Patent Application
20090076019
The invention relates to compositions and methods to treat neurological disorders or damage, in particular brain or CNS cancer.
The identification of self-renewing and multipotent neural stem cells (NSC) in the mammalian brain holds promise for the treatment of many neurological diseases and has yielded new insight into brain cancer (5-7). However, the NSC “ground state”—defined by the complete repertoire of pathways that govern NSC proliferation, self-renewal and differentiation—remains largely uncharacterized. The in vitro culture of embryonic or postnatal brain cells isolated from anatomic precursor compartments in serum-free conditions containing FGF and EGF results in the expansion of a rare subpopulation of precursor cells and the formation of floating clonogenic clusters termed neurospheres (8-10) (
Applicants have developed a clonogenic neurosphere assay to carry out high throughput screens (HTS) to identify potent and/or selective modulators of proliferation, differentiation and/or renewal of neural precursor cells, neural progenitor cells and/or NSCs. The modulators disclosed herein and/or identified by a method described herein are also referred to herein as “NSC Modulating Agents”.
In one aspect, a method is provided for identifying putative NSC Modulating Agents comprising incubating a neurosphere culture in the presence of a test agent and determining the effect of the test agent on proliferation, differentiation and/or renewal of neural precursor cells, neural progenitor cells and/or NSCs in the culture, wherein a difference in proliferation and/or renewal of neural precursor cells, neural progenitor cells and/or NSCs compared with a control neurosphere culture indicates that the test agent is a putative NSC Modulating Agent.
A method further comprises assessing the selectivity and/or potency of a putative NSC Modulating Agent by determining the effect of a putative NSC Modulating Agent on a normal astrocyte cell line. In an aspect, selectivity and/or potency are assessed by constructing dose-response curves and EC50s for the normal astrocyte cell line and calculating a neurosphere selectivity ratio. A neurosphere selectivity ratio can be defined as EC50 astrocytes/EC50 precursor cells. A neurosphere selectivity ratio greater than that observed in controls indicates that the putative NSC Modulating Agent is potent and/or selective. Therefore a method may further comprise assessing the selectivity and/or potency of a putative modulator by comparing a neurosphere selectivity ratio of the modulator in a normal astrocyte cell line to that of a control. In certain embodiments, the controls comprise cycloheximide, etoposide and carboplatin. In other embodiments, the neurosphere selectivity ratio is greater than 3, 4, 5, 6, 7, 8, 9 or 10.
Using the methods described herein, modulators have been identified that modulate proliferation, differentiation and/or renewal of normal and diseased (e.g. cancerous) neural precursor cells, neural progenitor cells and/or NSCs.
In another aspect, a composition comprising one or more NSC Modulating Agents, and a pharmaceutically acceptable carrier, excipient or diluent is provided.
In a further aspect, a composition is also provided and comprises one or more NSC Modulating Agent in a therapeutically effective amount for inhibiting proliferation, differentiation and/or renewal of neural precursor cells, neural progenitor cells and/or NSCs, in particular diseased (e.g., cancerous) neural precursor cells, neural progenitor cells and/or NSCs.
In one embodiment, a composition comprising one or more NSC Modulating Agent in a therapeutically effective amount for treatment of a brain or CNS cancer, more particularly a primary CNS tumor is further provided.
In another embodiment, a composition comprising one or more NSC Modulating Agent in a therapeutically effective amount for treatment of a brain tumor having a genetic profile resembling that of normal and embryonic neural precursor cells is also provided.
In another embodiment, a composition comprises one or more NSC Modulating Agent in a therapeutically effective amount for treatment of a brain tumor enriched for cancer stem cells.
In other embodiments of compositions for treating a condition requiring inhibition of proliferation, differentiation and/or renewal of neural precursor cells, neural progenitor cells and/or NSCs, the NSC Modulating Agents in the composition are one or more agents that modulate neurotransmission in the dopamine, serotonin, opioid, glutamate, and/or vanilloid pathways. More particularly, the NSC Modulating Agents in the composition are one or more of a dopamine receptor antagonist, a dopamine receptor agonist, an acetylcholine receptor antagonist, an NMDA receptor antagonist, an opioid receptor agonist, a retinoic acid receptor agonist, a JAK3 antagonist, a p38 MAPK antagonist, a serotonin receptor agonist, or a vanilloid receptor agonist. Most particularly the NSC Modulating Agents are one or more of (±)butaclamol, R(−) propylnorapomorphine, apomorphine, cis-(Z) flupenthixol, hexahydro-sila-difenidol, ifenprodil tartrate, carbetapentane citrate, fenretinide, WHI-P131, SB 202190, p-aminophenethyl-m-trifluoromethylphenyl piperazine (PAPP), and dihydrocapsaicin. In certain aspects, the NSC Modulating Agent in the composition is one or both of apomorphine and ifenprodil.
In another aspect, a composition comprises one or more NSC Modulating Agent in a therapeutically effective amount for inducing proliferation of normal neural precursor cells and/or neural progenitor cells.
In still another aspect, a composition comprising one or more NSC Modulating Agent in a therapeutically effective amount for inducing differentiation and/or renewal of normal neural precursor cells, neural progenitor cells and/or NSCs is further provided.
In yet a further aspect, a composition comprises an NSC Modulating Agent in a dosage effective for inducing proliferation of neural stem cells into an increased amount of neural progenitor cells, or for inducing proliferation of neural stem cells or neural progenitor cells into an increased amount of neural cells, e.g., glia, neurons, astrocytes and/or oligodendrocytes.
In another aspect, a composition for treatment of a neural disorder, in particular a neurological disease, neurodegenerative disease, or central nervous system (CNS) trauma is provided and comprises an NSC Modulating Agent in a dosage effective for inducing proliferation of neural stem cells into an increased amount of neural progenitor cells.
In yet another aspect, a composition is provided for treatment of a neural disorder, in particular a neurological disease, neurodegenerative disease, or central nervous system (CNS) trauma comprising an NSC Modulating Agent in a dosage effective for inducing proliferation and/or differentiation of neural stem cells or neural progenitor cells into an increased amount of neural precursor cells or neural cells, e.g., glia, neurons, astrocytes and/or oligodendrocytes.
Proliferation, differential and/or renewal of neural precursor cells, neural progenitor cells and/or NSCs neural precursor cells may be induced ex vivo or in vivo. The composition can be in a pharmaceutically acceptable carrier, excipient, or vehicle.
Additionally provided is a method of preparing a stable pharmaceutical composition comprising one or more NSC Modulating Agent. A method can comprise mixing one or more NSC Modulating Agent and a pharmaceutically acceptable carrier, excipient, or vehicle, in particular, a pharmaceutically acceptable carrier, excipient, or vehicle which may be effective to physically stabilize the compound(s). After compositions have been prepared, they can be placed in an appropriate container and labeled for treatment of an indicated condition. For administration of a composition described herein, such labeling would include amount, frequency, and method of administration.
NSC Modulating Agents may be used in the treatment of conditions that require modulation of proliferation, differentiation and/or renewal of normal or diseased neural precursor cells, neural progenitor cells and/or NSCs.
Therefore, in an aspect, a method is provided for treating or preventing a condition requiring modulation (e.g., inhibition) of proliferation, differentiation and/or renewal of diseased neural precursor cells, neural progenitor cells and/or NSCs comprising administering to a subject in need thereof a therapeutically effective amount of an NSC Modulating Agent or a composition of the invention. In embodiments of this aspect, the NSC Modulating Agent is one or more of a dopamine receptor antagonist, a dopamine receptor agonist, an acetylcholine receptor antagonist, an NMDA receptor antagonist, an opioid receptor agonist, a retinoic acid receptor agonist, a JAK3 antagonist, a p38 MAPK antagonist, a serotonin receptor agonist, or a vanilloid receptor agonist. More particularly, the NSC Modulating Agents are one or more of (±)butaclamol, R(−) propylnorapomorphine, apomorphine, cis-(Z) flupenthixol, hexahydro-sila-difenidol, ifenprodil tartrate, carbetapentane citrate, fenretinide, WHI-P131, SB 202190, p-aminophenethyl-m-trifluoromethylphenyl piperazine (PAPP), and dihydrocapsaicin.
In another aspect, a method for treating or preventing a condition requiring modulation of proliferation, differentiation and/or renewal of normal neural precursor cells, neural progenitor cells and/or NSCs is provided and comprises administering to a subject in need thereof a therapeutically effective amount of an NSC Modulating Agent or a composition described herein.
Also contemplated is the use of an NSC Modulating Agent or a composition described for the preparation of medicaments for treating or preventing a condition requiring modulation of proliferation, differentiation and/or renewal of normal or diseased neural precursor cells, neural progenitor cells and/or NSCs. Additionally provided are uses of a pharmaceutical composition described herein in the preparation of medicaments for the prevention and/or treatment of conditions and/or diseases disclosed herein.
The invention has particular application in preventing and/or treating brain or CNS cancer. Thus, a method of treatment is provided and comprises administering a therapeutically effective amount of one or more NSC Modulating Agent or a composition described herein which upon administration to a subject with symptoms of a brain or CNS cancer produces beneficial effects, preferably sustained beneficial effects (e.g., inhibition of proliferation, differentiation and/or renewal of normal or diseased neural precursor cells, neural progenitor cells and/or NSCs), in particular cancerous neural precursor cells.
In an embodiment, a method is provided for preventing and/or treating a primary CNS tumor comprising administering a therapeutically effective amount of one or more NSC Modulating Agent or a composition discussed herein.
In a further embodiment, a method for ameliorating progression of a condition and/or disease or obtaining a less severe stage of a condition and/or disease in a person suffering from a brain or CNS cancer, in particular a primary CNS tumor, is provided and comprises administering a therapeutically effective amount of one or more NSC Modulating Agent or a composition discussed herein.
A method of delaying the progression of a brain or CNS cancer, in particular a primary CNS tumor, is further provided and comprises administering a therapeutically effective amount of one or more NSC Modulating Agent or a composition provided herein.
A kit is also provided and comprises one or more one or more NSC Modulating Agent or a composition described herein. In an aspect, a kit is provided for preventing and/or treating brain or CNS cancer, containing a composition comprising one or more NSC Modulating Agent or a composition described herein, a container, and instructions for use. The composition of the kit can further comprise a pharmaceutically acceptable carrier, excipient, or vehicle.
These and other aspects, features, and advantages of the present invention should be apparent to those skilled in the art from the following drawings and detailed description.
For convenience, certain terms employed in the specification, examples, and appended claims are collected here.
The recitation of numerical ranges by endpoints herein includes all numbers and fractions subsumed within that range (e.g. 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.90, 4, and 5). It is also to be understood that all numbers and fractions thereof are presumed to be modified by the term “about.” Further, it is to be understood that “a,” “an,” and “the” include plural referents unless the content clearly dictates otherwise. Thus, for example, reference to a composition containing “a NSC Modulating Agent” includes a mixture of two or more compounds. The term “about” means plus or minus 0.1 to 50%, 5-50%, or 10-40%, preferably 10-20%, more preferably 10% or 15%, of the number to which reference is being made.
The terms “subject” and “patient” are used interchangeably herein and refer to an animal including a warm-blooded animal such as a mammal, which is afflicted with or suspected of having or being pre-disposed to a condition disclosed herein. Preferably, the terms refer to a human. The terms also include domestic animals bred for food, sport, or as pets, including horses, cows, sheep, poultry, fish, pigs, cats, dogs, and zoo animals. The methods herein for use on subjects and patients contemplate prophylactic as well as curative use. Typical subjects for treatment include persons susceptible to, suffering from or that have suffered a condition disclosed herein.
The terms “administering” or “administration” refers to the process by which a therapeutically effective amount of an NSC Modulating Agent or composition contemplated herein is delivered to a patient for prevention and/or treatment purposes. Compositions are administered in accordance with good medical practices taking into account the patient's clinical condition, the site and method of administration, dosage, patient age, sex, body weight, and other factors known to physicians.
The term “pharmaceutically acceptable carrier, excipient, or vehicle” refers to a medium which does not interfere with the effectiveness or activity of an active ingredient and which is not toxic to the hosts to which it is administered. A carrier, excipient, or vehicle includes diluents, binders, adhesives, lubricants, disintegrates, bulking agents, wetting or emulsifying agents, pH buffering agents, and miscellaneous materials such as absorbants that may be needed in order to prepare a particular composition. The use of such media and agents for an active substance is well known in the art.
By “pharmaceutically acceptable salts” is meant those salts which are suitable for use in contact with the tissues of a subject or patient without undue toxicity, irritation, allergic response and the like, and are commensurate with a reasonable benefit/risk ratio. Pharmaceutically acceptable salts are well known in the art and are described for example, in S. M. Berge, et al., J. Pharmaceutical Sciences, 1977, 66:1 The term “pharmaceutically acceptable salt(s)” includes salts of acidic or basic groups which may be present in the compounds which can be employed. In particular, pharmaceutically acceptable acid addition salts of an NSC Modulating Agent are provided. Acids which can be used to prepare the pharmaceutically acceptable acid addition salts are those which form non-toxic acid addition salts, i.e., salts containing pharmacologically acceptable anions, such as the hydrochloride, hydrobromide, hydroiodide, nitrate, sulfate, bisulfate, phosphate, acid phosphate, acetate, lactate, citrate, acid citrate, tartrate, bitartrate, succinate, maleate, fumarate, gluconate, saccharate, benzoate, methanesulfonate, ethanesulfonate, benzenesulfonate, para-toluenesulfonate and pamoate [i.e., 1,1′-methylene-bis-(2-hydroxy-3-naphthoate)] salts. In other aspects, pharmaceutically acceptable base addition salts of an NSC Modulating Agent are also provided. Chemical bases that may be used as reagents to prepare pharmaceutically acceptable base salts are those that form non-toxic base salts with such compounds. Suitable nontoxic base salts include, without limitation, those derived from such pharmacologically acceptable cations such as alkali metal cations (e.g., potassium and sodium) and alkaline earth metal cations (e.g., calcium and magnesium), ammonium or water-soluble amine addition salts such as N-methylglucamine (meglumine), and the lower alkanolammonium and other base salts of pharmaceutically acceptable organic amines.
The term “treating” refers to reversing, alleviating, or inhibiting the progress of a disease, or one or more symptoms of such disease, to which such term applies. Depending on the condition of the subject, the term also refers to preventing a disease, and includes preventing the onset, or preventing the symptoms associated with a disease. A treatment may be either performed in an acute or chronic way. The term also refers to reducing the severity of a disease or symptoms associated with such disease prior to affliction with the disease. Such prevention or reduction of the severity of a disease prior to affliction refers to administration of a compound or composition described herein to a subject that is not at the time of administration afflicted with the disease. “Preventing” also refers to preventing the recurrence of a disease, or of one or more symptoms associated with such disease. The terms “treatment” and “therapeutically,” refer to the act of treating, as “treating” is defined above. The purpose of prevention and intervention is to combat the disease, condition, or disorder and includes the administration of the active compounds to prevent or delay the onset of the symptoms or complications, or alleviating the symptoms or complications, or eliminating the disease, condition, or disorder.
The terms “treating” and “treatment” utilized herein in respect to a CNS tumor or primary CNS tumor refer to a situation where the severity of a symptom of a CNS tumor, including the volume of the tumor or the frequency with which any symptom or sign of the tumor is experienced by a patient, or both, is reduced, or where time to tumor progression or survival time is increased.
A “beneficial effect” refers to an effect of an NSC Modulating Agent or composition described herein that is greater than the effect without the agent or composition. The beneficial effect includes favorable pharmacological and/or therapeutic effects, and improved pharmacokinetic properties and biological activity. In another aspect, the beneficial effect is a “sustained beneficial effect” where the beneficial effect is sustained for a prolonged period of time after termination of treatment. A beneficial effect may be sustained for at least about 1 to 5 days, 2 to 7 days, 1 to 2 weeks, 1 to 4 weeks, and 1 to 6 weeks, 2 to 16 weeks, 2 weeks to 6 months or periodically following treatment. The period of time a beneficial effect is sustained may correlate with the duration and timing of the treatment. A subject may be treated continuously for about 1 to 3 days, 1 to 5 days, 2 to 7 days, 1 to 2 weeks, 1 to 4 weeks, and 1 to 6 weeks, 2 to 16 weeks, 2 weeks to 6 months or periodically.
The beneficial effect may be a statistically significant effect in terms of statistical analysis of an effect of an agent when compared to no agent. “Statistically significant” or “significantly different” effects or levels with an agent may represent levels that are higher or lower than a standard. In one embodiment, the difference may be 1.5, 2, 3, 4, or 5 times higher or lower compared with the effect obtained without the agent.
A “medicament” refers to a pharmaceutical composition suitable for administration of a pharmaceutically active compound(s) (i.e., NSC Modulating Agent) to a patient.
“Therapeutically effective amount” relates to the amount or dose of an active compound or composition described herein that will lead to one or more therapeutic effect, in particular desired beneficial effects. A therapeutically effective amount of a substance can vary according to factors such as the disease state, age, sex, and weight of the subject, and the ability of the substance to elicit a desired response in the subject. Dosage regime may be adjusted to provide the optimum therapeutic response. For example, several divided doses may be administered daily or the dose may be proportionally reduced as indicated by the exigencies of the therapeutic situation.
A “neural stem cell” refers to an undifferentiated neural cell capable of proliferation, self-maintenance, and production of differentiated functional progeny.
A “neural progenitor cell” refers to an undifferentiated cell derived from a neural stem cell, which is not itself a stem cell. Some progenitor cells can produce progeny that are capable of differentiating into more than one cell type. A progenitor cell, unlike a stem cell, has limited proliferative ability and thus does not exhibit self-maintenance. It is committed to a particular path of differentiation and will, under appropriate conditions, eventually differentiate into neurons, glia, astrocytes or oligodendrocytes. In one embodiment, the neural progenitor cells are early neural progenitor cells.
The term “neural precursor cells” refers to the progeny of neural stem cells, and thus includes both progenitor cells and daughter neural stem cells.
A “modulator” includes an “inhibitor”, “antagonist”, “stimulator”, “activator”, “enhancer” or “agonist”. An “inhibitor” or “antagonist” is defined by any molecule/compound/agent that is capable of eliciting a decrease in an activity or response (e.g., a NSC Modulating Agent that elicits a decrease in proliferation, differentiation and/or renewal of neural precursor cells, neural progenitor cells and/or NSCs). A “stimulator”, “activator”, “enhancer” or “agonist” is defined by any molecule/compound/agent that is capable of eliciting an increase in an activity or response (e.g., a NSC Modulating Agent that elicits an increase in proliferation, differentiation and/or renewal of neural precursor cells, neural progenitor cells and/or NSCs).
“NSC Modulating Agent” refers to a modulator that modulates proliferation, differentiation and/or renewal of neural precursor cells, neural progenitor cells and/or NSCs. Examples of NSC Modulating Agents that modulate proliferation, differentiation and/or renewal of diseased neural precursor cells, neural progenitor cells and/or NSCs include without limitation, dopamine receptor antagonists, dopamine receptor agonists, acetylcholine receptor antagonists, NMDA receptor antagonists, opioid receptor agonists, retinoic acid receptor agonists, JAK3 antagonists, p38 MAPK antagonists, serotonin receptor agonists, or vanilloid receptor agonists. An NSC Modulating Agent may be a commercially available drug or a new formulation of a commercially available drug adapted for treating a condition disclosed herein.
A “dopamine receptor” refers to a receptor that mediates dopaminergic neurotransmission in the central nervous system and in particular members of the G protein-coupled receptor family, more particularly striatal dopamine receptors. Dopamine receptors include without limitation D1, D2, D3, D4, and D5 dopaminergic receptors.
“Dopamine receptor agonists” include natural and synthetic agents that function as specific agonists acting on dopamine receptors, in particular striatal dopamine receptors. Suitable agonists are well known in the art and readily available for use within the methods and compositions described herein. A principal class of dopamine receptor agonists for use herein includes natural and synthetic or semisynthetic ergolines derived or modeled after ergot alkyloids, for example, apomorphines and ergotamines.
Particular examples of dopamine receptor agonists include, without limitation, levodopa/carbidopa, amantadine, bromocriptine, pergolide, R(−) propylnorapomorphine, apomorphine, benserazide, lysuride, mesulergine, lisuride, lergotrile, memantine, metergoline, piribedil, tyramine, tyrosine, phenylalanine, bromocriptine mesylate, pergolide mesylate, and the like, preferably R(−) propylnorapomorphine or apomorphine.
The dopamine receptor agonist may be selected from among adrogolide, A-86929, rotigotine, NeurVex, Nolomirole, pramipexole, talipexole, CHF 1512, (−)-stepholidine, DAR-201, Diacrin/Genzyme, bromocriptine, Bupropion, LEK-8829, BAM-1110, AIT-203, NS-2330, Terguride, Aripiprazole, OPC-4392, GMC-1111, PD-148903, apomorphine HCl, PD-89211, PD-158771, cabergoline, sumanirole, PNU-14277E, POL-255, dihydrexidine, GBR-12783, quinagolide HCl, (R)-bupropion, S-32504, S-33592, SKF-80723, SKF-83959, fenoldopam, ropinirole, SKF-82958, SKF-77434, DU 127090, SLV-308, SLV 318, NeuroCRIB, SP-1037C, spheramine, Gallotrank, Preclamol, DAB-452, YM-435, BP-897, ProSavin, Etilevodopa, P63, A 68930, A 77636, Alaptide, Alentemol, CI 1007; PD 143188, BLSI, JA 116a; JA 116, Melevodopa; Levodopa methyl; CHF 1301; NSC 295453; Levomet, MR 708, PD 128483, RD 211, SKF 38393, SKF 81297, U 86170F, U 91356A, WAY 124486 and Z 15040.
A dopamine receptor agonist that acts on one or more specific dopamine receptors may be selected. For example, certain tetralins and related ergoline derivatives have been reported as centrally acting D2 dopamine receptor agonists (Wickstrom, Prog Med. Chem. 29:185-216, 1992); and 5-hydroxy-2-N,N-n-dipropylaminotetralin (5-OH-DPAT), 7-OH-DPAT and 8-OH-DPAT, have been reported as specific and selective ligands for the D3 receptors (Levesque, Proc. Natl. Acad. Sci. USA 89:8155-8159, 1992; Mulder, et al., Arch. Pharmacol 336: 494-501, 1987; and Beart, et al, Arch. Pharmacol. 336: 487-493, 1987)
Additional dopamine receptor agonists that may be useful include for example, SKF-38393 HCl (SKF), a D1 dopaminergic receptor agonist (Muralikrishnan, Brain Res. 892:241-7, 2001); ropinirole (SKF-101468) (Reaville et al., J. Pharm. Pharmacol 52:1129-35, 2000); and, ABT-431, a D1 agonist (Self et al., Ann. N Y Acad. Sci. 909:133-44, 2000). See also DeWald et al., J. Med. Chem. 33:445-450, 1990; Grol et al., J. Pharm. Pharmacol. 43:481-485, 1991; Hall et al., J. Med. Chem. 30:1879-1887, 1987; Horn et al., J. Med. Chem. 27: 1340-1343, 1984; Johansson et al., J. Med. Chem. 30: 1827-1837, 1987; Jobansson et al., Mol. Pharmacol. 30:258-269, 1986; Johansson et al., J. Med. Chem. 28:1049-1053, 1985; Johansson et al., J. Med. Chem. 30:602-611, 1987; Johansson et al., J. Org. Chem. 51: 5252-5258, 1986; Johansson et al., J. Med. Chem. 33:2925-2929, 1990; Jones et al., J. Med. Chem. 27:1607-1613; 1984; Langlois et al., Synthetic Comm. 22:1723-1734, 1992; Martin et al., J. Pharmacol. Exp. Ther. 230:569-576, 1989; Neumeyer et al., J. Med. Chem. 34:24-28, 1991; Seiler et al., Mol. Pharmacol. 22:281-289, 1982; and Sibley et al., TIPS 13: 61-68, 1992 for additional teachings regarding identification, selection, pharmacology, and production of dopamine receptor agonists and their derivatives and analogs for use within the methods and compositions described herein.
“Dopamine receptor antagonists” include natural and synthetic agents that function as specific antagonists acting on dopamine receptors, in particular striatal dopamine receptors. A dopamine receptor antagonist is generally capable of blocking, either completely or partially, the action and/or function of the receptor. Suitable antagonists are well known in the art and readily available for use within the methods and compositions described herein. Particular examples of dopamine receptor antagonists are cis-(Z) flupenthixol, perphenazine, (±) butaclamol, and alkylphosphocholines, in particular miltefosine, domperidone and pimozide, preferably butaclamol.
“NMDA receptor antagonist” refers to compounds which are capable of blocking, either completely or partially, the action and/or function of the NMDA receptor or the NMDA receptor complex. NMDA receptor antagonists block the ion channel, others act at the glycine(B) site, and still others are selective for NR2B NMDA receptor subtypes (see, inter alia, Danysz and Parsons (2002) Neurotox Res 4, 119-126 or Danysz et al (2002) Curr Pharm Des 8, 835-843). “NMDA receptor antagonists” include natural and synthetic agents that function as specific antagonists acting directly on an NMDA receptor. NMDA receptor antagonists are well known and can be selected for use herein.
An NMDA receptor antagonist to be employed preferably inhibits/blocks a human NMDA receptor(s). Human NMDA receptors have been described in the art and are also described by their protein structure and/or their encoding nucleotide sequences. Sequences for NMDA receptors may easily be obtained in current databases, like the EMBL-EBI™ database under www.ebi.ac.uk or the NCBI database under www.ncbi.nlm.nih.gy. Exemplified, non limiting NMDA receptors comprise the receptors encoded by nucleotide sequences as shown under NM 00835 and NM 00833 in the NCBI database (gene accession number).
Examples of NMDA receptor antagonists include 1-amino-alkylcyclohexanes like memantine or neramexane (MRz 2/579 or 1-amino-1,3,3,5,5-pentamethyl-cyclohexane) (see International Patent Publication No. WO 2005/009421, US Patent Publication No. 2004/0087658, U.S. Pat. No. 4,122,193; U.S. Pat. No. 4,273,774 or U.S. Pat. No. 5,061,703), 6,7-dichloro-5-nitro-1,4-dihydro-2,3-quinoxalinedione (licostinel) (ACEA 1021), gavestinel, CP-101606, Ro-25-6981, Co101244 (see Kohl (2001) Curr Med. Chem. 8, 1275-1289), eliprodi (see U.S. Pat. No. 5,547,963, International Patent Publication No. WO 97/33582, International Patent Publication No. WO 97/02823, U.S. Pat. No. 5,023,266), dizocilpine, conantokins, ifenprodil, ifenprodil tartrate, arcaine, pentamidine isethionate, L-701, 324, CGP4O1 16, LY235959, LY233053, MRZ2/576, LU73068, 4-Cl—KYN or pharmaceutically acceptable salts or prodrugs of these substances, including the hydrochloride salt of neramexane, namely 1-amino-1,3,3,5,5-pentamethyl-cyclohexane hydrochloride, and the mesylate salt of neramexane, namely 1-amino-1,3,3,5,5-pentamethyl-cyclohexane mesylate. In one embodiment, the NMDA receptor antagonist is ifenprodil, ifenprodil tartrate, memantine or neramexane.
“Acetylcholine receptor antagonists” include natural and synthetic agents that function as specific antagonists acting on acetylcholine receptor. An acetylcholine receptor antagonist is generally capable of blocking, either completely or partially, the action and/or function of the receptor. Suitable antagonists are well known in the art and readily available for use within the methods and compositions described herein. Particular examples of acetylcholine receptor antagonists are the M1 antagonists R-trihexyphenidyl, telenzepine and pirenzepine, the M3 antagonists hexahydro-sila-difenidol and p-fluorohexahydro-siladifenidol, and the M2 and M4 antagonists himbacine methoctramine, AF-DX 116 and AQ-RA 741, preferably hexahydro-sila-difenidol.
“Opioid receptor agonists” include natural and synthetic agents that function as specific agonists acting on an opioid receptor. An opioid dopamine receptor agonist is generally capable of stimulating or enhancing, either completely or partially, the action and/or function of the receptor. Suitable antagonists are well known in the art and readily available for use within the methods and compositions discussed herein. Particular examples of opioid receptor agonists are carbetapentane citrate, dextromethorphan, dextromethorphan hydrobromide, noscapine, metaphit methanesulfonate, and chlophedianol hydrochloride, preferably carbetapentane citrate.
“Retinoic acid receptor agonists” include natural and synthetic agents that function as specific agonists acting on a retinoic acid receptor. A retinoic acid receptor agonist is generally capable of stimulating or enhancing, either completely or partially, the action and/or function of the receptor. Suitable agonists are well known in the art and readily available for use within the methods and compositions provided herein. An “RAR agonist” can be either naturally occurring or a synthetic retinoid, preferably having selective activity as an agonist for RARs and high potency in antagonism of AP-1-dependent gene expression. Examples of naturally occurring retinoids with activity as RAR agonists are all-trans retinoic acid (all-trans RA) and 9-cis retinoic acid (9-cis RA), which are stereoisomers, all-trans RA being naturally converted into 9-cis RA during metabolism (J. G. Allen, et al., Pharmac. Ther. 40:1-27, 1989). Synthetically retinoids are well known in the art. For example, U.S. Pat. No. 5,234,926, discloses methods of synthesizing disubstituted acetylenes bearing heteroaromatic and heterobicyclic groups with selective activity as RAR agonists. U.S. Pat. No. 4,326,055 discloses methods for synthesizing 5,6,7,8-tetrahydro naphthyl and indanyl stilbene derivatives with retinoid-like activity. Examples of synthetic RAR agonists that may be used are ethyl 6-[2-(4,4-dimethylthiochroman-6-yl)ethynyl]nicotinate and 6-[2-(4,4-dimethylchroman-6-yl)ethynyl]nicotinic acid (see U.S. Pat. No. 5,234,926); and p-[(E)-2-(5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-naphthyl)propenyl]-benzoic acid (see U.S. Pat. No. 4,326,055). In one aspect, the retinoic acid receptor agonist is fenretinide.
“JAK3 antagonists” include natural and synthetic agents that function as specific antagonists acting on JAK3. A JAK3 antagonist is generally capable of blocking, either completely or partially, the action and/or function of JAK3. Suitable antagonists are well known in the art and readily available for use within the methods and compositions described herein. Particular examples of JAK3 antagonists are WHI-P131 and the JAK3 inhibitors disclosed in U.S. Pat. No. 6,933,300 including without limitation 4-(4′-hydroxylphenyl)-amino-6,7-dimethoxyquinazoline (P131), 4-(3′-bromo-4′-hydroxylphenyl)-amino-6,7-dimethoxyquinazoline (P154), 4-(3′-hydroxyphenyl)-amino-6,7-dimethoxyquinazoline, (P180) and 4-(3′,5′-dibromo-4′-hydroxyphenyl)-6,7-dimethoxyquinazoline (P97).
“p38 MAPK antagonists” include natural and synthetic agents that function as specific antagonists acting on the p38 subfamily of MAP kinases, including p38α, p38β, p38γ, and p38δ. A p38 MAPK antagonist is generally capable of blocking, either completely or partially, the action and/or function of a MAP kinase. Suitable antagonists are well known in the art and readily available for use within the methods and compositions described herein. Particular examples of p38 MAPK antagonists are SB 202190 (Sigma Aldrich), SB203580 and PD169316 (Fu Y et al, Biochem Biophys Res Commun. 2003 Oct. 17; 310(2):391-7), and FR167653 (Nishikawa et al, Arthritis Rheum. 2003 September; 48(9):2670-81).
“Serotonin receptor agonists” include natural and synthetic agents that function as specific agonists acting on a serotonin receptor. A serotonin receptor agonist is generally capable of stimulating or enhancing, either completely or partially, the action and/or function of the receptor. Suitable agonists are well known in the art and readily available for use within the methods and compositions provided herein. Particular examples of serotonin receptor agonists are aminophenethyl-m-trifluoromethylphenyl piperazine (PAPP), 8-OH-DPAT, sumatriptan, L694247 (2-[5-[3-(4-methylsulphonylamino)benzyl-1,2,4-oxadiazol-5-yl]-1H-indol-3yl]ethanamine), buspirone, alnitidan, zalospirone, ipsapirone, gepirone, zolmitriptan, risatriptan, 311C90, α-Me-5-HT, BW723C86 (1-[5(2-thienylmethoxy)-1H-3-indolyl[propan-2-amine hydrochloride), and MCPP (m-chlorophenylpiperazine).
“Vanilloid receptor agonists” include natural and synthetic agents that function as specific agonists acting on a vanilloid receptor. A vanilloid receptor agonist is generally capable of stimulating or enhancing, either completely or partially, the action and/or function of the receptor. Suitable agonists are well known in the art and readily available for use within the methods and compositions herein. Particular examples of opioid receptor agonists are dihydrocapsaicin, resiniferatoxin and other resiniferatoxin-like complex polycyclic compounds such as tinyatoxin, capsaicin and other capsaicin analogs such as dihydrocapsaicin, ovanil, anandamid, eicosinoids prostacyclin, PGE2, 20-homovanillyl esters of diterpenes such as 12-deoxyphorbol 13-phenylacetate 20-homovanillate and mezerein 20-homovanillate (see U.S. Pat. Nos. 4,939,194; 5,021,450; and 5,232,684), analogs of capsaicins including vanillylacylamides, homovanillyl acylamides, carbamate derivatives, sulfonamide derivatives, urea derivatives, aralkylamides and thioamides, aralkyl aralkanamides, phenylacetamides and phenylacetic acid esters, olvanil (N-vanillyl-9-octadecenamide). See, e.g., U.S. Pat. No. 5,962,532; U.S. Pat. No. 5,762,963; U.S. Pat. No. 5,221,692; U.S. Pat. No. 4,313,958; U.S. Pat. No. 4,532,139; U.S. Pat. No. 4,544,668; U.S. Pat. No. 4,564,633; U.S. Pat. No. 4,544,669; and U.S. Pat. Nos. 4,493,848; 4,532,139; 4,564,633; and 4,544,668; and the agonists described in International Patent Publication No. WO 00/50387, and agonists disclosed by Hwang et al., PNAS 97 (11): 6155-6160 (2000).
The terms “dopainine receptor agonists”, “dopamine receptor antagonists”, “acetylcholine receptor antagonist”, “NMDA receptor antagonist”, “opioid receptor agonist”, “retinoic acid receptor agonist”, “JAK3 antagonist”, “p38 MAPK antagonist”, “serotonin receptor agonist”, and “vanilloid receptor agonist” as used herein also embrace chemically modified analogs, derivatives, salts and esters of the agonists/antagonists which are “pharmaceutically acceptable,” for example salts and esters that are suitable for use in contact with mucosal tissues of humans and other mammals, without undue toxicity, irritation, allergic response, and the like, and which retain activity for their intended use. Pharmaceutically acceptable salts can be prepared in situ during isolation and purification of the agonists or antagonists, or separately by reacting the free base or acid functions of the agonists or antagonists with a suitable organic acid or base. Representative acid addition salts include the hydrochloride, hydrobromide, sulphate, bisulphate, acetate, oxalate, valerate, oleate, palmitate, stearate, laurate, borate, benzoate, lactate, phosphate, tosylate, mesylate, citrate, maleate, fumarate, succinate, tartrate, ascorbate, glucoheptonate, lactobionate, lauryl sulphate salts and the like. Representative alkali or alkaline earth metal salts include the sodium, calcium, potassium and magnesium salts, and the like.
As used herein, the terms “condition” and “disease” are used interchangeably to refer to a condition or disease in a subject. “Condition” and “disease” include but are not limited to diseases or disorders where there is neurological damage or a neurological disorder.
In one aspect, the disease is a disease of the brain or central nervous system. In particular aspects utilizing NSC Modulating Agents that are antagonists or inhibitors of proliferation, differentiation and/or renewal of diseased (e.g. cancerous) neural precursor cells, neural progenitor cells and/or NSCs, the condition or disease is an abnormal growth in the brain or central nervous system, more particularly a primary CNS tumor. In an embodiment, the condition is brain or CNS cancer, more particularly a primary CNS tumor. In embodiments, the condition is a brain tumor having a genetic profile resembling that of normal and embryonic neural precursor cells. In other embodiments, the condition is a brain tumor enriched for cancer stem cells.
“Primary CNS tumor” includes a neoplasia with origins in the brain, in that the cancerous cells did not originate in another part of the body and metastasize to the brain. Examples of primary CNS tumors include, but are not limited to, gliomas, well-differentiated astrocytomas, anaplastic astrocytomas, glioblastoma multiforme, ependymomas, oligodendrogliomas, ganglioneuromas, mixed gliomas, brain stem gliomas, optic nerve gliomas, meningiomas, pineal tumors, pituitary tumors, pituitary adenomas, reactive gliosis, primitive neuroectodermal tumors, medulloblastomas, schwannomas, lymphomas, vascular tumors, and lymphomas.
In aspects utilizing NSC Modulating Agents that are agonists or stimulators of proliferation, differentiation and/or renewal of normal neural precursor cells, neural progenitor cells and/or NSCs the condition or disease is a neurological disorder including Down Syndrome, Parkinson's disease, Huntington's Chorea, pathogenic psychotic conditions, schizophrenia, neurodegenerative disorders including cognitive dysfunction and dementia (e.g., Alzheimer's disease) or central nervous system (CNS) trauma (e.g., stroke and epilepsy).
In particular aspects utilizing NSC Modulating Agents that are agonists or stimulators of proliferation, differentiation and/or renewal of normal neural precursor cells, neural progenitor cells and/or NSCs, the condition or disease is a neurological disorder including without limitation a presenile dementia (early onset Alzheimer's disease), senile dementia (dementia of the Alzheimer's type), Parkinsonism including Parkinson's disease, Huntington's chorea, tardive dyskinesia, hyperkinesias, mania, attention deficit disorder, attention deficit hyperactivity disorder, sleep-wake disorder, chronic-fatigue syndrome, tremor, epilepsy, neuropathic pain, addiction (e.g., nicotine addiction), anxiety, dyslexia, schizophrenia, obsessive-compulsive disorder, and Tourette's syndrome.
A pharmaceutical composition which has been adapted for administration to a subject to treat a condition or disease disclosed herein (e.g., brain or CNS tumors) is provided. In an aspect the composition is in a form such that administration to a subject results in modulation of proliferation, differentiation and/or renewal of normal or diseased (e.g. cancerous) neural precursor cells, neural progenitor cells and/or NSCs. In an embodiment, the composition is in a form such that administration to a subject results in inhibition of proliferation, differentiation and/or renewal of diseased (e.g. cancerous) neural precursor cells, neural progenitor cells and/or NSCs. In another embodiment, the composition is in a form such that administration to a subject results in stimulation of proliferation, differentiation and/or renewal of normal neural precursor cells, neural progenitor cells and/or NSCs.
Methods are provided for the prevention, treatment or intervention of a condition in a subject comprising administering an NSC Modulating Agent or a pharmaceutical composition described herein to provide a beneficial effect, more particularly a sustained beneficial effect.
In an aspect, a method is also provided for the prevention or intervention of a condition discussed herein in a subject comprising administering a therapeutically effective amount of an NSC Modulating Agent. In one aspect, a treatment or intervention is provided which provides beneficial effects, including sustained beneficial effects following treatment.
In methods providing beneficial effects, in particular statistically significant beneficial effects or sustained beneficial effects, an NSC Modulating Agent inhibits proliferation, differentiation and/or renewal of diseased neural precursor cells, neural progenitor cells and/or NSCs.
The invention relates to a method of treatment comprising administering a therapeutically effective amount of at least one NSC Modulating Agent which upon administration to a subject with symptoms of, or diagnosed brain or CNS cancer, produces beneficial effects, preferably sustained beneficial effects, manifested as decreased proliferation, differentiation and/or renewal of diseased neural precursor cells, early neural progenitor cells and/or NSCs.
In another aspect, methods are provided for treating a primary CNS tumor in a patient in need thereof by administering a composition comprising an NSC Modulating Agent in a therapeutically effective amount to decrease proliferation differentiation and/or renewal of diseased neural precursor cells, early neural progenitor cells and/or NSCs.
Also contemplated is the use of a composition comprising an NSC Modulating Agent for the preparation of a medicament. In one aspect, a therapeutically effective amount of at least one NSC Modulating Agent is used to r provide beneficial effects, preferably sustained beneficial effects, in treating a disease disclosed herein. In another aspect, the use of an NSC Modulating Agent for the preparation of a medicament for inhibiting proliferation, differentiation and/or renewal of diseased (e.g. cancerous) neural precursor cells, neural progenitor cells and/or NSCs is provided. In a further aspect, the use of an NSC Modulating Agent for the preparation of a medicament for stimulating proliferation, differentiation and/or renewal of normal neural precursor cells, neural progenitor cells and/or NSCs is provided.
The compounds, compositions, and medicaments discussed herein can be administered by any means that produce contact of the active agent(s) with the agent's sites of action in the body of a subject or patient. The compounds, compositions, and medicaments in the described dosages are administered by conventional methods including without limitation orally, intranasally, by inhalation, intraperitoneally, subcutaneously, intramuscularly, transdermally, sublingually or intravenously.
The active ingredients can be administered simultaneously or sequentially, and in any order at different points in time, to provide the desired beneficial effects. The compounds and compositions can be formulated for sustained release, for delivery locally or systemically. It lies within the capability of a skilled physician or veterinarian to select a form and route of administration that optimizes the effects of the compositions and treatments.
The compositions may be administered in oral dosage forms such as tablets, capsules (each of which includes sustained release or timed release formulations), pills, powders, granules, elixirs, tinctures, suspensions, syrups, and emulsions. They may also be administered in intravenous (bolus or infusion), intraperitoneal, subcutaneous, or intramuscular forms all utilizing dosage forms well known to those of ordinary skill in the pharmaceutical arts. The compositions may be administered by intranasal route via topical use of suitable intranasal vehicles, or via a transdermal route, for example using conventional transdermal skin patches. A dosage protocol for administration using a transdermal delivery system may be continuous rather than intermittent throughout the dosage regimen.
A dosage regimen will vary depending upon known factors such as the pharmacodynamic characteristics of the agents and their mode and route of administration; the species, age, sex, health, medical condition, and weight of the patient, the nature and extent of the symptoms, the kind of concurrent treatment, the frequency of treatment, the route of administration, the renal and hepatic function of the patient, and the desired effect. The effective amount of a drug required to prevent, counter, or arrest progression of a condition can be readily determined by an ordinarily skilled physician or veterinarian.
A composition, medicament, or treatment may comprise a unit dosage of at least one NSC Modulating Agent. A “unit dosage” refers to a unitary i.e. a single dose which is capable of being administered to a patient, and which may be readily handled and packed, remaining as a physically and chemically stable unit dose comprising either the active agents as such or a mixture with one or more solid or liquid pharmaceutical excipients, carriers, or vehicles.
In another aspect, an improved pharmaceutical composition is provided comprising therapeutically effective suboptimal amounts of a NSC Modulating Agent in a form for chronic or acute therapy of a condition disclosed herein, in particular a brain or CNS cancer.
A composition or formulation may be administered to a subject continuously or periodically.
The compositions or fractions thereof typically comprise suitable pharmaceutical diluents, excipients, vehicles, or carriers selected based on the intended form of administration, and consistent with conventional pharmaceutical practices. The carriers, vehicles etc. may be adapted to provide an additive, synergistically effective or therapeutically effective amount of the active compounds. Suitable pharmaceutical diluents, excipients, vehicles, and carriers are described in the standard text, Remington: The Science and Practice of Pharmacy (21st Edition. 2005, University of the Sciences in Philadelphia (Editor), Mack Publishing Company), and in The United States Pharmacopeia: The National Formulary (USP 24 NF 19) published in 1999. By way of example, for oral administration in the form of a capsule or tablet, the active components can be combined with an oral, non-toxic pharmaceutically acceptable inert carrier such as lactose, starch, sucrose, methyl cellulose, magnesium stearate, glucose, calcium, sulfate, dicalcium phosphate, mannitol, sorbital, and the like. For oral administration in a liquid form, the agents may be combined with any oral, non-toxic, pharmaceutically acceptable inert carrier such as ethanol, glycerol, water, and the like. Suitable binders (e.g. gelatin, starch, corn sweeteners, natural sugars including glucose; natural and synthetic gums, and waxes), lubricants (e.g. sodium oleate, sodium stearate, magnesium stearate, sodium benzoate, sodium acetate, and sodium chloride), disintegrating agents (e.g. starch, methyl cellulose, agar, bentonite, and xanthan gum), flavoring agents, and coloring agents may also be combined in the compositions or components thereof.
In one aspect, a pharmaceutical composition has a pH from about 7 to 10.
Formulations for parenteral administration of a composition may include aqueous solutions, syrups, aqueous or oil suspensions and emulsions with edible oil such as cottonseed oil, coconut oil or peanut oil. Dispersing or suspending agents that can be used for aqueous suspensions include synthetic or natural gums, such as tragacanth, alginate, acacia, dextran, sodium carboxymethylcellulose, gelatin, methylcellulose, and polyvinylpyrrolidone.
Compositions for parenteral administration may include sterile aqueous or non-aqueous solvents, such as water, isotonic saline, isotonic glucose solution, buffer solution, or other solvents conveniently used for parenteral administration of therapeutically active agents. A composition intended for parenteral administration may also include conventional additives such as stabilizers, buffers, or preservatives, e.g. methylhydroxybenzoate or similar additives.
In an embodiment, a solid form pharmaceutical composition is provided (e.g. tablets, capsules, powdered, or pulverized form) comprising a crystalline or amorphous NSC Modulating Agent.
In another embodiment, a liquid drug formulation is provided and comprises pharmaceutically acceptable salts of an NSC Modulating Agent, and to lyophilized drug formulations that can be reconstituted to provide suspensions that are stable and suitable for parenteral administration.
A composition described herein may be sterilized by, for example, filtration through a bacteria retaining filter, addition of sterilizing agents to the composition, irradiation of the composition, or heating the composition. Alternatively, the compounds and compositions may be provided as sterile solid preparations e.g. lyophilized powder, which are readily dissolved in sterile solvent immediately prior to use.
After pharmaceutical compositions have been prepared, they can be placed in an appropriate container and labeled for treatment of an indicated condition. For administration of a composition, such labeling would include amount, frequency, and method of administration.
Kits are also provided. In an aspect, a kit comprises or consists essentially of agents or compositions described herein. The kit is a package that houses a container which contains agents, a NSC Modulating Agent or composition disclosed herein, and also houses instructions for administering the agent or composition to a subject. In one aspect, a pharmaceutical pack or kit is provided comprising one or more containers filled with one or more NSC Modulating Agent or one or more ingredients of a composition described herein. Associated with such container(s) can be various written materials such as instructions for use, or a notice in the form prescribed by a governmental agency regulating the manufacture, use or sale of pharmaceuticals or biological products, which notice reflects approval by the agency of manufacture, use, or sale for human administration.
As there may be advantages to mixing a component of a composition described herein and a pharmaceutically acceptable carrier, excipient or vehicle near the time of use, the invention encompasses kits in which components of the compositions are packaged separately. For example, the kit can contain an active ingredient in a powdered or other dry form in, for example, a sterile vial or ampule and, in a separate container within the kit, a carrier, excipient, or vehicle, or a component of a carrier, excipient, or vehicle (in liquid or dry form). In an aspect, the kit can contain a component in a dry form, typically as a powder, often in a lyophilized form in, for example, a sterile vial or ampule and, in a separate container within the kit, a carrier, excipient, or vehicle, or a component of a carrier, excipient, or vehicle. Alternatively, the kit may contain a component in the form of a concentrated solution that is diluted prior to administration. Any of the components described herein, any of the carriers, excipients or vehicles described herein, and any combination of components and carriers, excipients or vehicles can be included in a kit.
A kit can include two or more therapeutic agents. The components can be combined with a carrier, excipient, or vehicle or packaged separately. For example, a kit can contain an NSC Modulating Agent, and, in a separate container, another therapeutic agent.
Optionally, a kit may also contain instructions for preparation or use (e.g., written instructions printed on the outer container or on a leaflet placed therein) and one or more devices to aid the preparation of the solution and/or its administration to a patient (e.g., one or a plurality of syringes, needles, filters, tape, tubing (e.g., tubing to facilitate intravenous administration) alcohol swabs and/or the Band-Aid® applicator). Compositions which are more concentrated than those administered to a subject can be prepared. Accordingly, such compositions can be included in the kits with, optionally, suitable materials (e.g., water, saline, or other physiologically acceptable solutions) for dilution. Instructions included with the kit can include, where appropriate, instructions for dilution.
In other embodiments, the kits can include pre-mixed compositions and instructions for solubilizing any precipitate that may have formed during shipping or storage. Kits containing solutions of one or more NSC Modulating Agent and one or more carriers, excipients or vehicles may also contain any of the materials mentioned above (e.g., any device to aid in preparing the composition for administration or in the administration per se). The instructions in these kits may describe suitable indications (e.g., a description of patients amenable to treatment) and instructions for administering the solution to a patient.
The invention will be described in greater detail by way of specific examples. The following examples are offered for illustrative purposes, and are not intended to limit the invention in any manner. Those of skill in the art will readily recognize a variety of noncritical parameters which can be changed or modified to yield essentially the same results.
Small molecule high throughput screens in complex cell-based assays hold great promise for drug discovery but have not yet been widely applied to primary precursor cells (1). A library of 1,267 pharmacologically active compounds was screened against clonogenic colonies derived from murine neural stem cells (NSCs). From 160 initial hits, 12 potent and selective inhibitors of both normal and cancerous neural precursor cell proliferation and self renewal were characterized. These inhibitory compounds spanned a broad range of neurotransmission modulators, suggesting that the NSC may be anchored in a complex “ground state” in which proliferation and cell fate determination are regulated by myriad neural signaling pathways (2,3). These findings suggest that the mechanism of action of neuroactive drugs must be re-evaluated in the context of the NSC and that redeployment of clinically approved agents may afford a potent means to treat intractable CNS tumors. (4,5).
Although the candidate gene approach has been successful at uncovering vital pathways in NSC biology, to date only a small set of highly-studied networks has been sampled. Comprehensive identification of the signaling signature that regulates the neural precursor compartment is essential to define the NSC ground state. Because previous studies have demonstrated an intimate relationship between NSC self-renewal and neurosphere proliferation (13), a chemical genetic screen for inhibitors of neurosphere proliferation was undertaken in order to systematically profile the operational circuitry of the NSC (
The following methods were employed in the study described in the Examples:
Primary Embryonic Murine Neural Stem Cell (mNSC) Isolation and Culture. Isolation and culture of primary embryonic (e14.5) mouse NSCs was performed as previously described (36). Briefly, pregnant FVB mice were sacrificed by cervical dislocation at gestational age 14.5 (E14.5) and embryonic telencephalons were dissected in artificial cerebral spinal fluid (ACSF). After mechanical dissociation with a flame-narrowed Pasteur pipette, the telencephalic tissue was then passed through a 40 μm cell strainer (Falcon) and quantified for viable cells using trypan blue exclusion. Living cells were plated at a density of 106 cells/mL at 37° C. in chemically-defined neural stem cell media (37) containing 20 ng/mL−1 human recombinant epidermal growth factor (EGF) (Sigma), 20 ng/mL−1 basic fibroblast growth factor (bFGF) (Upstate) and 2 μg/mL−1 heparin (Sigma) and fed every 2-3 days. Secondary mNSC Neurosphere Culture and Chemical Screens. Prior to chemical screens and other manipulations, the NSC fraction in culture was expanded by growing freshly dissected cells as primary neurospheres (8,38) in bulk culture (106 cells/mL). After 7 days, primary neurospheres were collected and enzymatically digested for 3 minutes at 37° C. using the ACCUTASE™ reagent (Sigma) and then briefly mechanically dissociated with a 1 mL pipette. Cells were then strained and counted as above. Viable cells were plated at clonal density (20 cells/μL) in 96-well plates (Falcon) in a final volume of 100 μL and screened in singlets against the LOPAC™ library (Sigma) at a concentration of 3 μM (0.03% DMSO). On day 4, each well in the screen was supplemented with an additional 50 μL of fresh mNSC media and another aliquot of the LOPAC™ library (maintaining the final concentration of each compound at 3 μM). Secondary neurosphere cultures were then incubated for an additional 3 days (day 7) at which point the effect of each compound was assessed by quantifying the total proliferation of each well using the MTT proliferation assay. Z-score and p-values for the entire screen are listed in Table 3.
Assessment of Total Neurosphere Culture Proliferation. Total neurosphere proliferation for all experiments was assessed after seven days using the Thiazolyl Blue Tetrazolium Bromide (MTT) (Sigma) calorimetric proliferation assay (5 mg/mL). Briefly, 15 μL of MTT were added to the 150 μL of media in each well and incubated at 37° C. for 4 hours. After this time, the reaction was quenched by solubilizing the cells with 100 μL of 10% SDS/0.01 M HCl. Each well was then quantified using a microplate reader (Versamax) at an optical density of 575 nm. Background plate effects (
where x′i,j is the value at well i of plate j, h is the number of excluded hits that were 2 standard deviations below the mean and bi represents the estimated background at each well position (39). The respective background was then subtracted from the raw MTT value measured for each point (
Dose-Response Curves and EC50 Calculations. Potency of confirmed bioactive compounds was quantified by generating dose-response curves for mNSC under the same cell density and culture conditions described for the initial screen. Starting from initial concentrations between 300-30 μM, each compound was titrated across a series of 10 half-log dilutions. Each agent was tested in triplicate in at least three independent experiments. The average effective concentration that decreased the MTT reading by 50% (EC50) after seven days was calculated by fitting the data points to the four-parameter logistic sigmoidal dose-response curve:
where X is the logarithm of concentration and Y is the predicted response. Curve fitting was performed with the GraphPad PRISM® Software.
Assessment of the Neural Stem Cell Specific Effects of Selected Inhibitory Agents. To directly address if the identified agents and their respective pathways were specifically affecting the NSC fraction of the precursor cultures, the number of neurospheres generated from a single cell suspension of 2000, 1000, and 500 cells following chemical pretreatment were counted. Specifically, primary neurospheres were dissociated into a single cell suspension and subjected to the estimated EC75 of selected agents from different neurotransmission classes for 7 days. These cultures were then taken, dissociated once again and plated in fresh media. Neurospheres (>50 μm in diameter) generated from these cultures after seven days were then used as an index of the number of NSC present in culture following treatment. Data shown represents the average of two independent experiments each containing 6 replicates.
Astrocyte Screen and Neurosphere Selectivity Assessment. Selectivity of each compound for mNSC was assessed by constructing dose-response curves and EC50 calculations for the normal astrocytic GFAP expressing cell line C8-D1A (ATCC), which was derived from cells from the cerebellum of an 8 day old mouse. For consistency, cell densities and feeding schedules for these cells were identical to those described in the in NSC cultures. For all experiments, astrocytes were grown in DMEM media (GIBCO) supplemented with 10% fetal bovine serum and cultured as described in the ATCC product information guide.
Murine Medulloblastoma Generation and Culture. Tumor cells were isolated from the cerebellum of 16 week old patched heterozygous (ptc1+/−) mice displaying ataxia. Mice were sacrificed using cervical dislocation and the cerebellum immediately removed and washed with artificial cerebrospinal fluid (ACSF). Tumors were macroscopically separated from normal tissue/blood and resuspended in 2 mL of the ACCUTASE™ reagent. The tissue was gently triturated with a flamed polished Pasture pipette and incubated at 37° C. for 5 minutes. Cells were then washed with DMEM/F12 and resuspended in the serum-free chemically defined media described above. Subsequent culture and HTS of these cells was preformed as described above for normal E14.5 NSC; data shown represents the average and standard deviation of a single experiment preformed in triplicate.
Flow Cytometry. To confirm that precursor markers found in human brain tumors are also expressed in ptc1+/− tumors, primary spheres were dissociated to single cell suspension using the ACCUTASE™ reagent, resuspended in 1×PBS with 0.5% BSA and 2 mM EDTA and passed through a 40 μM cell strainer. Four μL CD133-PE (eBioscience) was added to 100 μL of cell suspension and incubated for 30 min in the dark at 4° C. 4 μg/mL Propidium Iodide was added to exclude dead cells. Prominin-1 expression was assessed by the proportion of cells that were positive for expression above the levels see in the unstained control.
To assess if the clonogenic neurosphere assay was suitable for high throughput screening (HTS), the Z′-factor (a measurement of HTS assay quality)(16) of neural precursor cells grown at clonal density for seven days was determined. Incorporation of the vital dye Thiazolyl Blue Tetrazolium Bromide (MTT) was used to compare proliferation of cultures grown in the presence of negative (0.03% DMSO) and positive (3 M cycloheximide) controls; the Z′-factor of this assay was 0.78, well within a suitable range for HTS (
1,267 compounds in the Library of Pharmacologically Active Compounds (the LOPAC™ library, Sigma MO) were screened for inhibitors of neurosphere proliferation. 160 compounds significantly decreased MTT values from the predicted underlying distribution of the screen (P<0.01) (
To verify hits from the primary screen, a representative sample of candidate agents from each pharmacological class were retested at the original screen concentration of 3 μM. Of the 43 candidates retested, 93% exhibited significant activity (P<0.05) when compared to vehicle control in triplicate for three independent experiments (see
Neurospheres are comprised of a heterogeneous population of neural stem cells and lineage restricted progenitor cells (10). To determine if the inhibitors affected NSC self renewal, as opposed to proliferation of more committed precursor populations, the colony forming efficiency of treated neurosphere cultures was analyzed. With the exception of dihydrocapsaicin from the vanilloid class, representative compounds from each major class reduced secondary neurosphere formation upon re-culture in the absence of drug (
As gene expression profiles of a variety of brain tumor subtypes resembles that of normal and embryonic neural precursor cells (118-21), agents that inhibit normal neural precursor growth might inhibit cultures of brain tumors that are enriched for cancer stem cells. Therefore the activity of the 12 most selective inhibitors of neural precursor growth were assessed against low passage (<4) neurosphere cultures of a spontaneous medulloblastoma from a heterozygous patched (ptc1+/−) mouse (22). Like their normal counterparts, cancerous precursor cells isolated from the tumors of these mice grow as spheres in the absence of serum and in the presence of EGF and FGF and express the neural precursor marker prominin1 (CD133) (
The ex vivo and in situ manipulation of NSC for treating neurological disorders, including brain cancer, will require a global understanding of the pathways that regulate the behavior of these cells. Through a chemical genetic approach the existence of a complex functional “ground state” has been uncovered in neural stem cells, as defined operationally by the plethora of pathways that suppress neural precursor proliferation (
The strong selectivity of many agents for precursor cultures and primary medulloblastoma cells suggests that the affected pathways lie high in the hierarchical organization of the NSC lineage. Furthermore, the often complete inhibition of neurosphere proliferation and the effects on secondary replating suggests that stem cells and/or very early progenitor components of the population are affected by these agents. The finding that both inhibitors and activators of specific pathways inhibit neurosphere proliferation (e.g. dopamine receptor agonists and antagonists) suggests that a complex signaling landscape dictates NSC fate (33). It is also possible that off-target effects account for these observations in neural precursors (34).
The results of this small molecule screen have important implications for current clinical practice in the treatment of neurological diseases. The unanticipated actions of well-characterized clinical agents on the neural precursor compartment may be partly or even solely responsible for the observed clinical benefits of these agents and/or the adverse side-effects that arise after prolonged therapy. Investigation of these possibilities for various neurological disorders may enable the development of novel NSC-specific or NSC-sparing approaches in the clinic.
In light of evidence that CNS tumors are maintained by cancer stem cells (5,6), which have similarities to normal neural stem cells (18), the potent and selective anti-proliferative agents identified in this study may presage a next generation of therapeutic agents in brain cancer. That the same agents can also potently suppress primary medulloblastoma sphere cultures supports this prospect. Intriguingly, a retrospective analysis of cancer incidence in Parkinson's patients revealed a significant reduction in the prevalence of brain tumors (35); it is suggested that this correlation may derive from the effect of anti-Parkinsonian drugs on the precursor cells from which brain tumors are thought to arise. If the complex neuronal precursor ground state as proposed also defines the identity of brain tumor stem cells, redeployment of pharmacologically-approved agents may well afford a potent and non-toxic means to treat often intractable CNS tumors.
The cancer stem cell hypothesis posits that important functional analogies exist between normal neural stem cells (NSCs) and brain tumor stem cells (BTSCs). New insights into human brain tumour biology and treatment will thus likely emerge from further study of normal neural stem cells. These parallels have recently been exploited in a chemical genetic screen that identified a surprising repertoire of neurotransmission modulators that inhibit the growth of both NSC and BTSC cultures in vitro (see Example 1). Prompted by these findings, an investigation was conducted to determine whether epidemiological evidence supports a hypothesis that brain tumors might be regulated by neurotransmission pathways in vivo. Analysis of previously published retrospective studies suggests that patients with a wide variety of neuropsychiatric disorders exhibit a decrease in brain tumor incidence. This reduction may derive from the use of drugs that collaterally affect the neural stem cell compartment, and thereby limit the precursor populations that give rise to brain tumors. Standard chronic neuropharmacological interventions that have been used for decades in neuropsychiatric care are thus candidates for redeployment as low toxicity brain cancer therapeutics. This is the first application of concepts in stem cell biology to identify previously unappreciated sub-populations with reduced cancer incidence.
In adults, high grade gliomas represent at least one third of all primary brain tumors diagnosed. Even with intensive radio- and chemotherapy following surgical resection, the median survival of these patients is 9-12 months, with only 8-12% of patients surviving past 2 years [Burger, P. C., V et al Cancer 56, 1106-1111 (1985); Galanis, E. & Buckner, J. Br. J. Cancer 82, 1371-1380 (2000)]. The recent introduction of the DNA alkylating agent temozolomide, which prolongs the median survival time from 12.1 to 14.6 months [Cohen, M. H., et al., Clin. Cancer Res. 11, 6767-6771 (2005)], represents the most significant chemotherapeutic advancement in the management of gliomas in the last 30 years [Newlands, E. S., et al., Cancer Treat Rev. 23, 35-61 (1997)]. With such a grim prognosis and so few, if any, documented examples of complete remission [Stupp, R. et al. N. Engl. J. Med. 352, 987-996 (2005)], brain tumor treatment strategies must apparently shift away from traditional anti-neoplastic drug classes.
Recent evidence suggests that brain tumors are maintained by rare cancer cells with stem cell-like properties [Singh, S. K. et al. Nature 432, 396-401 (2004) and Vescovi, A. L., et al., Nat. Rev. Cancer 6, 425-436 (2006)]. Moreover, the discovery of stem cells in the postnatal brain suggests not only that normal neural stem cells (NCSs) may direct neuronal regeneration but that such cells may be the root cause of brain cancers. The inability of traditional therapeutics to eliminate rare brain tumour stem cells (BTSCs) may account for frequent therapeutic failure and uniform clinical relapse [Bao, S. et al. Nature 444, 756-760 (2006)]. The development of agents that act on BTSCs offers the prospect of more effective means to treat brain cancer. Although a number of studies suggest a role for neurotransmission pathways in NSC proliferation and/or differentiation, it is unknown if similar regulatory networks influence cancer of the brain. To substantiate this, evidence was sought that suggests that patients initially diagnosed with a variety of neuropsychiatric disorders (and hence presumed to be on chronic neuromodulatory medication) exhibited differential brain tumor incidence compared to the general population.
The analysis of historical cohorts has made it possible to identify strong correlations between many cancers and human behavior; however, the relative rarity of brain cancer and typical late-stage diagnosis hampers statistical analysis. Brain cancer is thus a disease with few known risk and preventative factors, including the potential association with extrinsic environmental modifiers such as use of neuromodulatory drugs in clinical settings. Fortunately, the differential incidence of more prevalent cancers (such as breast, skin, and lung) among neuropsychiatric patients has prompted investigation of the relationships of these co-morbidities.
Reports of brain tumor incidence in some of these studies allowed retrospective assessment of correlations between psychiatric diagnosis (and presumed neuromodulator consumption) on brain cancer risk. Published studies were identified from 2000 onwards that report patients with co-morbid neurologic or psychiatric conditions and cancer. From these, eight studies were found that reported brain cancer incidence rates following an initial neurologic or psychiatric diagnosis. In the analysis of these studies, it was assumed that patients included in the studies are on chronic neuromodulatory pharmacologic therapy. This is a valid assumption for Parkinson's disease, schizophrenia and major depression in the periods of time that the studies encompass.
Notably, Lalonde and Myslobodsky examined the association between breast cancer incidence, among 144,364 subjects previously diagnosed with Parkinson's disease (PD) [Lalonde, F. M. & Myslobodsky, M. Breast 12, 280-282 (2003)]. Within this study was the unremarked-upon correlation that PD patients experienced a 5-fold reduction (˜0.625% vs. ˜0.125%; P<0.01) in the incidence of brain tumors, as compared to a control normal population. The continuous administration of anti-Parkinsonian drugs in this cohort might have decreased NSC and/or BTSC proliferation, and thereby attenuated the cell populations that are the likely origins of cells responsible for propagating brain cancer. However, other studies that followed brain tumor incidence in patient populations presumed to be treated with psychoactive drugs revealed less conclusive correlations (See “Reported SIR” in Table 9). For example, although Lichtermann et al. [Arch. Gen. Psychiatry 58, 573-578 (2001)] also reported a reduced standardized incidence ratio (SIR) of brain tumors in schizophrenia patients (SIR=0.86), this reduction was not statistically significant. Similar non-significant reductions in brain tumor SIRs have also been noted in schizophrenic patients by others [Dalton, S. O., et al, Schizophr. Res. 75, 315-324 (2005); Goldacre, M. J., et al Br. J. Psychiatry 187, 334-338 (2005); Barak, Y., et al., Cancer 104, 2817-2821 (2005); and Grinshpoon, A., et al. 73, 333-341 (2005)]. Interestingly, other studies report an opposite and positive association between neurological diseases and brain cancer incidence [Dalton, S. O., et al. Am. J. Epidemiol. 155, 1088-1095 (2002); Olsen, J. H. et al. 92, 201-205 (2005); and Carney, C. P., et al Psychosom. Med. 66, 735-743 (2004)]. These studies, however, reveal a characteristic bimodal temporal pattern of brain tumor incidence. For example, in a study of patients with depression, although a remarkably high SIR of 3.27 for brain tumour incidence was observed within the first year following diagnosis, this value steadily decreased to 0.84 after 10 or more years from initial diagnosis (
Recent model system studies lend strong support to a BTSC neuromodulation hypothesis. Notably, the mGlu4 glutamate receptor agonist PHCCC has to be shown to attenuate medulloblastoma formation in vivo in mice [Iacovelli, L. et al. J. Neurosci. 26, 8388-8397 (2006)]. The generality of this phenomenon is suggested by the finding that a wide variety of psychoactive drugs known to act on diverse neurotransmission pathways inhibit both normal and cancerous neural precursor cell proliferation in vitro [Examples 1 and 3]. Intriguingly, the most potent anti-BTSC agents identified in these in vitro screens included the clinically prescribed dopamine agonist apomorphine [Hagell, P. & Odin, P. J. Neurosci. Nurs. 33, 21-28 (2001)] and the glutamate antagonist ifenprodil [Caillard, P., et al., Angiology 44, 552-560 (1993)]. Beyond the potential clinical implications for the long term use of neuropsychiatric agents acting on normal neural precursors, the cohort of well-tolerated neuropharmacological agents used in standard psychiatric practice offer the prospect of rapid redeployment in clinical trials for late stage brain cancers.
To profile the signaling network of primary cultures of neural precursor cells (NPCs), 1,267 compounds were screened in the library of pharmacologically active compounds (the LOPAC™ library) for inhibitors of neurosphere proliferation, as measured by incorporation of the vital dye thiazolyl blue tetrazolium bromide (MTT) (
To verify hits from the primary screen, 43 representative candidates were retested at the original screen concentration of 3 mM; of these, 40 (93%) showed significant activity (Po0.05) (Table 8). Because other neural cell types express and signal through a number of neurotransmitter receptors (42), the selectivity and potency of each agent were assessed for a normal mouse astrocyte cell line versus NPCs. Dose-response curves were generated for 28 compounds in both neurosphere and astrocyte cultures and used to determine the effective concentration needed to decrease proliferation by 50% (EC50) (
Neurospheres are comprised of a heterogeneous population of NSCs and lineage-restricted progenitor cells. To determine whether the inhibitors affected NSC self-renewal, as opposed to proliferation of more committed precursor populations, the higher order colony-forming efficiency of treated neurosphere cultures was analyzed. With the exception of dihydrocapsaicin, representative compounds from the main neurotransmission classes significantly reduced higher order neurosphere formation upon re-culture in the absence of drug (
To further delineate the mechanism through which neuromodulatory agents impede expansion of NPCs in culture, timecourse analyses were performed for both cell viability and apoptosis. Unlike etoposide (
As gene expression profiles of brain tumors resemble those of normal and embryonic NPCs (18-21), agents that inhibit normal neural precursor growth may also inhibit cultures of brain tumors that are enriched for cancer stem cells (41, 7, 18) Therefore the activity of a subset of NPC-specific inhibitors was assessed against low-passage (<4) neurosphere cultures derived from spontaneously formed medulloblastomas in heterozygous patched (Ptch1+/−) and Ptch1+/−Trp53−/− mice22. Like their normal counterparts, cancerous NPCs from these tumors grow as spheres in serum-free culture and express the neural precursor marker prominin1 (CD133) (
As even well-characterized agents may exert biological effects through off-target pathways (34), it was verified that a number of the known receptors for various agents are indeed expressed in both normal and tumor NPCs. The dopamine (DRD2), acetylcholine (M3), NMDA (NR1) and serotonin (5HT-1A) receptors were present in primary and secondary normal mouse neurosphere cultures and Ptch1+/− tumor neurosphere cultures, as determined by RT-PCR (
In one example, (±)-sulpride (34), a D2 dopamine receptor antagonist, was able to competitively rescue the inhibitory effects of the D2 and D3 dopamine receptor agonist bromocriptine (24), as judged by both colony formation (
Through a chemical genetic approach the existence of a complex functional ‘ground state’, was uncovered whereby NSC proliferation and self-renewal is regulated by numerous signaling pathways (
Though the precursor subpopulations targeted by each inhibitor identified in the screen have yet to be definitively identified, the strong selectivity of many agents for NPCs and primary brain tumor cells suggests that the affected pathways lie high in the hierarchical organization of the neuronal lineage. Indeed, the often complete inhibition of neurosphere proliferation and the effects on secondary replating suggest that stem cells and/or very early progenitor components of the population are affected by these agents. The finding that both inhibitors and activators of specific pathways inhibit neurosphere proliferation (for example, dopamine receptor agonists and antagonists) suggests that a complex signaling landscape dictates NSC fate (33). The pro-proliferative culture conditions used in the neurosphere assay may have biased the assay against identification of significant numbers of small molecules that stimulate proliferation. A small-molecule activator of embryonic stem cell proliferation has recently been identified (43), which suggests that analogous screens may succeed in identifying activators of NPC proliferation. The unanticipated actions of well-characterized clinical agents on NPCs may account in whole or in part for the observed clinical benefits of these agents and/or the adverse side effects that arise after prolonged therapy. Effective in vivo concentrations of the anti-Parkinsonian drug apomorphine reach 6-7 μM (44), which is substantially higher than doses that affect NPCs in vitro. Thus the regulation of NSC proliferation by neurotransmitters may also dictate how the CNS is wired both during development and in the adult brain (45). Recent evidence suggests that appropriate GABA stimulation of NPCs is required for the proper integration of neurons in the adult hippocampus (46). Through structure-activity analysis, we also identified specific chemical substitutions that are important for the bioactivity of these agents in our in vitro system (
In light of the evidence that CNS tumors are maintained by cancer stem cells (41,5), which have similarities to normal NSCsm (18), the potent and selective antiproliferative agents identified in this study may presage a new generation of therapeutic agents in brain cancer. Notably, a retrospective analysis of cancer incidence in individuals with Parkinson disease revealed a significant reduction in the incidence of brain tumors relative to the expected incidence in the general population (35); this correlation may derive from the effect of anti-Parkinsonian drugs on the NPCs from which brain tumors are thought to arise. As the complex NSC ground state is likely to at least in part define the identity of brain tumor stem cells, re-deployment of pharmacologically approved neuroactive agents may provide an immediate and nontoxic means to treat often intractable CNS tumors.
Primary embryonic mouse NSC isolation and culture. Isolation and culture of primary embryonic (e14.5) mouse NSCs was performed as previously described in chemically defined NSC medium (37) containing 20 ng mL−1 human recombinant epidermal growth factor (Sigma), 20 ng mL−1 basic fibroblast growth factor (Upstate) and 2 μg mL−1 heparin (Sigma). Cells were fed every 2-3 d (36).
Secondary mouse NSC neurosphere culture and chemical screens. Before chemical screens and other manipulations, the NSC fraction in culture was expanded by growing freshly dissected cells as primary neurospheres (8) in bulk culture (106 cells mL−1). After 7 d, primary neurospheres were collected and enzymatically digested for 3 min at 37° C. using the ACCUTASE™ reagent (Sigma), mechanically dissociated with a 1-mL pipette and passed through a cell strainer (Falcon). Viable cells were plated at low cell densities (20 cells μl−1) in 96-well plates (Falcon) in a final volume of 100 μL and screened in singlets against the LOPAC™ library (Sigma) at a concentration of 3 μM (0.03% DMSO). On day 4, each well in the screen was supplemented with an additional 50 mL of fresh mouse NSC medium and another aliquot of the LOPAC™ library (maintaining the final concentration of each compound at 3 μM). Secondary neurosphere cultures were then incubated for an additional 3 d (until day 7), at which point the effect of each compound was assessed by quantifying the total proliferation of each well using the incorporation of the vital dye MTT (Sigma) as previously described (4).
Statistical analysis for chemical screen. Background plate effects occurring from the evaporation of medium over the course of the experiment were estimated by:
where x′i,j is the value at well i of plate j, Nhih is the number of excluded hits or outliers that were 2 s.d. below the mean, N is the total number of plates in the screen, and bi is the estimated background at each well position (39). The respective background was then subtracted from the raw MTT value measured for each point. To calculate significance (z score and P value), the theoretical probability density function N(1.0, 0.11) was fitted to the empirical normalized distribution obtained from the screen. Compounds that caused optical density readings to significantly deviate from this predicted underlying distribution function (P<0.01) were designated as bioactive (40).
Dose-response curves and EC50 calculations. Potency of confirmed bioactive compounds was quantified by generating dose-response curves for mouse NSC under the same cell density and culture conditions described for the initial screen. Starting from initial concentrations between 300 and 30 μM, each compound was titrated across a series of ten half-log dilutions. Each agent was tested in triplicate in at least three independent experiments. EC50 values for each agent were calculated by fitting the data points to the four-parameter logistic sigmoidal dose-response curve:
where X is the logarithm of concentration and Y is the predicted response. Curve fitting was performed with GraphPad PRISMS software (GraphPad Software, Inc.).
The present invention is not to be limited in scope by the specific embodiments described herein, since such embodiments are intended as but single illustrations of one aspect of the invention and any functionally equivalent embodiments are within the scope of this invention. Indeed, various modifications of the invention in addition to those shown and described herein will become apparent to those skilled in the art from the foregoing description and accompanying drawings. Such modifications are intended to fall within the scope of the appended claims.
All publications, patents and patent applications referred to herein are incorporated by reference in their entirety to the same extent as if each individual publication, patent or patent application was specifically and individually indicated to be incorporated by reference in its entirety. All publications, patents and patent applications mentioned herein are incorporated herein by reference for the purpose of describing and disclosing the methods etc. which are reported therein which might be used in connection with the invention. Nothing herein is to be construed as an admission that the invention is not entitled to antedate such disclosure by virtue of prior invention.
13¥
†Includes all classes with a “% Active in Class” of at least 10%.
‡Only includes inhibitors
§Includes: antibiotics, apoptosis, cell cycle, cell stress, cytoskeleton, and DNA
¥Frequency of whole screen
aCompounds listed represent confirmed hits with high selectivity for NPCs (neurosphere selectivity >5).
bPtch1+/− and Ptch1+/− Trp53−/− neurosphere cultures were derived from mouse cerebeller tumor samples.
†Only includes inhibitors of MTT readings.
‡Frequency of whole screen
§Total calculated without cytotoxic compounds: antibiotics, apoptosis, cell cycle, cell stress, cytoskeleton, and DNA
†Qualifying brain cancer cases have been modified as noted by authors to only include cases more than 2 years after mental disorder diagnosis.
Excludes data from Lalonde et al (2003). Although supportive, the large sample size in this study would significantly skew the results of the analysis.
Excludes data from Carney et al (2004) as authors did not reanalyze their data following the observed temporal discrepancy in their brain tumor SIR.
10Lalonde, F. M. & Myslobodsky, M. Breast 12, 280-282 (2003).
11Lichtermann, D., Arch. Gen. Psychiatry 58, 573-578 (2001).
12Dalton, S. O., et al, Schizophr. Res. 75, 315-324 (2005).
13Goldacre, M. J., et al Br. J. Psychiatry 187, 334-338 (2005).
14Barak, Y., et al., Cancer 104, 2817-2821 (2005).
15Grinshpoon, A. et al. 73, 333-341 (2005).
16Dalton, S. O., et al. Am. J. Epidemiol. 155, 1088-1095 (2002).
17Olsen, J. H. et al. 92, 201-205 (2005).
18Carney, C. P., et al Psychosom. Med. 66, 735-743 (2004).
†Only a selected array of the identified mouse neural precursor selective agents were tested in human cells. All agents tested are displayed in this table.
¶Values against neural precursors derived from human fetal CNS tissue.
≠Pathological diagnosis of hGBM1 was WHO grade IV GMB
§Pathological diagnosis of hGBM2 was WHO grade IV GBM (giant cell variant).
-(1S,2R)-
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hydrochloride
fumarate
citrate
hydrochloride
hydrochloride
hydrochloride
benamide
dihydrochloride
hydrochloride
hydrochloride
E−01
4E−01
470E−03
axane sodium
E−02
E−02
E−02
E−01
E−03
hydrohloride
27E−21
hydrobromide
E−05
E−02
E−20
E−30
E−01
hydrochloride
E−01
bromide 1(S)
hydrochloride
E−
hydrochloride
hydrochloride
acid
acid
AG 1478
sensitive
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hydrochloride
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hydrochloride
hydrochloride
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sodium and hydrate
hydrochloride
hydrochloride
hydrochloride
dihydrochloride hydrate
synthatase
Topoll
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chloride
hydrochloride
5385
acid
hydrochloride
diphosphate-trisodium
4-[2-4phyenlsulfinylamino)ethylthio]phenoxyacetamide
E−01
E−01
E−01
nosine
E−01
E−01
hydrochloride
hydrochloride
phenyl]spiperone hydrochloride
chloride
amine hydrochloride
linesterase
-hydrochloride
din
hydrochloride
hydrochloride
acid
sesquifumarate salt
hydro
hydrochloride
dac
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hydrochloride
7E−01
hydrochloride
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maleate
hydrochloride
disulfide
pramine maleate
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hydrochloride
tine
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hydrochloride
from Penicillium funicolosum
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-ATPase
mide
triphosphate tetrasodium
hydrochloride
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hydrochloride
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menthane
pld
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ridic Acid
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indole di-trifluoroacetate
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acid
roine hydrochloride
2
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nolinylsulfonyl)-3-me
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77
indicates data missing or illegible when filed
Cancer Cell 9, 391-403 (2006).
| Number | Date | Country | |
|---|---|---|---|
| 60851615 | Oct 2006 | US |
