Treatment of tropical spastic paresis with peptide T

Abstract: Intranasal therapy using short peptides of the formula: R a -Ser-Thr-Thr-Thr-Asn-Tyr-R b where R a represents an amino terminal residue Ala- or D-Ala and R b represents a carboxy terminal residue -Thr or -Thr amide or a derivative thereof with an additional Cys- residue at one or both of the amino and carboxy terminals, or a peptide of formula (II): R¹-R²-R³-R⁴-R⁵ (II) where R¹ is an amino terminal residue Thr-, Ser-, Asn-,Leu-,Ile-, Arg- or Glu- R² is Thr, Ser or Asp R³ is Thr, Ser, Asn, Arg, Gln, Lys or Trp R⁴ is Tyr and R⁵ is a carboxy terminal amino group or a derivative thereof with a corresponding D- amino acid as the amino terminal residue, and/or a corresponding amide derivative at the carboxy terminal residue and/or additionally a Cys- residue at one or both of the amino and carboxy terminals, or a physiologically acceptable salt thereof. Such peptides bind to T4 receptors are useful for intranasal administration in preventing viral infectivity in mammals by viruses which bind to the T4 receptors. These peptides are believed to act as completitive blocking agents.

Description: This invention relates to the use of certain polypeptides for the manufacture of a medicament for the treatment of Tropical Spastic Paresis (TSP) or a disease caused by the HTLV-1 virus. It also relates to compositions for use as aforesaid. The present invention relates to the use of peptide T for the manufacture of a medicament for the treatment of Tropical Spastic Paresis (TSP). Treatment of TSP is also accomplished by intranasal therapy using Peptide T. The treatment of TSP with Peptide T has resulted in substantial reversal of the symptoms associated with the disease e.g., paralysis of feet and legs. Improvements in bladder and sexual function were also observed as well as decreased deterioration in memory and attention deficits. The present invention relates to the use for the manufacture of a medicament for the treatment of Tropical Spastic Paresis or for the treatment of a disease caused by the HTLV-I virus of a peptide of formula (I); where R a represents an amino terminal residue Ala- or D-Ala or Cys-Ala and R b represents a carboxy terminal residue -Thr, -Thr amide, -Thr-Cys or -Thr-Cys-Amide or a derivative thereof which is an ester or an amide, or a peptide of formula (II): R 1 -R 2 -R 3 -R 4 -R 5 where R 1 is an amino terminal residue R 6 X or R 6 wherein R 6 is Thr-, Ser-, Asn-, Glu-, Arg-, Ile- or Leu- and X is Cys-; R 2 is Thr, Ser or Asp; R 3 is Thr, Ser, Asn, Arg, Gln, Lys or Trp; R 4 is Tyr; and R 5 is a carboxy terminal residue which is R 7 X or R 7 wherein R 7 may be any amino acid and X is Cys or a derivative thereof which is an ester or an amide, with R 5 preferably being a carboxy terminal residue -Thr, -Arg or -Gly or a derivative thereof with a corresponding D-amino acid as the amino terminal residue. While the preferred amino acids at R 5 have been designated, it is known that the amino acid at this position may vary widely. In fact, it is possible to terminate the peptide with R 4 (tyrosine) as the carboxy terminal amino acid wherein R 5 is absent. Such peptides retain the binding properties of the group taught therein. Serine and threonine appear to be interchangeable for purposes of biological properties taught herein. The active compounds may exist as physiologically acceptable salts of the peptides. Most preferred peptides, as well as peptide T above, are the following octapeptides of formula (I): and and the following pentapeptides of formula (II): and and their analogues with D-Thr as the amino terminal residue and/or an amide derived at the carboxy terminal. The above compounds may be beneficially modified by methods known to enhance passage of molecules across the blood-brain barrier. Acetylation has proven to be especially useful for enhancing binding activity of the peptide. The terminal amino and carboxy sites are particularly preferred sites for modification. The above peptides invention may also be modified in a constraining conformation to provide improved stability and oral availability. The following abbreviations are used hereinafter: Amino Acid Three Letter Code One letter Code arginine Arg R asparagine Asn N aspartic acid Asp D cysteine Cys C glycine Gly G serine Ser S threonine Thr T tyrosine Tyr Y Unless otherwise indicated the amino acids are, of course, the natural form of L-stereoisomers. A comparison of amino acid sequences of 12 pentapeptides is presented in Table 1. Although historically our initial computer search revealed peptide T (contained in the ARV isolate) to be the relevant moiety, as additional viral sequences became available it became clear that the relevant, bioactive sequence, might be a shorter pentapeptide comprising, nominally, peptide T[4-8], or the sequence TTNYT. In the isolates we compared (Table 1) substantial homologies were discerned only in this, shorter, region. The majority of changes are the interconversions of serine (S) and threonine (T), two closely related amino acids. The tyrosine of position 7 of peptide T is an invariant feature of all these constructs indicating that it may be obligatory for bioactivity. Substitutions occurring at position 5 include T, G, R or S. Position 4 and 6 were first restricted (with one exception) to S, T and N, all amino acids containing uncharged polar groups with closely similar stearic properties. The region around and including the peptide T sequence is a highly variable area. Such variability may indicate specialization through strong selective diversification of the function(s) which may be defined at this locus. Like the opiate peptides, these peptide T analogs seem to exist in multiple forms, reminiscent of met and leuenkephalin. The peptides that can be administered intranasally in accordance with the invention may be produced by conventional methods of peptide synthesis e.g. the Merrifield method of solid phase peptide synthesis was used (See U.S. Patent No. 3,531,258). Both solid phase and liquid phase methods, as well as other methods e.g., enzymatic methods, may be used. We have found the solid phase method of Merrifield to be particularly convenient. In this process the peptide is synthesized in a stepwise manner while the carboxy end of the chain is covalently attached to an insoluble support. During the intermediate synthetic stages the peptide remains in the solid phase and therefore can be conveniently manipulated. The solid support is a chloromethylated styrene-divinylbenzene copolymer. An N-protected form of the carboxy terminal amino acid, e.g. a t-butoxycarbonyl protected (Boc-) amino acid, is reacted with the chloromethyl residue of the chloromethylated styrene divinylbenzene copolymer resin to produce a protected amino acyl derivative of the resin, where the amino acid is coupled to the resin as a benzyl ester. This is deprotected and reacted with the next required amino acid thus producing a protected dipeptide attached to the resin. The amino acid will generally be used in activated form, e.g. by use of a carbodiimide or active ester. This sequence is repeated and the peptide chain grows one residue at a time by condensation at the amino end with the required N-protected amino acids until the required peptide has been assembled on the resin. The peptide-resin is then treated with anhydrous hydrofluoric acid to cleave the ester linking the assembled peptide to the resin, in order to liberate the required peptide. Side chain functional groups of amino acids which must be blocked during the synthetic procedure, using conventional methods, may also be simultaneously removed. Synthesis of a peptide with an amide group on its carboxy terminal can be carried out in a conventional manner, using a 4-methylbenzylhydroxylamine resin. Thus, the peptides may be formulated for oral, intranasal, buccal, parenteral, topical or rectal administration. In particular, the peptides may be formulated for injection or for infusion and may be presented in unit dose form in ampoules or in multidose containers with an added preservative. The compositions may take such forms as suspensions, solutions, or emulsions in oily or aqueous vehicles, and may contain formulatory agents such as suspending, stabilizing and/or dispersing agents. Alternatively, the active ingredient may be in powder form for constitution with a suitable vehicle, e.g., sterile, pyrogen-free water, before use. In a particularly preferred embodiment, the active ingredient may be administered intranasally, preferably in more than one daily application. The pharmaceutical compositions according to the invention may also contain other active ingredients such as antimicrobial agents, or preservatives. The peptides of the present invention were found to be effective in the treatment of Tropical Spastic Paresis (TSP). TSP is a disease characterized by paralysis of feet and legs, there is bladder and sexual impairment, progressive deterioration as well as memory and attention deficits. The disease is endemic in tropical climates and southern Japan where approximately 200,000 people have the disease. TSP appears to be transmitted sexually as well as through human breast milk and is caused by a human retrovirus - HTLV I which is related to HIV, the AIDS virus (formerly called HTLV III). TSP is becoming more prevalent in the U.S. than previously believed as most likely a sexually transmitted disease. The disease is a nyclo-neurological degenerative disease. The TSP or HTLV I virus has the peptide T-sensitive sequence in the viral envelope and as such peptide T has a broad spectrum anti-retroviral activity just like penicillin is a broad spectrum anti-bacterial of those bacteria with a similar cell wall (analogous to the viral envelope). Peptide T has been found to work on the neurons in the Sacral Spinal Cord that control the functions impaired in TSP disease. The peptide of the present invention for treating TSP may be formulated for injection or for infusion and may be presented in unit dose forms in ampoules or in multidose containers as outlined above. In a preferred embodiment, the active ingredient may be administered intranasally, preferably in more than one daily application. The dosage levels of the peptides may vary, but generally are from about 0.2 to 50 mg/day, for example, about 1.2, 6 or 30 mg/day, given intranasally by metered spray in three generally equally divided doses three times a day and preferably every eight hours. The use of the above peptides and especially peptide T has no toxic effect on blood cell counts, EKG, blood chemistries or urinalysis. Intranasal peptide T, according to the present invention is a safe therapeutic agent for the treatment of TSP. Treatment of TSP with Peptide T In a preliminary and unblinded study, 3 patients with TSP were given Peptide T for 10 weeks. HTLV-1, but nct HIV antibodies were present in the serum and CSF of all three patients. Patient 1 was a male, age 63, who had progressive gait ataxia for 9 years associated with postural hypotension. Patients 2 and 3 were female, both age 59 with a 9 year history of progressive spastic paraparesis. All patients were ambulant. A plastic aerosol system, containing 5 mg/ml of a Peptide T solution was provided and about 6 mg administered each day, via four metered intranasal sprays 3 times daily. Patients were reviewed at monthly intervals and videotaped. No side effects were observed. Patients 1 and 2 showed no substantial changes in symptoms and were timed over 10 meters at 166 and 19.5 initially, and 227 and 16.5 seconds respectively at the end of week 10. Patient 3 reported substantial improvement which began in week 2 and continued to the end of week 10. She took only 15 seconds to walk 10 meters at this time, compared to 65 seconds initially. Four weeks after treatment was stopped, stiffness in her legs returned. As can be seen from the above limited trial, Peptide T is a non-toxic therapeutic modality that is easily administered, and has a beneficial effect in some patients with TSP. Another patient 4, a woman was treated similarly as above, and return of bladder control and ability to walk and climb was achieved as a result of Peptide T therapy. The data presented with this invention suggests that peptide T acts to reduce or eliminate the symptoms of TSP. Intranasal administration at 6 mg/day resulted in improvement in feet and legs paralysis, improvement in bladder and sexual function as well as improvement in memory and attention deficits.

Claims: Use of a peptide of the formula (I) where R a represents an amino acid terminal residue Ala-, D-Ala- or Cys-Ala- and R b represents a carboxy terminal residue -Thr, or -Thr-amide, -Thr-Cys or -Thr-Cys amide, or a derivative thereof which is an ester or an amide or a peptide of formula (II): R 1 -R 2 -R 3 -R 4 -R 5 where R 1 is an amino terminal residue R 6 X or R 6 wherein R 6 is Thr-, Ser-, Asn-, Leu, Ile, Arg or Glu and X is Cys, R 2 is Thr, Ser or Asp, R 3 is Thr, Ser, Asn, Arg, Gln, Lys or Trp, R 4 is Tyr, and R 5 is a carboxy terminal residue which is R 7 X or R 7 wherein R 7 may be any amino acid and X is Cys or a derivative thereof which is an ester or an amide, or a physiologically acceptable salt thereof for the manufacture of a medicament for the treatment of tropical spastic paresis or a disease caused by the HTLV-I virus or for the improvement of the neuromotor and cognitive performance of HTLV-I infected patients. Use of a peptide of formula (II): R 1 -R 2 -R 3 -R 4 -R 5 where R 1 represents an amino terminal residue Thr-, Ser-, or Asn-, R 2 is Thr, Ser or Asp, R 3 is Thr, Ser, Asn or Arg, R 4 is Tyr, and R 5 is a carboxy terminal residue -Thr, -Thr-amide, -Thr-Cys, -Thr-Cys-amide, -Arg, -Arg-amide, -Arg-Cys, -Arg-Cys-amide, Gly, -Gly-amide, -Gly-Cys or -Gly-Cys-amide, or a derivative thereof which is an ester or an amide or a physiologically acceptable salt thereof for the manufacture of a medicament for the treatment of tropical spastic paresis or a disease caused by the HTLV-I virus or for the improvement of the neuromotor and cognitive performance of HTLV-I infected patients. Use of a peptide of formula (I): where R a represents an amino terminal residue Ala-, D-Ala or Cys-Ala, and R b represents a carboxy terminal residue -Thr, -Thr-amide -Thr-Cys or -Thr-Cys-amide, or a derivative thereof which is an ester or an amide, or a peptide of formula (III): R 1 -R 2 -R 3 -R 4 where R 1 is an amino terminal residue Thr-, Cys-Thr-, Ser, Cys-Ser-Asn-, Cys-Asn-, Glu-, Cys-Glu-, Arg-, Cys-Arg-, Ile-, Cys-Ile, Leu-, or Cys-Leu-, R 2 is Thr, Ser or Asp, R 3 is Thr, Ser, Asn, Arg, Gln, Lys or Trp, and R 4 is a carboxy terminal -Tyr or -Tyr-Cis or an ester or amide thereof for the manufacture of a medicament for the treatment of tropical spastic paresis or a disease caused by the HTLV-I virus or for the improvement of the neuromotor and cognitive performance of HTLV-I infected patients. Use according to claim 1 wherein the peptide is of the formula: X-R 1 -R 2 -R 3 -R 4 -R 5 X wherein X is cysteine. Use according to any preceding claim, wherein the medicament is for intranasal administration.

Inventors: BERT CANDACE B, RUFF MICHAEL R, PERT, CANDACE B., RUFF, MICHAEL R., BERT, CANDACE B.
Applicants: ADVANCED PEPTIDES & BIOTECH, ADVANCED PEPTIDES AND BIOTECHNOLOGY SCIENCES
Application year: 1993
Main classification: A61K39
IPC codes: A61K38