# Patent

## Title
Aqueous gel formulations containing immune response modifiers

## Abstract

Aqueous gel formulations, including an immune response modifier (IRM), such as those chosen from imidazoquinoline amines, tetrahydroimidazoquinoline amines, imidazopyridine amines, 6,7-fused cycloalkylimidazopyridine amines, 1,2-bridged imidazoquinoline amines, imidazonaphthyridine amines, imidazotetrahydronaphthyridine amines, oxazoloquinoline amines, thiazoloquinoline amines, oxazolopyridine amines, thiazolopyridine amines, oxazolonaphthyridine amines, thiazolonaphthyridine amines, pyrazolopyridine amines, pyrazoloquinoline amines, tetrahydropyrazoloquinoline amines, pyrazolonaphthyridine amines, tetrahydropyrazolonaphthyridine amines, and 1H-imidazo dimers fused to pyridine amines, quinoline amines, tetrahydroquinoline amines, naphthyridine amines, or tetrahydronaphthyridine amines, are provided. Methods of use and kits are also provided.

## Background
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a national stage filing under 35 U.S.C. §371 of PCT International application PCT/US2006/004201 designating the United States of America, and filed Feb. 3, 2006. This application claims the benefit under 35 U.S.C. §119 of U.S. provisional application Ser. No. 60/650,030, filed Feb. 4, 2005.


BACKGROUND
Many imidazoquinoline amine, imidazopyridine amine, 6,7-fused cycloalkylimidazopyridine amine, 1,2-bridged imidazoquinoline amine, thiazoloquinoline amine, oxazoloquinoline amine, thiazolopyridine amine, oxazolopyridine amine, imidazonaphthyridine amine, imidazotetrahydronaphthyridine amine, and thiazolonaphthyridine amine compounds have demonstrated potent immunostimulating, antiviral and antitumor (including anticancer) activity, and have also been shown to be useful as vaccine adjuvants and for the treatment of TH2-mediated diseases. These compounds are hereinafter collectively referred to as “IRM” (immune response modifier) compounds.
The mechanism for the immunostimulatory activity of these IRM compounds is thought to be due in substantial part to enhancement of the immune response by induction of various important cytokines (e.g., interferons, interleukins, tumor necrosis factor, etc.). Such compounds have been shown to stimulate a rapid release of certain monocyte/macrophage-derived cytokines and are also capable of stimulating B cells to secrete antibodies, which play an important role in these IRM compounds' activities. One of the predominant immunostimulating responses to these compounds is the induction of interferon (IFN)-α production, which is believed to be very important in the acute antiviral and antitumor activities seen. Moreover, up regulation of other cytokines such as, for example, tumor necrosis factor (TNF), Interleukin-1 (IL-1), IL-6, and IL-12 also have potentially beneficial activities and are believed to contribute to the antiviral and antitumor properties of these compounds.
Although some of the beneficial effects of IRMs are known, the ability to provide therapeutic benefit via topical application of an IRM compound for treatment of a particular condition at a particular location may be hindered by a variety of factors. These factors include irritation of the dermal or mucosal tissue to which the formulation is applied, ciliary clearance of the formulation, formulation wash away, insolubility and/or degradation of the IRM compound in the formulation, physical instability of the formulation (e.g., separation of components, thickening, precipitation/agglomeration of active ingredient, and the like), and poor permeation, for example. Accordingly, there is a continuing need for new methods and formulations to provide the greatest therapeutic benefit from this class of compounds.
SUMMARY
The present invention is directed to aqueous gel formulations, kits, and methods of use. Herein, a “gel” is a composition that is substantially free of oil (and hence, is not a cream or a lotion). Preferably, gels of the present invention have a viscosity of at least 1000 Centipoise (cps) at room temperature (i.e., about 25° C.). Preferably, gels of the present invention have a viscosity of no greater than 50,000 cps, and more preferably no greater than 30,000 cps.
Aqueous gels are not easily formed using certain IRMs due to the low intrinsic aqueous solubility of the free base (typically less than 500 μg/mL at 25° C.). As a result, a cosolvent is typically used or a salt of the IRM is prepared in situ. This can result in the need for negatively charged thickeners, particularly two negatively charged thickeners, to provide the desirable viscosity. In preferred embodiments of the present invention, the negatively charged thickeners are not covalently bonded to the IRM.
In one embodiment, such aqueous gels include: water; an immune response modifier (IRM) other than 1-(2-methylpropyl)-1H-imidazo[4,5-c][1,5]naphthyridin-4-amine; a pharmaceutically acceptable acid; a water-miscible cosolvent; and a thickener system including a negatively charged thickener; wherein the aqueous gel has a viscosity of at least 1000 cps at 25° C.
In one embodiment, such aqueous gels are prepared by a method that includes combining components including: water; an immune response modifier (IRM) other than 1-(2-methylpropyl)-1H-imidazo[4,5-c][1,5]naphthyridin-4-amine, or a salt thereof; a water-miscible cosolvent; and a thickener system including a negatively charged thickener; wherein the aqueous gel has a viscosity of at least 1000 cps at 25° C.
Gel formulations of the present invention can provide desirable vehicles for an IRM compound and can allow for easier manufacture and increased residence time of an IRM compound, particularly on dermal and/or mucosal tissue.
Furthermore, the use of negatively charged thickeners in the aqueous gels of the present invention reduces systemic exposure to the drug and hence reduces systemic levels of cytokines. This is desirable for many conditions for which treatment at a particular location (e.g., cervical dysplasia) is preferred. The use of a combination of negatively charged thickeners (i.e., at least two) is desirable when higher levels of cosolvents are used due to the low solubility of the drug (whether in free base or salt form) in water. This results in an aqueous gel that reduces systemic exposure and is physically stable.
In certain embodiments, the immune response modifier is selected from the group consisting of imidazoquinoline amines, tetrahydroimidazoquinolines, imidazopyridine amines, 6,7-fused cycloalkylimidazopyridine amines, imidazonaphthyridine amines, tetrahydroimidazonaphthyridine amines; oxazoloquinoline amines; thiazoloquinoline amines; oxazolopyridine amines; thiazolopyridine amines; oxazolonaphthyridine amines; thiazolonaphthyridine amines; pyrazolopyridine amines; pyrazoloquinoline amines; tetrahydropyrazoloquinoline amines; pyrazolonaphthyridine amines; tetrahydropyrazolonaphthyridine amines; 1H-imidazo dimers fused to pyridine amines, quinoline amines, tetrahydroquinoline amines, naphthyridine amines, or tetrahydronaphthyridine amines; and combinations thereof.
The present invention also provides methods of using the formulations of the present invention. In one embodiment, the present invention provides a method for delivering an IRM compound to mucosal tissue of a subject, the method including applying an aqueous gel of the present invention. Preferably, the mucosal tissue is associated with a condition selected from the group consisting of a cervical dysplasia, a papilloma virus infection of the cervix, a low-grade squamous intraepithelial lesion, a high-grade squamous intraepithelial lesion, atypical squamous cells of undetermined significance, a cervical intraepithelial neoplasia, an atopic allergic response, allergic rhinitis, a neoplastic lesion, and a premalignant lesion.
In another method, the aqueous gels of the present invention can be used to treat a dermal and/or mucosal condition in a subject in need thereof. The method includes applying an aqueous gel of the invention to the affected area of the subject. The present invention also provides kits that include a barrel type applicator and an aqueous gel of the present invention, which can be in a separate container or prefilled in the barrel type applicator.
The terms “comprises” and variations thereof do not have a limiting meaning where these terms appear in the description and claims.
As used herein, “a,” “an,” “the,” “at least one,” and “one or more” are used interchangeably. Thus, for example, an aqueous formulation that comprises “an” immune response modifier can be interpreted to mean that the formulation includes “one or more” immune response modifiers. Similarly, a formulation comprising “a” preservative can be interpreted to mean that the formulation includes “one or more” preservatives.
Also herein, the recitations of numerical ranges by endpoints include all numbers subsumed within that range (e.g., 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, 5, etc.).
The above summary of the present invention is not intended to describe each disclosed embodiment or every implementation of the present invention. The description that follows more particularly exemplifies illustrative embodiments. In several places throughout the application, guidance is provided through lists of examples, which examples can be used in various combinations. In each instance, the recited list serves only as a representative group and should not be interpreted as an exclusive list.


DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS
The present invention provides aqueous gel formulations, kits, and methods of use. Such gels are compositions that are substantially free of oil (and hence, they are not creams or lotions). Preferably, gels of the present invention have a viscosity of at least 1000 Centipoise (cps) at 25° C. Preferably, gels of the present invention have a viscosity of no greater than 50,000 cps, and more preferably no greater than 30,000 cps.
In one embodiment, such aqueous gels include: water; an immune response modifier (IRM) other than 1-(2-methylpropyl)-1H-imidazo[4,5-c][1,5]naphthyridin-4-amine; a pharmaceutically acceptable acid; a water-miscible cosolvent; and a thickener system including a negatively charged thickener (preferably, at least two negatively charged thickeners, which are typically of different charge density); wherein the aqueous gel has a viscosity of at least 1000 cps at 25° C.
In one embodiment, such aqueous gels are prepared by a method that includes combining components including: water; an immune response modifier (IRM) other than 1-(2-methylpropyl)-1H-imidazo[4,5-c][1,5]naphthyridin-4-amine, or a salt thereof; a water-miscible cosolvent; and a thickener system including a negatively charged thickener (preferably, at least two negatively charged thickeners, which are typically of different charge density); wherein the aqueous gel has a viscosity of at least 1000 cps at 25° C.
The immune response modifier is substantially completely dissolved at a therapeutic level (i.e., therapeutically effective amount) in the formulation at room temperature. This amount is effective to treat and/or prevent a specified condition. In general, the amount of IRM present in an aqueous gel formulation of the invention will be an amount effective to provide a desired physiological effect, e.g., to treat a targeted condition (e.g., reduce symptoms of allergic rhinitis), to prevent recurrence of the condition, or to promote immunity against the condition. For certain embodiments, an amount effective to treat or inhibit a viral infection is an amount that will cause a reduction in one or more manifestations of viral infections, such as viral load, rate of virus production, or mortality as compared to untreated control animals.
In certain methods of the present invention, the mucosal tissue is associated with a condition selected from the group consisting of a cervical dysplasia, a papilloma virus infection of the cervix, a low-grade squamous intraepithelial lesion, a high-grade squamous intraepithelial lesion, atypical squamous cells of undetermined significance, a cervical intraepithelial neoplasia, an atopic allergic response, allergic rhinitis, a neoplastic lesion, and a premalignant lesion.
In certain methods of the present invention, the mucosal tissue is on the cervix and the associated condition is selected from the group consisting of cervical dysplasia, high-grade squamous intraepithelial lesions, low-grade squamous intraepithelial lesions, and atypical squamous cells of undetermined significance with the presence of high risk HPV.
In certain methods of the present invention, the mucosal tissue is on the cervix and the associated condition is atypical squamous cells of undetermined significance with the presence of high risk HPV.
In certain methods of the present invention, the mucosal tissue is on the cervix and the associated condition is a papilloma virus infection of the cervix.
The amount of IRM compound that will be therapeutically effective in a specific situation will depend on such things as the dosing regimen, the application site, the particular formulation and the condition being treated. As such, it is generally not practical to identify specific administration amounts herein; however, those skilled in the art will be able to determine appropriate therapeutically effective amounts based on the guidance provided herein, information available in the art pertaining to these compounds, and routine testing.
In some embodiments, the methods of the present invention include administering sufficient formulation to provide a dose of an IRM compound of, for example, from 100 ng/kg to 50 mg/kg to the subject, although in some embodiments the methods may be performed by administering an IRM compound in concentrations outside this range. In some of these embodiments, the method includes administering sufficient formulation to provide a dose of an IRM compound of from 10 μg/kg to 5 mg/kg to the subject, for example, a dose of from 100 μg/kg to 1 mg/kg.
In certain embodiments of the formulations of the invention, the amount or concentration of an IRM compound is at least 0.0001% by weight (wt-%), in other embodiments, at least 0.001 wt-%, in other embodiments at least 0.01 wt-%, and in other embodiments at least 0.1 wt-%, based on the total weight of the aqueous gel. In certain embodiments, the amount of an IRM compound is no greater than 7 wt-%, in other embodiments no greater than 5 wt-%, in other embodiments no greater than 3 wt-%, in other embodiments no greater than 2 wt-%, and in other embodiments no greater than 1 wt-%, based on the total weight of the aqueous gel.
One or more IRM compounds may be present in the formulation as the sole therapeutically active ingredient or in combination with other therapeutic agents. Such other therapeutic agents may include, for example, antibiotics, such as penicillin or tetracycline, corticosteroids, such as hydrocortisone or betamethasone, nonsteroidal antiinflammatories, such as flurbiprofen, ibuprofen, or naproxen, or antivirals, such as acyclovir or valcyclovir.
In some embodiments, the above-described formulations are particularly advantageous for application for a period of time sufficient to obtain a desired therapeutic effect without undesired systemic absorption of the IRM compound.
The IRM of the present invention is present in the gel formulations in combination with a pharmaceutically acceptable acid. Such acid is preferably present in a stoichiometric amount relative to the IRM.
A wide range of pharmaceutically acceptable acids can be used to form salts of IRMs. Examples of such acids are described in Berge et al., J. Pharm. Sciences, 66, 1-19 (1977). Preferred pharmaceutically acceptable acids (e.g., suitable for incorporation in the gels of the present invention or for forming salts of the IRM of the present invention) include, for example, an alkylsulfonic acid, an arylsulfonic acid, a carboxylic acid, a halo acid, sulfuric acid, phosphoric acid, a dicarboxylic acid, a tricarboxylic acid, and combinations thereof. More preferred pharmaceutically acceptable acids include acetic acid, hydrobromic acid, hydrochloric acid, D-gluconic acid, D- and L-lactic acid, methanesulfonic acid, ethanesulfonic acid, propionic acid, benzenesulfonic acid, citric acid, phosphoric acid, succinic acid, sulfuric acid, D- and L-tartaric acid, p-toluenesulfonic acid, and combinations thereof. Particularly preferred salts of the IRM are alkylsulfonate salts (e.g., ethanesulfonate or methanesulfonate).
An IRM compound, and salts thereof, described herein include any of their pharmaceutically acceptable forms, such as isomers (e.g., diastereomers and enantiomers), solvates, polymorphs, and the like. In particular, if a compound is optically active, the invention specifically includes the use of each of the compound's enantiomers as well as racemic combinations of the enantiomers. Also, if a salt is optically active, the invention specifically includes the use of each of the salt's enantiomers as well as racemic combinations of the enantiomers.
IRM Compounds
Preferred IRM compounds suitable for use in the formulations of the invention preferably include compounds having a 2-aminopyridine fused to a five membered nitrogen-containing heterocyclic ring. Other small organic molecules known to function as IRM compounds are also suitable for use in the formulations of the invention.
Certain IRMs are small organic molecules (e.g., molecular weight under about 1000 Daltons, preferably under about 500 Daltons, as opposed to large biologic protein, peptides, and the like) such as those disclosed in, for example, U.S. Pat. Nos. 4,689,338; 4,929,624; 5,266,575; 5,268,376; 5,346,905; 5,352,784; 5,389,640; 5,446,153; 5,482,936; 5,756,747; 6,110,929; 6,194,425; 6,331,539; 6,376,669; 6,451,810; 6,525,064; 6,541,485; 6,545,016; 6,545,017; 6,573,273; 6,656,938; 6,660,735; 6,660,747; 6,664,260; 6,664,264; 6,664,265; 6,667,312; 6,670,372; 6,677,347; 6,677,348; 6,677,349; 6,683,088; 6,756,382; 6,797,718; and 6,818,650; U.S. Patent Publication Nos. 2004/0091491; 2004/0147543; and 2004/0176367; and International Publication Nos. WO 2005/18551, WO 2005/18556, WO 2005/20999, WO 2005/032484, WO 2005/048933, WO 2005/048945, WO 2005/051317, WO 2005/051324, WO 2005/066169, WO 2005/066170, WO 2005/066172, WO 2005/076783, WO 2005/079195, and WO2005/094531.
IRM compounds suitable for use in the invention preferably include compounds having a 2-aminopyridine fused to a five membered nitrogen-containing heterocyclic ring. Such compounds include, for example, imidazoquinoline amines including but not limited to substituted imidazoquinoline amines such as, for example, amide substituted imidazoquinoline amines, sulfonamide substituted imidazoquinoline amines, urea substituted imidazoquinoline amines, aryl ether substituted imidazoquinoline amines, heterocyclic ether substituted imidazoquinoline amines, amido ether substituted imidazoquinoline amines, sulfonamido ether substituted imidazoquinoline amines, urea substituted imidazoquinoline ethers, thioether substituted imidazoquinoline amines, hydroxylamine substituted imidazoquinoline amines, oxime substituted imidazoquinoline amines, 6-, 7-, 8-, or 9-aryl, heteroaryl, aryloxy or arylalkyleneoxy substituted imidazoquinoline amines, and imidazoquinoline diamines; tetrahydroimidazoquinoline amines including but not limited to amide substituted tetrahydroimidazoquinoline amines, sulfonamide substituted tetrahydroimidazoquinoline amines, urea substituted tetrahydroimidazoquinoline amines, aryl ether substituted tetrahydroimidazoquinoline amines, heterocyclic ether substituted tetrahydroimidazoquinoline amines, amido ether substituted tetrahydroimidazoquinoline amines, sulfonamido ether substituted tetrahydroimidazoquinoline amines, urea substituted tetrahydroimidazoquinoline ethers, thioether substituted tetrahydroimidazoquinoline amines, hydroxylamine substituted tetrahydroimidazoquinoline amines, oxime substituted tetrahydroimidazoquinoline amines, and tetrahydroimidazoquinoline diamines; imidazopyridine amines including but not limited to amide substituted imidazopyridine amines, sulfonamide substituted imidazopyridine amines, urea substituted imidazopyridine amines, aryl ether substituted imidazopyridine amines, heterocyclic ether substituted imidazopyridine amines, amido ether substituted imidazopyridine amines, sulfonamido ether substituted imidazopyridine amines, urea substituted imidazopyridine ethers, and thioether substituted imidazopyridine amines; 1,2-bridged imidazoquinoline amines; 6,7-fused cycloalkylimidazopyridine amines; imidazonaphthyridine amines; tetrahydroimidazonaphthyridine amines; oxazoloquinoline amines; thiazoloquinoline amines; oxazolopyridine amines; thiazolopyridine amines; oxazolonaphthyridine amines; thiazolonaphthyridine amines; pyrazolopyridine amines; pyrazoloquinoline amines; tetrahydropyrazoloquinoline amines; pyrazolonaphthyridine amines; tetrahydropyrazolonaphthyridine amines; and 1H-imidazo dimers fused to pyridine amines, quinoline amines, tetrahydroquinoline amines, naphthyridine amines, or tetrahydronaphthyridine amines.
In certain embodiments of the present invention, the IRM is an imidazoquinoline amine.
In certain embodiments of the present invention, the IRM is 1-(2-methylpropyl)-1H-imidazo[4,5-c]quinolin-4-amine (imiquimod).
In certain embodiments of the present invention, the IRM is 2-propylthiazolo[4,5-c]quinolin-4-amine.
In certain embodiments of the present invention, IRM is an amide substituted imidazoquinoline amine. Preferably, the IRM is selected from the group consisting of 3-(4-amino-2-propyl-1H-imidazo[4,5-c]quinolin-1-yl)propionamide, N-[2-(4-amino-7-benzyloxy-2-ethoxymethyl-1H-imidazo[4,5-c]quinolin-1-yl)-1,1-dimethylethyl]acetamide, and 4-(4-amino-2-propyl-1H-imidazo[4,5-c]quinolin-1-yl)-N-propylbutyramide.
In certain embodiments of the present invention, the IRM is N-[2-(4-amino-7-benzyloxy-2-ethoxymethyl-1H-imidazo[4,5-c]quinolin-1-yl)-1,1-dimethylethyl]acetamide.
In certain embodiments of the present invention, the IRM is a urea substituted imidazoquinoline amine. Preferably, the IRM is N-[2-(4-amino-2-ethoxymethyl-1H-imidazo[4,5-c]quinolin-1-yl)ethyl]-N′-isopropylurea.
Exemplary IRM Compounds
In certain embodiments of the present invention the IRM compound can be chosen from 1H-imidazo[4,5-c]quinolin-4-amines defined by one of Formulas I-V below:




wherein

R11 is selected from alkyl of one to ten carbon atoms, hydroxyalkyl of one to six carbon atoms, acyloxyalkyl wherein the acyloxy moiety is alkanoyloxy of two to four carbon atoms or benzoyloxy, and the alkyl moiety contains one to six carbon atoms, benzyl, (phenyl)ethyl and phenyl, said benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by one or two moieties independently selected from alkyl of one to four carbon atoms, alkoxy of one to four carbon atoms and halogen, with the proviso that if said benzene ring is substituted by two of said moieties, then said moieties together contain no more than six carbon atoms;
R21 is selected from hydrogen, alkyl of one to eight carbon atoms, benzyl, (phenyl)ethyl and phenyl, the benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by one or two moieties independently selected from alkyl of one to four carbon atoms, alkoxy of one to four carbon atoms and halogen, with the proviso that when the benzene ring is substituted by two of said moieties, then the moieties together contain no more than six carbon atoms; and
each R1 is independently selected from alkoxy of one to four carbon atoms, halogen, and alkyl of one to four carbon atoms, and n is an integer from 0 to 2, with the proviso that if n is 2, then said R1 groups together contain no more than six carbon atoms;




wherein

R12 is selected from straight chain or branched chain alkenyl containing two to ten carbon atoms and substituted straight chain or branched chain alkenyl containing two to ten carbon atoms, wherein the substituent is selected from straight chain or branched chain alkyl containing one to four carbon atoms and cycloalkyl containing three to six carbon atoms; and cycloalkyl containing three to six carbon atoms substituted by straight chain or branched chain alkyl containing one to four carbon atoms; and
R22 is selected from hydrogen, straight chain or branched chain alkyl containing one to eight carbon atoms, benzyl, (phenyl)ethyl and phenyl, the benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by one or two moieties independently selected from straight chain or branched chain alkyl containing one to four carbon atoms, straight chain or branched chain alkoxy containing one to four carbon atoms, and halogen, with the proviso that when the benzene ring is substituted by two such moieties, then the moieties together contain no more than six carbon atoms; and
each R2 is independently selected from straight chain or branched chain alkoxy containing one to four carbon atoms, halogen, and straight chain or branched chain alkyl containing one to four carbon atoms, and n is an integer from zero to 2, with the proviso that if n is 2, then said R2 groups together contain no more than six carbon atoms;




wherein

R23 is selected from hydrogen, straight chain or branched chain alkyl of one to eight carbon atoms, benzyl, (phenyl)ethyl and phenyl, the benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by one or two moieties independently selected from straight chain or branched chain alkyl of one to four carbon atoms, straight chain or branched chain alkoxy of one to four carbon atoms, and halogen, with the proviso that when the benzene ring is substituted by two such moieties, then the moieties together contain no more than six carbon atoms; and
each R3 is independently selected from straight chain or branched chain alkoxy of one to four carbon atoms, halogen, and straight chain or branched chain alkyl of one to four carbon atoms, and n is an integer from zero to 2, with the proviso that if n is 2, then said R3 groups together contain no more than six carbon atoms;




wherein

R14 is —CHRxRy wherein Ry is hydrogen or a carbon-carbon bond, with the proviso that when Ry is hydrogen Rx is alkoxy of one to four carbon atoms, hydroxyalkoxy of one to four carbon atoms, 1-alkynyl of two to ten carbon atoms, tetrahydropyranyl, alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to four carbon atoms, or 2-, 3-, or 4-pyridyl, and with the further proviso that when Ry is a carbon-carbon bond Ry and Rx together form a tetrahydrofuranyl group optionally substituted with one or more substituents independently selected from hydroxy and hydroxyalkyl of one to four carbon atoms;
R24 is selected from hydrogen, alkyl of one to four carbon atoms, phenyl, and substituted phenyl wherein the substituent is selected from alkyl of one to four carbon atoms, alkoxy of one to four carbon atoms, and halogen; and
R4 is selected from hydrogen, straight chain or branched chain alkoxy containing one to four carbon atoms, halogen, and straight chain or branched chain alkyl containing one to four carbon atoms;




wherein

R15 is selected from hydrogen; straight chain or branched chain alkyl containing one to ten carbon atoms and substituted straight chain or branched chain alkyl containing one to ten carbon atoms, wherein the substituent is selected from cycloalkyl containing three to six carbon atoms and cycloalkyl containing three to six carbon atoms substituted by straight chain or branched chain alkyl containing one to four carbon atoms; straight chain or branched chain alkenyl containing two to ten carbon atoms and substituted straight chain or branched chain alkenyl containing two to ten carbon atoms, wherein the substituent is selected from cycloalkyl containing three to six carbon atoms and cycloalkyl containing three to six carbon atoms substituted by straight chain or branched chain alkyl containing one to four carbon atoms; hydroxyalkyl of one to six carbon atoms; alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to six carbon atoms; acyloxyalkyl wherein the acyloxy moiety is alkanoyloxy of two to four carbon atoms or benzoyloxy, and the alkyl moiety contains one to six carbon atoms; benzyl; (phenyl)ethyl; and phenyl; said benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by one or two moieties independently selected from alkyl of one to four carbon atoms, alkoxy of one to four carbon atoms, and halogen, with the proviso that when said benzene ring is substituted by two of said moieties, then the moieties together contain no more than six carbon atoms;
R25 is




wherein

RS and RT are independently selected from hydrogen, alkyl of one to four carbon atoms, phenyl, and substituted phenyl wherein the substituent is selected from alkyl of one to four carbon atoms, alkoxy of one to four carbon atoms, and halogen;
X is selected from alkoxy containing one to four carbon atoms, alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to four carbon atoms, hydroxyalkyl of one to four carbon atoms, haloalkyl of one to four carbon atoms, alkylamido wherein the alkyl group contains one to four carbon atoms, amino, substituted amino wherein the substituent is alkyl or hydroxyalkyl of one to four carbon atoms, azido, chloro, hydroxy, 1-morpholino, 1-pyrrolidino, alkylthio of one to four carbon atoms; and
R5 is selected from hydrogen, straight chain or branched chain alkoxy containing one to four carbon atoms, halogen, and straight chain or branched chain alkyl containing one to four carbon atoms;
and pharmaceutically acceptable salts of any of the foregoing.
In another embodiment, the IRM compound can be chosen from 6,7 fused cycloalkylimidazopyridine amines defined by Formula VI below:




wherein

m is 1, 2, or 3;
R16 is selected from hydrogen; cyclic alkyl of three, four, or five carbon atoms; straight chain or branched chain alkyl containing one to ten carbon atoms and substituted straight chain or branched chain alkyl containing one to ten carbon atoms, wherein the substituent is selected from cycloalkyl containing three to six carbon atoms and cycloalkyl containing three to six carbon atoms substituted by straight chain or branched chain alkyl containing one to four carbon atoms; fluoro- or chloroalkyl containing from one to ten carbon atoms and one or more fluorine or chlorine atoms; straight chain or branched chain alkenyl containing two to ten carbon atoms and substituted straight chain or branched chain alkenyl containing two to ten carbon atoms, wherein the substituent is selected from cycloalkyl containing three to six carbon atoms and cycloalkyl containing three to six carbon atoms substituted by straight chain or branched chain alkyl containing one to four carbon atoms; hydroxyalkyl of one to six carbon atoms; alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to six carbon atoms; acyloxyalkyl wherein the acyloxy moiety is alkanoyloxy of two to four carbon atoms or benzoyloxy, and the alkyl moiety contains one to six carbon atoms, with the proviso that any such alkyl, substituted alkyl, alkenyl, substituted alkenyl, hydroxyalkyl, alkoxyalkyl, or acyloxyalkyl group does not have a fully carbon substituted carbon atom bonded directly to the nitrogen atom; benzyl; (phenyl)ethyl; and phenyl; said benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by one or two moieties independently selected from alkyl of one to four carbon atoms, alkoxy of one to four carbon atoms, and halogen, with the proviso that when said benzene ring is substituted by two of said moieties, then the moieties together contain no more than six carbon atoms; and —CHRxRy 
wherein
Ry is hydrogen or a carbon-carbon bond, with the proviso that when Ry is hydrogen Rx is alkoxy of one to four carbon atoms, hydroxyalkoxy of one to four carbon atoms, 1-alkynyl of two to ten carbon atoms, tetrahydropyranyl, alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to four carbon atoms, 2-, 3-, or 4-pyridyl, and with the further proviso that when Ry is a carbon-carbon bond Ry and Rx together form a tetrahydrofuranyl group optionally substituted with one or more substituents independently selected from hydroxy and hydroxyalkyl of one to four carbon atoms;
R26 is selected from hydrogen; straight chain or branched chain alkyl containing one to eight carbon atoms; straight chain or branched chain hydroxyalkyl containing one to six carbon atoms; morpholinoalkyl; benzyl; (phenyl)ethyl; and phenyl, the benzyl, (phenyl)ethyl, or phenyl substituent being optionally substituted on the benzene ring by a moiety selected from methyl, methoxy, and halogen; and —C(RS)(RT)(X) wherein RS and RT are independently selected from hydrogen, alkyl of one to four carbon atoms, phenyl, and substituted phenyl wherein the substituent is selected from alkyl of one to four carbon atoms, alkoxy of one to four carbon atoms, and halogen;
X is selected from alkoxy containing one to four carbon atoms, alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to four carbon atoms, haloalkyl of one to four carbon atoms, alkylamido wherein the alkyl group contains one to four carbon atoms, amino, substituted amino wherein the substituent is alkyl or hydroxyalkyl of one to four carbon atoms, azido, alkylthio of one to four carbon atoms, and morpholinoalkyl wherein the alkyl moiety contains one to four carbon atoms; and
R6 is selected from hydrogen, fluoro, chloro, straight chain or branched chain alkyl containing one to four carbon atoms, and straight chain or branched chain fluoro- or chloroalkyl containing one to four carbon atoms and at least one fluorine or chlorine atom;
and pharmaceutically acceptable salts thereof.
In another embodiment, the IRM compound can be chosen from imidazopyridine amines defined by Formula VII below:




wherein

R17 is selected from hydrogen; —CH2RW wherein RW is selected from straight chain, branched chain, or cyclic alkyl containing one to ten carbon atoms, straight chain or branched chain alkenyl containing two to ten carbon atoms, straight chain or branched chain hydroxyalkyl containing one to six carbon atoms, alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to six carbon atoms, and phenylethyl; and —CH═CRZRZ wherein each RZ is independently straight chain, branched chain, or cyclic alkyl of one to six carbon atoms;
R27 is selected from hydrogen; straight chain or branched chain alkyl containing one to eight carbon atoms; straight chain or branched chain hydroxyalkyl containing one to six carbon atoms; alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to six carbon atoms; benzyl, (phenyl)ethyl and phenyl, the benzyl, (phenyl)ethyl and phenyl being optionally substituted on the benzene ring by a moiety selected from methyl, methoxy, and halogen; and morpholinoalkyl wherein the alkyl moiety contains one to four carbon atoms;
R67 and R77 are independently selected from hydrogen and alkyl of one to five carbon atoms, with the proviso that R67 and R77 taken together contain no more than six carbon atoms, and with the further proviso that when R77 is hydrogen then R67 is other than hydrogen and R27 is other than hydrogen or morpholinoalkyl, and with the further proviso that when R67 is hydrogen then R77 and R27 are other than hydrogen;
and pharmaceutically acceptable salts thereof.
In another embodiment, the IRM compound can be chosen from 1,2 bridged imidazoquinoline amines defined by Formula VIII below:




wherein

Z is selected from
—(CH2)p— wherein p is 1 to 4;
—(CH2)a—C(RDRE)(CH2)b—, wherein a and b are integers and a+b is 0 to 3, RD is hydrogen or alkyl of one to four carbon atoms, and RE is selected from alkyl of one to four carbon atoms, hydroxy, —ORF wherein RF is alkyl of one to four carbon atoms, and —NRGR′G wherein RG and R′G are independently hydrogen or alkyl of one to four carbon atoms; and
—(CH2)a—(Y)—(CH2)b— wherein a and b are integers and a+b is 0 to 3, and Y is O, S, or —NRJ— wherein RJ is hydrogen or alkyl of one to four carbon atoms;
q is 0 or 1, and
R8 is selected from alkyl of one to four carbon atoms, alkoxy of one to four carbon atoms, and halogen,
and pharmaceutically acceptable salts thereof.
In another embodiment, the IRM compound can be chosen from thiazoloquinoline amines, oxazoloquinoline amines, thiazolopyridine amines, oxazolopyridine amines, thiazolonaphthyridine amines and oxazolonaphthyridine amines defined by Formula IX below:




wherein:

R19 is selected from oxygen, sulfur and selenium;
R29 is selected from

    
    
        -hydrogen;
        -alkyl;
        -alkyl-OH;
        -haloalkyl;
        -alkenyl;
        -alkyl-X-alkyl;
        -alkyl-X-alkenyl;
        -alkenyl-X-alkyl;
        -alkenyl-X-alkenyl;
        -alkyl-N(R59)2;
        -alkyl-N3;
        -alkyl-O—C(O)—N(R59)2;
        -heterocyclyl;
        -alkyl-X-heterocyclyl;
        -alkenyl-X-heterocyclyl;
        -aryl;
        -alkyl-X-aryl;
        -alkenyl-X-aryl;
        -heteroaryl;
        -alkyl-X-heteroaryl; and
        -alkenyl-X-heteroaryl;
    
    


R39 and R49 are each independently:

    
    
        -hydrogen;
        —X-alkyl;
        -halo;
        -haloalkyl;
        —N(R59)2;
        or when taken together, R39 and R49 form a fused aromatic, heteroaromatic, cycloalkyl or heterocyclic ring;
    
    


X is selected from —O—, —S—, —NR59—, —C(O)—, —C(O)O—, —OC(O)—, and a bond; and
each R59 is independently H or C1-8alkyl;
and pharmaceutically acceptable salts thereof.
In another embodiment, the IRM compound can be chosen from imidazonaphthyridine amines and imidazotetrahydronaphthyridine amines defined by Formulas X and XI below:




wherein

A is —N—CR═CR—CR═; ═CR—N═CR—CR═; ═CR—CR═N—CR═; or ═CR—CR═CR—N═;
R110 is selected from:
-hydrogen;
—C1-20 alkyl or C2-20 alkenyl that is unsubstituted or substituted by one or more substituents selected from:

    
    
        -aryl;
        -heteroaryl;
        -heterocyclyl;
        —O—C1-20 alkyl;
        —O—(C1-20 alkyl)0-1-aryl;
        —O—(C1-20 alkyl)0-1-heteroaryl;
        —O—(C1-20 alkyl)0-1-heterocyclyl;
        —CO—O—C1-20 alkyl;
        —S(O)0-2—C1-20 alkyl;
        —S(O)0-2—(C1-20 alkyl)0-1-aryl;
        —S(O)0-2—(C1-20 alkyl)0-1-heteroaryl;
        —S(O)0-2—(C1-20 alkyl)0-1-heterocyclyl;
        —N(R310)2;
        —N3;
        oxo;
        -halogen;
        —NO2;
        —OH; and
        —SH; and
    
    


—C1-20 alkyl-NR310-Q-X—R410 or —C2-20 alkenyl-NR310-Q-X—R410 wherein Q is —CO— or —SO2—; X is a bond, —O— or —NR310— and R410 is aryl; heteroaryl; heterocyclyl; or —C1-20 alkyl or C2-20 alkenyl that is unsubstituted or substituted by one or more substituents selected from:

    
    
        -aryl;
        -heteroaryl;
        -heterocyclyl;
        —O—C1-20 alkyl;
        —O—(C1-20 alkyl)0-1-aryl;
        —O—(C1-20 alkyl)0-1-heteroaryl;
        —O—(C1-20 alkyl)0-1-heterocyclyl;
        —CO—O—C1-20 alkyl;
        —S(O)0-2—C1-20 alkyl;
        —S(O)0-2—(C1-20 alkyl)0-1-aryl;
        —S(O)0-2—(C1-20 alkyl)0-1-heteroaryl;
        —S(O)0-2—(C1-20 alkyl)0-1-heterocyclyl;
        —N(R310)2;
        —NR310—CO—O—C1-20 alkyl;
        —N3;
        oxo;
        -halogen;
        —NO2;
        —OH; and
        —SH; or R410 is
    
    






    
    
        wherein Y is —N— or —CR—;
    
    


R210 is selected from:
-hydrogen;
—C1-10 alkyl;
—C2-10 alkenyl;
-aryl;
—C1-10 alkyl-O—C1-10 alkyl;
—C1-10 alkyl-O—C2-10 alkenyl; and
—C1-10 alkyl or C2-10 alkenyl substituted by one or more substituents selected from:

    
    
        —OH;
        -halogen;
        —N(R310)2;
        —CO—N(R310)2;
        —CO—C1-10 alkyl;
        —N3;
        -aryl;
        -heteroaryl;
        -heterocyclyl;
        —CO-aryl; and
        —CO-heteroaryl;
    
    


each R310 is independently selected from hydrogen and C1-10 alkyl; and
each R is independently selected from hydrogen, C1-10 alkyl, C1-10 alkoxy, halogen and trifluoromethyl;




wherein

B is —NR—C(R)2—C(R)2—C(R)2—; —C(R)2—NR—C(R)2—C(R)2—; —C(R)2—C(R)2—NR—C(R)2— or —C(R)2—C(R)2—C(R)2—NR—;
R111 is selected from:
-hydrogen;
—C1-20 alkyl or C2-20 alkenyl that is unsubstituted or substituted by one or more substituents selected from:

    
    
        -aryl;
        -heteroaryl;
        -heterocyclyl;
        —O—C1-20 alkyl;
        —O—(C1-20 alkyl)0-1-aryl;
        —O—(C1-20 alkyl)0-1-heteroaryl;
        —O—(C1-20 alkyl)0-1-heterocyclyl;
        —CO—O—C1-20 alkyl;
        —S(O)0-2—C1-20 alkyl;
        —S(O)0-2—(C1-20 alkyl)0-1-aryl;
        —S(O)0-2—(C1-20 alkyl)0-1-heteroaryl;
        —S(O)0-2—(C1-20 alkyl)0-1-heterocyclyl;
        —N(R311)2;
        —N3;
        oxo;
        -halogen;
        —NO2;
        —OH; and
        —SH; and
    
    


—C1-20 alkyl-NR311-Q-X—R411 or —C2-20 alkenyl-NR311-Q-X—R411 wherein Q is —CO— or —SO2—; X is a bond, —O— or —NR311— and R411 is aryl; heteroaryl; heterocyclyl; or —C1-20 alkyl or C2-20 alkenyl that is unsubstituted or substituted by one or more substituents selected from:

    
    
        -aryl;
        -heteroaryl;
        -heterocyclyl;
        —O—C1-20 alkyl;
        —O—(C1-20 alkyl)0-1-aryl;
        —O—(C1-20 alkyl)0-1-heteroaryl;
        —O—(C1-20 alkyl)0-1-heterocyclyl;
        —CO—O—C1-20 alkyl;
        —S(O)0-2—C1-20 alkyl;
        —S(O)0-2—(C1-20 alkyl)0-1-aryl;
        —S(O)0-2—(C1-20 alkyl)0-1-heteroaryl;
        —S(O)0-2—(C1-20 alkyl)0-1-heterocyclyl;
        —N(R311)2;
        —NR311—CO—O—C1-20 alkyl;
        —N3;
        oxo;
        -halogen;
        —NO2;
        —OH; and
        —SH; or R411 is
    
    






    
    
        wherein Y is —N— or —CR—;
    
    


R211 is selected from:
-hydrogen;
—C1-10 alkyl;
—C2-10 alkenyl;
-aryl;
—C1-10 alkyl-O—C1-10-alkyl;
—C1-10 alkyl-O—C2-10 alkenyl; and
—C1-10 alkyl or C2-10 alkenyl substituted by one or more substituents selected from:

    
    
        —OH;
        -halogen;
        —N(R311)2;
        —CO—N(R311)2;
        —CO—C1-10 alkyl;
        —N3;
        -aryl;
        -heteroaryl;
        -heterocyclyl;
        —CO-aryl; and
        —CO-heteroaryl;
    
    


each R311 is independently selected from hydrogen and C1-10 alkyl; and
each R is independently selected from hydrogen, C1-10 alkyl, C1-10 alkoxy, halogen, and trifluoromethyl;
and pharmaceutically acceptable salts thereof.
In another embodiment, the IRM compound can be chosen from 1H-imidazo[4,5-c]quinolin-4-amines and tetrahydro-1H-imidazo[4,5-c]quinolin-4-amines defined by Formulas XII, XIII and XIV below:




wherein

R112 is -alkyl-NR312—CO—R412 or -alkenyl-NR312—CO—R412 wherein R412 is aryl, heteroaryl, alkyl or alkenyl, each of which may be unsubstituted or substituted by one or more substituents selected from:

    
    
        -alkyl;
        -alkenyl;
        -alkynyl;
        -(alkyl)0-1-aryl;
        -(alkyl)0-1-(substituted aryl);
        -(alkyl)0-1-heteroaryl;
        -(alkyl)0-1-(substituted heteroaryl);
        —O-alkyl;
        —O-(alkyl)0-1-aryl;
        —O-(alkyl)0-1-(substituted aryl);
        —O-(alkyl)0-1-heteroaryl;
        —O-(alkyl)0-1-(substituted heteroaryl);
        —CO-aryl;
        —CO-(substituted aryl);
        —CO-heteroaryl;
        —CO-(substituted heteroaryl);
        —COOH;
        —CO—O-alkyl;
        —CO-alkyl;
        —S(O)0-2-alkyl;
        —S(O)0-2-(alkyl)0-1-aryl;
        —S(O)0-2-(alkyl)0-1-(substituted aryl);
        —S(O)0-2-(alkyl)0-1-heteroaryl;
        —S(O)0-2-(alkyl)0-1-(substituted heteroaryl);
        —P(O)(OR312)2;
        —NR312—CO—O-alkyl;
        —N3;
        -halogen;
        —NO2;
        —CN;
        -haloalkyl;
        —O-haloalkyl;
        —CO-haloalkyl;
        —OH;
        —SH; and in the case that R412 is alkyl, alkenyl, or heterocyclyl, oxo; or R412 is
    
    






wherein
R512 is an aryl, (substituted aryl), heteroaryl, (substituted heteroaryl), heterocyclyl or (substituted heterocyclyl) group;
R212 is selected from:

    
    
        -hydrogen;
        -alkyl;
        -alkenyl;
        -aryl;
        -(substituted aryl);
        -heteroaryl;
        -(substituted heteroaryl);
        -heterocyclyl;
        -(substituted heterocyclyl);
        -alkyl-O-alkyl;
        -alkyl-O-alkenyl; and
        -alkyl or alkenyl substituted by one or more substituents selected from:
        
            —OH;
            -halogen;
            —N(R312)2;
            —CO—N(R312)2;
            —CO—C1-10 alkyl;
            —CO—O—C1-10 alkyl;
            —N3;
            -aryl;
            -(substituted aryl);
            -heteroaryl;
            -(substituted heteroaryl);
            -heterocyclyl;
            -(substituted heterocyclyl);
            —CO-aryl; and
            —CO-heteroaryl;
        
        
    
    


each R312 is independently selected from hydrogen; C1-10 alkyl-heteroaryl; C1-10 alkyl-(substituted heteroaryl); C1-10 alkyl-aryl; C1-10 alkyl-(substituted aryl) and C1-10 alkyl;
v is 0 to 4;
and each R12 present is independently selected from C1-10 alkyl, C1-10 alkoxy, halogen, and trifluoromethyl;




wherein

R113 is -alkyl-NR313—SO2—X—R413 or -alkenyl-NR313—SO2—X—R413;
X is a bond or —NR513—;
R413 is aryl, heteroaryl, heterocyclyl, alkyl or alkenyl, each of which may be unsubstituted or substituted by one or more substituents selected from:

    
    
        -alkyl;
        -alkenyl;
        -aryl;
        -heteroaryl;
        -heterocyclyl;
        -substituted cycloalkyl;
        -substituted aryl;
        -substituted heteroaryl;
        -substituted heterocyclyl;
        —O-alkyl;
        —O-(alkyl)0-1-aryl;
        —O-(alkyl)0-1-substituted aryl;
        —O-(alkyl)0-1-heteroaryl;
        —O-(alkyl)0-1-substituted heteroaryl;
        —O-(alkyl)0-1-heterocyclyl;
        —O-(alkyl)0-1-substituted heterocyclyl;
        —COOH;
        —CO—O-alkyl;
        —CO-alkyl;
        —S(O)0-2-alkyl;
        —S(O)0-2-(alkyl)0-1-aryl;
        —S(O)0-2-(alkyl)0-1-substituted aryl;
        —S(O)0-2-(alkyl)0-1-heteroaryl;
        —S(O)0-2-(alkyl)0-1-substituted heteroaryl;
        —S(O)0-2-(alkyl)0-1-heterocyclyl;
        —S(O)0-2-(alkyl)0-1-substituted heterocyclyl;
        -(alkyl)0-1-NR313R313;
        -(alkyl)0-1-NR313—CO—O-alkyl;
        -(alkyl)0-1-NR313—CO-alkyl;
        -(alkyl)0-1-NR313—CO-aryl;
        -(alkyl)0-1-NR313—CO-substituted aryl;
        -(alkyl)0-1-NR313—CO-heteroaryl;
        -(alkyl)0-1-NR313—CO-substituted heteroaryl;
        —N3;
        -halogen;
        -haloalkyl;
        -haloalkoxy;
        —CO-haloalkyl;
        —CO-haloalkoxy;
        —NO2;
        —CN;
        —OH;
        —SH; and in the case that R413 is alkyl, alkenyl, or heterocyclyl, oxo;
    
    


R213 is selected from:

    
    
        -hydrogen;
        -alkyl;
        -alkenyl;
        -aryl;
        -substituted aryl;
        -heteroaryl;
        -substituted heteroaryl;
        -alkyl-O-alkyl;
        -alkyl-O-alkenyl; and
        alkyl or alkenyl substituted by one or more substituents selected from:
        
            —OH;
            -halogen;
            —N(R313)2;
            —CO—N(R313)2;
            —CO—C1-10 alkyl;
            —CO—O—C1-10 alkyl;
            —N3;
            -aryl;
            -substituted aryl;
            -heteroaryl;
            -substituted heteroaryl;
            -heterocyclyl;
            -substituted heterocyclyl;
            —CO-aryl;
            —CO-(substituted aryl);
            —CO-heteroaryl; and
            —CO-(substituted heteroaryl);
        
        
    
    


each R313 is independently selected from hydrogen and C1-10 alkyl; or when X is a bond R313 and R413 can join to form a 3 to 7 membered heterocyclic or substituted heterocyclic ring;
R513 is selected from hydrogen and C1-10 alkyl, or R413 and R513 can combine to form a 3 to 7 membered heterocyclic or substituted heterocyclic ring;
v is 0 to 4;
and each R13 present is independently selected from C1-10 alkyl, C1-10 alkoxy, halogen, and trifluoromethyl;




wherein

R114 is -alkyl-NR314—CY—NR514—X—R414 or
-alkenyl-NR314—CY—NR514—X—R414 
wherein
Y is ═O or ═S;
X is a bond, —CO— or —SO2—;
R414 is aryl, heteroaryl, heterocyclyl, alkyl or alkenyl, each of which may be unsubstituted or substituted by one or more substituents selected from:

    
    
        -alkyl;
        -alkenyl;
        -aryl;
        -heteroaryl;
        -heterocyclyl;
        -substituted aryl;
        -substituted heteroaryl;
        -substituted heterocyclyl;
        —O-alkyl;
        —O-(alkyl)0-1-aryl;
        —O-(alkyl)0-1-substituted aryl;
        —O-(alkyl)0-1-heteroaryl;
        —O-(alkyl)0-1-substituted heteroaryl;
        —O-(alkyl)0-1-heterocyclyl;
        —O-(alkyl)0-1-substituted heterocyclyl;
        —COOH;
        —CO—O-alkyl;
        —CO-alkyl;
        —S(O)0-2-alkyl;
        —S(O)0-2-(alkyl)0-1-aryl;
        —S(O)0-2-(alkyl)0-1-substituted aryl;
        —S(O)0-2-(alkyl)0-1-heteroaryl;
        —S(O)0-2-(alkyl)0-1-substituted heteroaryl;
        —S(O)0-2-(alkyl)0-1-heterocyclyl;
        —S(O)0-2-(alkyl)0-1-substituted heterocyclyl;
        -(alkyl)0-1-NR314R314;
        -(alkyl)0-1-NR314—CO—O-alkyl;
        -(alkyl)0-1-NR314—CO-alkyl;
        -(alkyl)0-1-NR314—CO-aryl;
        -(alkyl)0-1-NR314—CO-substituted aryl;
        -(alkyl)0-1-NR314—CO-heteroaryl;
        -(alkyl)0-1-NR314—CO-substituted heteroaryl;
        —N3;
        -halogen;
        -haloalkyl;
        -haloalkoxy;
        —CO-haloalkoxy;
        —NO2;
        —CN;
        —OH;
        —SH; and, in the case that R414 is alkyl, alkenyl or heterocyclyl, oxo;
    
    


with the proviso that when X is a bond R414 can additionally be hydrogen;
R214 is selected from:

    
    
        -hydrogen;
        -alkyl;
        -alkenyl;
        -aryl;
        -substituted aryl;
        -heteroaryl;
        -substituted heteroaryl;
        -alkyl-O-alkyl;
        -alkyl-O-alkenyl; and
        -alkyl or alkenyl substituted by one or more substituents selected from:
        
            —OH;
            -halogen;
            —N(R314)2;
            —CO—N(R314)2;
            —CO—C1-10 alkyl;
            —CO—O—C1-10 alkyl;
            —N3;
            -aryl;
            -substituted aryl;
            -heteroaryl;
            -substituted heteroaryl;
            -heterocyclyl;
            -substituted heterocyclyl;
            —CO-aryl;
            —CO-(substituted aryl);
            —CO-heteroaryl; and
            —CO-(substituted heteroaryl);
        
        
    
    


each R314 is independently selected from hydrogen and C1-10 alkyl;
R514 is selected from hydrogen and C1-10 alkyl, or R414 and R514 can combine to form a 3 to 7 membered heterocyclic or substituted heterocyclic ring;
v is 0 to 4;
and each R14 present is independently selected from C1-10 alkyl, C1-10 alkoxy, halogen, and trifluoromethyl;
and pharmaceutically acceptable salts thereof.
In another embodiment, the IRM compound can be chosen from 1H-imidazo[4,5-c]quinolin-4-amines and tetrahydro-1H-imidazo[4,5-c]quinolin-4-amines defined by Formulas XV, XVI, XVII, XVIII, XIX, XX, XXI, XXII, XXIII, XXIV, XXV, and XXVI below:




wherein:

    
    
        X is —CHR515—, —CHR515-alkyl-, or —CHR515-alkenyl-;
        R115 is selected from:
        
            —R415—CR315—Z—R615-alkyl;
            —R415—CR315—Z—R615-alkenyl;
            —R415—CR315—Z—R615-aryl;
            —R415—CR315—Z—R615-heteroaryl;
            —R415—CR315—Z—R615-heterocyclyl;
            —R415—CR315—Z—H;
            —R415—NR715—CR315—R615-alkyl;
            —R415—NR715—CR35—R615-alkenyl;
            —R415—NR715—CR315—R615-aryl;
            —R415—NR715—CR35—R615-heteroaryl;
            —R415—NR715—CR315—R615-heterocyclyl; and
            —R415—NR715—CR315—R815;
        
        
        Z is —NR515—, —O—, or —S—;
        R215 is selected from:
        
            -hydrogen;
            -alkyl;
            -alkenyl;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            -alkyl-Y-alkyl;
            -alkyl-Y-alkenyl;
            -alkyl-Y-aryl; and
            -alkyl or alkenyl substituted by one or more substituents selected from:
            
                —OH;
                -halogen;
                —N(R515)2;
                —CO—N(R515)2;
                —CO—C1-10 alkyl;
                —CO—O—C1-10 alkyl;
                —N3;
                -aryl;
                -heteroaryl;
                -heterocyclyl;
                —CO-aryl; and
                —CO-heteroaryl;
            
            
        
        
        R315 is ═O or ═S;
        R415 is alkyl or alkenyl, which may be interrupted by one or more —O— groups;
        each R515 is independently H or C1-10 alkyl;
        R615 is a bond, alkyl, or alkenyl, which may be interrupted by one or more —O— groups;
        R715 is H, C1-10 alkyl, or arylalkyl; or R415 and R715 can join together to form a ring;
        R815 is H or C1-10 alkyl; or R715 and R815 can join together to form a ring;
        Y is —O— or —S(O)0-2—;
        v is 0 to 4; and
        each R15 present is independently selected from C1-10 alkyl, C1-10 alkoxy, hydroxy, halogen, and trifluoromethyl;
    
    






wherein:

    
    
        X is —CHR516—, —CHR516-alkyl-, or —CHR516-alkenyl-;
        R116 is selected from:
        
            —R416—CR316—Z—R616-alkyl;
            —R416—CR316—Z—R616-alkenyl;
            —R416—CR316—Z—R616-aryl;
            —R416—CR316—Z—R616-heteroaryl;
            —R416—CR316—Z—R616-heterocyclyl;
            —R416—CR316—Z—H;
            —R416—NR716—CR316—R616-alkyl;
            —R416—NR716—CR316—R616-alkenyl;
            —R416—NR716—CR316—R616-aryl;
            —R416—NR716—CR316—R616-heteroaryl;
            —R416—NR716—CR316—R616-heterocyclyl; and
            —R416—NR716—CR316—R816;
        
        
        Z is —NR516—, —O—, or —S—;
        R216 is selected from:
        
            -hydrogen;
            -alkyl;
            -alkenyl;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            -alkyl-Y-alkyl;
            -alkyl-Y-alkenyl;
            -alkyl-Y-aryl; and
            -alkyl or alkenyl substituted by one or more substituents selected from:
            
                —OH;
                -halogen;
                —N(R516)2;
                —CO—N(R516)2;
                —CO—C1-10 alkyl;
                —CO—O—C1-10 alkyl;
                —N3;
                -aryl;
                -heteroaryl;
                -heterocyclyl;
                —CO-aryl; and
                —CO-heteroaryl;
            
            
        
        
        R316 is ═O or ═S;
        R416 is alkyl or alkenyl, which may be interrupted by one or more —O— groups;
        each R516 is independently H or C1-10 alkyl;
        R616 is a bond, alkyl, or alkenyl, which may be interrupted by one or more —O— groups;
        R716 is H, C1-10 alkyl, arylalkyl; or R416 and R716 can join together to form a ring;
        R816 is H or C1-10 alkyl; or R716 and R816 can join together to form a ring;
        Y is —O— or —S(O)0-2—;
        v is 0 to 4; and
        each R16 present is independently selected from C1-10 alkyl, C1-10 alkoxy, hydroxy, halogen, and trifluoromethyl;
    
    






wherein:

    
    
        X is —CHR317—, —CHR317-alkyl-, or —CHR317-alkenyl-;
        R117 is selected from:
        
            -alkenyl;
            -aryl; and
            —R417-aryl;
        
        
        R217 is selected from:
        
            -hydrogen;
            -alkyl;
            -alkenyl;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            -alkyl-Y-alkyl;
            -alkyl-Y-alkenyl;
            -alkyl-Y-aryl; and
            -alkyl or alkenyl substituted by one or more substituents selected from:
            
                —OH;
                -halogen;
                —N(R317)2;
                —CO—N(R317)2;
                —CO—C1-10 alkyl;
                —CO—O—C1-10 alkyl;
                —N3;
                -aryl;
                -heteroaryl;
                -heterocyclyl;
                —CO-aryl; and
                —CO-heteroaryl;
            
            
        
        
        R417 is alkyl or alkenyl, which may be interrupted by one or more —O— groups;
        each R317 is independently H or C1-10 alkyl;
        each Y is independently —O— or —S(O)0-2—;
        v is 0 to 4; and
        each R17 present is independently selected from C1-10 alkyl, C1-10 alkoxy, hydroxy, halogen, and trifluoromethyl;
    
    






wherein:

    
    
        X is —CHR318—, —CHR318-alkyl-, or —CHR318-alkenyl-;
        R18 is selected from:
        
            -aryl;
            -alkenyl; and
            —R418-aryl;
        
        
        R218 is selected from:
        
            -hydrogen;
            -alkyl;
            -alkenyl;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            -alkyl-Y-alkyl;
            -alkyl-Y-aryl;
            alkyl-Y-alkenyl; and
            alkyl or alkenyl substituted by one or more substituents selected from:
            
                —OH;
                -halogen;
                —N(R318)2;
                —CO—N(R318)2;
                —CO—C1-10 alkyl;
                —CO—O—C1-10 alkyl;
                —N3;
                -aryl;
                -heteroaryl;
                -heterocyclyl;
                —CO-aryl; and
                —CO-heteroaryl;
            
            
        
        
        R418 is alkyl or alkenyl, which may be interrupted by one or more —O— groups;
        each R318 is independently H or C1-10 alkyl;
        each Y is independently —O— or —S(O)0-2—;
        v is 0 to 4; and
        each R18 present is independently selected C1-10 alkyl, C1-10 alkoxy, hydroxy, halogen, and trifluoromethyl;
    
    






wherein:

    
    
        X is —CHR319—, —CHR319-alkyl-, or —CHR319-alkenyl-;
        R119 is selected from:
        
            -heteroaryl;
            -heterocyclyl;
            —R419-heteroaryl; and
            —R419-heterocyclyl;
        
        
        R219 is selected from:
        
            -hydrogen;
            -alkyl;
            -alkenyl;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            -alkyl-Y-alkyl;
            -alkyl-Y-alkenyl;
            -alkyl-Y-aryl; and
            -alkyl or alkenyl substituted by one or more substituents selected from:
            
                —OH;
                -halogen;
                —N(R319)2;
                —CO—N(R319)2;
                —CO—C1-10 alkyl;
                —CO—O—C1-10 alkyl;
                —N3;
                -aryl;
                -heteroaryl;
                -heterocyclyl;
                —CO-aryl; and
                —CO-heteroaryl;
            
            
        
        
        R419 is alkyl or alkenyl, which may be interrupted by one or more —O— groups;
        each R319 is independently H or C1-10 alkyl;
        each Y is independently —O— or —S(O)0-2—;
        v is 0 to 4; and
        each R19 present is independently selected from C1-10 alkyl, C1-10 alkoxy, hydroxy, halogen, and trifluoromethyl;
    
    






wherein:

    
    
        X is —CHR320—, —CHR320-alkyl-, or —CHR320-alkenyl-;
        R120 is selected from:
        
            -heteroaryl;
            -heterocyclyl;
            —R420-heteroaryl; and
            —R420-heterocyclyl;
        
        
        R220 is selected from:
        
            -hydrogen;
            -alkyl;
            -alkenyl;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            -alkyl-Y-alkyl;
            -alkyl-Y-alkenyl;
            -alkyl-Y-aryl; and
            -alkyl or alkenyl substituted by one or more substituents selected from:
            
                —OH;
                -halogen;
                —N(R320)2;
                —CO—N(R320)2;
                —CO—C1-10 alkyl;
                —CO—O—C1-10 alkyl;
                —N3;
                -aryl;
                -heteroaryl;
                -heterocyclyl;
                —CO-aryl; and
                —CO-heteroaryl;
            
            
        
        
        R420 is alkyl or alkenyl, which may be interrupted by one or more —O— groups;
        each R320 is independently H or C1-10 alkyl;
        each Y is independently —O— or —S(O)0-2—;
        v is 0 to 4; and
        each R20 present is independently selected from C1-10 alkyl, C1-10 alkoxy, hydroxy, halogen, and trifluoromethyl;
    
    






wherein:

    
    
        X is —CHR521—, —CHR521-alkyl-, or —CHR521-alkenyl-;
        R121 is selected from:
        
            —R421—NR321—SO2—R621-alkyl;
            —R421—NR321—SO2—R621-alkenyl;
            —R421—NR321—SO2—R621-aryl;
            —R421—NR321—SO2—R621-heteroaryl;
            —R421—NR321—SO2—R621-heterocyclyl;
            —R421—NR321—SO2—R721;
            —R421—NR321—SO2—NR521—R621-alkyl;
            —R421—NR321—SO2—NR521—R621-alkenyl;
            —R421—NR321—SO2—NR521—R621-aryl;
            —R421—NR321—SO2—NR521—R621-heteroaryl;
            —R421—NR321—SO2—NR521—R621-heterocyclyl; and
            —R421—NR321—SO2—NH2;
        
        
        R221 is selected from:
        
            -hydrogen;
            -alkyl;
            -alkenyl;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            -alkyl-Y-alkyl;
            -alkyl-Y-alkenyl;
            -alkyl-Y-aryl; and
            -alkyl or alkenyl substituted by one or more substituents selected from:
            
                —OH;
                -halogen;
                —N(R521)2;
                —CO—N(R521)2;
                —CO—C1-10 alkyl;
                —CO—O—C1-10 alkyl;
                —N3;
                -aryl;
                -heteroaryl;
                -heterocyclyl;
                —CO-aryl; and
                —CO-heteroaryl;
            
            
        
        
        Y is —O— or —S(O)0-2—;
        R321 is H, C1-10 alkyl, or arylalkyl;
        each R421 is independently alkyl or alkenyl, which may be interrupted by one or more —O— groups; or R321 and R421 can join together to form a ring;
        each R521 is independently H, C1-10 alkyl, or C2-10 alkenyl;
        R621 is a bond, alkyl, or alkenyl, which may be interrupted by one or more —O— groups;
        R721 is C1-10 alkyl; or R321 and R721 can join together to form a ring;
        v is 0 to 4; and
        each R21 present is independently selected from C1-10 alkyl, C1-10 alkoxy, hydroxy, halogen, and trifluoromethyl;
    
    






wherein:

    
    
        X is —CHR522—, —CHR522-alkyl-, or —CHR522-alkenyl-;
        R122 is selected from:
        
            —R422—NR322—SO2—R622-alkyl;
            —R422—NR322—SO2—R622-alkenyl;
            —R422—NR322—SO2—R622-aryl;
            —R422—NR322—SO2—R622-heteroaryl;
            —R422—NR322—SO2—R622-heterocyclyl;
            —R422—NR322—SO2—R722;
            —R422—NR322—SO2—NR522—R622-alkyl;
            —R422—NR322—SO2—NR522—R622-alkenyl;
            —R422—NR322—SO2—NR522—R622-aryl;
            —R422—NR322—SO2—NR522—R622-heteroaryl;
            —R422—NR322—SO2—NR522—R622-heterocyclyl; and
            —R422—NR322—SO2—NH2;
        
        
        R222 is selected from:
        
            -hydrogen;
            -alkyl;
            -alkenyl;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            -alkyl-Y-alkyl;
            -alkyl-Y-alkenyl;
            -alkyl-Y-aryl; and
            -alkyl or alkenyl substituted by one or more substituents selected from:
            
                —OH;
                -halogen;
                —N(R522)2;
                —CO—N(R522)2;
                —CO—C1-10 alkyl;
                —CO—O—C1-10 alkyl;
                —N3;
                -aryl;
                -heteroaryl;
                -heterocyclyl;
                —CO-aryl; and
                —CO-heteroaryl;
            
            
        
        
        Y is —O— or —S(O)0-2—;
        R322 is H, C1-10 alkyl, or arylalkyl;
        each R422 is independently alkyl or alkenyl, which may be interrupted by one or more —O— groups; or R322 and R422 can join together to form a ring;
        each R522 is independently H, C1-10 alkyl, or C2-10 alkenyl;
        R622 is a bond, alkyl, or alkenyl, which may be interrupted by one or more —O— groups;
        R722 is C1-10 alkyl; or R322 and R722 can join together to form a ring;
        v is 0 to 4; and
        each R22 present is independently selected from C1-10 alkyl, C1-10 alkoxy, hydroxy, halogen, and trifluoromethyl;
    
    






wherein:

    
    
        X is —CHR323—, —CHR323-alkyl-, or —CHR323-alkenyl-;
        Z is —S—, —SO—, or —SO2—;
        R123 is selected from:
        
            -alkyl;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            -alkenyl;
            —R423-aryl;
            —R423-heteroaryl; and
            —R423-heterocyclyl;
        
        
        R223 is selected from:
        
            -hydrogen;
            -alkyl;
            -alkenyl;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            -alkyl-Y-alkyl;
            alkyl-Y-alkenyl;
            -alkyl-Y-aryl; and
            -alkyl or alkenyl substituted by one or more substituents selected from:
            
                —OH;
                -halogen;
                —N(R323)2;
                —CO—N(R323)2;
                —CO—C1-10 alkyl;
                —CO—O—C1-10 alkyl;
                —N3;
                -aryl;
                -heteroaryl;
                -heterocyclyl;
                —CO-aryl; and
                —CO-heteroaryl;
            
            
        
        
        each R323 is independently H or C1-10 alkyl;
        each R423 is independently alkyl or alkenyl;
        each Y is independently —O— or —S(O)0-2—;
        v is 0 to 4; and
        each R23 present is independently selected from C1-10 alkyl, C1-10 alkoxy, hydroxy, halogen, and trifluoromethyl;
    
    






wherein:

    
    
        X is —CHR324—, —CHR324-alkyl-, or —CHR324-alkenyl-;
        Z is —S—, —SO—, or —SO2—;
        R124 is selected from:
        
            -alkyl;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            -alkenyl;
            —R424-aryl;
            —R424-heteroaryl; and
            —R424-heterocyclyl;
        
        
        R224 is selected from:
        
            -hydrogen;
            -alkyl;
            -alkenyl;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            -alkyl-Y-alkyl;
            alkyl-Y-alkenyl;
            -alkyl-Y-aryl; and
            -alkyl or alkenyl substituted by one or more substituents selected from:
            
                —OH;
                -halogen;
                —N(R324)2;
                —CO—N(R324)2;
                —CO—C1-10 alkyl;
                —CO—O—C1-10 alkyl;
                —N3;
                -aryl;
                -heteroaryl;
                -heterocyclyl;
                —CO-aryl; and
                —CO-heteroaryl;
            
            
        
        
        each R324 is independently H or C1-10 alkyl;
        each R424 is independently alkyl or alkenyl;
        each Y is independently —O— or —S(O)0-2—;
        v is 0 to 4; and
        each R24 present is independently selected from C1-10 alkyl, C1-10 alkoxy, hydroxy, halogen, and trifluoromethyl;
    
    






wherein:

    
    
        X is —CHR525—, —CHR525-alkyl-, or —CHR525-alkenyl-;
        R125 is selected from:
        
            —R425—NR825—CR325—NR525—Z—R625-alkyl;
            —R425—NR825—CR325—NR525—Z—R625-alkenyl;
            —R425—NR825—CR325—NR525—Z—R625-aryl;
            —R425—NR825—CR325—NR525—Z—R625-heteroaryl;
            —R425—NR825—CR325—NR525—Z—R625-heterocyclyl;
            —R425—NR825—CR325—NR525R725;
            —R425—NR825—CR325—NR925—Z—R625-alkyl;
            —R425—NR825—CR325—NR925—Z—R625-alkenyl;
            —R425—NR825—CR325—NR925—Z—R625-aryl;
            —R425—NR825—CR325—NR925—Z—R625-heteroaryl; and
            —R425—NR825—CR325—NR925—Z—R625-heterocyclyl;
        
        
        R225 is selected from:
        
            -hydrogen;
            -alkyl;
            -alkenyl;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            -alkyl-Y-alkyl;
            -alkyl-Y-alkenyl;
            -alkyl-Y-aryl; and
            alkyl or alkenyl substituted by one or more substituents selected from:
            
                —OH;
                -halogen;
                —N(R525)2;
                —CO—N(R525)2;
                —CO—C1-10 alkyl;
                —CO—O—C1-10 alkyl;
                —N3;
                -aryl;
                -heteroaryl;
                -heterocyclyl;
                —CO-aryl; and
                —CO-heteroaryl;
            
            
        
        
        each R325 is ═O or ═S;
        each R425 is independently alkyl or alkenyl, which may be interrupted by one or more —O— groups;
        each R525 is independently H or C1-10 alkyl;
        R625 is a bond, alkyl, or alkenyl, which may be interrupted by one or more —O— groups;
        R725 is H or C1-10 alkyl which may be interrupted by a hetero atom, or R725 can join with R525 to form a ring;
        R825 is H, C1-10 alkyl, or arylalkyl; or R425 and R825 can join together to form a ring;
        R925 is C1-10 alkyl which can join together with R825 to form a ring;
        each Y is independently —O— or —S(O)0-2—;
        Z is a bond, —CO—, or —SO2—;
        v is 0 to 4; and
        each R25 present is independently selected C1-10 alkyl, C1-10 alkoxy, hydroxy, halogen, and trifluoromethyl;
    
    






wherein:

    
    
        X is —CHR526—, —CHR526-alkyl-, or —CHR526-alkenyl-;
        R126 is selected from:
        
            —R426—NR826—CR326—NR526—Z—R626-alkyl;
            —R426—NR826—CR326—NR526—Z—R626-alkenyl;
            —R426—NR826—CR326—NR526—Z—R626-aryl;
            —R426—NR826—CR326—NR526—Z—R626-heteroaryl;
            —R426—NR826—CR326—NR526—Z—R626-heterocyclyl;
            —R426—NR826—CR326—NR526R726;
            —R426—NR826—CR326—NR926—Z—R626-alkyl;
            —R426—NR826—CR326—NR926—Z—R626-alkenyl;
            —R426—NR826—CR326—NR926—Z—R626-aryl;
            —R426—NR826—CR326—NR926—Z—R626-heteroaryl; and
            —R426—NR826—CR326—NR926—Z—R626-heterocyclyl;
        
        
        R226 is selected from:
        
            -hydrogen;
            -alkyl;
            -alkenyl;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            -alkyl-Y-alkyl;
            -alkyl-Y-alkenyl;
            -alkyl-Y-aryl; and
            -alkyl or alkenyl substituted by one or more substituents selected from:
            
                —OH;
                -halogen;
                —N(R526)2;
                —CO—N(R526)2;
                —CO—C1-10 alkyl;
                —CO—O—C1-10 alkyl;
                —N3;
                -aryl;
                -heteroaryl;
                -heterocyclyl;
                —CO-aryl; and
                —CO-heteroaryl;
            
            
        
        
        each R326 is ═O or ═S;
        each R426 is independently alkyl or alkenyl, which may be interrupted by one or more —O— groups;
        each R526 is independently H or C1-10 alkyl;
        R626 is a bond, alkyl, or alkenyl, which may be interrupted by one or more —O— groups;
        R726 is H or C1-10 alkyl which may be interrupted by a hetero atom, or R726 can join with R526 to form a ring;
        R826 is H, C1-10 alkyl, or arylalkyl; or R426 and R826 can join together to form a ring;
        R926 is C1-10 alkyl which can join together with R826 to form a ring;
        each Y is independently —O— or —S(O)0-2—;
        Z is a bond, —CO—, or —SO2—;
        v is 0 to 4; and
        each R26 present is independently selected from C1-10 alkyl, C1-10 alkoxy, hydroxy, halogen, and trifluoromethyl;

and pharmaceutically acceptable salts of any of the foregoing.

    
    


In another embodiment, the IRM compound can be chosen from 1H-imidazo[4,5-c]pyridin-4-amines defined by Formula XXVII below:




wherein

    
    
        X is alkylene or alkenylene;
        Y is —CO— or —CS;
        Z is a bond, —O—, or —S—;
        R127 is aryl, heteroaryl, heterocyclyl, alkyl or alkenyl, each of which may be unsubstituted or substituted by one or more substituents independently selected from:
        -alkyl;
        -alkenyl;
        -aryl;
        -heteroaryl;
        -heterocyclyl;
        -substituted cycloalkyl;
        -substituted aryl;
        -substituted heteroaryl;
        -substituted heterocyclyl;
        —O-alkyl;
        —O-(alkyl)0-1-aryl;
        —O-(alkyl)0-1-(substituted aryl);
        —O-(alkyl)0-1-heteroaryl;
        —O-(alkyl)0-1-(substituted heteroaryl);
        —O-(alkyl)0-1-heterocyclyl;
        —O-(alkyl)0-1-(substituted heterocyclyl);
        —COOH;
        —CO—O-alkyl;
        —CO-alkyl;
        —S(O)0-2-alkyl;
        —S(O)0-2-(alkyl)0-1-aryl;
        —S(O)0-2-(alkyl)0-1-(substituted aryl);
        —S(O)0-2-(alkyl)0-1-heteroaryl;
        —S(O)0-1-(alkyl)0-1-(substituted heteroaryl);
        —S(O)0-2-(alkyl)0-1-heterocyclyl;
        —S(O)0-2-(alkyl)0-1-(substituted heterocyclyl);
        -(alkyl)0-1-N(R627)2;
        -(alkyl)0-1-NR627—CO—O-alkyl;
        -(alkyl)0-1-NR627—CO-alkyl;
        -(alkyl)0-1-NR627—CO-aryl;
        -(alkyl)0-1-NR627—CO-(substituted aryl);
        -(alkyl)0-1-NR627—CO-heteroaryl;
        -(alkyl)0-1-NR627—CO-(substituted heteroaryl);
        —N3;
        -halogen;
        -haloalkyl;
        -haloalkoxy;
        —CO-haloalkyl;
        —CO-haloalkoxy;
        —NO2;
        —CN;
        —OH;
        —SH; and in the case of alkyl, alkenyl, and heterocyclyl, oxo;
        R227 is selected from:
        -hydrogen;
        -alkyl;
        -alkenyl;
        -aryl;
        -substituted aryl;
        -heteroaryl;
        -substituted heteroaryl;
        -alkyl-O-alkyl;
        -alkyl-S-alkyl;
        -alkyl-O-aryl;
        -alkyl-S-aryl:
        -alkyl-O-alkenyl;
        -alkyl-S-alkenyl; and
        -alkyl or alkenyl substituted by one or more substituents selected from:
        
            —OH;
            -halogen;
            —N(R627)2;
            —CO—N(R627)2;
            —CS—N(R627)2;
            —SO2—N(R627)2;
            —NR627—CO—C1-10 alkyl;
            —NR627—CS—C1-10 alkyl;
            —NR627—SO2—C1-10 alkyl;
            —CO—C1-10 alkyl;
            —CO—O—C1-10 alkyl;
            —N3;
            -aryl;
            -substituted aryl;
            -heteroaryl;
            -substituted heteroaryl;
            -heterocyclyl;
            -substituted heterocyclyl;
            —CO-aryl;
            —CO-(substituted aryl);
            —CO-heteroaryl; and
            —CO-(substituted heteroaryl);
        
        
        R327 and R427 are independently selected from hydrogen, alkyl, alkenyl, halogen, alkoxy, amino, alkylamino, dialkylamino, and alkylthio;
        R527 is H or C1-10 alkyl, or R527 can join with X to form a ring that contains one or two heteroatoms; or when R127 is alkyl, R527 and R127 can join to form a ring;
        each R627 is independently H or C1-10alkyl;

and pharmaceutically acceptable salts thereof.

    
    


In another embodiment, the IRM compound can be chosen from 1H-imidazo[4,5-c]pyridin-4-amines defined by Formula XXVIII below:




wherein

    
    
        X is alkylene or alkenylene;
        Y is —SO2—;
        Z is a bond or —NR628—;
        R128 is aryl, heteroaryl, heterocyclyl, alkyl or alkenyl, each of which may be unsubstituted or substituted by one or more substituents independently selected from:
        -alkyl;
        -alkenyl;
        -aryl;
        -heteroaryl;
        -heterocyclyl;
        -substituted cycloalkyl;
        -substituted aryl;
        -substituted heteroaryl;
        -substituted heterocyclyl;
        —O-alkyl;
        —O-(alkyl)0-1-aryl;
        —O-(alkyl)0-1-(substituted aryl);
        —O-(alkyl)0-1-heteroaryl;
        —O-(alkyl)0-1-(substituted heteroaryl);
        —O-(alkyl)0-1-heterocyclyl;
        —O-(alkyl)0-1-(substituted heterocyclyl);
        —COOH;
        —CO—O-alkyl;
        —CO-alkyl;
        —S(O)0-2-alkyl;
        —S(O)0-2-(alkyl)0-1-aryl;
        —S(O)0-2-(alkyl)0-1-(substituted aryl);
        —S(O)0-2-(alkyl)0-1-heteroaryl;
        —S(O)0-2-(alkyl)0-1-(substituted heteroaryl);
        —S(O)0-2-(alkyl)0-1-heterocyclyl;
        —S(O)0-2-(alkyl)0-1-(substituted heterocyclyl);
        -(alkyl)0-1-N(R628)2;
        -(alkyl)0-1-NR628—CO—O-alkyl;
        -(alkyl)0-1-NR628—CO-alkyl;
        -(alkyl)0-1-NR628—CO-aryl;
        -(alkyl)0-1-NR628—CO-(substituted aryl);
        -(alkyl)0-1-NR628—CO-heteroaryl;
        -(alkyl)0-1-NR628—CO-(substituted heteroaryl);
        —N3;
        -halogen;
        -haloalkyl;
        -haloalkoxy;
        —CO-haloalkyl;
        —CO-haloalkoxy;
        —NO2;
        —CN;
        —OH;
        —SH; and in the case of alkyl, alkenyl, and heterocyclyl, oxo;
        R228 is selected from:
        -hydrogen;
        -alkyl;
        -alkenyl;
        -aryl;
        -substituted aryl;
        -heteroaryl;
        -substituted heteroaryl;
        -alkyl-O-alkyl;
        -alkyl-S-alkyl;
        -alkyl-O-aryl;
        -alkyl-S-aryl:
        -alkyl-O-alkenyl;
        -alkyl-S-alkenyl; and
        -alkyl or alkenyl substituted by one or more substituents selected from:
        
            —OH;
            -halogen;
            —N(R628)2;
            —CO—N(R628)2;
            —CS—N(R628)2;
            —SO2—N(R628)2;
            —NR628—CO—C1-10 alkyl;
            —NR628—CS—C1-10 alkyl;
            —NR628—SO2—C1-10 alkyl;
            —CO—C1-10 alkyl;
            —CO—O—C1-10 alkyl;
            —N3;
            -aryl;
            -substituted aryl;
            -heteroaryl;
            -substituted heteroaryl;
            -heterocyclyl;
            -substituted heterocyclyl;
            —CO-aryl;
            —CO-(substituted aryl);
            —CO-heteroaryl; and
            —CO-(substituted heteroaryl);
        
        
        R328 and R428 are independently selected from hydrogen, alkyl, alkenyl, halogen, alkoxy, amino, alkylamino, dialkylamino, and alkylthio;
        R528 is H or C1-10 alkyl, or R528 can join with X to form a ring; or when R128 is alkyl, R528 and R128 can join to form a ring;
        each R628 is independently H or C1-10alkyl;
    
    


and pharmaceutically acceptable salts thereof.
In another embodiment, the IRM compound can be chosen from 1H-imidazo[4,5-c]pyridin-4-amines defined by Formula XXIX below:




wherein

    
    
        X is alkylene or alkenylene;
        Y is —CO— or —CS;
        Z is —NR629—, —NR629—CO—, —NR629—SO2—, or —NR729—;
        R129 is aryl, heteroaryl, heterocyclyl, alkyl or alkenyl, each of which may be unsubstituted or substituted by one or more substituents independently selected from:
        -alkyl;
        -alkenyl;
        -aryl;
        -heteroaryl;
        -heterocyclyl;
        -substituted cycloalkyl;
        -substituted aryl;
        -substituted heteroaryl;
        -substituted heterocyclyl;
        —O-alkyl;
        —O-(alkyl)0-1-aryl;
        —O-(alkyl)0-1-(substituted aryl);
        —O-(alkyl)0-1-heteroaryl;
        —O-(alkyl)0-1-(substituted heteroaryl);
        —O-(alkyl)0-1-heterocyclyl;
        —O-(alkyl)0-1-(substituted heterocyclyl);
        —COOH;
        —CO—O-alkyl;
        —CO-alkyl;
        —S(O)0-2-alkyl;
        —S(O)0-2-(alkyl)0-1-aryl;
        —S(O)0-2-(alkyl)0-1-(substituted aryl);
        —S(O)0-2-(alkyl)0-1-heteroaryl;
        —S(O)0-2-(alkyl)0-1-(substituted heteroaryl);
        —S(O)0-2-(alkyl)0-1-heterocyclyl;
        —S(O)0-1-(alkyl)0-1-(substituted heterocyclyl);
        -(alkyl)0-1-N(R629)2;
        -(alkyl)0-1-NR629—CO—O-alkyl;
        -(alkyl)0-1-NR629—CO-alkyl;
        -(alkyl)0-1-NR629—CO-aryl;
        -(alkyl)0-1-NR629—CO-(substituted aryl);
        -(alkyl)0-1-NR629—CO-heteroaryl;
        -(alkyl)0-1-NR629—CO-(substituted heteroaryl);
        —P(O)(O-alkyl)2;
        —N3;
        -halogen;
        -haloalkyl;
        -haloalkoxy;
        —CO-haloalkyl;
        —CO-haloalkoxy;
        —NO2;
        —CN;
        —OH;
        —SH; and in the case of alkyl, alkenyl, and heterocyclyl, oxo;
        R229 is selected from:
        -hydrogen;
        -alkyl;
        -alkenyl;
        -aryl;
        -substituted aryl;
        -heteroaryl;
        -substituted heteroaryl;
        -alkyl-O-alkyl;
        -alkyl-S-alkyl;
        -alkyl-O-aryl;
        -alkyl-S-aryl:
        -alkyl-O-alkenyl;
        -alkyl-S-alkenyl; and
        -alkyl or alkenyl substituted by one or more substituents selected from:
        
            —OH;
            -halogen;
            —N(R629)2;
            —CO—N(R629)2;
            —CS—N(R629)2;
            —SO2—N(R629)2;
            —NR629—CO—C1-10 alkyl;
            —NR629—CS—C1-10 alkyl;
            —NR629—SO2—C1-10 alkyl;
            —CO—C1-10 alkyl;
            —CO—O—C1-10 alkyl;
            —N3;
            -aryl;
            -substituted aryl;
            -heteroaryl;
            -substituted heteroaryl;
            -heterocyclyl;
            -substituted heterocyclyl;
            —CO-aryl;
            —CO-(substituted aryl);
            —CO-heteroaryl; and
            —CO-(substituted heteroaryl);
        
        
        R329 and R429 are independently selected from hydrogen, alkyl, alkenyl, halogen, alkoxy, amino, alkylamino, dialkylamino, and alkylthio;
        R529 is H or C1-10 alkyl, or R529 can join with X to form a ring that contains one or two heteroatoms;
        each R629 is independently H or C1-10alkyl;
        R729 is H or C1-10 alkyl which may be interrupted by a heteroatom; or when R129 is alkyl, R729 and R129 can join to form a ring;

and pharmaceutically acceptable salts thereof.

    
    


In another embodiment, the IRM compound can be chosen from 1-position ether or thioether substituted 1H-imidazo[4,5-c]pyridin-4-amines defined by Formula XXX below:




wherein:

X is —CH(R530)—, —CH(R530)-alkylene-, —CH(R530)-alkenylene-, or CH(R530)-alkylene-Y-alkylene-;
Y is —O—, or —S(O)0-2—;
—W—R130 is selected from —O—R130-1-5 and —S(O)0-2—R130-6;
R130-1-5 is selected from

    
    
        —R630—C(R730)—Z—R830-alkyl;
        —R630—C(R730)—Z—R830-alkenyl;
        —R630—C(R730)—Z—R830-aryl;
        —R630—C(R730)—Z—R830-heteroaryl;
        —R630—C(R730)—Z—R830-heterocyclyl;
        —R630—C(R730)—Z—H;
        —R630—N(R930)—C(R730)—R830-alkyl;
        —R630—N(R930)—C(R730)—R830-alkenyl;
        —R630—N(R930)—C(R730)—R830-aryl;
        —R630—N(R930)—C(R730)—R830-heteroaryl;
        —R630—N(R930)—C(R730)—R830-heterocyclyl;
        —R630—N(R930)—C(R730)—R1030;
        —R630—N(R930)—SO2—R830-alkyl;
        —R630—N(R930)—SO2—R830-alkenyl;
        —R630—N(R930)—SO2—R830-aryl;
        —R630—N(R930)—SO2—R830-heteroaryl;
        —R630—N(R930)—SO2—R830-heterocyclyl;
        —R630—N(R930)—SO2—R1030;
        —R630—N(R930)—SO2—N(R530)—R830-alkyl;
        —R630—N(R930)—SO2—N(R530)—R530-alkenyl;
        —R630—N(R930)—SO2—N(R530)—R830-aryl;
        —R630—N(R930)—SO2—N(R530)—R830-heteroaryl;
        —R630—N(R930)—SO2—N(R530)—R830-heterocyclyl;
        —R630—N(R930)—SO2—NH2;
        —R630—N(R930)—C(R730)—N(R530)-Q-R830-alkyl;
        —R630—N(R930)—C(R730)—N(R530)-Q-R830-alkenyl;
        —R630—N(R930)—C(R730)—N(R530)-Q-R830-aryl;
        —R630—N(R930)—C(R730)—N(R530)-Q-R830-heteroaryl;
        —R630—N(R930)—C(R730)—N(R530)-Q-R830-heterocyclyl;
        —R630—N(R930)—C(R730)—N(R530)2;
    
    






    
    
        —R630—N(R930)—C(R730)—N(R1130)-Q-R830-alkyl;
        —R630—N(R930)—C(R730)—N(R1130)-Q-R830-alkenyl;
        —R630—N(R930)—C(R730)—N(R1130)-Q-R830-aryl;
        —R630—N(R930)—C(R730)—N(R1130)-Q-R830-heteroaryl;
        —R630—N(R930)—C(R730)—N(R1130)-Q-R830-heterocyclyl;
        —R630—N(R930)—C(R730)—N(R1130)H;
        -alkenyl;
        -aryl;
        —R630-aryl;
        -heteroaryl;
        -heterocyclyl;
        —R630-heteroaryl; and
        —R630-heterocyclyl;
    
    


Z is —N(R530)—, —O—, or —S—;
Q is a bond, —CO—, or —SO2—;
A represents the atoms necessary to provide a 5- or 6-membered heterocyclic or heteroaromatic ring that contains up to three heteroatoms;
R130-6 is selected from:

    
    
        -alkyl;
        -aryl;
        -heteroaryl;
        -heterocyclyl;
        -alkenyl;
        —R630-aryl;
        —R630-heteroaryl; and
        —R630-heterocyclyl;
    
    


each R530 is independently hydrogen, C1-10 alkyl, or C2-10 alkenyl;
R630 is alkylene, alkenylene, or alkynylene, which may be interrupted by one or more —O— groups;
R730 is ═O or ═S;
R830 is a bond, alkylene, alkenylene, or alkynylene, which may be interrupted by one or more —O— groups;
R930 is hydrogen, C1-10 alkyl, or arylalkyl; or R930 can join together with any carbon atom of R630 to form a ring of the formula




R1030 is hydrogen or C1-10 alkyl; or R930 and R1030 can join together to form a ring selected from




R1130 is C1-10 alkyl; or R930 and R1130 can join together to form a ring having the structure




R1230 is C2-7 alkylene which is straight chain or branched, wherein the branching does not prevent formation of the ring; and
R230, R330 and R430 are independently selected from hydrogen and non-interfering substituents;
and pharmaceutically acceptable salts thereof.
Illustrative non-interfering R230 substituents include:

    
    
        -alkyl;
        -alkenyl;
        -aryl;
        -heteroaryl;
        -heterocyclyl;
        -alkylene-Y-alkyl;
        -alkylene-Y-alkenyl;
        -alkylene-Y-aryl; and
        alkyl or alkenyl substituted by one or more substituents selected from the group consisting of:
        
            —OH;
            -halogen;
            —N(R530)2;
            —C(O)—C1-10 alkyl;
            —C(O)—O—C1-10 alkyl;
            —N3;
            -aryl;
            -heteroaryl;
            -heterocyclyl;
            —C(O)-aryl; and
            —C(O)-heteroaryl.
        
        
    
    


Illustrative non-interfering R330 and R430 substituents include:
C1-10 alkyl, C2-10 alkenyl, C2-10 alkynyl, C1-10 alkoxy, C1-10 alkylthio, amino, alkylamino, dialkylamino, halogen, and nitro.
In another embodiment, the IRM compound can be chosen from 1H-imidazo dimers of the formula (XXXI):




wherein:

A is a divalent linking group selected from the group consisting of:

    
    
        straight or branched chain C4-20 alkylene;
        straight or branched chain C4-20 alkenylene;
        straight or branched chain C4-20 alkynylene; and
        —Z—Y—W—Y—Z—;
    
    


each Z is independently selected from the group consisting of:

    
    
        straight or branched chain C2-20 alkylene;
        straight or branched chain C4-20 alkenylene; and
        straight or branched chain C4-20 alkynylene;
        
            any of which may be optionally interrupted by —O—, —N(R531)—, or —S(O)2—;
        
        
    
    


each Y is independently selected from the group consisting of:

    
    
        a bond;
        —N(R531)C(O)—;
        —C(O)N(R531)—;
        —N(R531)C(O)N(R531)—;
        N(R531)S(O)2—;
        —S(O)2N(R531)—;
        —OC(O)O—;
        —OC(O)—;
        —C(O)O—;
        —N(R531)C(O)O—; and
        —OC(O)N(R531)—;
    
    


W is selected from the group consisting of:

    
    
        straight or branched chain C2-20 alkylene;
        straight or branched chain C2-20 alkenylene;
        straight or branched chain C4-20 alkynylene;
        straight or branched chain perfluoro C2-20 alkylene;
        C1-4 alkylene-O—C1-4 alkylene;
        —S(O)2—,
        —OC(O)O—;
        —N(R531)C(O)N(R531)—;
    
    






    
    
        1,5-naphthylene;
        2,6-pyridinylene;
        1,2-cyclohexylene;
        1,3-cyclohexylene;
        1,4-cyclohexylene;
        trans-1,4-cyclohexylene;
    
    






and

    
    
        trans-5-norbornen-2,3-diyl;
        wherein n is 0-4; each R is independently selected from the group consisting of C1-4 alkyl, C1-4 alkoxy, and halogen; and Q is selected from the group consisting of a bond, —CH2—, and —O—;
    
    


R231 is selected from the group consisting of:

    
    
        -hydrogen;
        -alkyl;
        -alkenyl;
        -aryl;
        -substituted aryl;
        -heteroaryl;
        -substituted heteroaryl;
        -alkyl-X-alkyl;
        -alkyl-X-aryl;
        -alkyl-X-alkenyl; and
        -alkyl or alkenyl substituted by one or more substituents selected from the group consisting of:
        
            —OH;
            -halogen;
            —N(R631)2;
            —C(O)—N(R631)2;
            —C(S)—N(R631)2;
            —S(O)2—N(R631)2;
            —N(R631)—C(O)—C1-10 alkyl;
            —N(R631)—C(S)—C1-10 alkyl;
            —N(R631)—S(O)2—C1-10 alkyl;
            —C(O)—C1-10 alkyl;
            —C(O)—O—C1-10 alkyl;
            —N3;
            -aryl;
            -substituted aryl;
            -heteroaryl;
            -substituted heteroaryl;
            -heterocyclyl;
            -substituted heterocyclyl;
            —C(O)-aryl;
            —C(O)-(substituted aryl);
            —C(O)-heteroaryl; and
            —C(O)-(substituted heteroaryl);
        
        
    
    


R331 and R431 are each independently selected from the group consisting of:

    
    
        -hydrogen;
        -halogen;
        -alkyl;
        -alkenyl;
        —X-alkyl; and
        —N(R631)2;
        or when taken together, R331 and R431 form a fused aryl or heteroaryl ring that is unsubstituted or substituted by one or more substituents selected from the group consisting of:
        
            -halogen;
            -alkyl;
            -alkenyl;
            —X-alkyl; and
            —N(R631)2;
        
        
        or when taken together, R331 and R431 form a fused 5 to 7 membered saturated ring, containing 0 to 2 heteroatoms and unsubstituted or substituted by one or more substituents selected from the group consisting of:
        
            -halogen;
            -alkyl;
            -alkenyl;
            —X-alkyl; and
            —N(R631)2;
        
        
    
    


each R531 is independently selected from the group consisting of:

    
    
        hydrogen;
        C1-6 alkyl;
        C3-7 cycloalkyl; and
        benzyl; or
    
    


when Y is —N(R531)C(O)—, —C(O)N(R531)—, —N(R531)C(O)N(R531)—, —N(R531)S(O)2—, —S(O2)N(R531)—, —N(R531)C(O)O—, or —OC(O)N(R531)— and the nitrogen of the N(R531) group is bonded to Z, then R531 can join with Z to form a ring having the structure




each R631 is independently hydrogen or C1-10 alkyl;
R731 is C3-8 alkylene; and
X is —O— or —S—;
with the proviso that if W is —C(O)—, —S(O)2—, —OC(O)O—, or —N(R531)C(O)N(R531)— then each Y is a bond;
and pharmaceutically acceptable salts thereof.
In another embodiment, the IRM compound can be chosen from 6-, 7-, 8-, or 9-position aryl or heteroaryl substituted 1H-imidazo[4,5-c]quinolin-4-amines of the following Formula (XXXII):




wherein:

R32 is selected from the group consisting of alkyl, alkoxy, hydroxy, and trifluoromethyl;
n is 0 or 1;
R132 and R232 are independently selected from the group consisting of hydrogen and non-interfering substituents;
R332 is selected from the group consisting of:

    
    
        —Z—Ar,
        —Z—Ar′-Y—R432,
        —Z—Ar′-X—Y—R432,
        —Z—Ar′-R532, and
        —Z—Ar′-X—R532;
    
    


Ar is selected from the group consisting of aryl and heteroaryl both of which can be unsubstituted or can be substituted by one or more substituents independently selected from the group consisting of alkyl, alkenyl, alkoxy, methylenedioxy, haloalkyl, haloalkoxy, halogen, nitro, hydroxy, hydroxyalkyl, mercapto, cyano, carboxy, formyl, aryl, aryloxy, arylalkoxy, heteroaryl, heteroaryloxy, heteroarylalkoxy, heterocyclyl, heterocyclylalkyl, amino, alkylamino, and dialkylamino;
Ar′ is selected from the group consisting of arylene and heteroarylene both of which can be unsubstituted or can be substituted by one or more substituents independently selected from the group consisting of alkyl, alkenyl, alkoxy, haloalkyl, haloalkoxy, halogen, nitro, hydroxy, hydroxyalkyl, mercapto, cyano, carboxy, formyl, aryl, aryloxy, arylalkoxy, heteroaryl, heteroaryloxy, heteroarylalkoxy, heterocyclyl, heterocyclylalkyl, amino, alkylamino, and dialkylamino;
X is selected from the group consisting of alkylene, alkenylene, alkynylene, arylene, heteroarylene, and heterocyclylene wherein the alkylene, alkenylene, and alkynylene groups can be optionally interrupted or terminated with arylene, heteroarylene, or heterocyclylene, and optionally interrupted by one or more —O— groups;
Y is selected from the group consisting of:

    
    
        —S(O)0-2—,
        —S(O)2—N(R832)—,
        —C(R632)—,
        —C(R632)—O—,
        —O—C(R632)—,
        —O—C(O)—O—,
        —N(R832)-Q-,
        —C(R632)—N(R832)—,
        —O—C(R632)—N(R832)—,
        —C(R632)—N(OR932)—,
    
    






Z is selected from the group consisting of a bond, alkylene, alkenylene, and alkynylene;
R432 is selected from the group consisting of hydrogen, alkyl, alkenyl, alkynyl, aryl, arylalkylenyl, aryloxyalkylenyl, alkylarylenyl, heteroaryl, heteroarylalkylenyl, heteroaryloxyalkylenyl, alkylheteroarylenyl, and heterocyclyl wherein the alkyl, alkenyl, alkynyl, aryl, arylalkylenyl, aryloxyalkylenyl, alkylarylenyl, heteroaryl, heteroarylalkylenyl, heteroaryloxyalkylenyl, alkylheteroarylenyl, and heterocyclyl groups can be unsubstituted or substituted by one or more substituents independently selected from the group consisting of alkyl, alkoxy, hydroxyalkyl, haloalkyl, haloalkoxy, halogen, nitro, hydroxy, mercapto, cyano, aryl, aryloxy, arylalkyleneoxy, heteroaryl, heteroaryloxy, heteroarylalkyleneoxy, heterocyclyl, amino, alkylamino, dialkylamino, (dialkylamino)alkyleneoxy, and in the case of alkyl, alkenyl, alkynyl, and heterocyclyl, oxo;
R532 is selected from the group consisting of:




each R632 is independently selected from the group consisting of ═O and ═S;
each R732 is independently C2-7 alkylene;
each R832 is independently selected from the group consisting of hydrogen, alkyl, alkoxyalkylenyl, and arylalkylenyl;
R932 is selected from the group consisting of hydrogen and alkyl;
each R1032 is independently C3-8 alkylene;
A is selected from the group consisting of —O—, —C(O)—, —S(O)0-2—, —CH2—, and —N(R432)—;
Q is selected from the group consisting of a bond, —C(R632)—, —C(R632)—C(R632), —S(O)2—, —C(R632)—N(R832)—W—, —S(O)2—N(R832)—, —C(R632)—O—, and —C(R632)—N(OR932)—;
V is selected from the group consisting of —C(R632)—, —O—C(R632)—, —N(R832)—C(R632)—, and —S(O)2—;
W is selected from the group consisting of a bond, —C(O)—, and —S(O)2—; and
a and b are independently integers from 1 to 6 with the proviso that a+b is ≦7;
and pharmaceutically acceptable salts thereof.
Illustrative non-interfering R132 substituents include:

    
    
        —R432,
        —X—R432,
        —X—Y—R432,
        —X—Y—X—Y—R432, and
        —X—R532;
    
    


wherein:
each X is independently selected from the group consisting of alkylene, alkenylene, alkynylene, arylene, heteroarylene, and heterocyclylene wherein the alkylene, alkenylene, and alkynylene groups can be optionally interrupted or terminated with arylene, heteroarylene, or heterocyclylene, and optionally interrupted by one or more —O— groups;
each Y is independently selected from the group consisting of:

    
    
        —S(O)0-2—,
        —S(O)2—N(R832)—,
        —C(R632)—,
        —C(R632)—O—,
        —O—C(R632)—,
        —O—C(O)—O—,
        —N(R832)-Q-,
        —C(R632)—N(R832)—,
        —O—C(R632)—N(R832)—,
        —C(R632)—N(OR932)—,
    
    






R432 is selected from the group consisting of hydrogen, alkyl, alkenyl, alkynyl, aryl, arylalkylenyl, aryloxyalkylenyl, alkylarylenyl, heteroaryl, heteroarylalkylenyl, heteroaryloxyalkylenyl, alkylheteroarylenyl, and heterocyclyl wherein the alkyl, alkenyl, alkynyl, aryl, arylalkylenyl, aryloxyalkylenyl, alkylarylenyl, heteroaryl, heteroarylalkylenyl, heteroaryloxyalkylenyl, alkylheteroarylenyl, and heterocyclyl groups can be unsubstituted or substituted by one or more substituents independently selected from the group consisting of alkyl, alkoxy, hydroxyalkyl, haloalkyl, haloalkoxy, halogen, nitro, hydroxy, mercapto, cyano, aryl, aryloxy, arylalkyleneoxy, heteroaryl, heteroaryloxy, heteroarylalkyleneoxy, heterocyclyl, amino, alkylamino, dialkylamino, (dialkylamino)alkyleneoxy, and in the case of alkyl, alkenyl, alkynyl, and heterocyclyl, oxo;
R532 is selected from the group consisting of:




each R632 is independently selected from the group consisting of ═O and ═S;
each R732 is independently C2-7 alkylene;
each R832 is independently selected from the group consisting of hydrogen, alkyl, alkoxyalkylenyl, and arylalkylenyl;
each R932 is independently selected from the group consisting of hydrogen and alkyl;
each R1032 is independently C3-8 alkylene;
A is selected from the group consisting of —O—, —C(O)—, —S(O)0-2—, —CH2—, and —N(R432)—;
each Q is independently selected from the group consisting of a bond, —C(R632)—, —C(R632)—C(R632)—, —S(O)2—, —C(R632)—N(R832)—W—, —S(O)2—N(R832)—, —C(R632)—O—, and —C(R632)—N(OR932)—;
each V is independently selected from the group consisting of —C(R632)—, —O—C(R632)—, —N(R832)—C(R632)—, and —S(O)2—;
each W is independently selected from the group consisting of a bond, —C(O)—, and —S(O)2—; and
a and b are independently integers from 1 to 6 with the proviso that a+b is ≦7;
Illustrative non-interfering R232 substituents include:

    
    
        —R432,
        —X—R432,
        —X—Y—R432, and
        —X—R532;
    
    


wherein:
X is selected from the group consisting of alkylene, alkenylene, alkynylene, arylene, heteroarylene, and heterocyclylene wherein the alkylene, alkenylene, and alkynylene groups can be optionally interrupted or terminated with arylene, heteroarylene, or heterocyclylene, and optionally interrupted by one or more —O— groups;
Y is selected from the group consisting of:

    
    
        —S(O)0-2—,
        —S(O)2—N(R832)—,
        —C(R632)—,
        —C(R632)—O—,
        O—C(R632)—,
        —O—C(O)—O—,
        —N(R832)-Q-,
        —C(R632)—N(R832)—,
        —O—C(R632)—N(R832)—,
        —C(R632)—N(OR932)—,
    
    






R432 is selected from the group consisting of hydrogen, alkyl, alkenyl, alkynyl, aryl, arylalkylenyl, aryloxyalkylenyl, alkylarylenyl, heteroaryl, heteroarylalkylenyl, heteroaryloxyalkylenyl, alkylheteroarylenyl, and heterocyclyl wherein the alkyl, alkenyl, alkynyl, aryl, arylalkylenyl, aryloxyalkylenyl, alkylarylenyl, heteroaryl, heteroarylalkylenyl, heteroaryloxyalkylenyl, alkylheteroarylenyl, and heterocyclyl groups can be unsubstituted or substituted by one or more substituents independently selected from the group consisting of alkyl, alkoxy, hydroxyalkyl, haloalkyl, haloalkoxy, halogen, nitro, hydroxy, mercapto, cyano, aryl, aryloxy, arylalkyleneoxy, heteroaryl, heteroaryloxy, heteroarylalkyleneoxy, heterocyclyl, amino, alkylamino, dialkylamino, (dialkylamino)alkyleneoxy, and in the case of alkyl, alkenyl, alkynyl, and heterocyclyl, oxo;
R532 is selected from the group consisting of:




each R632 is independently selected from the group consisting of ═O and ═S;
each R732 is independently C2-7 alkylene;
each R832 is independently selected from the group consisting of hydrogen, alkyl, alkoxyalkylenyl, and arylalkylenyl;
R932 is selected from the group consisting of hydrogen and alkyl;
each R1032 is independently C3-8 alkylene;
A is selected from the group consisting of —O—, —C(O)—, —S(O)0-2—, —CH2—, and —N(R432)—;
Q is selected from the group consisting of a bond, —C(R632)—, —C(R632)—C(R632)—, —S(O)2—, —C(R632)—N(R832)—W—, —S(O)2—N(R832)—, —C(R632)—O—, and —C(R632)—N(OR932)—;
V is selected from the group consisting of —C(R632)—, —O—C(R632)—, —N(R832)—C(R632)—, and —S(O)2—;
W is selected from the group consisting of a bond, —C(O)—, and —S(O)2—; and
a and b are independently integers from 1 to 6 with the proviso that a+b is ≦7;
In some embodiments the IRM can be chosen from amide substituted 1H-imidazo[4,5-c]quinolin-4-amines, tetrahydro-1H-imidazo[4,5-c]quinolin-4-amines, 1H-imidazo[4,5-c]pyridin-4-amines, 1H-imidazo[4,5-c]naphthyridin-4-amines, or tetrahydro-1H-imidazo[4,5-c]naphthyridin-4-amines of the following Formula XXXIII.




wherein:

R133 is selected from the group consisting of:

    
    
        —X′—C(O)—N(R133′)(R133′′) and
    
    






X′ is selected from the group consisting of —CH(R933)—, —CH(R933)-alkylene-, and —CH(R933)-alkenylene-;
X′′ is selected from the group consisting of —CH(R933)—, —CH(R933)-alkylene-, and —CH(R933)-alkenylene-; wherein the alkylene and alkenylene are optionally interrupted with one or more —O— groups;
R133′ and R133′′ are independently selected from the group consisting of:

    
    
        hydrogen,
        alkyl,
        alkenyl,
        aryl,
        arylalkylenyl,
        heteroaryl,
        heteroarylalkylenyl,
        heterocyclyl,
        heterocyclylalkylenyl, and
        alkyl, alkenyl, aryl, arylalkylenyl, heteroaryl, heteroarylalkylenyl, heterocyclyl, or heterocyclylalkylenyl, substituted by one or more substituents selected from the group consisting of:
        
            hydroxy,
            alkyl,
            haloalkyl,
            hydroxyalkyl,
            alkoxy,
            haloalkoxy,
            halogen,
            cyano,
            nitro,
            amino,
            alkylamino,
            dialkylamino,
            arylsulfonyl, and
            alkylsulfonyl;
        
        
    
    


A′ is selected from the group consisting of —O—, —C(O)—, —CH2—, —S(O)0-2—, and —N(Q-R433)—;
a and b are independently integers from 1 to 6 with the proviso that a+b is ≦7;
RA and RB are independently selected from the group consisting of:

    
    
        hydrogen,
        halogen,
        alkyl,
        alkenyl,
        alkoxy,
        alkylthio, and
        —N(R933)2;
    
    


or RA and RB taken together form either a fused aryl ring that is unsubstituted or substituted by one or more Ra groups, or a fused 5 to 7 membered saturated ring that is unsubstituted or substituted by one or more Rc groups;
or RA and RB taken together form a fused heteroaryl or 5 to 7 membered saturated ring containing one heteroatom selected from the group consisting of N and S, wherein the heteroaryl ring is unsubstituted or substituted by one or more Rb groups, and the 5 to 7 membered saturated ring is unsubstituted or substituted by one or more Rc groups;
each Ra is independently selected from the group consisting of halogen, alkyl, haloalkyl, alkoxy, and —N(R933)2;
each Rb is independently selected from the group consisting of halogen, hydroxy, alkyl, haloalkyl, alkoxy, and —N(R933)2;
each Rc is independently selected from the group consisting of halogen, hydroxy, alkyl, alkenyl, haloalkyl, alkoxy, alkylthio, and —N(R933)2;
R233 is selected from the group consisting of:

    
    
        —R433,
        —X—R433,
        —X—Y—R433, and
        —X—R533;
    
    


X is selected from the group consisting of alkylene, alkenylene, alkynylene, arylene, heteroarylene, and heterocyclylene wherein the alkylene, alkenylene, and alkynylene groups are optionally interrupted or terminated by arylene, heteroarylene or heterocyclylene and optionally interrupted by one or more —O— groups;
Y is selected from the group consisting of:

    
    
        —S(O)0-2—,
        —S(O)2—N(R833)—,
        —C(R633)—,
        —C(R633)—O—,
        —O—C(R633)—,
        —O—C(O)—O—,
        —N(R833)-Q-,
        —C(R633)—N(R833)—,
        —O—C(R633)—N(R833)—,
        —C(R633)—N(OR933)—,
    
    






each R433 is independently selected from the group consisting of hydrogen, alkyl, alkenyl, alkynyl, aryl, arylalkylenyl, aryloxyalkylenyl, alkylarylenyl, heteroaryl, heteroarylalkylenyl, heteroaryloxyalkylenyl, alkylheteroarylenyl, and heterocyclyl wherein the alkyl, alkenyl, alkynyl, aryl, arylalkylenyl, aryloxyalkylenyl, alkylarylenyl, heteroaryl, heteroarylalkylenyl, heteroaryloxyalkylenyl, alkylheteroarylenyl, and heterocyclyl groups are unsubstituted or substituted by one or more substituents independently selected from the group consisting of alkyl, alkoxy, hydroxyalkyl, haloalkyl, haloalkoxy, halogen, nitro, hydroxy, mercapto, cyano, aryl, aryloxy, arylalkyleneoxy, heteroaryl, heteroaryloxy, heteroarylalkyleneoxy, heterocyclyl, amino, alkylamino, dialkylamino, (dialkylamino)alkyleneoxy, and in the case of alkyl, alkenyl, alkynyl, and heterocyclyl, oxo;
R533 is selected from the group consisting of:




each R633 is independently selected from the group consisting of ═O and ═S;
each R733 is independently C2-7 alkylene;
each R833 is independently selected from the group consisting of hydrogen, alkyl, alkoxyalkylenyl, and arylalkylenyl;
each R933 is independently selected from the group consisting of hydrogen and alkyl;
each R1033 is independently C3-8 alkylene;
A is selected from the group consisting of —O—, —C(O)—, —S(O)0-2—, —CH2—, and —N(R433)—;
each Q is independently selected from the group consisting of a bond, —C(R633)—, —C(R633)—C(R633)—, —S(O)2—, —C(R633)—N(R833)—W—, —S(O)2—N(R833)—, —C(R633)—O—, and —C(R633)—N(OR933)—;
V is selected from the group consisting of —C(R633)—, —O—C(R633)—, —N(R833)—C(R633)—, and —S(O)2—; and
each W is independently selected from the group consisting of a bond, —C(O)—, and —S(O)2—;
with the proviso that when RA and RB form a fused heteroaryl or 5 to 7 membered saturated ring containing one heteroatom selected from the group consisting of N and S, wherein the heteroaryl ring is unsubstituted or substituted by one or more Rb groups, and the 5 to 7 membered saturated ring is unsubstituted or substituted by one or more Rc groups, then R133 can also be
—X′′—C(O)—N(R133′)(R133′′);
or a pharmaceutically acceptable salt thereof.
In another embodiment, the IRM compound can be chosen from aryloxy or arylalkyleneoxy substituted 1H-imidaz[4,5-c]quinoline-4-amines of the following Formula XXXIV:




wherein:

R334 is selected from the group consisting of:

    
    
        —Z—Ar,
        —Z—Ar′-Y—R434,
        —Z—Ar′-X—Y—R434,
        —Z—Ar′-R534, and
        —Z—Ar′-X—R534;
    
    


Z is selected from the group consisting of a bond, alkylene, alkenylene, and alkynylene wherein alkylene, alkenylene, and alkynylene are optionally interrupted with —O—;
Ar is selected from the group consisting of aryl and heteroaryl both of which can be unsubstituted or can be substituted by one or more substituents independently selected from the group consisting of alkyl, alkenyl, alkoxy, methylenedioxy, haloalkyl, haloalkoxy, halogen, nitro, hydroxy, hydroxyalkyl, mercapto, cyano, carboxy, formyl, aryl, aryloxy, arylalkyleneoxy, heteroaryl, heteroaryloxy, heteroarylalkyleneoxy, heterocyclyl, heterocyclylalkylenyl, amino, alkylamino, and dialkylamino;
Ar′ is selected from the group consisting of arylene and heteroarylene both of which can be unsubstituted or can be substituted by one or more substituents independently selected from the group consisting of alkyl, alkenyl, alkoxy, haloalkyl, haloalkoxy, halogen, nitro, hydroxy, hydroxyalkyl, mercapto, cyano, carboxy, formyl, aryl, aryloxy, arylalkyleneoxy, heteroaryl, heteroaryloxy, heteroarylalkyleneoxy, heterocyclyl, heterocyclylalkylenyl, amino, alkylamino, and dialkylamino;
R34 is selected from the group consisting of alkyl, alkoxy, hydroxy, halogen, and trifluoromethyl;
n is 0 or 1;
R134 is selected from the group consisting of:

    
    
        —R434,
        —X—R434,
        —X—Y—R434,
        —X—Y—X—Y—R434, and
        —X—R534;
    
    


R234 is selected from the group consisting of:

    
    
        —R434,
        —X—R434,
        —X—Y—R434, and
        —X—R534;
    
    


each X is independently selected from the group consisting of alkylene, alkenylene, alkynylene, arylene, heteroarylene, and heterocyclylene wherein the alkylene, alkenylene, and alkynylene groups can be optionally interrupted by arylene, heteroarylene or heterocyclylene or by one or more —O— groups;
each Y is independently selected from the group consisting of:

    
    
        —S(O)0-2—,
        —S(O)2—N(R834)—,
        —C(R634)—,
        —C(R634)—O—,
        —O—C(R634)—,
        —O—C(O)—O—,
        —N(R834)-Q-,
        —C(R634)—N(R834)—,
        —O—C(R634)—N(R834)—,
        —C(R634)—N(OR934)—,
    
    






each R434 is independently selected from the group consisting of hydrogen, alkyl, alkenyl, alkynyl, aryl, arylalkylenyl, aryloxyalkylenyl, alkylarylenyl, heteroaryl, heteroarylalkylenyl, heteroaryloxyalkylenyl, alkylheteroarylenyl, and heterocyclyl wherein the alkyl, alkenyl, alkynyl, aryl, arylalkylenyl, aryloxyalkylenyl, alkylarylenyl, heteroaryl, heteroarylalkylenyl, heteroaryloxyalkylenyl, alkylheteroarylenyl, and heterocyclyl groups can be unsubstituted or substituted by one or more substituents independently selected from the group consisting of alkyl, alkoxy, hydroxyalkyl, haloalkyl, haloalkoxy, halogen, nitro, hydroxy, mercapto, cyano, aryl, aryloxy, arylalkyleneoxy, heteroaryl, heteroaryloxy, heteroarylalkyleneoxy, heterocyclyl, amino, alkylamino, dialkylamino, (dialkylamino)alkyleneoxy, and in the case of alkyl, alkenyl, alkynyl, and heterocyclyl, oxo;
each R534 is independently selected from the group consisting of:




each R634 is independently selected from the group consisting of ═O and ═S;
each R734 is independently C2-7 alkylene;
each R834 is independently selected from the group consisting of hydrogen, alkyl, alkoxyalkylenyl, and arylalkylenyl;
each R934 is independently selected from the group consisting of hydrogen and alkyl;
each R1034 is independently C3-8 alkylene;
each A is independently selected from the group consisting of —O—, —C(O)—, —S(O)0-2—, —CH2—, and —N(R434)—;
each Q is independently selected from the group consisting of a bond, —C(R634)—, —C(R634)—C(R634)—, —S(O)2—, —C(R634)—N(R834)—W—, —S(O)2—N(R834)—, —C(R634)—O—, and —C(R634)—N(OR934)—;
each V is independently selected from the group consisting of —C(R634)—, —O—C(R634)—, —N(R834)—C(R634)—, and —S(O)2—;
each W is independently selected from the group consisting of a bond, —C(O)—, and —S(O)2—; and
a and b are independently integers from 1 to 6 with the proviso that a+b is ≦7;
or a pharmaceutically acceptable salt thereof.
Herein, “non-interfering” means that the ability of the compound or salt to modulate (e.g., induce or inhibit) the biosynthesis of one or more cytokines is not destroyed by the non-interfering substituent.
As used herein, the terms “alkyl”, “alkenyl”, “alkynyl” and the prefix “alk-” are inclusive of both straight chain and branched chain groups and of cyclic groups, i.e. cycloalkyl and cycloalkenyl. Unless otherwise specified, these groups contain from 1 to 20 carbon atoms, with alkenyl and alkynyl groups containing from 2 to 20 carbon atoms. In some embodiments, these groups have a total of up to 10 carbon atoms, up to 8 carbon atoms, up to 6 carbon atoms, or up to 4 carbon atoms. Cyclic groups can be monocyclic or polycyclic and preferably have from 3 to 10 ring carbon atoms. Exemplary cyclic groups include cyclopropyl, cyclopropylmethyl, cyclopentyl, cyclohexyl, adamantyl, and substituted and unsubstituted bornyl, norbornyl, and norbornenyl.
Unless otherwise specified, “alkylene”, “alkenylene”, and “alkynylene” are the divalent forms of the “alkyl”, “alkenyl”, and “alkynyl” groups defined above. Likewise, “alkylenyl”, “alkenylenyl”, and “alkynylenyl” are the divalent forms of the “alkyl”, “alkenyl”, and “alkynyl” groups defined above. For example, an arylalkylenyl group comprises an alkylene moiety to which an aryl group is attached.
The term “haloalkyl” is inclusive of groups that are substituted by one or more halogen atoms, including perfluorinated groups. This is also true of other groups that include the prefix “halo-”. Examples of suitable haloalkyl groups are chloromethyl, trifluoromethyl, and the like. Similarly, the term “fluoroalkyl” is inclusive of groups that are substituted by one or more fluorine atoms, including perfluorinated groups (e.g., trifluoromethyl).
The term “aryl” as used herein includes carbocyclic aromatic rings or ring systems. Examples of aryl groups include phenyl, naphthyl, biphenyl, fluorenyl and indenyl.
The term “heteroatom” refers to the atoms O, S, or N.
The term “heteroaryl” includes aromatic rings or ring systems that contain at least one ring heteroatom (e.g., O, S, N). Suitable heteroaryl groups include furyl, thienyl, pyridyl, quinolinyl, isoquinolinyl, indolyl, isoindolyl, triazolyl, pyrrolyl, tetrazolyl, imidazolyl, pyrazolyl, oxazolyl, thiazolyl, benzofuranyl, benzothiophenyl, carbazolyl, benzoxazolyl, pyrimidinyl, benzimidazolyl, quinoxalinyl, benzothiazolyl, naphthyridinyl, isoxazolyl, isothiazolyl, purinyl, quinazolinyl, pyrazinyl, 1-oxidopyridyl, pyridazinyl, triazinyl, tetrazinyl, oxadiazolyl, thiadiazolyl, and so on.
The term “heterocyclyl” includes non-aromatic rings or ring systems that contain at least one ring heteroatom (e.g., O, S, N) and includes all of the fully saturated and partially unsaturated derivatives of the above mentioned heteroaryl groups. Exemplary heterocyclic groups include pyrrolidinyl, tetrahydrofuranyl, morpholinyl, thiomorpholinyl, piperidinyl, piperazinyl, thiazolidinyl, imidazolidinyl, isothiazolidinyl, tetrahydropyranyl, quinuclidinyl, homopiperidinyl, homopiperazinyl, and the like.
The terms “arylene,” “heteroarylene,” and “heterocyclylene” are the divalent forms of the “aryl,” “heteroaryl,” and “heterocyclyl” groups defined above. Likewise, “arylenyl,” “heteroarylenyl,” and “heterocyclylenyl” are the divalent forms of the “aryl,” “heteroaryl,” and “heterocyclyl” groups defined above. For example, an alkylarylenyl group comprises an arylene moiety to which an alkyl group is attached.
Unless otherwise specified, the aryl, heteroaryl, and heterocyclyl groups of Formulas IX-XXXIV can be unsubstituted or substituted by one or more substituents independently selected from the group consisting of alkyl, alkoxy, methylenedioxy, ethylenedioxy, alkylthio, haloalkyl, haloalkoxy, haloalkylthio, halogen, nitro, hydroxy, mercapto, cyano, carboxy, formyl, aryl, aryloxy, arylthio, arylalkoxy, arylalkylthio, heteroaryl, heteroaryloxy, heteroarylthio, heteroarylalkoxy, heteroarylalkylthio, amino, alkylamino, dialkylamino, heterocyclyl, heterocycloalkyl, alkylcarbonyl, alkenylcarbonyl, alkoxycarbonyl, haloalkylcarbonyl, haloalkoxycarbonyl, alkylthiocarbonyl, arylcarbonyl, heteroarylcarbonyl, heterocyclylcarbonyl, aryloxycarbonyl, heteroaryloxycarbonyl, arylthiocarbonyl, heteroarylthiocarbonyl, alkanoyloxy, alkanoylthio, alkanoylamino, aroyloxy, aroylthio, aroylamino, alkylaminosulfonyl, alkylsulfonyl, arylsulfonyl, heteroarylsulfonyl, aryldiazinyl, alkylsulfonylamino, arylsulfonylamino, arylalkylsulfonylamino, alkylcarbonylamino, alkenylcarbonylamino, arylcarbonylamino, arylalkylcarbonylamino, heteroarylcarbonylamino, heteroarylalkycarbonylamino, alkylsulfonylamino, alkenylsulfonylamino, arylsulfonylamino, arylalkylsulfonylamino, heteroarylsulfonylamino, heteroarylalkylsulfonylamino, alkylaminocarbonyl, dialkylaminocarbonyl, arylaminocarbonyl, arylalkylaminocarbonyl, alkenylaminocarbonyl, heteroarylaminocarbonyl, heteroarylalkylaminocarbonyl, alkylaminocarbonylamino, alkenylaminocarbonylamino, arylaminocarbonylamino, arylalkylaminocarbonylamino, heteroarylaminocarbonylamino, heteroarylalkylaminocarbonylamino and, in the case of heterocyclyl, oxo. If any other groups are identified as being “substituted” or “optionally substituted”, then those groups can also be substituted by one or more of the above enumerated substituents.
When a group (or substituent or variable) is present more that once in any Formula described herein, each group (or substituent or variable) is independently selected, whether explicitly stated or not. For example, for the formula —N(R631)2 each R631 group is independently selected. In another example, when an R232 and an R332 group both contain an R432 group, each R432 group is independently selected. In a further example, when more than one Y group is present (i.e. R232 and R332 both contain a Y group) and each Y group contains one or more R832 groups, then each Y group is independently selected, and each R832 group is independently selected.
In certain embodiments, the immune response modifier is selected from the group consisting of imidazoquinoline amines, tetrahydroimidazoquinoline amines, imidazopyridine amines, 6,7-fused cycloalkylimidazopyridine amines, 1,2-bridged imidazoquinoline amines, imidazonaphthyridine amines, imidazotetrahydronaphthyridine amines, oxazoloquinoline amines, thiazoloquinoline amines, oxazolopyridine amines, thiazolopyridine amines, oxazolonaphthyridine amines, thiazolonaphthyridine amines, pyrazolopyridine amines, pyrazoloquinoline amines, tetrahydropyrazoloquinoline amines, pyrazolonaphthyridine amines, tetrahydropyrazolonaphthyridine amines, 1H-imidazo dimers fused to pyridine amines, quinoline amines, tetrahydroquinoline amines, naphthyridine amines, or tetrahydronaphthyridine amines, and combinations thereof.
In certain embodiments, the immune response modifier is selected from the group consisting of imidazoquinoline amines, tetrahydroimidazoquinoline amines, imidazopyridine amines, and combinations thereof.
In certain embodiments, the immune response modifier is selected from the group consisting of amide substituted imidazoquinoline amines, sulfonamide substituted imidazoquinoline amines, urea substituted imidazoquinoline amines, aryl ether substituted imidazoquinoline amines, heterocyclic ether substituted imidazoquinoline amines, amido ether substituted imidazoquinoline amines, sulfonamido ether substituted imidazoquinoline amines, urea substituted imidazoquinoline ethers, thioether substituted imidazoquinoline amines, 6-, 7-, 8-, or 9-aryl, heteroaryl, aryloxy or arylalkyleneoxy substituted imidazoquinoline amines, amide substituted tetrahydroimidazoquinoline amines, sulfonamide substituted tetrahydroimidazoquinoline amines, urea substituted tetrahydroimidazoquinoline amines, aryl ether substituted tetrahydroimidazoquinoline amines, heterocyclic ether substituted tetrahydroimidazoquinoline amines, amido ether substituted tetrahydroimidazoquinoline amines, sulfonamido ether substituted tetrahydroimidazoquinoline amines, urea substituted tetrahydroimidazoquinoline ethers, thioether substituted tetrahydroimidazoquinoline amines, amide substituted imidazopyridine amines, sulfonamide substituted imidazopyridine amines, urea substituted imidazopyridine amines, aryl ether substituted imidazopyridine amines, heterocyclic ether substituted imidazopyridine amines, amido ether substituted imidazopyridine amines, sulfonamido ether substituted imidazopyridine amines, urea substituted imidazopyridine ethers, thioether substituted imidazopyridine amines, and combinations thereof.
In certain embodiments, the immune response modifier is selected from the group consisting of amide substituted imidazoquinoline amines, urea substituted imidazoquinoline amines, and combinations thereof.
Cosolvents
Aqueous gel formulations of the invention include a water-miscible cosolvent. The water-miscible cosolvent assists in dissolving the immune response modifier in salt form. The cosolvent can be a single component or a combination. Examples of suitable cosolvents include monopropylene glycol, dipropylene glycol, hexylene glycol, butylene glycol, glycerin, polyethylene glycol (of various molecular weights, e.g., 300 or 400), diethylene glycol monoethyl ether, and combinations thereof. Monopropylene glycol (i.e., propylene glycol) is particularly preferred as a cosolvent.
In certain embodiments, the cosolvent (or combination of cosolvents) is present in an amount of at least 10 wt-%, in other embodiments in an amount of greater than 25 wt-%, and in other embodiments at least 30 wt-%, based on the total weight of the aqueous gel. In certain embodiments, the cosolvent (or combination of cosolvents) is present in an amount of no greater than 90 wt-%, in other embodiments no greater than 80 wt-%, in other embodiments no greater than 70 wt-%, in other embodiments no greater than 60 wt-%, based on the total weight of the aqueous gel.
In certain embodiments, water is present in an amount of at least 10 wt-%, in other embodiments at least 15 wt-%, in other embodiments at least 20 wt-%, and in other embodiments at least 25 wt-%, based on the total weight of the aqueous gel. In certain embodiments, water is present in an amount of no greater than 95 wt-%, in other embodiments no greater than 90 wt-%, and in other embodiments no greater than 85 wt-%, based on the total weight of the aqueous gel.
Thickeners
Aqueous gel formulations of the invention include a negatively charged thickener, preferably at least two negatively charged thickeners (typically of differing charge density). Preferably the thickeners are mucoadhesives. Examples of suitable negatively charged thickeners include: cellulose ethers such as carboxymethylcellulose sodium; polysaccharide gums such as xanthan gum; and acrylic acid polymers (i.e., homopolymers and copolymers) made from acrylic acid crosslinked with, for example, allyl sucrose or allyl pentaerythritol such as those polymers designated as carbomers in the United States Pharmacopoeia, and acrylic acid polymers made from acrylic acid crosslinked with divinyl glycol such as those polymers designated as polycarbophils in the United States Pharmacopoeia. Combinations of such thickeners can be used if desired.
In some embodiments of the invention, the negatively charged thickeners include carboxylic acid and/or carboxylate groups. Examples of such agents include carboxymethylcellulose sodium, xanthan gum, and the acrylic acid polymers. Preferably, certain embodiments of the present invention include a combination of an acrylic acid polymer (i.e., polyacrylic acid polymer) and a polysaccharide gum (e.g., xanthan gum).
Carbomers are exemplary (and preferred) acrylic acid polymers. Suitable carbomers include, for example, those commercially available under the trade designation CARBOPOL (all available from Noveon, Inc., Cleveland, Ohio, USA). CARBOPOL polymers can provide a range of viscosities. For example, a 0.5% solution of CARBOPOL 971P or CARBOPOL 941 has a viscosity of 4,000-11,000 cPs (pH 7.5, 25° C., Brookfield viscometer at 20 rpm); a 0.5% solution of CARBOPOL 934P or CARBOPOL 974P has a viscosity of 29,400-39,400 cPs (pH 7.5, 25° C., Brookfield viscometer at 20 rpm); and a 0.5% solution of CARBOPOL 940 or CARBOPOL 980 has a viscosity of 40,000-60,000 cPs (pH 7.5, 25° C., Brookfield viscometer at 20 rpm). For certain embodiments, carbomers such as CARBOPOL 934P, CARBOPOL 974P, CARBOPOL 940, and CARBOPOL 980 are preferred. A particularly preferred carbomer is CARBOPOL 974P.
For certain embodiments, it is desirable to have a relatively highly crosslinked carbomer. Preferred relatively highly crosslinked carbomers include CARBOPOL 974P, CARBOPOL 940, and CARBOPOL 980. A particularly preferred relatively highly crosslinked carbomer is CARBOPOL 974P.
Suitable polycarbophils include, for example, those commercially available under the trade designation NOVEON polycarbophils (all available from Noveon, Inc., Cleveland, Ohio, USA). A preferred polycarbophil is NOVEON AA-1 USP Polycarbophil.
Various grades of carboxymethylcellulose sodium are commercially available that have differing aqueous viscosities. Aqueous 1% weight by volume (w/v) solutions with viscosities of 5-13,000 cps may be obtained. Examples include carboxymethylcellulose sodium, high viscosity, USP (CA194); carboxymethylcellulose sodium, medium viscosity, USP (CA192); and carboxymethylcellulose sodium, low viscosity, USP (CA193); all of which are available from Spectrum Chemicals and Laboratory Products, Inc., Gardena, Calif., USA; and AKUCELL AF 3085 (high viscosity), AKUCELL AF 2785 (medium viscosity), and AKUCELL AF 0305 (low viscosity), all of which are available from Akzo Nobel Functional Chemicals, Amersfoort, The Netherlands.
In certain embodiments, the thickener system includes a non-ionic thickener. Examples of suitable non-ionic thickeners include hydroxyethyl cellulose, hydroxymethyl cellulose, and hydroxypropyl cellulose. If included, the weight ratio of non-ionic thickener to negatively charged thickener (total weight of all negatively charged thickeners if more than one negatively charged thickener is included) is within the range of 1:4 to 1:10. In certain embodiments, the weight ratio is within the range of 1:4 to 1:7.
Hydroxypropyl cellulose is commercially available in a number of different grades that have various solution viscosities. Examples include KLUCEL HF and KLUCEL MF, both of which are available from the Aqualon Division of Hercules Incorporated, Wilmington, Del., USA.
In certain embodiments, the thickener system includes a polysaccharide gum and an acrylic acid polymer. Preferably, the weight ratio of polysaccharide gum to acrylic acid polymer is within a range of 1:20 to 20:1. In certain embodiments, the weight ratio is within a range of 1:10 to 10:1, in other embodiments the weight ratio is within a range of 1:5 to 5:1, in other embodiments the weight ratio is within a range of 1:3 to 3:1, and in other embodiments the weight ratio is within a range of 1:2 to 2:1. A particularly preferred ratio is 1:2.
The thickener system is present in formulations of the invention in an amount sufficient to bring the viscosity to a level of at least than 1000 Centipoise (cps), preferably at least 5,000 cps, more preferably at least 8000 cps, and most preferably at least 10,000 cps. The viscosity is determined at 20±0.5° C. using a Haake RS series rheometer equipped with a 35 mm 2° cone using a controlled rate step test between 1 and 80 s−1 with an interpolation at 16 s−1 for viscosity versus shear rate.
In certain embodiments, the amount or concentration of the thickener system is at least 0.1 wt-%, in other embodiments at least 0.5 wt-%, in other embodiments at least 1.0 wt-%, and in other embodiments at least 1.5 wt-%, based on the total weight of the aqueous gel. In certain embodiments, the amount of the thickener system is no greater than 7 wt-%, in other embodiments no greater than 6 wt-%, in other embodiments no greater than 5 wt-%, and in other embodiments no greater than 4 wt-%, based on the total weight of the aqueous gel.
pH Adjusting Agents and Buffers
Aqueous gel formulations of the invention can additionally include a pharmaceutically acceptable pH adjusting agent to adjust the pH of the formulation to the desired range. Generally, the pH is at least 2, and preferably at least 3. Generally, the pH is no greater than 6, preferably no greater than 5, and more preferably no greater than 4. The pH adjusting agent may be any pharmaceutically acceptable acid or base. Examples of suitable pH adjusting agents include hydrochloric acid, sodium hydroxide, tromethamine, and potassium hydroxide. Combinations of such agents can be used if desired.
Aqueous gel formulations of the invention can additionally include a pharmaceutically acceptable buffer to maintain the pH of the formulations in the desired range (preferably, 2 to 6, and more preferably, 3 to 4). The buffer may be any pharmaceutically acceptable buffer that provides one or more of the desired pH ranges. Examples of suitable buffers include buffers containing lactic acid, tartaric acid, citric acid, and succinic acid. Combinations of buffers can be used if desired. The buffers can also function as tonicity adjusting agents.
Preservatives
Aqueous gel formulations of the invention can additionally include a preservative. The preservative includes one or more compounds that inhibit microbial growth (e.g., fungal and bacterial growth) within the composition. Suitable preservatives are water soluble and include quaternary ammonium compounds (e.g., benzalkonium chloride), benzethonium chloride, parabens (e.g., methylparaben, propylparaben), boric acid, isothiazolinone, organic acids (e.g., sorbic acid), alcohols (e.g., phenyl ethyl alcohol, cresol, chlorobutanol, benzyl alcohol), carbamates, chlorhexidine, and combinations thereof. Preferably, the preservative is methylparaben, propylparaben, or combinations thereof. Certain water-miscible cosolvents, such as glycerin or propylene glycol, also have antimicrobial properties.
In certain embodiments, the preservative (or combination of preservatives) is present in an amount of at least 0.005 wt-%, in other embodiments at least 0.01 wt-%, in other embodiments at least 0.015 wt-%, and in other embodiments at least 0.02 wt-%, based on the total weight of the aqueous gel. In certain embodiments, the preservative (or combination of preservatives) is present in an amount of no greater than 1.0 wt-%, in other embodiments at most 0.75 wt-%, in other embodiments at most 0.5 wt-%, and in other embodiments no greater than 0.4 wt-%, based on the total weight of the aqueous gel.
Chelating Agents
Aqueous gel formulations of the invention can additionally include a chelating agent. Chelating agents are compounds that complex metal ions. Examples of suitable chelating agents include ethylenediaminetetracetic acid (EDTA) and derivatives thereof such as the disodium salt, ethylenediaminetetracetic acid disodium salt dehydrate, and combinations thereof. Preferably, the chelating agent is ethylenediaminetetracetic acid disodium salt dihydrate (edetate disodium).
In certain embodiments, the chelating agent (or combination of chelating agents) is present in an amount of at least 0.001 wt-%, in other embodiments at least 0.01 wt-%, and in other embodiments at least 0.02 wt-%, based on the total weight of the aqueous gel. In certain embodiments, the chelating agent (or combination of chelating agents) is present in an amount of no greater than 2.0 wt-%, in other embodiments no greater than 1.5 wt-%, and in other embodiments no greater than 1.0 wt-%, based on the total weight of the aqueous gel.
Applications
Aqueous gel formulations of the present invention can be used to treat or prevent conditions associated with mucosal tissue. In some embodiments, the invention provides methods that are particularly advantageous for the topical application to the cervix for treatment of cervical conditions such as cervical dysplasias including dysplasia associated with human papillomavirus (HPV), low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions, atypical squamous cells of undetermined significance (typically, with the presence of high-risk HPV), and cervical intraepithelial neoplasia (CIN).
The present invention also provides methods of treating a mucosal associated condition. Alternatively stated, the present invention provides methods of treating a condition associated with mucosal tissue.
In the methods of the present invention, the aqueous gels of the present invention may be applied once a week or several times a week. For example, the aqueous gel may be applied twice a week, three times a week, five times a week, or even daily.
In the methods of the present invention, the applications of the aqueous gels of the present invention may extend for a total time period of at least one week, at least two weeks, at least three weeks, at least one month, at least two months, at least three months, or more, depending on the desired treatment regimen.
The actual dosing (treatment) regimen used for a given condition or subject may depend at least in part on many factors known in the art, including, but not limited to, the physical and chemical nature of the IRM compound, the nature of the delivery material, the amount of the IRM compound being administered, the state of the subject's immune system (e.g., suppressed, compromised, stimulated), the method of administering the IRM compound, and the species to which the IRM compound is being administered.
The methods of the present invention may be applicable for any suitable subject. Suitable subjects include, but are not limited to, animals such as, but not limited to, humans, non-human primates, rodents, dogs, cats, horses, pigs, sheep, goats, cows, or birds.
The methods of the present invention are suitable for a variety of medical objectives, including therapeutic, prophylactic (e.g., as a vaccine adjuvant), or diagnostic. As used herein, “treating” a condition or a subject includes therapeutic, prophylactic, and diagnostic treatments.
The term “an effective amount” (e.g., therapeutically or prophylactically) means an amount of the compound sufficient to induce a desired (e.g., therapeutic or prophylactic) effect, such as cytokine induction, inhibition of TH2 immune response, antiviral or antitumor activity, reduction or elimination of neoplastic cells. The amount of the IRM compound that will be therapeutically effective in a specific situation will depend on such things as the activity of the particular compound, the dosing regimen, the application site, the particular formulation and the condition being treated. As such, it is generally not practical to identify specific administration amounts herein; however, those skilled in the art will be able to determine appropriate therapeutically effective amounts based on the guidance provided herein and information available in the art pertaining to these compounds.
The aqueous gels of the present invention may be used for the application of an IRM compound to the affected area of a subject for treating a dermal and/or mucosal condition. Examples of such conditions include herpes, keloids, warts, molluscum, or combinations thereof. It will be understood by one of skill in the art that such conditions (e.g., warts) can be on both mucosal and dermal tissue.
The aqueous gels of the present invention may be used for the application of an IRM compound to mucosal tissue for the treatment of a mucosal associated condition.
As used herein, a “mucosal associated condition” means an inflammatory, infectious, neoplastic, or other condition that involves mucosal tissue or that is in sufficient proximity to a mucosal tissue to be affected by a therapeutic agent topically applied to the mucosal tissue. Examples of such conditions include a papilloma virus infection of the cervix, cervical dysplasias including dysplasia associated with human papillomavirus (HPV), low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions, atypical squamous cells of undetermined significance (typically, with the presence of high risk HPV), and cervical intraepithelial neoplasia, an atopic allergic response, allergic rhinitis, a neoplastic lesion, and a premalignant lesion.
As used herein, “mucosal tissue” includes mucosal membranes such as buccal, gingival, nasal, ocular, tracheal, bronchial, gastrointestinal, rectal, urethral, ureteral, vaginal, cervical, and uterine mucosal membranes. For example, one could treat oral lesions, vaginal lesions, or anal lesions by the methods described. One could also use the methods in combination with mucosal application of vaccines.
In one embodiment, the IRM compound can be applied to vaginal or supravaginal mucosal tissue for the treatment of a cervical dysplasia. In other embodiments, an IRM can be applied to the mucosal tissue of the rectum for the treatment of, e.g., anal canal condyloma.
Cervical dysplasias to be treated by the methods of the present invention preferably include dysplastic conditions such as low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions, atypical squamous cells of undetermined significance (typically, with the presence of high-risk HPV), and cervical intraepithelial neoplasia (CIN).
Approximately 16,000 new cases of invasive cancer of the cervix are diagnosed each year in the U.S. despite extensive screening of women to detect predictive cellular changes. There are also about 3,000 deaths due to cervical cancer in the U.S. alone and this is usually secondary to not detecting the primary cancerous lesion in a timely manner.
The Papanicoulaou Test (Pap smear) is the screening test that has been accepted since the 1950s as the method to detect abnormal cells of the cervix, including inflammation and dysplasia, which includes cervical cancer. This screening test has been widely adopted in industrialized countries and has had a profound impact on mortality associated with cervical cancers. An abnormal Pap smear prompts close observation for disease progression with the potential for the therapeutic interventions of destruction or excision of cancerous or pre-cancerous tissues. These excisional treatments are expensive, uncomfortable and associated with failure rates that range from 2% to 23% and with higher failure rates reported for the more advanced lesions. Failure rates have recently been documented to approximate 10% following laser treatment.
The etiologic agent for cervical cancer was originally thought to be the herpes virus. However, there was a gradual shift from this focus on herpes virus to the human papillomavirus (HPV). Improved experimental methods over the recent past have allowed the characterization of a full spectrum of HPV subtypes, which has resulted in the conclusion that the high risk HPV types (e.g., HPV 16, 18, and less frequently 31, 33, 35, 45) are very likely the exclusive initiating factor (i.e., oncogenic agent) for cervical dysplasia and subsequent cancers. The mechanism of HPV transformation of the normal cell to a dysplastic cell is associated with the HPV encoded oncoproteins (E6 and E7) from the high risk genotypes binding the cell's tumor suppressor gene products p53 and Rb resulting in disruption of the cell cycle control mechanism in which p53 and Rb play an important role. In addition, the application of these molecular methods has resulted in the epidemilogic observation that HPV is isolated from approximately 93% of cervical tumors, which has further strengthened the generally accepted conclusion that HPV infection is the most important initiating agent for cervical cancer.
Exposure to HPV is common in sexually active women, but it does not invariably lead to dysplasia or cancer in most of the exposed women. Infected women who harbor persistent viral DNA have about five times the chance of persistent dysplasia compared to women who are able to eradicate the virus. The importance of cell-mediated immune response to HPV infection is illustrated by the observation that the antibody mediated immune response is not effective in eliminating established infections as is demonstrated by the fact that patients with invasive cervical cancer often exhibit high antibody levels against the viral E6 and E7 proteins. This particular antibody response probably reflects extensive antigen exposure in the face of increasing tumor burden. In contrast to the apparently inconsequential effect of the humoral immune response; the cell-mediated immune response (Th-1-Type Response) appears to be effective in controlling tumor progression. Regression of intraepithelial lesions is accompanied by a cellular infiltrate consisting of CD4+ T-cells, CD8+ T-cells, natural killer cells (NK) and macrophages. This inflammatory infiltrate was usually associated with tumor regression that is in contrast to women who lack the ability to mount this inflammatory response and who experience disease progression. In addition, patients with a defect in cell-mediated immunity have increased cervical cancer rates, whereas those with defects in the production of antibody do not exhibit the same susceptibility.
Aqueous gels of the present invention may be applied to mucosal tissue with the use of a delivery device. Suitable devices include barrel type applicators, cervical caps, diaphragms, and solid matrices such as tampons, cotton sponges, cotton swabs, foam sponges, and suppositories. The IRM can be removed by withdrawing the device from contact with the mucosal tissue, if desired.
In some embodiments the device can be used in combination with the aqueous gel formulation. In one embodiment, a gel containing an IRM compound can be placed into the concave region of a cervical cap, which is then place directly over the cervix. In another embodiment, a cotton or foam sponge can be used in combination with an aqueous gel of the present invention.
In some embodiments, an applicator may be used to place the device and/or gel in the proper location on the mucosal tissue. Examples of such applicators include, for example, paperboard or plastic tube applicators commonly used for inserting tampons or suppositories. A preferred applicator is a barrel type applicator, which may be prefilled or supplied in a kit together with a container of gel and filled by the patient.
EXAMPLES
The following examples have been selected merely to further illustrate features, advantages, and other details of the invention. It is to be expressly understood, however, that while the examples serve this purpose, the particular materials and amounts used as well as other conditions and details are not to be construed in a matter that would unduly limit the scope of this invention.
The IRMs used to prepare the gels in the following examples are shown in Table 1.









TABLE 1





IRM
Chemical Name
Reference







IRM1
4-(4-amino-2-propyl-1H-imidazo[4,5-
International Publication



c]quinolin-1-yl)-N-propylbutyramide
No. WO2005/094531




Example 2


IRM2
N-[2-(4-amino-7-benzyloxy-2-
International Publication



ethoxymethyl-1H-imidazo[4,5-
No. WO2005/020999



c]quinolin-1-yl)-1,1-
Example 142



dimethylethyl]acetamide


IRM3
3-(4-amino-2-propyl-1H-imidazo[4,5-
International Publication



c]quinolin-1-yl)propionamide
No. WO2005/094531



hydrochloride
Example 18


IRM4
N-[2-(4-amino-2-ethoxymethyl-1H-
U.S. Pat. No.



imidazo[4,5-c]quinolin-1-yl)ethyl]-N′-
6,541,485#



isopropylurea


IRM5
N-[4-(4-amino-2-buytl-1H-imidazo[4,5-
U.S. Pat. No.



c]quinolin-1-
6,331,539



yl)butyl]methanesulfonamide
Example 6


IRM6
N-{4-[4-amino-2-(2-methoxyethyl)-1H-
U.S. Pat. No.



imidazo[4,5-c]quinolin-1-
6,331,539



yl]butyl}methanesulfonamide
Example 111


IRM7
1-(2-methylpropyl)-1H-imidazo[4,5-
U.S. Pat. No.



c]quinolin-4-amine (imiquimod)
4,689,338




Example 99


IRM8
2-propylthiazolo[4,5-c]quinolin-4-amine
U.S. Pat. No.



hydrochloride
6,110,929




Example 14





#IRM4 is not specifically exemplified but can be readily prepared using the synthetic methods disclosed in the cited reference.






Test Method
In the examples below the serum and intravaginal cytokine data were obtained using the following general test method.
Rats were acclimated to collars (Lomir Biomedical, Malone, N.Y.) around the neck on two consecutive days prior to actual dosing. Rats were collared to prevent ingestion of the drug. Animals were then dosed intravaginally with 50 μL of gel. Single dosed rats received one intravaginal dose with samples collected at various times following dosing. Multiple dosed rats were dosed as described in the examples below with samples collected at various times following the final dose. Blood was collected by cardiac puncture. Blood was allowed to clot briefly at room temperature and serum was separated from the clot via centrifugation. The serum was stored at −20° C. until it was analyzed for cytokine concentrations.
Following blood collection, the rats were euthanized and their vaginal tract, including the cervix, was then removed and the tissue was weighed, placed in a sealed 1.8 mL cryovial and flash frozen in liquid nitrogen. The frozen vaginal tissue sample was then suspended in 1.0 mL of RPMI medium (Celox, St. Paul, Minn.) containing 10% fetal bovine serum (Atlas, Fort Collins, Colo.), 2 mM L-glutamine, penicillin/streptomycin and 2-mercaptoethanol (RPMI complete) combined with a protease inhibitor cocktail set III (Calbiochem, San Diego, Calif.). The tissue was homogenized using a Tissue Tearor (Biospec Products, Bartlesville, Okla.) for approximately one minute. The tissue suspension was then centrifuged at 2000 rpm for 10 minutes under refrigeration to pellet the debris, and the supernatant collected and stored at −20° C. until analyzed for cytokine concentrations.
ELISA kits for rat tumor necrosis factor-alpha (TNF) were purchased from BD PharMingen (San Diego, Calif.) and the rat monocyte chemoattractant protein-1 (MCP-1) ELISA kits were purchased from BioSource Intl. (Camarillo, Calif.). Both kits were performed according to manufacturer's specifications. Results for both TNF and MCP-1 are expressed in pg/mL and are normalized per 200 mg of tissue. The sensitivity of the TNF ELISA, based on the lowest value used to form the standard curve, is 32 pg/mL and for the MCP-1 ELISA it is 12 pg/mL.
Examples 1 and 2
The gels shown in Table 2 below were prepared using the following method.
Step 1: The parabens were dissolved in the propylene glycol.
Step 2: The IRM was combined with the aqueous ethanesulfonic acid and a portion of the water.
Step 3: The solution from step 1 was combined with the mixture from step 2.
Step 4: Edetate disodium was dissolved in water. The carbomer was added to the solution and stirred until well hydrated.
Step 5: The dispersion from step 4 was combined with the mixture from step 3.
Step 6: 20% tromethamine was added to adjust the pH.
Step 7: Sufficient water was added to adjust the final weight and the gel was mixed well.










TABLE 2









Gels (% w/w)













Ex 1
Ex 2



Ingredient
IRM1
IRM2















IRM
0.1
0.1



0.25 N ethanesulfonic acid
0.594
0.452



Carbomer 974P
2.1
2.1



Propylene glycol
15
15



Methylparaben
0.15
0.15



Propylparaben
0.03
0.03



Edetate disodium
0.05
0.05



20% Tromethamine solution
1.5
1.5



Purified water
80.48
80.62



pH
3.95
4.07










Example 3
The gel shown in Table 3 below was prepared using the following method.
Step 1: The parabens were dissolved in the propylene glycol.
Step 2: IRM3 was combined with a portion of the water.
Step 3: The solution from step 1 was combined with the mixture from step 2 and heated to 55° C. and ultrasonicated.
Step 4: Edetate disodium was dissolved in water. The carbomer was added to the solution and stirred until well hydrated.
Step 5: The dispersion from step 4 was combined with the mixture from step 3.
Step 6: 20% tromethamine was added to adjust the pH.
Step 7: Sufficient water was added to adjust the final weight and the gel was mixed well.










TABLE 3







Ingredient
(% w/w)



















IRM 3
0.1



Carbomer 974P
2.1



Propylene glycol
15



Methylparaben
0.15



Propylparaben
0.03



Edetate disodium
0.05



20% Tromethamine solution
1.5



Purified water
80.65



pH
3.99










The ability of the gels of Examples 1-3 to induce cytokines was determined using the test method described above. The animals received an intravaginal dose once a day on day 0 and on day 3 for a total of 2 doses. The results are shown in Table 4 below where each value is the mean of 3 animals±SEM (standard error of the mean).









TABLE 4







Time




(hours)

Cytokine Concentrations










Post

TNF (pg/mL)
MCP-1 (pg/mL)












Dose
Gel
Serum
Tissue
Serum
Tissue





2
Example 1
 36 ± 18
356 ± 14
136 ± 23
226 ± 35 


2
Example 2
 84 ± 16
1736 ± 794
147 ± 33
588 ± 221


2
Example 3
97 ± 6
 568 ± 458
114 ± 33
282 ± 192


4
Example 1
 53 ± 10
 273 ± 172
 77 ± 28
501 ± 291


4
Example 2
79 ± 6
1064 ± 290
 15 ± 15
1839 ± 113 


4
Example 3
49 ± 9
188 ± 48
161 ± 13
637 ± 252


6
Example 1
44 ± 3
210 ± 19
161 ± 38
756 ± 205


6
Example 2
 73 ± 10
 743 ± 211
260 ± 14
1857 ± 276 


6
Example 3
 56 ± 13
105 ± 37
218 ± 63
444 ± 298


4
1Vehicle
101 ± 32
 94 ± 10
173 ± 20
176 ± 59 





1Vehicle (2.1% carbomer 974, 15% propylene glycol, 0.15% methylparaben, 0.03% propylparaben, 0.05% edetate sodium, 1.35% 20% tromethamine solution, and 81.32% water)






Examples 4-6
The gels in Table 5 below were prepared using the following general method.
Step 1: The parabens were dissolved in the propylene glycol.
Step 2: IRM4 was dissolved in the aqueous ethanesulfonic acid.
Step 3: The solution from step 1 was combined with the solution from step 2.
Step 4: Edetate disodium was dissolved in water. The carbomer and xanthan gum, if used, were added to the solution and stirred until well hydrated.
Step 5: The dispersion from step 4 was combined with the solution from step 3.
Step 6: 20% tromethamine was added to adjust the pH.
Step 7: Sufficient water was added to adjust the final weight and the gel was mixed well.









TABLE 5









Gels (% w/w)












Ingredient
Ex 4
Ex 5
Ex 6
















IRM4
0.01
0.1
1



0.5 N ethanesulfonic acid
0.054
0.54
5.4



Carbomer 974P
1.7
1.7
2



Xanthan gum
0.0
0.0
0.56



Propylene glycol
15
15
30



Methylparaben
0.15
0.15
0.15



Propylparaben
0.03
0.03
0.03



Edetate disodium
0.05
0.05
0.05



20% Tromethamine solution
0.7
0.5
1.9



Purified water
82.31
81.93
58.91



pH
3.9
3.9
4.3










The ability of the gels of Examples 4-6 to induce cytokines following a single dose was determined using the test method described above. The results are shown in Table 6 below where each value is the mean of 5 animals±SEM.









TABLE 6







Time




(hours)

Cytokine Concentrations










Post

TNF (pg/mL)
MCP-1 (pg/mL)












Dose
Gel
Serum
Tissue
Serum
Tissue





2
Example 4
16 ± 2
331 ± 24
96 ± 4
134 ± 57


2
Example 5
19 ± 6
433 ± 64
 91 ± 11
 298 ± 104


2
Example 6
 45 ± 21
 853 ± 150
90 ± 6
 501 ± 111


4
Example 4
11 ± 6
257 ± 9 
115 ± 10
112 ± 41


4
Example 5
30 ± 6
397 ± 32
123 ± 13
 462 ± 159


4
Example 6
 70 ± 32
700 ± 86
103 ± 9 
 866 ± 150


8
Example 4
13 ± 5
297 ± 11
142 ± 13
283 ± 84


8
Example 5
21 ± 5
275 ± 21
146 ± 16
337 ± 96


8
Example 6
14 ± 2
 557 ± 232
171 ± 23
 641 ± 144


4
1Vehicle
 37 ± 14
255 ± 15
108 ± 16
 9 ± 3





1Vehicle (2% carbomer 974, 30% propylene glycol, 0.15% methylparaben, 0.03% propylparaben, 0.05% edetate sodium, 0.3% of 20% tromethamine solution, and 67.47% water)






Examples 7 and 8
The gels shown in Table 7 were prepared using the following general method.
Step 1: IRM2 was combined with the aqueous ethanesulfonic acid and a portion of the water. The combination was mixed until the IRM was dissolved.
Step 2: The parabens were dissolved in the propylene glycol.
Step 3: Edetate sodium was dissolved in water. The carbomer was added and the mixture was stirred until the carbomer was hydrated.
Step 4: The solution from step 2 was added to the solution from step 1 and the combination was mixed until uniform.
Step 5: The dispersion from step 3 was added to the solution from step 4 and the combination was mixed until a uniform, smooth gel was obtained.
Step 6: Sufficient 20% tromethamine was added to adjust the pH to about 4.
Step 7: Sufficient water was added to adjust the final weight and the gel was mixed well until uniform.










TABLE 7









Gels (% w/w)












Ingredient
Ex 7
Ex 8















IRM2
0.01
0.1



Ethanesulfonic acid (0.5M + 5% extra)
0.0455
0.455



Carbomer 974P
2.1
2.1



Propylene glycol
15
15



Methylparaben
0.15
0.15



Propylparaben
0.03
0.03



Edetate disodium
0.05
0.05



20% Tromethamine solution
qs pH 4
qs pH 4



Purified water
qs 100
qs 100



pH
4.1
4.2










Example 9
The gel shown in Table 8 was prepared using the following general method.
Step 1: IRM2 was combined with the aqueous ethanesulfonic acid and a portion of the water. The combination was mixed until the IRM was dissolved.
Step 2: The parabens were dissolved in the propylene glycol.
Step 3: Edetate sodium was dissolved in water. The carbomer was added and the mixture was stirred until the carbomer was hydrated.
Step 4: The solution from step 2 was added to the solution from step 1 and the combination was mixed until uniform.
Step 5: The dispersion from step 3 was added to the solution from step 4. The combination was mixed well resulting in a milky, fluid dispersion.
Step 6: Sufficient 20% tromethamine was added to adjust the pH to about 4 and the dispersion thickened and foamed.
Step 7: Xanthan gum was mixed with water and then added to the dispersion from step 6. The mixture was heated at 50° C. with stirring for 4 hours. The gel was allowed to cool to ambient temperature overnight with stirring.










TABLE 8







Ingredient
(% w/w)



















IRM4
1



Ethanesulfonic acid (0.5M + 5% extra)
4.565



Carbomer 974P
2.1



Xanthan gum
0.2



Propylene glycol
15



Methylparaben
0.15



Propylparaben
0.03



Edetate disodium
0.05



20% Tromethamine solution
qs pH 4



Purified water
qs 100



pH
4.0










The ability of the gels of Examples 7-9 to induce cytokines following a single dose was determined using the test method described above. The gel of Example 9 was stirred prior to dosing to minimize air bubbles. The results are shown in Table 9 below where each value is the mean of 6 animals±SEM.









TABLE 9







Time




(hours)

Cytokine Concentrations










Post

TNF (pg/mL)
MCP-1 (pg/mL)












Dose
Gel
Serum
Tissue
Serum
Tissue















0.5
Exam-
159 ± 49
315 ± 63
212 ± 66
34 ± 1



ple 7


0.5
Exam-
 716 ± 341
288 ± 22
239 ± 57
 59 ± 21



ple 8


0.5
Exam-
 359 ± 220
375 ± 85
130 ± 33
39 ± 2



ple 9


1
Exam-
199 ± 76
343 ± 79
110 ± 39
41 ± 7



ple 7


1
Exam-
 237 ± 123
340 ± 93
156 ± 65
34 ± 2



ple 8


1
Exam-
 306 ± 160
 681 ± 222
119 ± 40
 74 ± 30



ple 9


4
Exam-
165 ± 50
 915 ± 175
261 ± 64
 476 ± 127



ple 7


4
Exam-
105 ± 10
1165 ± 250
247 ± 32
1098 ± 307



ple 8


4
Exam-
 233 ± 144
1628 ± 202
254 ± 38
1217 ± 271



ple 9


8
Exam-
133 ± 18
1190 ± 368
279 ± 27
583 ± 67



ple 7


8
Exam-
166 ± 51
1029 ± 268
259 ± 36
 923 ± 131



ple 8


8
Exam-
159 ± 44
1336 ± 149
325 ± 44
1895 ± 254



ple 9


4
1Vehi-
125 ± 0 
 642 ± 101
191 ± 39
 88 ± 41



cle





1Vehicle (2.1% carbomer 974, 0.4% xanthan gum, 15% propylene glycol, 0.15% methylparaben, 0.03% propylparaben, 0.05% edetate sodium, 20% tromethamine solution qs to pH 4.0, and water qs to 100%)






Examples 10 and 11
The gels shown in Table 10 were prepared using the following general method.
Step 1: The IRM was combined with the aqueous ethanesulfonic acid and the combination was mixed until the IRM was dissolved.
Step 2: The parabens were dissolved in the propylene glycol.
Step 3: Edetate sodium was dissolved in the bulk of the water. The carbomer was added and the mixture was stirred until the carbomer was hydrated.
Step 4: The solution from step 2 was added to the solution from step 1 and the combination was mixed until uniform.
Step 5: The dispersion from step 3 was added in portions to the solution from step 4 and the combination was mixed well.
Step 6: 20% tromethamine was added to adjust the pH to about 4.
Step 7: Sufficient water was added to adjust the final weight and the gel was mixed well until uniform.










TABLE 10









Gels (% w/w)












Ingredient
Ex 10
Ex 11







IRM
0.05 IRM5
0.5 IRM6



Ethanesulfonic acid (0.05 N)
2.76
0



Ethanesulfonic acid (0.02 N)
0
6.8



Carbomer 974P
3.3
3.5



Propylene glycol
15
15



Methylparaben
0.15
0.15



Propylparaben
0.03
0.03



Edetate disodium
0.05
0.05



20% Tromethamine solution
3.2
4.5



Purified water
qs 100
qs 100



pH
*
4.4







* Not measured






The ability of the gels of Examples 10 and 11 to induce cytokines following a single dose was determined using the test method described above except that the dose was 100 μL instead of 50 μL. The results are shown in Table 11 below where each value is the mean of 3 animals±SEM (standard error of the mean).









TABLE 11







Time

Cytokine Concentrations










(hours)

TNF (pg/mL)
MCP-1 (pg/mL)












Post Dose
Gel
Serum
Tissue
Serum
Tissue





2
Example 10
0 ± 0
230 ± 23
83 ± 7
276 ± 27


2
Example 11
33 ± 33
101 ± 28
96 ± 7
31 ± 4


4
Example 10
0 ± 0
169 ± 52
123 ± 36
 411 ± 241


4
Example 11
0 ± 0
214 ± 19
87 ± 6
197 ± 72


2
Untreated
0 ± 0
 90 ± 17
77 ± 7
26 ± 2









Example 12
The gel shown in Table 12 was prepared using the following general method.
Step 1: IRM7 was combined with the aqueous methanesulfonic acid and mixed. Water was added in portions until the IRM was completely dissolved.
Step 2: The edetate sodium was dissolved in the bulk of the water.
Step 3: The hydroxypropyl cellulose was combined with propylene glycol (about two thirds of the amount used to achieve the final weight percent) and the combination was mixed to form a slurry.
Step 4: The carbomer was slowly added to the solution from step 2. The mixture was stirred until the carbomer was fully hydrated.
Step 5: The slurry from step 3 was added to the mixture from step 4 and mixed thoroughly.
Step 6: The parabens were dissolved in propylene glycol (about one third of the amount used to achieve the final weight percent).
Step 7: The solution from step 6 was added to the solution from step 1 and thoroughly mixed.
Step 8: The solution from step 7 was slowly added to the mixture from step 5 with mixing.
Step 9: 20% tromethamine was added to adjust the pH to 4.










TABLE 12







Ingredient
(% w/w)



















IRM7
0.05



Methanesulfonic acid (0.15 M)
14.6



Carbomer 974P
3.5



1Hydroxypropyl cellulose
0.50



Propylene glycol
15



Methylparaben
0.15



Propylparaben
0.03



Edetate disodium
0.05



20% Tromethamine solution
qs pH 4



Purified water
qs 100



pH
4.0







1KLUCEL HF






Examples 13-15
The gels in Table 13 below were prepared using the following general method.
Step 1: The parabens were dissolved in propylene glycol (about one third of the amount used to achieve the final weight percent).
Step 2: IRM8 and a small portion of the water were added to the solution from step 1. The mixture was stirred until the IRM was completely dissolved.
Step 3: The edetate sodium was dissolved in the bulk of the water.
Step 4: The hydroxypropyl cellulose was slowly added with stirring to propylene glycol (about two thirds of the amount used to achieve the final weight percent).
Step 5: The mixture from step 4 was added to the solution from step 3.
Step 6: The carbomer was slowly added with stirring to the mixture from step 5. Stirring was continued until the carbomer was fully hydrated.
Step 7: About half of the 20% tromethamine solution was slowly added with stirring to the mixture from step 6.
Step 8: The solution from step 2 was slowly added with stirring to the mixture from step 7.
Step 9: The remainder of the 20% tromethamine solution was slowly added with stirring to the mixture from step 8. Stirring was continued until a uniform gel was obtained.









TABLE 13









Gels (% w/w)










Ingredient
Ex 13
Ex 14
Ex 15













IRM8
0.0574
0.574
1.148


Carbomer 974P
2.00
3.50
3.50


Hydroxypropyl cellulose (HF grade)
0.50
0.50
0.50


Propylene glycol
15.0
15.0
15.0


Methylparaben
0.15
0.15
0.15


Propylparaben
0.03
0.03
0.03


Edetate disodium
0.05
0.05
0.05


20% Tromethamine solution
0.94
3.47
5.00


Purified water
qs 100
qs 100
qs 100









Example 16
The gel shown in Table 14 below was prepared using the following general method of Examples 13-15 except that all of the 20% tromethamine solution was added in step 7.










TABLE 14







Ingredient
(% w/w)



















IRM8
0.00574



Carbomer 974P
2.0



Hydroxypropyl cellulose (HF grade)
0.5



Propylene glycol
15.0



Methylparaben
0.15



Propylparaben
0.03



Edetate disodium
0.05



20% Tromethamine solution
0.94



Purified water
qs 100



pH
4.0










The ability of the gels of Examples 13-16 to induce cytokines following a single dose was determined using the test method described above except that the dose was 100 μL instead of 50 μL. The results are shown in Table 15 below where each value is the mean of 6 animals±SEM (standard error of the mean).









TABLE 15







Time

Cytokine Concentrations










(hours)

TNF (pg/mL)
MCP-1 (pg/mL)












Post Dose
Gel
Serum
Tissue
Serum
Tissue





2
Example 16
2 ± 1
214 ± 29
 83 ± 12
 315 ± 122


2
Example 13
0 ± 0
285 ± 52
115 ± 25
 609 ± 111


2
Example 14
2 ± 1
328 ± 18
 98 ± 13
 895 ± 132


2
Example 15
3 ± 1
428 ± 27
 95 ± 21
1202 ± 72 


2
1Vehicle
7 ± 5
159 ± 18
 94 ± 16
47 ± 7


4
Example 16
0 ± 0
234 ± 34
118 ± 21
 727 ± 172


4
Example 13
5 ± 3
196 ± 26
121 ± 9 
1027 ± 81 


4
Example 14
2 ± 1
246 ± 32
166 ± 33
1422 ± 120


4
Example 15
0 ± 0
246 ± 25
175 ± 40
1257 ± 224


4
1Vehicle
0 ± 0
155 ± 25
117 ± 15
30 ± 3


6
Example 16
0 ± 0
110 ± 10
160 ± 16
457 ± 88


6
Example 13
2 ± 2
151 ± 19
137 ± 34
574 ± 71


6
Example 14
1 ± 0
191 ± 37
188 ± 43
1121 ± 213


6
Example 15
3 ± 3
177 ± 24
221 ± 27
1183 ± 139


6
1Vehicle
8 ± 5
117 ± 26
148 ± 16
28 ± 4





1Vehicle (2.00% carbomer 974, 0.50% hydroxypropyl cellulose, 15.0% propylene glycol, 0.15% methylparaben, 0.03% propylparaben, 0.05% edetate sodium, 0.94% 20% tromethamine solution, and water qs to 100%)






The complete disclosures of the patents, patent documents, and publications cited herein are incorporated by reference in their entirety as if each were individually incorporated. Various modifications and alterations to this invention will become apparent to those skilled in the art without departing from the scope and spirit of this invention. It should be understood that this invention is not intended to be unduly limited by the illustrative embodiments and examples set forth herein and that such examples and embodiments are presented by way of example only with the scope of the invention intended to be limited only by the claims set forth herein as follows.

## Claims

1. An aqueous gel comprising:
water;
an immune response modifier (IRM) other than 1-(2-methylpropyl)-1H-imidazo[4,5-c][1,5]naphthyridin-4-amine, or a salt thereof, an immune response modifier (IRM), other than 1-(2-methylpropyl)-1H-imidazo[4,5-c][1,5]naphthyridin-4-amine, or a salt thereof, and wherein the said IRM is selected from the group consisting of imidazoquinoline amines, tetrahydroimidazoquinolines, imidazopyridine amines, 6,7-fused cycloalkylimidazopyridine amines, imidazonaphthyridine amines, tetrahydroimidazonaphthyridine amines; oxazoloquinoline amines; thiazoloquinoline amines; oxazolopyridine amines; thiazolopyridine amines; oxazolonaphthyridine amines; thiazolonaphthyridine amines; pyrazolopyridine amines; pyrazoloquinoline amines; tetrahydropyrazoloquinoline amines; pyrazolonaphthyridine amines; tetrahydropyrazolonaphthyridine amines; 1H-imidazo dimers fused to pyridine amines, quinoline amines, tetrahydroquinoline amines, naphthyridine amines, or tetrahydronaphthyridine amines, salts thereof, and combinations thereof;
a pharmaceutically acceptable acid;
water-miscible cosolvent; and
a thickener system comprising a negatively charged thickener;
wherein the aqueous gel has a viscosity of 1000 cps to 50,000 cps at 25° C.; and
wherein the aqueous gel does not contain oil.

2. An aqueous gel prepared by a method comprising combining components comprising:
water;
an immune response modifier (IRM) other than 1-(2-methylpropyl)-1H-imidazo[4,5-c][1,5]naphthyridin-4-amine, or a salt thereof, an immune response modifier (IRM), other than 1-(2-methylpropyl)-1H-imidazo[4,5-c][1,5]naphthyridin-4-amine, or a salt thereof, and wherein the said IRM is selected from the group consisting of imidazoquinoline amines, tetrahydroimidazoquinolines, imidazopyridine amines, 6,7-fused cycloalkylimidazopyridine amines, imidazonaphthyridine amines, tetrahydroimidazonaphthyridine amines; oxazoloquinoline amines; thiazoloquinoline amines; oxazolopyridine amines; thiazolopyridine amines; oxazolonaphthyridine amines; thiazolonaphthyridine amines; pyrazolopyridine amines; pyrazoloquinoline amines; tetrahydropyrazoloquinoline amines; pyrazolonaphthyridine amines; tetrahydropyrazolonaphthyridine amines; 1H-imidazo dimers fused to pyridine amines, quinoline amines, tetrahydroquinoline amines, naphthyridine amines, or tetrahydronaphthyridine amines, salts thereof, and combinations thereof;
a water-miscible cosolvent; and
a thickener system comprising a negatively charged thickener;
wherein the aqueous gel has a viscosity of 1000 cps to 50,000 cps at 25° C.; and
wherein the aqueous gel does not contain oil.

3. The aqueous gel of claim 1 claim wherein the IRM in its free base form has an intrinsic aqueous solubility of less than 500 μg/mL at 25° C.

4. The aqueous gel of claim 1 wherein the pharmaceutically acceptable acid is present in a stoichiometric amount relative to the IRM.

5. The aqueous gel of claim 1 wherein the IRM is provided as a salt.

6. The aqueous gel of claim 1 wherein the IRM is an imidazoquinoline amine or a salt thereof.

7. The aqueous gel of claim 1 wherein the water-miscible cosolvent is present in an amount of from 10 wt-% to 90 wt-%, based on the total weight of the aqueous gel.

8. The aqueous gel of claim 1 wherein the water-miscible cosolvent is selected from the group consisting of monopropylene glycol, dipropylene glycol, hexylene glycol, butylene glycol, glycerin, polyethylene glycol, diethylene glycol monoethyl ether, and combinations thereof.

9. The aqueous gel of claim 1 wherein the thickener system further comprises a non-ionic thickener.

10. The aqueous gel of claim 1 wherein the thickener is selected from the group consisting of hydroxyethyl cellulose, hydroxymethyl cellulose, hydroxypropyl cellulose, a cellulose ether, a polysaccharide gum, an acrylic acid polymer, carboxylic acid, carboxylate groups, and/or combinations thereof.

11. The aqueous gel of claim 1 wherein the thickener system is present in an amount of from 0.1 wt-% to 7 wt-%, based on the total weight of the aqueous gel.

12. The aqueous gel of claim 1 further comprising a pharmaceutically acceptable pH adjusting agent.

13. The aqueous gel of claim 1 further comprising a pharmaceutically acceptable buffer.

14. The aqueous gel of claim 1 having a pH of 2 to 5.

15. The aqueous gel of claim 1 further comprising a preservative.

16. The aqueous gel of claim 1 further comprising a chelating agent.

17. A method of delivering an IRM to mucosal tissue of a subject, the method comprising applying the aqueous gel of claim 1 to the mucosal tissue.

18. The method of claim 17 wherein the mucosal tissue is associated with a condition selected from the group consisting of a cervical dysplasia, a papilloma virus infection of the cervix, a low-grade squamous intraepithelial lesion, a high-grade squamous intraepithelial lesion, atypical squamous cells of undetermined significance, a cervical intraepithelial neoplasia, an atopic allergic response, allergic rhinitis, a neoplastic lesion, and a premalignant lesion.