USE OF K-252A DERIVATIVE FOR THE TREATMENT OF PERIPHERAL OR CENTRAL NERVE DISORDERS, AND CYTOKINE OVERPRODUCTION

Abstract: Disclosed herein are therapeutic methodologies utilizing a ring substituted derivative of the indolocarbazole K252a, the derivative represented by the formula (A). The compound is useful for treating peripheral neuropathies, central neuronal degeneration and cytokine overproduction. Typical diseases related to the above are peripheral neuropathy, Alzheimer's disease, Parkinson's disease and autoimmune and allergic conditions.

Description: USE OF K-252A DERIVATIVE FOR THE TREATMENT OF PERIPHERAL OR CENTRAL NERVE DISORDERS. AND CYTOKINE OVERPRODUCTION Field of the Invention The invention relates to a πng-substituted derivative of K-252a for use in methods directed to ameliorating the deleterious effects of a variety of diseases, disorders and conditions. Background of the Invention I. The Indolocarbazole )<-2S2a K-252a is a compound having an indolocarbazole skeleton [Japanese Published Unexamined Patent Application No. 41489/85 (US No. 4555402)] with the stereochemistry shown in Formula I . I It has been reported thεt K-252a strongly inhibits protein kinase C (PKC) which plays a central role in regulating cell functions, and has various activities such as the action of inhibiting smooth muscle contraction (Jpn. J. Pharmacol. 43 (suppl.): 284. 1987), the action of inhibiting serotonin secretion (Biochem E iophys Res. Comrnun., 144: 35, 1987), the action of inhibiting elongation of neuraxonc (J. Neiiroscience, 8: 715, 1988), the action of inhibiting histamine release (Allergy, 43 100, 1988), the action of inhibiting smooth muscle MLCK (J. Biol. Chem., 263 6215, 1988), anti-ώfJarnmatory action (Acta Physiol. Hung., 80: 423, 1992), and the activity of cell survival (J. Neurochcmistry, 64: 1502, 1995). It has also been disclosed in Experimental Cell Research, 193: 175-182, 1991 , that K-252a has the activity of inhibiting IL-2 production. In addition, it has been reported that derivatives of K-252a have PKC inhibitory activity, the acUvtty of inhibiting histamine release (Japanese Published Unexamined Patent Application No. 295588/88), antitumor activity Japanese Published Unexamined Patent Application No. 168689/89 (US 4,877,776), WO 88/07045 (US 4,923,986), WO 94/04541], the action of increasing blood platelets [WOϊ'4/06799 (EP 630898A)], vasodepressor activity (Japanese Published Unexamined Patent Application No. 120388/87), the action of accelerating cholinergic neuron functions [WO 94/0248 * (US 5,461,146 and US 5,621,100)] and, curative effect on prostate cancer [WO 94/27982 (US 5,516,771)]. Selected amino-contauung tπndeπe compounds have been prepared by Beckmaitn rearrangement of the corresponding staurospoπne oximes (WO 97/05140) The indolocarbazolcs are generally lypophilic Because of this feature, the indolocarbazoles are able to cress biological membranes with relative ease, compared to proteins. Also, indolocarbazoles generally have longer in vivo half lives than proteins In addition to K-252a itself, various derivatives of K-252a have been synthesized and tested for biological activity. Among the K-252a derivatives shown to have biological activity is a compound disclosed in Lewis ei. al., U.S. Patent Nos. 5,461,146. and 5,621.100. and PCT Pubhcation WO 94/02488, and designated therein as "Compound 11-51 " Compound II-51 has been shown to enhance the function of cholinergic neurons, striatal neurons, and sensory neurons II. Neurodegenerative Diseases and Disorders Parkinson's disease is a neurodegenerative disorder that involves progressive and selective loss of doparninergic neurons of the rugro-stnatal pathway (Agid, Lancet; 337 1991) Administration of l-methyl-4-phenyl-l,2,3,6-ιetrahydropyπdine (MPTP) to mice leads to doparninergic neuron degeneration and serves as an animal model for the doparninergic neuronal loss and behavioral deficits observed in Parkinson's disease. Peripheral administration of MPTP leads to a highly selective degeneration of the nigrostriatal doparninergic neuronal system in humans, monkeys and mice (Huikkila et al.. Science 224; 1451-1453, 1984; Bums et al , Proc. Natl Acad. Set USA 80:4546-4550, 1983). ■ I - Neurodegeneration in the MPTP mouse model has been well-charactenzed. Systemic administration of MPTP produces selective loss of dopaπune content (and metabolites), tyrosine hydroxylase activity, and dopaπiine uptake sites in doparninergic neurons of the murine striatum (Heikkila et al„ Nature 311:467-469, 1984a,b; Tipton et al., J. Neurochem. 61:1191-1206, 1993). This effect is dose-dependent. Maximal loss occurs between 3 and 7 days post-lesion (Jackson- Lewis et al., Neurodegeneration 4:257-269, 1995) ' , The doparninergic cell bodies in the nigra are less sensitive to MPTP toxicity than their corresponding nerve terminals. At high MPTP doses, or multiple MPTP injections, subs-aπtial loss of TH immunopositive cells in the substantia nigra occurs within a week (Heikkila st al., Science 224; 1451-1453, 1984; Jackson-Lewis et al.. Neurodegeneration 4:257-269, 1995). At lower MPTP doses, or with a single injection, loss of mgral tyrosine hydroxylase positive cells occurs later (Tatton et al., J- Neiiroscience. Res 30:666- 672, 1991). Thus, at lower dosss of MPTP and a short-time period after lesion, striatal damage can be observed in the absence of nigral tyrosine hydroxylasc-positive cell loss This neurodegenerative sequence is similar to that observed in the disease. The MPTP mouse model is a recognized and widely used model for the study of Parkinson's disease. Non-choliπergic neurons that use γ-aπunobutyric acid (GABA) as a neurotxansmittcr (i.e., GABA-ergic neurons) are widespread throughout the brain. For example, they are found in the nucleus basalis magnocellularis in the rodent (the equivalent region in the human brain is called nucleus basalis of Meynert), a legion of the basal forcbrain important in attention and memory functions. Damage to GABA-c rgic neurons in the basal forebrain may also contribute to behavioral deficits in neurodegenerative diseases such as Alzheimer's disease (Dekker et al , Neurosci. and Biobehav. Rev. , 15:299-317, 1991; Gallagher et al., Seminars in Neuroscwnce, 6:351-358, 1994: Torres et al , Neurosaence, 63:95-122, 1994). Neurons in the basal forebrain die in several diseases of the central nervous system, notably Alzheimer's disease (Arendt et al., Actα Neuropathol. (Berl.) 61:101-108, 1983; Iraαzoz et &\ , Neurosaence, 41:33-40. 1 ( >91; Vogels et al., Neurobiol. Aging, 1 1 :3-13, 1990). A contributing factor in such neu onal cell death is glutamate excitotoxicity, i.e. over-stimulation of neurons by excess glutamate (Choi, Neuron, 1:623-634, 1988) Accordingly, several animal models of Alzheimer's disease use glutamate or a glutamate analog to produce excitotoxic death in the region of the basal forebrain where neuron death occurs, i.e.. the nucleus basalis magnocellularis (Wenk, Beh. train Res.. 72.17-24, 1996). Neuronal pathology in Alzheimer's disease is first seen in the cntorhinal cortex, and loss of neurons in this region becomes severe as the disease progresses (Braak et al., Acta Neuropathol. 82:239-259, 19S 1; Hyman et al.. Ann. Neurol. 20:472-181, 1986) Neurons in layer 2 of the entorhinaJ cortex project to the dentate gyms of the hippocampus, and this neuronal pathway plays an important role in memory formation (Lcvisohn et al., Brain Res. 564:230-244. 1991; 01ton et al., J3rσι« Λej 139.295-308, 1978; Steward et al., Bratn Res. Bull. 2:41-48, 1977) Neurons in layer 2 of the entorhinal cortex, like many other neurons in the cerebral cortex, use glutamate as a neurotransmitter (Mattson et al.. Neuron 1 :865-876, 1988; White et al., Nature 270:356-357, 1977). Thus, los:; of glutamatergic neurons in the entorhinal cortex contributes to the behavioral deficits seen in Alzheimer's disease and other neurological disorders. III. Peripheral Neuropathy Peripheral neuropathy generally refers to a disorder that affects the peripheral nerves, most often manifested as one or a combination of motor, sensory, sensonmotor. or autonomic neural dysfunction. The wide variety of morphologies exhibited by peripheral neuropathies can each be uniquely attributed to an equally wide variety of causes For instance, pcnpheral neuropathies can be genetically acquired, can res lit from a systemic disease, or can be induced by a toxic agent. Some toxic agents that cause m urotoxicities arc therapeutic drugs, antincoplastic agents, contaminants in foods or medic inals, and environmental and industrial pollutants. In particular, chemotherapeutic agents known to cause sensory and/or motor neuropathies include vincristine, an antineop astic drug used to treat haematological malignancies and sarcomas. The ncurotoxicity is dose-related, and exhibits as reduced intestinal motihty and pcnpheral neuropathy, expeciaJly in the distal muscles of the hands and feet, postural hypotension, and atony of the urinary bladder. Similar problems have been documented with taxol and cisplatin (Mollman, 1990, New Eng. Jour. Med 322: 126-127), although cisplatin-related neurotoxicity can be alleviated with nerve growth faΛor ( ΝGF) (Apfel, et al., 1992, Annals of Neurology 31 76-80) Although the neurotoxicity is sometimes reversible after removal of the ncurotoxic agent, recovery can be a very slow process ( Lcgha, 1986, Medical Toxicology 1.421-427; Olesen, et al , 1991, Drug Safety 6:302-314) There are a number of inherited peripheral neuropathies, including: Rcfsum's disease, A- betallpoproteinemia. Tangier disease, Krabbc's disease, Metachromatic leukodystrophy, Fabry ' s disease, Dejenne-Sottas syndrome, and others Of all the inherited neuropathies, the most common by far is Charcot-Marie-Tooth disease {see also, U S Patent No. 5,420,112 for additional information on peripheral neuropathies). IV. Cytokines Tumor necrosis factor α (TNF-α) and intcrleukin-lβ (IL-lβ) are polypeptides known to be involved in a number of inflammatory and metabohc processes tn vivo . For a review which relates the role of TNF-α in inflammatory diseases , including septic shock, see Ann. Rev. Immunol.7:625 (1980) , and Clnical Trials Jor the Treatment of Sepsis, Sibbald, W. J. and Vincent, J.-L (Eds.), Springer- Verlag Berlin Heidelberg 1995 It is generally accepted that the overproduction or inappropriate production of TNF-α is involved in several pathological conditions, including septic shock (Spooner et al., Clinical Immunology and Immunopathology, 62:ρ. SI 1 (1992)) and vanous other allergic and inflammatory conditions or diseases, including but not limited to rheumatoid arthri'is. ostcoarthπtis, asthma, bronchitis, chrome obstructive airway disease, psoriasis, allergic rhiniiis, dermatitis, and inflammatory bowel disease, and other autoimmune diseases. Immuno '. Res 10.122 (1991), Science 229:896 (1985) and Proc. Natl. Acad Set 89:7375 (1992). Summary of the Invention Generally, the inveαtion features methodologies for ameliorating the deleterious effects of a variety of diseases, disorders and conditions by treating a subject in need thereof with a therapeutically effective amount of Compound A More specifically, the invention features a method for treating the deleterious effects of diseases, disorders and conditiens which lead to or cause the death of, or lead to or cause inhibition of the function of, certain neurons by enhancing die function or survival of a doparninergic, GAB A-ergic, or glutamatcrgic neuron in a mammal, comprising the step of contacting the neuron with Compound A Typically, the mammal in which the neuron is found is a human. Typically, the doparninergic, GABA-ergic , or glutamatergic neuron contacted with Compound A has impaired function, or is at risk of dying, because of a neurodegenerative disease. Typically, the neurodegenerative disease is P.-rkinson's disease or Alzheimer's disease More specifically, the nvenuon also features a method of reducing a peripheral neuropathy comprising administering to a mammal a neuropathy-reducing amount of Compound A While it has been reported that the indolocarbazole compound K-252a reduces the lethality resulting from endotoxin administration, this ability has been ascribed to the ability of K-252a to inhibit protein kinases, especialy protein lάnase C (Inaba et al., Jpn J Surg 23:234 (1993). It has unexpectedly been found that Compound A, which has little or no inhibitory activity against PKC, provides surprisingly good activity as an inhibitor of TNF-α production and production of the cytokine LT_,-1|V Therefore, and with further specificity, the invention also features a method of inhibiting production of TNF-α and IL-lβ in a mammal and a method of treating or alleviating inflarnrna ory conditions or diseases, including but not limited to septic shock, rheumatoid arthritis, ostroarthntis, asthma, bronchitis, chronic obstructive airway disease. psoriasis, allergic rhinitis, dermititis, and inflammatory bowel disease and other autoimmune diseases, which method compri: es administering to said mammal an effective amount of Compound A and pharmaceutically acceptable salts thereof in combination with a pharmaceutically acceptable earner. As used herein, "Compound A" means the compound whose chemical structure is shown below CHsCHzSCHz Compound A is also referred tci as Compound II-51 ( Lewis et al., U.S . Patent Nos 5,461, 146 and 5,621 , 100; WO 94/02488). As used herein, "ameliorate" and "ameliorating" mean to therapeutically improve and/or therapeutically reduce and/or to make more therapeutically tolerable. As used herein, "deleterious" means damaging and/or haπnful and/or negative As used herein, this word "overproduction" when used to modify TNF-α and IL-lβ means production of TNF-α and/or IL-lβ leading to deleterious conditions such as, for example, septic shock, allergic conditions, mflamrnatory conditions, etc As used herein, the terms "inhibit" or "inhibiting" means that the presence of Compound A has a comparative ly greater effect on reducing and/or prohibiting and/or preventing the production of a material contacted with Compound A than a comparative material not contacted with Compound A. As used herein, the terms "enhance" or "enhancing" when used to modify the terms "function" or "survival" means that the presence of Compound A has a comparatively greater effect on the function and/or suivival of the specified neuron than a comparative neuron not presented with Compound A. For example, and not by way ot limitation, with respect to the survival of, e.g., a doparninergic neuron, Compound A would evidence enhancement of the function of a doparninergic neuronal population at nsk of dying (due to, e.g., injury, a disease condition, a degenerative condition or natural progression) when compared to a doparninergic neuronal population not presented with Compound A_ if the treated population has a comparatively greater period of functionality than the non-treated population. As used herein, "dcpamiπergic neuron" means a neuron that uses dopaπune as a neurotransrnittcr. As used herein, "GAB A-ergic neuron" means a neuron that uses γ-armnobutyπc acid as a neurotransmitter As used herein, "glutamatcrgic neuron" means a neuron that uses glutamate as a neurotransmitter. As used herein, "nbm" means nucleus basalis magnocellularis Unless otherwise d .fined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the an to which this invention pertains. Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention, the preferred methods and materials are described below. All publications, patent applications, patents, and other references mentioned herein are incorporated by refeience in their entirety. In case of conflict, the present document, including definitions, will contiol Unless otherwise indicated, mateπals, methods, and examples descπbed herein arc illustrative only and not intended to be limiting. Various features and advantages of the invention will be apparent from the following detailed description and from the claims. Brief Description of the Drawings Fig. 1 is a graph of data demonstrating that Compound A is not a monoaπunc oxidase- A inhibitor. The IC S0 of Clorgyline was 21 nm. Upright triangles. Clorgyline; inverted triangles, Compound A; squares, L-depreuyl. Fig. 2 is a graph of data demonstrating that Compound A is not a mσnoamine oxidasc- B inhibitor The IC 50 of Clorgyline was 21 nm Upright triangles, Clorgyline: inverted triangles. Compound A; squares, L-dcpreiyl. Fig. 3 is a bar graph showing that animals receiving Compound A (Light bars) had significantly more Fluoro-Gold- labeled neurons in the rostral portion of the lesioned nbm (over 400 μm from the midpoint of the lesion), compared to lesioned animals receiving vehicle only (dark bars). *=P<0.05 by Newrnan-Kculs test. Fig. 4 is a bar graph showing the total number of errors committed in the T-maze rewarded alternation task by normal control animals, sham surgery animals, surgically-lesioned animals receiving vehicle only ("Les") and surgically-lesioned animals receiving Compound A at a dose of 0.1 mg/kg q.o.d ("0.1"). Numbers of animals in each group are shown in parentheses. *=P<0.05 compared to Sham,ll|=»P<0.01 compared to Les, by Ncwman-Keuls tests. Fig. 5 shows the effect of Compound A on acrylamide-induced peripheral neuropathy. Detailed Description Generally, the invention features methodologies for ameliorating the deleterious effects of a variety of diseases, disorders and conditions by treating a subject in need thereof with a therapeutically effective amour t of Compound A This invention pro •'ides a method for treating the deleterious effects of diseases. disorders and conditions which negatively affect the function and/or survival of neurons at nsk of dying due to such diseases and disorders by enhancing the function or survival of specific types of neurons of the marnmalian ceroral nervous system. More particularly, the invention provides a method for enhancing the fund ion or survival of doparninergic neurons, GAB A-ergic neurons, and glutamatergic neurons in a mammal by administering to the mammal Compound A, a ring- substituted K-252a derivative <with the following chemical structure. Compound A Doparninergic neurons, GABA-ergic neurons, and glutamatcrgic neurons are widespread in the mammalian central nervous system Each of these three neuronal ceil types suffers impaired function, or even death, in one or more neurodegenerative diseases of the central nervous system. Parkinson's disease involves progressive loss of doparninergic neurons of the nigrostriatal pathway. Alzheimer's disease involves the death of various types of neurons. including GABA-ergic neurons in the nucleus basalis of Meynert of the basal forebrain Alzheimer's disease also involves death of glutamatergic neurons in the entorhinal cortex One method of treating Parkinson's disease or Alzheimer's disease is to administer a compound that enhances the function or survival of doparninergic neurons. GABA-ergic neurons, or glutamatcrgic neurons. Compound A is pharmacologically active in biological assays and in vivo models for enhanced function or survival of doparninergic neurons, GABA-ergic neurons, and glutamatcrgic neurons. Therefore, the present invention has utility for treating Parkinson's disease or Alzheimer's disease. The invention, however, is not limited to the treatment of those diseases The use of Compound A to enr ance the function or survival of doparninergic neurons, GABA-ergic neurons, or glutamatergic neurons whose impaired function or risk of dying results from causes other than Parkinson's disease or Alzheimer's disease is also within the scope of the present invention. This invention also features a method of reducing a peripheral neuropathy. The method involves administering a neuropathy-reducing amount of Compound A to a mammal. In various preferred embodiments, the mammal is a human, or an agriculturcal or domestic mammal that develops a neuropathy, e.g , as a result of treatment of a neoplasm with a chemotherapeutic agent Compound A can be administered in a manner deemed effective by one skilled in the art; a preferred mode of administration is subcutaneous injection. As used herein, "penph.ral neuropathy" refers to a disorder affecting a segment of the peripheral nervous system The invention involves using Compound A to reduce a neurotoxicity. including, but not limited to, distal sensorimotor neuropathy, or autonomic neuropathies such as reduced motility of the gastrointestinal tract or atony of the uπnary bladder. Preferred neuropathies hat can be effectively treated with Compound A include neuropathies associated with systemic disease, e.g., post-polio syndrome, genetically acquired neuropathies, e.g., Charcot-Maiie-Tooth disease: and neuropathies caused by a toxic agent, e.g., acrylamide, or a chemotherapeutic agent, e.g., vincnsune. Where Compound A is used to treat a neuropathy induced by a toxic agent, it can be administered before, sunultanecusly with, or after exposure to the toxic agent, or before, dunng or after adrrunistration of a chemoiJierapeutic. Preferably. Compound A and the chemotherapeutic agent are each administered at effective time intervals, during an overlapping period of treatment. Compound A can be administered to the mammal following exposure to the neurotoxic agent, or following chemotherapy, to restore at least a portion of the neurofunction destroyed by the neurotoxic agent or chemotherapeutic. The chemotherapeutic can be any chemotherapeutic agent that causes neurotoxicity, such as vincristine, taxol, dideoxyinosinc, or cisplatin. By "toxic agent" or "neurotoxic agent," is meant a substance that through its chemical action injures, impairs, or inhibits the activity of a component of the nervous system The list of neurotoxic agents that cause neuropathies is lengthy, and includes, but is not limited to. neoplastic agents such as vincristine, vtnblastine, cisplatin, taxol, or dideoxy-compounds, e.g., dideoxyinosine. alcohol; metals; industrial toxins involved in occupational or environmental exposure; contarninants of fboc or medicinals; or over-doses of vitamins or therapeutic drugs, e.g.. antibiotics such as penicillan oi chloramphenicol, or megadoses of vitamins A. D, or B6 An extensive, although not complee, list of chemical compounds with neurotoxic side-effects is found in Table 1. Although this list p rovides examples of neurotoxic compounds, it is intended to exemplify, not limit, the scope 3f the invention. Other toxic agents can cause neuropathies, and can be characterized by methods known to one skilled in the art. By "exposure to a toxic agent" is meant that the toxic agent is nude available to, or comes into contact with, a mamrnal of the invention. Exposure to a toxic agent can occur by direct adrninistrauon, e.g., by iπgcstion or administration of a food, medicinal, or therapeutic agent, e.g., a chemotherapeutic agent, by accidental contamination, or by environmental exposure, e.g., aerial or aqueous exposure. Despite the widely disparate morphologies and causes attributed to peripheral neuropathies in vivo, applicants have hypothesized that Compound A can be an effecuve means of preventing or treating such neuropathies in a mammal. TABLE 1 AGENTS THAT CAUSE PERIPHERAL NEUROPATHY Compound A has also been demonstrated to inhibit production of the cytokiπe TNF-α, despite having little or no inhibi Jory activity against PKC Compound A also inhibits the production of the cvtokinc IL-1|J The production of TNF-α is associated with a variety of diseases and disorders such that the inhibition thereof via use of Compound A can beneficially provide value to a subject in nc<:d of such inhibition of TNF-α production. Accordingly, Compound A can also be utilized to inhibit production of TNF-α in a mammal and/or a method of treating or alleviating inflammatory conditions or disease, including but not limited to septic shock, heumatoid arthritis, ostcoarthritis, asthma, bronchitis, chronic obstructive airway disease, psonasis, allergic rhinitis, dermatitis, and inflammatory bowel disease, and other autoimmune diseases which method compnses administering to said mammal a therapeutically effective amoun : of Compound A For use in the present invention, Compound A can be formulated into a pharmaceutical composition by admixture with pharmaceutically acceptable nontoxic excipients and carriers Such a composition can be prepared for administration by any of various routes. Routes of administration and pi eferred dosage forms include the following, parenteral, preferably in the form of liquid solutions or suspensions: oral, preferably in the form of tablets or capsules, lπtranasal, preferably particularly in the form of powders, nasal drops, or aerosols; and dermal. via, for example, trans-dermal patches. Composition A can be conveniently administered in unit dosage form and may be prepared by any of the methods well known in the pharmaceutical art, for example, as described in Remington's Pharmaceutical Sciences (Mack Pub Co , Easton, PA. 1980), Formulations for parenteral administration may contain as common excipients sterile water or saline, polyalkylene glycols such as polyethylene gl ycol, oils and vegetable origin, hydrogenated naphthalenes and the like In particular, biocompatihle, biodegradable lactide polymer, lactide/glycolide copolymer, or polyoxyethylenc-polyoxypropylene copolymers may be useful excipients to control the release of the active compounds. Other potentially useful parenteral delivery systems for Compound A include ethylene-vinyl acetate copolymer particles, osmotic pumps, implantable infusion systems, and liposomes. Formulations for inhalation adrrumstration contain as excipients, for example, lactose, or may be aqueous sol itions containing, for example, lactose, or may be aqueous solutions containing, for example, polyo <ycthyleπe~9-lauryl ether, glycocholate and deoxycholate. or oily solutions for administration in the form of nasal drops, or as a gel to be applied intranasally. Formulations for parenteral administration may also include glycochσlate for buccal administration, a salicylate for lectal administration, or citric acid for vaginal administration. Formulations for trans-dermal patches are preferably lipophilic emulsions. Compound A can be employed as the sole active ingredient in a pharmaceutical composition. Alternatively, it can be used in combination with other active ingredients, e.g., growth factors that facilitate neironal survival or axonal regeneration in diseases or disorders. The concentration of Compound A used in the practice of this invention in a therapeutic composition can vaiy. The concentration will depend upon factors such as the total dosage of me drug to be administered and the route of administration. Compound A typically would be provided in an aqueoi s physiological buffer solution containing about 0.1 to 10% w/v for parenteral adrninistration. Typ cal dose ranges are from about 1 μg/kg to about I g/kg of body weight per day; a preferred do»: range is from about 0.01 mg/kg to 100 mg/kg of body weight per day. A preferred dosage of Compound A to be administered is likely to depend on variables such as the type and extent of progression of the disease or disorder, the overall health status of the particular patient, the relative efficacy of Compound A for the particular disease or disorder treated the particular formulation used, and its route of administration. Compound A for use in the present invention is preferably obtained according to the methods described in Lewis et al., U.S. Patent No. 5,461,146. The present invent on will be further illustrated by the following examples. These examples are not to be construed as limiting the scope of the invention, nor the scope of the claims appended hereto EXAMPLES Example 1 Pharmacological Activity on Doparninergic Neurons Experiments were conducted using Compound A in MPTP -lesioned doparninergic neurons in mice (MPTP mouse model). A single s.c. dose of MPTP (20 mg/kg) provided to C57 black mice produced approximately 60% loss of striatal tyrosine hydroxylase activity. Administration of Compound A, at daily doses ranging from 0.01 to 10 mg/kg (s.c), to such MPTP-treated mice reduced the loss of striatal tyrosine hydroxylase activity. These data are shown in Table 2. Table 2 Striatal Tyrosine Hydroxylase (TH) Activity in Low-Dose MPTP-Treated Mice" * Average of three dose - response experiments. Mice were treated with MPTP (20 mg/kg; s.c.) 4-6 hrs after the first Compound A injection. Compound A was then injected every day until the end of the experiment, which was 7 days in duration. Striata were .issessed for tyrosine hydroxylase enzyme activity. Asterisk indicates statistically significanr. difference (p < 0.05) from MPTP- Vehicle treated animals. In a separate experiment, the activities of Compound A were assessed in a high dose MPTP-mouse model A single 40 mg/kg injection of MPTP produced a 95% depletion in stnatal tyrosine hydroxylase enzyme activity 7 days post-injection. Adrninistration of Compound A at daily doses of between 0.03 and 3.0 mg/kg reduced the magnitude of the lesion, in a dose dependent manner These data are shown in Table 3. Table 3 Striatal Tyrosine Hydroxylase (TH) Activity in High-Dose MPTP-Treated Mice" • Data are from a single experiment. Mice were treated with MPTP (40 mg/kg, s c.) 4-6 hrs after the first Compound A injection Compound A was then injected every day until the end of the experiment which was 7 days in duration. Striata were assessed for tyτosine hydroxylase enzyme activity. Asterisk indicates statistically significant difference (p < 0.05) from MPTP -Vehicle treated animals MPTP-mediated dspaminergic toxicity is dependent on MAO mediated conversion of MPTP to MPP + (l-mcthyl-4-plιenylpyridinium ion) and uptake of MPP + into doptiminergic neurons. Compounds found to be active in the MPTP-mouse model should be determined not to be inhibitors of MAO or dopamine uptake. Compound A has been found not to inhibit monoaminc oxidase A or B in vitro (Figure; 1 and 2) or block uptake of catecholaπunes into nerve endings, indicating that this compound daes not prevent the metabolic conversion of MPTP to MPP + or inhibit the active uptake of MP1' 4 into doparninergic neurons. These data demonstrating efficacy of Compound A in the MPTP-mouse doparninergic lesion model indicate utility of Compound A in the treatment of neurodegenerative disorders such as Parkinson's disease. Example 2 Pharmacological Activity on GABA-ergic Neurons Compound A was lested for its ability to prevent depletion (e.g., enhance the survival) of GABA-ergic neurons in the nucleus basalis magnocellularis, using the well-established ibotemc acid lesion model. Ibotenic acid, an excitotoxin, is known to reduce numbers of GAB A-cxprcssiπg neurons in the nbm region (Linciefors et al., Neurosci. Lett., 135:262-264, 1992: Shaugnessy et al., Brain Res., 637:15-26, 1994). Adult male Sprague-Dawley rats received injections of ibotenic acid (5.0 g) into the nbm unilaterally. The rats wen: then dosed with Compound A (0.03 mg/kg) via subcutaneous injection beginning 18 hours afier the lesion, and continuing q.o.d. until 18 days post-lesion. Tissue sections were then collected throughout the rostral-caudal extent of the nbm, and processed to detect glutamic acid decarboxylase. an enzyme required for biosynthesis of GABA. The numbers of neurons expressing glutamic acid decarboxylase were then counted throughout the rostral-caudal extent of the nucleus basalis magnocellularis, in a region where glutamic acid decarboxylase-cxpressing neurons of the nbm are easily distinguished from glutamic acid decarboxylasc-cxpressing neurons in adjacent structures (white matter medial and ventral to the globus pallidus). The results were expressed as percent glutamic acid decarboxylase-expressing neurons on the lesioned side relative to the number on the opposite, unlesioned side. The results were also calculated separately for the rostral nbm, mid-nbm. and caudal nbm. A mean of 78 (± 15 s.u.m.) percent glutamic acid decarboxylase neurons were counted in the rostral nbm of animals receiving Compound A, compared to 34 (± 19 s.e.m.) percent in animals receiving vehicle only, a statistically significant difference by t test (p < 0.05). No *7 statistically significant differences between Compound A-treated animals and vehicle-only (control) animals were seen in mid-nbm or caudal nbm. These results demonstrate that Compound A can protect against a GABA-ergic neuron loss that results from an excitotoxic lesion, and thus has a neurotrophic effect on that neuronal population. Example 3 Pharmacological Activity on nbm Neurons To test directly the ability of Compound A to prevent excitotoxic neuron death, nbm neurons in adult male Sprague- Dawley rats were first labeled with a long-lasting marker. This was done by injecting Fluoro-Gold (FG), a neuronal tracer that is taken up by nerve terminals and transported back to the cell body (Book et al., J. Neuropath. Exp. Neurology, 53.95-102. 1994), into target regions of nbm neurons in the frontal and parietal cortex. 7-10 days later the animals received lesions of the nbm unilaterally, using 5 ug of ibotenic acid. Beginning 18 hours after this lesion, the animals received Compound A (0.03mg/kg) via subcutaneous injection, every other day until 18 days post-lesion. Tissu: sections were collected throughout the entire rostral-caudal extent of the nbm on both sides of the brain, and numbers of nbm neurons with the FG label were counted. The counts were cαrπictcd for size differences using standard procedures, and the results expressed as the percent of labeled neurons in the- nbm on the lesioned side of each animal relative to the number of labeled neurots in the nbm on the opposite unlesioned side of the brain. Animals receiving compound A had significantly more FG-labclcd neurons in the rostral portion of the lesioned nbm (over 400 μm from the mid-point of the lesion), compared to lesioned animals receiving vehicle only (Figure 3). At mid-icsion and caudal to the lesion Compound A had a declining eifect . These results demenstrate directly that Compound A can prevent the loss of pre- labeled neurons in the nbm that results from excitotoxic damage. lib - Example 4 Lone-Lasting Functional Improvement Upon Short Term Dosing with Compound A Adult male Spraguc-Dawlcy rats were first trained to alternate responses in a standard rewarded-altemation T-maze task (Hepler et al., J. Neurosci.. 5:866-873, 1985). The animals then received bilateral lesions of the nucleus basalis magnocellularis, to impair performance in T-maze tasks (e.g., Salamone et al., Behav. Brain Res., 13:63-70, 1984). Beginning 18 hours after the lesion, the animals received Compound A via subcutaneous injection (0.1 mg/kg) every other day until 12 days post-lesion. Twenty-four hours following the last injection all animals were placed in the T-maze once a day, until thdr alternation performance reached pre-opcrative levels, which took anywhere from 3 to 10 days. After reaching criterion, the animals were not further tested for 8-10 weeks. At that point the animals were again placed in the T-maze, once a day until they reached pre-operative performance. The total number of errors the animals committed during this test is shown in Figure 4. The lesionei animals receiving vehicle only committed significantly more errors than either unoperated ncrmals or sham-operates, while lesioned animals that received Compound A 10-12 weeks previously were not different from normals. These results demonstrate that Compound A produces a chronic improvement in a behavior reflective of an improvement in attention or memory several months after dosing has ceased. Example 5 Efficiency of Compound A in Entorhinal Cortex Lesion Model Glutamate-contairυng neurons in layer 2 of the entorhinal cortex project to the molecular layer of the dentate gyms, where they form synapses on the dendπtes of the dentate gyrus granule cells A lesion cirn be created in layer 2 of entorhinal cortex by stereotaxic injection of the excitotoxin N-methyl-D-;ιspartatc (NMDAJ). Under sodium pentobarbital anesthesia, rats received an injection of NMD A (15 nmols/sitc) at each of 2 sites in the entorhinal cortex Two i' weeks later, the rats were sacriiiced and perfusedilwith a 50 mM sodium sulfide solution. The brains were removed, sectioned In the horizontal plane at a thickness of 40 μm, and stained with either Cresvl violet or Timm's ;;tain. The survival of neurons in layer 2 of entorhinal cortex was *9 assessed in Cresyl violet stained sections, while the integrity of their axon terminals in the molecular layer of the dentate gyms was measured in alternate sections stained with Timm's stain. Injection of NMD/., destroyed 62 ± ll;l% (s.e.m.) of entorhinal layer 2 and decreased reduced the loss of entorhinal layer 2 neurons to Ϊ2 ± 10% (s.e.m.)(p < 0 05, 't' test) and prevented the decrease in area of the middle molecular layer (p < 0.05. T test). Thus, Compound A protected neurons in the entorhinal cortex from an excitotoxic lesion and maintained the mtegrity of their axon terminals in the dentate gyms. These data demonstrate the efficacy of Compound A in protecting glutamatergic neurons of the entorhinal cortey Lesions of entorhinal cortex in animal models have been shown to produce memory deficits, anil severe degeneration of these neurons occurs in Alzheimer's F disease. This supports the position that Compound A is useful in treating neurological disorders that involve loss of or damage lo glutamatergic neurons and neurons of the cerebral cortex, including but not limited to Alzheimer's disease, (stroke and head trauma. Example 6 Effect of Compound A on Acrylamide-lnduced Peripheral Neuropathy s Acrylamide produces s "dying back" central-peripheral distal neuropathy ui humans and animals. The lesion is a mixed sensory/motor neuropathy characterized by weakness, tremor and ataxia in humans. In animals, lcrylarrude produces changes in behavior (sensory, motor and proprioceptive), histopatholog) , ekctrophysiolotiy and weight loss. In the periphery, large diameter, long axon, AA fibers are preferenually affected by acrylamide. In rats, acrylamide administration produces an axcuiopathy as measured by increased landing foot spread (LFS), a measure of proprioccption. | Acrylamide-induced neuropathy is a model of chemically induced toxicity. It differs from other chemically-induced mode Is (such as chemαtherapeutic models) in that the duration is relatively short (3 weeks) and the animals are in (relatively good health. Acrylamide does not produce gross systemic toxicity. -10 Male Sprague-Dawley rats weighing 2S0|grams at the start of the experiment were used. Acrylamide (50 mg/kg, IP) was administered three times/week for three weeks. The animals were dropped from a height of 30 cπ and the distance between the hindfcet was recorded (Edwards, P.M. and Parker, V.H. (1977) "A simple, sensitive, and objective method for early assessment of acrylamide neuropathy in rats ' Toxicol Appl Phhrmacol, 40:589-591) Compound A (0.1 , 0.3 or 1 0 mg/kg, s.c. ui 5% solutol) v/as administered once daily for the duration of the experiment Acrylaπude-treatcd animals had larger distances in the LFS than the vehicle treated animals. Compound A (0.3 mg/kg/day) reduced the magnitude of the increase in LFS produced by acrylamide (Figure 5). I These data indicate that Compound A is useful for the treatment of pcnpheral neuropathies. Example 7 Failure of Compound A to Inhibit Protein! Kinase C, In Vitro The protein kinase C assay and the inhibition of protein kinase C by K-252a is disclosed in US Patent 4,923,986 and Kase, H. ct.al., (cds.) Japan Scientific Societies Press, Tokyo, pp 293- 296, (1988) By means of an essentially similar assay, it was found that K-252a inhibits protein kinase C with an IC 50 of 0.028 μM while the IC 5 o of Compound A is 16.0 μM, i.e., 570 fold less active. Compound A has an 1C 50 of 139 nM, asian inhibitor of the production of TNF-ot, and an ICJ O value of 261nM as an inhibitor of the production of IL-lβ, concentrations at which Compound A is inactive as an inhibitor of protein kinase C. Example 8 In Vitro Inhibition of TNI -α and TT ^ lB Production by Compound A I I The ability of Compound A to inhibit the 1 induction of TNF-α was demonstrated by use of a standard in vitro pharmacological testing procedure as described below. ι Stock solutions consisting of 4 inM Compound A. in 100% DMSO, were stored at 4°C Cell culture medium RPMI 1640 (Media Tech, Hemdon, Va) and fetal bovine serum (Hyclone. Logan, UT) comprised the test medium Lipopolysaccharide (LPS) (Sigma. St. Louis, MO) from E coh scrotype 0111 :B4, extracted wi Ji tnchloroacctic acid, was used. Stock solutions of LPS were prepared and stored at 4°C in phosphate-buffered Isaline (PBS). ELISA kits for assaying tumor necrosis factor alpha CTNF-α) iind IL-lβ were purchased from Boehringer-Mannheim, (Indianapolis, IN) and were used according to the (manufacturer's instructions. THP-1 cells, a human monocyte-deπved cell hie, was obtained from the American Type Culture Collection (ATCC TIB 202). Cells were grown in RPMI 1640 containing 10% fetal bovine scmm (medium) I in a humidified atmosphere of f % C0 2 :95% air at 37°C. Experiments were performed in 24 well culture plates (Nunc) with 5 x 0 s THP-1 cells in! 1 ml of medium. Cells were incubated with LPS at 2 ug/ml to induce TNF-α After a 3-hr incubation period, the cells and medium were centrifuged at 1,000 x g for 5 nun, and the resulting supernatant fluid was either assayed immediately for TNF-α or stoπ:d at -70°C and assayed later. Media samples were measured for I content of TNF-α and IL-lβ by Elisa assays. To test Compound A for the ability to inhibit the induction of TNF-α, cells were incubated with varying concentrations of Compound A for 1 hr prior to the addition of LPS. Compounds were diluted so that DMSO was never present in the cell culture medium at a concentration higher than 0 1% Compound A was vested and assayed! as described above for its ability to inhibit TNF- α and IL-lβ production Example 9 Inhibition of LPS-Induced TNF-α and IL-lβ in the Serum of Mice. Sixty female C57BL rriice (4-6 weeks olq) were divided into six groups, each with 10 I animals. Three groups (1,3,5) received vehicle oily (PBS containing 0 1% TEA (tetraethyl ammonium hydrochloride)), 200 μl/mouse via intrapeπtoneal (ip) administration The other three groups (2,4,6) received Compound A (30 mg/kg in 200 μl, ip) of vehicle (PBS containing 10% of the ethyl ester of 12-hydroxystι:aπc acid; solutol) Two hours later, the animals received by ip adiniriistration, 0.1 mg/kg of LPS (groups 1 & 2)[ 0.5 mg/kg of LPS (groups 3 & 4), and 1.0 mg/kg of LPS (groups 5 & 6). Two hours after LPS adrninistration, all of the animals were sacrificed, and plasma samples were obtained and assayed for their TNF-α and IL- 1 β content. Assays were carried out as desrribed in Example! 8. *2 Data arc summarized in Table 4. The numbers in ( ) are the group numbers as described above. N indicates the number of animals from which plasma measurements were made. ND = not done. j Table 4 LPS dose TNF-α (og/ml) IL-1P (pg/ml) mg/mouse, ip Vehicle CMP A Vehicle Cmp A 0.1 d) (2) ND ND 6129±676 27144448* N=10 N=10 0.5 (3) (4) ND ND 7141±1113 3766±375 # N=9 N=7 1.0 (5) (β) (5) (6) 3745±610 2399±1398 300187 S9±19" N=8 N=9 N=β N=8 Indicates statistical difference from vehicle-treefted control (p<0.05) As shown m Table 4, LPS administratioi to the mice caused the production by those mice of TNF-α, and the amount of TNF-α produced was markedly inhibited by a two hour pretreatment with Compound A Pretreatment with Compound A also markedly inhibited the production of IL- lβ, produced in response to the administration of tl.O mg/kg of LPS. Example 10 Prevention of LPS-Inducccl Death in Mice Forty mice were divided into three groups! two groups consisting of ten mice and one group of twenty mice. Adrninistrations of vehicle! i, LPS. and Compound A were iπtraperitoneal Group 1 (n=10) mice received vehicle (phosphate buffered saline for LPS, 200 μl/mouse) at time zero and vehicle for Compound A (200 μl/mouse)! 2 hours later. Group 2 (n=10) mice received the vehicle for Compound A at zero time (200 μl/moμsc) and LPS (2mg in 200 μl/mousc) two hours -12$ later. Group 3 (n=20) received Compound A (30 mg/kg in 200 μl of vehicle) at time zero and LPS (2mg in 200 μl/mouse) two hours later. . The aα^mnistration of LPS caused 90% mortality within 20 hours and 100% mortahty by 42 hours after administration. In the group of animals which received Compound A two hours I prior to receiving LPS, there was 25% mortality at 20 hours after LPS administration, 75% mortahty at 42 hours after LPS . and 80% mortality one week after LPS administration Vehicle treatments were well tolerated and caused no deaths. Those skilled in the art will appreciate that numerous changes and modificatins may be made to the preferred embodiments of the invention and that such chamges and modificatins may i be made without departing froπ ι the spirit of the invention. It is therefore intended that the appended claims cover all equivalent variations asl fall within the true spirit and scope of the invention. Documents cited throughout this patent disclosure are herebv incorporated herein by reference. - Z4 -

Claims: CLAIMS What is claimed is: 1. A method for inhibiting overproduction of tumor necrosis factor alpha in a mammal comprising the step of administering tαj a 1 mammal in need thereof a therapeutically I effective amount of Compound A, said Compound A represented by the formula: ObCHjSO-b 2. A method for ameliorating the deleterious effects of overproducdon of tumor necrosis factor alpha in a mamrial compπsing the step of administering to a mammal in need thereof a therapeutically effective amount of Compound A, said Compound A represented by the formula: α-bα-fescH- 3. A method for inhibiting overproduction of interleukin-1 beta in a mammal comprising the step of administι:ring to a mammal in need thereof a therapeutically effective amount of Compound A, said C ompouπd A represented by the formula 4 A method for ameliorating the deleterious effects of overproduction of interleukin-1 beta in a mammal comprising the step of administering to a mammal in need thereof a therapeutically effective amoun: of Compound A, said Compound A represented by the formula: 5. from the group comprising chronic obstructive bowel disease The method of claim 2 wherein (said deleterious effect is an autoimmune disease. 7. A method for ameliorating a peripheral neuropathy in a mammal comprising the step of administering to a maπunal in need thereof a therapeutically effective amount of Compound A, said Compound A represented by the formuli: 8. is caused by a toxic agent. 9. The method of claim 8 wherein Isaid toxic agent is selected from the group comprising neoplasbc agents, a cohol, metals, industrial toxins, antibiotics, food contamments and medicinal contarninents 10. The method of claim 7 wherein (said peripheral neuropathy is associated with a systemic di sease . 11. The method of claim 7 wherein fsaid peripheral neuropathy is associated with a genetically acquired neuropath) 12. A method for a meliorating the deleterious effects of Alzheimer's disease on neurons selected from the group consisting of GABA-ergic neurons and glutamatergic neurons comprising the step of administ .ring to a mamrnul in need thereof a therapeutically effective amount of Compound A, said Compound A repijesented by the formula' ChfeCH ∑ SCH; 13 A method for meliorating the ήdetcπous effects of Parkinson's disease on doparninergic neurons comprising the step of administering to a mammal in need thereof a therapeuucally effective amount of Compound A- said Compound A represented by the formula:

Inventors: AIMONE LISA D, ENGBER THOMAS M, HAUN FORREST A, KNIGHT ERNEST JR, MILLER MATTHEW S, SAPORITO MICHAEL S, AIMONE, LISA, D., ENGBER, THOMAS, M., HAUN, FORREST, A., KNIGHT, ERNEST, JR., MILLER, MATTHEW, S., SAPORITO, MICHAEL, S.
Applicants: AIMONE LISA D, CEPHALON INC, ENGBER THOMAS M, HAUN FORREST A, KNIGHT ERNEST JR, MILLER MATTHEW S, SAPORITO MICHAEL S, AIMONE, LISA, D., CEPHALON, INC., ENGBER, THOMAS, M., HAUN, FORREST, A., KNIGHT, ERNEST, JR., MILLER, MATTHEW, S., SAPORITO, MICHAEL, S.
Application year: 1997
Main classification: A61K31
IPC codes: A61K31, A61P1, A61P11, A61P17, A61P19, A61P25, A61P29, A61P43, C07D498