Organ arrest, protection and preservation
The present invention relates to a method for arresting, protecting and/or preserving an organ which includes administering effective amounts of (i) a potassium channel opener or agonist and/or an adenosine receptor agonist and (ii) local anaesthetic to a subject in need thereof. The present invention also relates to a method for arresting, protecting and/or preserving an organ which comprises adding a composition which includes effective amounts of (i) a potassium channel opener or agonist and/or an adenosine receptor agonist and (ii) a local anaesthetic to the organ. The present invention further provides a pharmaceutical or veterinary composition which includes effective amounts of (i) a potassium channel opener or agonist and/or an adenosine receptor agonist and (ii) a local anaesthetic.
1. A composition comprising:
a pharmaceutically acceptable carrier;
a compound chosen from the group consisting of a potassium channel opener, a potassium channel agonist and an adenosine receptor agonist; and
a local anesthetic;
wherein the compound and the local anesthetic are present in the composition in an amount sufficient to arrest an organ.
2. The composition of claim 1 , wherein the potassium channel opener or potassium channel agonist is selected from the group consisting of nicorandil, diazoxide, minoxidil, pinicadil, aprikalim, cromokulim, NS-1619 (1,3-dihydro-1-[2-hydroxy5(trifluoromethyl) phenyl]5-(trifluoromethyl)2-H-benimidazol-one), amlodipine, Bay K 8644(L-type)(1,4-dihydro-26-dimethyl-5-nitro-4[2(trifluoromethyl)phenyl]-3-pyridine carboxylic acid (methyl ester)), bepridil HCl (L-type), calciseptine (L-type), omega-conotoxin GVIA (N-type), omega-conotoxin MVIIC (Q-type), cyproheptadine HCl, dantrolene sodium (Ca 2+ release inhibitor), diltiazem HCl (L-type), filodipine, flunarizine HCl (Ca 2+ /Na + ), fluspirilene (L-type), HA-1077 2HCl(1-(5 isoquinolinyl sulphonyl) homo piperazine.HCl), isradipine, loperamide HCl, manoalide (Ca 2+ release inhibitor), nicardipine HCl (L-type), nifedipine (L-type), niguldipine HCl (L-type), nimodipine (L-type), nitrendipine (L-type), pimozide (L- and T-type), ruthenium red, ryanodine (SR channels), taicatoxin, verapamil HCl (L-type), methoxy-verapamil HCl (L-type), YS-035 HCl (L-type)N[2(3,4-dimethoxyphenyl)ethyl]-3,4-dimethoxy N-methyl benzene ethaneamine HCl) and AV blockers.
3. The composition of claim 2 , wherein the potassium channel opener or potassium channel agonist is an AV blocker and wherein the AV blocker is adenosine.
4. The composition of claim 3 , wherein the concentration of adenosine is about 0.01 to about 10mM.
5. The composition of claim 3 , wherein the local anesthetic is a Class 1B antiarrhythmic agent and wherein the Class 1B antiarrhythmic agent is lignocaine.
6. The composition of claim 5 , wherein the concentration of adenosine is about 0.01 to about 5 mg/min/kg, and the concentration of lignocaine is about 0.01 to about 10 mg/min/kg.
7. The composition of claim 5 , wherein the concentration of adenosine is about 0.01 to about 10 mM, and the concentration of lignocaine is about 0.01 to about 10 mM.
8. The composition of claim 5 , wherein the concentration of adenosine is about 0.05 to about 5 mM, and the concentration of lignocaine is about 0.05 to about 5 mM.
9. The composition of claim 8 , wherein the pharmaceutically acceptable carrier comprises magnesium having a concentration of about 20 mM.
10. The composition of claim 9 , wherein the pharmaceutically acceptable carrier includes potassium at a concentration of less than about 10 mM.
11. The composition of claim 1 , wherein the adenosine receptor agonist is selected from the group consisting of N 6 -cyclopentyladenosine (CPA), N-ethylcarboxamido adenosine (NECA), 2-[p-(2-carboxyethyl)phenethyl-amino-5′-N-ethylcarboxamido adenosine (CGS-21680),2-chloroadenosine, N 6 -[2-(3,5-dimethoxyphenyl)-2-(2-methoxyphenyl]ethyladenosine, 2-chloro-N 6 -cyclopentyladenosine (CCPA), N-(4-aminobenzyl)-9-[5-(methylcarbonyl)-beta-D-robofuranosyl]-adenine (AB-MECA), ([IS-[1a, 2b, 3b, 4a(S*)]]-4-[7-[[2-(3-chloro-2-thienyl)-1-methyl-propyl]amino]-3H-imidazole[4,5-b]pyridyl-3-yl]cyclopentane carboxamide (AMP579, N 6 —(R)-phenylisopropyladenosine (R-PLA), aminophenylethyladenosine (APNEA) and cyclohexyladenosine (CHA).
12. The composition of claim 1 , wherein the local anesthetic is selected from the group consisting of mexiletine, diphenylhydantoin, prilocalne, procaine, mepivicaine and Class 1B antiarrhythmic agents.
13. The composition of claim 12 , wherein the local anesthetic is a Class 1B antiarrhythmic agent and wherein the Class 1B antiarrhythmic agent is lignocaine.
14. The composition of claim 13 , wherein the concentration of lignocaine is about 0.01 to about 10mM.
15. The composition of claim 1 , wherein the pharmaceutically acceptable carrier comprises a buffer which maintains the pH of the composition in the range from about 6 to about 9.
16. The composition of claim 1 , wherein the pharmaceutically acceptable carrier comprises magnesium having a concentration of about 2.5mM.
17. A method of arresting an organ including the step of contacting the organ with an effective amount of a composition according to claim 1 .
18. The method of claim 17 , wherein the organ is a heart intact in the body of a subject or is an isolated heart.
19. The method of claim 18 , wherein the heart is arrested during open-heart surgery.
20. The method according to claim 19 , further comprising preserving and/or protecting the heart with the composition.
21. A method according to claim 17 , wherein the potassium channel opener or potassium channel agonist is selected from the group consisting of nicorandil, diazoxide, minoxidil, pinicadil, aprikalim, cromokulim, NS-1619 (1,3-dihydro-1-[2-hydroxy-5(trifluoromethyl) phenyl]5-(trifluoromethyl)2-H-benimidazol-one), amlodipine, Bay K 8644(L-type)(1,4-dihydro-26-dimethyl-5-nitro-4[2(trifluoromethyl)phenyl]-3-pyridine carboxylic acid (methyl ester)), bepridil HCl (L-type), calciseptine (L-type), omega-conotoxin GVIA (N-type), omega-conotoxin MVIIC (Q-type), cyproheptadine HCl, dantrolene sodium (Ca 2+ release inhibitor), diltiazem HCl (L-type), filodipine, flunarizine HCl (Ca 2+ /Na + ), fluspirilene (L-type), HA-1077 2HCl(1-(5 isoquinolinyl sulphonyl) homo piperazine.HCl), isradipine, loperamide HCl, manoalide (Ca 2+ release inhibitor), nicardipine HCl (L-type), nifedipine (L-type), niguldipine HCl (L-type), nimodipine (L-type), nitrendipine (L-type), pimozide (L- and T-type), ruthenium red, ryanodine (SR channels), taicatoxin, verapamil HCl (L-type), methoxy-verapamil HCl (L-type), YS-035 HCl (L-type)N[2(3,4-dimethoxyphenyl)ethyl]-3,4-dimethoxy N-methyl benzene ethaneamine HCl) and AV blockers.
22. The method according to claim 21 , wherein the Potassium channel opener or potassium channel agonist is an AV blocker and wherein the AV blocker is adenosine.
23. The method of claim 22 , wherein the concentration of adenosine is about 0.01 to about 10mM.
24. The method of claim 22 , wherein the local anesthetic is a Class 1B antiarrhythmic agent and wherein the Class 1B antiarrhythmic agent is lignocaine.
25. The method of claim 24 , wherein the concentration of adenosine is about 0.01 to about 10 mM, and the concentration of lignocaine is about 0.01 to about 10 mM.
26. The method of claim 24 , wherein the concentration of adenosine is about 0.05 to about 5 mM, and the concentration of lignocaine is about 0.05 to about 5 mM.
27. The method of claim 24 , wherein the concentration of adenosine is about 0.01 to about 5 mg/min/kg, and the concentration of lignocaine is about 0.01 to about 10 mg/min/kg.
28. The method of claim 27 , wherein the pharmaceutically acceptable carrier comprises magnesium having a concentration of about 20 mM.
29. The method of claim 28 , wherein the pharmaceutically acceptable carrier includes potassium at a concentration of less than about 10 mM.
30. The method according to claim 17 , wherein the adenosine receptor agonist is selected from the group consisting of N 6 -cyclopentyladenosine (CPA), N-ethylcarboxamido adenosine (NECA), 2-[p-(2-carboxyethyl)phenethyl-amino-5′-N-ethylcarboxamido adenosine (CGS-21680),2-chloroadenosine, N 6 -[2-(3,5-dimethoxyphenyl)-2-(2-methoxyphenyl]ethyladenosine, 2-chloro-N 6 -cyclopentyladenosine (CCPA), N-(4-aminobenzyl)-9-[5-(methylcarbonyl)-beta-D-robofuranosyl]-adenine (AB-MECA), ([IS-[1a, 2b, 3b, 4a(S*)]]-4-[7-[[2-(3-chloro-2-thienyl)-1-methyl-propyl]amino]-3H-imidazole[4,5-b]pyridyl-3-yl]cyclopentane carboxamide (AMP579, N 6 —(R)-phenylisopropyladenosine (R-PLA), aminophenylethyladenosine (APNEA) and cyclohexyladenosine (CHA).
31. The method of claim 17 , wherein the local anesthetic is selected from the group consisting of mexiletine, diphenylhydantoin, prilocalne, procaine, mepivicaine and Class 1B antiarrhythmic agents.
32. The method of claim 31 , wherein the local anesthetic is a Class 1B antiarrhythmic agent and wherein the Class 1B antiarrhythmic agent is lignocaine.
33. The method of claim 32 , wherein the concentration of lignocaine is about 0.01 to about 10mM.