Patent Application
20060160781
The present invention relates to preparation of new corticoid compounds.
In particular it relates to steroid-structured compounds having anti-inflammatory, immmunodepressive and angiostatic activities (the so-called steroid anti-inflammatory drugs).
The compounds according to the present invention are therapeutically useful in the treatment of pathologic conditions where generally corticosteroid (corticoids) preparations are used, but with increased benefits.
This represents an unexpected advantage over the known corticoids products. In fact, by taking into account the various defined therapeutic uses of a specific product, it is always possible, with the new products of the present invention, to find a better combination of results with respect to the known corticoids. Contrary to any expectation the products of the present invention are characterised by the fact that they show an improved therapeutic profile: high activity combined with low side-effects.
Corticoids are well known as a first-choice pharmacological measure in the treatment of inflammatory disease. Drugs in this category - which include, for example, hydrocortisone, cortisone, prednisolone, prednisone, fludrocortisone, desoxycorticosterone, methylprednisolone, triamcinolone, paramethasone, betametasone, dexamethasone, triamcinolone acetonide, fluocinolone acetonide, beclomethasone, acetoxypregnelone, etc.—have marked pharmacotoxicological effects on various organs. Because of this, the clinical use and discontinued use thereof cause a series of side effects, some of which are very severe. See for example Goodman & Gilman: “The Pharmaceutical Basis of Therapeutics”, 9th Ed., pages 1459-1465, 1996.
These toxic effects include:
those on bone which lead to changed cell metabolism and a high frequency of osteoporosis;
those on the cardiovascular system which cause hypertensive reactions;
those on the gastrointestinal tract which cause gastric damage. See for instance Martindale: “The Extrapharmacopoeia”, 30th Ed., pages 712-723, 1993.
According to the above mentioned art it appears to be almost impossible for therapeutic activities to be separated from side effects, see Goodman et al., as mentioned above, at page 1474.
Known in the art are non-steroid anti-inflammatory drugs either with or without acidic ending, see patents WO 94/04484, WO 94/12463, WO 95/09831, WO 95/30641 for non-acidic ending and the patents therein mentioned for those with acidic ending.
However, it should be noted that steroid compounds are completely different from non-steroid compounds chemically, pharmacologically and biochemically as the pharmaco-toxicological mechanism of action of non-steroid products is based on inhibition of one or more cyclo-oxygenases (COX), while steroid produces have nothing to share with COX and have more complex pharmaco-toxicological mechanisms of action which have not yet been fully explained.
It is well known that these two groups of compounds are listed in completely separate categories in international pharmacopoeias.
The applicant has surprisingly and unexpectedly found corticosteroids (corticoids) which are very effective, even superior to those in the known art, and have, at the same time, a higher tolerance than the known corticoids as unexpectedly they do not cause the above side effects, or when they do, these are lower.
An object of the present invention are corticosteroids and their use as anti-inflammatory, immunosuppressive and angiostatic agents having the general formula:
B—X1—NO2
or their esters or salts, where:
The compounds which can be mentioned, and which are those preferred, are the ones listed below where B can be obtained according to the known processes of the art.
For example, the precursors and related processes described for example in The Merck Index, 12th Ed. of 1996, herein incorporated by reference, can be mentioned as precursors and related processes. The precursors (according to the Merck nomenclature) include the following, where H2, H, R, R′, R″ have the meaning as defined in the compounds listed below: budesonide, hydrocortisone, alclometasone, algestone, beclomethasone, betamethasone, chloroprednisone, clobetasol, clobetasone, clocortolone, cloprednol, cortisone, corticosterone, deflazacort, desonide, desoximetasone, dexamethasone, diflorasone, diflucortolone, difluprednate, fluazacort, flucloronide, flumethasone, flunisolide, fluacinolone acetonide, fluocinonide, fluocortyn butyl, fluocortolone, fluorometholone, fluperolone acetate, fluprednidene acetate, fluprednisolone, flurandrenolide, formocortal, halcinonide, halobetasol propionate, halometasone, halopredone acetate, hydrocortamate, loteprednol etabonate, medrysone, meprednisone, methylprednisolone, mometasone furoate, parametasone, prednicarbate, prednisolone, prednisolone 25-diethylaminoacetate, prednisolone sodium phosphate, prednisone, prednival, prednylidene, rimexclone, triamcinolone, triamcinolone acetonide, 21-acetoxypregnenolone, cortivazol, amcinonide, fluticasone proprionate, mazipredone, tixocortol, triamcinolone hexacetonide.
The X1 connecting bridges as above defined are obtainable by using the methods known in the art as indicated above or by modifing the known methods by introducing X1 bridges when these are different from the connecting bridges described in the listed patents, using processes known in the art. Generally the connection between B and X1 is, as seen, of an ester or amide type (NH or NR1C, as defined in X). Any well known synthetic route for forming these bonds can be used to form this connection.
In the case of esters, the most direct synthethic route includes:
The reaction products of formula B—CO—O—Y—Cl(Br,I) can also be obtained by reacting the sodium or potassium salts of salts acids B—CO—OH with dihalogen derivatives of the general formula YaCl2,YaBra or YaI2, ClYaBr, ClYaI, BrYaI.
The reaction products are converted into the final products by reacting with AgNO3 in acetonitrile according to what is known in the literature.
The general scheme is as follows:
The general scheme may also be as follows:
In this case of amide, the synthetic sequence includes reaction of the same acyl chlorides BCOCl with aminoalcohols of the general formula NH2—Ya—OH, NHR1C—Ya—OH to give amides of the general formula:
B—CO—NH—Ya—OH and B—CO—NR1C—Ya—OH
according to known methods.
Reaction of these amides with halogenating agents such as, for example PCls, PBr3, SOCl2, etc., gives the halogen derivatives of the general formula:
B—CO—NH—Ya—Br(Cl) and B—CO—NR1C—Ya—Br(Cl)
The latter give the final products BX1NO2 by reacting with AgNO3 in acetonitrile according to methods known in the literature.
The sequence may be represented as: PCls
An alternative route to ester formation is reaction of the sodium or potassium salts of the acids with the nitric esters of halogen alcohols of the general formula:
NO2—O—Ya—Cl(Br,I)
to directly give the products of the invention.
The reaction scheme is as follows:
Other synthetic routes similar to those described above include those in which the dihalogen derivative Br2Ya is reacted with enolates. The reaction products are then converted by reacting with AgNO3 in acetonitrile according to the above reaction. The general scheme is shown for an —OH in group B, of the type —CH2—OH, ═CH—OH, is as follows:
The processes to obtain these X1 connecting groups are described in patent application WO95/30641 herein incorporated by reference.
As said above the compounds of the invention of formula B—X1—NO2 or their pharmaceutical compositions, are used for the treatment of diseases in which the well known corticoids products are employed.
In particular, it can be specifically mentioned the use in respiratory disorders, e.g. antiasthmatic, the use as antiarthritic, antipruritic, antipsoriatic, antieczematic; the use in vascular disorders, e.g. as angiostatic, the use in immunology disorders, e.g. as immunosoppressive.
The compounds, or their compositions, of the present invention can be administered for example by oral, rectal (intestinal disorders), parenteral route or by local (dermal, topical, transdermal, ocular, inhalatory, etc.) application.
The following examples are given only for illustrative purpose as an explanation but not as a limitation of the present invention.
Chemical Synthesis: Preparation of Hydrocortisone Nitroderivative (HCN)
Preparation of Hydrocortisone (4-Chloro)Butanoate
4 portions of 4-chlorobutanoylchloride (0.32 ml×4) and triethylamine (0.3 g×4) were added in 24 hours to a solution of hydrocortisone (1 g) in CHCl3 dried over P2O5, and stirred for 3 days. The solution was treated with water, the organic phase was separated, dried (Na2SO4) and deprived of the solvent at reduced pressure. The crude residue was ground with hexane and CCl2 to give a white solid with a 53% yield by weight, which had a melting point (m.p.) of 155° C.
The product was characterised by mass spectometry:
AgNO3 (0.2 g) was added to a solution of hydrocortisone-4-chlorobutanoate prepared as above (0.23 g) in acetonitrile (70 ml) and refluxed for 16 hours. The solution was deprived of the solvent at reduced pressure and chromatographed on silica gel using a solution of ethyl acetate and CH2Cl2 (3:7) as an eluant.
Cortisone 4-nitroxybutanoate was recovered from the head fractions.
The product was characterised by 1H NMR (300 MHz CDCL3): 0,95 (3H, s, CH3), 1.45 (3H, s, CH3), 2.12 (2H, t, CH2 in 2), 2.6 (2H, t, CH2COO), 4.45 (1H, m, CHOH), 4.45 (2H, t, CH2O-NO2), 4.35 and 5.05 (2H, 2d, COCH2O), 5.68 (1H, s, olefin H).
The product from Example 1A was also prepared using another synthetic route.
Preparation of Hydrocortisone 4-Bromobutanoate
Five portions of 4-bromobutanoylchloride (0.35 ml×5) and potassium carbonate (0.4 g×x 5) were added in 24 hours to a solution of hydrocortisone (1 g) in CHCI3 dried over P2O5 and stirred for 5 days. The solution was treated with water, the organic phase was separated, dried (Na2SO4) and deprived of the solvent at reduced pressure.
Preparation of Hydrocortisone 4-Nitroxybutanoate (HCN)
AgNO3 (0.2 g) was added to a solution of hydrocortisone 4-bromobutanoate prepared as above (0.23 g) in acetonitrile (70 ml) and stirred for 48-hours at room temperature.
The solution was deprived of the solvent at reduced pressure and chromatographed on silica gel using a solution of ethyl acetate and CH2Cl2 (3:7) as an eluant.
Cortisone 4-nitroxybutanoate was recovered from the head fractions and characterised by mass spectometry: M+ 493. The spectrum was the same as that shown in Example 1A.
Evaluation of Safety and Activity
The products were administered in a 2%-by-weight carboxymethyl cellulose suspension during in vivo tests, while a 0.1%-by-weight dimethylsulphoxide suspension was used for in vitro studies.
The test groups always included 8 samples (except when differently stated in the examples) for adequate statistical evaluation, to be carried out when necessary according to common statistical procedures.
Acute Toxicity Study
The acute toxicity of the product from Example 1A was roughly evaluated by orally administering a single dose of substance to a group of 10 mice of the Swiss strain.
Death incidence and appearance of toxic symptoms were observed during a period of 14 days after the compound administration.
The animals showed no sign of apparent toxicity even after administration of a 50 mg/kg dose.
Study of Antiarthritic Activity
Adjuvant arthritis was induced in male rats of Lewis strain, weighing 170±15 g by intracaudal injection of 0.6 mg of Mycobacterium butyricum (Difco) suspended in 0.1 ml of mineral oil. The animals were treated with a vehicle made up of an intraperitoneal (i.p.) 2%-by-weight suspension of carboxymethyl cellulose in water, with intraperitoneal hydrocortisone of HCN (a suspension as described above) at doses of 5 mg/kg or doses of 10 mg/kg, starting from the first day after mycobacterium inoculation.
Arthritis development was assessed 21 days later. To the arthritic lesions an arbitrary score was assigned according to the following scale:
hind limbs: 0 to 7 for each (0 for no lesions and 7 for most severe lesions);
forelimbs: 0 to 4.5 for each (0 for no lesions and 4.5 for most severe lesions);
tail: 0 to 5 (0 for no lesions and 5 for most severe lesions);
ears: 0 to 2 for each (0 for no lesions and 2 for most severe lesions);
nose and eyes: 0 to 1 ofr each (0 for no lesions and 1 for most severe lesions).
The results were expressed as a percentage of inhibition compared to the value obtained in the control group (animals treated withe the vehicle alone).
The result are shown in Table 1.
As shown by the results in Table 1, the test products were capable of similarly inhibiting development of the arthritic process caused by mycobacterium. However, being the tolerability of HCN much higher than that of hydrocortisone (see ex 2C below), the results in terms of activity are much better in the case of HCN (see for comparison 40% of antiarthitic activity obtained with 5 mg/kg hydrocortisone with respect to 62% obtained with 10 mg/kg HCN).
Study of Gastric Tolerability Safety)
Male Sprague-Dawley rats fasted for 24 hours were treated with 5 to 10 mg/kg of intraperitoneal hydrocortisone or HRC.
Twenty-four hours later the animals were sacrified, the stomach was removed and tissue was grossly examined for the presence of lesions as described by Del Soldato et al.: “The influence of fasting and cimetidine on the relationship between ulcerogenic and anti-inflammatory properties of cimetidine”, Br. J. Pharmacol. 67, 33-37, 1979. The degree of severity of the disease was evaluated according to common methods and expressed as arbitrary values. The results are shown in Table 2.
Data are expressed as arbitrary values according to the following scale: 0 = absent; 1 = mild lesions; 2 = moderate lesions; 3 = punctiform ulcers; 4 = severe ad numerous ulcers.
*P < 0.05 (where P is probability) compared to corresponding value in group treated with hydrocortisone.
As shown in Table 2, the rats treated with hydrocortisone exhibited a marked disease in the gastrointestinal tract, varying in severity from mucosal erosion to ulcer involving the muscle layer, wall adhesions, ascites, peritonitis. In the other groups treated with the vehicle alone or HCN, the damage was much lower or even absent.
Study of Nitroxysynthetase Activity
The nitroxy-sinthetase inhibiting activity induced by lipopolysaccharide (LPS) was determined in rat neutrophils and stomach after administration of one of the test compounds and compared with that obtained after treatment with the suspending vehicle only. Wistar rats fasted for 24 hours before treatment received one of the test compounds intraperitoneally (10 mg/kg) or LPS intravenously (caudal vein) (5 mg/kg). Four hours later the animals were sacrificed. Blood for neutrophil isolation and stomach were removed.
Enzymatic activity was determined according to the method described by Assreuy et al.: “Feedback inhibition of nitric oxide synthase activity by nitric oxide”, Br. J. Pharmacol. 108, 833-7, 1993. The results-are shown in Table 3.
aper cent inhibition compared to group treated with vehicle alone
*p < 0.05 compared to corresponding value in group treated with vehicle.
As shown by Table 3, both test products proved to be very effective in inhibiting nitroxysynthetase compared to the group treated with the vehicle alone.
Study of Bone Toxicity
Bone tissues (parietal bone from rat foetus) grown in vitro according to the method described by Doherty et al. (“The effect of glucocorticoids on osteoblast function. The effect of corticosterone on osteoblast, expression of beta-I integrins”, Journal of Bone and Joint Surgery, Series A77/3, 396-404, 1995) was used. Hydrocortisone or HCN or the vehicle were incubated at concentrations of 100 nmol.
Ninety six hours later calcium content and bone dry weight were measured.
The results are shown in Table 4.
°Compared to initial value (incubation time zero)
*P < 0.05 compared to values obtained in control group (vehicle)
As shown in Table 4, a significant increase in tissue dry weight and increased calcium were observed after incubation with the vehicle or HCN. After incubation with hydrocortisone, the calcium content decreased and the bone dry weight did not increase. This shows that this treatment with hydrocortisone adversely affected bone growth.
Study of Some Cardiovascular Parameters
The effect of the test products on some cardiovascular parameters was studied in conscious Long Evans rats (350 to 450 g) which were appropriately monitored, as described by Gardiner et al.: “Influence of dexamethasone on the regional haemodynamic responses to lipopolysaccharide in conscious rats: effect of the non-selective endothelin antagonist: SB 209670”, Br. J. Pharmacology 117, 49P, 1996. The animals were treated with the vehicle (physiologic saline solution, 0.9% sodium chloride, s.c.) subcutaneous hydrocortisone or HCN (10 mg/kg). Heart rate and blood pressure were recorded 4 hours after treatment.
Table 5 shows the data obtained as per-cent variation from control values.
*P < 0.05 compared to group treated with vehicle
aper-cent change compared to value recorded in group treated with vehicle alone (324 ± 7 beats per minute)
bper-cent change compared to value recorded in group treated with vehicle alone (101 ± 2 mm Hg)
The results in Table 5 show that the product of the invention HCN does not affect the cardiovascular parameters measured. On the contrary, hydrocortisone used in the known art shows significant pressure as well as cardiac changes.
Study of Anciostatic Activity in Rats
Male Wistar rats weighing 180 to 200 g were used according to the procedure described by Andrade et al.: “Quantitative in vivo studies on angiogenesis in a rat sponge model”, Brit. J. Exp. Pathol. 68, 755-766, 1987. The neovascularisation was evaluated in relation to blood flow by implanting a small sponge in the subcutaneous tissue for 14 days and determining 133Xe clearance. Briefly, an amount of 133Xe equal to 10 μl was injected into the sponge using a small polyethylene cannula. The residual radioactivity from implantation using a gamma ray detector and the 133Xe clearance for 6 minutes was measured as a percentage of the initial value. The validity of this method for measuring neovascularisation was recently demonstrated by HU et as.: “Correlation of 133Xe clearance, blood flow and histology in the rat sponge model for angionenesis. Further studies with angiogenic modifiers”, Lab. Invest. 72, 601-610, 1995.
The test compounds were administered by the subcutaneous route at a dose of 10 mg/kg from day 1 to day 13 after implantation. 133Xe was measured at day 14 from subcutaneous implantation, the animals were then sacrificed and the weights of thymus and spleen were recorded.
Table 6 shows the data obtained regarding the effect of the test products on neovascularisation and on the weight of spleen and thymus.
*P < 0.05 compared to values obtained in control group (vehicle)
As evident, HCN proved to be capable of exerting a marked angiostatic effect without changing the weight of spleen or thymus, differently from the reference product.
As it is clear from the whole of the data shown in Tables 1 to 6, the pharmacodynamic activity—anti-arthritic, immunosuppressive and antiangiogenic activities—and tolerability of the nitroderivative are superior than those of the corticoid from the known art.
Dexamethasone 21-(4-Bromobutyrate) [II]
The solution of compound I in tetrahydrofuran is portionwise treated with 4-bromobutyryl chloride (0.81 ml×5) and potassium carbonate (0.98 g×5) during 7 hours. The mixture is stirred overnight, the solvent is evaporated under vacuum and the residue is treated with ethyl ether and water. The organic layer is separated, washed with water and dried with anhydrous sodium sulfate. After evaporation of the solvent, the residue is purified by silica gel flash column chromatography eluting with t.butyl methyl ether-hexane 1-1 to give:
Dexamethasone 21-(4-nitrooxybutyrate) [III] (Compound DXN)
The mixture of compound II and silver nitrate in acetonitrile is refluxed for 7 hours. After filtration of inorganic salts, the solvent is evaporated under vacuum and the residue is treated with ethyl ether-. The organic layer is twice washed with water, dried with anhydrous sodium sulfate and evaporated under vacuum. The residue is poured into ethyl ether and filtered to give 1.27 g of pure compound III as a white solid (m.p. 183-185° C.; yield 90%)
synthetic scheme;
NCX 1005 batch 1;
NCX 1005/1 analysis.
Study of the Activity on Leucocyte Accumulation
Male Swiss albino mice (27-33 g) maintained on a standard chow pellet diet and tap water ad libitum were used. The experiment was done as previously described by Perretti et al. (Perretti M., Solito E., Parente L., “Evidence that endogenous interleukin-1 is involved in neutrophil migration in acute experimental inflammation in rats and mice”, Agents Actions, 35, 71, 1992). Animals were pretreated with zymosan (1 mg/0.5 ml) i.p. at time 0. Two hours later DEXAMETHASONE (1 mg/kg) (Ex3-I), DXN (Ex3-III) (1 mg/kg) or phosphate buffered saline (PBS) was given intravenously. The animals were sacrificed at 4 and 24h the lavage fluids were collected and differential cell counts were performed following staining in Turk's.
Table 7 reports results obtained on the inhibitory effect of the tested compounds on zymosan-induced leucocyte migration in mice. As can be observed the nitroderivative steroid is much more active than dexamethasone.
Study of the Anti-Proliferative Activity in Human Airway Smooth Muscle Cells
Human airway smooth muscle cells were cultured by standard explant methods. Tissues were collected into sterile pots containing PBS and penicillin and streptomycin. Under sterile tissue culture conditions, tissues were cut into small pieces (approximately 1 mg weight) and placed into standard medium containing 20% fetal calf serum (FCS) for several days (medium changed every 2-4 days). 3H-thymidine was measured in the DNA fraction of cells cultured into 48 well plates. Cells were cultured to confluence in the medium containing 10% FCS. Cells were deprived of serum for 24h before the addition of 10% FCS, together with different concentration of steroids. After 24h, 3H-thymidine was added to the cells for 4h. Cells were washed with phosphate buffered saline and ethanol. The DNA was extracted with sodium hydroxide solution and the 3H material counted by scintillation. The data represent observations made in triplicate wells from smooth muscle cultured from one healthy lung donor. Table 8 reports results obtained on the inhibitory effect of the tested compounds on human airway smooth cell proliferation. As can be observed the nitroderivative steroid is much more active than dexamethasone.
As can be observed from results reported above, both activity and safety of the new nitroderivatives are better than those owned by the precursor steroids.
| Number | Date | Country | Kind |
|---|---|---|---|
| MI96A002048 | Oct 1996 | IT | national |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 10462637 | Jun 2003 | US |
| Child | 11374315 | Mar 2006 | US |
| Parent | 09269729 | Apr 1999 | US |
| Child | 10462637 | Jun 2003 | US |
