# Patent

## Title
Ghrelin/growth hormone releasing peptide/growth hormone secretatogue receptor antagonists and uses thereof

## Abstract

The present invention provides novel compounds that have been demonstrated to be modulators of the ghrelin receptor (growth hormone secretagogue receptor, GHS-R1a and subtypes, iso forms and variants thereof). These compounds are useful as antagonists of the ghrelin receptor as well as inverse agonist, partial agonist or a combination of these activities as medicaments for treatment and prevention of a range of medical conditions including, but not limited to, metabolic and/or endocrine disorders, gastrointestinal disorders, cardiovascular disorders, obesity and obesity-associated disorders, diabetes, central nervous system disorders, genetic disorders, and hyperproliferative disorders.

## Background
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a 35 U.S.C. 371 National Stage of International Application No. PCT/US2007/010389 filed on Apr. 30, 2007, which designates the United States, and which claims the benefit under 35 U.S.C. §119(e) of U.S. Provisional Application No. 60/795,960 filed on Apr. 28, 2006, the entire contents of which are incorporated herein by reference.


FIELD OF THE INVENTION
This invention relates to novel compounds that disrupt the activity of ghrelin, growth hormone releasing peptide and the growth hormone secretagogue, receptor when introduced to animals, preferably humans, and methods of use thereof.
BACKGROUND OF THE INVENTION
The elevation of growth hormone (GH) levels in animals, e.g., mammals including humans, upon administration of GH-releasing compounds can lead to enhanced body weight. Ghrelin, identified as an endogenous ligand for the GH secretagogue receptor (GHS-R) is a powerful stimulator of pulsatile GH secretion and exhibits intricate interactions with the primary hypothalamic GH regulators (1-3). Ghrelin as well as growth hormone releasing peptides (GHRPs) and growth hormone secretagogues (GHSs) also function as potent orexigenic peptides (4-7). Initial peptide antagonists that inhibited the binding activity of GHSs in hypothalamic tissue in vitro were reported in 1991-92 (8-10). This included the Substance P analog, [Arg1 DPhe5 DTrp7,9 Leu11]-Substance P, that subsequently was demonstrated by Hoist et al (vide infra) to have both inverse agonist and ghrelin-R antagonist activity. Orexigenic compounds stimulate appetite.
Ghrelin is a 28 amino acid peptide, which has a unique structure among peptide hormones as it is acylated at Ser3 usually with an n-octanyl moiety (Bednarek et al., 2000; Kojima et al., 1999). This post-translational modification is essential for the activity of the hormone—as mediated through the seven transmembrane 0 (7TMG) protein coupled ghrelin receptor—both in vitro and in vivo (Kojima et al., 1999; Nakazato et al., 2001; Tschop et al., 2000).
Plasma levels of ghrelin rise precipitously in the blood before meals, when the stomach is empty, and fall after or during food consumption. Since intracardiac venous (i.v.) or intracerebroventricular (i.c.v) administration of ghrelin increases food intake, it appears that the physiological role of ghrelin is a link or messenger between the stomach and the hypothalamus and the pituitary. One hypothesis is that when an organism is getting ready for a meal, the CNS sends signals to the GI tract telling that a meal is about to be consumed in order to obtain information back about the status of the digestive process, state of distension etc. from the various chemical and mechanical sensors in the gut. Here, ghrelin could be an important hormonal messenger, which is sent back to the central nervous system (CNS) as a signal telling that there is no food in the stomach and that the gastrointestinal (GI) tract is ready for a new meal. In such a paradigm it is clear that a blocker of the ghrelin receptor would be a very efficient anti-obesity agent, as it would block the meal initiating, appetite signal from the GI tract.
The ghrelin receptor, GHS-R1a, belongs to a relatively small family of 7 transmembrane G-protein coupled receptors (11). A number of findings demonstrate how the ghrelin receptor may uniquely play a role in mediating the action on GH release and food intake. This includes ghrelin receptor genetics, mutations, structure, intracellular signaling, high constitutive activity, enhancement of the number of hypothalamic ghrelin receptors during starvation, etc. A spectrum of growth and metabolic changes occur in mice as a result of knockout of the ghrelin molecule as well as the ghrelin receptor. Adiposity in mice followed overexpression of the ghrelin receptor in hypothalamic growth hormone releasing hormone (GHRH) arcuate neurons. Over time, select biological effects of ghrelin/GHSs, especially non-endocrine effects, have been revealed which presumably occur via subtypes receptors of ghrelin or perhaps ghrelin receptors with select mutations. Evidence indicates binding and activation of the multifunctional CD36 receptor by GHSs. Another noteworthy finding of the ghrelin receptor was that under pathophysiological conditions the density of this receptor was reported to be five times greater in atherosclerotic coronary arteries (12).
Holst and Schwartz characterized the high constitutive activity of this receptor. Also, they demonstrated inhibition of the constitutive activity of the [DArg1, DPhe5, DTrp7,9 Leu11]-substance P analog which has been previously characterized both in vitro and in vivo as a weak competitive receptor antagonist to acute and chronic actions of GHRP-2 and ghrelin. These investigators demonstrated in vitro that this analog has 2 types of ghrelin receptor inhibiting activities. At a low dose (5 nM, IC50), this Sub P analog is a potent inverse receptor agonist since it decreases elevated intracellular IP3 levels in the absence of ghrelin but also it is a weak ghrelin GHRP-6 competitive receptor antagonist since high dosages (630 nM, IC50) inhibit receptor binding of both peptides (13, 14). Petersen, Holst, Schwartz et. al. reported that continuous i.c.v 7 day infusion of a very low dose of the Sub P ghrelin receptor inverse agonist inhibited body weight gain of male rats (15). This was a dose that would be too low to function as a competitive ghrelin receptor antagonist and thus it was considered to be due to the inverse agonist activity of the Sub P analog. In vitro evidence supports GHS-R antagonists with only inverse agonist or only ghrelin/GHS-R activity or a combination of the two (16).
Another possible novel functional role of the high constitutive activity of the ghrelin receptor in the CNS was proposed by Zigman et al on the distribution and functional implication of the ghrelin receptor in the brain of the rat and mouse (17). They proposed that the high constitutive activity of the ghrelin receptor plays a key functional role at CNS sites at which the receptor is expressed within the blood brain barrier and thus does not have immediate access to circulating ghrelin. This is in contrast to the ghrelin receptor located in the arcuate nucleus and dorsal vagal complex role. Thus it is possible that select GHSs, because of their different chemistry, may have ready access to brain sites inaccessible to ghrelin. If this occurs, GHSs' actions at these sites may alter the CNS ghrelin constitutive activity via receptor number and/or activity.
Although regulation of food intake by numerous hormones reveals its complexity, the inhibition of ghrelin induced food intake implies a fundamental biological functional aspect of the ghrelin system. For example, in the absence of the ghrelin receptor, transgenic female and male mice fed a high fat diet eat less food, less of the consumed calories are stored, fat is more of the energy substrate, and body weight and body fat are less in these mice than control mice (17, 18). When the ghrelin receptor was absent and mice were fed a normal diet, body weight and body fat were decreased in female but not in male mice. In the absence of the ghrelin peptide, transgenic male mice (female mice not studied) had less rapid body weight gain on a high fat diet (19). This was associated with increased energy expenditure and increased locomotive activity as well as decreased adiposity. Both of these studies indicate the ghrelin system is involved in body weight control especially when consuming a high caloric type of obese inducing diet. In the absence of the ghrelin receptor (GHS-R1a), ghrelin no longer increased food intake. Thus, the singularity of this receptor for mediating ghrelin induced food intake is indicated. Also, hyperphagia is an established risk factor in diabetes mellitus in humans and evidence indicates that sub-threshold doses of ghrelin increases food intake in streptozotocin treated rats (20). Experimental studies in rats revealed interrelationships of ghrelin, somatostatin and GHRH on function of the GH axis (21, 22).
Thus, compounds which effectively inhibit the ghrelin receptor are needed to disrupt the activity of ghrelin at the level of the CNS. Such compounds would be useful in the treatment of metabolic diseases and disorders such as obesity, diabetes mellitus, and inhibition of growth hormone secreted from tumors such as pituitary, prostate, osteoblast, pancreatic and hepatoma. Relevant basic and clinical ghrelin and GHS data have been discussed by Bowers et al (23, 24) as well as by other investigators (25-27).
SUMMARY OF THE INVENTION
We have surprisingly discovered new groups of compounds that provide desirable in vitro and in vivo inhibition of activation of the ghrelin receptor, GHS-R1a.
In one embodiment, the compounds have the formula:
A1-A2-A3-A4-A5-A6 (Formula I), wherein A1 is His, Tyr, desamino Tyr, D or LAla, β-Ala, CyclohexylAla (Cyclohexylalanine), DArg, Ava (aminovaleric acid), Gly, <Glu (pyroglutamic acid), αAib (alpha-aminoisobutyric acid), γAbu (gamma-aminobutyric acid), αAbu (alpha-aminobutyric acid), α,γAbu (alpha, gamma-diaminobutyric acid or 2,4-diaminobutyric acid), DVal, DPhe, DThr, DPal (pyridylalanine), DLys, AcDLys, DLeu, DTrp, Dβnaphthylalanine, or AcDβnaphthylalanine. There can be a normal or reduced psi (ψ, CH2NH) peptide bond between the positions 1 and 2. Alternatively, A1 may be amino acids with methylation of the terminal nitrogen of the alpha carbon atom of the A1 residue when a terminal nitrogen is present at the α carbon atom; and A2 is Dαnaphthylalanine, Dβnaphthylalanine, D or L Trp, D or L Phe, Ala, His, PicLys (Nε-picoloyl-lysine), or DCyclohexylalanine, wherein A2 is with or without methylation of the terminal nitrogen of the α carbon atom of the A2 residue. In one embodiment, A2 could have extended aromatic chains, such as, for example, D-4-halo-Phe, D-4-pyrolidylalanine, homologues and analogues thereof, wherein A2 is with or without methylation of the terminal nitrogen of the α carbon atom of the A2 residue;

A3 is D or L Lys, lysine derivatives, Arg, arginine derivatives, Orn, Phe, Trp, Leu, Pro, Ala, Ser, Pal, or α,γAbu;

A4 is D or L Trp, Phe, Ala, Ser, Tyr, Met, Pro, Thr, ILys, or CyclohexylAla;

A5 is D or L Trp, Phe, Ala, Lys, Arg, Orn, Thr, Leu, or DCyclohexylAla; and

A6 is Lys, Arg, Orn, D or L Phe, Pro, Nle (norleucine), or α,γAbu; or prodrugs, metabolite or pharmaceutically acceptable salts thereof, wherein the A6 residue can be present either in a C terminal amidated form or as a free carboxylic acid.

In one preferred embodiment, the ghrelin receptor antagonist is HisDβNalDLysTrpDPheLysNH2, or analogues, prodrug, metabolite, or pharmaceutical salts thereof.
In another embodiment, the ghrelin receptor antagonist is HisDTrpDLysTrpDPheLys NH2.
In another embodiment, the compounds of the formulas A1-A2-A3-A4-A5-A6 excludes HisDβNalDLysTrpDPheLysNH2.
In one embodiment, the compounds have the formula:
A7-A8-A9-A10 (Formula II), wherein A7 is DαNal, DβNal, AcDβNal, AcDαNal, Tyr, AcDTyr, Lys, D Phe, His, αAbu α,γAbu, γAbu, DcyclohexylAla, or isonipecotic carboxylic acid (inip);
A8 is D or L Trp, Ala, His, Phe, or Leu;
A9 is D or L Trp, Ala, CyclohexylAla, Phe, Pro, Lys, or Sarcosine (N-methylglycine) (Sar), or a free acid carboxyl group;
A10 is D or L Arg, Phe, CyclohexylAla, Lys, Ser, or NMePhe (methylated phenylalanine amino nitrogen), DPal, Aib, or Orn.
In one embodiment, the compounds have the formula:




wherein R1 is a hydroxyl group (—OH); and

R2 is —H,





or isomers thereof.

R3 is —H,





R5 is —H, or





In one embodiment, the compounds have the formula:




wherein R6 is





R7 is —H,





or isomers thereof.

In one embodiment, the compounds have the formula




wherein R8 is —H,





or isomers thereof.

Such compounds can be administered to a mammal, e.g. a human, to disrupt the activity of ghrelin at the level of the CNS. Thus, the present invention provides novel compounds and methods for their use in disrupting ghrelin. Accordingly, methods for the treatment of various diseases and disorders such as obesity, overeating, diabetes, unregulated cellular proliferation, and cancer using the novel compounds of the present invention are encompassed.
We have shown that administration of such compounds attenuates GH pulses and reduces food intake in mammals. Thus, in one embodiment, methods for the treatment of obesity are encompassed. In this method, an individual, preferably an obese or overweight individual, is administered a compound of Formula I of the present invention such as HisDβNalDLysTrpDPheLysNH2, analogues, prodrug, metabolite, or pharmaceutical salts thereof. The compound may also be administered in combination with other anti-obesity compounds. Such compounds are well known in the art.
Typically, an overweigh individual is considered to have a body mass index (BMI) of over 25 but under 30 and an obese individual is considered to have a BMI of over 30.
The methods and uses of the present invention are applicable for both sexes and all age groups including children and teenagers.
Also encompassed is a method for the treatment of obesity related diseases and disorders such as, but not limited to diabetes mellitus, metabolic syndrome, hypertension, elevated plasma insulin concentrations, insulin resistance, dyslipidemias, and hyperlipidemia, by administering to the individual in need thereof an effective ghrelin activity inhibiting amount of the novel compounds of the present invention.
In another embodiment, the invention provides a method for reducing a desire of a human subject to consume calories following gastric banding or gastric bypass surgery, by administering the ghrelin receptor antagonists of the present invention.
The present invention also provides methods for treating hormonally functional endocrine or non-endocrine tumors, such as, pituitary tumors, including ACTH-secreting pituitary tumors, in a mammal. The inventive methods involve administering to the mammal having or at risk for developing a pituitary tumor a therapeutically effective amount of the novel ghrelin receptor antagonist of the present invention. In one embodiment, the ghrelin receptor antagonist is administered in combination with other compounds useful in the treatment of pituitary tumor such as, for example, PPARγ ligands. Such PPARγ ligands include thiazolidinediones (TZDs), such as troglitazone, pioglitazone, and rosiglitazone.
In another embodiment, methods for the treatment of tumors that produce prolactin are encompassed. In this method, the novel ghrelin receptor antagonists of the present invention are administered to an individual with or at risk for developing a tumor that produces prolactin. Such tumors include, but are not limited to, breast and prostate cancer.
The novel ghrelin receptor antagonists of the present invention may also be used to inhibit adrenocorticotropic hormone. Also encompassed are methods for the treatment of ectopic neuroendocrine tumors such as functional ectopic neuroendocrine tumors, carcinoid and pancreatic tumors via the administration of ghrelin receptor antagonists.
The novel ghrelin receptor antagonists may also function to inhibit signaling via subtype receptors of ghrelin in addition to GHS-type 1 receptors. Thus, methods to treat diseases and disorders associated with these subtype receptors, e.g. prostate cancer, osteoblast cancer, pancreatic cancer, adenocarcinomas and hepatoma cells is encompassed in the present invention.



BRIEF DESCRIPTION OF THE FIGURES
FIGS. 1A and 1B show mean plasma GH responses to 500 ng ghrelin administered icv 15 min after the icv injection of 5 μg GHS-A (FIG. 1B) or normal saline (FIG. 1A). Central pretreatment with GHS-A abolished the stimulatory action of ghrelin on GH release compared with normal saline i.c.v. pretreated controls. Values are the mean±SE. The number of animals in each group is shown in parentheses. Arrows indicate the times of i.c.v. injections.
FIGS. 2A and 2B show mean plasma GH responses to 5 μg ghrelin administered iv 15 min after the iv injection of 250 μg GHS-A (FIG. 2B) or normal saline (FIG. 2A). Peripheral administration of GHS-A strongly blocked ghrelin's ability to release GH compared with normal saline-pretreated controls. Values are the mean±SE. The number of animals in each group is shown in parentheses. Arrows indicate the times of i.v. injections.
FIG. 3 shows a summary of the effects of GHS-A, given centrally (icv) or peripherally (iv), on ghrelin-induced GH release. The GH AUC following i.c.v. (500 ng) and i.v. (5 μg) ghrelin injection was reduced by 15- and 5-fold, respectively, in the GHS-A pretreated groups compared with their respective normal saline-treated controls. Each bar represents the mean±SE. *, P<0.0003 or less compared with normal saline-pretreated animals.
FIGS. 4A and 4B show that Individual representative plasma GH profiles in rats i.c.v. administered either 5 μg GHS-A (FIG. 4B) or normal saline (FIG. 4A) 15 min prior to the expected onset of the spontaneous GH secretory bursts typical of the male rat. GHS-A administration severely attenuated the amplitude of the spontaneous GH pulses compared with normal saline icv-injected controls. Arrows indicate the times of i.c.v. injections.
FIG. 5 shows that the 1-h GH AUC's of the spontaneous GH secretory episodes at 1100 h and 1400 h, and the overall 6-h GH AUC, were significantly reduced in animals treated i.c.v. with 5 μg GHS-A compared with normal saline i.c.v.-treated controls. Values are the mean±SE. *, P<0.01 or less compared with normal saline i.c.v.-treated group.
FIG. 6 shows a cluster analysis of the effects of centrally-administered GHS-A (5 μg) or normal saline on spontaneous GH pulse parameters. Cluster analysis revealed a significant suppression of GH peak height, but no significant effect of GHS-A on any other parameters of GH pulsatility, including GH peak frequency, interpeak interval and nadir, compared with normal saline icv-treated controls. Values are the mean±SE. *, P<0.03 vs. normal saline i.c.v.-treated controls.
FIGS. 7A and 7B show a feeding response to icv-administered ghrelin (500 ng) in animals pretreated icv with either GHS-A (5 μg) or normal saline (FIG. 7A). GHS-A significantly inhibited ghrelin's stimulatory effects on food intake in the first hour after injections, compared with normal saline i.c.v.-pretreated controls (FIG. 7B). Cumulative food intake was significantly suppressed for up to 5 h after GHS-A injection. Values are the mean±SE. *, P<0.02 or less compared with normal saline icv-pretreated controls.
FIGS. 8A and 8B show the effects of icv-administered GHS-A (5 μg) or normal saline on spontaneous food intake in overnight-fasted animals (FIG. 8A). GHS-A significantly inhibited spontaneous food intake in the first hour after injection, compared with normal saline icv-treated controls (FIG. 8B). Cumulative food intake was not inhibited by GHS-A beyond the first hour after injection. Values are the mean±SE. *, P<0.004 compared with normal saline icv-treated controls.
FIG. 9 shows a diagram of one ghrelin receptor antagonist HisDβNalDLysTrpDPheLysNH2.



DETAILED DESCRIPTION OF THE INVENTION
The present invention provides novel ghrelin, growth hormone releasing peptide and the growth hormone secretagogue receptor antagonists.
Compounds
In one embodiment, the ghrelin receptor antagonist has the formula: A1-A2-A3-A4-A5-A6 (Formula I) as described more fully above. One preferred antagonist has the formula HisDβNalDLysTrpDPheLysNH2.
In one embodiment, the ghrelin receptor antagonist is HisDTrpDLysTrpDPheLysNH2.
In another embodiment, the antagonist is HisDTrpDArgTrpDPhe NH2.
In yet another embodiment, the antagonist is HisDTrpDLysTrpDPhe NH2.
Examples of ghrelin receptor antagonists are shown in Tables 1-12. Examples of some preferred compounds are listed below.















TyrDTrpDLysTrpDPheNH2



TyrDTrpLysTrpDPhe NH2



HisDTrpDLysTrpDPheNH2



HisDTrpDLysPhe DTrpNH2



HisDTrpDArgTrpDPheNH2



HisDTrpDLysTrpDPheLysNH2



DesaminoTyrDTrpAlaTrpDPheNH2



DesaminoTyrDTrpDLysTrpDPheNH2



DeaminoTyrDTrpSerTrpDPheLysNH2



DesaminoTyrDTrpSerTrpDPheNH2



HisDTrpDTrpPheMetNH2



TyrDTrpDTrpPhePheNH2



GlypsiDβNalAlaTrpDPheLysNH2



GlypsiDβNalDLysTrpDPheLysNH2



Dala DβNalDLysDTrpPheLysNH2



HisDβNalDLysTrpDPheLysNH2



AlaHisDTrpDLysTrpDPheLysNH2

















TABLE 1







In Vitro Ghrelin/GHRP/GHS Receptor Antagonist Activity on Stimulated GH (ng/ml) release from isolated pituitary glands by the


pituitary incubation method. Stimulator is His-DTrp-Ala-Trp-DPhe-Lys-NH2 at 10 ng/ml










Peptide

Stimulated
Peptide Antagonist Dosage μg/ml
















Antagonist
Control
Control
0.1
0.3
1
3
10
30
100





1-Tyr-DTrp-
47 ± 22
1528 ± 214



−480 ± 95   

−363 ± 66



DLys-Trp-


DPhe-NH2


2-Tyr-DTrp-
−461 ± 163  
1053 ± 182






−555 ± 121


Lys-Trp-


DPhe-NH2


3-His-DTrp-
57 ± 77
2120 ± 311

1765 ± 160

949 ± 178

   91 ± 103


DLys-Trp-


DPhe-NH2


4-His-DTrp-
N/A


DLys-Phe-


DTrp-NH2


5-His-DTrp-
−461 ± 163  
1953 ± 182



341 ± 222
−125 ± 101
−122 ± 44


DArg-Trp-


DPhe-NH2


6-His-DTrp-
−129 ± 52   
1267 ± 64 

 952 ± 200
324 ± 181
134 ± 91 
 −83 ± 132
−175 ± 59


DLys-


Trp-DPhe-


Lys-NH2


7-DesaminoTyr-
58 ± 77
2120 ± 311



1302 ± 269 

−959 ± 75


DTrp-Ala-


Trp-DPhe-NH2


8-DesminoTyr-
223 ± 203
 5189 ± 1513
4297 ± 1061
2404 ± 802
688 ± 327
−466 ± 432  
−1068 ± 318  
 −576 ± 110


DTrp-DLys-


Trp-DPhe-NH2


9-DeaminoTyr-
 8 ± 305
 4436 ± 1006




3325 ± 391
  3810 ± 621


DTrp-Ser-


Trp-DPhe-Lys-


NH2


10-DesaminoTyr-
 8 ± 305
 4436 ± 1006




3119 ± 488
  3258 ± 682


DTrp-Ser-


Trp-DPhe-NH2


11-His-DTrp-
−129 ± 52   
1267 ± 164

1542 ± 523
323 ± 69 
445 ± 188
287 ± 68
−319 ± 95


DTrp-Phe-


Met-NH2


12-Tyr-DTrp-
47 ± 22
1528 ± 214

1274 ± 329


1034 ± 182
 −167 ± 157


DTrp-Phe-


Phe-NH2
















TABLE 2







In Vivo Ghrelin/GHRP/GHS Receptor Antagonist Activity on Stimulated GH (ng/ml) release from rat. Sitmulator is


DAla-DβNal-Ala-Trp-DPhe-Lys-NH2 at 0.3 μg or 1 μg











Stimulated
Stimulated




Control
Control
Peptide Antagonist Dosage μg/i.v.















Peptide Antagonist
Control
0.3 μg
1 μg
1
3
10
30
100





1-Glyψ[CH2NH]-DβNal-Ala-
138 ± 11
1412 ± 400



1112 ± 200
578 ± 82



Trp-DPhe-Lys-NH2



138 ± 11

3214 ± 276


2307 ± 176
 890 ± 236



164 ± 14

3105 ± 429


1842 ± 454
1135 ± 140


2-Glyψ[CH2NH]-DβNal-DLys-
143 ± 19

2406 ± 288
2305 ± 320
1990 ± 196
1550 ± 284
 946 ± 133
 462 ± 122


Trp-DPhe-Lys-NH2


3-DAla-DβNal-DLys-DTrp-Phe-
327 ± 39

4950 ± 98 



2884 ± 828
1198 ± 114


Lys-NH2


4-His-DβNal-DLys-Trp-DPhe-
 91 ± 46
2253 ± 252




733 ± 85


Lys-NH2



 91 ± 46

2825 ± 134




 818 ± 269


5-Ala-His-DTrp-DLys-Trp-DPhe-
 91 ± 46
2253 ± 252




1487 ± 397


Lys-NH2


6-Alaψ[CH2NH]-DβNal-Ala-
164 ± 14

3104 ± 429

2771 ± 157
2341 ± 416
1948 ± 450
1639 ± 221


Trp-DPhe-Lys-NH2
















TABLE 3







In Vivo Ghrelin/GHRP/GHS Receptor Antagonist Activity on Unstimulated Basal GH (ng/ml) Release from rat.











Stimulated
Stimulated




Control
Control
Peptide Dosage μg/i.v.















Partial Agonist/Antagonist Peptide
Control
0.3 μg
1 μg
1
3
10
30
100





1-DβNal-Ala-Trp-DPhe-Ala-NH2
253 ± 34
1991 ± 214

623 ± 60
694 ± 70
654 ± 58
713 ± 71



2-DAla-DcyclohexylAla-Ala-Phe-
204 ± 46
1850 ± 324

 435 ± 152
195 ± 34
250 ± 41
393 ± 51
697 ± 75


DPhe-Nle-NH2


3-DcyclohexylAla-Ala-Phe-DTrp-
204 ± 46
1765 ± 330

199 ± 63
266 ± 68
199 ± 23
346 ± 82
350 ± 61


Lys-NH2


4-DAla-DβNal-Ala-Thr-DThr-Lys-NH2
244 ± 56
1538 ± 215


255 ± 38

288 ± 31
386 ± 57


5-DcyclohexylAla-Ala-Trp-DPhe-NH2
176 ± 44
2282 ± 258


181 ± 28
237 ± 18
354 ± 81
771 ± 76


6-DAla-DβNal-Ala-Ala-DAla-Lys-NH2
135 ± 19
1485 ± 200


235 ± 43
178 ± 33
172 ± 15
185 ± 39


7-DβNal-Ala-Trp-DPhe-Leu-NH2
145 ± 48
1470 ± 338


253 ± 79
277 ± 43
347 ± 66
 645 ± 117


8-His-DTrp-Phe-Trp-DPhe-Lys-NH2
240 ± 55

2766 ± 726
 67 ± 14
141 ± 53
197 ± 70
509 ± 48


9-DAla-DβNal-DAla-DTrp-
100 ± 22

4785 ± 798
184 ± 55
 467 ± 201
 244 ± 107


Phe-Lys-NH2


10-βAla-Trp-DAla-DTrp-Phe-NH2
195 ± 33

4130 ± 349



341 ± 46
 636 ± 171


11-His-Trp-DAla-DTrp-Phe-LysNH2
150 ± 26
1847 ± 362

204 ± 44
127 ± 44
83 ± 5
















TABLE 4







In Vivo Ghrelin/GHRP/GHS Receptor Antagonist Activity on Unstimulated and Stimulated (S) GH (ng/ml) release from rats.


The Stimulator is DAla-DβNal-Ala-Trp-DPhe-Lys-NH2 at 0.3 μg, 1 μg, or 10 μg.











Stimulated
Stimulated




Control
Control
Peptide Anatgonist Dosage μg/i.v.















Peptide Antagonist (P)
Control
0.3
1
1
3
10
30
100



















Pentobarbital Rats











1-DLys-DβNal-Ala-Trp-DPhe-Lys-NH2
−S
197 ± 81



 616 ± 169
847 ± 17
 629 ± 148
228 ± 45


1-DLys-DβNal-Ala-Trp-DPhe-Lys-NH2
P + S

5052 ± 511


5232 ± 346
3404 ± 396
 704 ± 169


2-DAla-DβNal-DLys-DTrp-Phe-Lys-
−S
327 ± 39





323 ± 50
812 ± 6 


NH2


2-DAla-DβNal-DLys-DTrp-Phe-Lys-
P + S


4950 ± 98 



2884 ± 828
1198 ± 114


NH2


Non-Pentobarbital Rats



10 μg


1-Tyr-DAla-Phe-Aib-NH2
−S
12 ± 1





18 ± 1


1-Tyr-DAla-Phe-Aib-NH2
P + S


72 ± 9



23 ± 5


2-Tyr-DAla-Sar-NMePhe-NH2
−S
12 ± 1





18 ± 4


2-Tyr-DAla-Sar-NMePhe-NH2
P + S


72 ± 9



24 ± 6
















TABLE 5







In Vivo Ghrelin/GHRP/GHS Receptor Antagonist Activity on Unstimulated Basal GH (ng/ml) release from rats.











Stimulated
Stimulated




Control
Control
Peptide Antagonist Dosage μg/i.v.















Peptide Antagonist
Control
0.3 μg
1 μg
1
3
10
30
100





1-αγAbu-DTrp-DTrp-Ser-NH2
106 ± 9 

2742 ± 206
 80 ± 35

 62 ± 15
67 ± 8



2-αγAbu-DTrp-DTrp-Lys-NH2
136 ± 31

1968 ± 294
57 ± 7
 84 ± 18
 62 ± 15


3-αγAbu-DTrp-DTrp-Orn-NH2
167 ± 13

2819 ± 530
118 ± 16

126 ± 27
 79 ± 31


4-αAbu-DTrp-DTrp-Orn-NH2
167 ± 13

2819 ± 530
 85 ± 25

 88 ± 18
50 ± 6


5-DThr-DαNal-DTrp-DPro-Arg-NH2
164 ± 23

2691 ± 281
60 ± 5
130 ± 24
134 ± 31


6-DAla-Ala-DAla-DTrp-Phe-Lys-NH2
180 ± 20

4785 ± 798


228 ± 76
172 ± 14
153 ± 45


7-Alaψ[CH2NH]His-DTrp-Ala-Trp-DPhe-Lys-NH2
211 ± 30

2335 ± 323
127 ± 32
147 ± 37


8-Lys-DHis-DTrp-Phe-NH2
211 ± 30

2335 ± 323


121 ± 24


9-γAbu-DTrp-DTrp-Orn-NH2
167 ± 13

2819 ± 530
 82 ± 28

90 ± 5
113 ± 32


10-inip-Trp-Trp-Phe-NH2
155 ± 31

2503 ± 240


69 ± 3
 81 ± 10





inip = isonipecotic carboxylic acid


αγAbu = alpha gamma diaminobutyric acid













TABLE 6







In Vitro Ghrelin/GHRP/GHS Receptor Antagonist Activity on Unstimulated and Stimulated(S) GH (ng/ml) release


from cell culture of pituitary cells. The Sitmulator is DAla-DβNal-Ala-Trp-DPhe-Lys-NH2 at at 10 ng/ml.










Stimulated




Control
Peptide Antagonist Dosage μg/ml















Peptide Antagonist (P)
Control
10 ng/ml
0.1
0.3
1
3
10
30



















1-Ac-DTrp-Phe-DTrp-Leu-NH2
−S
1640 ± 100






400 ± 20


1-Ac-DTrp-Phe-DTrp-Leu-NH2
P + S

2420 ± 0



2100 ± 0 
1200 ± 20
600 ± 20


2-Ac-DTrp-Phe-DTrp-Lys-NH2
−S
1640 ± 100






350 ± 80


2-Ac-DTrp-Phe-DTrp-Lys-NH2
P + S

2420 ± 0



1750 ± 10
800 ± 0
470 ± 30


3-Ac-DTrp-DTrp-Lys-NH2
−S
1640 ± 100





 610 ± 30
420 ± 20


3-Ac-DTrp-DTrp-Lys-NH2
P + S

2420 ± 0



1970 ± 70
1130 ± 30
900 ± 0 


4-DLys-Tyr-DTrp-DTrp-Phe-Lys-
−S
1640 ± 100





1340 ± 60
1060 ± 0 


NH2


4-DLys-Tyr-DTrp-DTrp-Phe-Lys-
P + S

2420 ± 0



2100 ± 40
1710 ± 10
1270 ± 10 


NH2


5-Ac-DβNal-Leu-Pro-NH2
−S
1233 ± 49 


5-Ac-DβNal-Leu-Pro-NH2
P + S

 2811 ± 229



1998 ± 36
1206 ± 53
860 ± 33


6-βAla-Trp-DTrp-DTrp-Orn-NH2
−S
1722 ± 205


6-βAla-Trp-DTrp-DTrp-Orn-NH2
P + S

2385 ± 8


3103 ± 471

1633 ± 34
1166 ± 13 
















TABLE 7







In Vitro Ghrelin/GHRP/GHS Receptor Antagonist Activity on Unstimulated and Stimulated (S) GH (ng/ml) release from cell


culture of pituitary cells. The Stimulator is DAla-DβNal-Ala-Trp-DPhe-Lys-NH2 at 1 ng/ml.










Stimulated




Control
Peptide Dosage μg/ml














Partial Agonist/Antagonist Peptide (P)
Control
1 ng/ml
1
3
10
30
100


















1-DVal-DαNal-DTrp-Phe-Arg-NH2
−S
480 ± 16


 934 ± 34
850 ± 19
598 ± 7 



1-DVal-DαNal-DTrp-Phe-Arg-NH2
P + S

1399 ± 27

 949 ± 52
672 ± 64
520 ± 5 


2-DLeu-DαNal-DTrp-Phe-Arg-NH2
−S
480 ± 16


1156 ± 10
971 ± 5 
520 ± 5 


2-DLeu-DαNal-DTrp-Phe-Arg-NH2
P + S

1399 ± 27

1136 ± 7 
957 ± 44
777 ± 71


3-CyclohexylAla-DαNal-DTrp-Phe-Arg-NH2
P + S
734 ± 6 
1841 ± 41

1362 ± 59
1021 ± 22 


4-DTrp-DαNal-DTrp-Phe-Arg-NH2
P + S
734 ± 6 
1851 ± 41

1239 ± 17
878 ± 28


5-DAla-DβNal-DPro-Phe-Arg-NH2
P + S
734 ± 6 
1851 ± 41

1779 ± 27
1328 ± 59 


6-Ac-DαNal-DTrp-Phe-Arg-NH2
−S
480 ± 16


1106 ± 7 
996 ± 16
704 ± 76


6-Ac-DαNal-DTrp-Phe-Arg-NH2
P + S

1399 ± 27

1128 ± 12
970 ± 25
704 ± 76


7-DαNal-DTrp-Phe-Arg-NH2
−S
480 ± 16


1170 ± 43
987 ± 52
727 ± 44


7-DαNal-DTrp-Phe-Arg-NH2
P + S

1399 ± 27

1288 ± 40
1079 ± 17 
824 ± 29


8-inip-Trp-Trp-Phe-NH2
−S
625 ± 12



 553 ± 111
247 ± 9 
132 ± 7


8-inip-Trp-Trp-Phe-NH2
P + S

 749 ± 28


393 ± 6 
278 ± 35
154 ± 4





inip = isonipecotic carboxylic acid













TABLE 8







In Vitro Ghrelin/GHRP/GHS Receptor Antagonist Activity on Unstimulated Basal GH (ng/ml) release from cell


cultures of pituitary cells.










Stimulated




control
Peptide Antagonist Dosage μg/ml














Peptide Antagonist (P)
Control
1 ng/ml
1
3
10
30
100





1-His-DTrp-DTrp-Lys-NH2
1089 ± 47
1551 ± 2

1124 ± 37
749 ± 10
615 ± 41



2-Ac-DβNal-DTrp-NH2
1089 ± 47
1551 ± 2

1264 ± 2 
980 ± 72
699 ± 7 


3-αAib-DTrp-DcyclohexylAla-NH2
478 ± 8
1014 ± 8
 980 ± 44
 826 ± 32
602 ± 53
492 ± 11


4-αAib-DTrp-DAla-cyclohexylAla-NH2
478 ± 8
1014 ± 8
1086 ± 52
1103 ± 18
994 ± 22
 704 ± 115


5-DAla-DcyclohexylAla-Ala-Ala-Phe-DPhe-Nle-
 500 ± 116
 1991 ± 214
 286 ± 75
 177 ± 44
271 ± 38
376 ± 28


NH2


6-DPhe-Ala-Phe-DPal-NH2
 176 ± 44


 170 ± 19
181 ± 31
161 ± 20
146 ± 21


7-DPhe-Ala-Phe-DPhe-Lys-NH2
 368 ± 32



267 ± 27
276 ± 65
360 ± 84


8-DLys-Tyr-DTrp-DTrp-Phe-NH2
1403 ± 13

1451 ± 19
1175 ± 77
1129 ± 6 
744 ± 44


9-Ac-DLys-Tyr-DTrp-DTrp-Phe-NH2
1403 ± 13


105 ± 8
950 ± 91
782 ± 56
756 ± 1 


10-Arg-DTrp-Leu-Tyr-Trp-Pro(cyclic Arg-Pro)
1403 ± 13


1480 ± 19
802 ± 26
601 ± 16
509 ± 49


11-Ac-DβNal-PicLys-ILys-DPhe-NH2
1333 ± 41


 1013 ± 207
976 ± 13
928 ± 16


12-DPal-Phe-DTrp-Phe-Met-NH2
1333 ± 41


1081 ± 50
997 ± 30
425 ± 25


13-DPhe-Trp-DPhe-Phe-Met-NH2
1333 ± 41


1146 ± 34
1086 ± 32 
871 ± 89


14-DPal-Trp-DPhe-Phe-Met-NH2
1333 ± 41


1105 ± 18
891 ± 4 
567 ± 24





ILys = Lys(iPr)













TABLE 9







In Vitro Ghrelin/GHRP/GHS Receptor Antagonist Activity on Unstimulated and


Stimulated(S) GH (ng/ml) release from cell cultures of pituitary cells. The Stimulator is


DAla-DβNal-Ala-Trp-DPhe-Lys-NH2 at 1 ng/ml.










Stimulated




control
Peptide Antagonist Dosage μg/ml














Peptide Antagonist (P)
Control
1 ng/ml
1
3
10
30
100


















1-βAla-Pal-DTrp-DTrp-Orn-NH2
−S
894 ± 18



759 ± 11
861 ± 25




P + S

1232 ± 34


855 ± 11
828 ± 11


2-αγAbu-Trp-DTrp-DTrp-Orn-NH2
−S
894 ± 18



609 ± 3 
503 ± 5 



P + S

1232 ± 34


666 ± 2 
578 ± 31


3-βAla-Trp-DTrp-DTrp-Lys-NH2
−S
894 ± 18



733 ± 25
616 ± 21



P + S

1232 ± 34


806 ± 45
596 ± 18


4-γAbu-Trp-DTrp-DTrp-Orn-NH2
−S
894 ± 18



840 ± 30
634 ± 1 



P + S

1232 ± 34


835 ± 5 
655 ± 40


5-Ava-Trp-DTrp-DTrp-Orn-NH2
−S
894 ± 18



481 ± 3 
406 ± 21



P + S

1232 ± 34


505 ± 19
420 ± 34





αγAbu = alpha gamma diaminobutyric acid


Ava = aminovaleric acid













TABLE 10







In Vitro Ghrelin/GHRP/GHS Receptor Antagonist Activity on Unstimulated and Stimulated(S) GH (ng/ml) release


from cell cultures of pituitary cells. The Stimulator is DAla-DβNal-Ala-Trp-DPhe-Lys-NH2 at 1 ng/ml.










Stimulated




Control
Partial Peptide/Non-peptide Dosage μg/ml













Partial Peptide/Non-peptide(P)
Control
1 ng/ml
1
3
10
30

















1-DTrp-4-phenylpiperdinamide
P + S
385 ± 49
1060 ± 24
815 ± 26
390 ± 35
520 ± 61
577 ± 24






1085 ± 1 
917 ± 4 
344 ± 6 
486 ± 29


2-2,3-di[N-(2-methoxylphenyl)
P + S
361 ± 30
905 ± 6
338 ± 3 
204 ± 10
262 ± 4 


piperazyl-naphthalene carboxylamide



654 ± 18
442 ± 4 
537 ± 28



P + S
385 ± 17
1153 ± 36


136 ± 11
118 ± 8 








648 ± 16
309 ± 46


3-Benzamide-DSerDLysTrp-p-
P + S
370 ± 24
1216 ± 26

393 ± 54
369 ± 30


phenylpiperidinamide




432 ± 25
353 ± 10


4-Ser(Bzl)Lys(Ac)DTrp-p-
P + S
385 ± 17
1153 ± 36


388 ± 41
273 ± 39


phenylpiperidinamide





571 ± 32
399 ± 24


5-O-(2-methylallyl) benzophonone oxime
P + S
969 ± 33
1461 ± 58


929 ± 28
616 ± 23








1281 ± 58 
699 ± 53


6-D Ser(BZL)-N′-phenyl-N-piperazinamide
P + S
626 ± 4 
1016 ± 18


585 ± 10
368 ± 2 








719 ± 26
435 ± 0 


7-αAibDSer(BZL)-N′-phenyl-N-piperazinamide
P + S
626 ± 4 
1016 ± 18


777 ± 34
499 ± 18








878 ± 30
510 ± 15


8-2-[acetylester]-3-(p-m-methoxyl phenyl)
P + S
421 ± 16
859 ± 4


373 ± 2 
176 ± 11


piperidinamide]-naphthalene carboxamide





480 ± 9 
223 ± 22
















TABLE 11







In Vitro Ghrelin/GHRP/GHS Receptor Antagonist Activity on Unstimulated and Stimulated(S) GH (ng/ml) release from


cell cultures of pituitary cells. The Stimulator is DAla-DβNal-Ala-Trp-DPhe-Lys-NH2 at 1 ng/ml.










Stimulated




Control
Partial Peptide/Non-peptide Dosage μg/ml













Partial Peptide/Non-peptide(P)
Control
1 ng/ml
1
3
10
30

















1-2-[methylester]-3-[p-methylphenylamide
P + S
626 ± 4 
1016 ± 18 


754 ± 32
498 ± 26


naphthalene carboxylamide





1149 ± 33 
886 ± 29


2-p-phenyl(piperidinamide-DTrpLysSer(BZL)-
P + S
408 ± 40
905 ± 6 
680 ± 13
489 ± 41
245 ± 16


acetylamide


3-γAbuDTrp-p-[m-methoxyphenyl]
P + S
364 ± 31
947 ± 11


557 ± 19
378 ± 18


piperidinamide





526 ± 27
428 ± 22


4-αAibDTrp-p-(o-methoxylphenyl)
P + S
377 ± 24
947 ± 33


365 ± 2 
375 ± 30


piperidinamide





441 ± 21
384 ± 16


5-2-[ethylester-3-m-methoxylphenylamide]
P + S
364 ± 31
947 ± 11


698 ± 18
552 ± 20


naphthalene carboxylamide





670 ± 32
458 ± 15


6-1,3-diaminobutyricamide-DβNal-4-
P + S
626 ± 4 
1016 ± 18 


794 ± 34
504 ± 20


phenylpiperidinamide





644 ± 33
529 ± 20
















TABLE 12







In Vitro Ghrelin/GHRP/GHS Receptor Antagonist Activity on Unstimulated and Stimulated(S) GH (ng/ml) release


from isolated pituitary glands by the pituitary incubation method. The Stimulator S = His-DTrp-Ala-Trp-DPhe-Lys-NH2


(10 ng/ml) and Stimulator *S = Tyr-DTrp-Ala-Trp-Dphe-NH2 (0.3 μg/ml)










Stimulated
Peptide Dosage μg/ml














Peptide(P)
Control
Control
1
3
10
30
100


















1-His-DTrp-DLys-Trp-DPhe-NH2
P + S
654 ± 255
8769 ± 583
8121 ± 687
5929 ± 857
3017 ± 413 
 269 ± 140



2-Ala-His-DTrp-DLys-Trp-DPhe-
P + S
1674 ± 1171
5218 ± 507
4850 ± 539
 947 ± 551
3977 ± 1360


Lys-NH2








−2384 ± 868   


3-DLys-Tyr-DTrp-Ala-Trp-DPhe-
P + S
148 ± 137
2218 ± 194

1233 ± 268
 688 ± 3233
916 ± 80


NH2*


4-His-DTrp-DArg-Trp-DPhe-NH2
P + S
−14 ± 62  
 776 ± 142

−109 ± 124
209 ± 124
−500 ± 104







 136 ± 108

−454 ± 95  


5-<Glu-His-Trp-DSer-DArg-NH2

246 ± 67 



−4 ± 25
 6 ± 34


6-DPhe-DPhe-DTrp-Met-DLys-
P + S
148 ± 137
2218 ± 194

1584 ± 136
1398 ± 98 
1388 ± 300


NH2*









In another embodiment, the antagonist is a compound of Formula I other than HisDβNalDLysTrpDPheLysNH2. Pharmaceutically acceptable organic and inorganic addition salts thereof are also included.
The abbreviations for the residues of amino acids used herein are in agreement with the standard nomenclature, and are as follows: L Gly—Glycine, L Tyr—Tyrosine, L Ile—Isoleucine, L Glu—Glutamic Acid, L Thr—Threonine, L Phe—Phenylalanine, L Ala—Alanine, L Lys—Lysine, L Asp—Aspartic Acid, L Cys—Cysteine, L Arg—Arginine, L Gln—Glutamine, L Pro—Proline, L Leu—Leucine, L Met—Methionine, L Ser—Serine, L Asn—Asparagine, L His—Histidine, L Trp—Tryptophan, L Val—Valine, L Orn—Ornithine, Desamino Tyr—Desamino Tyrosine, Desamino His—Desamino Histidine, Desamino alpha Aib—Desamino alpha aminoisobutyric acid, Desamino alpha Abu—Desamino alpha aminobutyric acid, Desamino alpha, gamma Abu—Desamino alpha, gamma aminobutyric acid.
Moreover, all of the three letter-abbreviations of the amino acids preceded by a “D” indicate the dextro-isomer of the amino acid residue, and glycine is considered to be included in the term naturally occurring L-amino acids. Other abbreviations used herein include: Aib—aminoisobutyric acid, inip—isonipecotyl, Abu—aminobutyric acid, alpha Nal—alpha-naphthylalanine, beta Nal—beta-naphthylalanine, D alpha Nal—alpha-naphthyl-D-alanine, D beta Nal—beta-naphthyl-D-alanine, Pal 3-pyridyl alanine, CHx—cyclohexyl, CHxAla—L-cyclohexylalanine, Ava—Aminovaleric acid, IMA—N alpha-imidazole acetic acid, imc—imidazole carboxylic acid, beta Ala—beta-Alanine, ILys—Lysine (iPr) which is isopropylαNεlysine, α,γAbu—alpha gamma diaminobutyric acid, Nle—norleucine, PicLys—Nε-picoloyl-lysine, inip—isonipecotoc carboxylic acid, NMePhe—methylated phenylalanine amino nitrogen, Sar—sarcosine (N-methylglycine), <Glu—pyroglutamic acid, AcDβNal—acetylated D beta-naphthylalanine, and AcDαNal—acetylated D alpha-naphthylalanine, NAcDβNal—acetyl N-DβNaphthylalanine.
In one embodiment, the ghrelin receptor antagonist has the formula: A7-A8-A9-A10 (Formula II) as described more fully above. Examples of antagonist compound of formula II are shown in Tables 4-8. The preferred antagonist has the formula αγAbu-DTrp-DTrp-(Ser/Lys/Orn)-NH2. A few select examples include: Tyr-DAla-Phe-Aib-NH2; Tyr-DAla-Sar-NMePhe-NH2; Lys-DHis-DTrp-Phe-NH2; γAbu-DTrp-DTrp-Orn-NH2; inip-Trp-Trp-Phe-NH2; Ac-DTrp-Phe-DTrp-Leu-NH2; Ac-DTrp-DTrp-Lys-NH2; Ac-DβNal-Leu-Pro-NH2.
In another embodiment, the antagonist compound has a formula other than the preferred αγAbu-DTrp-DTrp-(Ser/Lys/Orn)-NH2. Pharmaceutically acceptable organic and inorganic addition salts thereof are also included.
A compound having the formula S1B1S2B2S3, wherein S1 is R1, R1R2, R1R2R3, H or COOH, wherein R1, R2 and R3 are selected from the group consisting of any natural L amino acid, Pal (3-pyridyl alanine), cyclo-Ala, Aib, Nle, inip, Abu, βNal, αNal, Orn, carboxylic acid and their respective D isomers;
B1 is selected from the group consisting of Trp, βNal, αNal, Leu, Lys, cyclohexyl Ala and their respective D isomers;
S2 is des Amino, R1, R1R2, R1R2R3, H or COOH, wherein R1, R2 and R3 are as defined above;
B2 is any natural L amino acid, Pal (3-pyridyl alanine), cycloAla, Aib, Nle, inip, Abu, βNal, αNal, Orn and their respective D isomers; and
S3 is NH2, COOH, R1, R1R2, R1R2R3, wherein R1, R2 and R3 are as defined above, or pharmaceutically acceptable salts thereof.
In other embodiments, the compound can be a dipeptide, a tripeptide and/or a tetrapeptide. Examples of such peptides include, but are not limited to, the following embodiments.
In one embodiment, the ghrelin receptor antagonist has at least a tetrapeptide core of DTrp-Ala-Trp-DPhe. The position 1 of the tetrapeptide core comprise DTrp, DβNal, DαNal, DPhe, and DcyclohexylAla, while the position 2 of the tetrapeptide core comprise L or D natural or unnatural or derivatized amino acid residues including but not exclusive to DLys, DOrn, Ser, DPal, DLeu, Phe. In one embodiment, there may be additional amino acids at the N-terminus alone, C-terminus alone, or N- and C-termini of the tetrapeptide core. N terminus additions may comprise of L or D natural derivative amino acids such as—Tyr, His, desamino Tyr, GlyψAlaψ, DAla, βAla, α, γ, αγAbu, DLys, <Glu, DArg, DOrn or carboxylic acid or mono, di tripeptides or longer peptides such as His-Lys, His-DLys, DHis-Lys. The C-terminus additions may comprise of L or D natural or unnatural amino acid residues with terminal amidation or carboxylation including mono, di, tripeptides or longer peptides such as Lys, Arg, Lys-Gln, Lys-Gln-Gly. Examples of tetrapeptide core containing antagonist are DHis-DTrp-DPro-DIleNH2, DHis-DTrp-DPro-DArgNH2, and DβNal-DTrp-DPro-DArgNH2.
In one embodiment, the ghrelin receptor antagonist has at least a tripeptide core of DAla-DTrp-Phe. The positions 1 and 2 of this tripeptide core may be substituted with any amino acids selected from D amino acid residues or unnatural amino acid residues. The position 3 position may be substituted with amino acids selected from Trp, Leu, Val, Ile, Pro, Phe, cyclohexylAla and cyclopentylAla. In one embodiment, there may be additional amino acids at the N-terminus alone, C-terminus alone, or at both N- and C-terminus of the tripeptide core. N terminus additions may comprise L or D natural or unnatural amino acid residues and/or organic carboxylic acid, dipeptides or longer peptides with L or D natural or unnatural amino acid residues in various combinations and/or sequences including but not limited to DAla-DβNal, DAla-DαNal, βAla-Trp, His-Trp, DHis-Trp, DHis-DTrp, His-DTrp. C terminus additions may comprise L or D natural or unnatural amino acid residues with terminal amidation or carboxylation including, but are not limited to, mono, di, tripeptides or longer peptides such as Lys, Arg, Lys-Gln, Lys-Gln-Gly or carboxylic acid. Examples of tripeptide core containing antagonist are αAib-DTrp-cyclohexylDAlaNH2, NAcDTrp-DTrpLysNH2 and NAcDβNal-Leu-ProNH2.
In one embodiment, the ghrelin receptor antagonist has at least a tripeptide core of DTrp-Phe-DTrp. The positions 1 and 3 of this core may be substituted with amino acids selected from DβNal, DαNal, DPhe, and DcyclohexylAla, and the position 2 of the tripeptide core may be substituted with amino acids selected from Trp βNal, αNal, Leu, DLeu, and DLys. In one embodiment, there may be additional amino acids at the N-terminus alone, C-terminus alone, or at both N- and C-terminus of the tripeptide core. N terminus additions may comprise a L or D natural or unnatural amino acid residues or organic carboxylic acid. N terminus additions may comprise a dipeptides, tripeptide, or tetrapeptides comprising L or D natural or unnatural amino acid residues in various combinations and/or sequences, for example DAla-DβNal, DAla-DαNal, βAla-Trp, His-Trp, DHis-Trp, DHis-DTrp, His-DTrp. C terminus additions may comprise an amino acid residue selected from Leu, Lys, and Arg. C terminus additions may also comprise a dipeptide or tripeptide comprising the amino acids Leu, Lys, Arg, and combinations thereof. Examples of C terminus additions are Leu, Leu-Leu, Leu-Lys, Leu-Arg, Leu-Leu-Lys.
In yet another embodiment, the ghrelin receptor antagonist has at least a dipeptide core of DTrp-DTrp wherein the core amino acids may be substituted with D natural and/or derivatized amino acid residues of Trp, βNal, αNal, Phe, and various combinations thereof. In one embodiment, there may be additional amino acids at the N-terminus alone, C-terminus alone, or at both the N- and C-terminus of the dipeptide core. N terminus additions may comprise L or D natural or derivatized amino acid residues and/or organic carboxylic acid. Additionally, N terminus additions may also comprise a dipeptide or tripeptide or tetrapeptide or pentapeptide comprising amino acid residues selected from Tyr, His, desamino Tyr, Lys, Glyψ, Alaψ, DAla, αγAbu, αAbu, γAbu, Lys, DLys, isonipecotic carboxylic acid (inip), βAla, DAla, DLys, DThr, DVal, DLeu, cyclohexylAla, cyclopentylAla, DTrp, iPrLys, and diethyl guanidinoArg. Examples of N-terminus additions include His-Trp, DLys-Tyr, βAla-Trp, N-AcDLys-Tyr, βAla-Pal, αγAbu-Trp, γAbu-Trp, Ava-Trp, αAbu-Trp, His-DLys, Lys-DHis, DLys-Tyr-DHis. C terminus additions may comprise L or D natural or derivatized amino acid residues or organic carboxylic acids. C terminus additions may also comprise a dipeptide or tripeptide or tetrapeptide or pentapeptide comprising amino acids residues selected from Phe, DPro, Leu, Met, Ser, Lys, Orn, Arg, cyclohexylAla, and cyclopentylAla. examples of the C-terminus additions are Phe-Lys, DPro-Lys, Phe-DPro-Lys, DPro-Arg, Phe-Met, Phe-Ala, Phe-Ser. Examples of dipeptide core containing antagonist are NAcDβNal-DTrpNH2 and DThr-DαNal-DTrp-DPro-ArgNH2.
In one embodiment, the ghrelin receptor antagonist compound has a formula (Formula III) as described in detailed above:




Examples of ghrelin receptor antagonist compounds having the formula III are shown in Tables 10 and 11.
In one embodiment, the ghrelin receptor antagonist compounds having the formula III are:




    (R)-2-amino-3-(1H-indol-3-yl)-1-(4-phenylpiperidin-1-yl)propan-1-one






    N—((R)-1-((R)-1-((S)-3-(1H-indol-3-yl)-1-oxo-1-(4-phenylpiperidin-1-yl)propan-2-ylamino)-6-amino-1-oxohexan-2-ylamino)-3-hydroxy-1-oxopropan-2-yl)benzamide






    (S)—N—((S)-3-(1H-indol-3-yl)-1-oxo-1-(4-phenylpiperidin-1-yl)propan-2-yl)-6-acetamido-2-((S)-2-amino-3-(benzyloxy)propanamido)hexanamide






    (S)—N—((R)-3-(1H-indol-3-yl)-1-oxo-1-(4-phenylpiperidin-1-yl)propan-2-yl)-2-((S)-2-acetamido-3-(benzyloxy)propanamido)-6-aminohexanamide






    (R)—N-(3-(1H-indol-3-yl)-1-(4-(2-methoxyphenyl)piperidin-1-yl)-1-oxopropan-2-yl)-4-aminobutanamide






    (R)-2-amino-N-(3-(benzyloxy)-1-oxo-1-(4-phenylpiperazin-1-yl)propan-2-yl)-2-methylpropanamide


In one embodiment, the isomers of ghrelin receptor antagonist compounds of formula III are included.
In another embodiment, the ghrelin receptor antagonist compound has a formula (Formula IV) as described in detailed above:




Examples of ghrelin receptor antagonist compounds having the formula IV are shown in Tables 10 and 11.
In one embodiment, the ghrelin receptor antagonist compounds having the formula IV are:




    naphthalene-2,3-diylbis((4-(2-methoxyphenyl)piperazin-1-yl)methanone)






    3-(2-methoxyphenylcarbamoyl)-2-naphthoate






    (S)-2,4-diamino-N—((R)-3-(naphthalen-2-ylmethoxy)-1-oxo-1-(4-phenylpiperidin-1-yl)propan-2-yl)butanamide






    ethyl 3-(4-(2-methoxyphenyl)piperidine-1-carbonyl)-2-naphthoate






    methyl 3-(p-tolylcarbamoyl)-2-naphthoate


In one embodiment, the isomers of ghrelin receptor antagonist compounds of formula IV are included.
In yet another embodiment, the ghrelin receptor antagonist compound has a formula (Formula V) as described in detailed above:




Examples of ghrelin receptor antagonist compounds having the formula V are shown in Tables 10 and 11.
In one embodiment, the ghrelin receptor antagonist compounds having the formula V are:




    (R)-2-amino-N-(3-(benzyloxy)-1-oxo-1-(4-phenylpiperazin-1-yl)propan-2-yl)-2-methylpropanamide






    (R)-2-amino-3-(benzyloxy)-1-(4-phenylpiperazin-1-yl)propan-1-one


In one embodiment, the isomers of ghrelin receptor antagonist compounds of formula V are included.
In one embodiment, the compound has a formula:
AA1-AA2-AA3-AA4-AA5-AA6 (Formula I′), wherein A1 is His, Gly, αAib (alpha-aminoisobutyric acid), γAbu (gamma-aminobutyric acid), or α,γAbu (alpha, gamma-diaminobutyric acid or 2,4-diaminobutyric acid). There can be a normal or reduced psi (ψCH2NH) peptide bond between positions 1 and 2. Alternatively, AA1 may be amino acids with methylation of the terminal nitrogen of the alpha carbon atom of the A1 residue when a terminal nitrogen is present at the α carbon atom;
AA2 is Dα,βnaphthylalanine, DTrp, DPhe, or DCyclohexylalanine, wherein AA2 is with or without methylation of the terminal nitrogen of the α carbon atom of the AA2 residue. In one embodiment, AA2 could have extended aromatic chains, such as, for example, D-4-halo-Phe, D-4-pyrolidylalanine, homologues and analogues thereof, wherein AA2 is with or without methylation of the terminal nitrogen of the α carbon atom of the AA2 residue;
AA3 is D or L Lys, Arg, Orn, or α,γAbu;
AA4 is D or L Trp, Phe, or Cyclohexylalanine;
AA5 is DPhe or DCyclohexylalanine; and
AA6 is Lys, Arg, Orn, or α,γAbu, or pharmaceutically acceptable salts thereof, wherein the AA6 residue can be present either in a C terminal amidated form or as a free carboxylic acid.
Unless otherwise defined herein, scientific and technical terms used in connection with the present application shall have the meanings that are commonly understood by those of ordinary skill in the art.
It should be understood that this invention is not limited to the particular methodology, protocols, and reagents, etc., described herein and as such may vary. The terminology used herein is for the purpose of describing particular embodiments only, and is not intended to limit the scope of the present invention, which is defined solely by the claims.
The novel antagonists embodied in the invention can be synthesized according to the usual methods of solution and solid phase peptide chemistry, or by classical methods known in the art. Purification of peptides is well known in the art and can be, for example, HPLC. Methods describing useful peptide synthesis and purification methods can be found, for example, in U.S. Patent Application No. 20060084607.
In another embodiment of the present invention, methods for the treatment of various diseases and disorders such as obesity, overeating, diabetes, unregulated cellular proliferation, and cancer using the novel compounds of the present invention are encompassed. In such embodiments, the novel ghrelin receptor antagonists of the present invention are administered to an individual in need of such treatment.
In one embodiment, the invention provides use of the ghrelin receptor antagonist compounds as described throughout the specification for the treatment of obesity, overeating, diabetes mellitus, metabolic syndrome, unregulated cellular proliferation, and cancer. In one preferred embodiment, the invention provides use of the ghrelin compound for the treatment of obesity alone or in combination with other obesity treatments.
In one preferred embodiment, use of the ghrelin receptor antagonist compounds, including compositions of compounds having formulae I-V for the treatment of obesity is combined with a surgical or mechanical procedure used to treat obesity. Such procedures include but are not limited to gastric bypass surgery and gastric banding.
In one preferred embodiment, use of the ghrelin receptor antagonist compounds, comprising compositions of compounds having formulae I, II, III, IV or V, or combinations thereof for the treatment of obesity is combined with a surgical or mechanical procedure used to treat obesity. Such procedures include but are not limited to gastric bypass surgery and gastric banding.
In one preferred embodiment, use of the ghrelin receptor antagonist compounds, consisting essentially of compositions of compounds having formulae I, II, III, IV or V, or combinations thereof for the treatment of obesity is combined with a surgical or mechanical procedure used to treat obesity. Such procedures include but are not limited to gastric bypass surgery and gastric banding.
In one preferred embodiment, use of the ghrelin receptor antagonist compounds, consisting of compositions of compounds having formulae I, II, III, IV or V, or combinations thereof for the treatment of obesity is combined with a surgical or mechanical procedure used to treat obesity. Such procedures include but are not limited to gastric bypass surgery and gastric banding.
In another embodiment, the invention provides for the use of the ghrelin compounds, including compositions of compounds having formulae I, II, III, IV or V, or combinations thereof, for the treatment, prevention, or management of hormonally functional endocrine or non-endocrine tumors.
In one embodiment, compositions of compounds having formulae I, II, III, IV or V, or combinations thereof can be used in combination for the treatment of various diseases and disorders.
The experimental data regarding the effect of the compounds of this invention has been produced in well known animal models that are typically used for the effects of anti-obesity treatments at the first stage and are thus likely to be applicable to human obesity.
The invention provides novel compounds including:
A compound with the formula Tyr-DTrp-DLys-Trp-DPhe-NH2, Tyr-DTrp-Lys-Trp-DPhe-NH2, His-DTrp-DLys-Trp-DPhe-NH2, His-DTrp-DLys-Phe-DTrp-NH2, His-DTrp-DArg-Trp-DPhe-NH2, His-DTrp-DLys-Trp-DPhe-Lys-NH2, DesaminoTyr-DTrp-Ala-Trp-DPhe-NH2, DesaminoTyr-DTrp-DLys-Trp-DPhe-NH2, DesaminoTyr-DTrp-Ser-Trp-DPhe-Lys-NH2, DesaminoTyr-DTrp-Ser-Trp-DPhe-NH2, His-DTrp-DTrp-Phe-Met-NH2, Tyr-DTrp-DTrp-Phe-Phe-NH2, Glyψ[CH2NH]-DβNal-Ala-Trp-DPhe-Lys-NH2, Glyψ[CH2NH]-DβNal-DLys-Trp-DPhe-Lys-NH2, DAla-DβNal-DLys-DTrp-Phe-Lys-NH2, His-DβNal-DLys-Trp-DPhe-Lys-NH2, Ala-His-DTrp-DLys-Trp-DPhe-Lys-NH2, Alaψ[CH2NH]-DβNal-Ala-Trp-DPhe-Lys-NH2, DβNal-Ala-Trp-DPhe-Ala-NH2, DAla-DcyclohexylAla-Ala-Phe-DPhe-Nle-NH2, DcyclohexylAla-Ala-Phe-DTrp-Lys-NH2, DAla-DβNal-Ala-Thr-DThr-Lys-NH2, DcyclohexylAla-Ala-Trp-DPhe-NH2, DAla-DβNal-Ala-Ala-DAla-Lys-NH2, DβNal-Ala-Trp-DPhe-Leu-NH2, His-DTrp-Phe-Trp-DPhe-Lys-NH2, DAla-DβNal-DAla-DTrp-Phe-Lys-NH2, βAla-Trp-DAla-DTrp-Phe-NH2, His-Trp-DAla-DTrp-Phe-LysNH2, DLys-DβNal-Ala-Trp-DPhe-Lys-NH2, DAla-DβNal-DLys-DTrp-Phe-Lys-NH2, Tyr-DAla-Phe-Aib-NH2, Tyr-DAla-Sar-NMePhe-NH2, α,γAbu-DTrp-DTrp-Ser-NH2, α,γAbu-DTrp-DTrp-Lys-NH2, α,γAbu-DTrp-DTrp-Orn-NH2, αAbu-DTrp-DTrp-Orn-NH2, DThr-DαNal-DTrp-DPro-Arg-NH2, DAla-Ala-DAla-DTrp-Phe-Lys-NH2, Alaψ[CH2NH]His-DTrp-Ala-Trp-DPhe-Lys-NH2, Lys-DHis-DTrp-Phe-NH2, γAbu-DTrp-DTrp-Orn-NH2, inip-Trp-Trp-Phe-NH2, AcDTrp-Phe-DTrp-Leu-NH2, AcDTrp-Phe-DTrp-Lys-NH2, AcDTrp-DTrp-Lys-NH2, DLys-Tyr-DTrp-DTrp-Phe-Lys-NH2, AcDβNal-Leu-Pro-NH2, βAla-Trp-DTrp-DTrp-Orn-NH2, DVal-DαNal-DTrp-Phe-Arg-NH2, DLeu-DαNal-DTrp-Phe-Arg-NH2, CyclohexylAla-DαNal-DTrp-Phe-Arg-NH2, DTrp-DαNal-DTrp-Phe-Arg-NH2, DAla-DβNal-DPro-Phe-Arg-NH2, AcDαNal-DTrp-Phe-Arg-NH2, DαNal-DTrp-Phe-Arg-NH2, His-DTrp-DTrp-Lys-NH2, AcDβNal-DTrp-NH2, αAib-DTrp-DcyclohexylAla-NH2, αAib-DTrp-DAla-cyclohexylAla-NH2, DAla-DcyclohexylAla-Ala-Ala-Phe-DPhe-Nle-NH2, DPhe-Ala-Phe-DPal-NH2, DPhe-Ala-Phe-DPhe-Lys-NH2, DLys-Tyr-DTrp-DTrp-Phe-NH2, AcDLys-Tyr-DTrp-DTrp-Phe-NH2, Arg-DTrp-Leu-Tyr-Trp-Pro, AcDβNal-PicLys-ILys-DPhe-NH2, DPal-Phe-DTrp-Phe-Met-NH2, DPhe-Trp-DPhe-Phe-Met-NH2, DPal-Trp-DPhe-Phe-Met-NH2, βAla-Pal-DTrp-DTrp-Orn-NH2, α,γAbu-Trp-DTrp-DTrp-Orn-NH2, βAla-Trp-DTrp-DTrp-Lys-NH2, γAbu-Trp-DTrp-DTrp-Orn-NH2, Ava-Trp-DTrp-DTrp-Orn-NH2, DLys-Tyr-DTrp-Ala-Trp-DPhe-NH2, His-DTrp-DArg-Trp-DPhe-NH2, <Glu-His-Trp-DSer-DArg-NH2, DPhe-DPhe-DTrp-Met-DLys-NH2, O-(2-methylallyl)benzophenone oxime, (R)-2-amino-3-(1H-indol-3-yl)-1-(4-phenylpiperidin-1-yl)propan-1-one, N—((R)-1-((R)-1-((S)-3-(1H-indol-3-yl)-1-oxo-1-(4-phenylpiperidin-1-yl)propan-2-ylamino)-6-amino-1-oxohexan-2-ylamino)-3-hydroxy-1-oxopropan-2-yl)benzamide, (S)—N—((S)-3-(1H-indol-3-yl)-1-oxo-1-(4-phenylpiperidin-1-yl)propan-2-yl)-6-acetamido-2-((S)-2-amino-3-(benzyloxy)propanamido)hexanamide, (S)—N—((R)-3-(1H-indol-3-yl)-1-oxo-1-(4-phenylpiperidin-1-yl)propan-2-yl)-2-((S)-2-acetamido-3-(benzyloxy)propanamido)-6-aminohexanamide, (R)—N-(3-(1H-indol-3-yl)-1-(4-(2-methoxyphenyl)piperidin-1-yl)-1-oxopropan-2-yl)-4-aminobutanamide, (R)—N-(3-(1H-indol-3-yl)-1-(4-(2-methoxyphenyl)piperidin-1-yl)-1-oxopropan-2-yl)-2-amino-2-methylpropanamide, methyl 3-(p-tolylcarbamoyl)-2-naphthoate, ethyl 3-(4-(2-methoxyphenyl)piperidine-1-carbonyl)-2-naphthoate, 3-(2-methoxyphenylcarbamoyl)-2-naphthoate, (S)-2,4-diamino-N—((R)-3-(naphthalen-2-ylmethoxy)-1-oxo-1-(4-phenylpiperidin-1-yl)propan-2-yl)butanamide, naphthalene-2,3-diylbis((4-(2-methoxyphenyl)piperazin-1-yl)methanone), (R)-2-amino-N-(3-(benzyloxy)-1-oxo-1-(4-phenylpiperazin-1-yl)propan-2-yl)-2-methylpropanamide, (R)-2-amino-3-(benzyloxy)-1-(4-phenylpiperazin-1-yl)propan-1-one or pharmaceutically acceptable salts, prodrugs, or active metabolites thereof.
Uses of these compounds for the modulation, specifically inhibition of ghrelin receptor are also provided.
Additionally, the invention provides uses of these compounds for the treatment of diseases wherein inhibition of ghrelin receptor is advantageous. Such diseases include but are not limited to obesity, diabetes mellitus, metabolic syndrome or certain types of cancer as described in this specification.
Thus, in connection with the administration of a novel compound of the invention, e.g. a ghrelin receptor antagonist, a compound which is “effective against” a disease or disorder indicates that administration in a clinically appropriate manner results in a beneficial effect for at least a statistically significant fraction of patients, such as a improvement of symptoms, a cure, a reduction in symptoms or disease load, reduction in tumor mass or cell numbers, extension of life, improvement in quality of life, or other effect generally recognized as positive by medical doctors familiar with treating the particular type of disease or condition.
The therapeutic compositions of this invention may be administered intravenously (i.v.), as by injection of a unit dose, for example. The term “unit dose” when used in reference to a therapeutic composition of the present invention refers to physically discrete units suitable as unitary dosage for the subject, each unit containing a predetermined quantity of active material calculated to produce the desired therapeutic effect in association with the required diluent; i.e., carrier, or vehicle. Suitable therapeutic vehicle include, but not limited to, sterile saline, buffered phosphate saline, lactated Ringer's saline.
The compositions are administered in a manner compatible with the dosage formulation, and in a therapeutically effective amount. The quantity to be administered and timing depends on the subject to be treated, capacity of the subject's system to utilize the active ingredient, and degree of therapeutic effect desired. Precise amounts of active ingredient required to be administered depend on the judgment of the practitioner and are peculiar to each individual.
The compositions of the invention comprising the ghrelin receptor antagonists having the formulae I-V can be administered in any suitable manner, e.g., topically, parenterally, or by inhalation. The term “parenteral” includes injection, e.g., by subcutaneous, intravenous, or intramuscular routes, also including localized administration, e.g., at a site of disease or injury. Sustained release from implants is also contemplated. One skilled in the pertinent art will recognize that suitable dosages will vary, depending upon such factors as the nature of the disorder to be treated, the patient's body weight, age, and general condition, and the route of administration. Preliminary doses can be determined according to animal tests, and the scaling of dosages for human administration is performed according to art-accepted practices.
The amount of ghrelin receptor antagonist or combination of compounds of the present invention administered will vary depending on numerous factors, e.g., the particular animal treated, its age and sex, the desired therapeutic affect, the route of administration and which polypeptide or combination of polypeptides are employed. In all instances, however, a dose effective (therapeutically effective amount) to promote inhibition of growth hormone level in the blood of the recipient animal is used. The dose will depend on a combination of factors, i.e., antagonist receptor action(s), potency, efficacy, pharmacokinetics, pharmacodynamics, route of administration, method of administration and clinical disorder and/or metabolic status. Generally, dosage levels of between 0.0001 to 100 mg/kg of body weight daily are administered to patients and mammals in need to obtain effective inhibition of growth hormone in the blood. The preferred amount can readily be determined empirically by the skilled artisan.
When combinations of ghrelin receptor antagonist compounds are used, lower amounts of the antagonist may be used in the treatment of diseases and disorders. This occurs when one compound exhibit synergistic effect over the activity of a second compound when used in combination.
In another embodiment, the compounds of the inventions may be used in combination with other treatment regime for treating the diseases and disorders associated with obesity, overeating, diabetes, unregulated cellular proliferation, and cancer.
The compounds of the present invention may be formulation for sustained or controlled release. The antagonists of the present invention may be admixed with biologically compatible polymers or matrices which control the release rate of the antagonists into the immediate environment. Controlled or sustained release compositions include formulation in lipophilic depots (e.g., fatty acids, waxes, oils). Also contemplated by the invention are particulate compositions coated with polymers (e.g., poloxamers or poloxamines). Other embodiments of the compositions of the invention incorporate particulate forms, protective coatings, protease inhibitors or permeation enhancers for various routes of administration, including parenteral, pulmonary, nasal and oral.
Controlled release permits dosages to be administered over time, with controlled release kinetics. In some instances, delivery of the therapeutic agent is continuous to the site where treatment is needed, for example, over several weeks. Controlled release over time, for example, over several days or weeks, or longer, permits continuous delivery of the therapeutic agent to obtain optimal treatment. The controlled delivery vehicle is advantageous because it protects the therapeutic agent from degradation in vivo in body fluids and tissue, for example, by proteases.
Controlled release from the pharmaceutical formulation may be designed to occur over time, for example, for greater than about 12 or 24 hours. The time of release may be selected, for example, to occur over a time period of about 12 hours to 24 hours; about 12 hours to 42 hours; or, e.g., about 12 to 72 hours. In another embodiment, release may occur for example on the order of about 2 to 90 days, for example, about 3 to 60 days. In one embodiment, the therapeutic agent is delivered locally over a time period of about 7-21 days, or about 3 to 10 days. In other instances, the therapeutic agent is administered over 1, 2, 3 or more weeks in a controlled dosage. The controlled release time may be selected based on the condition treated.
As used herein, the terms “pharmaceutically acceptable”, “physiologically tolerable” and grammatical variations thereof, as they refer to compositions, carriers, diluents and reagents, are used interchangeably and represent that the materials are capable of administration to or upon a mammal without the production of undesirable physiological effects.
Compositions comprising an effective amount of a ghrelin receptor antagonist of the present invention, in combination with other components, such as a physiologically acceptable diluent, carrier, or excipient, are provided herein. The antagonists can be formulated according to known methods used to prepare pharmaceutically useful compositions. They can be combined in admixture, either as the sole active material or with other known materials suitable for a given indication, with pharmaceutically acceptable diluents (e.g., saline, Tris-HCl, acetate, and phosphate buffered solutions), preservatives (e.g., thimerosal, benzyl alcohol, parabens), emulsifiers, solubilizers, adjuvants and/or carriers. Suitable formulations for pharmaceutical compositions include those described in Remington's Pharmaceutical Sciences, 16th ed. 1980, Mack Publishing Company, Easton, Pa.
In addition, such compositions can be complexed with polyethylene glycol (PEG), metal ions, or incorporated into polymeric compounds such as polyacetic acid, polyglycolic acid, hydrogels, dextran, etc., or incorporated into liposomes, microemulsions, micelles, unilamellar or multilamellar vesicles, erythrocyte ghosts or spheroblasts. Such compositions will influence the physical state, solubility, stability, rate of in vivo release, and rate of in vivo clearance, and are thus chosen according to the intended application.
Treatment of Diseases and Disorders
In one embodiment, a method to treat obesity is encompassed. In particular, the present invention comprises methods for regulating food intake in a human subject; for improving a compliance of a human subject to caloric restriction; and for reducing a desire of a human subject to consume an over-abundance of calories and/or fats. This method comprises the administration of novel ghrelin receptor antagonists as described above.
The present invention further provides a method for preventing or reducing weight gain in a human subject, by administration of ghrelin receptor antagonists that have a pharmacological half-life that allows an efficient treatment regime thereof.
Also encompassed are methods for reducing a desire of a human subject to consume calories following gastric banding or gastric bypass surgery, by administration of ghrelin receptor antagonists of the present invention.
In addition to the obesity related disorders discussed above, the ghrelin receptor antagonist compositions of the present invention are useful in the treatment or prevention of the following obesity related diseases and/or disorders: overeating; bulimia; hypertension; diabetes, elevated plasma insulin concentrations; insulin resistance; dyslipidemias; hyperlipidemia; endometrial, breast, prostate and colon cancer; osteoarthritis; obstructive sleep apnea; cholelithiasis; gallstones; abnormal heart rhythms; heart arrythmias; myocardial infarction; congestive heart failure; coronary heart disease; sudden death; stroke; polycystic ovarian disease; craniopharyngioma; the Prader-Willi Syndrome; Frohlich's syndrome; GH-deficient subjects; normal variant short stature; Turner's syndrome; and other pathological conditions showing reduced metabolic activity or a decrease in resting energy expenditure as a percentage of total fat-free mass, e.g., children with acute lymphoblastic leukemia.
The present invention also encompasses the treatment of obesity and obesity related diseases and disorders by administering a combination of a ghrelin receptor antagonist and an anti-obesity agent, which may be administered separately or concurrently.
Anti-obesity agents to be used in combination with the ghrelin receptor antagonists of the present invention are known to those of skill in the art and may include, but are not limited to, a 5HT (serotonin) transporter inhibitor, a NE (norepinephrine) transporter inhibitor, a CB-1 (cannabinoid-1) antagonist/inverse agonist, a H3 (histamine H3) antagonist/inverse agonist, a MCH1R (melanin concentrating hormone 1R) antagonist, a MCH2R agonist/antagonist, a NPY1 antagonist, leptin, a leptin derivative, an opioid antagonist, an orexin antagonist, a BRS3 (bombesin receptor subtype 3) agonist, a CCK-A (cholecystokinin-A) agonist, a CNTF (Ciliary neurotrophic factor), a CNTF derivative, a GHS (growth hormone secretagogue receptor) agonist, a 5HT2C (serotonin receptor 2C) agonist, a Mc4r (melanocortin 4 receptor) agonist, a monoamine reuptake inhibitor, an UCP-1 (uncoupling protein-1), 2, or 3 activator, a β3 (beta adrenergic receptor 3) agonist, a thyroid hormone β agonist, a PDE (phosphodiesterase) inhibitor, a FAS (fatty acid synthase) inhibitor, a DGAT1 (diacylglycerol acyltransferase) inhibitor, a DGAT2 inhibitor, an ACC2 (acetyl-CoA carboxylase-2) inhibitor, a glucocorticoid antagonist, an acyl-estrogen, a lipase inhibitor, a fatty acid transporter inhibitor, a dicarboxylate transporter inhibitor, a glucose transporter inhibitor, a serotonin reuptake inhibitors, metformin, and topiramate.
The anti-obesity compound to be used in combination with the novel ghrelin receptor antagonists of the present invention may act via a mechanism other than ghrelin, thus providing for additive anti-obesity effects.
In one embodiment, the novel ghrelin receptor antagonist of the present invention is administered prior to taking a meal, for example, 4 hours, 3 hours, 2 hours, 1 hour, or 0.5 hours prior to expected meal time. Preferably, the ghrelin receptor antagonist is administered 0.5 hours prior to feeding. Alternatively, the ghrelin receptor antagonist may be administered continuously, for example, systemically, as a single administration every 6, 5, 4, 3, 2, or 1 month, preferably every 3 months. Here, the novel ghrelin receptor antagonist of the present invention may normalize an otherwise dysfunctional endocrine system. The compound may be active in the individual for several months.
In another embodiment of the present invention, a method for treating diabetes is encompassed. Diabetes may include both insulin-dependent diabetes mellitus (i.e., IDDM, also known as type I diabetes) and non-insulin-dependent diabetes mellitus (i.e., NIDDM, also known as Type II diabetes). In this method, individuals with or at risk for developing diabetes are administered the ghrelin receptor antagonists of the present invention alone or in combination with other diabetes treatments known to those of skill in the art.
“Treatment” (of obesity and obesity-related disorders) refers to the administration of the compounds or combinations of the present invention to reduce or maintain the body weight of an obese subject. One outcome of treatment may be reducing the body weight of an obese subject relative to that subject's body weight immediately before the administration of the compounds or combinations of the present invention. Another outcome of treatment may be preventing body weight regain of body weight previously lost as a result of diet, exercise, or pharmacotherapy. Another outcome of treatment may be decreasing the occurrence of and/or the severity of obesity-related diseases. Another outcome of treatment may be to maintain weight loss. The treatment may suitably result in a reduction in food or calorie intake by the subject, including a reduction in total food intake, or a reduction of intake of specific components of the diet such as carbohydrates or fats; and/or the inhibition of nutrient absorption; and/or the inhibition of the reduction of metabolic rate; and in weight reduction in patients in need thereof. The treatment may also result in an alteration of metabolic rate, such as an increase in metabolic rate, rather than or in addition to an inhibition of the reduction of metabolic rate; and/or in minimization of the metabolic resistance that normally results from weight loss.
In one embodiment, the ghrelin receptor antagonists of the present invention are used to treat or prevent hormonally functional endocrine or non-endocrine tumors.
In one embodiment, the invention provides a method to decrease/regulate gastrointestinal motility/acidity in a mammal, said method comprising use of a compound of claims 1-7.
In another embodiment, the invention provide a method of treatment, prevention or management of psychobehavior related to under and over nutrition such as hunger, satiety and anxiety.
In yet another embodiment, the invention provides a method for augmenting the actions of desacyl ghrelin by decreasing the action of acyl ghrelin and its receptor, said method comprising use of a compound of claims 1-7.
In another embodiment, the novel ghrelin receptor antagonists are administered to an individual for the treatment of pituitary tumor, e.g. to inhibit pituitary tumor producing growth hormone.
In another embodiment, the novel ghrelin receptor antagonists are administered in conjunction with methods for the treatment of tumors that produce prolactin. Prolactin (“PRL”) is a 23-kDa neuroendocrine hormone which is structurally related to growth hormone. Prolactin secretion has been associated with several types of cancer including, but not limited to breast and prostrate. Thus, the present invention relates to methods and compositions for inhibiting the cell proliferation-promoting effects of prolactin on its receptor. Conditions which may benefit from the administration of a novel ghrelin receptor antagonist of the invention include both benign and malignant proliferation of cells which express a prolactin receptor. Such conditions include but are not limited to proliferative diseases of the breast, including benign conditions such as breast adenomas and fibrocystic disease, and malignant conditions such as breast cancer, including ductal, scirrhous, medullary, colloid and lobular carcinomas (local or metastatic); and proliferative diseases of the prostate, including benign prostatic hypertrophy and prostate cancer (local or metastatic).
Also encompassed are methods for the treatment of metabolic syndrome. The term “metabolic syndrome”, also known as syndrome X, is defined in the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATP-III). E. S. Ford et al., JAMA, vol. 287 (3), Jan. 16, 2002, pp 356-359. Briefly, a person is defined as having metabolic syndrome if the person has three or more of the following symptoms: abdominal obesity, hypertriglyceridemia, low HDL cholesterol, high blood pressure, and high fasting plasma glucose. The criteria for these are defined in ATP-III. Metabolic syndrome is obesity related and thus administration of the novel ghrelin receptor antagonists of the present invention are useful in its treatment.
Furthermore, methods for the diagnosis of obesity and obesity related diseases and disorders, including diabetes are encompassed. In this embodiment, the ghrelin receptor antagonist(s) of the present invention are administered to an individual and their response is closely analyzed. A decrease in desire for food immediately following administration of the compounds or a decrease in weight gain or a reduction in weight indicates a propensity to or a current affliction with obesity or an obesity related disease or disorder.
In one embodiment, Ghrelin/GHRP/GHS receptor antagonists can be utilized as a diagnostic agent to assess the role of ghrelin, other ghrelin-like molecules, and ghrelin receptor agonists or its receptor in the regulation of GH secretion, food intake, and gastrointestinal motility. The antagonists can also be used to rule out endogenous pathophysiological activities of ghrelin, assess the role of ghrelin in various physiological and metabolic processes, assess the effects of exogenous ghrelin, GHSs as well as other agents that possibly act via release of endogenous ghrelin or via ghrelin mimics, and determine biological actions of acylated ghrelin over that of desacylated ghrelin.
Specifically, in one embodiment diagnostic indicates/reveals a role of ghrelin and/or its receptor(s) in over, under or dysfunctional secretion in the pathophysiology of GH release. In another embodiment, diagnostic indicates/reveals a role of ghrelin and/or its receptor(s) in the pathophysiology of food intake in over or under nutrition. In yet another embodiment, diagnostic indicates/reveals risk of developing obesity, metabolic syndrome, diabetes and/or success rate of anti-obesity therapy. In yet another embodiment, diagnostic indicates/reveals a role of ghrelin and/or its receptor(s) in cognitive-memory and psychobehavior related to under and/or or nutrition such as hunger, satiety and anxiety. In another embodiment, the diagnostic indicates/reveals role of ghrelin and/or its receptor(s) in the pathophysiology of insulin secretion and/or its actions. In another embodiment, the diagnostic indicates/reveals role of ghrelin and its receptor(s) on the pathophysiology of gastrointestinal (GI) motility, acidity or other GI disorders. In yet another embodiment, the diagnostic method indicates/reveals role of ghrelin and its receptor(s) on endothelial dysfunction in particular related to vasoconstriction and/or insulin actions in particular hypertension, diabetes and metabolic syndrome. In another embodiment, the diagnostic method indicates/reveals role and action of ghrelin and its receptor(s) on hepatic gluconeogenesis and body fat as indicated by effects on circulating glucose, insulin, adipokines, leptin, resistin, adiponectin and plasminogen activator inhibitor. In still another embodiment, the diagnostic indicates/reveals/distinguishes the actions of acylated ghrelin and desacylated ghrelin on selective actions of certain GH secretagogues. In another method, the diagnostic method indicates/reveals a role of ghrelin and its receptor(s) on agents that increase (i.e., anti-depressants, glucocorticoids and other drugs that influence food intake). In still another embodiment, the diagnostic method indicates/reveals a role of ghrelin and its receptor(s) in hormonally functional endocrine and non-endocrine tumors.
Definitions
The terms “administration of” and or “administering” a compound should be understood to mean providing a ghrelin receptor antagonist compound of the invention, a prodrug or an active metabolite of a compound of the invention to a subject in need of treatment.
The term “ghrelin receptor” as used herein includes growth hormone secretagogue receptor, GHS-R1a and subtypes, isoforms and variants thereof.
The term “diabetes,” as used herein, includes both insulin-dependent diabetes mellitus (i.e., IDDM, also known as type I diabetes) and non-insulin-dependent diabetes mellitus (i.e., NIDDM, also known as Type II diabetes). Type I diabetes, or insulin-dependent diabetes, is the result of an absolute deficiency of insulin, the hormone which regulates glucose utilization. Type II diabetes, or insulin-independent diabetes (i.e., non-insulin-dependent diabetes mellitus), often occurs in the face of normal, or even elevated levels of insulin and appears to be the result of the inability of tissues to respond appropriately to insulin. Most of the Type II diabetics are also obese. The compositions of the present invention are useful for treating both Type I and Type II diabetes. The compositions are especially effective for treating Type II diabetes. The compounds or combinations of the present invention are also useful for treating and/or preventing gestational diabetes mellitus.
“Obesity” is a condition in which there is an excess of body fat. The operational definition of obesity is based on the Body Mass Index (BMI), which is calculated as body weight per height in meters squared (kg/m2). “Obesity” refers to a condition whereby an otherwise healthy subject has a Body Mass Index (BMI) greater than or equal to 30 kg/m2, or a condition whereby a subject with at least one co-morbidity has a BMI greater than or equal to 27 kg/m2. An “obese subject” is an otherwise healthy subject with a Body Mass Index (BMI) greater than or equal to 30 kg/m2 or a subject with at least one co-morbidity with a BMI greater than or equal to 27 kg/m2. A “subject at risk of obesity” is an otherwise healthy subject with a BMI of 25 kg/m2 to less than 30 kg/m2 or a subject with at least one co-morbidity with a BMI of 25 kg/m2 to less than 27 kg/m2.
The term “drug” or “compound” as used herein refers to a chemical entity or biological product, or combination of chemical entities or biological products, administered to a person to treat or prevent or control a disease or condition.
As used herein, the terms “effective” and “effectiveness” includes both pharmacological effectiveness and physiological safety. Pharmacological effectiveness refers to the ability of the treatment to result in a desired biological effect in the patient. Physiological safety refers to the level of toxicity, or other adverse physiological effects at the cellular, organ and/or organism level (often referred to as side-effects) resulting from administration of the treatment. “Less effective” means that the treatment results in a therapeutically significant lower level of pharmacological effectiveness and/or a therapeutically greater level of adverse physiological effects. The ghrelin receptor antagonists described herein are effective in treating obesity and obesity related diseases and disorders including diabetes and various types of cancer.
A “cancer” in an animal refers to the presence of cells possessing characteristics typical of cancer-causing cells, such as uncontrolled proliferation, immortality, metastatic potential, rapid growth and proliferation rate, and certain characteristic morphological features. Often, cancer cells will be in the form of a tumor, but such cells may exist alone within an animal, or may be a non-tumorigenic cancer cell, such as a leukemia cell. In some circumstances, cancer cells will be in the form of a tumor; such cells may exist locally within an animal, or circulate in the blood stream as independent cells, for example, leukemic cells. Examples of cancer include but are not limited to breast cancer, a melanoma, adrenal gland cancer, biliary tract cancer, bladder cancer, brain or central nervous system cancer, bronchus cancer, blastoma, carcinoma, a chondrosarcoma, cancer of the oral cavity or pharynx, cervical cancer, colon cancer, colorectal cancer, esophageal cancer, gastrointestinal cancer, glioblastoma, hepatic carcinoma, hepatoma, kidney cancer, leukemia, liver cancer, lung cancer, lymphoma, non-small cell lung cancer, osteosarcoma, ovarian cancer, pancreas cancer, peripheral nervous system cancer, prostate cancer, sarcoma, salivary gland cancer, small bowel or appendix cancer, small-cell lung cancer, squamous cell cancer, stomach cancer, testis cancer, thyroid cancer, urinary bladder cancer, uterine or endometrial cancer, and vulval cancer.
The term “inverse agonist” as used herein refers to an agent which binds to the same ghrelin receptor binding-site as an agonist for that receptor but exerts the opposite pharmacological effect.
The term “antagonist” is used in the broadest sense, and includes any molecule that partially or fully blocks, inhibits, or neutralizes a biological activity of ghrelin.
It should be understood that this invention is not limited to the particular methodology, protocols, and reagents, etc., described herein and as such may vary. The terminology used herein is for the purpose of describing particular embodiments only, and is not intended to limit the scope of the present invention, which is defined solely by the claims.
Other than in the operating examples, or where otherwise indicated, all numbers expressing quantities of ingredients or reaction conditions used herein should be understood as modified in all instances by the term “about.” The term “about” when used in connection with percentages may mean±1%.
The invention is further illustrated by the following examples which should not be construed as limiting. The contents of all references cited throughout this application, including the U.S. provisional application Ser. No. 60/795,960 filed Apr. 28, 2006 as well as the figures and tables are incorporated herein by reference.
EXAMPLES
Animals and Experimental Procedures
Adult male Sprague Dawley rats (225-260 g) were purchased from Charles River Canada (St. Constant, Canada) and individually housed on a 12-h light, 12-h dark cycle (lights on, 0600-1800 h) in a temperature (22±1° C.)—and humidity-controlled room. Purina rat chow (Ralston Purina Co., St. Louis, Mo.) and tap water were available ad libitum.
Chronic intracerebroventricular (i.c.v.) and intracardiac venous cannulas were implanted under sodium pentobarbital (50 mg/kg, i.p.) anesthesia using previously described techniques in (2) and (11). The placement of the icv cannulae was verified by both a positive drinking response to i.c.v. carbachol (100 ng/10 μl) injection on the day after surgery and methylene blue dye at the time of death. After surgery, the rats were placed directly in isolation test chambers with food and H2O freely available until body weight returned to preoperative levels (usually within 5-7 d). During this time the rats were handled daily to minimize any stress associated with handling on the day of the experiment. On the test day, food was removed 1.5 h before the start of sampling and was returned at the end.
The efficacy of GHS-A to antagonize ghrelin's stimulatory action on GH at both central and peripheral sites was examined. For the central experiments, free-moving rats were i.c.v. injected with either normal saline or GHS-A (5 μg) at 1045 h and, 15 min later (at 1100 h), were subsequently administered ghrelin i.c.v. (500 ng). Both the human ghrelin peptide (provided by Dr. K. Chang, Phoenix Pharmaceuticals, Inc., Belmont, Calif.) and the GHS-A were diluted in normal saline just before use. Blood samples (0.35 ml) were withdrawn every 15 min over a 6-h sampling period (1000-1600 h) from all animals. To document the rapidity of the GH response to ghrelin, an additional blood sample was obtained 5 min after injection of ghrelin. All blood samples were immediately centrifuged, and plasma was separated and stored at −20° C. for subsequent assay of GH. To avoid hemodynamic disturbance, the red blood cells were resuspended in normal saline and returned to the animal after removal of the next blood sample.
For the peripheral experiments, free-moving rats were iv injected with either normal saline or GHS-A (250 μg) at 1045 h and subsequently with ghrelin i.v. (5 μg) at 1100 h. Blood samples were withdrawn from 1000-1600 h, as described above.
For the study designed to assess the involvement of endogenous ghrelin in the genesis of pulsatile GH secretion, free-moving animals were i.c.v.-injected with either normal saline or GHS-A (5 μg) at two different times in the 6-h sampling period: 1045 h and 1345 h. These time points were chosen because they correspond closely to the time of onset of the spontaneous GH secretory episodes, as previously documented in our laboratory (2, 4). Blood samples were withdrawn from 1000-1600 h, as described above; however, no blood sample was withdrawn 5 min after the injections.
The effects of the GHS-A on both spontaneous and ghrelin-induced food intake and body weight gain were investigated. For the spontaneous experiments, the rats were fasted overnight (1600-1100 h next morning) and were i.c.v.-injected with either normal saline or GHS-A (5 μg) at 1100 h. Food intake was monitored on an hourly basis for 5 h after the initial injection (until 1600 h) and subsequently overnight (1600-0900 h next morning). A measured amount of rat chow pellets was placed in the cage every hour. Spillage was collected by placement of a diaper under the rat cages, and total food consumed for each period was calculated by subtracting uneaten food plus spillage from total given. Body weights were recorded daily at 0900 h. The latency to the onset of the first meal after the injection and the duration of that meal were also monitored.
To examine the effect of GHS-A on ghrelin-stimulated food intake, animals were icv injected with either normal saline or GHS-A (5 μg) at 1045 h and subsequently with ghrelin (500 ng) at 1100 h. Food intake was monitored on an hourly basis as described above. In this experiment, food was removed 1.5 h before the start of the test.
All animal-based procedures were approved by the McGill University Animal Care Committee.
Receptor Binding and Calcium Mobilization Studies
The human ghrelin receptor type 1a (GHS-R1a) was expressed in HEK-293 cells, whose cell membranes were subsequently harvested and used in the binding assay. The receptor concentration (Bmax) used in the assay was 2.3 pmol/mg of protein, resulting in a Kd for ghrelin binding of 0.016 nM. The ability of the antagonist to displace 0.009 nM radiolabelled ghrelin was then tested, at a concentration range of 0.1 nM to 10 μM. The binding affinities (Ki) for ghrelin, GHRP-6 and hexarelin in this system were 0.016 nM, 0.58 nM and 0.59 nM respectively.
The ability of the antagonist to mobilize calcium or to inhibit ghrelin-stimulated calcium mobilization was examined using Euroscreen's AequoScreen platform. This method is based on the co-expression in recombinant cell lines of the GHS-R1a and aequorin, a photoprotein capable of detecting calcium concentrations in the lower micromolar range. The agonistic properties of GHS-A were tested at a concentration range of 1 nM to 3 μM, and its capacity to inhibit the calcium mobilized by 22.15 nM ghrelin was tested at a concentration range of 1 nM to 1.5 μM. In this system, ghrelin was found to have an EC50 of 9.33 nM, EC80 of 22.15 nM, and induced maximal activation at a concentration of 100 nM.
The peptides were synthesized by the solid phase method and purified by HPLC. GH was determined by Radioimmunoassay (RIA).
The In Vitro Cell Culture Method
In vitro GH Release-Female rats of the CD-1 strain were housed in a constant temperature room at 24° C. with 14 h light and 10 h darkness. The rats were fed Purina Rat chow and water at libitum. All studies were started between 0800-1000 hours. Pituitaries of mature female Sprague Dawley rats were rapidly removed after decapitation, neurointermediate lobe discarded and then placed in a pH 7.4 buffer. The pituitaries were cut into  ̃3-mm pieces and then transferred to a flask containing HEPS buffer with trypsin and incubated at 37° C. Cells were triturated several times during this period. After dispersion, the cells were collected by centrifugation, wash with DMEM and placed into culture well. Cell cultures were maintained for 4 days at 37° with 8% CO2 added to the incubator atmosphere. After 4 days in culture, cells were washed with lactated Ringer's solution adjusted to pH 7.2-7.4 and then vehicle, peptide alone or peptide plus stimulator was added to media. Incubation time was 60-120 minutes after which media was removed from each well for GH determination. The GH RIA reagents were distributed by the NIH. Control data was collected from cell cultures treated with only the corresponding vehicle in the absence of peptide or stimulator. Control stimulated data was collected from cell cultures treated with stimulator alone in the absence of any peptide.
The In Vitro Pituitary Incubation Method
Hormonal activities were obtained from in vitro studies using pituitaries of 20 day old CD-1 strain Sprague Dawley female rats. Two pituitaries were incubated for a total of 4-6 hours. Medium was removed each hour for RIA of GH level and fresh medium was added again. After two one hour preincubation periods (P1-P2), the vehicle/peptides were added to two one hour incubations (I3-I4). Peptide activity was calculated as the change in the hormonal level (delta) between I3+I4 and P2. For antagonist activity, the incubation was continued for 2 additional hours (I5-I6) where both the peptide and a stimulator of GH secretion was added and the antagonist activity was calculated as the change in the hormonal level (delta) between I5+I6 and P2. The peptides were assayed in triplicate and the hormone was assayed in duplicate. Each value recorded represents the mean of 6. The GH RIA reagents were distributed by the NIH. Control data was collected from isolated pituitary glands treated with only the corresponding vehicle in the absence of peptide or stimulator. Control stimulated data was collected from isolated pituitary glands treated with stimulator alone in the absence of any peptide.
The In Vivo Assay
For the in vivo assay of GH Release in rat, immature female Sprague Dawley rats were obtained from Charles River from Wilmington, Mass. After arrival they were housed at 25° C. with a 14:10 h light:dark cycle. Water and Purina rat chow were available at libitum. Pups were weaned at 21 days of age.
Immature twenty six day old female Sprague Dawley rats, 3-6 rats per treatment dose, were pretreated with pentobarbital 20 minutes before iv injection of vehicle/peptide or peptide plus stimulator. Injection was made as a 0.1 ml solution. For the non-pentobarbital treated rat assay, peptides were administered iv into the tail vein of conscious rats. All animals were sacrificed by guillotine after iv peptide or vehicle. Trunk blood was collected at +10-15 minutes after decapitation, allowed to clot, centrifuged and serum stored until assayed for GH levels by RIA. The GH RIA reagents were distributed by the NIH. Control data was collected from rats treated with only the corresponding vehicle in the absence of peptide or stimulator. Control stimulated data was collected from rats treated with stimulator alone in the absence of any peptide.
Results
The data obtained show that ghrelin receptor antagonists of the present invention such as HisDβNalDLysTrpDPheLysNH2, can be used as a tool to disrupt the activity of ghrelin at the level of the CNS. This peptide is a GHRP derivative antagonist. ICV administration of 5 μg of this antagonist prior to i.c.v. injection of ghrelin (500 ng) in free moving, adult rats virtually obliterated the GH response to ghrelin. A similar block of ghrelin (5 μg iv) induced GH release was observed when rats were pretreated peripherally with the GHS-R antagonist (250 μg i.v.). In contrast, this GHS-R antagonist did not significantly reduce the GH response to GHRH (5 μg i.v.). With respect to feeding, i.c.v. administered GHS antagonist (5 μg) significantly inhibited ghrelin's (500 ng i.c.v.) stimulatory effects on food intake in the first hr after injections. These results provide evidence of a modulatory role for endogenous ghrelin in maintaining the high amplitude of spontaneous GH pulses under physiological conditions, likely acting through the GHS-R1a on GHRH containing neurons in the arcuate nucleus (16, 17). While ghrelin may be necessary for the full response of GHRH (the major driving regulator) on pulsatile GH release, it is not an active player in generating the ultradian rhythm of GH secretion. The lack of a dissociated effect on GH and food intake by the GHS antagonist suggest that the GHS-R1a mediates the effects of ghrelin on feeding (via NPY-containing neurons) as well as on GH.
All patents and other publications identified throughout the specification and examples and in the references section are expressly incorporated herein by reference for the purpose of describing and disclosing, for example, the methodologies described in such publications that might be used in connection with the present invention. These publications are provided solely for their disclosure prior to the filing date of the present application. Nothing in this regard should be construed as an admission that the inventors are not entitled to antedate such disclosure by virtue of prior invention or for any other reason. All statements as to the date or representation as to the contents of these documents is based on the information available to the applicants and does not constitute any admission as to the correctness of the dates or contents of these documents.
REFERENCES


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## Claims

1. A compound having a formula:


A1-A2′-A3′-A4-A5-A6,

wherein
A1 is His, Tyr, desamino Tyr, D Ala, β-Ala, CyclohexylAla (Cyclohexylalanine), DArg, Ava (aminovaleric acid), Gly, <Glu (pyroglutamic acid), αAib (alpha-aminoisobutyric acid), γAbu (gamma-aminobutyric acid), αAbu (alpha-aminobutyric acid), α,γAbu (alpha, gamma-diaminobutyric acid or 2,4-diaminobutyric acid), DVal, DPhe, DThr, DPal (pyridylalanine), DLys, AcDLys, DLeu, DTrp, Dβnaphthylalanine or AcDβnaphthylalanine, wherein the A1 residue is with or without methylation of the terminal nitrogen of the α carbon atom of the A1 residue when a terminal nitrogen is present at the α carbon atom, and wherein the peptide bond between the A1 and A2′ residues is a normal or reduced psi (Ψ, CH2NH) peptide bond;
A2′ is Dα or Dβnaphthylalanine, Trp, D or L Phe, Ala, His, PicLys, DCyclohexylalanine, D-4-halo-Phe or D-4-pyrolidylalanine, wherein A2′ is with or without methylation of the terminal nitrogen of the α carbon atom of the A2′ residue;
A3′ is D or L Lys, lysine derivatives, Orn, Phe, Trp, Leu, Pro, Ser, Pal, or α,γAbu;
A4 is D or L Trp, Phe, Ala, Ser, Tyr, Met, Pro, Thr, ILys, or CyclohexylAla;
A5 is D or L Trp, D or LPhe, Ala, Lys, Arg, Orn, Thr, Leu, or DCyclohexylAla; and
A6 is Lys, Arg, Orn, D or L Phe, Pro, Nle (norleucine), or α,γAbu; or prodrugs or pharmaceutically acceptable salts thereof, wherein the A6 residue can be present either in a C terminal amidated form or as a free carboxylic acid.

2. A method for treatment, prevention or management of obesity in an individual, said method comprising the step of administering an effective amount of a compound of claim 1.

3. A method for treatment, prevention or management of diabetes mellitus in an individual in need thereof, said method comprising the step of administering an effective amount of a compound of claim 1.

4. The method of claim 2 further comprising the step of administering at least one other anti-obesity treatment.

5. The method of claim 4, wherein the other anti-obesity treatment is a combination of dietary restriction therapy with a 5HT (serotonin) transporter inhibitor, a NE (norepinephrine) transporter inhibitor, a CB-1 (cannabinoid-1) antagonist/inverse agonist, a H3 (histamine H3) antagonist/inverse agonist, a MCH1R (melanin concentrating hormone 1R) antagonist, a MCH2R agonist/antagonist, a NPY1 antagonist, leptin, a leptin derivative, an opioid antagonist, an orexin antagonist, a BRS3 (bombesin receptor subtype 3) agonist, a CCK-A (cholecystokinin-A) agonist, a CNTF (Ciliary neurotrophic factor), a CNTF derivative, or a lipase drug inhibitor administered simultaneously, concurrently or sequentially.

6. A compound having a formula:


A1-A2*-A3-A4-A5-A6,


wherein
A1 is His, Tyr, desamino Tyr, DAla, β-Ala, CyclohexylAla (Cyclohexylalanine), DArg, Ava (aminovaleric acid), Gly, <Glu (pyroglutamic acid), αAib (alpha-aminoisobutyric acid), γAbu (gamma-aminobutyric acid), αAbu (alpha-aminobutyric acid), α,γAbu (alpha, gamma-diaminobutyric acid or 2,4-diaminobutyric acid), DVal, DPhe, DThr, DPal (pyridylalanine), DLys, AcDLys, DLeu, DTrp, Dβnaphthylalanine, or AcDβnaphthylalanine, wherein the A1 residue is with or without methylation of the terminal nitrogen of the α carbon atom of the A1 residue when a terminal nitrogen is present at the α carbon atom, and wherein the peptide bond between the A1 and A2* residues is a normal or reduced psi (Ψ, CH2NH) peptide bond;
A2* is Dα or Dβnaphthylalanine, Trp, DPhe, Ala, His, PicLys, DCyclohexylalanine, D-4-halo-Phe or D-4-pyrolidylalanine, wherein the A2* is with or without methylation of the terminal nitrogen of the α carbon atom of the A2* residue;
A3 is D or L Lys, lysine derivatives, Arg, arginine derivatives, Orn, Phe, Trp, Leu, Pro, Ser, Pal, or α,γAbu;
A4 is D or L Trp, Phe, Ala, Ser, Tyr, Met, Pro, Thr, ILys, or CyclohexylAla;
A5 is D or L Trp, D or L Phe, Ala, Lys, Arg, Orn, Thr, Leu, or DCyclohexylAla; and
A6 is Lys, Arg, Orn, D or L Phe, Pro, Nle (norleucine), or α,γAbu; or prodrugs or pharmaceutically acceptable salts thereof, wherein the A6 residue can be present either in a C terminal amidated form or as a free carboxylic acid.

7. The compound of claim 1, wherein
A1 is His, D Ala, Tyr, desamino Tyr, Gly, αAib, γAbu or α,γAbu, wherein the A1 residue is with or without methylation of the terminal nitrogen of the α carbon atom of the A1 residue when a terminal nitrogen is present at the α carbon atom, and wherein the peptide bond between the A1 and A2′ residues is a normal or reduced psi (Ψ, CH2NH) peptide bond;
A2′ is Dα or Dβnaphthylalanine, Trp, DPhe, DCyclohexylalanine, D-4-halo-Phe or D-4-pyrolidylalanine;
A3′ is D or L Lys, Orn, Ser, or α,γAbu;
A4 is D or L Trp, Phe, or CyclohexylAla;
A5 is D or L Phe, DTrp, or DCyclohexylAla; and
A6 is Lys, Arg, Orn, or α,γAbu; or prodrugs or pharmaceutically acceptable salts thereof, wherein the A6 residue can be present either in a C terminal amidated form or as a free carboxylic acid.

8. The compound of claim 7, wherein the compound has the formula: Glyψ[CH2NH]-DβNal-DLys-Trp-DPhe-Lys-NH2, DAla-DβNal-DLys-DTrp-Phe-Lys-NH2 or His-DβNal-DLys-Trp-DPhe-Lys-NH2.

9. The method of claim 3, wherein the compound has the formula: Glyψ[CH2NH]-DβNal-DLys-Trp-DPhe-Lys-NH2, DAla-DβNal-DLys-DTrp-Phe-Lys-NH2, or His-DβNal-DLys-Trp-DPhe-Lys-NH2.

10. A compound with the formula: O-(2-methylallyl)benzophenone oxime or methyl 3-(p-tolylcarbamoyl)-2-naphthoate.