Patent Application
20230364112
The disclosure relates in general to a method of treating central nervous system in a subject, and more particularly to a method of treating neurodegenerative diseases such as Huntington's disease and/or trinucleotide repeat disorder in a subject.
Huntington's disease (HD) is an autosomal dominant neurodegenerative disease that manifests clinically as progressive involuntary movement disorders, dementia, and eventual death [1]. It is caused by CAG trinucleotide expansion in exon 1 of the huntingtin (Htt) gene, which is located on the short arm of human chromosome 4 (4p63). When the number of CAG repeats exceeds 36, the translated polyglutamine (polyQ)-containing the Htt protein [mutant Htt (mHtt)] interferes with the normal functions of many cellular proteins and subsequently jeopardizes important cellular machinery [2]. Abnormal accumulation of polyQ-expanded mutant Htt also leads to aggregate formation in the nuclei of neurons, astrocytes, cochlear neurons, and many different types of peripheral cells [3].
Mutant Htt is known to promote protein misfolding and thus inhibit the activity of proteosome activity, dysregulates transcription, impairs synaptic functions, elevates oxidative stress, degenerates axons, and eventually lead to in neurodegeneration and neuronal loss [3]. Extensive release of glutamate from the cortico-striatal terminals and impairment of neuronal survival are believed to account for striatal neurodegeneration which triggers the initial symptoms of HD. Dysfunction of the nigro-striatal pathway also contributes to striatal excitotoxicity. Together, the neuronal degeneration induced by mutant Htt takes place mainly in nonstriatal brain regions (e.g. cortex and substantia nigra) [4, 5], and causes movement disorders, dementia, and eventual death [1, 6].
In addition to neuronal dysregulation, metabolic abnormalities are another important hallmark of HD [7]. Hyperglycemia and abnormal glucose metabolism were observed in several mouse models of HD and in patients with HD [8]. Deficiencies in several other metabolic pathways (e.g., cholesterol biosynthesis and urea cycle metabolism) are also well documented [9, 10]. Deficit of energy metabolism had been proposed as an important pathogenic factor for many neurological disorders. Lately, energy deficit emerged as an important pathogenic factor in HD [7]. Hyperglycemia and reduced insulin had been reported in several transgenic mouse models [8]. Aberrant expressions of proteins associating with glucose metabolism had also been observed in several HD mouse models as well as in HD patients [8]. Although studies of HD have attracted much attention lately, very limited effective treatment for curing HD is not available yet.
Until now, no prior art references report the effect of Antcin H in the HD treatment. The present disclosure using cell experiment (in vitro) proves that Antcin H is a good Inhibitor of the NLRP3 inflammasome, and thus could be used for treating central nervous system diseases such as cerebrovascular diseases (ischemic stroke and hemorrhagic stroke), neurodegenerative diseases (Alzheimer's disease, Huntington's disease, and Parkinson's disease), multiple sclerosis and depression [15, 16, 17].
Neurosci 2008, 27:2803-2820.
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.
The disclosure is directed to a new method of treating central nervous system (CNS) diseases in a subject.
According to one embodiment, the method comprises administering to the subject a therapeutically effective amount of Antcin H and/or its derivatives.
In some embodiments, said subject is mammalian or human.
In some embodiments said central nervous system diseases includes cerebrovascular diseases, neurodegenerative diseases, multiple sclerosis and depression.
In some embodiments, said neurodegenerative diseases is Huntington's disease (HD), and said subject has a mutation in the Htt gene and has exhibited at least one symptom of HD.
In some embodiments, said Antcin H and/or its derivatives are naturally derived or synthetic.
In some embodiments, said therapeutically effective amount of Antcin H and/or its derivatives are in a range of from about 0.001 mg/kg/day to about 500 mg/kg/day.
In some embodiments, said Antcin H and/or its derivatives are administering to said subject by at least one route selected from the group consisting of: parenteral, subcutaneous, intramuscular, intravenous, oral, inhalation, rectal, topical, buccal, sub-lingual and transdermal.
In some embodiments, said Antcin H and/or its derivatives are used as inhibitor of the NLRP3 inflammasome.
According to another embodiment, a use of Antcin H and/or its derivatives is provided. The Antcin H and/or its derivatives are used for the manufacture of a medicament for the treatment of CNS diseases.
In some embodiments, said medicament is administered to a subject more than once a day, at least once a day, at least once a week, or at least once a month.
According to an alternative embodiment, a package is provided. The package comprises a pharmaceutical composition comprising one or more unit doses, each such unit dose comprising 0.001-500 mg of Antcin H and/or its derivatives; and instruction for use of the pharmaceutical composition to treat a subject afflicted with CNS diseases.
According to an alternative embodiment, a pharmaceutical composition is provided. The pharmaceutical composition comprises one or more unit doses, each such unit dose comprising 0.001-500 mg of Antcin H and/or its derivatives, for use in treating a subject afflicted with CNS diseases.
The details of one or more embodiments of the invention are set forth in the description below. Other features or advantages of the present invention will be apparent from the following detailed description of several embodiments, and also from the appending claims.
In the following detailed description, for purposes of explanation, numerous specific details are set forth in order to provide a thorough understanding of the disclosed embodiments. It will be apparent, however, that one or more embodiments may be practiced without these specific details. In other instances, well-known structures and devices are schematically shown in order to simplify the drawing.
As will be described in more detail below, the present invention relates to compounds, compositions, methods, packages and/or the like, for treating central nervous system (CNS) diseases in a subject.
The term “subject”, as used herein, refers to any animal who would benefit from treatment and/or diagnosis. Non-limiting examples of a subject includes mammalian animals, such as primates (humans, apes, gibbons, chimpanzees, orangutans, macaques), domestic animals (dogs and cats), farm animals (horses, cattle, goats, sheep, pigs) and experimental animals (mouse, rat, rabbit, guinea pig). In a specific example, the subject is a human.
The term “treatment” or “treating”, as used herein, refers to preventing, reducing, ameliorating, abrogating, delaying disease progression, delaying disease onset, and/or the diminishment of pain. Treatment or treating may further comprise increasing the survival time of a subject suffering from CNS diseases, or increasing the survival time of an individual susceptible to CNS diseases.
Pharmaceutical composition that comprise the combination of the disclosure will typically comprise one or more carriers or excipients and optionally other therapeutic ingredients. The carrier(s) will generally be “acceptable” in the sense of being compatible with the other ingredients of the formulation and physiologically innocuous to the recipient thereof. Such carriers or excipients are known, e.g., fillers, lubricants, binders and various liquid excipients for liquid formulations. Suitable carriers include those disclosed in the references cited herein.
Preferably the combination of this disclosure are in unit dosage forms such as tablets, pills, capsules, powders, granules, sterile parenteral solutions or suspensions, metered aerosol or liquid sprays, drops, ampoules, auto-injector devices or suppositories; for oral, parenteral, intranasal, sublingual or rectal administration, or for administration by inhalation or insufflation. Alternatively, the combinations may be presented in a form suitable for once-weekly or once-monthly administration. An erodible polymer containing the active ingredient may be envisaged. For preparing solid combinations such as tablets, the principal active ingredient is mixed with a pharmaceutical carrier, e.g. conventional tableting ingredients such as corn starch, lactose, sucrose, sorbitol, talc, stearic acid, magnesium stearate, dicalcium phosphate or gums, and other diluents, e.g. water, to form a solid preformulation combination containing a homogeneous mixture of the compound of the present invention, or a salt, derivative or composition thereof. When referring to these preformulation combinations as homogeneous, it is meant that the ingredient is dispersed evenly throughout the combination so that the combination may be readily subdivided into equally effective unit dosage forms such as tablets, pills and capsules. The tablets or pills of the novel combination can be coated or otherwise compounded to provide a dosage form affording the advantage of prolonged action. For example, the tablet or pill can comprise an inner dosage and an outer dosage component, the latter being in the form of an envelope over the former. The two components can be separated by an enteric layer which serves to resist disintegration in the stomach and permits the inner component to pass intact into the duodenum or to be delayed in release. A variety of materials can be used for such enteric layers or coatings, such materials including a number of polymeric acids and mixtures of polymeric acids with such materials as shellac, cetyl alcohol and cellulose acetate.
Suitable compositions include aqueous or oily solutions of the combination of the disclosure. Compositions suitable for parenteral delivery of the active ingredient include aqueous and non-aqueous compositions where the active ingredient is dissolved or suspended in solution. Compositions suitable for parenteral administration include aqueous and non-aqueous sterile injection solutions which may contain anti-oxidants, buffers, bacteriostats or solutes that render the formulation isotonic with the blood of the intended recipient. Other parenteral compositions may comprise aqueous and non-aqueous sterile suspensions which may include suspending agents and thickening agents.
When the CNS diseases is Huntington's disease (HD), delaying disease progression may be indicated by a lack of measurable change in, or an improvement of, one or more indicators of HD, including molecular markers or symptoms of the disease. An improvement in an indicator of HD may include the absence of an undesirable change, or the presence of a desirable change. Treatment or treating may refer to the reduction and/or improvement of any one of the overt symptoms of HD, including, but not limited to, psychiatric, mental cognitive or physical motor impairments. Non-limiting symptoms of HD include, but not limited to, dementia or psychiatric disturbances, ranging from apathy and irritability to bipolar or schizophreniform disorder, physical motor impairment including chorea, hypokinesia, cognitive impairment, motor manifestations including flicking movements of the extremities, a lilting gait, motor impersistence, facial grimacing, ataxia and/or dystonia. It is to be understood that any clinically beneficial effect that arises from the methods, compounds, compositions and kits disclosed herein, is to be considered to be encompassed by the invention.
As used herein, “a subject suffering from CNS diseases” refers to a subject who has CNS diseases. In one example, a subject who has CNS diseases received a diagnosis of CNS diseases from, for example, a health professional, such as a physician. Relevant diagnostic tests are known in the art and include, but are not limited to, genetic testing to determine the presence of a mutation in the huntingtin gene, neurological examination, and brain imaging.
As used herein, “a subject susceptible to CNS diseases” refers to a subject who, based on genetic testing and/or family history, is likely to develop CNS diseases.
Antcin H is a natural triterpene derived from medical fungus Antrodia cinnamomea. The chemical structure of Antcin H is as following:
Antcin H has various derivatives, includes but not limited to Antcin A, Antcin B, Antcin C, Antcin D, Antcin E, Antcin F and Antcin K. As The derivatives of Antcin H can be represented by the following formula:
wherein R1 is ═O or OH; R2 is H or OH; R3 is H, ═O, OH or O-acetyl; R4 is H or OH; R5 is H; R6 is H or OH; and R7 is ═O or OH. Both naturally derived or synthetic Antcin H and/or its derivatives could use in the present disclosure.
Examples of routes of administration Antcin H include parenteral (e.g., subcutaneous, intramuscular, intradermal, or intravenous), oral, inhalation (in solid and liquid forms), rectal, topical, buccal (e.g., sub-lingual) and transdermal administration, although the most suitable route in any given case may depend on the nature and severity of the condition being treated and on the nature of the particular form of Antcin H, its derivative, or a pharmaceutically acceptable salt thereof, which is being used.
Compositions of the disclosure suitable for oral administration are prepared as discrete units such as capsules, cachets, gums or tablets each containing a predetermined amount of the low polar fraction of Antcin H and/or its derivatives; as a powder or granules; as solution or a suspension in an aqueous liquid or a non-aqueous liquid; or as an oil-in-water liquid emulsion or a water-in-oil liquid emulsion.
Compositions for rectal administration may be presented as a suppository with a suitable base.
Compositions suitable for intrapulmonary or nasal administration will have a particle size, for example, in the range of 0.01 to 200 microns (including particle sizes in a range between 0.01 and 500 microns in increments of 0.1 microns such as 0.1, 0.2, 0.3, 0.4, 0.5, 1, 2, 5, 30 microns, 35 microns, etc.), which is administered by inhalation through the nasal passage or by inhalation through the mouth so as to reach the various bronchi or alveolar sacs. Formulations suitable for aerosol or dry powder administration may be prepared according to conventional methods and may be delivered with other therapeutic agents.
Compositions suitable for transdermal administration may be presented as transdermal patches. The transdermal patch provides a base line or steady state nicotine level to the patient. The total amount of the low polar fraction of antcin H and/or its derivatives released by the patch during the period of use will vary depending on the user's body size, history of exposure to nicotine, and response to treatment. The size of the patch will vary according to the amount of nicotine to be delivered.
Compositions comprising the combination of the invention are presented in unit-dose or multi-dose containers, for example sealed ampoules and vials, and may be stored in a freeze-dried (lyophilized) condition requiring only the addition of the sterile liquid carrier, for example water for injection, immediately prior to use. Extemporaneous injection solutions and suspensions are prepared from sterile powders, granules and tablets of the kind previously described. Preferred unit dosage formulations are those containing a daily dose or unit daily sub-dose, as described herein.
As used herein, the term “pharmaceutical package” defines an array of one or more unit doses of a pharmaceutical composition, optionally contained wthin common outer packaging. In pharmaceutical package comprising a combination of two or more compounds/agents, the individual compounds/agents may unitary or non-unitary formulations. The unit dose(s) may be contained within a blister pack. The pharmaceutical package may optionally further comprise instructions for use.
The following materials and methods are implemented in the present disclosure:
Conditionally immortalized wild-type STHdhQ7 striatal neuronal progenitor cells expressing endogenous normal htt (referred to as wild-type striatal cells), and homozygous mutant STHdhQ109 striatal neuronal progenitor cells from homozygous STHdhQ109 knock-in mice expressing mutant htt with 109 glutamines (referred to as mutant striatal cells). STHdhQ7 and STHdhQ109 cells were generous gifts from Dr. Elena Cattaneo and Marta Valenza (Department of pharmacological sciences and center for stem cell research, University of Milano, Italy). These cells were maintained in an incubation chamber at 33° C. in Dulbecco's modified Eagle's medium supplemented with 10% fetal bovine serum.
STHdhQ7 and STHdhQ109 cells were treated with 5 or 10 μM Antcin H or vehicle (DMSO) for 24 h. STHdhQ7 and STHdhQ109 cells viability was quantified by the CCK-8 assay. The survival rate of the indicated cells was normalized to those survival rate of vehicle-treated STHdhQ7 cells.
STHdhQ7 and STHdhQ109 cells were treated with 5 or 10 μM Antcin H or vehicle (DMSO) in the presence of 10 μM intracellular ROS indicator fluorescent probe CM-H2DCFDA (Molecular Probes, Inc., Eugene, Oregon, USA) for 1 h. Intracellular ROS (Reactive Oxygen Species) levels were measured by detecting the fluorescence intensity (Excitation/Emission: 488 nm/510 nm) using a fluorescence plate reader (Fluoroskan Ascent; Thermo Electron Corporation, Woburn, MA, USA). J774A.1 macrophages were treated with or without 1 μg/ml LPS for 5 h, followed by treated with or without 50 μM Antcin H for 0.5 h. Cells were then activated by 5 mM ATP for 0-60 min. The levels of intracellular ROS were measured by CM-H2DCFDA staining and detected by a fluorescence plate reader.
R6/2 mice or wild-type mice were treated with Antcin H (10 mg/kg of body weight) or vehicle by oral gavage daily starting from the age of 7 weeks to the age of 12 weeks. Mice were tested on a Rotarod apparatus three times a week. Motor coordination was assessed using a rotarod apparatus assay (UGO BASILE, Comerio, Italy) at a constant speed (12 rpm) over a period of 2 min. The body weight and the lifespan were monitored weekly.
The mHtt Aggregation Assay (Filter Retardation Assay)
Brain tissues will be suspended and homogenized in ice-cold RIPA buffer (50 mM Tris-HCl, 0.25% sodium deoxycholate, 1% Triton X-100, 150 mM NaCl, 1 mM phenylmethylsulfonyl fluoride, 1 mM Na3VO4, 0.5 mg/mL aprotinin, 0.1 mM leupeptin, and 4 mM pepstatin), mixed with 2% SDS, and applied to OE66 membrane filters (0.2 mm pore size; Whatman Schleicher and Schuell, Middlesex, UK) through a slot-blot manifold (Bio-Rad, Irvine, CA, USA). The blots will be blocked with 5% skim milk in PBS and incubated overnight with an anti-EM48 antibody (1:500; Millipore Bioscience Research Reagents, Temecula, CA, USA) at 4° C., followed by incubation with the corresponding secondary antibody for 1 h at RT. The immunoreactive bands will be detected by ECL (Pierce, Rockford, IL, USA) and recorded using Kodak XAR-5 film.
The method was according to the previous report [14]. In brief, brain sections were incubated overnight with anti-lba-I polyclonal antibody (1:500), anti-NeuN polyclonal antibody (1:500), anti-NLRP3 monoclonal antibody (1:200) or anti-EM48 monoclonal antibody (1:500) in PBS containing 5% normal goat serum at 4° C. and then incubated with the corresponding secondary antibody for 2 h at room temperature. Nuclei were stained with Hoechst 33258. Slides were mounted and analyzed with a laser confocal microscope.
BV2 microglia were treated with or without 1 μg/ml LPS for 5 h, followed by treated with or without 1 or 5 μM Antcin H for 0.5 h. Cells were then activated by 1 mM ATP for 24 h. The IL-1β levels in the supernatants were measured by ELISA, and the levels of iNOS and NLRP3 in the cell lysates were measured by Western blotting. J774A.1 macrophages were treated with or without 1 μg/ml LPS for 5 h, followed by treated with or without Antcin H for 0.5 h. Cells were then activated by 5 mM ATP for 0.5 h. The IL-1β levels in the supernatants were measured by ELISA.
The results are expressed as the means±SEM of triplicate samples. Each experiment will be repeated at least three times to confirm the reproducibility of the findings. Multiple groups will be analyzed with one-way analysis of variance (ANOVA), followed by a post-hoc Student-Newman-Keuls test. A p value of <0.05 will be considered significant.
To investigate the neuroprotective potential of Antcin H in CNS disease, the present example used striatal cell line as an in vitro model of Huntington's disease. STHdhQ109 cells carry the polyQ-expanded mouse gene Htt, which encodes 109 CAG repeats in the Htt gene. Compared with STHdhQ109 cells, the control cell line (STHdhQ7) only carry 7 copies of the CAG repeat.
Experimental shows that treatment with Antcin H significantly prevented STHdhQ109 cell death, as 5- and 10-μM Antcin H-treated cells show higher survival ratio then vehicle-treated cells (
To investigate the therapeutic potential of Antcin H in the pathogenesis of Huntington's disease, R6/2 mice were used as an animal model of HD. R6/2 mice or wild-type mice were treated with Antcin H (10 mg/kg of body weight) or vehicle by oral gavage daily starting from the age of 7 weeks to the age of 12 weeks.
The body weight had monitored weekly and represented as a health condition of mice. It is found that the body weight of vehicle-treated R6/2 mice gradual decreased from 8 to 12 weeks of age, by contrast, the R6/2 mice treated with Antcin H showed a higher weekly weight gain (
The present example further investigates the effect of Antcin H in the neuronal death of R6/2 mice brains by immunofluorescence staining.
Confocal microscope images showed a reduced neuronal cells number in the brain of vehicle-treated R6/2 mice compared to the wild-type mice, indicating the neuronal death increased in R6/2 mice brain (
HD commonly associated with inflammation in nervous system and activated microglia. To investigate the anti-inflammatory potential of Antcin H, immunofluorescence staining for striatum was performed to detect the expression levels of lba-1, a protein up-regulated in activated microglia. It is found that the number of lba-1 positive cells was increased in vehicle-treated R6/2 mice compared to WT mice.
The number of lba-1 positive cells was decreased in Antcin H-treated R6/2 mice compared to vehicle-treated R6/2 mice (
Microglia are macrophage-like immune cells of the central nervous system. It has been demonstrated that neuroinflammation caused by dysregulated activation of microglia promotes the pathogenesis of various neurodegenerative diseases such as Huntington's disease, Alzheimer's disease and Parkinson's disease [9] (Subhramanyam et al., 2019). In addition, overexpressed IL-1β, the end-product of the NLRP3 inflammasome, plays important roles in the development of many diseases including neurodegenerative diseases [10] (Siew et al., 2019). NLRP3 inflammasome composed of NLRP3, ASC and caspase-1 and controls the maturation and release of IL-1β. NLRP3 inflammasome can be activated by medical relevant stimuli such as ATP from damage tissues and amyloid-β of Alzheimer's disease [11] (Guo et al., 2015).
In addition, Antcin H reduced the expression levels of inducible nitric oxide synthase (iNOS) and NLRP3 in LPS and ATP activated BV2 microglia (
Examples 4 and 5 prove that Antcin H is a good Inhibitor of the NLRP3 inflammasome, and thus could be used for treating central nervous system diseases such as cerebrovascular diseases (ischemic stroke and hemorrhagic stroke), neurodegenerative diseases (Alzheimer's disease, Huntington's disease, and Parkinson's disease), multiple sclerosis and depression [15, 16, 17].
Over-production of IL-113 from NLRP3 inflammasome activated macrophages promotes inflammatory disorders such as neurodegenerative diseases [12] (Mangan et al., 2018). It is found that ATP induces significant IL-18 secretion in LPS-primed macrophages, and this effect was inhibited by Antcin H (
In addition, ROS is one of the crucial elements for NLRP3 inflammasome activation [13] (Tschopp and Schroder, 2010). To determine whether the inhibition of IL-1β secretion by Antcin H occurred via inhibition of ATP-induced ROS production, LPS-primed macrophages were incubated with Antcin H before ATP stimulation. It is found that Antcin H significantly reduced ATP-induced ROS production (
It will be apparent to those skilled in the art that various modifications and variations can be made to the disclosed embodiments. It is intended that the specification and examples be considered as exemplary only, with a true scope of the disclosure being indicated by the following claims and their equivalents.
This application claims the benefit of U.S. Provisional Application Ser. No. 63/084,969, filed Sep. 29, 2020, the disclosure of which is incorporated by reference herein in its entirety.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/CN2021/121859 | 9/29/2021 | WO |
| Number | Date | Country | |
|---|---|---|---|
| 63084969 | Sep 2020 | US |
