Patent Grant
6875758
This invention relates to the novel use of D-ring unsaturated pregnadienols/pregnadienones represented by general formula (I) as shown in the accompanying drawings, possessing both pronounced hypolipidemic and hypoglycemic activities and devoid of androgenic and progestational activities. More particularly this invention relates to the novel use of 3β-hydroxy-pregna-5,16-dienone an important prototype of this class, represented by the formula (II) as shown in the accompanying drawings, for the treatment of diabetes and pronounced hypolipidemic and hypoglycemic activities.
High plasma cholesterol and related lipids are known to be one of the factors that predispose an individual to atherosclerosis and thus to myocardial infarction. Diabetes mellitus, which eventually impairs the function of kidneys, eyes, nervous and vascular systems, is quite often associated with lipid disorders. Both hyperlipidemia and diabetes mellitus require long term management and pose problems in choice of pharmacotherapeutic interventions when these conditions manifest together. Though a number of drugs are known separately to treat these conditions, there are a number of side effects associated with them which limit their long term use.
The most important hypolipidemic drugs available today belong to the statin and fibrate classes [McCarthy, P. A., Med. Res. Rev., 13, 139-59 (1993)] whereas hypoglycemic drugs fall into the category of sulphonylureas, biguanidines and amidines [Wolff, M. E. (Ed), Burger's Medicinal Chemistry Part II, 1045 (1981), John Wiley & Sons, New York]. However, these therapeutic agents are not free of side effects-statins (HMG-CoA reductase inhibitors) the most widely used drugs today which hitherto were thought to be very safe drugs, have exhibited side effects following long term therapy [Carrier, M. et al.; Ann. Thorac. Surg., 57, 353-6 (1994)]. The adverse effects which have become the source of concern, are increases in hepatic transaminases and myopathies [Witztum, J. L., In Goodman & Gilman's The Pharmacological Basis of Therapeutics, eds. Hardman, J. et al. 9th edition, McGraw Hill, New York pp. 875-98, Fukami, M. et al; Res. Exp. Med., 193, 263-73 (1993); Appelkvist, E. et al.; Clin. Invest., 71 (suppl 8), 597-102 (1993), Wills, R. A. et al.; Proc. Natl. Acad. Sci. (US), 87, 8928-30 (1990)] and carcinogenesis, especially breast cancer in subjects undergoing treatment with pravastatin [Braunwald, E.; Scrip, 2117, 33 (1996)); Ciaravino, V. et al.; Mutat. Res.; 353, 95-107 (1995)]. The incidence of myopathy associated with rhabdomyolysis and renal failure is increased subsequent to such treatment [East, C. et al.; N. Engl. J. Med., 318, 47-48 (1998); Pierce L. R. et al.; J. Am.Med. Assoc., 265, 71-75 (1990)]. Also, these HMG-CoA inhibitors block mevalonate production which occurs at an early stage in cholesterol synthetic pathway. Mevalonate is a common precursor for all isoprenoids such as ubiquinones (Co-enzyme Q-10), the dolichols, isopentenyl t-RNA etc. Therefore, long term blockade of mevalonate synthesis leads to Q-10 deficiency. Serum Co-enzyme Q-10 is important for cardiac function [Laaksonen, R. et al., Eur. J. Clin. Pharmacol. 46,313-7 (1994); Bargossi, A. M. et al; Int.J. Clin. Lab. Res., 24, 171-6 (1994)]. The most common side-effects of fibrates and particularly clofibrate therapy are gastrointestinal upsets including nausea, vomiting, diarrhoea, dyspepsia, flatulence and abdominal discomfort [Oliver, M. F. et al.; Br. Heart J., 40,1069-1118 (1978)]. Elevated creatine phosphokinase concentration during clofibrate therapy may be associated with a syndrome of muscle pain and weakness. Large-scale long-term studies have demonstrated an increased incidence of cholecystitis, gallstones and sometimes pancreatitis in patients receiving clofibrate and some studies have indicated cardiovascular disorders [The coronary Drug Project Research Group; N. Engl. J. Med., 296, 1185-90 (1977)]. The unexpected finding of an increased mortality rate in patients taking clofibrate in the WHO study produced serious concern over the long-term safety of clofibrate and ultimately led to its withdrawal in many countries [Oliver, M. F. et al.; Lancet, ii, 600-604 (1984)].
The adverse effects of biguanidine antidiabetic agents include gastro-intestinal disturbances like diarrhoea and lactic acidosis [Paterson, K. R. et al.; Adverse Drug React Acute Poisoning Rev., 3, 173-82 (1984)]. With sulphonylureas the commonly associated adverse effects are hypoglycemia, gastrointestinal disturbances, hypersensitivity and vascular complications [Paice, B. J. et al., Adverse Drug React. Acute Poisoning, 4, 23-26 (1985)]. As diabetes and hyperlipidemia are quite commonly manifesting together, it would be of great clinical benefit if the same compound could have both these activities together because the available drugs are not free of toxic effects and neither data regarding toxic manifestations are available when drugs for two clinical conditions are mixed together.
Two approaches currently being pursued in search of drugs with hypolipidemic and hypoglycemic activities together. The first approach emerged during detailed study of antihypertensive action of adrenergic receptor modulators. The study revealed that a,-adrenergic blockers (particularly Doxazosin and Prazosin) [Lithell, H. O.; J. Hypertens, 15 (Suppl 1), S 39-42 (1997); Poliare, T. et al.; Diabetologia, 31, 415-420 (1988); Anderson, P. E. et al.; Am. J. Hypertens, 9, 323-333 (1996)] and β3-adrenergic agonist (BTA-243, BRL-37344, CGP 12177, CL 316243 [Arch, J. R. S. et al.; Med. Res. Rev., 13, 663-729 (1993); Largis, E. E. et al.; Drug Dev. Res., 32, 69-76 (1994)] also affect plasma lipoprotein metabolism and increase insulin sensitivity. As a result such antihypertensive drugs exhibit lipid lowering and hypoglycemic actions together. α1-adrenergic receptor blockers, however have the inherent limitations of causing orthostatic hypotension and syncope [Matyus, P.; Med. Res. Rev., 17(6), 523-35 (1977)]. The essential requirement of β3-agonist for antiobesity and antidiabetic actions is the need for high selectivity for β3-adrenoceptor. Any substantial β1- or β2-agonism would likely cause increased heart rate and muscle tremor respectively which are unacceptable in a drug which could be administered on long term basis [Connacher, A. A. et al.; Brit. Med. J., 296,1217-20 (1988); Mitchell, T. H. et al; Int. J. Obesity., 13(6), 757-66 (1989)]. The second line of approach for dual activity came into light during the study of anti-oxidant property of drugs. There have been many reports describing relationships between peroxidation and diseases such as diabetes mellitus, atherosclerosis and myocardial ischemia in terms of radical oxidation. Troglitazone, an antioxidant drug has been developed as an oral hypoglycemic agent which enhances the action of insulin in peripheral tissues and liver besides its hypolipidemic effects. However, troglitazone is also not free of major side effect causing liver damage. The drug, troglitazone, has been implicated in 35 cases of liver disease leading to one transplant and one death [Warner-Lambert; Chem. & Ind., No. 22, 897 (1977)]. Thus to the best of our knowledge no class of compound is yet available which has both effects together as the main action and have a fair safety margin.
We, in early eighties started our work for search of such compounds which have effect on endogenous transportation of lipids and glucose rather than interfering with exogenous transportation. Our research was mainly based on secondary metabolic actions of progesterone.
Progesterone, apart from its classical hormonal action on the reproductive system, is known to modulate lipid, carbohydrate, insulin and protein metabolism. The rise in the level of progesterone in the first trimester of pregnancy causes hyperphagia, pancreatic islet hypertrophy, hyperinsulinemia and body fat and glycogen deposition, when the metabolic demands of the fetus are very low. However, in the latter half of pregnancy, although the progesterone levels are still high, the carbohydrate, lipid and protein reservoirs shift into circulation to meet the needs of the growing fetus. [Kalkhoff, R. K.; Am. J. Obstet. Gynecol., 142, 735-38 (1982)].
Progesterone thus, having actions both on the reproductive and metabolic systems, seemed to offer the possibility of dissociating these two biological activities by structural modifications. The experience of the development of second generation progestins supported this contention. The first generation progestins such as levonorgestrel exhibited undesirable pharmacologic effects like alteration in carbohydrate and lipoprotein metabolism, weight gain and hypertension, which was shown to be related to their intrinsic androgenic/anabolic activity and ability to bind with androgen receptors. The androgenic affinity has been attributed to C-17 hydroxy functionality which makes these molecules resemble androgens. In recently discovered second generation progestins such as gestodene and 3-keto-desogestrel, an additional olefinic bond either in C- or D-ring brought a dramatic decrease in their affinity to androgen receptors (Table 1). As a result these compounds have a very high order of progestational effect with practically no androgenic activity and did not cause hyperlipidemia [London, R. S.; Obstetrical & Gynocological Survey, 47, 777-81 (1992)].
It is an object of the invention to explore the possibility of designing pregnadienones which while preserving the ability to modulate lipid and carbohydrate metabolism would not have any progestational effect. It would be pertinent to point out that earlier, the applicants had isolated a D-ring modified pregnenolone, named Gugulsterone represented by formula (9) as shown in Table 2, from guggul resin obtained from Commiphora mukul, which had potent hypolipidemic effect without any progestational effect [Arya, V. P.; Drugs Fut. 13, 618 (1998)].
It is another object of the invention to explore the possibility of dissociating the hypolipidemic and insulin sensitizing activities of progesterone from its hormonal actions. Accordingly, the applicants focused their attention to prepare and investigate analogues/prototypes with additional substituents in ring-D of pregnadienones.
FIGS. 2(A)-2(F) represents the structural formulae of hormones.
In accordance with the above objectives, the applicant's present invention relates to a method of using D-ring unsaturated pregnadienones represented by structural formula (I) which causes significant fall of serum cholesterol, triglycerides, LDL-cholesterol and glucose with mild increase in HDL-cholesterol, said method comprising administration of effective amounts of said compounds of formula (I) to mammals. The compounds possess fair safety margin having antioxidant and cardio protection activities.
The invention also provides a method of treatment of hyperlipidemic and hyperglycemic conditions which comprises administration to a recipient a therapeutic composition comprising a pharmaceutically effective amount of compound D-ring unsaturated preganadienones represented by the general formula (I) as shown hereinbelow and in the accompanying drawings:
Wherein X═OH or O or combination thereof and positioning of olefinic bonds are at 4(5); 5(6); 16(17); 17(20) or various combinations
The present invention concerns methods for lowering serum cholesterol, triglycerides and glucose levels in subjects with obesity and diabetic conditions or prophylactically holding in check the symptoms of such a disease state.
In particular, the applicants, during their study, have observed that the prenadienone, 3β-hydroxypregna-5,16-dien-20-one represented by the structural formula (II) shown hereinbelow and in the accompanying drawings is useful for the and hyperglycemic conditions.
Accordingly, the invention provides a method of using compounds represented by the structural formula (I) as shown in the accompanying drawings, containing at least one olefinic bond in or on their D-ring for the treatment of hyperlipidemic and hyperglycemic conditions in mammals, said method comprising administering an effective amount of the said compounds to recipient mammals.
In one embodiment, the compounds of formula (I) are administered in the form of tablets, capsules or injectibles.
In another embodiment, the compounds of formula (I) are characterized as pregnadienones and pregnadienols.
In yet another embodiment, the most preferred compound belonging to the family of preganienones and pregnadienols represented by formula (I) is 3β-hydroxy-pregna-5,16-dien-20-one, which is represented by the structural formula (II) as shown in the accompanying drawings.
In a further embodiment, the compounds of formula (I) are optionally administered to the recipient mammal as an admixture with conventional anti-platelet, anti-atherosclerotic, hypolipoproteinic and antidiabetic drugs.
In still another embodiment, the compounds of formula (I) are essentially free of side effects associated with conventional hypolipidemic and hypoglycemic drugs.
In an embodiment, the compounds of formula (I) exhibit cardioprotective, anti-diabetic, anti-atherosclerotic and anti-oxidant properties.
Further, the invention provides a method of treatment of hyperlipidemic and hyperglycemic conditions in mammals, which comprises administration to a recipient, a therapeutic composition comprising an effective amount of compound of formula (I) with conventional carriers.
In an embodiment, the recipient mammals are selected from the group comprising rats, human beings, rhesus monkeys and rabbits.
In another embodiment, the conventional carriers are selected from anti-platelet, anti-atherosclerotic, hypolipoproteinic and anti-diabetic drugs.
In yet another embodiment, the said compounds of formula (I) essentially contain an olefinic bond in or on their D-ring.
In a further embodiment, the compounds of formula (I) are essentially free of androgenic, progestinal and side effects.
In still another embodiment, the therapeutic composition is administered in the form of tablets, capsules and injectibles.
In another embodiment, the said preganadienones and preganadienols exhibit cardio protective, antidiabetic, antiatheroselerotic and antioxidant properties.
In yet another embodiment, the said preganadienones and pregnadienols of formula (I) essentially contain olefinic bond in one of the D-rings.
The methods of synthesis are essentially known in the literature, can be obtained from diosgenin by chemical degradation [G. Rosenleranz “History of Steroids”, Steroids, 57, 409 (1992)]. Although, it was later isolated from Veratrum Grandiflorum [Kanko, K. et al; Phytochemistry, 12 1509 (1973)] but yield is too low to be of any practical value. Oppenauer oxidation of 2 with aluminium-isopropoxide and cyciohexanone in toluene produces 4,16-dienpregna-3,20-dione [16-dehydroprogesterone, (3)]. The C-16 (17) olefinic bond in (1) is selectively reduced with Pd-C in diethylether at very low hydrogen gas pressure. The resultant product 4 on basic hydrolysis furnishes 5. The procedure of Benn and Dodson [J. Org. Chem. 29, 1142 (1964)] was followed for the preparation of Gugulsterone (9). The reduction of 16-DPA (1) with lithium aluminium hydride produces diol 6 which after Sigmatropic rearrangement in presence of p-toluenesulphonic acid, acetic acid and acetic anhydride produces the diacetate 7. Basic hydrolysis of the diacetate 7 followed by Oppenauer oxidation furnishes an 80:20 mixture of E&Z-Gugulsterone (9).
The primary hypolipidemic effect of these compounds was established in triton induced hyperlipidemia in Charles Foster rats. The compounds which exhibited significant lipid lowering effect in this model were then evaluated for their hypolipidemic effect in normal, and diet induced hyperlipidemic rats, rabbits and rhesus monkeys.
5.1.1 Hypolipidemic Activity in Triton Treated Rats
The cholesterol lowering effect of some representative compounds of pregrenadienols and pregrenadienones as compared to clofibrate and gugulsterone in triton treated Charles Foster rats is described in Table-2.
The results showed that of the compounds tested, the highest effect was exhibited by 16-DPA (1) and its 3-des-acetyl analog 2 comparable to gugulsterone (9), and that the removal of double bond in ring D of 1 or 2 almost abolished the effect.
5.1.2 Hypolipidemic Activity of 3β-Hydroxypregna-5,16-dien-20-one (2) in Normal Rats
In normal rats, 3β-hydroxypregna-5,16-dien-20one (2), at 50 mg/kg produced a significant lowering of serum cholesterol and triglycerides as describe in Table-3 below. The animals did not develop any tolerance to the compound even after administering for 30 days.
5.1.3 Hypolipidemic Activity in Diet Induced Hyperlipidemic Rats
Twenty three normal male rats average weight 110-120 g were taken for study and were divided into four groups. Group l: animals received special diet and 3β-hydroxypregna-5,16-dien-20-one (2) 50 mg/kg p.o. in 1% gum acacia. Group II: animals received 3β-hydroxypregna-5,16-dien-20-one (2), 100 mg/kg p.o. in 1% gum acacia and special diet. Group III: animals received special fat diet and 1% gum acacia and served as control. Group IV: animals were fed with stock diet and served as normal control. All animals were sacrificed at the end of 36 days. Blood was drawn from the tail at 10 days and from the aorta at the time of sacrifice for estimation of serum cholesterol, triglycerides and HDL-cholesterol. LDL-cholesterol was calculated as described. [Roschlau, P. In: Methods of Enzymatic Analysis 4th ed., H. U. Bergmeyer, Ed (Academic Press, New York) 1975 p 1890; Wahlefield, W. A. In: Methods of Enzymatic Analysis, 4th ed.; H. U. Bergmeyer, Ed. (Academic Press, New York) 1974 p 1831.]
Results
Animals treated with 3β-yydroxypregna-5,16-dien-20-one (2), at 50 and 100 mg/kg showed a significant lowering in serum cholesterol by 31 and 59%, triglycerides by 55 and 62%, LDL-cholesterol by 27 and 74% respectively (Table -4 & 5).
5.1.4 Hypolipidemic Activity in Hyperlipidemic Rabbits
Effect of 3β-Hydroxypregna-5,16-dien-20-one (2) was studied on hypercholesterolemic albino rabbits. Twelve male albino rabbits (approx 1.5-2 kg) on a stock diet were made hyperlipidemic by feeding daily cholesterol 0.5 g/kg in 2 ml of groundnut oil for 45 days and then blood was drawn from the marginal vein in the ear of rabbits for serum cholesterol and triglycerides estimation.
Two controlled experiments were carried out for a period of three months. In one set of experiments, the control group received 0.5 g/kg of cholesterol for 90 days and 3β-Hydroxypregna-5,16-dien-20-one (2) in dose of 100 mg/kg and 50 mg/kg while in control group (given only cholesterol) a massive rise of serum cholesterol and triglycerides were seen after 90 days, the addition of 3β-Hydroxypregna-5,16dien-20-one (2) at 50 and 100 mg/kg doses kept the rise well under control. The percentage decrease at 100 mg dose was 28% at 30 days to 52% at 90 days for cholesterol and 45 to 81% for triglycerides. In the 50 mg/kg dose group the decrease percentage ranged from 40% at 30 days to 50% at 90 days for cholesterol and 45% at 30 days to 75% at 90 days for triglyceride (Table6)
5.1.5 Hypolipidemic Activity in Rhesus Monkeys
In Rhesus monkeys: 3β-Hydroxypregna-5,16-dien-20one (2) was administered orally daily for 90 days in doses of 62.5, 125 or 650 mg/kg to different group of animals. Significant decrease in serum cholesterol was observed (45-52%). At 90 days, percentage decrease in triglycerides varied from 14 to 36%. Compound 2 caused a marked decrease in low density lipoprotein (75-90%) whereas changes in HDL-cholesterol were not significant (Table-8 & 9)
The compounds were tested for their hypoglycemic effects in normal, glucose loaded and streptozotocin induced diabetic rats. The experimental details of the testing of one such compound 3β-hydroxypregna-5,16-dien-20-one (2) is described below which possessed marked hypoglycemic effect in two models. (Tables 10 and 11).
5.2.1 Hypoglycemic Activity in Glucose Loaded Rats
The experiments were carried out with albino rats (Charles Foster strain) of either sex weighing 150-160 g. They were fed on laboratory diet prepared by M/s Lipton India Ltd. and maintained under 12 hr. light/dark cycle at 25±2° C.
The animals were divided into eight groups, each of six rats; group I was given 1% gum acacia (0.1 ml/100 g body weight) intragastrically (p.o.) and the group II were given 3β-hydroxypregna-5,16-dien-20-one (2) in 1% gum acacia. Animals of group III were given the standard antidiabetic drug, tolbutamide in the similar fashion. 2.0 g/kg glucose was given p.o. to all the rats along with the vehicle/Compound/Standard antidiabetic drug. Blood samples were taken from retroorbital plexus at periodic intervals. Glucose levels in the blood samples were measured by glucose oxidase method [Bergmeyer and Benut, 1963 cited in “Methods of Enzymatic Analysis” ed. H. Bergmeyer, Verlag Chemie, GmBH, Weinheim, Beroster, pp123, Academic press, New York].
5.2.2 Hypoglycemic Activity in Streptozotocin Induced Hyperglycemic Rats
Hyperglycemia in rats was produced by streptozotocin treatment. The animals showing blood glucose levels between 250-350 mg/dl were selected. Blood samples were collected after treatment at intervals and blood glucose levels were estimated immediately. The results showed lowering in blood glucose level within 1 hr and the maximum fall was observed at 12 hrs.
The free radical oxidative stress has been implicated in the pathogenesis of a variety of human disease conditions including atherosclerosis. Polyunsaturated fatty acids within cell membranes and lipoproteins are oxidized and resulting active species modify macrophages and bystander cells monocytes which then move to subeudothelial space, engorge cholesteryl esters and are transformed into what are known as foam cells. Group of these foam cells form atherosclerotic plaques in the intima. The antioxidant potential of compound 2 was evaluated against metal induced oxidation of LDL as well as generation of hydroxy (OH) radical.
In vivo experiment with cholesterol fed animals caused marked formation of lipid peroxides in serum lipoproteins. Simultaneous treatment with compound 2 caused significant reversal of the lipid peroxide levels in serum VLDL, LDL and liver in cholesterol fed animals. However gemfibrozil failed to protect the phenomenon of lipid peroxidation (Table 12). Human serum LDL was oxidized with Cu′2 in different concentrations of test compound in 0.05 mole PBS, pH 7.4 for 16 hr at 37° C. Thiobarbituric acid reactive lipid peroxides are measured by standard procedure. Compound 2 and α-tocopherol inhibit the generation of LDL lipid peroxide in concentration dependent manner. However the gemfibrozil at tested concentrations did not inhibit the oxidative modification (Table 13). Cu′2 induced oxidation in LDL lipids are mainly due to the free OH radical during incubation. Therefore the effect tested for generation of OH radical in vitro in nonenzymatic system of Fe′2, sodium ascorbate, hydrogenperoxide and deoxyribose oxidative attack of oxy radical on deoxyribose caused fragmentation and formation of dialdehyde which are spectrophotometrically measured after their reaction with thiobarbituric acid. As observed in case of oxidation of LDL by metal ion, the compound 2 inhibits the generation of OH radical in concentration dependent manner. However, the activity of 2 is of low order to that of mannitol, a selective inhibitor of OH radical (Table 14)
The underlying cause of myocardial infarction is believed to be the progressive deposition of lipids and fibrotic material into the arterial wall. These pregnadienols and pregnadienous also provided cardiac protection as assessed in isoproterneol induced myocardial necrosis in rat model, which produces myocardial infarction due to an increased blood pressure and heart rate. The protection was comparable with that of gemfibrozil as described in Table 15.
The relative affinity of a few selected compounds in the series for cytoplasmic androgenic receptors present in human breast tumour cells MCF-7 (Michigan Cancer Foundation, MCF, USA) was estimated and compared with 4,5-dihydrotestosterone (DHT). The results showed that the compounds 2,3 and 5 have no or only negligible binding affinity which therefore would be a reflection of their low androgenic effect.
The relative affinity of compounds for cytoplasmic progesterone receptors present in human tumour cells (MCF-7) were estimated and compared with 16-ethyl-21-hydroxy-19-norpregna-4-ene-3,20-dione (Org 2058). The experiments conducted revealed that the compounds 2,3 and 5 have no or only negligible binding affinity.
The progestational activity was also tested in vivo by Clauberg assay method. The degree of endometrial proliferation was estimated on the McPhail scale where 3′ or 4′ was considered as a full progestational effect. 3β-Hydroxypregna-5,16-dien-20-one (2) did not exhibit any activity even at 200 mg/kg dose, whereas progesterone showed, as expected marked progestational activity even at 50 mg/kg.
| Number | Date | Country | Kind |
|---|---|---|---|
| 67DEL/99 | Jan 1999 | IN | national |
This is a division of application Ser. No. 09/280,448, filed Mar. 30, 1999, now U.S. Pat. No. 6,579,862 which is incorporated herein by reference.
| Number | Date | Country |
|---|---|---|
| 0 562 849 | Sep 1993 | EP |
| Number | Date | Country | |
|---|---|---|---|
| 20030216363 A1 | Nov 2003 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 09280448 | Mar 1999 | US |
| Child | 10385936 | US |
