Abstract:
Novel diphenylethylene compounds containing thiazolidinedione or oxazolidinedione moieties are provided which are effective in lowering blood glucose level, serum insulin, triglyceride and free fatty acid levels in animal models of Type II diabetes. In contrast to previously reported thiazolidine compounds, known to lower leptin levels, the present compound increase leptin levels and have no known liver toxicity.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
     This is a continuation-in-part of U.S. application Ser. No. 09/074,925, filed on May 8, 1998, now U.S. Pat. No. 6,245,814. 
    
    
     BACKGROUND OF THE INVENTION 
     The present application is directed to novel anti-diabetic compounds formed by chemically coupling diphenylethylene compounds with thiazolidine or oxazolidine intermediates. These compounds are effective in lowering blood glucose, serum insulin and triglyceride levels in animal models of type II diabetes. However, surprisingly, these compounds increase the leptin level and have no liver toxicity. 
     The causes of type I and type II diabetes are yet unknown, although both genetics and environment seem to be the factors. Insulin dependent type I and non-insulin type II are the types which are known. Type I is an autonomic immune disease in which the responsible auto antigen is still unknown. Patients of type I need to take insulin intravenously to survive. However, type II diabetes, the more common form, is a metabolic disorder resulting from the body&#39;s inability to make a sufficient amount of insulin or to properly use the insulin that is produced. Insulin secretion and insulin resistance are considered the major defects, however, the precise genetic factors involved in the mechanism remain unknown. 
     Patients with diabetes usually have one or more of the following defects: 
     Less production of insulin by the pancreas; 
     Over secretion of glucose by the liver; 
     Independent of the glucose uptake by the skeletal muscles; 
     Defects in glucose transporters, desensitization of insulin receptors; and 
     Defects in the metabolic breakdown of polysaccharides. 
     Other than the intravenous application of insulin, there are about 4 classes of oral hypoglycemic agents used. 
     
       
         
               
               
               
               
               
             
           
               
                   
                   
               
               
                   
                   
                 Approved 
                 Mechanisms of 
                   
               
               
                   
                 Class 
                 Drugs 
                 Action 
                 Limitations 
               
               
                   
                   
               
             
             
               
                   
                 sulfonylurea 
                 4 (1st 
                 acts on 
                 dev. of 
               
               
                   
                   
                 generation) 
                 pancreas to 
                 resistance 
               
               
                   
                   
                 and 
                 release more 
               
               
                   
                   
                 2 (2nd 
                 insulin 
               
               
                   
                   
                 generation) 
               
               
                   
                 biguanides 
                 metformin 
                 reduces 
                 liver 
               
               
                   
                   
                   
                 glucose 
                 problems, 
               
               
                   
                   
                   
                 secretion by 
                 lactic 
               
               
                   
                   
                   
                 liver; 
                 acidosis 
               
               
                   
                   
                   
                 improves 
               
               
                   
                   
                   
                 insulin 
               
               
                   
                   
                   
                 sensitivity 
               
               
                   
                 alpha- 
                 acarbose 
                 interferes 
                 only useful 
               
               
                   
                 glucosidase 
                   
                 with 
                 at post- 
               
               
                   
                 inhibitor 
                   
                 digestive 
                 pradiandio 
               
               
                   
                   
                   
                 process; 
                 level 
               
               
                   
                   
                   
                 reduces 
               
               
                   
                   
                   
                 glucose 
               
               
                   
                   
                   
                 absorption 
               
               
                   
                 thiazolidin 
                 troglitazone 
                 reduces 
                 “add-on” 
               
               
                   
                 e-dione 
                   
                 insulin 
                 with 
               
               
                   
                   
                   
                 resistancy 
                 insulin; not 
               
               
                   
                   
                   
                   
                 useful for 
               
               
                   
                   
                   
                   
                 people with 
               
               
                   
                   
                   
                   
                 heart and 
               
               
                   
                   
                   
                   
                 liver 
               
               
                   
                   
                   
                   
                 disease 
               
               
                   
                   
               
             
          
         
       
     
     As is apparent from the above table, each of the current agents available for use in treatment of diabetes has certain disadvantages. Accordingly, there is a continuing interest in the identification and development of new agents, particularly, water soluble agents which can be orally administered, for the use of treatment of diabetes. 
     SUMMARY OF THE INVENTION 
     Anti-diabetic compounds of the following formula I are provided:                           
     n, m, q and r are independently integers from zero to 4; p and s are independently integers from zero to 5; a, b and c are double bonds which may be present or absent; 
     R, R′ and R″ are independently H, C 1 -C 20  linear or branched alkyl, C 2 -C 20  linear or branched alkenyl, —CO 2 H, —CO 2 R′″, —NH 2 , —NHR′″, —NR 2 ′″, —OH, —OR′″, halo, substituted C 1 -C 20  linear or branched alkyl or substituted C 2 -C 20  linear or branched alkenyl, wherein R′″ is C 1 -C 20  linear or branched alkyl or linear or branched alkenyl; 
     A, A′ and A″ are independently H, C 1 -C 20  acylamino; 
     C 1 -C 20  acyloxy; C 1 -C 20  alkanoyl; 
     C 1 -C 20  alkoxycarbonyl; C 1 -C 20  alkoxy; 
     C 1 -C 20  alkylamino; C 1 -C 20  alkylcarboxylamino; carboxyl; cyano; halo; hydroxy; 
     B, B′ and B″ are independently H; 
     C 1 -C 20  acylamino; C 1 C 20  acyloxy; C 1 -C 20  alkanoyl; 
     C 1 -C 20  alkenoyl; C 1 -C 20  alkoxycarbonyl; 
     C 1 -C 20  alkoxy; C 1 -C 20  alkylamino; 
     C 1 -C 20  alkylcarboxylamino; aroyl, aralkanoyl; carboxyl; cyano; halo; hydroxy; 
     X, X′ are independently —NH, —NR′″, O or S. 
     Pharmaceutical compositions containing compounds of the formula I are provided for treatment of diabetes and comprise a therapeutically effective amount of the compound in a physiologically acceptable carrier. 
     A method of treating diabetes is also provided comprising the step of orally administering to a subject suffering from a diabetic condition a therapeutically effective amount of a compound of formula I. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     FIGS. 1A and 1B show graphs of the blood glucose levels and body weights, respectively, of db/db (spontaneous diabetic) male rats given a compound according to the invention of a period of 15 days. 
     FIGS. 2A and 2B show graphs of the blood glucose levels and body weights of ob/ob (genetically obese and spontaneously diabetic) male rats given a compound according to the invention over a period of 15 days. 
     FIGS. 3A and 3B with graphs of blood glucose levels of db/db mice and ob/ob mice, respectively, given a compound according to the invention over a period of 20-25 days. 
     FIG. 4 shows a graph of blood glucose level in db/db male mice over 72 hours following a dosage of the compound. 
     FIGS. 5A,  5 B,  5 C and  5 D show graphs of the triglyceride levels, free fatty acid levels, glyc-Hb levels and leptin levels in serum of the db/db mice treated with a compound according to the present invention. 
     FIGS. 6A,  6 B,  6 C and  6 D are graphs showing the serum insulin levels, triglyceride levels, free fatty acid levels and Glyc-Hb levels of serum of ob/ob mice treated with a compound according to the present invention. 
     FIGS. 7A and 7B show the assays of liver enzymes in mice 21 days after treatment with a compound according to the invention. 
     FIGS. 8A and 8B show the glucose uptake assays in 3T3-L1 cells for a compound of the invention and troglitazone. 
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     Diphenylethylene compounds according to the present may be combined with a physiologically acceptable vehicle in a pharmaceutical composition, such as, lyophilized powder in the form of tablet or capsule with various fillers and binders. The effective dosage of a compound in the composition will be selected by those of ordinary skill in the art and may be empirically determined. The compounds of the present invention are useful for the treatment of diabetes, characterized by the presence of elevated blood glucose levels, that is, hyperglycemic disorders such as diabetes melitis, including both type I and II diabetes. As well as other hyperglycemic related disorders such as obesity, increased chloresterol, kidney related disorders and the like. 
     By “treatment”, it is meant that the compound is administered at least to reduce the blood glucose level in the patient suffering from the hyperglycemic disorder. The compound is administered in the amount sufficient to reduce the blood glucose level, free fatty acid level, cholesterol level, and the like to an acceptable range, where an acceptable range means + or −10%, and usually + or −5% of the normal average blood glucose level of the subject. A variety of subjects may be treated with the compound to reduce blood glucose levels such as livestock, wild or rare animals, pets, as well as humans. The compounds may be administered to the subject suffering from the hyperglycemic disorder using a convenient administration technique, including intravenous, intradermal, intramuscular subcutaneous, oral and the like. However, oral dosage is preferred. The dosage delivered to the host will necessarily depend upon the route by which the compound is delivered, but generally ranges from about 5-500 mg/kg human body weight or typically from about 50 to 200 mg/kg human body weight. 
     Of particular interest are methods of treating human hyperglycemic disorders such as diabetes, including type I and II, where the compound is administered to the human suffering from the hyperglycemic disorder to at least reduce the blood glucose level of the subject to amount the normal blood glucose range for a human. 
     Representative compounds according to the present invention may be synthesized by the methods disclosed below in Schemes IA, IB, II and III.                                                                                                         
     Referring to Scheme IA, the aldehyde (II) and acid (III) may be condensed in acetic anhydride and triethylamine to form the unsaturated acid (IV). After esterification of the acid, the phenolic hydroxy group is formed into an ether (VI) with p-fluorobenzaldehyde. The aldehyde (VI) is then condensed with the thiazolidinedione and the two non-cyclic double bonds are reduced with hydrogen to form the object compound (VIII). 
     The steps in Scheme IA are generalized in Scheme IB. The general formulas IIIB, IVB, VIB, VIIB and VIIIB correspond respectively to formulas III, IV, VI, VII and VIII in Scheme IA. 
     In Scheme II, the general synthesis of compounds where Z═—H, —A″ or —OB″ is shown. The aldehyde or ketone (IX) is condensed with the heterocyclic dione to form the bicyclic compound (X), which can be optionally hydrogenated to form the product (XI). 
     In Scheme III, the general synthesis of the tricyclic products (XV) and (XVI) is shown. The aldehyde or ketone (XII) is condensed with (XIII) to form the bicyclic compound (XIV). The compound (XIV) is condensed with the heterocyclic dione to form the tricyclic product (XV), which can be optionally hydrogenated to (XVI). 
     In formula I, C 1 -C 20  linear or branched alkyl means groups such as methyl, ethyl, propyl, isopropyl, n-butyl, isobutyl, t-butyl, sec-butyl, isopentyl, neopentyl, etc. The C 2 -C 20  linear or branched alkenyl means unsaturated groups such as ethenyl, propenyl, n-butenyl, isobutenyl, including groups containing multiple sites of unsaturation such as 1,3-butadiene, and the like. The halo groups include fluoro, bromo, iodo. Substituted C 1 -C 20  linear or branched alkyl or substituted C 2 -C 20  linear or branched alkenyl means that the alkyl or alkenyl groups may be substituted with groups such as halo, hydroxy, carboxyl, cyano, amino, alkoxy, and the like. The C 1 -C 20  acylamino or acyloxy group means an oxygen or amino group bonded to an acyl group (RCO) where R can be hydrogen, C 1 -C 20  linear or branched alkyl or C 2 -C 20  linear or branched alkenyl. Alkenyl groups are —C═C—, where R can be hydrogen, C 1 -C 20  linear or branched alkyl or C 2 -C 20  linear or branched alkyl. Alkoxycarbonyl means a group ROCO— where R can be hydrogen, C 1 -C 20  linear or branched alkyl or C 2 -C 20  linear or branched alkenyl. The C 1 -C 20  alkyl carboxyl amino group means a group RCON(R)— where R can be independently hydrogen, C 1 -C 20  linear or branched alkyl or C 2 -C 20  linear or branched alkenyl. Carboxyl is the group HOC 2 —, and alkanoyl is the group RCO— wherein R is a linear or branched carbon chain. The group aroyl is Ar—CO— wherein Ar is an aromatic group such as phenyl, naphthyl, substituted phenyl, and the like. Aralkanoyl is the group Ar—R—CO— wherein Ar is a aromatic group such as phenyl, naphthyl, substituted phenyl, etc. and R is a linear branched alkyl chain. 
     Referring to the figures, a compound according to the present invention, 5-(4-(4-(1-carbomethoxy)-2-(3,5-dimethoxy phenyl)-ethyl)-phenoxy)-benzyl)-2,4-thiazolidinedione (VIII), was administered in a single oral dose (50 mg/kg body weight) for 15 days to db/db male mice as shown in FIG. 1A. A substantial reduction in blood glucose level was observed. There was no increase in body weight in the treatment group as compared to the control treated with the vehicle without the active ingredient, FIG.  1 B. 
     The compound was orally administered to ob/ob mice with a single oral dose (50 mg/kg body weight). As shown in FIG. 2A, there was a 62% drop in blood glucose level and, similar to db/db mice, there was no significant increase in body weight between the control and the treatment groups as shown in FIG.  2 B. This is in contrast to treatment of diabetic animals by thiazolidine type compounds which are known to be associated with increase in body weight. See Okuno et al.,  J. Clin. Invest.,  101, 1354-1361 (1998) and Yoshioka et al.,  Metabolism,  42, 75-80 (1993). By stopping treatment after day 15 in both models, there was shown an increase in glucose level as depicted in FIGS. 3A and 3B. The time course of the drug effect is shown in FIG.  4 . Oral administration of a single dose of the compound in db/db mice was effective for 24 hours and beyond. 
     The triglyceride levels were also measured. Triglycerides, which are esters of fatty acids and glycerol, do not freely circulate in plasma but are bound to proteins and transported as macromolecular complexes called lipoproteins. The triglycerides were measured by the enzymatic method described by McGowen et al., 1983, with a modification to determine the triglyceride levels in db/db and ob/ob mice. There was shown a 24% drop in triglyceride levels in db/db mice (FIG. 5A) after 15 days of treatment with the compound and in ob/ob mice, a 65% decrease in triglyceride as compared to the control (FIG. 6B) after treatment for 10 days. 
     The free fatty acids (FFA) were enzymatically measured using coenzyme A in the presence of acyl CoA synthase (Wako Chemicals USA). The free fatty acid levels in db/db and ob/ob mice treated with the compound were significantly lower compared to the control animals. A 34% drop in FFA levels in db/db mice (FIG. 5B) were shown after 15 days of treatment with the compound. In ob/ob mice, after 10 days of treatment, a lowering of 33% of FFA was shown compared to the control (FIG.  6 C). 
     The percentage of glycohemoglobin (GHb) in blood reflects the average blood glucose concentration. It is a measure of overall diabetic control and can be use to monitor the average blood glucose levels. The glycosolation of hemoglobin occurs continuously in the red blood cells. But since the reaction is non-enzymatic and irreversible, the concentration of glycohemoglobin in a cell reflects the average blood glucose levels seen by the cell during its life. An assay was conducted using affinity chromatography with boronate as described by Abraham et al.,  J. Lab. Clin. Med.,  102, 187 (1983). There is a 0.7% drop in the GHb level in db/db mice (FIG. 5C) after 15 days of treatment with the compound and in ob/ob mice after 14 days of treatment, there is 1.3% decrease (FIG. 6D) in the GHb level compared to the control. 
     The blood insulin level was measured by ELISA following a standard protocol. A 58% drop of serum insulin in ob/ob mice (FIG. 6A) was shown after 10 days of treatment with the compound, thus, demonstrating its ability to act as an insulin sensitizer. 
     Obesity is considered as significant risk factor for various adult diseases such as diabetes and cardiac disease. Leptin, an obese gene product, has been identified from the investigation of ob/ob mice, where the leptin is lacking because of a mutation in that gene (Zhiang et al.,  Nature,  372, 425 (1994). Leptin is a protein of about 16 kDa, which is expressed in adipose tissue, and which promotes weight loss by suppressing appetite and stimulating metabolism. It is currently believed that leptin plays a key role in the obesity syndrome. In the db/db mice according to the experiment, the leptin level was measured by an ELISA, following a standard protocol. After 15 days of treatment with the compound, there is a 23% increase (FIG. 5D) in the serum leptin level compared to the control group. 
     The liver enzymes glutamic oxalacetic transaminase/aspartate aminotransferase (AST/GOT) and glutamic pyruvic transaminase/alanine aminotransferase (ALT/GPT) were assayed in the sera of ob/ob mice after 21 days of treatment (orally, 50 mg/kg) of the test compound. The test was also conducted using troglitazone. These enzyme levels are found to elevate in several kinds of hepatic disorders or liver necrosis. In FIG. 7A, the AST level in the mice was not elevated compared to untreated mice or to mice treated with troglitazone. Similarly, FIG. 7B shows that the ALT level did not elevate compared to untreated mice or mice treated with troglitazone. 
     Referring to FIGS. 8A and 8B glucose uptake in 3T3-L1 differentiated adipocytes was measured after treatment with trogliazone or the test compound. The assay was conducted according to the method of Tafuri,  Endocrinology,  137, 4706-4712 (1996). The serum-starved cells were treated with the test compound (or troglitazone) for 48 hours at different concentrations, then washed and incubated in glucose-free media for 30 minutes at 37° C. Then  14 C-deoxyglucose was added and uptake was monitored for 30 minutes under incubation. After washing, the cells were lyzed (0.1% SDS) and counted. As shown in FIG. 8A, there is a 3.5 to 4-fold increase in glucose uptake at the indicated concentrations of the test compound with respect to basal levels. There was only a 2 to 2.7-fold increase in uptade using troglitazone at 50× the concentration of the test compound as shown in FIG.  8 B. 
     Accordingly, it is seen that the above tests show that the compounds according to the present invention not only lower blood glucose level, triglyceride level, free fatty acid level, glycohemoglobin and serum insulin, but also raise the leptin level while showing no significant increase in body weight or liver toxicity.