Patent Grant
10472394
The invention is directed to isomeric mixtures of cyclosporin analogues that are related to cyclosporine A. It is contemplated that the mixtures possess enhanced efficacy and/or reduced toxicity over the individual isomers and over naturally occurring and other presently known cyclosporines and cyclosporine derivatives. In addition, the present invention relates to synthetic pathways for producing isomers of cyclosporin A analogs, where such pathways vary in the degree of stereoselectivity depending on the specific reaction conditions.
The following references are related hereto or referred to herein by patent or application number or in parenthesis by author and year at the relevant portions of this specification:
The disclosure of each of the above-referenced patents, patent applications and publications is incorporated herein by reference in its entirety.
Cyclosporine derivatives compose a class of cyclic polypeptides, consisting of eleven amino acids, that are produced as secondary metabolites by the fungus species Tolypocladium inflartem Gains. They have been observed to reversibly inhibit immunocompetent lymphocytes, particularly T-lymphocytes, in the Go or Gi phase of the cell cycle. Cyclosporine derivatives have also been observed to reversibly inhibit the production and release of lymphokines (Granelli-Piperno et al., 1986). Although a number of cyclosporine derivatives are known, cyclosporine A is the most widely used. The suppressive effects of cyclosporine A are related to the inhibition of T-cell mediated activation events. This suppression is accomplished by the binding of cyclosporine to the ubiquitous intracellular protein, cyclophilin. This complex, in turn, inhibits the calcium- and calmodulin-dependent serine-threonine phosphatase activity of the enzyme calcineurin. Inhibition of calcineurin prevents the activation of transcription factors such as NFATp/c and NF-κB, which are necessary for the induction of the cytokine genes (IL-2, IFN-γ, IL-4, and GM-CSF) during T-cell activation. Cyclosporine also inhibits lymphokine production by T-helper cells in vitro and arrests the development of mature CD8 and CD4 cells in the thymus (Granelli-Piperno et al., 1986). Other in vitro properties of cyclosporine include the inhibition of IL-2 producing T-lymphocytes and cytotoxic T-lymphocytes, inhibition of IL-2 released by activated T-cells, inhibition of resting T-lymphocytes in response to alloantigen and exogenous lymphokine, inhibition of IL-1 production, and inhibition of mitogen activation of IL-2 producing T-lymphocytes (Granelli-Pipemo et al., 1986).
Cyclosporine is a potent immunosuppressive agent that has been demonstrated to suppress humoral immunity and cell-mediated immune reactions such as allograft rejection, delayed hypersensitivity, experimental allergic encephalomyelitis, Freund's adjuvant arthritis and graft vs. host disease. It is used for the prophylaxis of organ rejection subsequent to organ transplantation; for treatment of rheumatoid arthritis; for the treatment of psoriasis; and for the treatment of other autoimmune diseases, including type I diabetes, Crohn's disease, lupus, and the like.
Since the original discovery of cyclosporin, a wide variety of naturally occurring cyclosporins have been isolated and identified and many further non-natural cyclosporins have been prepared by total- or semi-synthetic means or by the application of modified culture techniques. The class comprised by the cyclosporins is thus now substantial and includes, for example, the naturally occurring cyclosporins A through Z (cf. Traber et al. (1977); Traber et al. (1982); Kobel et al. (1982); and von Wartburg et al. (1986)), as well as various non-natural cyclosporin derivatives and artificial or synthetic cyclosporins including the dihydro- and iso-cyclosporins; derivatized cyclosporins (e.g., in which the 3′-O-atom of the -MeBmt-residue is acylated or a further substituent is introduced at the α-carbon atom of the sarcosyl residue at the 3-position); cyclosporins in which the -MeBmt-residue is present in isomeric form (e.g., in which the configuration across positions 6′ and 7′ of the -MeBmt-residue is cis rather than trans); and cyclosporins wherein variant amino acids are incorporated at specific positions within the peptide sequence employing, e.g., the total synthetic method for the production of cyclosporins developed by R. Wenger—see e.g., Traber et al. (1977), Traber et al. (1982) and Kobel et al. (1982); U.S. Pat. Nos. 4,108,985, 4,210,581, 4,220,641, 4,288,431, 4,554,351 and 4,396,542; European Patent Publications Nos. 0 034 567 and 0 056 782; International Patent Publication No. WO 86/02080; Wenger (1983); Wenger (1985); and Wenger (1986). Cyclosporin A analogues containing modified amino acids in the 1-position are reported by Rich et al. (1986). Immunosuppressive, anti-inflammatory, and anti-parasitic cyclosporin A analogues are described in U.S. Pat. Nos. 4,384,996; 4,771,122; 5,284,826; and 5,525,590, all assigned to Sandoz. Additional cyclosporin analogues are disclosed in WO 99/18120, assigned to Isotechnika. The terms Ciclosporin, ciclosporin, cyclosporine, and Cyclosporine are interchangeable and refer to cyclosporin.
There are numerous adverse effects associated with cyclosporine A therapy, including nephrotoxicity, hepatotoxicity, cataractogenesis, hirsutism, parathesis, and gingival hyperplasia to name a few (Sketris et al., 1995). Of these, nephrotoxicity is one of the more serious, dose-related adverse effects resulting from cyclosporine A administration. Immediate-release cyclosporine A drug products (e.g., Neoral® and Sandimmune®) can cause nephrotoxicities and other toxic side effects due to their rapid release and the absorption of high blood concentrations of the drug. It is postulated that the peak concentrations of the drug are associated with the side effects (Bennett, 1998). The exact mechanism by which cyclosporine A causes renal injury is not known; however, it is proposed that an increase in the levels of vasoconstrictive substances in the kidney leads to the vasoconstriction of the afferent glomerular arterioles. This can result in renal ischemia, a decrease in glomerular filtration rate and, over the long term, interstitial fibrosis. When the dose is reduced or another immunosuppressive agent is substituted, renal function improves (Valantine and Schroeder, 1995).
Accordingly, there is a need for immunosuppressive agents which are effective and have reduced toxicity.
Cyclosporin analogs containing modified amino acids in the 1-position are disclosed in WO 99/18120, which is assigned to the assignee of the present application, and incorporated herein in its entirety. Also assigned to the present assignee is U.S. Provisional Patent Application No. 60/346,201, in which applicants disclosed a particularly preferred cyclosporin A analog referred to as “ISATX247.” This analog is structurally identical to cyclosporin A except for modification at the 1-amino acid residue. Applicants discovered that certain mixtures of cis and trans isomers of ISATX247 exhibited a combination of enhanced potency, and/or reduced toxicity over the naturally occurring and presently known cyclosporins. Certain alkylated, arylated, and deuterated derivatives of ISATX247 were also disclosed.
Typically, the disclosed mixtures in U.S. Provisional Patent Application No. 60/346,201 range from about 10 to 90 percent by weight of the trans-isomer and about 90 to 10 percent by weight of the cis-isomer; in another embodiment, the mixture contains about 15 to 85 percent by weight of the trans-isomer and about 85 to 15 percent of the cis-isomer; in another embodiment, the mixture contains about 25 to 75 percent by weight of the trans-isomer and about 75 to 25 percent by weight of the cis-isomer; in another embodiment, the mixture contains about 35 to 65 percent by weight of the trans-isomer and about 65 to 35 percent by weight of the cis-isomer; in another embodiment, the mixture contains about 45 to 55 percent by weight of the trans-isomer and about 55 to 45 percent of the cis-isomer. In another embodiment, the isomeric mixture is an ISATX247 mixture which comprises about 45 to 50 percent by weight of the trans-isomer and about 50 to 55 percent by weight of the cis-isomer. These percentages by weight are based on the total weight of the composition. In other words, a mixture might contain 65 percent by weight of the (E)-isomer and 35 percent by weight of the (Z)-isomer, or vice versa. In an alternate nomenclature, the cis-isomer may also be described as a (Z)-isomer, and the trans-isomer could also be called an (E)-isomer.
Accordingly, there is a need in the art for methods of preparation of cyclosporin analogs, including isomers of ISATX247. Synthetic pathways are needed that produce enriched compositions of the individual isomers, as well mixtures of the isomers having a desired ratio of the two isomers. Methods of preparation of derivatives of ISATX247 are needed as well.
Cyclosporine and its analogs are members of a class of cyclic polypeptides having potent immunosuppressant activity. Despite the advantages these drugs offer with respect to their immunosuppressive, anti-inflammatory, and anti-parasitic activities, there are numerous adverse effects associated with cyclosporine A therapy that include nephrotoxicity and hepatotoxicity. Accordingly, there is a need for new immunosuppressive agents that retain pharmacological activity as the naturally occurring compound cyclosporin A, but without one or more of the associated toxic side effects.
Embodiments of the present invention provide certain mixtures of cis and trans-isomers of cyclosporin A analogs, which are pharmaceutically useful. A preferred analog is referred to as ISATX247. Mixtures of ISATX247 isomers exhibit a combination of enhanced potency and reduced toxicity over the naturally occurring and presently known cyclosporins.
The present invention is based, in part, on the discovery that certain isomeric mixtures of analogues of cyclosporine provide superior immunosuppressive effects without one or more of the adverse effects associated with cyclosporine A. In particular, we have unexpectedly found that isomeric mixtures (i.e., mixtures of both cis- and trans-isomers) ranging from about 10:90 to about 90:10 (trans- to cis-) of cyclosporine analogues modified at the 1-amino acid residue provide superior efficacy and safety. Examples of such analogues are disclosed in WO 99/18120, and include deuterated and non-deuterated compounds. In particular, mixtures in the range of about 45:55 to about 50:50 (trans- to cis-) and in the range of about 50% to about 55% trans- and about 45% to about 50% cis- are found to be particularly efficacious. Moreover, it has been demonstrated that these isomer mixtures exhibit a combination of superior potency and reduced toxicity over naturally occurring and other presently known cyclosporines and cyclosporine derivatives.
A particularly preferred analogue (referred to herein as “ISATX247”) is structurally similar to cyclosporine A except for a modified functional group on the periphery of the molecule, at the 1-amino acid residue. The structure of this particular isomeric analogue mixture compared to the structure of cyclosporine A is:
The isomeric mixtures can be used, among other things, for immunosuppression, and the care of various immune disorders, diseases and conditions, including the prevention, control, alleviation and treatment thereof.
According to embodiments of the present invention, ISATX247 isomers (and derivatives thereof) are synthesized by stereoselective pathways that may vary in their degree of selectivity. Stereoselective pathways produce compositions that are enriched in either of the (E) and (Z)-isomers, and these compositions may be combined such that the resulting mixture has a desired ratio of the two isomers. Alternatively, the reactions conditions of a stereoselective pathway may be tailored to produce the desired ratio directly in a prepared mixture. The percentage of one isomer or another in a mixture can be verified using nuclear magnetic resonance spectroscopy (NMR) or other techniques well known in the art.
Each of the pathways typically proceeds with the application of a protecting group to a sensitive alcohol functional group. In one embodiment the alcohol is protected as an acetate; in other embodiments the protecting groups are benzoate esters or silyl ethers. Although acetate protecting groups are common in the art, it is important to emphasize that in many of the exemplary embodiments described herein certain undesirable side-reactions involving an acetate protecting group may be avoided through the use of protecting groups such as benzoate esters or silyl ethers.
The protected compound may then serve as a precursor for a variety of stereoselective synthetic pathways including some that utilize phosphorus-containing reagents as participants in a Wittig reaction, and inorganic elements as members of organometallic reagents. The latter type may proceed through six-membered ring transition states where steric hindrance dictates the configurational outcome. Many organometallic reagents are available, including those that feature inorganic elements such as boron, silicon, titanium, lithium, and sulfur. Individual isomers may be prepared from single or multiple precursors.
The ratio of the (E) to (Z)-isomers in any mixture, whether produced stereoselectively or non-stereoselectively, may take on a broad range of values. For example, the mixture may comprise from about 10 to 90 percent of the (E)-isomer to about 90 to 10 percent of the (Z)-isomer. In other embodiments, the mixture may contain from about 15 to 85 percent by weight of the (E)-isomer and about 85 to 15 percent of the (Z)-isomer; in another embodiment, the mixture contains about 25 to 75 percent by weight of the (E)-isomer and about 75 to 25 percent by weight of the (Z)-isomer; in another embodiment, the mixture contains about 35 to 65 percent by weight of the (E)-isomer and about 65 to 35 percent by weight of the (Z)-isomer; in another embodiment, the mixture contains about 45 to 55 percent by weight of the (E)-isomer and about 55 to 45 percent of the (Z)-isomer. In another embodiment, the isomeric mixture is an ISATX247 mixture which comprises about 45 to 50 percent by weight of the (E)-isomer and about 50 to 55 percent by weight of the (Z)-isomer. These percentages by weight are based on the total weight of the composition, and it will be understood that the sum of the weight percent of the (E)-isomer and the (Z)-isomer is 100 weight percent. In other words, a mixture might contain 65 percent by weight of the (E)-isomer and 35 percent by weight of the (Z)-isomer, or vice versa.
In one aspect, the invention is directed to a composition comprising an isomeric mixture of a cyclosporine analogue modified at the 1-amino acid residue, wherein the range of the isomeric mixture is from about 10:90 to about 90:10 (trans- to cis). A preferred composition (referred to herein as “ISATX247”) comprises an isomeric mixture of isomers E- and Z-:
Typically, the isomeric mixture comprises about 10% to about 90% of the E-isomer and about 90% to about 10% of the Z-isomer; preferably, the mixture contains about 15% to about 85% of the E-isomer and about 85% to about 15% of the Z-isomer; more preferably the mixture contains about 25% to about 75% of the E-isomer and about 75% to about 25% of the Z-isomer; even more preferably the mixture contains about 35% to about 65% of the E-isomer and about 65% to about 35% of the Z-isomer, yet even more preferably the mixture contains about 45% to about 55% of the E-isomer and about 55% to about 45% of the Z-isomer. In most preferred embodiments, the isomeric mixture may be ISATX247 mixtures which comprise: about 45 to about 50% of the E-isomer and about 55 to 50% of the Z-isomer; about 50% to about 55% of the E-isomer and about 45% to about 50% of the Z-isomer; about 55% to about 65% of the E-isomer and about 35% to about 45% of the Z-isomer; about 65% to about 75% of the E-isomer and about 25% to about 35% of the Z-isomer; about 75% to about 85% of the E-isomer and about 15% to about 25% of the Z-isomer; about 85% to about 90% of the E-isomer and about 10% to about 15% of the Z-isomer. Further preferred isomeric mixtures comprise those of about 75% to about 65% Z-isomer and about 25% to about 35% E-isomer, and of about 65% to about 55% Z-isomer and about 35% to about 25% E-isomer. (The percentages are on a weight basis.)
In another aspect, the invention is directed to pharmaceutical compositions comprising an isomeric cyclosporine analogue mixture as described above and a pharmaceutically acceptable excipient. The isomeric analogue mixture is preferably an ISATX247 mixture.
In a further aspect, the invention is directed to a method of producing immunosuppression comprising administering to an animal in need thereof, an effective amount of an isomeric cyclosporine analogue mixture as described above or a composition comprising the isomeric analogue mixture. In a preferred embodiment, the mixture is an ISATX247 mixture. The method may be used to treat or alleviate transplant rejection, an autoimmune disease or condition, or an inflammatory disease or condition.
In yet a further aspect, the invention is directed to a method of reducing the toxicity of an immunosuppressive cyclosporine analogue by preparing an isomeric mixture of the analogue for use as the immunosuppressive agent. In a preferred embodiment, the mixture is an ISATX247 mixture.
In a still further aspect, the invention is directed to a method of increasing the efficacy of an immunosuppressive cyclosporine analogue by preparing an isomeric mixture of the analogue for use as the immunosuppressive agent. In a preferred embodiment, the mixture is an ISATX247 mixture.
In yet a further aspect, methods for the synthesis of isomeric analogue mixtures are provided.
Synthesis
Cyclosporin and its analogs are members of a class of cyclic polypeptides having potent immunosuppressive activity. Despite the advantages these drugs offer with respect to their immunosuppressive, anti-inflammatory, and anti-parasitic activities, there are numerous adverse effects associated with cyclosporine A therapy that include nephrotoxicity and hepatotoxicity. Accordingly, there is a need for new immunosuppressive agents that are as pharmacologically active as the naturally occurring compound cyclosporin A, but without the associated toxic side effects.
Applicants have previously disclosed a cyclosporin A analog referred to as “ISATX247.” This analog is structurally similar to cyclosporin A except for modification at the 1-amino acid residue. Applicants discovered that certain mixtures of cis and trans-isomers of ISATX247 exhibited a combination of enhanced potency, and reduced toxicity, over the naturally occurring and presently known cyclosporins.
According to embodiments of the present invention, ISATX247 isomers (and derivatives thereof) are synthesized by stereoselective pathways that may vary in their degree of stereoselectivity. Stereoselective pathways produce compositions that are enriched in either of the (E) and (Z)-isomers, and these compositions may be combined such that the resulting mixture has a desired ratio of the two isomers. Alternatively, the reaction conditions of a stereoselective pathway may be tailored to produce the desired ratio directly in a prepared mixture.
The chemical name of one immunosuppressive cyclosporin analog of the present invention, called ISATX247, is chemically described by the name cyclo{{E,Z)-(2S,3R,4R)-3-hydroxy-4-methyl-2-(methylamino)-6,8-nonadienoyl}-L-2-aminobutyryl-N-methyl-glycyl-N-methyl-L-Leucyl-L-valyl-N-methyl-L-leucyl-L-alanyl-D-alanyl-N-methyl-L-leucyl-N-methyl-L-leucyl-N-methyl-L-valyl). Its empirical formula is C63H111N11O12, and it has a molecular weight of about 1214.85. The term “ISATX247” is a trade designation given to this pharmacologically active compound.
The structure of ISATX247 has been verified primarily through nuclear magnetic resonance (NMR) spectroscopy. Both the 1H and 13C spectra were assigned using a series of one and two dimensional NMR experiments, and by comparison to the known NMR assignments for cyclosporin A. The absolute assignment of the (E) and (Z)-isomers of ISATX247 was confirmed by Nuclear Overhauser Effect (NOE) experiments. Additional supporting evidence was provided by mass spectral analysis, which confirmed the molecular weight, and by the infrared spectrum, which was found to be very similar to cyclosporin A. The latter result was expected, given the similarity between the two compounds.
The structure of cyclosporin A is illustrated in
Another schematic of the cyclosporin A structure is drawn in
As stated above, a particularly preferred cyclosporin A analog is called ISATX247, and its two stereoisomers E (or trans) and Z (or cis) are shown in
A word should be said about stereochemical nomenclature. In the present description the terms cis and (Z) will be used interchangeably, and the terms trans and (E) will be used interchangeably. Usage of the terms “erythro” and “threo” will be kept to a minimum due to apparent confusion in the literature with regard to their meaning. See R. W. Hoffmann and H.-J. Zei in “Stereoselective synthesis of Alcohols. 8. Diastereoselective Synthesis of β-Methylhomoallyl Alcohols via Crotylboronates,” J. Org. Chem., Vol. 46, pp. 1309-1314 (1981); A. Streitwieser and C. H. Heathcock, Introduction to Organic Chemistry, 2nd ed. (Macmillan, New York, 1981), pp. 845-846; and M. B. Smith and J. March, March's Advanced Organic Chemistry (Wiley, New York, 2001), pp. 144-147. In the few cases where threo/erythro terminology is employed herein the convention of Streitwieser and Heathcock is used, where “erythro” isomers refer to (R,S) and (S,R) configurations, and “threo” isomers refer to (R,R) and (S,S) configurations.
A final comment about nomenclature concerns the terminal carbon-carbon double bond shown in
The synthetic pathways illustrated in
An overview of the synthetic pathways according to embodiments of the present invention is given in
Embodiments of the present invention provide a variety of ways to arrive at the desired mixture of isomers. The flexibility and versatility of the synthetic strategies disclosed herein may be reflected in part by the symmetries and asymmetries of
In general, synthetic pathways of
Compositions enriched in one or the other of a pair of isomers may be prepared from a single precursor; alternatively, the two compositions may be prepared from different precursors. In one of the stereoselective pathways of
The reactions of
Protecting groups are well known in organic synthesis, and have been discussed by J. R. Hanson in Chapter 2, “The Protection of Alcohols,” of the publication Protecting Groups in Organic Synthesis (Sheffield Academic Press, Sheffield, England, 1999), pp. 24-25. Hanson teaches how to protect hydroxyl groups by converting them to either esters or ethers. Acetate esters are perhaps the most frequently used type of chemistry for protecting hydroxyl groups. There are a wide range of conditions that may be used to introduce the acetate group. These reagents and solvents include acetic anhydride and pyridine; acetic anhydride, pyridine and dimethylaminopyridine (DMAP); acetic anhydride and sodium acetate; acetic anhydride and toluene-p-sulfonic acid, acetyl chloride, pyridine and DMAP; and ketene. DMAP is a useful acylation catalyst because of the formation of a highly reactive N-acylpyridinium salt from the anhydride.
In one embodiment of the present invention, the β-alcohol of cyclosporin A 34 is protected as an acetate by reacting 34 with acetyl chloride, ethyl acetate, or combinations thereof, forming the compound acetyl cyclosporin A 35. In another embodiment, the β-alcohol undergoes a nucleophilic addition to acetic anhydride, forming acetyl cyclosporin A 35 and acetic acid. These reactions may be carried out in the presence of dimethylaminopyridine (DMAP) where an excess of acetic anhydride acts as the solvent. In these cases the prefix “acetyl” may be used in the nomenclature throughout the synthetic pathway, or until the acetyl group is removed. For example, the last intermediate in one pathway having an acetyl group at the β-carbon is called “acetyl-(E)-1,3-diene.”
Although the preparation of acetyl cyclosporin A is well established in the literature, it will be appreciated by those skilled in the art that protecting groups other than acetate esters may be used to protect the β-alcohol of the 1-amino acid residue of cyclosporin A 34. These protecting groups may include benzoate esters, substituted benzoate esters, ethers, and silyl ethers. Under certain reaction conditions, the acetate protecting group is prone to undesirable side reactions such as elimination and hydrolysis. Since benzoate esters, ethers and silyl ethers are often more resistant to such side reactions under those same reaction conditions, it is often advantageous to employ such protecting groups in place of acetate. Cyclosporin or cyclosporin derivatives which have been protected by an acetyl group or any other protecting group are referred to as “protected-cyclosporin A.” Likewise, the ultimate intermediate in the exemplary pathway referred to above would be called “protected-(E)-1,3-diene” instead of “acetyl-(E)-1,3-diene.” The nature of the chosen protecting group may have an influence on the desired course of further steps in the reaction sequences.
Referring to
Synthesis of Mixtures of the (E) and (Z)-Isomers of ISATX247 Via the Wittig Reaction
Wittig reaction pathways exemplified herein are identified by the reference number 31 in
The Wittig reactions used in the exemplary embodiments disclosed herein to synthesize mixtures of the (E) and (Z)-isomers of ISATX247 may optionally be carried out in the presence of a lithium halide. The presence of lithium halides in Wittig reactions is well known to have an effect on the ratio of geometrical isomers produced and, therefore, the addition of such a compound can aid in producing a desired mixture of the (E) and (Z)-isomers of ISATX247.
Method 1
In one embodiment of the present invention, a mixture of (E) and (Z)-isomers of ISATX247 is prepared as shown in
Referring to
The novel intermediate triphenylphosphonium bromide of acetyl cyclosporin A 42 may be prepared from acetyl-η-bromocyclosporin A 41 by heating the latter compound with triphenylphosphine in a solvent such as toluene.
The novel intermediate 42, and others like it, are contemplated to be key intermediates in the synthesis of a plurality of cyclosporin A analogs that contain a conjugated diene system in the 1-amino acid residue. For example, in addition to triphenylphosphine, compounds such as triarylphosphines, trialkylphosphines, arylalkylphosphines, and triarylarsines may be reacted with acetyl-mbromocyclosporin A 41 to prepare other activated compounds similar to 42.
Referring again to
Numerous organic chemistry textbooks describe the Wittig reaction. One description in particular is provided by J. McMurry, Organic Chemistry, 5th ed. (Brooks/Cole, Pacific Grove, 2000), pp. 780-783. A Wittig reaction may be used to convert a ketone or an aldehyde to an alkene. In such a process, a phosphorus ylide, also called a phosphorane, may be reacted with the aldehyde or ketone to give a dipolar intermediate called a betaine. Typically the betaine intermediate is not isolated; rather, it spontaneously decomposes through a four-membered ring to yield an alkene and triphenylphosphine oxide. The net result is a replacement of the carbonyl oxygen atom by the R2C═ group originally bonded to the phosphorus.
It will be appreciated by those skilled in the art that a wide variety of reagents may be substituted for the exemplary Wittig reaction reagents cited above. For example, numerous alkyl, aryl, aldehyde, and ketone compounds may be substituted for formaldehyde to prepare a vast number of cyclosporin derivatives. Applicants have carried out the above synthesis with formaldehyde, and in place of formaldehyde, compounds such as acetaldehyde, deuterated formaldehyde, deuterated acetaldehyde, 2-chlorobenzaldehyde, benzaldehyde, and butyraldehyde. Such Wittig reactions may be carried out with compounds other than triphenylphosphonium derivatives, such as triarylphosphines, trialkylphosphines, arylalkylphosphines and triarylarsines. Instead of using sodium hydroxide, various other bases such as sodium carbonate, butyllithium, hexyllithium, sodium amide, lithium hindered bases such as lithium diisopropylamide, and alkali metal alkoxides may be used. In addition to varying these reagents, the reaction may be conducted in various organic solvents or mixtures of organic solvents and water, in the presence of various salts, particularly lithium halides, and at varying temperatures. All of the factors listed above can reasonably be selected by one of ordinary skill in the art to have the desired effect on the stereochemistry of the formed double bond; i.e., the desired effect on the ratio of the cis to trans-isomers.
In a final step of this synthesis, the protecting group on the β-carbon is removed using the following procedure. The mixture of acetyl-(E)-1,3-diene and acetyl-(Z)-1,3-diene 43 is dissolved in methanol, and then water is added. A base such as potassium carbonate is added, and the reaction mixture stirred at room temperature. Bases other than potassium carbonate that may be used include sodium hydroxide, sodium carbonate, sodium alkoxide, and potassium alkoxide. Ethyl acetate is then used to extract the final product mixture of (E) and (Z)-isomers of ISATX247 44.
Method 2
In an alternative reaction pathway for synthesizing a mixture of (E) and (Z)-isomers of ISATX247 via a Wittig reaction strategy, a four step synthetic pathway may be employed as follows: 1) protection of the β-alcohol, as in method 1; 2) oxidation of the acetyl-cyclosporin A produced from the first step to produce an aldehyde; 3) a Wittig reaction; and 4) de-acetylation of the Wittig reaction product, or equivalently, hydrolysis of the acetate ester to retrieve the alcohol. This reaction sequence is illustrated in
This synthetic pathway begins in a manner similar to the Wittig reaction pathway of
The use of ruthenium based oxidizing agents has been discussed by H. J. Carlsen et al. in “A Greatly Improved Procedure for Ruthenium Tetroxide Catalyzed Oxidations of Organic Compounds,” J. Org. Chem., Vol. 46, No. 19, pp. 3736-3738 (1981). Carlsen et al. teach that, historically, the expense of ruthenium metal provided an incentive for the development of catalytic procedures, the most popular of which used periodate or hypochlorite as stoichiometric oxidants. These investigators found a loss of catalytic activity during the course of the reaction with the conventional use of ruthenium which they postulated to be due to the presence of carboxylic acids. The addition of nitriles to the reaction mixture, especially acetonitrile, was found to significantly enhance the rate and extent of the oxidative cleavage of alkenes in a CCl4/H2O/IO4− system.
According to one embodiment of the present invention, acetyl cyclosporin A aldehyde 51 may be produced from acetyl cyclosporin A 35 by dissolving it in a mixture of acetonitrile and water, and then adding first sodium periodate and then ruthenium chloride hydrate. The aldehyde 51 may be extracted with ethyl acetate. It should be noted that the synthesis of the aldehyde 51 by this oxidative cleavage strategy is important to many of the stereoselective pathways to be discussed below, and consequently the reader is referred back to this section accordingly.
The third step of method 2 involves converting the aldehyde 51 to a mixture of (E) and (Z) dienes via a Wittig reaction, in a similar fashion to that of method 1. As in method 1, a phosphorus ylide adds to the aldehyde to yield a betaine (which is not isolated), with the net result that the carbonyl oxygen atom of the aldehyde is replaced by the R2C═ group originally bonded to phosphorus. Again, such Wittig reactions may be carried out with phosphorus containing compounds other than triphenylphosphonium derivatives, such as triarylphosphines, trialkylphosphines, arylalkylphosphines and triarylarsines, at various temperatures, and using a variety of basic solutions and solvents or the addition of various inorganic salts may be used to influence the stereochemistry of the newly formed double bond.
In one embodiment, acetyl cyclosporin A aldehyde 51 is dissolved in toluene, to which is added a base such as sodium hydroxide in water. Allyl triphenylphosphonium bromide 52 is then added, and the reaction stirred for some time. Workup of the product mixture of acetyl (E) and (Z)-1,3-dienes 53 involves extraction with hexane and/or ethyl acetate, where the term “workup” is intended to mean the process of extracting and/or isolating reaction products from a mixture of reactants, products, solvent, etc.
In a final step of method 2, similar to the final step of method 1, the acetate ester group protecting the alcohol at the β-carbon position is removed with potassium carbonate, yielding a mixture of (E) and (Z) isomers of ISATX247 54. Bases other than potassium carbonate that may be used to remove the protecting group include sodium hydroxide, sodium carbonate, sodium alkoxide, and potassium alkoxide.
Synthesis of Compositions Enriched in Either of the ISATX247 (E) and (Z)-Isomers Via Organometallic Routes
According to embodiments of the present invention, stereoselective synthetic pathways may employ the use of inorganic reagents containing elements such as silicon, boron, titanium, sulfur, phosphorus, and/or lithium. These pathways may proceed through a six-membered ring transition state where one of the members of the ring is the inorganic element from the organometallic reagent. In some embodiments, steric hindrance effects related to the transition state may influence the stereochemical outcome of the reaction.
Two exemplary stereoselective schemes will be discussed in the present disclosure. In the first stereoselective scheme (method 3, also shown as Pathway 32 in
Method 3
This pathway proceeds via the acetyl cyclosporin A aldehyde 51.
A similar reaction scheme has been discussed in general by D. J. S. Tsai and D. S. Matteson in “A Stereocontrolled Synthesis of (Z) and (E) Terminal Dienes from Pinacol (E)-1-Trimethylsilyl-1-Propene-3-Boronate,” Tetrahedron Letters, Vol. 22, No. 29, pp. 2751-2752, (1981). The method is illustrated in
Formation of the alkene follows one of two distinct paths, depending on whether the elimination reaction (the olefination) is carried out under acidic or basic conditions. Under acidic conditions an anti-elimination occurs forming the (E)-isomer, whereas under basic conditions a cis-elimination occurs to form the (Z)-isomer. It will be appreciated by those skilled in the art that by using this synthetic pathway, either isomer may be prepared from the same precursor. The product of each elimination reaction comprises a composition enriched in one of the two isomers. In one embodiment, enriched means that the composition contains greater than or equal to about 75 percent by weight of an isomer. In other embodiments, the enriched composition my comprise 80, 85, and 90 percent by weight of one of the isomers. The compositions enriched in an isomer may then be combined in a predetermined ratio to arrive at the desired mixture as illustrated in
The reactions in
The deprotonation of allyltrimethylsilane (this step is not shown in
Allylsilanes are easily deprotonated because the anion that is generated is stabilized not only through conjugation with the adjacent double bond, but also by the neighboring silyl group. The anion may react with electrophiles through either its α-carbon or its γ-carbon. The regiochemical and stereochemical outcome of these reactions depends on several factors, one of the most important of which is the identity of the counterion. See the discussion of allylsilanes by S. E. Thomas in Organic Synthesis: The Roles of Boron and Silicon (Oxford University Press, New York, 1991), pp. 84-87.
In this reaction scheme, the deprotonated allylsilane then undergoes an electrophilic capture by trimethylborate to produce an intermediate, which, when reacted with pinacol, yields the trans-(trimethylsilyl) boronate compound 62. The boronate 62 may also be called an “allylborane” (allylboronate ester). Alternatively, if 9-methoxy-9-dialkylborane is used in the electrophilic capture it would lead to a boronate complex which can be demethoxylated using a boron trifluoride reagent (such as BF3Et2O) to generate the corresponding 9-(γ-trans-trimethylsilylallyl)-9-dialkylborane.
The addition of an aldehyde to an allylborane has been discussed by S. E. Thomas in the above reference at pages 34-35. The addition of an aldehyde to an allylborane, wherein the latter is unsymrnetrically substituted at the distal end of the carbon-carbon double bond (“distal” meaning furthest away from the boron atom) produces a homoallylic alcohol containing two adjacent chiral centers. (E)-allylboranes give rise to the threo-diastereoisomer, while (Z)-allylboranes give rise to the erythro-diastereoisomer. An exemplary reaction of an (E)-allylborane 62 with cyclosporin A aldehyde 51 is shown in
The reference numeral 69 in the boron intermediate 63 (
Alternatively, it is contemplated to prepare the elythro-silyl alcohol, for which acid elimination would give the cis-isomer and base elimination would give the trans-isomer, in an opposite manner to the elimination reactions discussed above. It will be obvious to those skilled in the art that the same products would be obtained at the end of the synthesis.
It has been postulated that the stereoselectivity that is achieved in reactions involving allylboranes with aldehydes may be due to the six-membered ring chair-like transition state exemplified by the boron intermediate 63, and depicted in
Alternatively, it is contemplated to prepare the erythro-silyl alcohol, for which acid elimination would give the cis-isomer and base elimination would give the trans-isomer, in an opposite manner to the elimination reactions discussed above. It will be obvious to those skilled in the art that the same products would be obtained at the end of the synthesis.
Treatment of the transition state product 63 with triethanolamine yields the β-trimethylsilyl alcohol 64. On the other hand, allylboration product of (trimethylsilylallyl)dialkyl borane yields silyl alcohol 64 upon oxidation using NaOH/H2O2 or aqueous workup. The alcohol 64 depicted in
In a method of alkene synthesis known as a Peterson olefination, elimination of the trialkylsilyl group and the hydroxy group from the β-trimethylsilyl alcohol 64 leads to an alkene; in this case a diene, due to the double bond that is already present between the two terminal carbons of the chain. A discussion of the conversion of β-hydroxysilanes to alkenes has been presented in the S. E. Thomas reference at pages 68-69. A further discussion of this reaction is presented by P. F. Hurdlik and D. Peterson in “Stereospecific Olefin-Forming Elimination Reactions of β-Hydroxysilanes,” J. Am. Chem. Soc., Vol. 97, No. 6, pp. 1464-1468 (1975).
Referring to
The stereospecificity occurs at this stage of the reaction pathway because elimination under acidic conditions requires the trimethylsilyl and hydroxy groups to be in an antiperiplanar relationship. In contrast, elimination under basic conditions requires that the trimethylsilyl and hydroxy groups adopt a synperiplanar relationship. The latter condition facilitates the formation of a strong silicon-oxygen bond and an intermediate four-membered ring, which breaks down in a manner analogous to the final step of a Wittig reaction. It will be appreciated by those skilled in the art that a strong silicon-oxygen bond replaces a weaker silicon-carbon bond, which overrides the replacement of a strong carbon-oxygen bond with a weaker carbon-carbon π bond.
Thus the products of the stereospecific elimination of a β-hydroxy alkylsilane are the acetyl-(E)-1,3-diene compound 67 and the acetyl-(Z)-1,3-diene compound 65. As in the previous methods, the protecting group may now be removed from each of these dienes by treatment with K2CO3 in methanol and water. This removes the acetate group bonded to the β-carbon of the 1-amino acid residue, returning the functional group on that carbon to an alcohol. Bases other than potassium carbonate that may be used to remove the protecting group include sodium hydroxide, sodium carbonate, sodium alkoxide, and potassium alkoxide.
At this stage of the preparation the synthesis is substantially complete. The compositions enriched in one or the other of the isomers may be mixed to achieve the desired ratio of isomers in the mixture. By “enriched” is meant a product that comprises at least about 75 percent by weight of that isomer; in other words, the product may contain up to 25 percent by weight of the “undesired” isomer. The mixture is designed to achieve the desired pharmacological result.
Method 4
This pathway also proceeds via the acetyl cyclosporin A aldehyde 51. An alternate scheme for producing stereoselective isomers is illustrated in
Titanium reagents are known to be particularly useful in organic synthesis because they are regio- and stereoselective in their reactions with aldehydes and ketones. The general nature of titanium in stereoselective chemistry has been discussed by M. T. Reetz in Organotitanium Reagents in Organic Synthesis (Springer-Verlag, Berlin, 1986), pp. VII, 148-149, and 164-165. Here it is stated that the nature of the titanium ligand may be varied such that the electronic and steric identity of the reagent can be manipulated, and the stereochemical outcome of many C—C bond forming reactions may be predicted. According to this chemistry, the union of two prochiral centers of achiral molecules creates two centers of chirality. A general rule governing the stereoselective outcome is that Z-configured enolates or crotyl metal compounds preferentially form syn-adducts, while E-configured reagents favor the anti-diastereomers. The trends may again be explained by assuming a six-membered cyclic transition state having a chair geometry.
A specific example of this type of stereoselective synthesis has been discussed by Y. Ikeda et al. in “Stereoselective Synthesis of (Z)- and (E)-1,3-Alkadienes from Aldehydes Using Organotitanium and Lithium Reagents,” Tetrahedron, Vol. 43, No. 4, pp. 723-730 (1987). This reference discloses that allyldiphenylphosphine may be used to produce a [3-(diphenylphosphino)-allyl]titanium reagent, which in turn may be condensed with an aldehyde followed by phosphonium salt formation to give a (Z)-1,3-alkadiene in a highly regio- and stereoselective manner. In contrast, a lithiated allyldiphenylphosphine oxide can condense with an aldehyde to give an (E)-1,3-alkadiene directly, again with the desired stereoselectivity.
Referring to
In accordance with the exemplary methods outlined in the present disclosure, the metal site of the organometallic reagent may be the entity that controls regioselectivity (Ikeda, p. 725). This means that the aldehyde 51 in
In contrast to the reaction pathway depicted in
Preparation of Mixtures
As stated previously, certain mixtures of cis and trans-isomers of ISATX247 were found to exhibit a combination of enhanced potency and/or reduced toxicity over the naturally occurring and presently known cyclosporins.
According to embodiments of the present invention, ISATX247 isomers (and derivatives thereof) are synthesized by stereoselective pathways that may vary in their degree of stereoselectivity. Stereoselective pathways may produce a first material or composition enriched in the (E)-isomer, and a second material or composition enriched in the (Z)-isomer, and these materials may then be combined such that the resulting mixture has a desired ratio of the two isomers. Alternatively, it is contemplated that the first material may be prepared by separating a reaction product to isolate and enrich the (E)-isomer, and the second material may be prepared by separating a reaction product to isolate and enrich the (Z)-isomer. In yet another embodiment, the reactions conditions of a stereoselective pathway may be tailored to produce the desired ratio directly in a prepared mixture.
These principles are illustrated in
In contrast to some synthetic pathways, where a mixture of isomers is produced, the isomers may first be prepared individually, and then mixed in predetermined proportions to achieve the desired ratio. This concept is illustrated in
After synthesizing the isomers individually, they may be mixed to achieve the desired ratio, as illustrated in
In an alternative embodiment, a mixture of the (E) and (Z)-isomers of ISATX247 isomers may be separated such that the mixture is enriched in one isomer over the other. For example, a Diels-Alder reaction may be used to convert the cis-isomer to a closed ring compound by reacting it with an alkene. If the alkene is bound to a substrate that is capable of isolation (e.g., filterable), the cis isomer may be substantially removed from the mixture, leaving a composition enriched in the trans isomer. The cis isomer may be re-constituted from the closed ring compound with the application of heat, producing a composition enriched in the cis isomer. Thus, in this manner, the cis and trans isomers may be separated.
In practice, the ratio of the (E) to (Z)-isomers in any mixture, regardless of the degree of stereoselectivity of the method by which it was produced, may take on a broad range of values. For example, the mixture may comprise from about 10 to 90 percent of the (E)-isomer to about 90 to 10 percent of the (Z)-isomer. In other embodiments, the mixture may contain from about 15 to 85 percent by weight of the (E)-isomer and about 85 to 15 percent of the (Z)-isomer; or about 25 to 75 percent by weight of the (E)-isomer and about 75 to 25 percent by weight of the (Z)-isomer; or about 35 to 65 percent by weight of the (E)-isomer and about 65 to 35 percent by weight of the (Z)-isomer; or about 45 to 55 percent by weight of the (E)-isomer and about 55 to 45 percent of the (Z)-isomer. In still another embodiment, the isomeric mixture is an ISATX247 mixture which comprises about 45 to 50 percent by weight of the (E)-isomer and about 50 to 55 percent by weight of the (Z)-isomer. These percentages by weight are based on the total weight of the composition, and it will be understood that the sum of the weight percent of the (E) isomer and the (Z) isomer is 100 weight percent. In other words, a mixture might contain 65 percent by weight of the (E)-isomer and 35 percent by weight of the (Z)-isomer, or vice versa.
The percentage of one isomer or another in a mixture can be verified using nuclear magnetic resonance (NMR), or other techniques well known in the art.
Pharmaceutical Compositions
This invention also relates to a method of treatment for patients in need of immune-suppression involving the administration of pharmaceutical compositions comprising the inventive mixture as the active constituents. The indications for which this combination is of interest include in particular autoimmune and inflammatory conditions and conditions associated with or causal to transplant rejection, e.g., treatment (including amelioration, reduction, elimination or cure of etiology or symptoms) or prevention (including substantial or complete restriction, prophylaxis or avoidance) of the following:
The isomeric analogue mixtures of this invention may be administered neat or with a pharmaceutical carrier to a warm-blooded animal in need thereof. The pharmaceutical carrier may be solid or liquid. The inventive mixture may be administered orally, topically, parenterally, by inhalation spray or rectally in dosage unit formulations containing conventional non-toxic pharmaceutically acceptable carriers, adjuvants and vehicles. The term parenteral, as used herein, includes subcutaneous injections, intravenous, intramuscular, intrasternal injection or infusion techniques.
The pharmaceutical compositions containing the inventive mixture may preferably be in a form suitable for oral use, for example, as tablets, troches, lozenges, aqueous or oily suspensions, dispersible powders or granules, emulsions, hard or soft capsules, or syrups or elixirs. Compositions intended for oral use may be prepared according to methods known to the art for the manufacture of pharmaceutical compositions and such compositions may contain one or more agents selected from the group consisting of sweetening agents, flavoring agents, coloring agents and preserving agents in order to provide pharmaceutically elegant and palatable preparation. Tablets containing the active ingredient in admixture with non-toxic pharmaceutically acceptable excipients may also be manufactured by known methods. The excipients used may be for example, (1) inert diluents such as calcium carbonate, lactose, calcium phosphate or sodium phosphate; (2) granulating and disintegrating agents such as corn starch, or alginic acid; (3) binding agents such as starch, gelatin or acacia, and (4) lubricating agents such as magnesium stearate, stearic acid or talc. The tablets may be uncoated or they may be coated by known techniques to delay disintegration and absorption in the gastrointestinal tract and thereby provide a sustained action over a longer period. For example, a time delay material such as glyceryl monostearate or glyceryl distearate may be employed. They may also be coated by the techniques described in U.S. Pat. Nos. 4,256,108; 4,160,452; and 4,265,874 to form osmotic therapeutic tablets for controlled release.
In some cases, formulations for oral use may be in the form of hard gelatin capsules wherein the active ingredient is mixed with an inert solid diluent, for example, calcium carbonate, calcium phosphate or kaolin. They may also be in the form of soft gelatin capsules wherein the active ingredient is mixed with water or an oil medium, for example peanut oil, liquid paraffin, or olive oil.
Aqueous suspensions normally contain the active materials in admixture with excipients suitable for the manufacture of aqueous suspensions. Such excipients may include: (1) suspending agents such as sodium carboxymethylcellulose, methylcellulose, hydroxypropylmethylcellulose, sodium alginate, polyvinylpyrrolidone, gum tragacanth and gum acacia; or (2) dispersing or wetting agents which may be a naturally-occurring phosphatide such as lecithin, a condensation product of an alkylene oxide with a fatty acid, for example, polyoxyethylene stearate, a condensation product of ethylene oxide with a long chain aliphatic alcohol, for example, heptadecaethyleneoxycetanol, a condensation product of ethylene oxide with a partial ester derived from a fatty acid and a hexitol such as polyoxyethylene sorbitol monooleate, or a condensation product of ethylene oxide with a partial ester derived from a fatty acid and a hexitol anhydride, for example polyoxyethylene sorbitan monooleate.
The aqueous suspensions may also contain one or more preservatives, for example, ethyl or n-propyl p-hydroxybenzoate; one or more coloring agents; one or more flavoring agents; and one or more sweetening agents such as sucrose, aspartame or saccharin.
Oily suspension may be formulated by suspending the active ingredient in a vegetable oil, for example arachis oil, olive oil, sesame oil or coconut oil, a fish oil which contains omega 3 fatty acid, or in a mineral oil such as liquid paraffin. The oily suspensions may contain a thickening agent, for example beeswax, hard paraffin or cetyl alcohol. Sweetening agents and flavoring agents may be added to provide a palatable oral preparation. These compositions may be preserved by the addition of an antioxidant such as ascorbic acid.
Dispersible powders and granules are suitable for the preparation of an aqueous suspension. They provide the active ingredient in a mixture with a dispersing or wetting agent, a suspending agent and one or more preservatives. Suitable dispersing or wetting agents and suspending agents are exemplified by those already mentioned above. Additional excipients, for example, those sweetening, flavoring and coloring agents described above may also be present.
The pharmaceutical compositions containing the inventive mixture may also be in the form of oil-in-water emulsions. The oily phase may be a vegetable oil such as olive oil or arachis oils, or a mineral oil such as liquid paraffin or a mixture thereof. Suitable emulsifying agents may be (1) naturally-occurring gums such as gum acacia and gum tragacanth, (2) naturally-occurring phosphatides such as soy bean and lecithin, (3) esters or partial ester 30 derived from fatty acids and hexitol anhydrides, for example, sorbitan monooleate, (4) condensation products of said partial esters with ethylene oxide, for example, polyoxyethylene sorbitan monooleate. The emulsions may also contain sweetening and flavoring agents.
Syrups and elixirs may be formulated with sweetening agents, for example, glycerol, propylene glycol, sorbitol, aspartame or sucrose. Such formulations may also contain a demulcent, a preservative and flavoring and coloring agents.
The pharmaceutical compositions may be in the form of a sterile injectable aqueous or oleagenous suspension. This suspension may be formulated according to known methods using those suitable dispersing or wetting agents and suspending agents which have been mentioned above. The sterile injectable preparation may also be a sterile injectable solution or suspension in a non-toxic parenterally-acceptable diluent or solvent, for example as a solution in 1,3-butanediol. Among the acceptable vehicles and solvents that may be employed are water, Ringer's solution and isotonic sodium chloride solution. In addition, sterile, fixed oils are conventionally employed as a solvent or suspending medium. For this purpose any bland fixed oil may be employed including synthetic mono- or di-glycerides. In addition, fatty acids such as oleic acid find use in the preparation of injectables.
The inventive mixture may also be administered in the form of suppositories for rectal administration of the drug. These compositions can be prepared by mixing the drug with a suitable non-irritating excipient which is solid at ordinary temperatures but liquid at the rectal temperature and will therefore melt in the rectum to release the drug. Such materials are cocoa butter and polyethylene glycols.
For topical use, creams, ointments, jellies, solutions or suspensions, etc., containing the disclosed cyclosporines are employed.
In a particularly preferred embodiment, a liquid solution containing a surfactant, ethanol, a lipophilic and/or an amphiphilic solvent as non-active ingredients is used. Specifically, an oral multiple emulsion formula containing the isomeric analogue mixture and the following non-medicinal ingredients: d-alpha Tocopheryl polyethylene glycol 1000 succinate (vitamin E TPGS), medium chain triglyceride (MCT) oil, Tween 40, and ethanol is used. A soft gelatin capsule (comprising gelatin, glycerin, water, and sorbitol) containing the isomeric analogue mixture and the same non-medicinal ingredients as the oral solution may also preferably be used.
Dosage levels of the order from about 0.05 mg to about 50 mg per kilogram of body weight per day are useful in the treatment of the above-indicated conditions. The dose level and schedule of administration may vary depending on the particular isomeric mixture used, the condition to be treated, and such additional factors as the age and condition of the subject. Preferred doses are from about 0.5 to about 10 mg/kg/day and from about 0.1 to about 10 mg/kg/day. In a preferred embodiment, from about 2 to about 6 mg/kg/day is administered orally b.i.d. In a particularly preferred embodiment, about 0.5 to about 3 mg/kg/day is administered orally b.i.d.
The amount of active ingredient that may be combined with the carrier materials to produce a single dosage form will vary depending upon the host treated and the particular mode of administration. For example, a formulation intended for the oral administration to humans may contain from 2.5 mg to 2.5 g of active agent compounded with an appropriate and convenient amount of carrier material which may vary from about 5 to about 95 percent of the total composition. Unit dosage forms will generally contain between from about 5 mg to about 500 mg of active ingredient. In a preferred embodiment, individual capsules containing about 50 mg isomeric mixture are employed for oral administration. In another preferred embodiment, oral solutions containing about 50 mg/mL isomeric mixture are used for oral administration.
It will be understood, however, that the specific dose level for any particular patient will depend upon a variety of factors including the activity of the specific compound employed, the age, body weight, general health, sex, diet, time of administration, route of administration, rate of excretion, drug combination and the nature and severity of the particular disease or condition undergoing therapy.
Methodology
The use of cyclosporine derivatives, a class of cyclic polypeptides produced by the fungus Tolypocladium inflatum Gams, is increasing in immunosuppressive therapy due to their preferential effects on T-cell mediated reactions. Cyclosporine derivatives have been observed to reversibly inhibit immunocompetent lymphocytes, particularly T-lymphocytes, as well as inhibit lymphokine production and release. This action is primarily mediated through cyclosporine A-induced inhibition of calcineurin, a phosphatase enzyme found in the cytoplasm of cells (Schreiber and Crabtree, 1992). An indicator of the efficacy of cyclosporine A or a cyclosporine A derivative is its ability to inhibit the phosphatase activity of calcineurin. The calcineurin inhibition assay measures the activity of the drug at its site of action, and, as such, is the most accurate and direct in vitro assessment of the potency of cyclosporine A analogues (Fruman et al., 1992).
ISATX247 is a cyclosporine A analogue that is similar to cyclosporine A, except for a novel modification of a functional group on the amino acid 1 residue of the molecule. We have now found that ISATX247 exhibits up to 3-fold greater potency than cyclosporine A in the in vitro calcineurin inhibition assay.
Pharmacodynamic studies (in vivo and in vitro) have shown that ISATX247 has more potency than other existing cyclosporine compounds. The efficacy of isomeric mixtures of cyclosporine analogues ranging from about 10:90 to about 90:10 (trans- to cis-), in particular ISATX247 having 50-55% Z-isomer and 45-50% E-isomer, as an immunosuppressive agent (versus cyclosporine A) has been demonstrated in an in vitro calcineurin activity assay, a rat heart transplant model, an islet cell allotransplantation mouse model, a collagen-induced arthritis model in the mouse, and/or an antigen-induced arthritis model in the rabbit. The data show that these isomeric mixtures are equivalent to or more potent than cyclosporine A, and therefore useful for the treatment of immunoregulatory disorders.
There are numerous adverse effects associated with cyclosporine A therapy, including nephrotoxicity, hepatotoxicity, cataractogenesis, hirsutism, parathesis, and gingival hyperplasia to name a few (Sketris et al., 1995). Of these, nephrotoxicity is one of the more serious dose-related adverse effects resulting from cyclosporine A administration. The exact mechanism by which cyclosporine A causes renal injury is not known. However, it is proposed that an increase in the levels of vasoconstrictive substances in the kidney leads to the local vasoconstriction of the afferent glomerular arterioles. This can result in ischemia, a decrease in glomerular filtration rate, and over the long term, interstitial fibrosis.
The nonclinical safety of ISATX247 has been evaluated in a number of animal species. Repeated-dose oral toxicity studies in rats, dogs, and primates showed that ISATX247 was well-tolerated and produced effects that were consistent with immunosuppression. The only toxicological effect noted in all species was diarrhea/loose feces.
ISATX247 does not exhibit mutagenic activity as demonstrated in in vitro bacterial reverse mutation and chromosome aberration assays, and in an in vivo rat micronucleus assay. No carcinogenicity studies have been completed to date. Reproductive toxicity studies with ISATX247 have been completed in pregnant rats and rabbits. There were no treatment-related malformations or alterations. At doses that resulted in maternal toxicity, corresponding embryotoxicity was observed.
Acetic anhydride (140 milliliters) was added to Cyclosporin A (50.0 grams, 41.6 millimoles) and the mixture stirred at room temperature under a N2 atmosphere until all of the Cyclosporin A has dissolved. Dimethylaminopyridine (7.62 g, 62.4 mmol) was added and the reaction stirred at room temperature under a N2 atmosphere for 3 hours or until the reaction was complete. The reaction mixture was cooled to 5° C. and then filtered. The collected solids were washed with hexane to drive off additional acetic anhydride. The resulting pasty solid was slowly transferred to a vigorously stirred 5% aqueous sodium bicarbonate solution (1.5 liters). The resulting suspension was stirred until a fine slurry was obtained and the evolution of CO2 had ceased. The solids were collected by filtration and washed with water until the filtrate had neutral pH. The solid product was dried in a vacuum oven overnight (55° C.) to give 44.0 g (85%) of the product as a colorless solid.
Acetonitrile (320 mL) and water (80 mL) were added to acetyl Cyclosporin A (42.97 g, 34.54 mmol) and the mixture stirred until all of the material was dissolved. Sodium periodate (14.77 g, 69.08 mmol) was added, followed by the addition of ruthenium chloride hydrate (0.358 g, 1.73 mmol) and then the reaction stirred at room temperature for 3 hours under a N2 atmosphere. Water (300 mL) was added and the mixture transferred to a separatory funnel. The mixture was extracted twice with ethyl acetate (300 mL and then 250 mL). The dark black ethyl acetate extracts were combined and washed with 250 mL water followed by 250 mL brine. The organic solution was then dried over MgSO4 and the solvent evaporated to give a greenish-black solid. The crude product was chromatographed over silica gel using 40% acetone/60% hexane as eluent to give the product (29.1 g, 68%) as a colorless solid.
Acetyl Cyclosporin A aldehyde (31.84 g, 25.84 mmol) was added to 340 mL toluene and the mixture stirred until the material was completely dissolved. To the resulting solution was added 340 mL of 1 normal aqueous sodium hydroxide. The resulting mixture was stirred vigorously and then allyl triphenylphosphonium bromide (58.22 g, 151.90 mmol) added. The reaction was stirred for 24 hours at room temperature and then additional allyl triphenylphosphonium bromide (16.64 g, 43.42 mmol) added and stirring continued for a further 24 hours. The mixture was transferred to a separatory funnel and the toluene phase separated. The aqueous phase was extracted with an additional 200 mL of toluene. The two toluene extracts were combined and washed sequentially with 200 mL deionized water and 200 mL saturated aqueous sodium chloride solution. The solution was dried over MgSO4, filtered, and the toluene evaporated to give a very viscous gel. This material was treated with 142 mL of ethyl acetate and stirred until a fine slurry formed. Hexane (570 mL) was slowly added with rapid stirring. The stirring was continued for 30 minutes and then the resulting suspension was filtered and the collected solids washed with 160 mL of 5:1 hexane/ethyl acetate. The combined filtrate was concentrated on a rotary evaporator to a viscous semi-solid. This material was treated with 75 mL ethyl acetate and stirred until a fine slurry was obtained. Hexane (225 mL) was slowly added with rapid stirring. Stirring was continued for 30 minutes and then the resulting suspension was filtered and the collected solids washed with 100 mL of 5:1 hexane/ethyl acetate. The filtrate was concentrated on a rotary evaporator to give a pale yellow solid. The crude product was chromatographed over silica gel using 40% acetone/60% hexane as eluent to give the product (14.09 g) as a colorless solid.
ii) Pre-Formed Ylide Generation and Reaction in Presence of LiBr:
To a stirred suspension of allyltriphenyl phosphonium bromide (7.67 g, 20 mmol) in THF (20 mL) being cooled to 0° C., was added a solution of KOBut in tetrahydrofuran (20 mL, 20 mmol, 1 M solution.). Stirring was continued at this temperature for 30 minutes and a solution of LiBr in THF (10 mL, 10 mmol, 1 M solution) was added. The reaction mixture was then stirred for 30 minutes and a solution of acetyl CsA-aldehyde (4.93 g, 4 mmol) in THF (10 mL) was added through a cannula. After stirring for 15 minutes at room temperature, the reaction mixture was quenched with saturated NH4Cl solution (25 mL). Workup and chromatography as above furnished acetylated ISATX247 as a colorless solid (3.5 g).
Acetyl ISATX247 (14.6 g, 11.62 mmol) was dissolved in 340 mL of methanol and then 135 mL deionized water added. Potassium carbonate (13.36 g, 96.66 mmol) was added and the mixture stirred at room temperature for 24 to 48 hours until the reaction was complete. Most of the methanol was evaporated and then 250 mL ethyl acetate was added with stirring. A 10% aqueous citric acid solution (120 mL) was slowly added and then the ethyl acetate phase separated. The aqueous phase was extracted with an additional 200 mL portion of ethyl acetate. The combined ethyl acetate extracts were washed sequentially with 150 mL deionized water, 100 mL 10% aqueous citric acid solution and 150 mL saturated aqueous sodium chloride and then dried over MgSO4. The ethyl acetate was evaporated to give a pale yellow solid. The crude product was chromatographed over silica gel using 40% acetone/60% hexane as eluent to give ISATX247 (10.51 g, 75%) as a colorless solid. ISATX247 contains 45-50% E-isomer and 50-55% Z-isomer.
The products in Examples 1-4 were characterized by mass spectrometry and/or nuclear magnetic resonance spectroscopy.
Acetyl Cyclosporin A (41.48 g, 33.3 mmol) prepared as in Example 1, N-bromosuccinimide (10.39 g, 58.4 mmol) and azo-bis-isobutyronitrile (1.09 g, 6.67 mmol) were dissolved in 250 mL of carbon tetrachloride and the resulting mixture heated to reflux for 2.5 hours. The mixture was cooled and the solvent evaporated. The residue was treated with 350 mL diethyl ether and filtered to remove the insoluble material. The filtrate was washed sequentially with 150 mL water and 150 mL brine, then dried over magnesium sulfate and the solvent evaporated. The crude material was chromatographed on silica gel with acetone/hexane (2:3) to give 28.57 g (65%) of acetyl-γ-bromocylosporin A as a yellow solid.
Acetyl-γ-bromocylosporin A (28.55 g, 21.6 mmol) and triphenylphosphine (7.55 g, 28.8 mmol) were dissolved in 210 mL of toluene and the resulting solution heated to 100° C. for 21 hours. The solution was cooled and the toluene evaporated. The resulting oily, semi-solid was treated with 250 mL of hexane/ether (1:4), mixed thoroughly and the solvent decanted off. This process was repeated 3 more times with 150 mL ether. The residue was then dissolved in 50 mL ethyl acetate and precipitated with 220 mL hexane. The resulting solid was then collected by filtration to give 22.5 g (66%) of triphenylphosphonium bromide of acetyl cyclosporin A as a tan-colored solid.
The triphenylphosphonium bromide of acetyl cyclosporin (100 mg, 0.06 mmol), an excess of 37% formaldehyde (0.25 mL) and toluene (2 mL) were stirred rapidly at room temperature. Aqueous sodium hydroxide as a 1N solution (2 mL) was added dropwise and stirring continued for 3.5 hours. The reaction mixture was diluted with ethyl acetate (20 mL) and water (10 mL). The ethyl acetate phase was separated, washed sequentially with water (10 mL) and brine (10 mL), dried over magnesium sulfate and the solvent evaporated. The crude material was chromatographed on silica gel with acetone/hexane (2:3) to give 70 mg (88%) of a mixture of (E) and (Z)-isomers of acetyl ISATX247 as a colorless solid.
The mixture of isomers from Example 7 (70 mg, 0.056 mmol) was dissolved in methanol (5 mL) and then water (1 mL) added. Potassium carbonate (75 mg) was added and the reaction stirred at room temperature for 19 hours. Most of the methanol was evaporated and 15 mL ethyl acetate added to the residue followed by 10 mL of 10% aqueous citric acid. The ethyl acetate phase was separated and the aqueous phase extracted with an additional 10 mL of ethyl acetate. The combined ethyl acetate extracts were washed sequentially with 10 mL water, 10 mL 10% aqueous citric acid and 10 mL brine before drying over magnesium sulfate and evaporating the solvent. The crude material was chromatographed on silica gel with acetone/hexane (2:3) to give 37 mg (54%) of ISATX247 as a colorless solid containing about 85% E-isomer and about 15% Z-isomer.
The products in Examples 5-8 were characterized by mass spectrometry and/or nuclear magnetic resonance spectrometry.
The cis- and trans-isomers of ISATX247 may be independently synthesized using the following reaction scheme. The sequence involves known metalation of allyltrimethylsilane, the electrophilic capture by a trimethylborate, followed by the hydrolysis and then transesterification to generate the intermediate trans-(trimethylsilyl)allylboronate ester. Allylboration of cyclosporine aldehyde furnished a boron intermediate, which is converted to the desired β-trimethylsilyl alcohol, by sequestration. The diastereoselectivity in the creation of new chiral centers is not determined at this stage due to removal of these centers at a later stage. It should be noted that the relative stereochemistry of the two centers in the β-trimethylsilyl alcohol is anti in agreement with expectations and is due to the trans double bond in the trans-(trimethylsilyl) boronate precursor.
Base-promoted elimination (Hurdlik et al., 1975) of β-trimethylsilyl alcohol furnished a composition enriched in acetyl-(Z)-1,3-diene while acid-promoted elimination gave a composition enriched in acetyl-(E)-1,3-diene. Deprotection leads to the respective diene alcohols, the (Z) and (E)-isomers of ISATX247, respectively.
An alternate approach to dienes utilizes the allylphosphoranes. Metalation of allyldiphenylphosphine and then transmetalation with Ti(OPri)4 gives the titanium intermediate. Allyltitanation followed by stereospecific elimination would generate a composition enriched in the (Z)-diene.
On the other hand, when allyldiphenylphosphine oxide is subjected to a similar sequence (
i) Allylboration of Acetyl CsA-CHO:
The (E)-1-trimethylsilyl-1-propene-3-boronate was prepared in accordance with previously reported methods (Ikeda et al., 1987). To a stirred solution of (E)-1-trimethylsilyl-1-propene-3-boronate (0.2 g, 0.832 mmol) in THF (3 mL) under nitrogen was added acetyl Cyclosporin A aldehyde (1.026 g, 0.832 mmol). The reaction mixture was monitored by high performance liquid chromatography (C-8 column, reverse phase) and stirred for a total period of 7 days. Then triethanolamine (0.196 g, 1.3 mmol) was added and stirring continued for a further period of 4 days. The β-trimethylsilyl alcohol was obtained by purification over a silica gel column. MS (ES) m/z 1368.9 (M+Na+).
To a suspension of KH (3.5 mg, 26.4 μmol, 30% mineral oil dispersion washed with anhydrous hexanes) in anhydrous THF (1 mL) was added β-trimethylsilyl alcohol (10 mg, 7.4 micromole) and stirred at room temperature for 10 min. The reaction mixture was diluted with diethyl ether (10 mL) and then washed with saturated NaHCO3 solution (2×5 mL). Drying (Na2SO4) and solvent removal furnished the enriched (Z)-acetyl-1,3-diene. MS (ES) m/z 1294.8 (M+K+).
ii) Allyltitanation of Acetyl CsA-CHO:
To a stirred and cooled (−78° C.) solution of allyldiphenylphosphine (0.54 g, 2.4 mmol) in anhydrous THF (8 mL) was added t-BuLi (1.42 mL, 2.4 mmol, 1.7 M solution in pentane). The brick-red colored solution was stirred for 15 min at this temperature and then at 0° C. for 30 min. It was then cooled again to −78° C. and added Ti(OPri)4 (0.71 mL, 2.4 mmol). The brown colored solution was stirred at this temperature for 15 minutes and then a solution of acetyl CsA-CHO (2.5 g, 2 mmol) in THF (10 mL) was added through a cannula. The pale-yellow colored solution was stirred for a further period of 30 minutes and then warmed to room temperature overnight. To the reaction mixture was added MeI (0.15 mL, 2.4 mmol) at 0° C. Stirring was continued for 1 h at this temperature and then at room temperature for 2 h. The reaction mixture was poured into ice-cold 1% HCl (100 mL). The aqueous layer was extracted with EtOAc (3×50 mL). The combined organic extract was washed with water (2×25 mL) and brine (25 mL). Removal of solvent gave a yellow solid which was chromatographed over a column of silica gel. Elution with 1:3 acetone-hexanes mixture furnished the (Z)-enriched isomer of acetyl ISATX247. Deprotection as in Example 4 gave (Z)-enriched isomer of ISATX247 (Z/E ratio, 75:25).
To a solution of allyldiphenylphosphine oxide (1 mmol) and hexamethylphosphoramide (2 mmol) in tetrahydrofuran (5 mL) at −78° C. was added n-butyllithium (1 mmol, in hexanes). The mixture was stirred at −78° C. for 30 minutes. A solution of acetyl cyclosporin A aldehyde (0.8 mmol) in tetrahydrofuran (7 mL) was added and the reaction mixture allowed to gradually warm to room temperature and then stirred for 18 hours. The mixture was poured into ice-cold 1N hydrochloric acid (50 mL) and then extracted into ethyl acetate. The organic extract was washed with water, dried over magnesium sulfate and the solvent evaporated. The residue was chromatographed over silica gel using 25% acetone/75% hexanes as eluent to give a mixture of the (E) and (Z)-isomers of acetyl ISATX247. Removal of the acetate protecting group as described in Example 4 gave an (E)-enriched mixture of the ISATX247 isomers. Proton NMR spectroscopy indicated that the mixture was comprised of 75% of the (E) and 25% of the (Z)-isomer of ISATX247. This reaction was also carried out according to Schlosser's modification (R. Liu, M. Schlosser, Synlett, 1996, 1195). To a stirred and cooled (−78° C.) solution of allyldiphenylphosphine oxide (1.21 g, 5 mmol) in THF (20 mL) was added n-BuLi (2 mL, 5 mmol, 2.5 M solution. in hexanes). The red-colored solution was stirred for 40 minutes at −78° C. A solution of acetyl CsA-CHO (1.25 g, 1.02 mmol) in THF (12 mL) was then added through a cannula during 15 minutes. The reaction mixture was stirred at room temperature for 2 hours. Workup and chromatography as above gave acetyl ISATX247 (Z:E ratio, 40:60 by 1H NMR analysis).
Cyclosporin A (6.01 g, 5 mmol) and 4-dimethylaminopyridine (305 mg, 2.5 mmol) were dissolved in pyridine (5 mL). Benzoic anhydride (3.4 g, 15 mmol) was added and the mixture stirred for 19 hours at 50° C. Additional benzoic anhydride (1.7 g, 7.5 mmol) and DMAP (305 mg, 2.5 mmol) were added and stirring at 50° C. continued for another 24 hours. Benzoic anhydride (0.85 g, 3.8 mmol) was added and the reaction stirred for an additional 23 hours. The reaction mixture was then poured slowly into water with stirring. Precipitated Cyclosporin A benzoate was filtered off and washed with water. The collected cake was dissolved in a minimum volume of methanol and added to a 10% citric acid solution and stirred for 1 hour. The precipitated product was collected by filtration and washed with water until the pH of the filtrate reached that of the water. The solid Cyclosporin A benzoate was dried at 50° C. under vacuum to give a colorless solid.
Cyclosporin A (3.606 g, 3 mmol) was dissolved in dry pyridine (8 mL) and then DMAP (122 mg, 1 mmol) was added. The reaction mixture was cooled to 0° C. and then triethylsilyl trifluoromethanesulfonate (3.6 mmol) added dropwise. The mixture was allowed to warm to room temperature and stirred overnight. The reaction mixture was then poured slowly into water with stirring. The precipitated triethylsilyl ether was filtered off and washed with water. The collected cake was dissolved in a minimum volume of methanol and added to a 5% citric acid solution and stirred for 30 minutes. The precipitated product was collected by filtration and washed with water until the pH of the filtrate reached that of the water. The solid triethylsilyl ether was dried at 50° C. under vacuum to give a colorless solid. Triisopropylsilyl and tert-butyldimethylsilylprotecting groups were also introduced by following an analogous procedure.
An indicator of the efficacy of cyclosporine A or a cyclosporine A derivative is its ability to inhibit the phosphatase activity of calcineurin. The calcineurin inhibition assay measures the activity of the drug at its site of action and as such is the direct in vitro assessment of the potency of cyclosporine A analogues (Fruman et al., 1992).
The immunosuppressive activity of ISATX247 (45-50% of E-isomer and 50-55% of Z-isomer) versus cyclosporine A has been assessed using the calcineurin (CN) inhibition assay. The results of this assay show that the inhibition of calcineurin phosphatase activity by ISATX247 (45-50% of Z-isomer and 50-55% of E-isomer) was up to a 3-fold more potent (as determined by IC50) as compared to cyclosporine A (
The immunosuppressive activity of various deuterated and non-deuterated isomeric analogue mixtures versus cyclosporine A has been assessed using the calcineurin (CN) inhibition assay. The structure and isomeric composition of these analogues is set forth in
The results of this assay show that the inhibition of calcineurin phosphatase activity by these isomeric analogue mixtures was at least as potent (as determined by IC50) as compared to cyclosporine A (
The efficacy of ISATX247 (45-50% of E-isomer and 50-55% of Z-isomer) in preventing the rejection of hearts transplanted between different strains of rats was assessed and compared to that of cyclosporine A. The rat heart transplant model has been the most frequently used model to assess the in vivo potency of new immunosuppressive drugs, as prolonged graft survival is difficult to achieve in this model due to immune rejection.
The procedure involved the heterotopic transplantation (to the abdominal aorta and inferior vena cava) of the heart from Wistar Furth rats to Lewis rats. Intraperitoneal injections of either cyclosporine A or an isomeric analogue mixture were given to the transplant recipient starting 3 days prior to transplantation and continuing for 30 days post-transplantation. If graft dysfunction was noted during the 30-day post-transplantation period, the animal was sacrificed. If the animal survived longer than 30 days post-transplantation, the test and control articles were discontinued and the animal was allowed to continue until graft dysfunction or up to 100 days post-transplantation.
The average survival rates for each group of recipient animals are summarized in Table 1. These results show that ISATX247 (45-50% of E-isomer and 50-55% of Z-isomer) at an optimal dose of 1.75 mg/kg/day increased survival time approximately 3-fold over Cyclosporine A. A number of animals receiving ISATX247 still had functioning grafts at 100 days post-transplant (70 days post discontinuation of dosing). These data demonstrate the immunosuppressive activity of this isomeric analogue mixture in preventing graft rejection.
a,cNot significantly different
bSignificantly different (p < 0.01)
The efficacy of various deuterated and non-deuterated isomeric analogue mixtures (structures given in
The ability of ISATX247 (45-50% of E-isomer and 50-55% of Z-isomer) versus cyclosporine A to prolong the survival of transplanted islet cells in a mouse model was investigated in a study involving the transplant of 500 islets from a CBA/J mouse into the renal capsule of diabetic Balb/c mouse recipients.
Following transplantation, ISATX247 or cyclosporine A was administered by intraperitoneal (i.p.) injection at a dose level of 0 (vehicle), 1.75, 10, 20, or 25 mg/kg/day for a total of 30 days. Blood glucose was monitored daily until the time of graft failure, as defined by a glucose level greater than 17 mmol/L on two consecutive days.
The results indicate that ISATX247 increased the length of graft survival by 40% at a dose of 20 mg/kg/day (Table 3). It was also noted that ISATX247 was less toxic than cyclosporine A as the dose level increased. This was especially apparent at the 25 mg/kg/day dose level.
Over the course of the past three decades, three animal models of human rheumatoid arthritis have been extensively examined and widely employed in the preclinical screening and development for novel anti-rheumatic agents. These include the adjuvant-induced, collagen-induced, and antigen-induced arthritis models. The following studies were designed to evaluate anti-inflammatory efficacy of ISATX247 (45-50% of E-isomer and 50-55% of Z-isomer) in both the collagen-induced arthritis model in the mouse and the antigen-induced arthritis model in the rabbit. The histopathology and immunopathology observed in these two models resemble the findings in the human disease. In both models, the efficacy of ISATX247 to prevent the onset of arthritis (prevention protocol) and to treat arthritis (treatment protocol) was examined. These studies support the immunosuppressive action of the claimed isomeric analogue mixtures.
A. Collagen-Induced Arthritis
Male DBA/1 Lac J mice, kept under virus antibody free conditions, were immunized subcutaneously at 8 to 10 weeks of age with 100 microgram of chick type II collagen, emulsified in Freund's complete adjuvant. ISATX247, cyclosporine A, or vehicle (Chremophor EL/ethanol 72:28, volume/volume) were administered daily by intraperitoneal (i.p.) injection of 1- to 50-fold dilutions of stock drug (0.25, 0.5, or 1 mg/mL) into saline to yield concentrations of 0 (vehicle); 125, 250, or 500 μg/mouse for ISATX247; and 250, or 500 μg/mouse for cyclosporine A. Animals assigned to the prevention protocol (12/group) were dosed starting on the day of immunization with collagen (Day 0) until sacrifice on Day 40. Animals assigned to the treatment protocol (12/group) were dosed starting on the day of disease onset (˜Day 28) until sacrifice on Day 38.
Evaluated parameters included mortality, serum creatinine, histology, and outcome assessments, such as clinical scoring (visual), hind paw swelling, histological scoring, erosion scoring, and immunohistochemistry.
Erosion scoring was done in a blinded manner by examining sagittal sections of the proximal interphalangeal (PIP) joint of the middle digit for the presence or absence of erosions (defined as demarcated defects in cartilage or bone filled with inflammatory tissue). This approach allowed for comparisons of the same joint. Previous studies have demonstrated erosions in >90% of untreated arthritic animals in this joint.
The results indicate that the negative erosion scores in the ISATX247 high-dose treatment group (500 μg/mouse) were significantly higher than the negative erosion scores in the vehicle treatment group (p<0.05). Both the mid-dose ISATX247 (250 μg/mouse) and high-dose cyclosporine A (500 μg/mouse) treatment groups had higher negative erosion scores as compared to the vehicle treatment group (p<0.1). Furthermore, the low-dose ISATX247 (125 μg/mouse) and mid-dose cyclosporine A control (250 μg/mouse) treatment groups have higher, although not statistically significant, negative erosion scores when compared to the vehicle control group.
The only treatment to significantly prevent the development of joint erosions was ISATX247 at 500 μg/mouse. This significant reduction in the proportion of the PIP joints showing erosive changes in the ISATX247-treated mice relative to the vehicle control group mice demonstrates that ISATX247 has disease-modifying properties.
B. Antigen-Induced Arthritis
New Zealand White rabbits, maintained under specific pathogen free conditions, were immunized with 10 mg of ovalbumin in saline emulsified with Freund's complete adjuvant that was given intramuscularly and subcutaneously into several sites in the nape of the neck. Fourteen days later, all animals started receiving 2 daily intra-articular injections of 5 mg ovalbumin and 65 ng of human recombinant transforming growth factor 2 in saline.
ISATX247, cyclosporine A, or vehicle (Chremophor EL/ethanol 72:28, V/V) were administered daily by subcutaneous injection of 1- to 4-fold dilutions of stock drug (in vehicle) into saline to yield concentrations of 0 (vehicle); 2.5, 5.0, or 10 mg/kg/day for ISATX247; and 5.0, 10, or 15 mg/kg/day for cyclosporine A. Animals assigned to the prevention protocol (8/group) were dosed starting on the day of immunization with ovalbumin (Day 0) until sacrifice on Day 42. Animals assigned to the treatment protocol (8/group) were dosed starting on the day of disease onset (˜Day 28) until sacrifice on Day 42.
Evaluated parameters included mortality, body weight, serum creatinine, histology, and outcome assessments such as knee joint swelling, synovial fluid counts, gross postmortem analysis, and histology.
A significant decrease in synovial histopathological scores was observed in ISATX247 (P 0.05) and cyclosporine A (P 0.05) animals after 28 days of therapy (prevention protocol) compared to vehicle control animals. This was accompanied by significant reductions in synovial fluid counts (ISATX247, P 0.05; cyclosporine A, P 0.05). Significant amelioration in synovial histopathological scores of animals with established arthritis was also evident following 14 days of treatment with ISATX247 (P 0.05) and cyclosporine A (P 0.05) compared to vehicle controls (treatment protocol). A significant reduction in macroscopic arthritis score was evident in ISATX247 (P=0.01), but not in cyclosporine A treated animals. Treatment was well tolerated with no significant toxicity upon analysis of serum creatinine or post-mortem histology.
The data show that ISATX247 is equivalent or potentially more potent than cyclosporine A in the treatment and prevention of rheumatoid arthritis in an antigen-induced arthritis model in the rabbit.
The pharmacokinetic and toxicokinetic parameters of ISATX247 (45-50% of E-isomer and 50-55% of Z-isomer) and cyclosporine A were tested in a rabbit model. The rabbit has also been used as a model to study cyclosporine A nephrotoxicity, but far less frequently than the rat. Studies have found that cyclosporine A administered to the rabbit causes structural and functional changes at a dose not only lower than has been previously reported in other animal models, but also within at least the upper level of the therapeutic range in humans (Thliveris et al., 1991, 1994). Also, the finding of interstitial fibrosis and arteriolopathy, in addition to the cytological changes in the tubules, suggests that the rabbit is a more appropriate model to study nephrotoxicity, since these structural entities are hallmarks of nephrotoxicity observed in humans. ISATX247 was administered intravenously (i.v.) for the first 7 days and subcutaneously (s.c.) for an additional 23 days according to the following schedule.
Pathogen free rabbits (SPF) were used to ensure any renal changes observed were due to the effect of ISATX247 and not due to pathogens. On Days 1 and 7, blood samples were collected prior to drug administration and at 0.5, 1, 2, 4, 8, 12, 18, and 24 hours post-dose to generate a pharmacokinetic profile. Other evaluated parameters included clinical observations, body weight, food consumption, hematology, clinical chemistry, gross pathology, and histopathological examination of selected tissues/organs.
Blood samples were analyzed via high performance liquid chromatography coupled with mass spectrometry (LCMS). Table 5 below summarizes the average pharmacokinetic parameters in rabbits that received 10 mg/kg of cyclosporine A or ISATX247.
There were no statistically significantly differences between the pharmacokinetic parameters of cyclosporine A and ISATX247 in male rabbits receiving 10 mg/kg/day. The pharmacokinetic parameters of ISATX247 in female rabbits receiving the same dose were not significantly different from that observed in the male rabbits, with the exception of maximum concentration on Day 7.
No significant changes were noted in the hematological parameters of rabbits receiving a vehicle control, cyclosporine A, or ISATX247. A difference was noted in the creatinine levels in the various groups over the course of the study, as is shown in Table 6 below. These differences indicated that cyclosporine A had a significantly greater negative effect on the kidneys than either the vehicle control or ISATX247. It should be noted that even at a 50% higher dose, 15 mg/kg/day, as compared to 10 mg/kg/day cyclosporine A, ISATX247 did not result in any significant increase in serum creatinine levels.
Examination of organs in all rabbits receiving the vehicle control, 10 mg/kg cyclosporine A, 5 mg/kg ISATX247, or 10 mg/kg ISATX247 revealed no significant abnormalities. This was especially true for the kidneys, in which no evidence of interstitial fibrosis, normally seen in cyclosporine A-treated animals (Thliveris et al., 1991, 1994) was noted. In male rabbits that received 15 mg/kg ISATX247, a decrease in spermatogenesis was noted. No changes were noted in the 3 female rabbits that completed the study at this dose of 15 mg/kg ISATX247.
Whole blood from cynomolgous monkeys (n=4) was incubated with ISATX247 or cyclosporine and stimulated with different mitogens in culture medium. Lymphocyte proliferation was assessed by tritium-labeled thymidine incorporation and by flow-cytometric analysis of expression of proliferating cell nuclear antigen (PCNA) on cells in SG2M phase. Flow cytometry was also used to assess production of intracellular cytokines by T cells and expression of T lymphocyte activation antigens. The EC50 (concentration of drug necessary to attain 50% of the maximum effect) was subsequently calculated using the WinNonlin™ software. Results showed that lymphocyte proliferation, cytokine production, and expression of T cell surface antigens were inhibited more potently by ISATX247 than by cyclosporine, as shown by the EC50 (expressed in ng/mL) set forth in Table 7 below.
3H-thymidine uptake
Thus, using an ex vivo whole blood assay we have found that ISATX247 suppresses diverse immune functions 2.3-6 times more potently than cyclosporine.
Potassium tert butoxide (0.31 g, 2.8 mmol) was dissolved in 20 mL of tetrahydrofuran. At about −40° C. tributyl allyl phosphonium bromide (0.99 g, 3.1 mmol) dissolved in 3 mL of tetrahydrofuran was slowly added. The resulting yellow mixture was stirred for about 10 minutes at about −40° C. before a solution of acetyl cyclosporin A aldehyde (1.5 g, 1.2 mmol) in 6 mL of tetrahydrofuran was slowly added. After stirring the yellow-orange reaction mixture for 1.5 hours the reaction was complete. For quenching the reaction mixture was transferred onto aqueous phosphoric acid (1.2 g, 1.0 mmol). The resulting aqueous solution was extracted with 100 mL of toluene followed by 50 mL of toluene. The combined organic layers were washed with water and concentrated under reduced pressure to dryness. The product, acetylated ISATX247, was obtained as a slightly yellow solid in approximately 90% yield. The isomer ratio was about 87% E-isomer and about 13% Z-isomer (as determined by 1H-NMR spectroscopy).
Tributyl allyl phosphonium bromide (1.38 g, 4.3 mmol) was dissolved in a mixture of 20 mL of toluene and 3 mL of tetrahydrofuran. At about −78° C. butyllithium (1.6 M in hexane, 2.43 mL, 3.9 mmol) was slowly added. The resulting yellow mixture was stirred for about 10 minutes at about −78° C. before a solution of acetyl cyclosporin A aldehyde (1.5 g, 1.2 mmol) in 6 mL of toluene was slowly added. After stirring the yellow-orange reaction mixture for 3.5 hours the reaction was quenched by transferring the reaction mixture onto a mixture of 50 mL toluene and aqueous phosphoric acid (0.25 g, 2.2 mmol). The resulting biphasic mixture was allowed to warm to ambient temperature before the two layers were separated. The toluene layer was washed with 20 mL water and concentrated under reduced pressure to dryness. The product, acetylated ISATX247, was obtained as a slightly yellow solid in approximately 80% yield. The isomer ratio was about 70% E-isomer and about 30% Z-isomer (as determined by 1H-NMR spectroscopy).
Running SAP018 as described above but only at about −40° C. The experimental conditions of Example 20 were repeated, this time using a reaction temperature of about −40° C. Under these conditions the isomeric ratio of the isolated product, acetylated ISATX247, was about 74% by weight of the E-isomer, and to about 26% by weight of the Z-isomer, as determined by 1H-NMR-spectroscopy.
A solution of acetyl cyclosporin A aldehyde (1.5 g, 1.2 mmol) and tributyl allyl phosphonium bromide (0.99 g, 3.1 mmol) in 15 mL of tetrahydrofuran was cooled to about −80° C. Potassium tert-butoxide (0.19 g, 1.7 mmol) dissolved in 9 mL of tetrahydrofuran was slowly added. The resulting yellow mixture was stirred for one hour at about −80° C. to complete the reaction before a solution of 6 mL of tetrahydrofuran was slowly added. After stirring the yellow-orange reaction mixture for 1.5 hours the reaction was complete. For quenching the reaction mixture aqueous phosphoric acid (0.15 g, 1.3 mmol) was added. The resulting mixture was concentrated and the residue was dissolved in 5 mL of methanol. Then the mixture was slowing added to 5 mL of water. The resulting precipitate was filtered, washed with 4 mL of methanol/water (1/1), and dried in vacuo. The product, acetylated ISATX247, was obtained as a colorless solid in approximately 90% yield. The isomer ratio was about 91% by weight E-isomer and 9% by weight Z-isomer (determined by 1H-NMR-spectroscopy).
A solution of acetyl cyclosporin A (15 g, 12.1 mmol) in 200 mL of methanol was ozonised at −78° C. using a Sander ozone generator at about 1.1 bar with a current flow of 300 L 02/hour until the reaction was complete (about 5 minutes). The solution was gassed with argon and quenched with dimethylsulfide dissolved in methanol. For completing the reduction the mixture was stirred overnight at room temperature. After concentration to about 50 mL the solution was slowly added to 500 mL of water. The resulting precipitate was filtered, washed with 60 mL of water and dried in vacuo. The product, acetylated CsA aldehyde, was obtained as a colorless solid in approximately 95% yield and a purity of about 98% (determined by HPLC).
Cyclosporine A (40 g, 1 equivalent) was dissolved in dichloromethane (100 ml) at 30° C. N,N-bis-(trimethylsilyl) urea (1.1 equivalent) was added. After 5 minutes stirring at 30° C., p-toluene-sulfonic acid (0.02 equivalents) was added. The reaction mixture was heated at reflux until completion of the reaction, as measured by thin layer chromatography (TLC), high pressure or high performance liquid chromatography (HPLC) or mass spectrometry (MS) and then cooled to room temperature. Half saturated aqueous sodium bicarbonate solution (100 ml) was added. The aqueous phase was separated and re-extracted with dichloromethane. The combined organic phases were dried over anhydrous Na2SO4 and filtered. The solvent was removed under reduced pressure providing the crude trimethylsilyl-protected Cyclosporine A.
Trimethysilyl-protected Cyclosporine A (5 g, 1 equivalent) was dissolved in dichloromethane (50 ml). The solution was then cooled to a temperature of about −78° C., after which ozone was bubbled through the solution until the appearance of a blue color. Next, argon was bubbled through the solution until a colorless solution was obtained in order to remove excess ozone it became colorless; this step was carried out to remove excess ozone. Triethylamine (5 equivalents) was added and the reaction mixture was stirred at room temperature for 17 hours. The trimethylsilyl-protected Cyclosporine A aldehyde was obtained after aqueous work-up.
To a mixture of potassium tert-butoxide (3 equivalents) and allyl-triphenyl-phosphonium bromide (2 equivalents) in toluene (10 ml) previously stirred for 60 minutes, was added the trimethylsilyl-protected Cyclosporine A aldehyde (1 g, 1 equivalent). Work-up of the reaction mixture after 1 hour reaction at room temperature provided a 3:1 mixture (by NMR) of Z and E double bond isomers of the trimethylsilyl-protected Cyclosporine A diene.
The trimethylsilyl-protected Cyclosporine A aldehyde (2.5 g) was dissolved in 25 ml of toluene and treated with 1N aqueous sodium hydroxide solution (10 equivalents). The reaction mixture was vigorously stirred and allyltriphenylphosphonium bromide (7.5 equivalents, portionwise) was added. Work-up of the reaction mixture after several hours reaction at room temperature provided a ca 1:1 mixture (by NMR) of Z and E double bond isomers of the trimethylsilyl-protected Cyclosporine A diene.
The trimethylsilyl-protected Cyclosporine A aldehyde (1 g) was dissolved in 5 ml of toluene together with potassium carbonate (1.5 equivalent) and allyltriphenylphosphonium bromide (1.5 equivalent). Work-up of the reaction mixture after 4 hours reaction at reflux under vigorous stirring provided a ca 1:2 mixture (by (NMR) of Z and E double bond isomers of the trimethylsilyl-protected Cyclosporine A diene.
Allyltributylphosphonium bromide (3 equivalents, prepared from allylbromide and tributylphosphine) was dissolved in THE (3.5 ml). Toluene (7.5 ml) was added followed by potassium tert-butoxide (4 equivalents). After 1 hour stirring at room temperature, the solution was cooled to ca −30° C. A solution of the trimethylsilyl-protected Cyclosporine A aldehyde (1 g, 1 equivalent) in toluene (5 mL) was added dropwise. After 45 minutes at about −30° C., the reaction mixture was worked up, providing an approximately 1:3 mixture (by NMR) of Z and E double bond isomers of the trimethylsilyl-protected Cyclosporine A diene.
The following two examples, Examples 30 and 31, are directed to allylmetallations.
To a solution of allyltrimethylsilane (10.1 equivalents) in THF (15 ml) was added butyl lithium (1.6 M in hexanes, 10 equivalents) at room temperature. After 30 minutes reaction, the solution was cooled to −75° C., and treated with diethyl-B-methoxyborane (10.1 equivalents). After 1 hour, borontrifluoride diethylether complex (10.1 equivalents) was added to generate the B-(γ-trimethylsilyl-allyl)-diethylborane reagent. After 1 hour, a solution of acetyl-protected Cyclosporine A aldehyde (5 g, 1 equivalent) in THF (15 ml) was added dropwise. After 20 minutes, the reaction mixture was warmed to −10° C. and a saturated aqueous NH4Cl solution was added. After stirring one hour at room temperature, water (45 ml) was added and the reaction mixture was extracted 3 times with 25 ml ethyl acetate. The organic phases were washed sequentially with water (25 ml) and a saturated aqueous NH4Cl solution (25 ml). The combined organic phases were dried over Na2SO4, filtered, and concentrated under reduced pressure. The crude product was chromatographed (Silicagel, dichloromethane/methanol or ethyl acetate/heptane) to yield the acetyl-protected Cyclosporine A β-trimethylsilylalcohol.
To a solution of allyltrimethylsilane (10.1 equivalent) in THF (15 ml), was added butyl lithium (1.6 M in hexanes, 10 equivalents) at room temperature. After allowing the reaction to proceed for about 30 minutes, the solution was cooled to −65° C., and treated with diethyl-B-methoxyborane (10.1 equivalents). After 1 hour, borontrifluoride diethylether complex (10.1 equivalents) was added to generate the B-(γ-trimethylsilyl-allyl)-diethylborane reagent. After 1 hour, a solution of trimethylsilyl-protected Cyclosporine A aldehyde (5 g, equivalent) in THF (15 ml) was added dropwise. After 15 minutes, the reaction mixture was warmed to 10° C. and a saturated aqueous NH4Cl solution was added. After stirring for one hour at room temperature, water (12.5 ml) and saturated NaHCO3 (25 ml) were added. The reaction mixture was extracted twice with 25 ml methyl-t-butyl ether. The organic phases were washed twice sequentially with water (2×25 ml) and a saturated aqueous NaCl solution (25 ml). The combined organic phases were dried over Na2SO4, filtered, and concentrated under reduced pressure. The crude product was chromatographed (Silicagel, heptane/ethyl acetate) to yield the trimethylsilyl-protected Cyclosporine A β-trimethylsilylalcohol.
The following three examples, Examples 32, 33, and 34, are directed to Peterson elimination reactions.
The acetyl-protected Cyclosporine A β-trimethylsilylalcohol (100 mg, 1 equivalent) was dissolved in THF (1 ml). Concentrated H2SO4 (10 μl) was added and the reaction mixture was stirred overnight at room temperature. Water (10 ml) was added and the reaction mixture was extracted with dichloromethane (10 ml). The aqueous phase was re-extracted with dichloromethane (10 ml). The combined organic phases were dried over Na2SO4, filtered and concentrated under reduced pressure to give the acetyl-protected Cyclosporine A diene (acetyl-protected ISATX247). The crude product was crystallized from methyl-t-butyl ether/THF and then recrystallized from methyl-t-butyl ether/DCM to give acetyl-protected Cyclosporine A diene (acetyl-protected ISATX247) as a 99-97%:1-3% mixture of E and Z double bond isomers (by 400 MHz NMR, 2% error of measurement).
Hydrolysis of E-acetyl-protected Cyclosporine A diene was conducted as following: Acetyl Cyclosporine A diene (4 g, 1 equivalent) was dissolved in methanol (80 ml) and water (32 ml). Potassium carbonate (3.65 g, 8.3 equivalent) was added. After stirring for 15 hours at room temperature, the reaction mixture was heated up to 40° C. for 4 hours. The reaction mixture was concentrated under reduced pressure and the residue was taken up in ethyl acetate (70 ml). Aqueous citric acid solution 15% (30 ml) was slowly added followed by water (10 ml). The aqueous layer was separated and re-extracted with ethyl acetate (56 ml). The organic phases were washed with, water (30 ml), 15% citric acid solution (40 ml) and saturated NaCl solution (30 ml). The organic layers were combined, dried over Na2SO4 and concentrated under reduced pressure to give Cyclosporine A diene (ISATX247).
The trimethylsilyl-protected Cyclosporine A β-trimethylsilylalcohol (2 g, 1 equivalent) was dissolved in THF (20 ml). The solution was cooled to 0-2° C. and potassium t-butoxide (4 equivalents) was added. After 1.5 hours reaction, ethyl acetate (20 ml) and water (40 ml) were added. The aqueous layer was separated and re-extracted with ethyl acetate (20 ml). The organic phases were washed with a saturated aqueous NaCl solution (20 ml). The combined organic phases were dried over Na2SO4, filtered, and concentrated under reduced pressure to give a mixture of Z-trimethylsilyl-protected Cyclosporine A diene (trimethylsilyl-protected ISATX247), and Z-Cyclosporine A diene (the Z-isomer of ISATX247). The desilylation was completed by dissolving the crude product mixture in methanol (10% by weight in the solution) and adding a 1 M aqueous hydrochloric acid solution (1 equivalent). After 15 minutes at room temperature, water and ethyl acetate were added. The aqueous layer was separated and re-extracted with ethyl acetate. The organic phases were washed with a saturated aqueous NaCl solution. The combined organic phases were dried over Na2SO4, filtered, and concentrated under reduced pressure, providing Cyclosporine A diene (ISATX247) as a 94:6 mixture of Z and E double bond isomers (by NMR).
The trimethylsilyl-protected Cyclosporine A β-trimethylsilylalcohol (500 mg, 1 equivalent) was dissolved in dichloromethane. This solution was cooled within a range of about 0-2° C., and treated with borontrifluoride diethylether complex (5 equivalents). After 1 hour, water (20 ml) and dichloromethane (20 ml) were added. The organic layer was separated and washed with water (20 ml), dried over Na2SO4, filtered, and concentrated under reduced pressure to provide directly Cyclosporine A diene (ISATX247) as a 91:9 mixture by weight of the E and Z double bond isomers (by NMR).
Trimethylsilyl-protected Cyclosporine A diene was dissolved in methanol (10% by weight in the solution). This solution was treated with 1 M aqueous hydrochloric acid solution (1 equivalent). After 15 minutes at room temperature, water and ethyl acetate were added. The aqueous layer was separated and re-extracted with ethyl acetate. The organic phases were washed with a saturated aqueous NaCl solution. The combined organic phases were dried over Na2SO4, filtered and concentrated under reduced pressure, providing Cyclosporine A diene (ISATX247).
Acetyl cyclosporine A (2.0 g, 1.61 mmol) was dissolved in acetonitrile (30 mL). 1,3-diacetoxy-acetone (0.14 g, 0.8 mmol) was added, followed by 0.0004 M aqueous ethylenediaminetetra-acetic acid disodium salt (20 mL) and sodium bicarbonate (0.405 g, 4.82 mmol). To the stirred mixture, oxone (43.8% KHSO5) (2.23 g, 6.43 mmol) was added portionwise over 2 hours. The pH was maintained at 8.2 by constant addition of 1 N NaOH (total amount 6.4 mL) using a pH stat. The temperature was kept at 22-25° C. by occasional cooling using a cold water bath. After 2.5 hours the reaction mixture was quenched by a few drops of a sodium bisulfite solution. Water (100 mL) was added and the mixture was extracted twice with tert-butyl methyl ether (100 mL, then 75 mL). The organic extracts were washed with dilute aqueous sodium chloride (100 mL), combined, dried over Na2SO4, and concentrated to afford crude acetyl cyclosporin A epoxide (1.92 g, 95%; HPLC: 99.4% area) as a white solid foam.
Crude acetyl cyclosporin A epoxide (1.92 g, 1.52 mmol) was dissolved in acetonitrile (25 mL). Water (20 mL) was added, followed by sodium periodate (489 mg, 2.28 mmol) and 0.5 M sulfuric acid (3.05 mL, 1.52 mmol). The reaction mixture was stirred at 40° C. for 18 hours, then the excess sodium periodate was quenched by addition of aqueous sodium bisulfite. Dilute aqueous sodium chloride (100 mL) was added and the mixture was extracted twice with tert-butyl methyl ether (100 mL each). The organic extracts were washed with dilute aqueous sodium chloride (100 mL), combined, dried over Na2SO4, and concentrated to afford crude acetyl cyclosporin A aldehyde (1.74 g, 92%; HPLC: 95.7% area) as a white foam. The crude product was chromatographed over silica gel using 40% acetone/60% hexane as eluent to give the product (1.41 g, 71% based on acetyl cyclosporin A; HPLC: 100% area) as a white solid foam.
Acetyl cyclosporin A (2.0 g, 1.61 mmol) was dissolved in acetonitrile (30 mL). 1,3-Diacetoxy-acetone (0.084 g, 0.48 mmol) was added, followed by 0.0004 M aqueous ethylenediaminetetra-acetic acid disodium salt (20 mL) and sodium bicarbonate (0.405 g, 4.82 mmol). To the stirred mixture, oxone (43.8% KHSO5) (1.67 g, 4.82 mmol) was added portionwise over 2 hours. The pH was maintained at 8.2 by constant addition of 1 N NaOH (total amount 3.4 mL) using a pH stat. The temperature was kept at 20-25° C. After 3.5 hours, 0.5 M sulfuric acid (5 mL, 2.5 mmol) was added to the reaction mixture, followed by a few drops of concentrated sulfuric acid, until pH 1.3 was reached. Then, sodium periodate (516 mg, 2.41 mmol) was added, and the reaction mixture was stirred at room temperature for 2 hours and at 40° C. for 22 hours. Water (100 mL) was added and the mixture was extracted twice with tert-butyl methyl ether (100 mL, then 75 mL). The organic extracts were washed with dilute aqueous sodium chloride (100 mL), combined, dried over Na2SO4, and concentrated to afford crude acetyl cyclosporin A aldehyde (1.9 g, 96%; HPLC: 83.4% area) as a white foam. The crude product was chromatographed over silica gel using 40% acetone/60% hexane as eluent to give the product (1.35 g, 68% based on acetyl cyclosporin A; HPLC: 100% area) as a white solid foam.
The acetylated Cyclosporine A aldehyde 1 was reacted with the salt-free ylide 2 which was generated from the reaction of 3-dimethylaminopropyltriphenylphosphonium bromide with potassium hexamethyldisilazide (Corey, E. J., and Desai, M. C. Tetrahedron Letters, 1985, 26, 5747). Selective N-oxidation of the cis compound 3 was achieved using m-chloroperbenzoic acid at 0° C. Cope elimination of the N-oxide at elevated temperature in vacuo furnished the acetylated Z-isomer. Deprotection as described earlier furnished the Z-isomer of ISATX247. 1H NMR (500 MHz) spectrum of this compound confirmed the Z-geometry by exhibiting a doublet of triplet at δ 6.58 with J values 16.99 and 10.5 Hz, characteristic of Z-isomer in a ISATX247 Z/E mixture. The isomeric purity is 99% since the doublet of a triplet characteristic of E-isomer in the mixture at δ 6.28 (J=17.5, 10.0 Hz) was not detectable.
To a stirred suspension of 3-dimethylaminopropyltriphosphonium bromide (2.5 g, 5.83 mmol) in anhydrous toluene (20 mL) was added potassium hexamethyldisilazide (11.6 mL, 5.8 mmol, 0.5 M solution in toluene) through a syringe. After stirring for 1 h at room temperature, the red-colored solution was centrifuged and the supernatant transferred to a reaction flask through a cannula. To the solid was added anhydrous toluene (10 mL), stirred and centrifuged. The supernatant was transferred to the reaction flask and to the combined red-colored ylide was added OAc-CsA-CHO (1.44 g, 1.17 mmol). Stirring was continued for a further period of 2 h at room temperature when the color turned light-yellow. The reaction mixture was diluted with EtOAc (50 mL) and washed subsequently with saturated NaHCO3 solution (50 mL) and brine (50 mL). Drying and solvent removal furnished a pale-yellow solid. Chromatography over a silica gel column and elution with acetone-hexanes mixture (gradient: 10 to 75% acetone and 90 to 25% hexanes) removed all phosphorous-related impurities. Further elution with acetone furnished desired product as a colorless solid (1.28 g, 84% yield). 1H NMR (300 MHz, CDCl3): 2.23 (s, 6H), 2.03 (s, 3H). 13C NMR (300 MHz, CDCl3): 129.33, 126.95; MS m/z: 1301 (M+), 1324 (M+Na+).
Conversion to N-Oxide
To a stirred and cooled (0° C.) solution of the dimethylamino compound obtained in the Wittig reaction (0.44 g, 0.34 mmol) in CHCl3 (3 mL) was added a solution of m-CPBA (0.07 g, 0.405 mmol) in CHCl3 (2 mL). After stirring for 30 min, dimethyl sulfide (0.5 mL) was added followed by CH2Cl2 (50 mL). Work-up by washing with NaHCO3 solution (25 mL) and water (25 mL), drying and solvent removal furnished a solid (0.43 g). 1H NMR (300 MHz, CDCl3): 3.19 (s, 3H), 3.18 (s, 3H), 2.03 (s, 3H). 13C NMR (300 MHz, CDCl3): 131.89, 124.13; MS m/z: 1340 (M+Na+).
Cope Elimination of N-Oxide, Preparation of (Z)-Isomer of Acetyl ISATX247
The N-oxide (350 mg) was stirred neat and heated at 100° C. in vacuo for 2 h. This was then passed through a column of silica gel. Elution with acetone-hexanes mixture (gradient, 5 to 25% acetone and 95 to 75% hexanes) furnished a colorless solid (314 mg). 1H NMR (500 MHz, CDCl3): 6.49 (dt, J=16.99, 10.5 Hz, 1H); 13C NMR (400 MHz, CDCl3): 132.20, 131.09, 129.70, 116.85; MS m/z: 1279 (M+Na+).
(Z)-Isomer of ISATX247
To a solution of (Z)-acetyl ISATX247 (50 mg) in MeOH (4 mL) was added water (1.5 mL) and K2CO3 (60 mg) and stirred for 48 h at room temperature. The reaction mixture was stripped off solvents and extracted with EtOAc (20 mL). The organic layer was washed with water (10 mL) and brine (10 mL). Drying and solvent removal furnished a colorless solid. 1H NMR (500 MHz, CDCl3): 6.58 (dt, J=16.99, 10.5 Hz, 1H); MS m/z: 1236.8 (M+Na+). The resulting compound was Z-isomer of ISATX247. No measurable E-isomer was observed by NMR.
Although only preferred embodiments of the invention are specifically disclosed and described above, it will be appreciated that many modifications and variations of the present invention are possible in light of the above teachings and within the purview of the appended claims without departing from the spirit and intended scope of the invention.
This application is a continuation of U.S. application Ser. No. 14/949,616, filed Nov. 23, 2015 now patented, which is a continuation of U.S. application Ser. No. 14/324,146, filed Jul. 4, 2014 now abandoned, which is a continuation of U.S. application Ser. No. 14/042,226, filed Sep. 30, 2013 and now abandoned, which is a continuation of U.S. application Ser. No. 13/684,574, filed Nov. 26, 2012 and now abandoned, which is a continuation of U.S. application Ser. No. 12/796,616, filed Jun. 8, 2010 and now abandoned, which is a continuation of U.S. application Ser. No. 11/969,174, filed Jan. 3, 2008 and now abandoned, which is a continuation of U.S. application Ser. No. 11/118,830, filed Apr. 28, 2005, now U.S. Pat. No. 7,332,472, which is a continuation of U.S. application Ser. No. 10/274,255, filed Oct. 17, 2002 now U.S. Pat. No. 6,998,385, which claims the benefit of U.S. provisional Application Ser. Nos. 60/346,201 filed Oct. 19, 2001, and 60/370,596 filed Apr. 5, 2002. The disclosure of each of these applications is incorporated herein by reference in its entirety.
| Number | Name | Date | Kind |
|---|---|---|---|
| 4108985 | Ruegger et al. | Aug 1978 | A |
| 4117118 | Härri et al. | Sep 1978 | A |
| 4160452 | Theeuwes | Jul 1979 | A |
| 4177188 | Hansen | Dec 1979 | A |
| 4201771 | Onishi et al. | May 1980 | A |
| 4210581 | Ruegger et al. | Jul 1980 | A |
| 4220641 | Traber et al. | Sep 1980 | A |
| 4256108 | Theeuwes | Mar 1981 | A |
| 4265874 | Bonsen et al. | May 1981 | A |
| 4288431 | Traber et al. | Sep 1981 | A |
| 4289851 | Traber et al. | Sep 1981 | A |
| 4304641 | Grandia et al. | Dec 1981 | A |
| 4384996 | Bollinger et al. | May 1983 | A |
| 4396542 | Wenger | Aug 1983 | A |
| 4404194 | Arala-Chaves | Sep 1983 | A |
| 4554351 | Wenger | Nov 1985 | A |
| 4639434 | Wenger et al. | Jan 1987 | A |
| 4681754 | Siegl | Jul 1987 | A |
| 4703033 | Seebach | Oct 1987 | A |
| 4727018 | Eichner et al. | Feb 1988 | A |
| 4764503 | Wenger | Aug 1988 | A |
| 4765980 | DePrince et al. | Aug 1988 | A |
| 4771122 | Seebach | Sep 1988 | A |
| 4798823 | Witzel | Jan 1989 | A |
| 4839342 | Kaswan | Jun 1989 | A |
| 4866036 | Durette | Sep 1989 | A |
| 4868155 | Durette | Sep 1989 | A |
| 4868157 | Durette | Sep 1989 | A |
| 4885276 | Witzel | Dec 1989 | A |
| 4914188 | Dumont et al. | Apr 1990 | A |
| 4963362 | Rahman et al. | Oct 1990 | A |
| 4963683 | Avery et al. | Oct 1990 | A |
| 4970076 | Horrobin | Nov 1990 | A |
| 4996193 | Hewitt et al. | Feb 1991 | A |
| 4997648 | Galpin et al. | Mar 1991 | A |
| 5013719 | Bowlin | May 1991 | A |
| 5047512 | Handschumacher et al. | Sep 1991 | A |
| 5051402 | Kurihara et al. | Sep 1991 | A |
| 5068247 | Fujita et al. | Nov 1991 | A |
| 5079341 | Galpin et al. | Jan 1992 | A |
| 5084441 | Shaw et al. | Jan 1992 | A |
| 5100889 | Misra et al. | Mar 1992 | A |
| 5116816 | Dreyfuss et al. | May 1992 | A |
| 5122511 | Patchett et al. | Jun 1992 | A |
| 5153327 | Misra et al. | Oct 1992 | A |
| 5169773 | Rosenthaler et al. | Dec 1992 | A |
| 5171812 | Domb | Dec 1992 | A |
| 5190935 | Binderup et al. | Mar 1993 | A |
| 5190972 | Dumble | Mar 1993 | A |
| 5206229 | Calverley et al. | Apr 1993 | A |
| 5214130 | Patchett et al. | May 1993 | A |
| 5217586 | Datta et al. | Jun 1993 | A |
| 5219884 | Fujita et al. | Jun 1993 | A |
| 5227467 | Durette et al. | Jul 1993 | A |
| 5236899 | Durette | Aug 1993 | A |
| 5239057 | Wang et al. | Aug 1993 | A |
| 5256547 | Rudat et al. | Oct 1993 | A |
| 5270419 | Domb | Dec 1993 | A |
| 5284826 | Eberle | Feb 1994 | A |
| 5298523 | Longley et al. | Mar 1994 | A |
| 5318901 | Patchett et al. | Jun 1994 | A |
| 5321043 | Dumble | Jun 1994 | A |
| 5342625 | Hauer et al. | Aug 1994 | A |
| 5350574 | Erlanger et al. | Sep 1994 | A |
| 5356633 | Woodle et al. | Oct 1994 | A |
| 5371081 | Houghton et al. | Dec 1994 | A |
| 5382655 | Szanya et al. | Jan 1995 | A |
| 5385915 | Buxbaum et al. | Jan 1995 | A |
| 5389382 | List et al. | Feb 1995 | A |
| 5393669 | Brown | Feb 1995 | A |
| 5401649 | Davalian et al. | Mar 1995 | A |
| 5401731 | Calverly et al. | Mar 1995 | A |
| 5405785 | Erlanger et al. | Apr 1995 | A |
| 5409816 | Lundell et al. | Apr 1995 | A |
| 5411952 | Kaswan | May 1995 | A |
| 5421987 | Tzanavaras et al. | Jun 1995 | A |
| 5427960 | Wang et al. | Jun 1995 | A |
| 5446034 | Bretting et al. | Aug 1995 | A |
| 5447924 | Bretting et al. | Sep 1995 | A |
| 5468772 | Xu et al. | Nov 1995 | A |
| 5489668 | Morrison et al. | Feb 1996 | A |
| 5498421 | Grinistaff et al. | Mar 1996 | A |
| 5510239 | Baracchini et al. | Apr 1996 | A |
| 5514788 | Bennett et al. | May 1996 | A |
| 5525590 | Bollinger | Jun 1996 | A |
| 5527820 | Ishizuka et al. | Jun 1996 | A |
| 5540931 | Hewitt et al. | Jul 1996 | A |
| 5545633 | Bretting | Aug 1996 | A |
| 5554599 | Grue-Sørensen et al. | Sep 1996 | A |
| 5554725 | Pettit | Sep 1996 | A |
| 5567300 | Datta et al. | Oct 1996 | A |
| 5571799 | Tkachuk et al. | Nov 1996 | A |
| 5578444 | Edwards et al. | Nov 1996 | A |
| 5589458 | Jameson et al. | Dec 1996 | A |
| 5589471 | Hansen et al. | Dec 1996 | A |
| 5591623 | Bennett et al. | Jan 1997 | A |
| 5616595 | Chu et al. | Apr 1997 | A |
| 5624902 | Blondelle et al. | Apr 1997 | A |
| 5627044 | Brown | May 1997 | A |
| 5632991 | Gimbrone, Jr. | May 1997 | A |
| 5635207 | Grinstaff et al. | Jun 1997 | A |
| 5637317 | Dietl | Jun 1997 | A |
| 5639473 | Grinstaff et al. | Jun 1997 | A |
| 5639724 | Cavanak | Jun 1997 | A |
| 5639852 | Rich et al. | Jun 1997 | A |
| 5643870 | Boelsterli et al. | Jul 1997 | A |
| 5648376 | Strobel et al. | Jul 1997 | A |
| 5650156 | Grinstaff et al. | Jul 1997 | A |
| 5665382 | Grinstaff et al. | Sep 1997 | A |
| 5665383 | Grinstaff et al. | Sep 1997 | A |
| 5665543 | Foulkes et al. | Sep 1997 | A |
| 5667764 | Kopia et al. | Sep 1997 | A |
| 5668734 | Krishna et al. | Sep 1997 | A |
| 5670478 | Stuchlik et al. | Sep 1997 | A |
| 5693760 | Seilhammer et al. | Dec 1997 | A |
| 5698448 | Soldin | Dec 1997 | A |
| 5709797 | Bocchiola et al. | Jan 1998 | A |
| 5741512 | Hauer et al. | Apr 1998 | A |
| 5741775 | Balkovec et al. | Apr 1998 | A |
| 5747330 | Casareto et al. | May 1998 | A |
| 5750413 | Lunetta et al. | May 1998 | A |
| 5750678 | Bauer et al. | May 1998 | A |
| 5756706 | Mansour et al. | May 1998 | A |
| 5767069 | Ko et al. | Jun 1998 | A |
| 5827706 | Leitner et al. | Oct 1998 | A |
| 5834266 | Crabtree et al. | Nov 1998 | A |
| 5840305 | Bukrinsky et al. | Nov 1998 | A |
| 5871753 | Crabtree et al. | Feb 1999 | A |
| 6039854 | Liu | Mar 2000 | A |
| 6183611 | Ting et al. | Feb 2001 | B1 |
| 6187152 | Ting et al. | Feb 2001 | B1 |
| 6365025 | Ting et al. | Apr 2002 | B1 |
| 6605593 | Naicker et al. | Aug 2003 | B1 |
| 6613739 | Naicker et al. | Sep 2003 | B1 |
| 6706691 | Van Buren et al. | Mar 2004 | B1 |
| 6998385 | Naicker | Feb 2006 | B2 |
| 7141648 | Naicker et al. | Nov 2006 | B2 |
| 7332472 | Naicker et al. | Feb 2008 | B2 |
| 7358229 | Naicker et al. | Apr 2008 | B2 |
| 7521421 | Naicker et al. | Apr 2009 | B2 |
| 7538189 | Naicker et al. | May 2009 | B2 |
| 9765119 | Naicker | Sep 2017 | B2 |
| 20010005501 | Marriott | Jun 2001 | A1 |
| 20080171850 | Naicker et al. | Jul 2008 | A1 |
| 20100311944 | Naicker et al. | Dec 2010 | A1 |
| 20130078280 | Naicker et al. | Mar 2013 | A1 |
| 20140142277 | Naicker et al. | May 2014 | A1 |
| 20140370082 | Naicker et al. | Dec 2014 | A1 |
| Number | Date | Country |
|---|---|---|
| 866810 | Nov 1978 | BE |
| 2086267 | Jun 1994 | CA |
| 630061 | May 1982 | CH |
| 630062 | May 1982 | CH |
| 8906499 | Aug 1992 | CS |
| 8906498 | Sep 1992 | CS |
| 3531597 | Mar 1987 | DE |
| 3927804 | Mar 1990 | DE |
| 4013910 | Oct 1990 | DE |
| 4433101 | Mar 1996 | DE |
| 19521974 | Dec 1996 | DE |
| 19611094 | Sep 1997 | DE |
| 0056782 | Aug 1984 | EP |
| 0034567 | Nov 1984 | EP |
| 0194972 | Sep 1986 | EP |
| 0283801 | Sep 1988 | EP |
| 0294239 | Dec 1988 | EP |
| 0296122 | Dec 1988 | EP |
| 0300785 | Jan 1989 | EP |
| 0321128 | Jun 1989 | EP |
| 0372541 | Jun 1990 | EP |
| 0372862 | Jun 1990 | EP |
| 0373260 | Jun 1990 | EP |
| 0414632 | Feb 1991 | EP |
| 0444897 | Sep 1991 | EP |
| 0473961 | Mar 1992 | EP |
| 0526200 | Feb 1993 | EP |
| 0532187 | Mar 1993 | EP |
| 0570829 | Nov 1993 | EP |
| 0577544 | Jan 1994 | EP |
| 0578616 | Jan 1994 | EP |
| 0651995 | May 1995 | EP |
| 0674178 | Sep 1995 | EP |
| 0712631 | May 1996 | EP |
| 2757520 | Jun 1998 | FR |
| 2757521 | Jun 1998 | FR |
| 2757522 | Jun 1998 | FR |
| 2205317 | Dec 1988 | GB |
| 2206119 | Dec 1988 | GB |
| 2207678 | Feb 1989 | GB |
| 2212499 | Jul 1989 | GB |
| 2222770 | Mar 1990 | GB |
| 2227244 | Jul 1990 | GB |
| 2257359 | Jan 1993 | GB |
| 2271121 | Apr 1994 | GB |
| 63-258491 | Oct 1988 | JP |
| 1277755 | Nov 1989 | JP |
| 2124100 | May 1990 | JP |
| 7278187 | Oct 1995 | JP |
| 9048737 | Feb 1997 | JP |
| 10029979 | Feb 1998 | JP |
| 10251137 | Sep 1998 | JP |
| 2001-519355 | Oct 2001 | JP |
| WO 1986002080 | Apr 1986 | WO |
| WO 1990000389 | Jan 1990 | WO |
| WO 1990006763 | Jun 1990 | WO |
| WO 1992004055 | Mar 1992 | WO |
| WO 1993025533 | Dec 1993 | WO |
| WO 1994023733 | Oct 1994 | WO |
| WO 1994025606 | Nov 1994 | WO |
| WO 1995005372 | Feb 1995 | WO |
| WO 1995005374 | Feb 1995 | WO |
| WO 1995011039 | Apr 1995 | WO |
| WO 1995026325 | Oct 1995 | WO |
| WO 1996006857 | Mar 1996 | WO |
| WO 1996022104 | Jul 1996 | WO |
| WO 1996031202 | Oct 1996 | WO |
| WO 1996033697 | Oct 1996 | WO |
| WO 1997004005 | Feb 1997 | WO |
| WO 1997025977 | Jul 1997 | WO |
| WO 1997032541 | Sep 1997 | WO |
| WO 1997033604 | Sep 1997 | WO |
| WO 1997034639 | Sep 1997 | WO |
| WO 1998008490 | Mar 1998 | WO |
| WO 1998013066 | Apr 1998 | WO |
| WO 1998014174 | Apr 1998 | WO |
| WO 1998025590 | Jun 1998 | WO |
| WO 1998046247 | Oct 1998 | WO |
| WO 1998049193 | Nov 1998 | WO |
| WO 1999010373 | Mar 1999 | WO |
| WO 1999018120 | Apr 1999 | WO |
| WO 1999032512 | Jul 1999 | WO |
| WO 2001021154 | Mar 2001 | WO |
| WO 2001028518 | Apr 2001 | WO |
| WO 2003033526 | Apr 2003 | WO |
| WO 2003033527 | Apr 2003 | WO |
| WO 2004072108 | Aug 2004 | WO |
| WO 2004082629 | Sep 2004 | WO |
| Entry |
|---|
| European Search Report from European Patent Application No. EP06013976, 6 pages, Search completed Dec. 5, 2006. |
| Abel et al., “ISATX247L: A Novel Calcineurin Inhibitor”, J. Heart Lung Transpl., vol. 20, No. 2, pp. 161 (2001) Abstract. |
| Abel, et al., “ISATx247: A Novel Calcineurin Inhibitor with Minimal Renal Toxicity”, Am. J. if Transpl., vol. 1, (Supp. 1), Abstract No. 1192 (2001). |
| Abel et al., “Phase 1 Evaluation of a Novel Calcineurin Inhibitor ISATx247”, Am. J. of Transpl., vol. 1, (Supp. 1), Abstract No. 1319 (2001). |
| Abel et al., “Preclinical Efficacy of a Novel Calcineurin InhibitorL ISATX247”, Am. J. of Transpl., vol. 1 (Supp. 1) Abstract 1191 (2001). |
| Adams, “d-Alpha Tocopheryl Polyethylene Glycol 1000 Succinate (Eastman Vitamin E TPGS) as an Emulsifier and Bioenhancer for Drugs and Lipophilic Compounds” Pamphlet by Eastman Chemical Co. (1996). |
| Aebi et al., “Synthesis, Conformation, and Immunosuppressive Activities of Three Analogues of Cyclosporin a Modified in the 1-Position”, J. Med. Chem., vol. 33, pp. 99-1009 (1990). |
| Aspeslet et al., “Requirements for therapeutic drug monitoring of sirolimus, an immunosuppressive agent used in renal transplantation”, Clinical Therapeutics, vol. 22, Supp. B pp. B86-B92 (2000). |
| Aspeslet et al., “ISATX247: A Novel Calcineurin Inhibitor”, Transpl. Proc., vol. 33, pp. 1048-1051 (2001). |
| Barrett et al., “B—[3—((Diisopropylamino)dimethylsilyl)allyl] diisopinocampheylborane: An Excellent Reagent for the Stereoselective Synthesis of Anti Vicinal Diols”, J. Org. Chem., vol. 56, pp. 5243-5245 (1991). |
| Belshaw et al., “Controlling protein association and subcellular localization with a synthetic ligand that induces heterodimerization of proteins”, Proceedings of the National Academy of Sciences of the USA, vol. 93, pp. 4604-4607 (1996). |
| Bennett, “The Nephrotoxicity of New and Old Irnmunosuppresive Drugs”, Renal Failure, vol. 20, pp. 687-690 (1998). |
| Bestmann et al., “(Z)-5-Decenyl Accetate, A Sex Attractant for the Male Turnip Moth”, Agnew. Chem. Int. Ed. Engl., vol. 17, No. 10, pp. 768-769 (1978). |
| Biellmann et al., “Allylic and Benzylic Carbanions Substituted by Heteroatoms”, Organic Reactions, vol. 27, pp. 9. (1982). |
| Birsan et al., “Ex Vivo Evaluation o the Immunosuppressive Effect of the Novel Caldineurin Inhibitor ISATX247 on Whole Blood Lymphocytes of Non-Human Primates”, Am . .J of Transpl., vol. 1, (Suppl. 1), Abstract No. 1199 (2001). |
| Blake et al., “Studies with Deuterated Drugs”, Journal of Pharmaceutical Sciences, vol. 64, No. 3, pp. 367-391 (1975). |
| Borel et al., “Biological Effects of Cyclosporin A: A Nevi Antilymphocytic Agent”, Agents and Actions, vol. 6, pp. 468-475 (1976). |
| Borel et al., “Effects of the new anti-lymphocytic peptide cyclosporine A in animals”, Immunology, vol. 32, No. 6, pp. 1017-1025 (1977). |
| Borok et al., “Effect of Glutathione Aerosol on Oxidant-Antioxidant Imbalance in Idiopathic Pulmonary Fibrosis”, The Lancet, vol. 338, pp. 215 and 697 (1991). |
| Brown et al., “Chrial Synthesis via Organoboranes. 13, A Highly Diastereoselective and Enantioselective Addition of [(Z)-K-Alkoxyallyl]diisopinocampheylboranes to Aldehydes”. J. Am. Chem. Soc., vol. 110, pp. 1535-1538 (1988). |
| Calne et al., “Pharmacological immunosuppression in clinical organ grafting. Observations on four agents: cyclosporine A. Asta 5122 (cytimun), lambda carrageenan and promethazine hydrochloride”, Clinical and Experimental Immunology, vol. 35, No. 1, pp. 1-9 (1979). |
| Calne et al., “Cyclosporin A in a patients receiving renal allografts from cadaver donors”, The Lancet, pp. 1323-1327 (1978). |
| Carey et al., “Scheme 2.6—Examples of Kinetic Resolutions”, Advanced Organic Chemistry: Part A: Structure and Mechanisms (4th ed.), Kluwer Academic/Plenum Publishers, pp. 93-94 (2000). |
| Carlsen et al., “A Greatly Improved Procedure for Ruthenium Tetraoxide Catalyzed Oxidations of Organic Compounds”, J. Org. Chem., vol. 46, No. 19, pp. 3936-3938 (1981). |
| Carruthers et al., “Simplified liquid-chromotographic analysis for cyclosporine A, and comparison with radioimmunoassay”, Clinical Chemistry, vol. 29, No. 1, pp. 180-183 (1983). |
| Chang et al., “The Effect of Water-Soluble Vitamin E on Cyclosporine Pharmacokinetics in Healthy Volunteers”, Clin. Pharmacol. Ther., vol. 59, pp. 297-303 (1996). |
| Chen et al., “A sensitive enzyme immunoassay for cyclosporin A using antibodies generated against a novel Hapten”, Research Communications in Molecular Pathology and Pharmacology, vol. 88, No. 3, pp. 317-326 (1995). |
| Christians et al., “Cyclosporin metabolism in transplant patients”, Pharmacology & Therapeutics, vol. 57, No. 2/3, pp. 291-345 (1993). |
| Copeland et al., “Toxicity of Cyclosporine Metabolites”, Therapeutic Drug Monitoring,vol. 12, No. 6, pp. 525-532 (1990). |
| Corey et al., “Highly Reactive Equivalents of Allylindenetriphennylphosporanes for the Stereospecific Synthesis of 1,3-dienes by Cis-Olefination of Hindered Aldehydes”, Tetrahedron Letters, vol. 26, No. 47, pp. 5747-5748 (1985). |
| Curran et al., “Intramolecular hydrogen transfer reactions of o-(Bromophenyl)dialkylsilyl ethers. Preparation of rapamycin-d1”, Tetrahedron Letters, vol. 33, No. 17, pp. 2295-2298 (1992). |
| Declaration of R. Yatscoff, Aug. 28, 2002, in U.S. Appl. No. 09/639,708. |
| Dreyfuss et al., “Cyclosporin A and C”, European Journal Applied Microbiology, vol. 3, pp. 125-133 (1976). |
| Eberle et al., “Synthesis of the Main Metabolite (OL-17) of Cyclosporin A”, J. Org. Chem., vol. 57, pp. 2689-2691 (1992). |
| Eberle et al., “Modifications of the MeBmt Side Chain of Cyclosporin A”, Biorganic & Medicinal Letters, vol. 5, No. 15, pp. 1725-1728 (1995). |
| Ehlinger et al., “Silicon in Synthesis. 10. The (trimethylsily)allyl amion: A β-acyl anion Equivalent for the conversion of Aldehydes and Ketones into γ-Lactones”, J. Am. Chem. Soc., vol. 102, No. 15, pp. 5004-5011 (1980). |
| Etzkorn et al., “Cyclophilin Residues That Affect Noncompetitive Inhibition of the Protein Serine Phosphatase Activity of Calcineurin by the Cyclophilin-Cyclosporin A Complex”, Biochemistry, vol. 33, pp. 2380-2388 (1994). |
| Foster et al., “Deuterium Isotope Effects in the Metabolism of Drugs and Xenobiotics: Implications for Drug Design”, Advances in Drug Research, Academic Press, London, vol. 14, pp. 2-40 (1985). |
| Fruman et al., “Calcineurin Phosphatase Activity in T Lymphocytes is Inhibited by FK 506 and Cyclosporine A”, Proc. Natl. Acad. Sci. USA, vol. 89, pp. 3686-3690 (1992). |
| Granelli-Piperno et al., “Lymphokine and Nonlymphokine mRNA Levels in Stimulated Human T Cells: Kinetics, Mitogen Requirements, and Effects of Cyclosporin A”, J. Exp. Med., vol. 163, pp. 922-937 (1986). |
| Gordon et al., “Selective effects of cyclosporine A on colony-forming lymphoid and myeloid cells in man”, Nature, vol. 279, pp. 433-434 (1979). |
| Harlow et al., “Antibodies. A Laboratory Manual”, Cold String Harbor Laboratory, New York (1988). |
| Hanson, “Esters a Protecting Groups for Alcohols”, Protecting Groups in Organic Synthesis, Ch. 2, pp. 24-25 (1999). |
| Hartman et al., “Mass Spectrometric Analysis of Cyclosproine Metabolites”, Biomedical & Environmental Mass Spectrometry, vol. 13, No. 7, pp. 361-372 (1986). |
| Hensens et al., “The Preparation of [2-Deutero-3-Fluoro-D-ALA8]Cyclosporin A by Directed Biosynthesis”, Journal of Antibiotics, vol. 45, No. 1, pp. 133-135 (1992). |
| Herbert et al., “Bioavailabity of cyclosporine with Concomitant Rifampin Administration is Markedly Less than Predicted by Hepatic Enzyme Induction”, Clin. Pharmacol. Ther., vol. 52, pp. 453-457 (1992). |
| Hoffman et al., “Diastereoselective Addition of γ-Alkylthio-Aliylboronates to Aldehydes”, Tetrahedron Letters, vol. 21, pp. 4883-4886 (1980). |
| Hoffman et al., “Stereoselective Synthesis of Alcohols. 8. Diastereoselective Synthesis of β-methylhomoallyl Alcohols via Crotylboronates”, J. Org. Chem., vol. 46, pp. 1309-1314 (1981). |
| Hofle et al., “4-Dialkylaminopyrides as Highly Active Acylation Catalysts”, Agnew. Chem. Int. Ed. Engl., vol. 17, pp. 569-583 (1978). |
| Hon et al., “A convenient and efficient workup of ozonolysis reactions using triethylamine”, Synthetic Communications, vol. 23, No. 11, pp. 1543-1553 (1993). |
| House, Modern Synthetic Reactions, W.A. Benjamin, Menlo Park, California, 2nd ed., pp. 302-319 (1972). |
| Hu et al., “Diastereoselective Chloroallylboration of I-Chiral Aldehydes”, J. Org. Chem., vol. 63, pp. 8843-8849 (1998). |
| Hughes et al., “The Isolation, Synthesis and Characterization of an Isomeric Form of Rapamycin”, Tetrahedron Letters, vol. 33, No. 33, pp. 4739-4742 (1992). |
| Hurdrlik et al., “Stereospecific Olefin-Forming Elimination Reactions of β-Hydroxyalkylsilanes”, J. Am. Chem. Soc., vol. 97, No. 6, pp. 1464-1468 (1975). |
| Ikeda et al., “Stereoselective Synthesis of (Z)- and (E)-1,3-alkadienes from Aldehydes Using Organotitanium and Lithium Reagents”, Tetrahedron, vol. 43, No. 4, pp. 723-730 (1987). |
| Isotechnika, Inc., Partial European search report dated Jul. 10, 2007 of the European patent application No. 07106871, 10 pages. |
| James R. Hanson, Protecting Groups in Organic Synthesis, Chapter 2 (Sheffield Academic Press, 1999). |
| Johnson et al., “The Chemistry of Ylids—V Trialkylphosphoniumfluorenylides Mechanism of the Wittig Reaction”, Tetrahedon, vol. 9, pp. 130-138 (1960). |
| Johnson et al., “4.1 Catalytic Assymmetric Epoxidation of Allylic Alchohols”, Catalytic Asymmetric Synthesis, Edited by I. Ojima, VCH Publishers, New York, NY, pp. 103-158 (1993). |
| Keown, “Chapter 1: Molecular and Clinical Therapeutics of Cyclosporine in Transplantation”, Immunosuppression in Transplantation, Edited by L Ginns, A. Cosimi, P. Morris, Blackwell Science, Malden, MA, pp. 1-12 (1999). |
| Kobel et al., “Directed Biosynthesis of Cyclosporins”, EP. J. Applied Microbiology and Biotechnogy vol. 14, pp. 237-240 (1982). |
| Kobel et al., “Contribution to knowledge of the biosynthesis of cyclosporin A”, Birkhauser Verlag Basel, Experientia, vol. 39, pp. 873-876 (1983). |
| K. Peter, C. Volhardt, Organic Chemistry, pp. 296 (W.H. Freeman and Company, 1987). |
| Lawen et al., “Cell-free biosynthesis of new cyclosporins”, The Journal of Antibiotics, vol. 42, No. 8, pp. 1283-1289 (1989). |
| Liu, J. et al., “Calcineurin is a Common Target of Cyclophilin-Cyclosporin A and FKBP-FK506 Complexes”, Cell, vol. 66, pp. 807-815 (1991). |
| Maksymowych et al., “Amelioration of Established Collagen-Induced Arthritis by ISATX247: a Novel Calcineurin Inhbitor”, J. of Rheum., vol. 28, supp 63 (2001) Abstract. |
| Maksymowych et al., “Prevention and Treatment of Antigen-Induced Arthritis by ISA 247, a Novel Calcineurin Inlribitor”, J. of Rheum., vol. 28, supp. 63 (2001). |
| Marshall, “Chiral Allylic and Allenic Stannanes as Reagents for Asymmetric Synthesis”, Chemical Reviews, vol. 96, pp. 31-47 (1996). |
| Mcmurry, “19. 12 Nucleophilic Addition of Phosphorous Ylides: The Wittig Reaction”, in Organic Chemistry, 5th Ed., pp. 780-783 (2000). |
| Metelitsa, “Reaction Mechanisms of the Direct Epoxidation of Aldenes in the Liquid Phase”, Russian Chemical Reviews, vol. 41, No. 10, pp. 807-821 (1972). |
| Mikol et al., “Crystal structure of the cyclophilin-like domain from the parasitic nematode Brugia malayi”, Protein Sci., vol. 7, No. 6, pp. 1310-1316 (1998). |
| Morrison and Boyd, “Organic Chemistry”, 6th Edition, pp. 186-188 and 362-366 (1994). |
| Non-final Office Action dated Aug. 27, 2014, in U.S. Appl. No. 14/042,226. |
| Park et al., “A semi-synthetic approach to olefinic analogs of amino acid one (MeBMT) in cyclosporin A”, Tetrahedron Letters, vol. 30, No. 32, pp. 4215-4218 (1989). |
| Patchett et al., “Analogs of Cyclosporin A Modified at the D-ALA8 Position”, The Journal of Antibiotics, vol. 45, No. 1, pp. 94-102 (1992). |
| Petcher et al., “Crystal and Molecular Structure of an lodo-derivative of the Cyclic Undecapeptide Cyclosporin A”, Helvetica Chimica Acta, vol. 50, Fasc. 5, pp. 1480-1488 (1976). |
| Peterson, “A Carbonyl Olefination Reaction Using Silyl-Substituted Organometallic Compounds”, J. Org. Chem., pp. 780-784 (1967). |
| Pflügl et al., “X-ray structure of a decameric cyclophilin-cydosporin crystal complex”, Nature, vol. 361, pp. 91-94 (1993). |
| Price et al., “Efficacy of Topical Cyclosporine 0.05% for the Prevention of Cornea Transplant Rejection Episodes”, Opthalmology vol. 13, pp. 1785-1790 (2006). |
| Prileschajew. “Oxydation ungesattigter Verbindungen mittels organischer Superoxyde”, Berichte der Deutschen Chemischen Gesellschaft, pp. 4811-4815, (1909) in Geman and its English translation. |
| Ramachandran et al., eds., “Intramolecular Allylboration Reactions”, in Organoboranes for Syntheses, pp. 162-164 and 174 (2001). |
| Reetz, Organotitanium Reagents in Organic Synthesis, pp. VII, 148-149, 162-168 (1986—Springer-Verlag, Berlin). |
| Rich et al., “Synthesis and Antimitogenic Activies of Four Analogues of Cyclosporin A Modified in the 1-Position”, .J. Med. Chem., vol. 29, p. 978-984 (1986). |
| Roush, “Allyl Organometallics”, Comp. Org. Synth., vol. 2, pp. 1-53 (1991). |
| Rüegger et al., “Cyclosporin A, ein immunsuppressiv wirksamer Peptidmetabolit aus Trichoderma polysporum (LINK EX PERS.) Rifai”, Helvetica Chimica Acta, vol. 59, Fasc. 4, pp. 1075-1092 (1976) in Gemmn and its English translation. |
| Schnurpfeil, “Zur Kataylse der Prilesaev—Reaktion”, vol. 20, p. 445 (1980) in German and its English translation. |
| Schrieber et al., “The Mechanism of Action of Cyclosporin A and FK506”, Immunol. Today, vol. 13, pp. 136-142 (1992). |
| Seebach et al., “Modification of Cyclosporin A (CS)1): Generation of an Enolate at the Sarcosine Residue and Reactions with Electrophiles”, Helvitica Chimica Acta, vol. 76, pp. 1564-1590 (1993). |
| Shapiro et al., “Prolonged Islet Allograft Survival Without Toxicity Using ISATX247: A Novel Calcineurin Inhibitor”, Am. J. of Transpl., vol. 1, Supp. 1, Abstract No. 828 (2001). |
| Sharpless et al., “The Osmium-Catalyzed Asymmetric Dihydroxylation: A New Ligand Class and a Process Improvement”, J. Org. Chem., vol. 57, No. 10, pp. 2768-2771 (1992). |
| Sketris et al., “Optimizing the Use of Cyclosporine in Renal Transplantation”, Clin Biochem., vol. 28, pp. 195-121 (1995). |
| Smith et al., “The Peterson Alkenylation Reaction”, March's Advanced Org. Chem., pp. 1228-1229 (2001). |
| Smith et al., “Stereochemistry: Molecules with More than One Chiral (Sterogenic) Center”, March's Advanced Org. Chem., pp. 144-147 (2001). |
| Smulik et al., “Synthesis of Cyclosporin A—Derived Affinity Reagents by Olefin Metathesis”, Organic Letters, vol. 4, No. 12, pp. 2051-2054 (2002). |
| Sokol et al., “Improvement of cyclosporin absorption in children after liver transplantation by meand of water-soluble vitamin E”, The Lancet, vol. 338, pp. 212-214 (1991). |
| Sokol et al., “Cyclosporin and vitamin E”, The Lancet, vol. 338, pp. 697 (1991). |
| Sonnet, Tetrahedron Report No. 77, Tetrahedron, vol. 36, pp. 557-604, (Pergamon Press Ltd., (1990). |
| Streitwieser, Jr., et al.,“16.4 Protecting Groups” and “27.3 Preparation of Diols”, Intro. To Org. Chem., 2nd Ed., pp. 475-476 and 844-846, respectively, (1981). |
| Swern, “Chapter 7: Epoxidation and Hydroxylation of Ethylenic Compounds with Organic Peracids”, Organic Reactions, vol. 7, pp. 378-433 (1953). |
| Swern, “Organic Peracids”, Chemical Review, vol. 45, pp. 16 (1949). |
| Tamura et al., “Stereoselective E and Z Olefin Formation by Wittig Olefination of Aldehydes with Allylic Phosphorus Ylides. Stereochemistry”, J. Org. Chem., vol. 53, pp. 2723-2728 (1988). |
| Thliveris et al., “Chronic Cyclosporin Nephrotoxicity: A Rabbit Model”, Nephron., vol. 57, pp. 470-476 (1991). |
| Thliveris et al., “Chronic Cyclosporine-Induced Nephrotoxicity: A Rabbit Model”, Transplantation, vol. 57, pp. 774-776 (1994). |
| Thomas, “Organic Synthesis: the Roles of Boron and Silicon”, pp. 34-35, 67-69 and 85-87 (1991). |
| Traber et al., “162. Isolierung and Strukturermittlung der neuen cyclosporine E, F, G, and I”, Helv. Chim. Acta, vol. 65, pp. 1655-1677 (1982). |
| Traber, R et al., “Neue Cydosporine aus Tolypocladium inflatum Die Cyclosporine K—Z”, Helvetica Chimica Acta, vol. 70, pp. 13-36 (1987) in German and its English translation. |
| Traber et al., “Cyclosporins—New Analogues by Precursor Directed Bio synthesis”, The Journal of Antibiotics, vol. 42, No. 4, pp. 591-597 (1989). |
| Tsai et al., “A Sterocontrolled Synthesis of (Z) and (E) Terminal Dienes from Pinacol (E)-1-Trimethylsiyl-1-Propene-3-Boronate”, Tetrahedron Letters, vol. 22, No. 29, pp. 2751-2752 (1981). |
| Tutschka et al., “Cyclosporin-A to Prevent Graft-Versus-Host Disease: A Pilot Study in 22 Patients Receiving Allogeneic Marrow Transplants”, Blood, vol. 61, No. 2, pp. 318-325 (1983). |
| Ukai et al., “Direct, Stereoselective Synthesis of Ehter E-or-Z-1,3-Dienes”, Tetrahedron Letters, vol. 24, No. 37, pp. 4029-4032 (1983). |
| Valantine et al., “Recent Advances in Cardiac Transplantation”, N. Eng. J. Med., [editorial comment], vol. 333, No. 10, pp. 660-661 (1995). |
| Von Rene Traber et al., “Die Stuktur von Cyclosporin C”, Helv. Chim. Acta., vol. 60, pp. 1247-1255 (1977). |
| Von Wartburg et al., “Chemistry of the Natural Cyclosporin Metabolites”, Progress in Allergy, vol. 38, pp. 28-45 (1986). |
| Von Wartburg et al., “Cyclosporins, Fungal Metabolites with Irnmunosuppressive Activities”, Progress in Medicinal Chemistry 25, pp. 1-33 (1998). |
| Wang et al., “Cyclosporine Nephrotoxicity: Attenuation by an Antioxidant-Inhibitor of Lipid Peroxidation In Vitro and In Vivo”, Transplantation, vol. 58, pp. 940-946 (1994). |
| Weidmann et al., “Organometallic Compounds of Titanium and Zirconium as Selective Neudeophilic Reagents in Organic Synthesis”, Agnes. Chem. Int. Ed. Engl., vol. 22, pp. 34-45 (1983). |
| Wenger, “Synthesis of Cyclosporine and Analogues: Structure, Activity, Relationships of New Cyclosporine Derivatives”, Transpl. Proc. vol. 15, Suppl. 1, pp. 2230-2241 (1983). |
| Wenger, “Synthesis of Cyclosporine and Analogues: Structural Requirements for Immunosuppresive Activity”, Angew. Chem. Int. Ed., vol. 24, pp. 77-85 (1985). |
| Wenger, “Cyclosporine and Analogues—Isolation and Synthesis—Mechanism of Action and Structural Requirements for Pharmacological Activity”, Progress in the Chemistry of Organic Natural Products, vol. 50, pp. 123-168 (1986). |
| White et al., “Cyclosporin A: An Immunosuppressive Agent Preferentially Active Against Proliferating T Cells”, Transplantation, vol. 27, No. 1, pp. 55-58 (1979). |
| Yamamoto et al., “Selective Reactions Using Allylic Metals”, Chemical Reviews, pp. 2207-2293 (1993). |
| Yang et al., “A C2 Symmetric Chiral Ketone for Catalytic Asymmetric Epoxidation of Unfunctionalized Olefins”, J Am. Chem. Soc., vol. 118, No. 2, pp. 491-492 (1996). |
| Yang et al., “Novel Cyclic Ketones for Catalytic Oxidation Reactions”, J. Org. Chem., vol. 63, pp. 9888-9894 (1998). |
| Yatscoff et al., “ISATX247: Phase 1 Clinical Trial Results of the Novel Calcineurin Inhibitor”, J. of Rheum., vol. 28 (Supp. 63), Abstract W133 (2001). |
| Yatscoff et al., “Pharmacokinetics of a Novel Calcineurin Inhibitor: ISATX247”, Therap. Drug. Monitor., vol. 23, No. 4, (2001). |
| Yatscoff et al., “The Preclinical Evaluation of a Novel Calcineurin Inhibitor: ISATX247”, Therap. Drug. Mon., vol. 23, No. 4, (2001). |
| Yatscoff et al., “Phase 1 Evaluation of a Novel Calcineurin Inhibitor ISATX247”, Therp. Drug. Mon., vol. 23, No. 4 (2001). |
| Yohannes et al., “Degredation of Rapamycin: Retrieval of Major Intact Subunits”, Tetrahedron Letters, vol. 33, No. 49, pp. 7469-7472 (1992). |
| Number | Date | Country | |
|---|---|---|---|
| 20170362277 A1 | Dec 2017 | US |
| Number | Date | Country | |
|---|---|---|---|
| 60370596 | Apr 2002 | US | |
| 60346201 | Oct 2001 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 14949616 | Nov 2015 | US |
| Child | 15676851 | US | |
| Parent | 14324146 | Jul 2014 | US |
| Child | 14949616 | US | |
| Parent | 14042226 | Sep 2013 | US |
| Child | 14324146 | US | |
| Parent | 13684574 | Nov 2012 | US |
| Child | 14042226 | US | |
| Parent | 12796616 | Jun 2010 | US |
| Child | 13684574 | US | |
| Parent | 11969174 | Jan 2008 | US |
| Child | 12796616 | US | |
| Parent | 11118830 | Apr 2005 | US |
| Child | 11969174 | US | |
| Parent | 10274255 | Oct 2002 | US |
| Child | 11118830 | US |
