Abstract:
The invention discloses a pharmaceutical composition for synergistically treating and preventing diabetic complication. The composition contains 1-deoxynojirimycin and fagomine, and the weight ration of the 1-deoxynojirimycin to the fagomine is 0.5-5:1.

Description:
FIELD OF INVENTION 
       [0001]    The invention relates to a pharmaceutical composition, in particular to a pharmaceutical composition for treating diabetes. 
       BACKGROUND 
       [0002]    1-deoxynojirimycin and fagomine are nitrogen-containing alkaloids contained in branches, leaves, bark or silkworm droppings of moraceae plants. The chemical name of 1-deoxynojirimycin is 3,4,5-trihydroxy-2-hydroxymethyl tetrahydropyridine. The compound has been commercialized and can be purchased from the market, there are many manufacturers providing the compound, such as Shanghai Winherb Medical S &amp; T Development Co., Ltd. 
         [0003]    There is no public sale of commodities of fagomine until now, and the literature has reported that Naoki Asano, et al. in Hokuriku University, Japan obtained fagomine through a method of extraction, repeated column chromatography and recrystallization (J. Carbohydrate Research, Vol. 253, pp, 235-245 (1994)). 
         [0004]    Domestic and international researches and reports show that alkaloid extracts from moraceae plants have the roles of inhibiting the rise of blood glucose and improving glucose tolerance, wherein the 1-deoxynojirimycin can be combined with maltase, sucrase, lactase and other α-glycosidases in the small intestine, thereby avoiding further decomposition of disaccharides and further inhibiting the sharp rise in the postprandial blood glucose; and fagomine not only has the role of a glycosidase inhibitor, but also has the role of reducing the blood glucose by increasing the release of insulin. 
         [0005]    Hypoglycemic chemicals including sulfonylureas such as glyburide, gliclazide and the like, biguanides such as metformin and the like, thiazolidinediones such as troglitazone, rosiglitazone and the like have been commercialized and applied clinically; and extracts of flavonoids from mulberry leaves,  ginkgo biloba  extract compound, bitter melon extract and tea polyphenol extract and the like are on sale in the market, such as by Hunan Geneham Biomedical Technology Ltd., Shaoguan Jumin Pharmaceutical Co., Ltd., and other medicine and extract manufactures. 
       SUMMARY OF INVENTION 
       [0006]    The invention aims at providing a pharmaceutical composition with better effect on reducing blood glucose. 
         [0007]    The composition contains 1-deoxynojirimycin and fagomine, wherein the weight ratio of the 1-deoxynojirimycin to the fagomine is 0.5˜5:1. 
         [0008]    Wherein, the preferential weight ratio of the 1-deoxynojirimycin to the fagomine is 2˜5:1. 
         [0009]    The invention firstly researches the role of reducing the blood glucose of the composition of the 1-deoxynojirimycin and the fagomine with different mixing ratios, with the result that the two compounds have good synergistic hypoglycemic effect within a certain proportion range. According to the embodiments of the invention, the mixing ratio with better synergistic hypoglycemic effect is selected. 
         [0010]    The invention further researches the synergistic hypoglycemic effect of the composition which is combined with other hypoglycemic compounds for use. On reducing the blood glucose value of rats with hyperglycemia after intragastric administration of sucrose, the joint application of the composition of the 1-deoxynojirimycin and the fagomine and other hypoglycemic substances can reduce blood glucose value more effectively than the other hypoglycemic substances or the combined application or the single application of the two. 
         [0011]    The pharmaceutical composition containing 1-deoxynojirimycin and fagomine can be prepared into a variety of formulations, including tablets, capsules, granules, powder, dripping pills, oral liquid and the like. The preparation method can adopt the conventional excipients and the conventional methods, 
         [0012]    The research results show that the pharmaceutical composition of present application has clear action mechanism and significant efficacy and can be used for treating and preventing diabetes and complications thereof. 
     
    
     DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     Embodiment 1 
       [0013]    Determination of α-D-glucosidase inhibitory activity of the combination compatibility of 1-deoxynojirimycin and fagomine. 
         [0000]    1. Medicines: 1-deoxynojirimycin and fagomine, homemade.
 
2. Reagents: potassium dihydrogen phosphate, sodium hydroxide, sodium bicarbonate, para-nitrophenyl glucoside (PNPG), reduced glutathione and α-D-glucosidase sucrose.
 
3. Instrument: TU-1901 UV-Vis spectrophotometer.
 
4. Test method and results
 
(1) Preparation of potassium phosphate buffer solution: dissolve 0.68120 g of potassium dihydrogen phosphate in 25 mL of distilled water, obtain stock solution 1, dissolve 0.2 g of NaOH in 25 mL of the distilled water, obtain stock solution 2, suck the stock solution 1 (25 mL), add into the stock solution 2 (11.8 mL), shake up, dilute to 100 mL and obtain the potassium phosphate buffer solution.
 
(2) Na 2 CO 3  stop solution: Na 2 CO 3  10.6 g→100 mL of distilled water (1 mol/L)
 
(3) PNPG: 17.47 mg→2 mL of distilled water (0.029 mol/L)
 
(4) Reduced glutathione: 2.10 mg→2 mL of distilled water (1.05 mg/mL)
 
(5) α-D-glucosidase sucrose: 0.5 mg→1 mL of distilled water (0.5 mg/mL)
 
(6) 1-deoxynojirimycin stock solution: 3.24 mg→1 mL of distilled water (20 μmol/mL)
 
(7) Fagomine stock solution: 3.00 mg→1 mL of distilled water (20 μmol/mL)
 
(8) Preparation of glycosidase inhibitor sample solution:
 
         [0014]    Take 250 μL of the 1-deoxynojirimycin stock solution, dilute to 1 mL with the distilled water, and obtain the stock solution 1. 
         [0015]    Take 250 μL of the fagomine stock solution, dilute to 1 mL with the distilled water, and obtain the stock solution 2. 
         [0016]    The compatibility of the stock solution 1 and the stock solution 2 is carried out according to the proportion in Table 2. 
         [0000]    (9) Determination reaction of α-D-glucosidase inhibitory activity 
         [0017]    Add the reagents according to the sequence in Table 1 for reaction, determine the absorbance value and calculate the α-glycosidase inhibition ratio of a sample according to the following formula: 
         [0000]    
       
         
           
             
               α 
                
               
                 - 
               
                
               glycosidase 
                
               
                   
               
                
               inhibition 
                
               
                   
               
                
               ratio 
                
               
                   
               
                
               % 
             
             = 
             
               
                 
                   
                     
                       
                         Absorbance 
                          
                         
                             
                         
                          
                         of 
                          
                         
                             
                         
                          
                         sample 
                       
                     
                   
                   
                     
                       
                         tube 
                          
                         
                           - 
                         
                          
                         absorbance 
                       
                     
                   
                   
                     
                       
                         of 
                          
                         
                             
                         
                          
                         blank 
                          
                         
                             
                         
                          
                         tube 
                       
                     
                   
                 
                 
                   
                     
                       
                         Absorbance 
                          
                         
                             
                         
                          
                         of 
                          
                         
                             
                         
                          
                         standard 
                       
                     
                   
                   
                     
                       
                         tube 
                          
                         
                           - 
                         
                          
                         absorbance 
                       
                     
                   
                   
                     
                       
                         of 
                          
                         
                             
                         
                          
                         blank 
                          
                         
                             
                         
                          
                         tube 
                       
                     
                   
                 
               
               × 
               100 
                
               % 
             
           
         
       
     
         [0000]    
       
         
               
             
               
               
               
               
             
               
             
               
               
               
             
               
             
               
               
               
               
             
           
               
                 TABLE 1 
               
               
                   
               
             
             
               
                 Design of Determination Test of α-glycosidase Inhibition Ratio 
               
             
          
           
               
                   
                   
                 Standard 
                   
               
               
                 Reagent (μL) 
                 Blank centrifuge tube 
                 tube 
                 Sample tube 
               
               
                   
               
               
                 Potassium phosphate 
                 2500 
                 2500 
                 2500 
               
               
                 buffer solution 
               
               
                 α-D-glucosidase 
                 15 
                 15 
                 15 
               
               
                 Reduced glutathione 
                 15 
                 15 
                 15 
               
               
                 Distilled water 
                 45 
                 30 
               
               
                 Glycosidase inhibitor 
                   
                   
                 30 
               
             
          
           
               
                 Constant temperature for 10 min in water bath cauldron at 37° C. 
               
             
          
           
               
                 PNPG 
                 15 
                 15 
               
             
          
           
               
                 Constant temperature for 10 min in water bath cauldron at 37° C. 
               
             
          
           
               
                 Na 2 CO 3  stop solution 
                 1425 
                 1425 
                 1425 
               
               
                   
               
               
                 Colorimetry at UV 400 nm 
               
             
          
         
       
     
       (10) Results: see Table 2. 
       [0018]      
         [0000]                                                      TABLE 2               Test of α-glycosidase Inhibition Ratio of 1-deoxynojirimycin and       Fagomine in Different Mixing Ratios                                DNJ:Fag    1:0    5:1   2:1   1:1   1:2   1:5    0:1        mixing ratio                                   DNJ:Fag sample   30:0   25:5   20:10   15:15   10:20   5:25   0:30       solution volume                                   α-glycosidase   44%   59%   54%   48%   42%   33%   21%       inhibition ratio %               Note:       In the table, 1-deoxynojirimycin is abbreviated as DNJ and fagomine is abbreviated as Fag.            
5. Conclusion: the test results show that the fagomine and the 1-deoxynojirimycin have a synergistic α-glycosidase inhibition role (the total amount of the 1-deoxynojirimycin and the fagomine is constant), when the mixing ratio of the 1-deoxynojirimycin to the fagomine is 0.5-5:1, the α-glycosidase can be better inhibited, wherein when the mixing ratio is 2-5:1, the effect is plainly better than the effect of the single use of the 1-deoxynojirimycin in the same concentration.
 
       Embodiment 2 
       [0019]    Impacts of the composition in different doses on blood glucose and serum insulin of mice with spontaneous hyperglycemia 
         [0000]    1, Medicines: 1-deoxynojirimycin and fagomine, prepared by the inventor. The two are prepared into the required concentrations with distilled water before the test (the sum of the concentrations of the 1-deoxynojirimycin and the fagomine in the composition is the same as the concentration of the fagomine or the 1-deoxynojirimycin which is prepared alone). Glibenclamide is obtained from Hunan Dongting Pharmaceutical Co., Ltd.
 
2. Animals: NOD mice with the weight of 25-35 g, provided by Experimental Animal Center, Peking University Health Science Center. Determine the blood glucose before the test and select the animals with the blood glucose value of above 11.1 mmol/L for carrying out the test.
 
3. Determination instrument: Yicheng blood glucose tester, developed by Beijing Yicheng Bioelectronic Technology Co., Ltd.
 
4. Main reagents:  125 I-insulin radioimmunoassay kit, produced by Department of Isotopes, China Institute of Atomic Energy.
 
5. Test method and results
 
(1) Impacts on the blood glucose of the mice: determine the blood glucose of the NOD mice after fasting for 6 h, select 70 animals with blood glucose above 11.1 mmol/L, randomly divide into seven groups, respectively carry out intragastric administration and give the following medicines: i) control group (distilled water); ii) glibenclamide group (50 mg/kg); and iii)-v) composition in different mixing ratios (20 mg/kg, with different medicine proportions and constant total amount). Carry out the continuous administration for 14 days, fast for 6 h before the administration at the 14 th  day, draw blood from the animals 1 h after the administration, use the Yicheng blood glucose tester to determine the blood glucose value of the animals, and determine the serum insulin by radioimmunoassay. The results are shown in Tables 3-4.
 
         [0000]    
       
         
               
             
               
               
               
               
               
             
           
               
                 TABLE 3 
               
             
             
               
                   
               
               
                 Impacts of Pharmaceutical Composition on Blood Glucose of Mice 
               
               
                 with Spontaneous Hyperglycemia (X ± SD) 
               
             
          
           
               
                   
                   
                   
                 Blood glucose 
                   
               
               
                   
                   
                 Number 
                 before 
                 Blood glucose after 
               
               
                   
                 Dose 
                 of 
                 administration 
                 administration 
               
               
                 Group 
                 (mg/kg) 
                 animals 
                 (mmol/L) 
                 (mmol/L) 
               
               
                   
               
               
                 Model control 
                 — 
                 10 
                 13.64 ± 2.08 
                 13.97 ± 1.86  
               
               
                 group 
               
               
                 Glibenclamide 
                 50 
                 10 
                 13.26 ± 2.26 
                 10.57 ± 2.17** 
               
               
                 DNJ 
                 20 
                 10 
                 14.20 ± 1.33 
                 10.60 ± 2.13** 
               
               
                 Fagomine 
                 20 
                 10 
                 13.49 ± 1.65 
                 12.24 ± 1.62** 
               
               
                 Composition 
                 20 
                 10 
                 14.14 ± 1.70 
                  9.75 ± 1.53** 
               
               
                 Composition 
                 20 
                 10 
                 13.58 ± 1.73 
                 10.04 ± 1.44** 
               
               
                 Composition 
                 20 
                 10 
                 13.92 ± 2.07 
                 10.39 ± 1.43** 
               
               
                   
               
               
                 Note: 
               
               
                 1. Compare with the model control group: *P &lt; 0.05, **P &lt; 0.01 (t-test). 
               
               
                 2. In the table, 1-deoxynojirimycin is abbreviated as DNJ and fagomine is abbreviated as Fag. 
               
             
          
         
       
     
         [0000]                                      TABLE 4                   Impacts of Pharmaceutical Composition on Serum Insulin of Mice with       Spontaneous Hyperglycemia (X ± SD)                Dose   Number of   Serum insulin       Group   (mg/kg)   animals   (MIU/L)               Model control group   —   10   14.84 ± 2.83       Glibenclamide   50   10   22.57 ± 3.05**       1-deoxynojirimycin   20   10   16.14 ± 2.63       Fagomine   20   10   21.78 ± 3.34**       Composition (DNJ:Fag = 5:1)   20   10   17.25 ± 2.15*       Composition (DNJ:Fag = 2:1)   20   10   19.83 ± 2.65**       Composition (DNJ:Fag = 1:2)   20   10   21.03 ± 3.22**               Note:       1. Compare with the model control group: *P &lt; 0.05, **P &lt; 0.01 (t-test).       2. In the table, 1-deoxynojirimycin is abbreviated as DNJ and fagomine is abbreviated as Fag.            
6. Conclusion: The single application of 1-deoxynojirimycin can significantly reduce the blood glucose of the NOD mice and has better effect than the single application of fagomine for reducing the blood glucose; and the single application of the 1-deoxynojirimycin has little effect on the serum insulin of the NOD mice, and the single application of the fagomine can significantly improve the serum insulin level.
 
         [0020]    When the mixing ratio of the 1-deoxynojirimycin to the fagomine is 2-5:1, the composition can improve the serum insulin level of the NOD mice and significantly reduce the blood glucose of the NOD mice, and the hypoglycemic effect is plainly better than the single application of 1-deoxynojirimycin or of fagomine with the same concentration, showing that the combined application of the two has synergistic effect. 
         [0021]    In addition, according to the results of the efficacy test, the effective dose of the composition of the 1-deoxynojirimycin and the fagomine approximately equals to 120 mg of the composition per person per day, with about 40 mg each time; calculated by the preferential proportion of 2-5:1. 
         [0022]    Each administration at least contains more than 25 mg of the 1-deoxynojirimycin. From the aspects of facilitating the administration to patients and reducing the administration dose, tablets or capsules are adopted, and each administration contains 5 tablets or 5 capsules at most (the total amount is calculated as 2500 mg at most), so that the preferential content of the 1-deoxynojirimycin in the pharmaceutical composition is larger than 1%. 
       Embodiment 3 
       [0023]    Joint application test with other hypoglycemic substances 
         [0000]    1. Medicines: 1-deoxynojirimycin-fagomine mixture (2:1), homemade. The mixture is prepared to the required concentration with distilled water before the test. Glucobay is obtained from Bayer Healthcare Co., Ltd. Catechin,  ginkgo biloba  extract and flavonoids from mulberry leaves were obtained from Hunan Geneham Biomedical Technology Ltd.
 
2. Animals: SD rats with the weight of 180-220 g, half male and half female, provided by Hunan Institute of Pharmaceutical Industry Research. Modeling method: carry out small dose intravenous injection of 25 mg/kg of streptozotocin on the rats after fasting for 24 h, once a week, simultaneously heat feed for feeding, induce H type diabetes, determine the blood glucose 1 week after the second injection, and select the animals with the fasting blood glucose of above 7.8 mmol/L for carrying out the test.
 
3. Reagents: streptozotocin, product of Sigma Company, USA. Use citric acid buffer solution (PH=4.0) before modeling, and prepare at low temperature; sucrose, analytically pure.
 
4. Instrument: SURESTEP PLUS blood glucose monitoring meter.
 
5. Test method and results: lead the SD rats to fast without water deprivation for 24 h, carry out intravenous injection of 25 mg/kg of streptozotocin, once a week, simultaneously heat feed for feeding, induce II type diabetes, determine the blood glucose 1 week after the second injection, and select 90 rats with the fasting blood glucose of above 7.8 mmol/L for carrying out the test. Randomly divide into 9 groups (n=10), wherein the first group is the control group with isometric distilled water for intragastric administration, the second group is the glucobay group, and other groups are the 1-deoxynojirimycin-fagomine mixture (the proportion of the mixture is 2:1, represented as DF in the table) and compositions of other different hypoglycemic substances; and carry out intragastric administration according to the above dose, give the test medicines continuously for 14 days, fast for 6 h before the administration at 14 th  day, carry out the administration according to the above dose, simultaneously carry out the intragastric administration with 5.0 g/kg of sucrose, and determine the blood glucose of the rats before sucrose administration and 1.0 h after the sucrose administration, wherein the temperature in a laboratory is 20° C.-25° C. The test results are shown in Table 5.
 
         [0000]                                                    TABLE 5                   Impacts of Composition on Blood Glucose Value of Rats with       Streptozotocin-induced Hyperglycemia after Intragastric Administration       with Sucrose                    Blood glucose value of rats           Medicine   with hyperglycemia (mmol/L)                dose   Before           Group   (mg/kg)   administration   After administration               Model control group   Isometric   8.45 ± 0.82   15.56 ± 2.54           distilled           water       Glucobay group   10.0   8.24 ± 0.93   12.21 ± 1.84**       DF:catechin (1:2)   60   8.97 ± 1.01   12.47 ± 2.03**       Catechin   60   9.17 ± 0.89   14.10 ± 1.50       DF:ginkgo biloba   60   8.31 ± 0.94   12.54 ± 1.61**       extract (1:2)       Ginkgo biloba extract   60   8.56 ± 1.11   13.82 ± 1.72       DF:flavonoids from   60   7.96 ± 1.07   12.04 ± 1.91**       mulberry leaves       Flavonoids from   60   8.72 ± 1.22   13.65 ± 2.12*       mulberry leaves       DF   20   8.37 ± 1.05   12.88 ± 1.55**               Note:       Compare with the model control group:       *P &lt; 0.05,       **P &lt; 0.01.            
6. Conclusion: The composition of the 1-deoxynojirimycin and the fagomine and other hypoglycemic substances can more effectively reduce the blood sugar value of the rats with the hyperglycemia after the intragastric administration of the sucrose in comparison with the combined and single applications of other hypoglycemic substances and DF.