Patent Application
20160326098
The present invention relates to a medicinally active compound of formula (I) and its use as anti-inflammatory agent. Further, the present invention relates to a method for the preparation of the compound of formula (I) as well as to a pharmaceutical composition comprising a compound of formula (I).
Tumor necrosis factor alpha (TNF-α) is an adipokine involved in systematic inflammation and is a member of a group of cytokines that stimulate the acute phase reaction. It is produced chiefly by activated macrophages (M1), although it can be produced by many other cell types such as CD4+ lymphocytes, NK cells and neurons.
The primary role of TNF-α is in the regulation of immune cells. TNF-α, being an endogenous pyrogen, is able to induce fever, apoptotic cell death, cachexia, inflammation and to inhibit tumorigenesis and viral replication and respond to sepsis via IL1IL6 producing cells. Dysregulation of TNF-α production has been implicated in a variety of human diseases including Alzheimer's disease, cancer, major depression and inflammatory bowel disease (IBD). While still controversial, studies of depression and IBD are currently being linked by TNF-α levels. Recombinant TNF-α can be produced ectopically in the setting of malignancy and parallels parathyroid hormone both in causing secondary hypercalcemia and in the cancers with which excessive production is associated.
Therefore, in order to provide effective treatment of the above mentioned diseases there is a high demand for TNF-α inhibitors. A TNF-α inhibitor is a pharmaceutical drug that suppresses response to TNF-α. Inhibition of TNF-α can, for example, be achieved with a monoclonal antibody or with a circulating receptor fusion protein such as etanercept.
Etanercept, which is commonly known under its trade name of Enbrel® is made from the combination of two naturally occurring soluble human 75-kDa TNF reactors linked to an Fc portion of an IgG1. The effect is an artificially engineered dimeric fusion protein. In the USA the FDA has licensed Enbrel® for moderate to severe rheumatoid arthritis, moderate to severe polyarticular juvenile idiopathic arthritis (JIA), psoriatic arthritis, ankylosing spondylitis (AS) and moderate to severe plaque psoriasis. However, patients treated with Enbrel® also suffered severe side effects, including infections or worsening of infections the patient already had; reactivation of hepatitis B; nervous system problems, such as multiple sclerosis, seizures or inflammation of the nerves of the eyes; blood problems; heart failure; psoriasis; allergic reactions; and autoimmune reactions, including lupus-like syndrome and autoimmune hepatitis.
Inflixinnab, commonly known under its trade name Remicade®, is a TNF-α inhibitor that is approved for the treatment of psoriasis, Crohn's disease, ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis and ulcerative colitis in the US. Remicade® is an artificial antibody which was originally developed in mice as a mouse antibody. Because humans have immune reactions to mouse proteins, the mouse common domains were replaced with similar human antibody domains. Due to the combination of mouse and human antibody amino acid sequences, it is called a chimeric monoclonal antibody. However, Infliximab has adverse effects common to drugs in the class of immunosuppressants, including serious and sometimes fatal blood disorders; serious infections; lymphoma and solid tissue cancers; serious liver injury; reactivation of hepatitis B; reactivation of tuberculosis; lethal hepatosplenic T-cell lymphoma; drug-induced lupus; demyelinating central nervous system disorders; psoriasis and psoriasiform skin lesions and new-onset vitiligo.
Due to the fact that the known TNF-α inhibitors presently on the market are accompanied by severe adverse effects, in part due to the fact that they are proteins, as well as due to their high costs, there is still a high demand for TNF-α inhibitors that do not suffer the above-mentioned draw backs and that are able to overcome the disadvantages of the known antibody TNF-α inhibitors.
U.S. Pat. No. 5,506,224 describes N-acyl-derivatives of hydroxyamines suitable for the therapeutic treatment of pathologies characterized by degranulation of mast cells caused by a neurogenic and/or immunogenic hyperstimulation. However, administration of the compounds disclosed therein may be accompanied by an increase of the nitrite/nitrate level in the blood which is considered disadvantageous.
It is therefore an object of the present invention to provide a medicinally active compound, preferably an anti-inflammatory agent that acts as a TNF-α inhibitor as well as a pharmaceutical composition comprising the same for use in the treatment of inflammatory processes, especially inflammatory bowel diseases.
It is a further object of the present invention to provide a medicinally active compound the administration of which does not lead to the drawbacks of the prior art, in particular the drawbacks associated with nitrite/nitrate level in the blood of the patient.
The object of the present invention is solved by the provision of a compound of formula (I) which surprisingly shows activity in the treatment of inflammatory processes.
One object of the present invention is therefore a compound of formula (I):
Without being bound by theory, it is believed that the absence of hydrogen atoms at the alpha-carbon increases the chemical and biological stability of the compound of formula (I) while the increased number of hydroxyl groups leads to an increased water solubility and increased tendency to crystallization which is advantageous in the manufacturing of the compound according to the invention. Further, it is believed that the amide link is more stable due to steric hindrance, e.g. in comparison to commonly known ethanolamine derivatives described in the state of the art.
As is known to the person skilled in the art, the administration of drugs in the treatment of inflammatory process, e.g. acetylsalicylic acid (ASS), may lead to an increase in the nitrite/nitrate level in the blood of the patient. However, nitrites are known to be toxic as they hinder the transport of oxygen in the blood by affecting the hemoglobin. Further, nitrites may act as donors of nitric oxide which in turn may lead to a relaxation of the smooth muscles and vasodilation with the consequence of a vast drop in blood pressure, circulatory collapse and even shock. It was now surprisingly found that administration of the compound according to the invention did not cause the expected increase of the nitrite/nitrate level experienced in conjunction with other drugs such as ASS. Rather, almost no increase in the nitrite/nitrate level could be detected in animals treated with the compound according to the invention in comparison to untreated control animals.
In a preferred embodiment of the present invention the compound of formula (I) is present as a salt. Preferably, the counter ion is a pharmaceutically acceptable counter ion of organic or inorganic nature, such as acetate, palmitate, citrate, sulfate, carbonate and hydrochloride.
Preferably the compound of formula (I) is for use in the treatment and/or prophylaxis of diseases associated with inflammatory processes of the human or animal body, in particular diseases selected from the group consisting of inflammatory bowel disease, psoriasis, Crohn's disease, ankylosing spondylitis, arthritis, especially psoriatic arthritis and rheumatoid arthritis, and ulcerative colitis.
It was surprisingly found that the compound of formula (I) possess a high medicinal activity, especially when employed in the treatment of inflammatory processes. A further object of the present invention is therefore an anti-inflammatory agent of a compound of formula (I) as defined in the present invention.
As there is still a high demand for effective and affordable drugs, another object of the present invention is a pharmaceutical composition comprising a compound of formula (I)
In a further preferred embodiment the pharmaceutical composition according to the invention comprises a compound of formula (I) or a pharmaceutical acceptable salt thereof.
Preferably the pharmaceutical composition according to the invention comprises the compound of formula (I), or a pharmaceutical acceptable salt thereof, in a pharmaceutically effective amount, preferably ranging from 0.001 to 10% by weight, based on the total weight of the pharmaceutical composition. Preferably the amount of the compound of formula (I), or a pharmaceutical acceptable salt thereof, is high enough to be pharmaceutically effective.
A surprising activity of the pharmaceutical composition according to the invention in the inhibition of TNF-α has been found. An increase of TNF-α is associated with inflammatory processes, especially inflammatory diseases, such as psoriasis, arthritis and inflammatory bowel diseases.
Further, it has surprisingly been found that the compound of the invention reduces the peroxidase activity which is an advantage compared to other acetyl salicyl acid derivatives such as O-acetylsalicyl derivatives selected from the group consisting of O-acetylsalicyl amino carbohydrates, O-acetylsalicyl amino acids and O-acetylsalicyl peptides.
Additionally, it has surprisingly been found that the compound of the invention reduces the concentration of the high-mobility group protein B1 in the plasma which makes this compound an interesting candidate in the treatment of age-related diseases. The compound of the present invention positively influences the redox balance.
Therefore, in a further embodiment of the present invention the compound of the present invention can be used in the treatment or prophylaxis of pathological aging, in particular selected from obesity, sarcopenia, metabolic syndrome, dementia, cancer, atherosclerosis and osteoporosis.
A further aspect of the invention is an embodiment wherein the pharmaceutical composition is for use in the treatment and prophylaxis of inflammation. Preferably the pharmaceutical composition is for use in the treatment of mammals. Further preferred is an embodiment wherein the pharmaceutical composition according to the invention is used in the treatment of pain and fever.
Any medicinally active compound or composition has to be used with all due care, in particular overdoses are to be avoided under all circumstances. Therefore, the pharmaceutical composition is preferably administered in a dosage ranging from 0.001 to 0.3 g per kg body weight and day. Further preferred is an embodiment wherein the pharmaceutical composition for use in the treatment and prophylaxis of inflammation is administered in a dosage ranging from 0.001 to 0.3 g per kg bodyweight and day.
In specific embodiments the dosage may vary depending on the condition of the patient and the disease to be treated. A further preferred dosage is ranging from 0.005 to 0.15, more preferably 0.01 to 0.1 or 0.05 to 0.5 g per kg body weight and day.
In particular, an embodiment of the present invention is preferred wherein the pharmaceutical composition according to the invention is for use in the treatment or prophylaxis of diseases selected from the group consisting of
Further preferred is an embodiment of the pharmaceutical composition according to the invention for use in the treatment or prophylaxis of inflammatory bowel diseases.
Any drug administered to a mammal, especially a human, suffering from diseases, should have high bioavailability in order to guarantee a treatment as effective and fast as possible. At the same time, the stress and inconveniences suffered by the sick person should be kept to a minimum.
Therefore, in a preferred embodiment, the pharmaceutical composition according to the invention is administered orally and/or parenterally. In an alternative preferred embodiment, the pharmaceutical composition according to the invention is applied topically to the patient, preferably in the form of an oil-in-water emulsion or a water-in-oil emulsion. In a still alternatively preferred embodiment the pharmaceutical composition for use according to the invention is administered in the form of tablets or capsules.
The compound of the present invention may also be combined with other medicinally active ingredients. In a further embodiment the pharmaceutical composition of the present invention may be formulated as solution, gel, lotion, cream, ointment, shampoo, spray, stick, powder, mouth rinse or wash, vaginal gel or preparation, or other form acceptable for use on skin, nail, hair, oral mucosa, vaginal mucosa, mouth or gums.
In a preferred embodiment the pharmaceutical composition according to the invention is for use in the treatment of age related diseases, in particular age relates diseases of the skin. In a further preferred embodiment the pharmaceutical composition is present in the form of an ointment to be applied topically to the skin.
A further object of the present invention is an ointment comprising the compound of formula (I). In a preferred embodiment the ointment comprising the compound of formula (I) is for use in the treatment of age related diseases of the skin. Preferably the ointment according to the invention is administered topically.
The pharmaceutical composition may be administered topically, orally, parenterally. Preferably, the composition is administered by injection, infusion or oral intake.
Arthritis is a form of joint disorder that involves inflammation of one or more joints. The major complaint by individuals who have arthritis is joint pain. The pain stemming from arthritis is due, among others, to inflammation that occurs around the joint. It was surprisingly found that the compound according to the invention lessens the symptoms and signs associated with arthritis. Therefore, in a further preferred embodiment of the present invention the compound of formula (I) is for use in the treatment of arthritis. Also in another embodiment of the present invention, the pharmaceutical composition according to the invention is for use in the treatment of arthritis.
The pharmaceutical composition according to the invention may additionally comprise further components. The nature of these additional components may depend on the form of administration that is used to administer the pharmaceutical composition according to the invention to the patient. These components may be galenic additives known to the person skilled in the art, such as tonicity agents, pharmaceutically acceptable solvents, disingrediants, lubricants, glidants, solubilizers, stabilizers, buffers, tonicity modifiers, bulking agents, viscosity enhancer/reducers, surfactants, chelating agents, adjuvants and the like. The pharmaceutical composition according to the invention may, e.g. comprise one or more filler, such as glucose, mannitol or sorbitol, one or more binders, such as MCC (microcrystalline cellulose), starch, cellulose ether or gelatin, and/or one or more exploder such as potato starch, corn starch, polyvinyl pyrrolidone (PVP), carbopol and magnesia peroxide. Further, the pharmaceutical composition according to the invention may comprise. The additives of the pharmaceutical composition are preferably chosen in accordance with the form of administration.
A further embodiment of the present invention is a method of preparation of a compound of formula (I). The method of preparation according to the invention comprises the following step:
Especially preferred is an embodiment wherein X is selected from the group consisting of Halogen, —OH and —N3. In a particular preferred embodiment X is —Cl.
In a further preferred embodiment the method according to the invention comprises the following steps:
Preferably the activation of the acid group (—C(O)OH) of the compound of formula (I) is carried out in the presence of a base.
Further preferred is an embodiment of the method according to the invention wherein steps i) and ii) are carried out in an organic solvent, preferably an aprotic organic solvent which is essentially free of water and possesses sufficient solubility properties to dissolve the reaction components. Essentially free of water in the context of the present invention refers to solvents that contain water in an amount of less than 500 ppm, preferably less than 250 ppm and especially preferred in a range from 0.001 ppm to 100 ppm, wherein the ppm are based on weight.
In an especially preferred embodiment the method according to the invention is carried out as a one-pot-reaction, i.e. steps i) to iii) are carried out in one reaction vessel, without isolation of the product of step ii).
Further preferred is an embodiment wherein step ii) of the method according to the invention is carried out at a temperature ranging from −25° C. to −5° C., preferably ranging from −20° C. to −10° C.
In a further preferred embodiment, step iii) of the method according to the invention is carried out at a temperature ranging from −25° C. to 30° C., preferably ranging from −15° C. to 25° C.
The present invention is further described in more detail in the following examples which are not to be understood to limit the present invention in any form.
2.88 g acetyl salicylic acid was dissolved in 150 ml abs. tetrahydrofurane and cooled to −15° C. Under stirring 2.1 ml of isobutylchloroformate and 2.23 ml triethylamine were added. After 25 minutes of stirring at −15° C., 1.94 g of tris hydroxymethyl amino methane was added. The reaction mixture was stirred at 0° C. for one hour. Stirring was continued at room temperature overnight. The reaction mixture was filtered, the solvent evaporated and the resulting crystalline material was washed with diethylether-hexane, rendering the pure product in form of the compound of formula (I).
Yield: 2.34 g (52%)
1H NMR (600 MHz, DMSO): δ=2.29 (s, 3H, CH3), 3.65 (d, J=4.90 Hz, 6H, 3×CH2—OH), 4.77 (t, J=4.90 Hz, 3H, CH2—OH), 7.19 (d, 3=7.53 Hz, 1H, H-3), 7.26 (s, 1H, NH), 7.34 (t, J=7.53 Hz, 1H, H-5), 7.52 (t, J=7.53 Hz, 1H, H-4), 7.69 (d, 3=7.53 Hz, 1H, H-6);
13C NMR (150 MHz, DMSO): δ=21.3 (CH3), 60.6 (CH2—OH), 63.0 (C—CH2—OH), 123.8 (C-3), 126.4 (C-5), 129.7 (C-1), 130.2 (C-6), 131.9 (C-4), 147.9 (C-2), 165.6 (C═O—NH), 169.4 (O—C═O).
The purity and identity was confirmed by electrospray MS and HPLC investigations.
3.6 g acetyl salicylic acid was dissolved in 150 ml abs. THF and cooled to −15° C. 2.6 ml of isobutylchloroformate and 2.79 ml triethylamine were added under stirring. After 25 minutes of stirring at −15° C., 1.2 ml of ethanolamine was added and the reaction mixture was stirred for an additional hour at 0° C. The stirring was continued overnight. The reaction mixture was then filtered, evaporated and the resulting oily material was dissolved in ethyl acetate and extracted with water. After evaporation of the solvent, the remaining oil was identified as the desired product.
The medicinal activity of the compound according to the invention and the pharmaceutical composition according to the invention was tested in a series of experiments performed on rats. The experiments were performed on male Sprague-Dawley rats (280-320 g) housed in plastic cages in a thermoneutral environment (21° C.±2° C.) with a 12 h dark-light cycle. The animals, fed on a normal diet with tap water ad libitum, were randomly allocated into experimental groups according to the feeding protocols.
Further experiments were performed on mice held under the same conditions.
Colonic inflammation was induced by intracolonic administration of TNBS (2,4,6-trinitrobenzenesulfonic acid) (40 mg/kg in 0.25 ml of 25% aqueous ethanol) through an 8-cm-long soft plastic catheter under transient diethylether anesthesia. In the sham-operated groups, only the vehicle for TNBS was administered. The animals were deprived of food, but not water, for 12 h before the enemas.
The animals were anesthetized with sodium pentobarbital (50 mg/kg body weight i.p.) 1 or 3 days after the enema and placed in a supine position on a heating pad. Tracheostomy was performed to facilitate spontaneous breathing, and the right jugular vein was cannulated with PE-50 tubing for fluid administration and Ringer's lactate infusion (10 ml/kg per hour) during the experiments. A thermistor-tip catheter (PTH-01; Experimetria Ltd, Budapest, Hungary) was positioned into the ascending aorta through the right common carotid artery to measure the CO by thermodilution technique. The right femoral artery was cannulated with PE-40 tubing for mean arterial pressure (MAP) and heart rate (HR) measurements.
Pressure signals (BPR-02 transducer, Experimetria Ldt, Budapest, Hungary) were measured continuously and registered with a computerized data-acquisition system (Experimetria Ldt). Cardiac output was detected by a thermodilution technique, using a SPEL Advanced Cardosys 1.4 computer (Experimetria Ldt). Gases in arterial blood samples were measured with a blood gas analyzer (AVL Compact 2, Graz, Austria).
Colon biopsies kept on ice were homogenized in phosphate buffer (pH 7.4) containing 50 mM Tris-HCl (Reanal, Budapest, Hungary), 0.1 mM EDTA, 0.5 mM dithiothreitol, 1 mM phenylmethylsulfonyl fluoride, 10 μg/ml soybean trypsin inhibitor, and 10 μg/ml leupeptin (Sigma Aldrich GmbH, Munich, Germany). The homogenate was centrifuged at 4° C. for 20 minutes at 24,000 g, and the supernatant was loaded into centrifugal tubes (Amicon Centricon-100; 100,000-molecular-weight cutoff ultrafilter, Millipore Corporation, Bedford, Mass.). The activity of myeloperoxidase (MPO) was measured on the pellet of the homogenate.
The levels of plasma nitrite/nitrate (NOx), stable end products of NO were measured by the Griess reaction. This assay depends on the reduction of nitrate to nitrite, which is then converted into a colored azo dye compound that is detected spectrophotometrically at 540 nm.
Blood samples (0.5 ml) were taken from the inferior caval vein into precooled, heparinized (100 U/ml) polypropylene tubes, centrifuged at 1,000 g at 4° C. for 30 minutes and then stored at −70° C. until assay. Plasma TNF-α concentrations were determined in duplicate by means of a commercially available enzyme-linked immunosorbent assay (Quantikine ultrasensitive enzyme-linked immunosorbent assay kit for rat TNF-α; Biomedica Hungaria Kft, Budapest, Hungary). The minimum detectable level was less than 5 pg/ml, and the inter-assay and intra-assay coefficients of variation were less than 10%.
The XOR activity was determined in the ultrafiltered, concentrated supernatant by fluorometric kinetic assay based on the conversion of pterine to isoxanthopterine in the presence (total XOR) or absence (xanthine oxidase activity) of the electron acceptor methylene blue.
The activity of MPO as a marker of tissue leukocyte infiltration was measured on the pellet of the homogenate. Briefly, the pellet was resuspended in K3PO4 buffer (0.05 M; pH 6.0) containing 0.5% hexa-1,6-bis-decyltriethylammonium bromide. After three repeated freeze-thaw procedures, the material was centrifuged at 4° C. for 20 minutes at 24,000 g, and the supernatant was used for MPO determination. Subsequently, 0.15 ml of 3,3′,5,5′-tetramethylbenzidine (dissolved in dimethyl sulfoxide, 1.6 mM) and 0.75 ml of hydrogen peroxide (dissolved in K3PO4 buffer, 0.6 mM) were added to 0.1 ml of the sample. The reaction led to the hydrogen peroxide-dependent oxidation of tetramethylbenzidine, which could be detected spectrophotometrically at 450 nm (UV-1601 spetrophotometer; Shimadzu, Kyoto, Japan). Myeloperoxidase activities were measured at 37° C.; the reaction was stopped after 5 minutes by the addition of 0.2 ml of H2SO4 (2 M), and the resulting data were referred to the protein content.
The intravital orthogonal polarization spectral imaging technique (Cytosan A/R; Cytometrics, Philadelphia, Pa.) was used for continuous visualization of the microcirculation of the colon serosa. This technique uses reflected polarized light at the wave length of the isobestic point of oxyhemoglobin and deoxyhemoglobin (548 nm). Because polarization is preserved in reflection, only photons scattered from a depth of 200 to 300 μm contribute to the image formation. A 10× objective was introduced into the intestinal lumen, and the microscopic images were recorded with an S-VHS video recorder (Panasonic AG-TL 700; Matsushita Electric Ind Co Ltd, Osaka, Japan). Microcirculatory evaluation was performed off-line by frame-to-frame analysis of the video taped images. The changes in capillary red blood cell velocity (RBCV, μm/s) in the postcapillary venules were determined in three separate fields by means of a computer-assisted image analysis system (IVM Pictron, Budapest, Hungary). All microcirculatory evaluations were performed by the same investigator.
High mobility group box protein 1 (HMGB-1) measurements in plasma:
Blood samples were drawn into chilled polypropylene tubes containing EDTA (1 mg/ml) and were centrifuged at 1200 g for 10 min at 4° C. The plasma samples were then collected and stored at −70° C. until assay. Plasma concentration of HMGB-1 was measured by a commercially available HMGB-1 ELISA kit (Shino-Test Corporation, Kanagawa, Japan).
First experiments regarding the effect of the compound of formula (I) and a pharmaceutical composition comprising the compound of formula (I) (clear aqueous solution of compound of formula (I) at pH 4.8), respectively, on gastric injury without inflammation were conducted on mice. 48 animals were randomly allocated into three groups. Group A (n=16) served as sham-operated controls. Samples of all animals were drawn on day 1 of the clinical tests. On day 2 the animals of group B (n=16) were force-fed acetylsalicylic acid (ASS) (1.11 mmol/kg body weight). Group C (n=16) was force-fed 1.11 mmol/kg body weight of the compound according to the invention. Group A only received the respective solvent (25% ethanol in water). One day after the gavage, additional samples were drawn. Fluorescence confocal endomicroscopy was performed to examine the microvasculature and morphologic changes of the mucosa of the distal colon, and full-thickness tissue samples and venous blood samples were taken to determine the biochemical changes in the colon and plasma. The effects were determined by way of measurement of body weight, blood gas analysation and biopsy. ASS was chosen as a comparative example due to its structural similarity and its known activity as anti-inflammatory agent.
1. Size of bleeding areas (score: 0-2)
2. Number of bleeding areas (score: 0-3)
3. Extension of ulcer (score: 0-2)
The average of the three criteria is calculated for the animals of each group, wherein “0” means for criteria 1 small or no bleeding area, for criteria 2 no bleeding area and for criteria 3 no ulcer.
The higher the number the more severe the damage.
The above-described clinical studies were repeated with animals having colitis which was induced as described above. 20 mice were randomly divided into four groups, wherein group D served as sham-operated control, having no colitis, group E served as second control having colitis but receiving no further treatment, group F having colitis and being treated with 1.11 mmol/kg body weight of ASS and group G having colitis and being treated with 1.11 mmol/kg of the compound according to the invention. One day after the animals received the enema with TNBS (40 mg/kg i.c.), wherein the animals of group D only received the respective solvent, the animals of group F and G were treated with ASS and the compound according to the invention, respectively. The other animals only received the respective solvent again. Two days after the enema the effects of the treatment were determined by measurement of body weight, blood gas analysis and biopsy. The animals were anesthetized two days after colitis induction. Surgery was performed to allow registration of the hemodynamic parameters at 1 h intervals for 6 h (cardiac output [CO] data were measured only at the end of the experiments). Intravital videomicroscopy was performed at the end of the experiments to visualize the serosal microcirculation 3 cm distal from the cecum. In addition, fluorescence confocal endomicroscopy was performed to examine the microvasculature and morphologic changes of the mucosa of the distal colon, and full-thickness tissue samples and venous blood samples were taken to determine the biochemical changes in the colon and plasma.
As can be seen from
Further experiments regarding the effect of a compound of formula (I) and a pharmaceutical composition comprising a compound of formula (I), respectively, on gastric injury without inflammation were conducted on rats. 15 animals were randomly allocated into three groups. Group H (n=5) served as sham-operated controls. Samples of all animals were drawn on day 1 of the clinical tests. On day 2 the animals of group I (n=5) were force-fed acetylsalicylic acid (ASS) (1.11 mmol/kg body weight). Group K (n=5) was force-fed 1.11 mmol/kg body weight of the compound according to the invention. Group H only received the respective solvent (25% ethanol in water). One day after the gavage, additional samples were drawn. Fluorescence confocal endomicroscopy was performed to examine the microvasculature and morphologic changes of the mucosa of the distal colon, and full-thickness tissue samples and venous blood samples were taken to determine the biochemical changes in the colon and plasma. The effects were determined by way of measurement of body weight, blood gas analysation and biopsy. ASS was chosen as a comparative example due to its structural similarity and its known activity as anti-inflammatory agent.
On the basis of the haematocrit measurements, the data can be divided into two groups:
a) high haematocrit level, indicating bleeding with plasma loss (
b) low haematocrit level, indicating severe bleeding with plasma and cell loss (
As shown in
As can be seen from the data shown in
The above-described clinical studies were repeated with animals having colitis which was induced as described above. 20 animals (rats) were randomly divided into four groups, wherein group L served as sham-operated control, having no colitis, group M served as second control having colitis but receiving no further treatment, group N having colitis and being treated with 1.11 mmol/kg body weight of ASS and group O having colitis and being treated with 1.11 mmol/kg of the compound according to the invention. One day after the animals received the enema with TNBS (40 mg/kg i.c.), wherein the animals of group L only received the respective solvent, the animals of group N and O were treated with ASS and the compound according to the invention, respectively. The other animals only received the respective solvent again. Two days after the enema the effects of the treatment were determined by measurement of body weight, blood gas analysis and biopsy. The animals were anesthetized two days after colitis induction. Surgery was performed to allow registration of the hemodynamic parameters at 1 h intervals for 6 h (cardiac output [CO] data were measured only at the end of the experiments). Intravital videomicroscopy was performed at the end of the experiments to visualize the serosal microcirculation 3 cm distal from the cecum. In addition, fluorescence confocal endomicroscopy was performed to examine the microvasculature and morphologic changes of the mucosa of the distal colon, and full-thickness tissue samples and venous blood samples were taken to determine the biochemical changes in the colon and plasma.
0=no signs of inflammation
1=erythema
2=erythema, edema and erosions
3=two or more bleeding ulcers, inflammation and adhesions,
4=severe ulceration and/or stenosis with dilatation of the proximal intestine.
As can be expected, animals of control group L did not show any signs of inflammation, wherein the animals of group M showed symptoms ranging from class 3 to 4. Animals of group N, treated with ASS, showed slightly less severe symptoms, whereas the animals of group O, treated with the compound according to the invention only showed increased erythema.
The data in
As can be seen from
Further, the damage of the mucosa can be reduced.
Further clinical studies were performed with animals having collagen-induced arthritis (CIA). In these studies, mice were used as test animals. At the age of eight weeks, the animals were immunized intradermally at the base of the tail with 50 μl of bovine collagen II emulsified in 50 μl of complete Freund's adjuvant. A second booster immunization was performed 3 weeks later, when 50 μl of incomplete Freund's adjuvant was administered with or without the same volume of collagen H. The animals were randomly allocated into experimental groups wherein group 1 served as control, having no arthritis, group 2 served as second control having arthritis, but receiving no further treatment, and group 3 having arthritis and being treated with compound according to the invention. The animals of group 3 were force-fed 1.11 mmol/kg body weight of the compound according to the invention from the first immunization until the end of the experiments. The severity of CIA was evaluated using a clinical scoring system; inflammatory hyperalgesia was detected with thermal stimulation.
The evaluation of CIA was performed in a blind manner by one investigator, using the scoring system of Nandakumar which is based on the number of inflamed joints in each paw, inflammation being defined by swelling and redness (see Nanakumar K S, Svensson L, Holmdahl L: Collagen type II-specific monoclodal antibody-induced arthritis in mice: description of the disease and the influence of age, sex, and genes; Am. J. Pathol. 2003, 163(5):1827-37). Briefly summarized each inflamed toe or knuckle equaled one point whereas an inflamed wrist or ankle equaled five points, resulting in a score from 0 to 15 points for each paw and from 0 to 60 points for each animal. The evaluation was conducted every second day during the observation period. The results are summarized in
The animals were acclimatized to the experimental conditions for 1 hour preceding the test. Then they were placed onto a heating plate set to 40° C. to assess their thermal hypersensitivity. After 10 minutes, the positions of the limbs were rated 3 time on a numeric scale during a period of 15 minutes, according to the method initially described by Attal et al (see Attal N, Jazat F, Kayser V, Guilbaud G: Further evidence for pain related behaviors in a model of unilateral peripheral mononeuropathy; Pain 1990, 41(2):235-51). The scores are as follows: 0, when the paw is pressed normally to the floor; 1, when the paw rests lightly on the floor and the toes are in ventroflexed position; 2, when only the internal edge of the paw is pressed to the floor; 3, when only the heel is pressed to the floor and the hindpaw is in an inverted position; 4, when the whole paw is elevated; and 5, when the animal licks the paw. The results are summarized in
As can be seen from
| Number | Date | Country | Kind |
|---|---|---|---|
| 13199793.4 | Dec 2013 | EP | regional |
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/EP2014/078296 | 12/17/2014 | WO | 00 |
