AGENTS FOR REDUCING CHOLESTEROL-UPTAKE AND LIQUID-UPTAKE

Abstract: beta -peptides are described as active substances suitable for the reduction of cholesterol-uptake and lipid-uptake from the gut. beta -peptides can act as inhibitors for the promoting proteins (e.g. scavenger proteins) and/or they can act as precipitants of bile salt micelles and unilamellar vesicles. In order to act as inhibitor, they need to have amphipathic character and to form a helical structure, and in order to act as precipitant, they need at least two positive charges positioned such as to allow precipitation of cholesterol and lipids comprising bile salt micelles and unilamellar vesicles in the gut.

Description: AGNETS FOR REDUCING CHOLESTEROL-UPTAKE AND LIQUID-UPTAKE Cross References to Related Applications This application claims the priority of European patent application 99 810 892.2, filed October 1, 1999, the disclosure of which is incorporated herein by reference in its entirety. Technical Field This invention relates to agents for the use in medicine, in particular for reducing uptake of choles- terol and other dietary lipids from the gut. The agents of the present invention therefore have application in hyperlipidaemia, including hypercholesterolaemia, and the management of obesity. Background Art Cholesterol, on the one hand, is an essential constituent of the plasma membrane of cells, on the other hand, in the case of high levels of blood cholesterol, deposition thereof in the wall of arteries can occur, favoring atherosclerotic plaque, myocardial infarction and stroke. In view of the high number of deaths caused by atherosclerosis in western industrialized nations, there is a great need for agents reducing the risk of such dis- eases. A large amount of cholesterol, about 1/3, in the body is of dietary origin taken up from the gut. Since cholesterol and other dietary lipids are insoluble in water and aqueous media they have to be transported therein dispersed in a stable form. Said stably dispersed form are either bile salt micelles or small unilamellar phospholipid vesicles. These lipid particles function as donors or carriers of water- insoluble dietary lipids in the lumen of the small intestine. Hitherto made efforts of reducing or inhibiting cholesterol absorption in the gut and in turn lowering cholesterol blood levels com- prise e.g. the administration of saponins as dietary supplement . (Harwood et al . , Journal of Lipid Research 34 , 377-395 (1993)). This method, however, can scarcely be applied due to problems to obtain pure saponins in sufficient quantities from natural sources. It is also already known that the absorption of cholesterol, esters of cholesterol and other dietary lipids by the brush border membrane ("BBM") of epithelial cells in the gut is protein-mediated (Turnhofer and Hau- ser, Biochemistry 29, 2142-2148 (1990); Compassi et al . , Biochemistry 34, 16473-16482 (1995); Turnhofer et al . , Biochim. Biophys . Acta. 1024, 249-262 (1990); Hauser et al., Biochemistry 37, 17843-17850 (1998)). From 097/36927 it is known that amphipathic molecules interact with the proteins involved in lipid absorption and thus inhibit lipid absorption (Boffelli et al . , FEBS Letters 411, 7-11 (1997) ) . However, there is still a need to improve the reduction in cholesterol-uptake and lipid-uptake. Disclosure of the Invention Hence, it is a general object of the invention to provide active substances and compositions comprising said substances that allow reduction of the cho- lesterol -uptake and lipid-uptake from the gut. It has now surprisingly be found that β-peptides, in particular amphipathic and/or at least two positive charges providing β-peptides are very suitable agents to reduce the cholesterol -uptake and lipid-uptake Brief description of the Drawings The invention will be better understood and objects other than those set forth above will become ap- parent when consideration is given to the following detailed description thereof. Such description makes reference to the annexed drawings, wherein: Figure 1A shows a β-peptide with precipitation effect only (TFA = trifluoroacetic acid) . Figure IB shows a β-peptide with precipitation and inhibitor effect (TFA = trifluoroacetic acid) . Figure 1C shows a β-peptide with precipitation and inhibitor effect (TFA = trifluoroacetic acid) . Figure ID shows a β-peptide with inhibitor effect only (TFA = trifluoroacetic acid) . Figure 2 shows a curve obtained according to the method described herein for a precipitant used for comparison purposes, namely polylysine with an average molecular weight of 21600; in said Figure, Cholesterol in Sup (%) means the percentage cholesterol remaining in the supernatant after centrifugation; A (500 nm) means absorption at 500 nm; Poly K (πiM) means the amount of polylysine added; the arrows indicate the theoretical concentration of precipitant at which charge neutraliza- tion occurs. Figure 3 shows the same curve as Figure 2 , but for polylysine with an average molecular weight of 2300; in said Figure, Cholesterol in Sup (%) means the percentage cholesterol remaining in the supernatant after centrifugation; A (500 nm) means absorption at 500 nm; Poly K (mM) means the amount of polylysine added; the arrows indicate the theoretical concentration of precipitant at which charge neutralization occurs. Modes for Carrying Out the Invention It could be shown, that by the use of β- peptides according to the present invention, the uptake of cholesterol, cholesterol esters and lipids may be reduced. The term lipids as it is used in the scope of the present invention does also comprise lipid-like substances . Beta-peptides suitable in the scope of the present invention comprise β-peptides (oligomers of β- amino acids) that are capable of forming helical struc- tures (usually at least about 6 residues are needed, (for further information see e.g. Guichard et al . , Helv. Chim. Acta 81, 187 (1998); Abele et al . ibid. 81, 2141 (1998); Seebach et al . Angew. Chem. Ill, 1700-1703 (1999); ibid., Int. Ed. 38, 1595 (1999)) and having amphipathic charac- ter, and β-peptides having at least two positive charges. Such β-peptides may also comprise synthetic amino acids, and they can have a chain length up to a chain length comparable to the one of a protein. It is already known that certain amphipathic, helical proteins and alpha-peptides (with a hydrophobic and a hydrophilic side) can inhibit proteins involved in cholesterol and lipid absorption (WO 97/36927) . Furthermore, WO 97/47593 proposes some β-peptides as pharmaceutically effective substances, however not for the reduc- tion of cholesterol -uptake and lipid-uptake. It has now been found that amphipathic β- peptides have a cholesterol -uptake and lipid-uptake inhibiting effect and that amphipathic and non-amphipathic β-peptides with regions comprising at least two positive charges are also suitable to act as precipitant for cholesterol and lipids comprising micelles and vesicles that have a negative surface charge. Relevant for their precipitating activity is the presence of at least two actual positive charges in suitable distance. In the scope of the present invention, it has e.g. been found that β-peptides (be it charged or uncharged β-peptides) forming helices and having amphipa- thic character are good inhibitors of the promoting proteins (scavenger receptors, see Hauser et al . , Biochemistry 37, 17843-17850 (1998) for a description of such proteins/scavenger receptors) . It has also been found that, β-peptides carrying at least two positive charges in suitable positions are suitable precipitants for cholesterol and lipid carrying bile salt micelles (further on referred to as micelles) and small unilamellar phospho- lipid vesicles (further on referred to as vesicles) . Such β-peptides carrying at least two positive charges can have non-helical structure, but preferred positively charged β-peptides are capable of forming helical structures. Thus, β-peptides can be designed acting primarily as inhibitor (see e.g. Figure ID for an example for a β- peptide with helical, amphipathic structure but without positive charges), or primarily as precipitant (see e.g. Figure 1A for an example for a β-peptide with helical, non-amphipathic structure) , or as a combination of both types (see e.g. Figures IB and 1C for examples of β- peptides with helical, amphipathic structures comprising charges) . It is of course also possible to simultaneously use more than one β-peptide of same or different "type" (i.e. amphipathic or charge carrying) to generate agents adapted to specific needs. A preferred β-peptide for the present invention that allows the reduction of cholesterol -uptake and lipid-uptake is characterized by a helical structure, the presence of at least two charges in the same region as well as amphipathic character. Such at least two charges can be present in the precipitant to be administered to a patient, or a respective administration form, e.g. a tablet, can comprise an uncharged precursor, e.g. a β-peptide comprising at least two synthetic amino acids carrying conversible groups. Conversion of such an uncharged precursor to the cation can e.g. occur in the stomach. A great advantage of β-peptides is that they are resistant to all kinds of mammalian proteases and peptidases, including the most aggressive ones such as pronase and proteinase K (T. Hintermann, D. Seebach, Chimia 51, 244-247 (1997)). In view of a precipitating effect, the presence of e.g. naturally occurring charged amino acids, namely lysine and arginine, is preferred that can be present in mixed or homo peptides. An example for a homo chain is e.g. the exclusively β-lysine comprising β- peptide of Figure 1A. It could be shown by in vitro tests that the amount of ionic agent needed to get quantitative precipitation of micelles is dependent not only on the charges carried by one molecule but also on the design of a specific cation implying that several factors are involved in such a precipitation reaction. On the one hand, there is of course an electrostatic interaction between the negatively charged micelles and vesicles and the cations. On the other hand, a second aspect involved is likely to be a "chelating effect", and a third aspect is a "linking" of two or more micelles/vesicles by the at least doubly charged cation. "Chelating effect" in the scope of the pres- ent text, means that by binding one of the charged groups one or more further charged groups of the same molecule are brought in close contact to the micellar surface whereby their binding is favoured. Tests performed with positively charged β- peptides and several components for comparison, e.g. polylysine, showed that a full precipitation is obtained at about the point of charge equivalence. In order to determine the efficiency of specific cations, an in vitro test was used in which micelles comprising radiolabeled cholesterol (cholesterol and micelles were produced according to known methods, see below) were generated. To a predetermined amount of such micelles, the respective precipitant was added in portions, and the precipitation formed upon addition of specific amounts of precipitant measured by two methods, namely by light scattering and by determination of the radioactivity in the supernatant after centrifugation. This test, e.g. for polylysines with an average molecular weight of 2300 and 21' 600 showed 100 % precipitation at the amount calculated for charge equivalence (see Figure 3, equivalence point: poly K = 0.056 mM; Figure 2, equivalence point: poly K = 0.0061 mM) whereby the actually used amount is not critical, since almost full precipitation already occures with a smaller amount, and since the precipitate remains precipitated in the presence of excess precipitant. The light scattering showed an increase over the point of charge equivalence, indicating that - although all micelles are precipitated by at least the equivalent amount, and remain precipitated - the nature of the precipitation is still altered. Similar effects are obtained with β-peptides (see Table 1) . The fact that for a great variety of β- peptide precipitants the precipitation is not dependent on an exactly predetermined amount of precipitant is of great importance for drug design and administration. Although besides charged β-peptides also other suitably charged cations are possible precipitants, in view of their efficacy and resistance to all kinds of mammalian proteases and peptidases as well as their possible "double effect" as inhibitor and precipitant β- peptides are especially suitable agents for the purposes of reduction of the cholesterol -uptake and lipid-uptake. Another very important aspect of the present invention is that the precipitant can be designed to provide the precipitate with specific characteristics, e.g. by using specific amino acids for building up β-peptides providing the micelle distant "surface" of the precipitate with specific features facilitating the cholesterol and lipid excretion. The counter anion(s) is not critical, however, pharmaceutically acceptable hydrated strong acids are preferred such as strong organic acids, chloride, phosphates, etc. Since the reduction of cholesterol-uptake, cholesterol ester-uptake and lipid-uptake is especially important for the treatment and/or prevention of hyper- lipidaemia, including hypercholesterolaemia, the management of obesity, atherosclerosis, myocardial infarction and stroke, such diseases are preferably treated according to the present invention. However, it needs no saying that respective agents are also suitable for cosmetic uses, such as not medically induced weight reduction and improvement of the skin due to "low fat diet". A preferred method of administration of the cholesterol -uptake and lipid-uptake lowering agents of the present invention is the oral administration. Since β-peptides according to present knowledge are not digested in the intestine, they can be administered in any composition, although, of course, they can also be administered in a composition designed for drug release in the gut. It may furthermore be desired for specific applications to administer the agent of the present invention in a form intended for slow release or continuous release. Such galenic formulations are known. The amount of β-peptides to be administered can largely vary dependent on the way of action, i.e. as inhibitor or precipitant, β-peptides acting as inhibitors need only be administered in amounts sufficient to block the receptors, while the β-peptides acting as precipitant need to be administered in an amount sufficient to precipitate mixed bile salt micelles in the gut. The present invention is now further described by means of examples . Examples Example 1: Inhibitor effect This example shows the inhibition of the sterol uptake by beta-peptides using brush border membrane vesicles (BBMV) as a model . A bile salt dispersion was diluted with either phosphate-buffered saline (PBS) alone (sample A) or the β-peptide shown in Figure ID in PBS (sample B) to yield a concentration of 6.25 mM taurocholate, 0.75 mM oleic acid and 0.125 mM radiolabeled cholesterol (samples A and B) and 1 mg/ml β-peptide (sample B) . Samples were vortexed, kept on a turning wheel for 3 min. and centrifuged at 14000 g for 3 min. An aliquot of the supernatants of both samples was removed and added to BBMV dispersed in PBS to give a BBMV concentration of 5 mg/ml protein, a cholesterol concentration of 0.1 mM and a concentration of the β-peptide of 0.8 mg/ml. The mixtures were incubated for 5 min. at room temperature and then centrifuged for 3 min. at 100000 g. The radioactivity in the pellets was determined and the percent inhibition was calculated. The sterol uptake measured for 5 min. in sample A (in the absence of inhibitor) was taken as 100 %. The reduced up- take of sterol measured in the presence of β-peptide was expressed as % inhibition. For the β-peptide presented in Figure ID an inhibition of 70 % was found. Example 2: Precipitation effect General Procedure: A micellar dispersion consisting of 5 mM taurocholate, 0.6 mM oleic acid and 0.1 mM radiolabeled cholesterol was prepared as described before (Schulthess et al., J. Lipid Res. 37, 2405-19 (1996)) using Mg- and Ca- free phosphate-buffered saline (PBS) from Life Technolo ¬ gies, Basel, Switzerland. This stock solution was diluted by adding various amounts of precipitant (counter anion provided by TFA) in PBS, and PBS was added to a final volume of 1 ml. The mixture was shortly vortexed and incubated at room temperature for about 5 min before measuring its optical density (turbidity) at 500 nm. Precipi- tation (in %) was determined as follows: an aliquot of 200 μl of the incubation mixture was centrifuged for 3 min. at 100000 g and the radioactivity of 100 μl supernatant was determined in a liquid scintillation counter. The radioactivity of 100 μl of the original mixture was also determined without centrifugation. The precipitation was determined as precipitation (%) = 100 [1- (X/A) ] A = radioactivity in supernatant without centrifugation X = radioactivity in supernatant after centrifugation As a control: the precipitation (%)was determined in the absence of precipitant and a value of precipitation (%) = 2 ± 1 was obtained. The performed precipitation experiments and the results are further described in Table 1. Table 1 shows, that cations carrying a single positive charge (lysine, arginine) do not result in a precipitation. The results furthermore show the advantage of compounds carrying more than two or at least two structurally "fixed" (helical structure) quaternary ammonium groups over those with only two structurally "un- fixed" quaternary ammonium groups (Diamines) or one such group . While there are shown and described presently preferred embodiments of the invention, it is to be distinctly understood that the invention is not limited thereto but may be otherwise variously embodied and practiced within the scope of the following claims . Table 1 * heptapeptide (see Figure 1C) ** heptalysine (see Figure 1A) *** nonapeptide (see Figure IB) max = maximal turbidity observed

Claims: Claims 1. Use of at least one β-peptide for the preparation of an agent for the reduction of the uptake of cholesterol, esters of cholesterol and lipids from the gut . 2. Use of at least one β-peptide for the preparation of an agent for the treatment and/or preven- tion of hyperlipidaemia, including hypercholesterolaemia, the management of obesity, atherosclerosis, myocardial infarction and stroke. 3. Use according to claim 1 or 2 wherein the β-peptide comprises a helix. 4. Use according to claim 3 wherein the β- peptide comprises a helix with amphipathic character. 5. Use according to anyone of the preceding claims wherein the β-peptide comprises at least two positive charges. 6. Use according to claim 5 wherein the counter anion to the positive charge is a deprotonated strong acid. 7. Use according to claim 5 wherein the deprotonated strong acid is a monoacid. 8. Use according to claim 6 wherein the deprotonated monoacid is chloride. 9. Use according to anyone of claims 4 to 8 wherein the β-peptide has an amphipathic character and comprises at least two positive charges. 10. Use according to claim 9 wherein the region of the helix opposite to the positive charges carrying region is modified such as to provide the precipitate with a non-lipid character. 11. Use according to anyone of the preceding claims together with a suitable carrier for administration, in particular oral administration. 12. A composition for the administration of at least one β-peptide as defined in one of claims 1 to 10 that is an oral composition, in particular an oral composition that disintegrates in the gut . 13. Method for the treatment and/or prevention of hyperlipidaemia, including hypercholesterolaemia, the management of obesity, atherosclerosis, myocardial infarction and stroke, wherein an effective amount of at least one β-peptide as defined in one of claims 1 to 10 is administered. 14. Use of at least one β-peptide as defined in one of claims 1 to 10 for the cosmetic treatment of cholesterol -uptake, cholesterol ester-uptake and lipid- uptake related conditions, such as reduction of weight or improvement of skin.

Inventors: HAUSER HELMUT, WERDER MORITZ, HAUSER, HELMUT, WERDER, MORITZ
Applicants: HAUSER HELMUT, WERDER MORITZ, HAUSER, HELMUT, WERDER, MORITZ
Application year: 2000
Main classification: A61K31
IPC codes: A61K31, A61K38, A61P3, A61P9, C07K7