IMPROVEMENTS IN OR RELATING TO ANTIPROTOZOAL AGENTS

Abstract: Novel combinations of the antiprotozoal naphtoquinone compound 2-(4-(4′-chloro-phenyl) cyclohexyl)-3-hydroxy-1,4-naphtoquinone and a 4-pyridinol or an alkanoic ester thereof wherein the anti­ protozoal activity of the combination is potentiated with respect to the corresponding activity of the components of the combination. The combinations are especially useful for the treatment or prophylaxis of malaria.

Description: The present invention relates to a specific naphthoquinone i.e. 2-(4-(4'-chloro-phenyl-)cyclohexyl-)3-hydroxy-1.4-naphthoquinone. Naphthoquinones of diverse structures have been described as possessing useful antiprotozoal activity, for example antimalarial, anticoccidial and antitheilerial activity. Some of these compounds have also been described as possessing activity against external parasites. In US-Patent 2,553,647,2-(4-phenylcyclohexyl-)3-hydroxy-1.4-naphthoquinone and its utility against malaria infection-causing organisms is disclosed. Fieser et al , J.Amer.Chem.Soc. 1948, 70 , 3158-3164 (and references cited therein) describes a large number of 2-substituted-3-hydroxy-1,4-naphthoquinones as having antimalarial activity. A number of these compounds have also been described in U.S. Patent Specification No. 2 553 648. An extension of this work is described in J. Med. Chem, 1967, Vol 10, No 4, 513 - 517 (Fieser et al.). U.S. Patent No. 3 367 830 describes a series of 2-substituted-3-hydroxy-1,4-naphthoquinones as anticoccidial agents. U.S. Patent No. 3 347 742 describes the use of 2-(4'-cyclohexylcyclohexyl)-3-hydroxy-1,4-naphthoquinone as an anticoccidial agent. U.K. Patent Specification No. 1553424 describes the use of 2-cyclohexyl- and 2-cyclohexylalkyl-3-hydroxy-1,4-naphthoquinones as antitheilerial agents. European Patent Specification No. 0 002 228 describes a number of 2-cycloalkyl-3-hydroxy-1,4-naphthoquinones as antitheilerial agents. European Patent Specification 77551 describes a series of 2-(4-substituted cyclohexyl)-3-hydroxy-1,4-naphthoquinones as antimalarial and anticoccidial agents. European Patent Specification 77550 describes a series of 2-(4-substituted cyclohexylmethyl)-3-hydroxy-1,4-naphthoquinones as antitheilerial agents. German Offenlegungsschrift 2,641,343 describes a series of 2-higher alkyl-3-hydroxy-1,4-naphthoquinones having acaricidal and aphicidal activity. It was an object of the invention to provide a new 3-hydroxy-1.4-naphthoquinone derivative. It was surprisingly found that the compound according to the invention, 2-(4-(4'-chlorophenyl-) cyclohexyl-)3-hydroxy-1.4-naphthoquinone, has a high antiprotozoal activity and may for example, be combined with a 4-Pyridinol or an alkanoic ester there of, where by compositions having potentiated anti-protozoal activity are obtained. The naphthoquinone according to the present invention is represented by the formula wherein R¹ is a 4-(4'-chlorophenyl-) cyclohexyl group and R₂ is hydroxy (2-(4-(4'-chorophenyl-) cyclohexyl-)3-hydroxy-1.4-naphthoquinone). The 2-(4-(4'-chlorophenyl-) cyclohexyl-) 3-hydroxy-1.4-naphthoquinone of the invention having antiprotozoal activity may be combined with a 4-pyridinol or an alkanoïc ester thereof. By providing such combinations, compositions having potentiated antiprotozoal activity are obtained. The pyridinols which may be employed in such combinations include those described in U.S. Patent No. 3,206,358. Preferred pyridinols include those of formula (II) wherein each R³ is the same or different and is a C₁₋₄ alkyl group and each X is the same or different and is halogen or a C₁₋₆ alkanoic acid ester thereof. Particularly preferred compounds of formula (II) include 3,5-dichloro-2,6-dimethyl-4-pyridinol; 3,5-dibromo-2,6-dimethyl-4-pyridinol; 3,5-dichloro-2,6-dipropyl-4-pyridinol and 3,5-dibromo-2,6-dipropyl-4-pyridinol. The naphthoquinone of the invention and 4-pyridinols and alkanoic esters thereof employed in such combinations may be prepared in conventional manner, for example, using analogous techniques to those described in the prior art. The two active ingredients of such combinations may be present in any convenient potentiating ratio. In general, the ratio of the naphthoquinone of the invention to pyridinol (w/w) will be in the range of 1:500 to 1:1. A combination of the naphthoquinone of the invention with a pyridinol may be used, as a therapeutic agent, for example for use in the treatment or prophylaxis of a protozoal disease as described below. Examples of protozoal diseases which may be treated include coccidiosis and malarial infections, in hosts, including mammals (such as man in the case of malaria) and birds (such as poultry in the case of coccidiosis). The amount of naphthoquinone of the invention required for therapeutic effect is at the ultimate discretion of the physician/veterinarian carrying out the treatment and will, of course, vary not only with the nature of the infection to be treated but also with the particular pyridinol used and the ratio thereof. In general, however, a suitable daily dose for a mammal (including man) for the treatment of malaria, for example, will lie in the range of 0.1mg to 200mg/kg bodyweight, for example 1mg to 100mg/kg such as 10mg to 40mg/kg. The amount of pyridinol present in the combination will be that necessary to provide the appropriate potentiating ratio of the naphthoquinone of the invention to pyridinol as hereinbefore defined. It will be appreciated that the amount of such combinations of the naphthoquinone of the invention with a pyridinol, required for use in treatment or prophylaxis will vary not only with the particular pyridinol used but also with the route of administration and nature of the infection. In general a suitable dose for a mammal (including man) for treatment, for example of malaria, will lie in the range of 0.1 mg to 200 mg per kilogram bodyweight per day, with a preferred range of 1 mg to 100 mg, particular 10 to 40 mg. For the prophylaxis or treatment of coccidiosis the combination will normally be administered ad lib in drinking water or diet and suitable levels of drug will be in the range of 1 to 500ppm, preferably 10-400ppm, ideally about 200ppm. The combinations of the naphthoquinone of the invention with a pyridinol are preferably employed as antiprotozoal agents in the form of therapeutic (pharmaceutical or veterinary) formulations. Such therapeutic formulations comprise a combination of the naphthoquinone according to the invention, with a 4-pyridinol, together with one or more pharmaceutically acceptable carriers therefore and/or optionally one or more further therapeutic and/or prophylactic ingredients. The combination of the naphthoquinone according to the invention with a 4-pyridinol is present in the therapeutic formulations in an effective antiprotozoal amount. The combinations may conveniently be presented (as therapeutic formulations) in unit dosage form. A convenient unit dose formulation contains the combination of the naphthoquinone of the invention with a 4-pyridinol in an amount of from 10 mg to 1 g. Therapeutic formulations include those suitable for oral, rectal or parenteral (including intramuscular and intravenous) administration, although the oral route is preferred. The formulations may, where appropriate, be conveniently presented in discrete dosage units and may be prepared by any of the methods well known in the art of pharmacy. All methods include the step of bringing into association the active compound with liquid carriers or finely divided solid carriers of both and then, if necessary, shaping the product into the desired formulation. Therapeutic formulations suitable for oral administration wherein the carrier is a solid are most preferably presented as unit dose formulations such as boluses, capsules, cachets or tablets each containing a predetermined amount of the combination. A tablet may be made by compression or moulding, optionally with one or more accessory ingredients. Compressed tablets may be prepared by compressing in a suitable machine the active compound in a free-flowing form such as a powder or granules optionally mixed with a binder, lubricant, inert diluent, lubricating, surface active or dispersing agent. Moulded tablets may be made by moulding an inert liquid diluent. Tablets may be optionally coated and, if uncoated, may be optionally scored. Capsules may be prepared by filling the combination, either alone or in admixture with one or more accessory ingredients, into the capsule cases and then sealing them in the usual manner. Cachets are analogous to capsules wherein the combination together with any accessory ingredient(s) is sealed in a rice paper envelope. Therapeutic formulations suitable for oral administration wherein the carrier is a liquid may be presented as a solution or a suspension in an aqueous liquid or a non-aqueous liquid, or as an oil-in-water or water-in-oil liquid emulsion. Therapeutic formulations suitable for rectal administration wherein the carrier is a solid are most preferably presented as unit dose suppositories. Suitable carriers include cocoa butter and other materials commonly used in the art, and the suppositories may be conveniently formed by admixture of the combination with the softened or melted carrier(s) followed by chilling and shaping moulds. Therapeutic formulations suitable for parenteral administration include sterile solutions or suspensions of the combination in aqueous or oleaginous vehicles. Such preparations are conveniently presented in unit dose or multi-dose containers which are sealed after introduction of the formulation until required for use. It should be understood that in addition to the aforementioned carrier ingredients the pharmaceutical formulations described above may include, as appropriate, one or more additional carrier ingredients such as diluents, buffers, flavouring agents, binders, surface-active agents, thickeners, lubricants, preservatives (including anti-oxidants) and the like, and substances included for the purpose of rendering the formulation isotonic with the blood of the intended recipient. The therapeutic formulations for veterinary use, may conveniently be in either powder or liquid concentrate form. In accordance with standard veterinary formulation practice, conventional water soluble excipients, such as lactose or sucrose, may be incorporated in the powders to improve their physical properties. Thus particularly suitable powders of this invention comprise 50 to 100% w/w, and preferably 60 to 80% w/w of the combination and 0 to 50% w/w and preferably 20 to 40% w/w of conventional veterinary excipients. These powders may either be added to animal feedstuffs, for example by way of an intermediate premix, or diluted in animal drinking water. Liquid concentrates suitably contain a water-soluble compound combination and may optionally include a veterinarily acceptable water miscible solvent, for example polyethylene glycol, propylene glycol, glycerol, glycerol formal or such a solvent mixed with up to 30% v/v of ethanol. The liquid concentrates may be administered to the drinking water of animals, particularly poultry. The following examples illustrate the invention:- Example 1 and Comparative Examples 1 to 3 Effect of Naphthoquinone clopidol (4-pyridinol) Combinations on P.yoelii in vivo A number of combinations of clopidol (3,5-dichloro-2,6-dimethyl-4-pyridinol) and naphthoquinones were assayed and compared with each drug alone for their antimalarial effect against P.yoelii in vivo by the method described below. Representative results for each combination showing percentage inhibition of parasitaemia are given in the Table below. A time 0,01 ml of a suspension of 10⁷ P.yoelii -parasitised red blood cells/ml of phosphate-buffered saline were injected intravenously into 15-20 g mice through a tail vein. Groups of 5 mice per treatment were dosed orally at times 6, 22, 30, 46, 54, 70 and 78 hours with 0.2ml of the drug suspension. Tail-blood smears were taken at 96 hours, stained with Giemsa and the percentage of red blood cells infected determined and compared to untreated, infected controls. Percent inhibition was correlated with dose to provide ED₅₀ values for each drug alone. In subsequent experiments dilutions of the two drugs, alone and in combination were used, and the percentage inhibition of parasitaemia and ED₅₀ values (of each drug at fixed concentrations of the other) were determined.

Claims: 2-(4-(4'-chlorophenyl)-cyclohexyl-)3-hydroxy-1,4-naphthoquinone. Claim for the following Contracting State : AT Process for preparing a therapeutic formulation comprising a combination of 2-(4-(4'-chlorophenyl-)cyclohexyl-)3-hydroxy-1,4-naphthoquinoneand a 4-pyridinol or an alkanoic ester thereof wherein the weight ratio of the naphthoquinone to 4-pyridinol or an alkanoic ester thereof is a potentiating ratio in the range of 1:500 to 1:1, which process comprises bringing said combination to association with a pharmaceutical acceptable carrier therefor.

Inventors: HUDSON, ALAN THOMAS, LATTER, VICTORIA SUSAN, RANDALL, ANTHONY WINCHESTER, RICHARDS, WILLIAM HENRY GEORGE
Applicants: THE WELLCOME FOUNDATION LIMITED
Application year: 1984
Main classification: A61K31
IPC codes: A61K31, A61P33