUTICALLY ACTIVE COMPOSITIONS
CONTAINING THEM
[ PDF ]
Inventor: DARKO LASZLO L // NAKANISHI KOJI (+1)
Applicant: RICHTER GEDEON VEGYESZET
Physiologically active crystalline products of manufacture
having the formulas: (I) and (II) are described. These
compounds are effective against the toxic venoms of
poisonous snakes, spiders and other insects, and against E.
coli endotoxins; methods are described for isolation of the
above compounds.
BACKGROUND
OF THE INVENTION
1. Field of the Invention
This invention relates to products of manufacture which are
substantially pure crystalline pterocarpan compounds which
have been isolated from the crude extracts of natural
products and to methods for isolating the compounds.
2.
Description of the Prior Art
It has been known that the aqeuous alcoholic extract of the
root of the South American cabeca de negra tree has been
available to plantation workers in the upper Amazon jungle
as an oral antidote against snake and spider venoms. About
ten varieties of the species cabeca de negra are known in
South America. Neither the nature of the active components
nor studies on the side effects, pharmacological activity,
stability and the like are known to have been published on
the compounds of the invention. Pterocarpans possessing
antimicrobial properties have been identified in the
literature, see Heterocycles, Vol. 15, 1163 (1981).
SUMMARY
OF THE INVENTION
The invention includes the following products of manufacture
which have been isolated in substantially pure crystalline
form: ##STR2## For convenience, the compounds of the above
structure will be referred to hereinafter as cabenegrin I
and cabenegrin II, or as compounds (I) and (II),
respectively. The invention also includes the step-wise
method employed to recover and isolate the essentially pure
crystalline products referred to as cabenegrin I and
cabenegrin II.

The compounds
cabenegrin I and cabenegrin II have pharmaceutical utility
in the treatment of mammals, including man, that have been
envenomated by poisonous snakes and insects. That is, these
compounds act as potent antidotes against effects of snake
and insect toxins. The compounds (I) and (II) are also
useful in treating the effects of other known organic toxins
such as E. coli endotoxin and that produced by Clostridium
botulinum, commonly referred to as botulism or food
poisoning. The details of tests establishing the utility of
compounds I and II are described in a co-pending application
filed concurrently herewith in the name of Lazslo Darko
under U.S. Ser. No. 358,191, and the entire disclosure of
that application is incorporated herein by reference.
Pharmaceutical utility is generally indicated for the
treatment of the effects in mammals of toxins produced by
pathogenic bacteria (endotoxins and exotoxins) which attack
the nervous system of the victim and particularly where
paralysis of the respiratory system is manifested. Treatment
against the effects of cardio-vascular toxins is also
indicated.
The compounds can be administered orally in liquid form as a
suspension or solubilized in a compatible pharmaceutical
carrier. The pure crystalline material can be administered
orally in capsule or tablet form when compounded with
suitable pharmaceutical carriers. Alternatively, either of
the compounds cabenegrin I or II can be dissolved in a
suitable liquid pharmaceutical carrier and the solution
administered intravenously by syringe, or by catheter where
monitoring equipment is available to determine the effects
of the therapy. If desired compounds (I) and (II) can be
mixed together in various proportions, and the mixture
prepared as described above with suitable pharmaceutical
carriers.
DETAILED
DESCRIPTION OF THE INVENTION
Approximately 1/2 kilo of the washed root of the cabeca de
negra tree is chopped into small pieces which may then be
mascerated, pulverized or otherwise treated to break down
the fibrous structure. This step can be accomplished in a
blender or laboratory homogenizer. Roots evidencing mold or
fungus should not be used. The pulverized root is placed in
a large glass beaker or other suitable vessel which may be
covered and subsequently stirred. A sufficient quantity of
ethanol:water 77:23 is added to cover the pulverized root
and briskly stirred for a few minutes. The vessel containing
the aqueous ethanol and root is allowed to stand at ambient
temperatures for at least 48 hours, with occasional
stirring. At the end of this period, the aqueous alcoholic
solution comprising the crude extract is separated from the
root by any convenient means, for example, by pouring
through medium filter paper. The pulverized root is
discarded. The filtered solution is the color of strong tea.
The following procedure was employed to isolate the active
compounds from the crude extract as prepared above.
The aqueous ethanol crude extract (135 ml) was concentrated
by gentle warming under vacuum to obtain 1.2 grams of a
brown oily residue. This concentrated material was treated
with 50% aqueous methanol and the solution was extracted by
vigorous shaking with hexane. The hexane layer was separated
and discarded. The water layer was extracted with ether by
vigorous shaking. The ether layer and the water layer were
separated, the ether layer (640 milligrams) being set aside.
The water layer was extracted with n-butyl alcohol by
vigorous shaking. The n-butyl alcohol layer was separated
and set aside, and the water layer was discarded.
The ether layer extracted above is subjected to high
pressure liquid chromatography (HPLC) on Sephadex LH-20 as a
first step and as the next step on silica gel using aqueous
methanol as the eluting solvent. This procedure results in
two fractions, and the first is further separated by HPLC
employing Partisil-10 eluted with 3% methanol in methylene
chloride to yield pure solid compounds.
The compound identified as cabenegrin I is recovered as a
white crystalline material in a yield of 44 mg. A sharp
melting point of 167 DEG-168 DEG C. is obtained and analysis
shows the composition to be C21 H20 O6. The Rf value of
compound I on thin layer chromatography employing silica gel
CO/Kiesel guhr F-254 and benzene/ethyl acetate/methanol
(15/4/1) was 0.53.
The U.V., C.D., and I.R. of compound I are as follows:
UV (in MeOH): 209 nm (E 75,000), 233 nm (shoulder, E
24,000), 309 nm (E 13,000)
CD (in MeOH): 213 nm (E -25.58), 220 nm (.DELTA.E -2.00),
238 nm (.DELTA.E -9.84); 302 (.DELTA.E +3.15)
IR (in CHCl3): 3550 cm@-1, 1600 cm@-1, 1113 cm@-1, 925
cm@-1.
In addition to these spectral data, the following @1 H-NMR,
@13 C-NMR, and MS (E1) data were measured; these
spectroscopic measurements led to the depicted structure.
PMR, CMR and MS of Compound (I): ##STR3##
The second sample of material recovered from the HPLC
described above comprised an oily mixture of approximately
10 mg. This second active fraction, which had been obtained
from the HPLC of the ether layer described above, is treated
as follows to obtain the compound cabenegrin II. The mixture
was subjected to further HPLC employing .mu.-Bondapak C18
and methanol/acetonitrile/H2 O/n-PrOH (71/71/59/2). Compound
(II) was obtained in essentially pure crystalline form in a
yield of about 1 mg. The structure of this compound is based
on the following physical constants: ##STR4##
The structure of
compound (II) is shown by NMR data to be a 3:1 mixture of
epimers at C-3'. The structures of both compounds cabenegrin
I and cabenegrin II have been confirmed by synthesis of
their respective racemates.
EP0089229
Physiologically active pterocarpan compounds, methods
for the isolation thereof and therapeutically active
compositions containing them.
The invention relates to physiologically active
pterocarpan-compounds and methods for the isolation thereof.
These compounds have the formula I <CHEM> wherein
R<1> represents a hydrogen atom and R<2>
represents a -CH2CH2-CH(CH3)-CH2OH group, or R<1>
represents a <CHEM> and R<2> represents a
hydrogen atom, together with all optical isomers and racemic
mixtures thereof. These compounds are effective against the
toxic venoms of poisonous snakes, spiders and other insects,
and against E. coli endotoxins. The invention further
relates to therapeutically active compositions containing
the above pterocarpan compounds.

[0001] This
invention relates to physiologically active
pterocarpan-compounds, methods for the isolation thereof and
therapeutically active compositions containing them. More
particularly it relates to products of manufacture which are
substantially pure crystalline pterocarpan compounds which
have been isolated from the crude extracts of natural
products and to methods for isolation of the compounds.
[0002] It is known that the aqueous alcoholic extract of the
root of the South American cabeca de negra tree has been
available to plantation workers in the upper Amazon jungle
as an oral antidote against snake and spider venoms. About
ten varieties of the species cabeca de negra are known in
South America. Neither the nature of the active components
nor studies of the side effects, pharmacological activity,
stability and the like are known to have been published on
the compounds of the invention. Pterocarpans possessing
antimicrobial properties have been identified in the
literature, see Heterocycles, Vol. 15, 1163 [1981].
[0003] In one aspect, the invention relates to pterocarpan
compounds having the formula (I)
wherein R<1>
represents a hydrogen atom and R<2> represents a
-CH2CH2-CH(CH3)-CH20H group, or R represents a
and R<2>
represents a hydrogen atom, together with all optical
isomers and racemic mixtures thereof.
[0004] We have been able to isolate such compounds in
substantially pure crystalline form. For convenience, the
compounds of the above structure will be referred to
hereinafter as cabenegrin I
[3-hydroxy-4-(3-hydroxymethyl-butene-2)-8,9-methylenedioxy-pterocarpan]
and cabenegrin II
[2-(3-hydroxymethyl-butyl)-3-hydroxy-8,9-methylenedioxy-pterocarpan],
respectively. The invention also relates to a step-wise
method employed to recover and isolate the essentially pure
- 95-100% - crystalline products referred to as cabenegrin I
and cabenegrin II.
[0005] The compounds cabenegrin I and cabenegrin II have
pharmaceutical utility in the treatment of mammals,
including man, that have been envenomated by poisonous
snakes and insects. These compounds have been found to acts
as potent antidotes against effects of snake and insect
toxins. The compounds of the invention are also useful in
treating the effects of other known organic toxins such as
E. coli endotoxin and that produced by Clostridium
botulinum, commonly referred to as botulism on food
poisoning. Pharmaceutical utility is generally indicated for
the treatment of the effects in mammals of toxins produced
by pathogenic bacteria (endotoxins and exotoxins) which
attack the nervous system of the victim and in particular
where paralysis of the respiratory system is manifested.
Treatment against the effects of cardio-vascular toxins is
also indicated.
[0006] The compounds can be administered orally e.g. in
liquid form as a suspension or solubilized in a compatible
pharmaceutical carrier. Pure crystalline material can be
administered orally in capsule or tablet form when
compounded with suitable pharmaceutical carriers.
Alternatively, either of the compounds cabenegrin I or II
can be dissolved in a suitable liquid pharmaceutical carrier
and the solution administered intravenously by syringe, or
by catheter where monitoring equipment is available to
determine the effects of the therapy. If desired, the
compounds of the invention can be mixed together in various
proportions, and the mixture prepared as described above
with suitable pharmaceutical carriers.
[0007] A crude extract from which the compounds of the
invention may be obtained may be prepared as follows:
[0008] Approximately 2 kilo of the washed root of the cabeca
de negra tree is chopped into small pieces which may be
macerated, pulverized or otherwise treated to break down the
fibrous structure. This step can be accomplished in a
blender or laboratory homogenizer. Roots evidencing mold or
fungus should not be used. The pulverized root is placed in
a large glass beaker or other suitable vessel which may be
covered and subsequently stirred. A sufficient quantity of
the mixture of water and aliphatic alcohol having 1-4 carbon
atoms, preferably ethanol:water 77:23 is added to cover the
pulverized root and briskly stirred for a few minutes. The
vessel containing the aqueous ethanol and root is allowed to
stand at ambient temperatures for at least 48 hours, with
occasional stirring.' At the end of this period, the aqueous
alcoholic solution comprising the crude extract is separated
from the root by any convenient means, for example, by
pouring through medium filter paper. The pulverized root is
discarded. The filtered solution is the color of strong tea.
[0009] The following procedure may then be employed to
isolate the active compounds from the crude extract as
prepared above.
[0010] The aqueous ethanol crude extract (135 ml) was
concentrated by gently warming under vacuum to obtain 1.2
grams of a brown oily residue. This concentrated material
was treated with 50% aqueous methanol and the solution was
extracted by vigorous shaking with an aliphatic hydrocarbon
having 5-8 carbon atoms, preferably with hexane. The hexane
layer was separated and discarded. The water layer was
extracted with ether by vigorous shaking..The ether layer
and the water layer was separated, the ether layer (640
milligrams) being set aside. The water layer was extracted
with n-butyl alcohol by vigorous shaking. The n-butyl
alcohol layer was separated and set aside for. a possible
investigation, and the water layer was discarded.
[0011] The ether layer extracted above is separated using
well-known chromatographic methods. Preferably, the ether
layer extracted above is subjected in a first step to high
pressure liquid chromatography (HPLC) on Sephadex LH-20 and
as a second step on silica gel using aqueous methanol as the
eluting solvent. This procedure results in two fractions and
the first is further separated by HPLC employing Partisil-10
eluted with 3% methanol in methylene chloride to yield pure
solid compounds.
[0012] The compound identified as cabenegrin I is recovered
as a white crystalline material in a yield of 44 mg. A sharp
melting point of 167-168[deg.]C is obtained and analysis
shows the composition to be C21H20O6. The <Rf> value
of this compound on thin layer chromatography employing
silica gel CO/Kieselguhr F-254 and benzene/ethyl
acetate/methanol (15/4/1) was 0.53.
[0013] The U.V., C.D., and I.R. of compound I are as
follows:
[0014] UV (in MeOH): 209 nm (e 75,000), 233 nm shoulder,
([epsilon] 24,000), 309 nm (e 13,000). CD (in MeOH): 213 nm
([Delta][epsilon] -25.38), 220 nm ([Delta][epsilon] -2.00),
238 nm ([Delta][epsilon] -9.84); 302 nm ([Delta][epsilon]
+3.15). IR (in CHC13): 3550 cm<-1>, 1600 cm<-1>,
1113 cm<-1>, 925 cm<-1>.
[0015] In addition to these spectral data, the following
<1>H-NMR, <13>C-NMR, and MS (El) data were
measured concerning cabenegrin I:
<1>H-NMR: 1.83 (3H, d, 1 Hz, 4'-CH3);
3.40 (2H, br, d, 7 Hz, C l');
3.40 (2H, ddd, 7, 7.5 Hz, C 6a);
3.61 (2H, d, d, 11.7 Hz, c 6[beta]);
3.90 (2H, -OCH20);
3.99 (2H, br, s, -CH2-OH);
4.28 (lH, dd, 11.5 Hz, C 6a);
5.45 (lH, br, t, 7 Hz, C 2');
5.45 (lH, d, 7 Hz, C lla);
6.41 (1H, s, C 10);
6.52 (lH, d, 9 Hz, C 2);
6.70 (1H, s, C 7);
7.23 (lH, d, 9 Hz, C 1) ppm.
<13>C-NMR: 13.74 (4'-CH3) ; 21.88 (C 1'); 40.16 (C
6a);
66.72 (C 6); 68.72 (-CH2-OH); 79.10 (C lla);
93.77 (C 10); 104.73 (C 7); 109.6 (C 2);
112.63 (C 4 or C la); 115.01 (C 4 or C la);
118.04 (C 6b); 123.49 (C 2'); 129.15 (C 1);
136.07 (C 3'); 141.67 (C 8); 148.06 (C 9);
154.20 (C 10a or C 4a); 154.20 (C 10a or C 4a);
155.08 (C 3) ppm.
MS (18 eV):
M<+ >= 368, 50%
m/e = 350, 100%; 335, 95%; 335, 95%; 176, 65%; 161, 90%.
[0016] The second sample of material recovered from the HPLC
described above comprised an oily mixture of approximately
10 mg. This second active fration, which had been obtained
from the HPLC of the ether layer described above, is treated
as follows to obtain the compound cabenegrin II. The mixture
was subjected to further HPLC employing /u-Bondapack C18 and
methanol/ acetonitrile/H2O/n-PrOH(71/71/59/2). The compound
(II) was obtained in essentially pure - 95-100% -
crystalline form in a yield of about 1 mg. The structure of
this compound is based on the following physical constants,
and analysis (MS) shows the composition to be C21H22O6'
[0017] <1>H-NMR: 0.69 (3H, d, 5.8 Hz, 3'-CH3);
2.50 (2H, m, C 1');
2.67 (2H, m, C 1');
2.94 (lH, ddd, 9.1, 6.3, 4.9Hz, C 6a);
3.10 (2H, dd, 8.8, 2.7 Hz, -CH2-OH);
3.18 (2H, dd, 8.8, 4.4 Hz, -CH2-OH);
3.50 (lH, dd, 9.1, 9.1 Hz, C 6[beta]);
3.86 (lH, dd, 9.1, 4.9 Hz, C 6a);
5.27 (lH, d, 6.3 Hz, C lla);
5.30 (2H, -OCH20-);
5.33 (2H, -OCH2O-);
6.36 (lH, C 10);
6.52 (lH, C 4);
6.53 (lH, C 7);
7.08 (lH, C 1) ppm.
[0018] UV (in MeOH):204 nm ([epsilon] 116,000), 230 nm
([epsilon] 8,000), 292 nm ([epsilon] 9,400), 308 nm
([epsilon] 11,800).
[0019] CD (in MeOH): 237 nm ([Delta][epsilon] -6.68), 280 nm
([Delta][epsilon] -0.46), 299 nm ([Delta][epsilon] -1.72) .
[0020] The structure of this compound is shown by NMR data
to be a 3:1 mixture of epimers at C-3' and the invention
includes the individual optical isomers together with
racemic mixtures within its scope. The structures of both
compounds cabenegrin I and cabenegrin II have been confirmed
by synthesis of their respective racemates.
[0021] The new compounds produced by the method of the
invention are suitable for making therapeutically active
compositions, which are antidotes for treating the effects
of poisonous snake and insect bites in mammals, including
man.
[0022] They are also suitable for the treatment of
pathogenic bacterial toxins such as E. coli endotoxins,
botulism and others which exhibit central nervous system
effects and related respiratory paralysis, and to the
treatment of the effects of cardiovascular toxins on
mammals.
[0023] As for the new compounds obtained by the above
extraction methods, the presence of physiologically active
compounds was determined by in vivo tests employing mice.
Test animals were Swiss Webster white mice, mixed sexes,
weighing from 25-30 grams. Each group of test animals was
envenomated with two and one-half times the lethal dose of
snake venom from the Fer de Lance (Bothrops atrox) by
intraperitoneal injection. In the absence of treatment,
envenomated animals succumbed within a few minutes.
[0024] Concentrates of compounds of the invention obtained
from each of the fractions of the above extraction scheme
were tested for antidotal activity by injecting the mice
immediately after envenomation with an aqueous ethanol
solution (77.23) of the material isolated from each
fractions. Each animal was treated with 0.25 ml of the
respective solutions. On the basis of this protocol, the
minimum dosage for survival against the Fer de Lance venom
was 2.8 mg/kg of cabenegrin I and 2.0 mg/kg of cabenegrin
II.
[0025] Toxicological studies indicate that administration of
aqueous ethanolic solutions of cabenegrin I and cabenegrin
II to healthy test animals produce no significant changes in
vital physiological functions. Administration can be by
intravenous or intramuscular injection, or orally via a
stomach tube. No significant change is noted in arterial
blood pressure, heart rate, respiration, EKG or central
venous pressure at any time following administration of
compounds I and II to normal healthy (i.e. non-envenomated)
animals.
[0026] Administration does not significantly alter resting
action potentials, end plate potentials, nerve impulse
transmission, neuro-muscular function or brain wave activity
in experimental animals.
1.
Antidotal effects against snake venom in dogs.
[0027] Envenomation by-a lethal dose of snake venom, such as
Bothrops atrox, Crotalus adamamteuns, or Crotalus atrox,
produces a precipitous fall in arterial blood pressure, a
decrease of heart rate and en elevation in central venous
pressure. This is followed by partial recovery of these
parameters and then by a complete respiratory and
cardiovascular collapse. Death appears to be due to a
combination of peripheral vascular collapse and to an
interruption in the normal respiratory mechanism. In
addition, there appears to be some action of these venoms on
the central nervous system of the experimental animals. This
CNS effect is exhibited by a decrease in both the alpha and
the beta rhythm of the brain (EEG). This change is also
associated with a decrease in impulse transmission over the
motor verves and progressive blockage of the neuromuscular
apparatus which is similar to that produced by curare.
Venoms had no effect on muscle response to direct
stimulation.
[0028] A series of seven adult beagle dogs are used to study
the effectiveness of cabenegrin I and II against the venoms.
The dogs are anaesthetized with Na pentobarbital (30 mg/kg)
and monitored for changes in arterial blood pressure, heart
rate, electrocardiogram and respiration. Lethal doses (five
to ten times of LD50) of lyophilized reconstituted Bothrops
atrox (Fer de Lance) (2.5 mg - 5.0 mg/kg) or (10 mg/kg)
South American rattle snake venom are administered.
[0029] Within 15 minutes following envenomation, marked
decreases in heart rate and blood pressure are consistently
noted. At from 15 to 30 minutes, respiration likewise
descreases from an average of 20 per minute to 5 per minute.
Treatment is initiated when severe cardio- vascular
embarrassment and apparent respiratory difficulties are
observed, usually at from 15-30 minutes following
envenomations.
[0030] A solution of cabenegrin I is prepared by dissolving
33 mg of the crystalline material of compound in 100 ml of
aqueous ethanol (25:75). Similarly, a solution of 24 mg of
cabenegrin II in 100 ml of aqueous ethanol (15:75) is
prepared. Doses are prepared for administration by stirring
5 ml of each of the respectve alcoholic solutions of the
compounds of the invention into 50 ml of water.
[0031] Administration of the respective solutions is through
a tube placed and advanced into the stomach of the dog.
Treatment is as follows: No immediate response is noted
following therapy. Blood pressure, heart rate and
respiration all remain extremely low. At approximately 30
minutes following the first dose of the respective alcoholic
solution of the compound of the invention, a slow gradual
improvement of breathing occurs followed by partial
restoration of heart rate and blood pressure. Continuous
therapy is provided at 30 minute intervals in 50 ml water
until all monitored vital signs return to within 10% of
control. The effective dose range is between 10 to 20 ml of
antivenom extract per animal. From two to four doses are
required. After observation for 8-10 hours the animals are
placed in a holding cage with food and water. At 24 hours,
all 7 dogs show signs of depressed activity. At 72 hours,
all dogs are taking food and water. No additional therapy is
required.
2.
Activity of cabenegrin I and II against E. coli endotoxin
[0032] Three adult beagle dogs are used to demonstrate the
effectiveness of the cabenegrin I and II in treating shock
caused by E. coli endotoxin. The dogs are anaesthetized with
Na pentobarbital (30 mg/kg) and monitored for changes in
arterial blood pressure, heart rate, EKG and respiration.
Lethal doses (1 mg/kg) of E. coli endotoxin are injected
i.v. into a catheter placed in the vein of the hind limb of
the dogs. In the first experiment no antidotal therapy was
initiated and the animal expired 2 hours after injection. In
the three additional cases antidotal therapy is initiated at
the time when severe cardiovascular collapse and respiratory
difficulties appear. These usually occur within about 112
hours after the injection of the toxin.
[0033] Solutions of cabenegrin I and II, prepared as
described above, are administered by stomach tube in a
single dose of 10 ml in 100 ml of water to each of the dogs.
The animals so treated survive and resume normal activity.
3.
Isolated heart (Langendorff) preparation
[0034] A series of 2 dog heart preparations are tested to
measure the antivenom effect on coronary blood flow, heart
rate, EKG, force of ventricular contraction and coronary
vascular resistance when cabenegrin I and II are given
either before or after lethal venom challenge. It is
observed that treatment appears capable of overcoming the
toxic effects of the venom on cardiovascular functions.
These effects are a decrease of the force of contraction and
heart rate. Coronary vascular resistance also increases
progressively following the administration of venom. When
solutions containing 0.05 mg/ml of either of the compounds
of the invention are injected directly into the circulation
prior to tropical rattle snake venom challenge, no
detrimental effect on the heart is observed. Rather, the
force of contraction and coronary blood flow increases by
about 15 to 20%.
[0035] When either of the compounds is given following.
lethal challenge of tropical rattle snake venom, the
antidote restores force of contraction and heart rate to
normal levels and reverses the minor arrhythmias caused by
envenomation.
4.
Neurophysiological function
[0036] Three dogs and one cat are tested for the antidotal
effect on neuromuscular function, action potential and brain
wave activity following envenomation with lethal doses of
Fer de Lance venom.
[0037] Snake venom decreases both brain wave activity and
nerve impulse transmission. These are restored to nearly, if
not completely, normal levels by the administration of
cabenegrin I and II. Action potentials and neuromuscular
function remain depressed for approximately 30 to 60 minutes
after treatment with each of the compounds. This is followed
by a slow, gradual return to control levels after from 12 to
24 hours.
[0038] In certain experiments in which complete neuro-
muscular blockage occurs and the animals are no longer
capable of spontaneous respiration, artificial ventilation
is required until the action of the compound has manifested
itself. This may occur after envenomation, but once
stabilized, the animals are capable of spontaneous breathing
and no further therapy is required.
[0039] Cortical electrical activity is markedly (25-30%)
depressed by the venom. These changes are restored to normal
by the administration of the compounds cabenegrin I and II.
Following treatment no further changes are noted.
[0040] Results of these studies indicate that oral or i.v.
doses of cabenegrin I and II are capable of treating
conditions clinically thought of as being either cardiotoxic
and/or neurotoxic in nature with no inherent observable side
effects.
[0041] As mentioned above, the new compounds of the method
of the invention are suitable for the preparation of
pharmaceutical compositions, preferably for oral
administration, or for parenteral injections.
[0042] Suitable pharmaceutical carriers for oral
administration include liquids which are inert to the
gastric mucosa. Liquid carriers can be of the type in which
a stable suspension of compounds of the invention can be
prepared. Alternatively the liquid carrier can be a solvent
for the cabenegrin I or II. In the latter case, the liquid
pharmaceutical carrier solution can be prepared for either
oral administration, or for parenteral injection.
[0043] Novel compositions for oral administration can also
be prepared by blending cabenegrin I and II with appropriate
dry pharmaceutical carriers known to the art. These dry
compositions can be put into any suitable dosage form for
ingestion including pills, tablets and capsules.
Micro-encapsulation techniques can be employed to provide a
sustained release of the desired dosage if the particular
condition of the subject indicates this form of therapy.
[0044] In many instances, either the nature of the poisonous
toxin, or the type of deteriorating condition of the subject
will necessitate that a liquid dosage be administered to
insure a prompt initiation of the therapeutic effects of the
compounds. Effective treatment of animals or of subjects
that are unconscious or whose vital functions are in an
advanced state of deterioration will require administration
of oral doses via stomach tube or intravenous injection by
syringe or catheter.
[0045] A pharmaceutical composition was prepared by blending
the following materials in the specified proportions by
weight:
After the dry composition was thoroughly blended tablets
were prepared from the mixture. Each tablet was formed so
that it contained 100 mg of cabenegrin I. Similarly, tablets
were prepared using the same mixture for the pharmaceutical
carrier and the same proportion of cabenegrin II was
substituted for the compound, with each tablet containing 70
mg of cabenegrin I.
US4443472
Method of treating mammals for effects of neuro-
and cardiovascular toxins
Inventor(s): DARKO LASZLO L [US] +
Applicant(s): RICHTER GEDEON VEGYESZET
[HU] +
Abstract
Methods of treating mammals, including man, for poisonous
snake and insect bites, E. coli endotoxins, botulism and
other neurotoxins and cardiovascular toxins by administering
therapeutic quantities of physiologically active compounds
of the formula: (I) and (II) and the materials from which
they are derived.
BACKGROUND
OF THE INVENTION
FIELD OF THE INVENTION
This invention relates to antidotes for treating the effects
of poisonous snake and insect bites in mammals, including
man. It also relates to the use of products of manufacture
in the treatment of pathogenic bacterial toxins such as E.
coli endotoxins, botulism and others which exhibit central
nervous system effects and related respiratory paralysis,
and to the treatment of the effects of cardiovascular toxins
on mammals with the products of manufacture and with aqueous
alcoholic extracts of the natural products from which they
are derived.
SUMMARY
OF THE INVENTION
The invention includes therapeutically active compositions
for the treatment of mammals comprising compounds selected
from the class of: ##STR2## and pharmaceutical carriers. The
invention also includes methods of treating mammals for the
effects of neuro toxins and cardiovascular toxins which
comprise administering to a mammal a therapeutic quantity of
a composition consisting of compounds selected from the
class of compounds (I) and (II) set forth above and
pharmaceutical carriers. The invention disclosed herein also
includes the treatment of specific symptoms in mammals,
including humans, with the aqueous alcoholic extracts, or
their equivalents, of the natural materials from which they
are derived.
The methods for producing cabenegrin I and cabenegrin II in
substantially pure crystalline form are described in a
co-pending application filed concurrently herewith in the
names of Laszlo Darko, Koji Nakanishi and Masachi Nakagawa,
under U.S. Ser. No. 357,805, entitled Physiologically Active
Compounds and Their Isolation, and the entire disclosure of
that application is incorporated herein by reference. That
application describes in detail an extraction scheme
whereby, as new products of manufacture, crystalline
compounds corresponding to compounds (I) and (II) and
referred to as cabenegrin I and cabenegrin II, respectively,
are obtained, that scheme may be summarized as follows:
About one-half kilo of the cleaned root from the cabeca de
negra tree is chopped and further comminuted to break down
the fibrous structure. The pulverized root is placed in a
container with a sufficient quantity of ethanol:water
(77:33) to cover it, and allow to stand, with occasional
stirring for about two days. The aqueous alcoholic solution
is separated from the root and reduced by gentle warming
under vacuum by to brown oily residue. This concentrate is
treated with 50% aqueous methanol and the solution extracted
with hexane. The hexane layer is discarded and the water
layer is extracted with ether. After separation the ether
layer is subjected to high pressure liquid chromatography
(HPLC) on a column of Sephadex LH-20 and silica gel, using
aqueous methanol as the eluting solvent. Two fractions are
obtained. The first fraction is subjected to further HPLC
and compounds (I), also referred to as cabenegrin I, is
obtained as a substantially pure white crystalline material
having a sharp melting point at 167 DEG-168 DEG C. The
second fraction described above is an oily material which is
subjected to further HPLC and compound (II), also referred
to as cabenegrin II, is obtained as a crystalline material.
In the above extraction scheme, the presence of
physiologically active compounds was determined by in vivo
tests employing mice. Test animals were Swiss Webster white
mice, mixed sexes, weighing from 20-25 grams. Each group of
test animals was envenomated with two and one-half times the
lethal dose of snake venom from the Fer de Lance (Bothrops
atrox) by intraperitoneal injection. In the absence of
treatment, envenomated animals succumbed within a few
minutes.
Concentrates or compounds (I) and (II) obtained from each of
the fractions of the above extraction scheme were tested for
antidotal activity by injecting the mice immediately after
envenomation with an aqueous ethanol solution (77:23) of the
material isolated from each fraction. Each animal was
treated with 0.25 ml of the respective solutions. On the
basis of this protocol, the minimum dosage for survival
against the Fer de Lance venom was 2.8 mg/kg of cabenegrin I
and 2.0 mg/kg of cabenegrin II.
Toxicological studies indicate that administration of
aqueous ethanolic solutions of cabenegrin I and cabenegrin
II to healthy test animals produce no significant changes in
vital physiological functions. Administration can be by
intravenous or intra muscular injection, or orally via a
stomach tube. No significant change is noted in arterial
blood pressure, heart rate, respiration, EKG or central
venous pressure at any time following administration of
compounds I and II to normal, healthy (i.e.,
non-envenomated) animals.
Administration does not significantly alter resting action
potentials, end plate potentials, nerve impulse
transmission, neuro-muscular function or brain wave activity
in experimental animals.
The following tests demonstrate the treatment with
cabenegrin I and II of the effects of toxins which affect
either the cardiovascular and/or the neurophysiological
systems of experimental animals.
ANTIDOTAL
EFFECTS AGAINST SNAKE VENOM IN DOGS
Envenomation by a lethal dose of snake venom, such as
Bothrops atrox, Crotalus adamamteuns, or Crotalus atrox,
produces a precipitous fall in arterial blood pressure, a
decrease of heart rate and an elevation in central venous
pressure. This is followed by partial recovery of these
parameters and then by a complete respiratory and
cardiovascular collapse. Death appears to be due to a
combination or peripheral vascular collapse and to an
interruption in the normal respiratory mechanism. In
addition, there appears to be some action of these venoms on
the central nervous system of the experimental animals. This
CNS effect is exhibited by a decrease in both the alpha and
the beta rhythm of the brain (EEG). This change is also
associated with a decrease in impulse transmission over the
motor nerves and progressive blockage of the neuromuscular
apparatus which is similar to that produced by curare.
Venoms had no effect on muscle response to direct
stimulation.
A series of seven adult beagle dogs are used to study the
effectiveness of cabenegrin I and II against the venoms. The
dogs are anesthetized with Na pentobarbitol (30 mg/kg) and
monitored for changes in arterial blood pressure, heart
rate, electrocardiogram and respiration. Lethal doses (five
to ten times of LD50) of lyophilized reconstituted Bothrops
atrox (Fer de Lance) (2.5 mg-5.0 mg/kg) or (10 mg/kg) South
American rattle snake venom are administered.
Within 15 minutes following envenomation, marked decreases
in heart rate and blood pressure are consistently noted. At
from 15 to 30 minutes, respiration likewise decreases from
an average of 20 per minute to 5 per minute. Treatment is
initiated when severe cardiovascular embarrassment and
apparent respiratory difficulties are observed (usually at
from 15-30 minutes following envenomation).
A solution of cabenegrin I is prepared by dissolving 33 mg
of the crystalline material of compound in 100 ml of aqueous
ethanol (25:75). Similarly, a solution of 24 mg of
cabenegrin II in 100 ml of aqueous ethanol (15:75) is
prepared. Doses are prepared for administration by stirring
5 ml of each of the respective alcoholic solution of
compounds (I) and (II) into 50 ml of water.
Administration of the respective solutions is through a tube
placed and advanced into the stomach of the dog. Treatment
is as follows: No immediate response is noted following
therapy. Blood pressure, heart rate and respiration all
remain extremely low. At approximately 30 minutes following
the first dose of the respective alcoholic solution of
compounds (I) and (II), a slow gradual improvement of
breathing occurs followed by partial restoration of heart
rate and blood pressure. Continuous therapy is provided at
30 minute intervals in 50 ml water until all monitored vital
signs return to within 10% of control.* From two to four
doses are required. After observation for 8-10 hours the
animals are placed in a holding cage with food and water. At
24 hours, all 7 dogs show signs of depressed activity. At 72
hours, all dogs are taking food and water. No additional
therapy is required.
*The effective dose range is between 10 to 20 ml of
antivenom extract per animal.
ACTIVITY
OF CABENEGRIN II AND II AGAINST E. COLI ENDOTOXIN
Three adult beagle dogs are used to demonstrate the
effectiveness of the cabenegrin I and II in treating shock
caused by E. coli endotoxin. The dogs are anesthetized with
Na pentabarbital (30 mg/kg) and monitored for changes in
arterial blood pressure, heart rate, EKG and respiration.
Lethal doses (1 mg/kg) of E. coli endotoxin are injected IV
into a catheter placed in the vein of the hind limb of the
dogs. In the first experiment no antidotal therapy was
initiated and the animal expired at 2 hours after injection.
In the three additional cases antidotal therapy is initiated
at the time when severe cardiovascular collapse and
respiratory difficulties appear. These usually occur within
about 11/2 hours after the injection of the toxin.
Solutions of cabenegrin I and II, prepared as described
above, are administered by stomach tube in a single dose of
10 ml in 100 ml of water to each of the dogs. The animals so
treated survive and resume normal activity.
ISOLATED
HEART (LANGENDORFF) PREPARATION
A series of 2 dog heart preparations are tested to measure
the antivenom effect on coronary blood flow, heart rate,
EKG, force of ventricular contraction and coronary vascular
resistance when cabenegrin I and II are given either before
or after lethal venom challenge. It is observed that
treatment appears capable of overcoming the toxic effects of
the venom on cardiovascular functions. These effects are a
decrease of the force of contraction and heart rate.
Coronary vascular resistance also increases progressively
following the administration of venom. When a solution
containing 0.5 mg/ml of either compound (I) or compound (II)
are injected directly into the circulation prior to tropical
rattle snake venom challenge, no detrimental effect on the
heart is observed. Rather, the force of contraction and
coronary blood flow increases by about 15 to 20 percent.
When either compound (I) or compound (II) is given following
lethal challenge of tropical rattle snake venom, the
antidote restores force of contraction and heart rate to
normal levels and reverses the minor arrhythmias caused by
envenomation.
NEUROPHYSIOLOGICAL
FUNCTION
Three dogs and one cat are tested for the antidotal effect
on neuromuscular function, action potential and brain wave
activity following envenomation with lethal doses of Fer de
Lance venom.
Snake venom decreases both brain wave activity and nerve
impulse transmission. These are restored to near, if not
completely, normal levels by the administration of
cabenegrin I and II. Action potentials and neuromuscular
function remain depressed for approximately 30 to 60 minutes
after treatment with each of the compounds. This is followed
by a slow, gradual return to control levels at from 12 to 24
hours.
In certain experiments in which complete neuromuscular
blockage occurs and the animals are no longer capable of
spontaneous respiration, artificial ventilation is required
until the action of the compound has manifested itself. This
may occur after envenomation, but once stabilized, the
animals are capable of spontaneous breathing and no further
therapy is required.
Cortical electrical activity is markedly (25-35%) depressed
by the venom. These changes are restored to normal by the
administration of the compounds cabenegrin I and II.
Following treatment, no further changes are noted.
Results of these studies indicate that oral or IV doses of
cabenegrin I and II are capable of treating conditions
clinically thought of as being either cardiotoxic and/or
neurotoxic in nature with no inherent observable side
effects.
Suitable pharmaceutical carriers for oral administration
include liquids which are bland to the gastric mucosa.
Liquid carriers can be of the type in which a stable
suspension of compounds I and II can be prepared.
Alternatively, the liquid carrier can be a solvent for the
cabenegrin I and II. In the latter case, the liquid
pharmaceutical carrier solution can be prepared for either
oral administration, or for parental injection.
Novel compositions for oral administration can also be
prepared by blending cabenegrin I and II with appropriate
dry pharmaceutical carriers known to the art. These dry
compositions can be put into any suitable dosage form for
ingestion including pills, tablets and capsules.
Micro-encapsulation techniques can be employed to provide a
sustained release of the desired dosage if the particular
condition of the subject indicates this form of therapy.
In many instances, either the nature of the poisonous toxin,
or the type or deteriorated condition of the subject will
necessitate that a liquid dosage be administered to insure a
prompt initiation of the therapeutic effects of the
compounds. Effective treatment of animals or of subjects
that are unconscious or whose vital signs are in an advanced
stage of deterioration will require administration of oral
doses via stomach tube or intravenous injection by syringe
or catheter.
A pharmaceutical composition was prepared by blending the
following materials in the specified proportions by weight:
Compound I: 20
Starch: 15.0
Magnesium stearate: 2.0
Sodium benzoate: 6.0
Benzalkonium chloride: 2.0
After the dry composition was throughly blended tablets were
prepared from the mixture. Each tablet was formed so that it
contained 100 mg of compound (I). Similarly, tablets were
prepared using the same mixture for the pharmaceutical
carrier and the same proportion of compound (II) was
substituted for the compound, with each tablet containing 70
mg of compound (I).