Abstract:
The present invention can be used in medical practice specifically in chemical and pharmaceutical production of medicinal agents capable of modulating the immune system.  
     This invention essentially relates to a new medicinal preparation  5 -amino- 2,3 -dihydrophthalazine- 1,4 -dione sodium salt having immunomodulatory, antiinflammatory, and antioxidant properties.  
     The preparation is obtained from  3 -nitro-phthalanhydride by consecutive isolation of intermediate and end products. The intermediate products include  5 -nitro- 2,3 -dihydrophthalazine- 1,4 -dione and  5 -amino- 2,3 -dihydrophthala 2 ine- 1,4 -dione. The reaction between  5 -amino- 2,3 -dihydrophthalazine- 1,4 -dione and sodium hydroxide yields the target product,  5 -animo- 2,3 -dihydrophthalazine- 1,4 -dione sodium salt.  
     The method allows to produce the medicinal preparation with high pharmaceutical activity.  
     It is provided an example of application of this preparation.

Description:
FIELD OF THE INVENTION  
         [0001]    The present invention relates to the field of medicine, specifically to medicinal preparations affecting the immune system, and to production of such preparations.  
         BACKGROUND OF THE INVENTION  
         [0002]    It is known a medicinal preparation “sodium nucleinate”—a sodium salt of nucleic acid which is an immunological activity preparation, a white or yellowish powder easily soluble in water with formation of opalescent solutions, stimulating migration and cooperation of T- and B-lymphocytes, enhancing phagocytic activity of macrophages, and activity of nonspecific resistance factors (M. D. Mashkovsky, Medicinal Preparations, Meditsina, Moscow (1985), Vol. 2, p. 172 [in Russian]).  
           [0003]    Injections of this preparation cause, however, pain feeling, which necessitates treatments of patients with analgesics.  
           [0004]    The closest art for “sodium nucleinate” is 2-amino-1,2,3,4-tetrahydrophthalazine-1,4-dione sodium salt dihydrate, used as an immunomodulator, which also has antiinflammatory and antioxidant properties (Russian Federation Patent No. 21113222, priority: Sep. 30, 1997; IPC: A 61 K 31/04, A 61 K 31/13), being a pale-yellow crystalline powder easily soluble in water.  
           [0005]    Administration of this preparation to patients with impaired cellular immunity, e.g., in case of malignant neoplasms, activates macrophages, interleukins and other acute-phase proteins. In case of inflammatory processes this immunomodulator inactivates macrophages for several hours, but stimulates the microbicidal system in cells.  
           [0006]    The preparation does not cause side effects and allergic reactions, however, in patients with chronic and other diseases longterm treatment with this agent causes tolerance and decreases the efficiency of therapy with this medicinal preparation, which dictates the necessity of substituting other more efficient analogues for the preparation.  
           [0007]    It is known a method for manufacturing the medicinal preparation including obtaining 3-amino-phthalhydrazide, its molecular rearrangement, followed by treatment with sodium hydroxide, and isolation of the target product of 2-amino-1,2,3,4-tetrahydrophthalazine-1,4-dione sodium salt dihydrate (Russian Federation Patent No. 2138264, Priority; May 6, 1999; IPC: A 61 K 31/50, C 07 D 237/32, Bull. No. 27, Sep. 27, 1999).  
           [0008]    This method allows to increase the yield of product and decrease the amount of waste products, however, its use is limited to manufacturing of said preparation.  
           [0009]    The closest art to the present invention is the method for manufacturing 5-amino-2,3-dihydrophthalazine-1,4-dione (luminol) (see e.g., USSR Inventor&#39;s Certificate No. 130903, Priority: Nov. 21, 1959; Bull. No. 16, 1960), comprising reduction of 3-nitrophtlialic acid with hydrazine hydrate in a water medium in presence of a skeletal nickel catalyst, followed by evaporation of the solution, and its beating in presence of hydrazine hydrate and acetic acid at 120° C.  
           [0010]    The end product of the known method is an orange-colored powder with pronounced luminescence properties, however; this compound is medically ineffective.  
         SUMMARY OF THE INVENTION  
         [0011]    The object of the present invention is a medicinal preparation, whose effects is similar, but more pronounced, than those of the closest art thereof, e.g. for replacement of the known preparation in case of patient&#39;s tolerance thereto.  
           [0012]    The present invention the “method for manufacturing the medicinal preparation” is based on development of a procedure providing production of an efficient medicinal preparation, having immunomodulatory, antiinflammatory, and antioxidant properties.  
           [0013]    The problem was solved by a medicinal preparation 5-amino-2,3-dihydrophthalazine-1,4-dione sodium salt having immunomodulatory, antiinflammatory, and antioxidant properties.  
           [0014]    This problem was solved by a method for manufacturing 5-amino-2,3-dihydrophthalazine-1,4-dione sodium salt, comprising reduction of the product by hydrazine hydrate in presence of a skeletal nickel catalyst, first by interacting 3-nitro-phthalanhydride with hydrazine hydrate in acetic acid at 90-120° C. with formation of 5-nitro-2,3-dihydrophthalazine-1,4-dione, after reduction thereof by hydrazine hydrate in a water-alkaline medium in presence of a skeletal nickel catalyst, isolating 5-amino-2,3-dihydrophthalazine-1,4-dione, which is then treated by sodium hydroxide in the presence of a lower alcohol or a ketone at 20-80° C. to obtain the target product.  
         DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT  
         [0015]    The medicinal preparation is a white or pale-yellow crystalline powder easily soluble in water.  
           [0016]    The medicinal preparation is obtained by the following process:  
           [0017]    3-nitro-phthalanhydride (C 8 H 3 NO 6 , 50-60 g) is mixed with acetic acid (CH 3 COOH, 120-200 ml) and heated to 90-100° C. under mixing with dropwise admixing of hydrazine hydrate (N 2 H 4 ·H 2 O, 15-20 ml), maintaining temperature of the reaction mixture at 105-120° C. After addition of hydrazine hydrate, the reaction mass is boiled and held at least 20-45 min and then rapidly cooled to 70-85° C.  
           [0018]    Crystallized 5-nitro-2,3-dihydrophthalazine-1,4-dione (C 8 H 5 N 3 O 4 ) is filtered and washed with acetic acid and distilled water. The product (5-10 g) is additionally removed from the filter, the total yield of which comprises 80-85% per 3-nitro-phthalanhydride weight.  
           [0019]    5-nitro-2,3-dihydrophthalazine-1,4-dione (40-50 g) and potassium hydroxide (KOH, 10-15 g) are mixed in distilled water (500-700 ml) to complete dissolution. The solution is heated to 60-75° C., hydrazine hydrate (N 2 ·H 4 H 2 O, 12-15 ml) and Ni-Rene catalyst (2-5 g) are added to the solution. This leads to a violent reaction with self-heating and emission of nitrogen (N 2 ) and hydrogen (H 2 ).  
           [0020]    When temperature reaches 85-95° C., the reaction mixture is cooled by adding distilled water. After 20-40 min, the additional catalyst (2-5 g) is fractionally added to the solution excluding the possibility of an extremely violent reaction. When self-heating is terminated, additional amounts (5-10 g) of the catalyst are added.  
           [0021]    After completing the reaction, the solution is decanted from the precipitated catalyst, filtered, and 5-amino-2,3-dihydrophthalazine-1,4-dion (C 8 H 7 N 3 O 2 ) is precipitated by acidification of the reaction mixture with an aqueous solution of hydrochloric acid (HCI) or a mixture of hydrochloric and acetic acids.  
           [0022]    The precipitate is filtered, washed with distilled water, and dried.  
           [0023]    The product yield per 5-nitro-2,3-dihydrophthalazine-1, 4-dione weight is 82-84%.  
           [0024]    In the final stage, 5-amino-2,3-dihydrophthalazine-1, 4-dione (30-40 g) is dissolved in an aqueous solution of sodium hydroxide (10-15 g NaOH per 300-500 ml H 2 O) at a temperature of 20-80° C. The solution is filtered, mixed with a lower alcohol (ROH. 1500-2000 ml), e.g., isopropyl alcohol (iso-C 3 H 7 OH) and held at 20-25° C. for 2-3 hours, isolating the target product (C 8 H 6 N 3 NaO 2 ). Other lower alcohols or a ketone can also be used.  
           [0025]    The target product yield per 5-amino-2,3-dihydrophthalazine-1,4-dione weight is 85-90 The obtained medicinal preparation is characterized by informative UV spectra in the field of 220400 μm, taken in concentration of 20 μg/ml in various solvents: water, 0.01 M solution of hydrochloric acid, 95% alcohol, and 0.1 M sodium hydroxide.  
           [0026]    Industrial Applicability  
           [0027]    Clinical tests showed that administration of the medicinal preparation 5-amino-2,3-dihydrophthalazine-1,4-dione sodium salt to patients with impaired cellular immunity, e.g., in case of malignant neoplasms, causes activation of macrophages, which is evident by release by them of tumor necrosis factor (TNF), interleukins, and other acute-phase proteins. Besides this, the agent initiates specific reactions of T-lymphocytes.  
           [0028]    In case of inflammatory diseases the medicinal preparation selectively (for 4-8 hours) inactivates macrophages, decreasing the contents of TNF and acute-phase proteins, that leads to attenuation of intoxication symptoms. At the same time 5-amino-2,3-dihydrophthalazine-1,4-dione sodium salt enhances super-oxidizing function and phagocytic activity of neutrophilic granulocytes, stimulating thus the microbicidal system in cells, and attenuating inflammation process.  
           [0029]    These results are confirmed by laboratory analyses on patients, by blood tests, that characterize immunological parameters of the leukocytic and lymphocytic systems.  
           [0030]    The medicinal preparation introduced into organism is practically completely eliminated therefrom with expired air and urine in 20-60 min. This preparation in a wide range of doses (20-1500 mg) does not cause side effects and allergic reactions, and its efficiency is similar or even higher than that of prior art immunomodulator, that allows to interchange these medicinal preparations during long-term therapy, in order to prevent the development of patient&#39;s tolerance.  
           [0031]    The medicinal preparation can be used in form of powder for injections or tablets for peroral administration.  
           [0032]    Clinical efficiency of the developed medicinal preparation is confirmed by the following observations. 
       
    
    
     EXAMPLE NO. 1  
       [0033]    Patient S. of 58 years old.  
         [0034]    Was hospitalized on Feb. 2, 2000 with complaints of fatigability, long-continued cough, and transient fever (presumably residual symptoms after influenza she had on Jan. 15-27, 2000).  
         [0035]    Examination of the patient revealed sub febrile temperature, dry cough, and rales in the lungs.  
         [0036]    The patient was treated with 5-amino-2,3-dmydrophthalazine-1,4-dione sodium salt (further Tamerit).  
         [0037]    Tamerit was injected in a single dose of 300 mg in 2 ml of distilled water for 5 days and then given perorally (powder or tablets) in a dose of 100 mg, 2 times a day, 1 hour after meals.  
         [0038]    Three days after beginning of the therapy the state of the patient was improved, cough disappeared, and temperature returned to normal.  
         [0039]    The patient was considered to be in a satisfactory state in 10 days after beginning of the therapy.  
         [0040]    Results of laboratory analyses are shown in Table 1.  
       EXAMPLE NO. 2  
       [0041]    Patient I., 68 years old.  
         [0042]    Was hospitalized with complaints of difficult urination and urges to urinate.  
         [0043]    Ultrasound examination revealed hypertrophy of the prostate.  
         [0044]    Diagnosis: stage 1I prostatic adenoma.  
         [0045]    Two courses of therapy with 2-amino-1,2,3,4-tetrahydrophthalazine-1,4-dione sodium salt dihydrate were performed by injections for 20 and 15 injections, respectively, with a 30-day interval between the injections. Doses of the preparation were from 100 to 500 mg in 1-5 ml of distilled water correspondingly.  
         [0046]    The size of adenoma decreased after the first course of 20 injections, but remained without further positive dynamic after the second course of final 15 injections.  
         [0047]    The patient state was considered to be unstable.  
         [0048]    The patient was additionally daily injected with Tamerit -10 injections in a single dose of 200 mg in 2 ml of distilled water, I injection daily.  
         [0049]    The state of this patient was improved, urination was normalized.  
         [0050]    The results of laboratory analyses are shown in Table 2.  
       EXAMPLE NO. 3  
       [0051]    Patient G., 42 years old.  
         [0052]    Was hospitalized with diagnosis of erysipelas of the left forearm, edema, and exacerbation of psoriasis (temperature at hospitalization was 39.9° C.).  
         [0053]    Before hospitalization, the symptoms of psoriasis were controlled by ointments.  
         [0054]    Tameril was injected daily in a single dose of 200 mg in 2 ml water.  
         [0055]    Edema and hyperemia of the left forelimb disappeared in 4 days after beginning of the therapy.  
         [0056]    The patient received injections of Tamerit in a single dose of 100 mg in 1 ml water for the next 5 days.  
         [0057]    The patient was considered to be in a satisfactory state. The state of the skin in the face and hands was improved.  
         [0058]    The patient was prescribed to take Tamerit perorally in a single dose of 100 mg (I tablet) 2-3 times a day for 7-10 days.  
         [0059]    The results of the laboratory analyses are shown in Table 3.  
                                                                                                         TABLE 1                           Laboratory Analyses of Patient S.                Parameter   Before therapy   After therapy                        Routine blood test                Hemoglobin, g/liter   100   147           Erythrocytes, *10 12 /liter   3.9   5.0           Color index   0.85   0.9           Leukocytes, *10 9 /liter   4.0   5.5           Eosinophils, %   2.9   3.0           Neutrophils:           Stab, %   6.0   6.0           Segmented, %   69.5   74.0           Lymphocytes, %   20.5   23.0           Monocytes, %   5.5   6.0           ESR, mm/h   5   13.0            Biochemical blood test                Iron, mg/dl   50.0   51.5           Glucose, mmol/liter   4.2   5.3           Urea, mg/dl   19.0   16.5           Uric acid, mg/dl   5.3   7.1           Albumin, g/liter   37.5   50.0           Protein, g/liter   76.5   71.5           Cholesterol, mg/dl   176.6   154.0           Triglycerides, mg/dl   212.1   195.0           Total bilirubin, mg/dl   0.35   0.4           Creatinine, mg/dl   0.6   0.45           Alkaline pliosphatase, U/liter   198.0   212.0           Creatine kinase, U/liter   32.8   34.0           Aspartate transaminase, U/l   33.0   29.5           Alanine transaminase, U/liter   85.0   70.7           g-Glutamyltransferase, U/liter   94.5   93.0           Lactate dehydrogenase, U/liter   201.0   207.5            Cellular and humoral immunity tests                Immunoglobulin A, g/liter   2.15   2.20           Immunoglobulin M, g/liter   2.0   2.21           Immunoglobulin G, g/liter   11.0   12.4           T-lymphocytes, %   52.0   67.0           B-lymphocytes, %   18.0   24.5           Latex phagocytosis, %   60.0   76.2           TNF   15.0   22.5           T-helpers, %   26.0   29.5           T-suppressors, %   21.0   23.5                      
 
         [0060]    [0060]                                                                                                                                       TABLE 2                           Laboratory Analyses of Patient I.                Before   After injections                Parameter   therapy   2-amino   5-amino                        Routine blood test                Hemoglobin, g/liter   120   130   135           Erythrocytes, *10 12 /liter   5.0   5.20   5.25           Color index   0.9   0.95   0.95           Leukocytes, *10 9 /liter   6.50   6.20   6.21           Eosinophils, %   4.0   3.80   3.85           Neutrophils:           Stab, %   6.5   5.5   6.0           Segmented, %   60.0   64.3   70.0           Lymphocytes, %   12.0   12.5   14.6           Monocytes, %   3.0   2.5   2.5           ESR, mm/h   357   17.0   10            Biochemical blood test                Iron, mg/dl   116.4   122.5   123           Glucose, mmol/liter   5.0   5.4   6.0           Urea, mg/dl   10.1   16.2   15.9           Uric acid, mg/dl   2.7   5.3   6.3           Albumin, g/liter   38.8   51.6   60.5           Protein, g/liter   71.3   69.0   65.5           Cholesterol, mg/dl   204.2   195.7   176.4           Triglycerides, mg/dl   160.1   135.0   128.0           Total bilirubin, mg/dl   0.3   0.52   0.55           Creatinine, mg/dl   0.47   0.38   0.34           Alkaline pliosphatase, U/liter   212.7   202.0   207.2           Creatine kinase, U/liter   34.0   37.5   38.5           Aspartate transaminase, U/l   35.5   29.9   28.6           Alanine transaminase, U/liter   87.7   72.5   68.2           g-Glutamyltransferase, U/liter   105.5   97.5   92.4           Lactate dehydrogenase, U/liter   204.7   210.0   214.5            Cellular and humoral immunity tests                Immunoglobulin A, g/liter   2.07   2.33   2.41           Immunoglobulin M, g/liter   1.92   2.07   2.11           Immunoglobulin G, g/liter   11.1   12.3   12.6           T-lymphocytes, %   54.5   66.0   71.6           B-lymphocytes, %   15.5   23.8   29.1           Latex phagocytosis, %   44.0   65.3   83.0           TNF   15.5   20.9   23.0           T-helpers, %   27.2   30.7   32.4           T-suppressors, %   19.7   23.5   24.0                        
         [0061]    [0061]                                                                                                         TABLE 3                           Laboratory Analyses of Patient G                Parameter   Before therapy   After therapy                        Routine blood test                Hemoglobin, g/liter   122   148           Erythrocytes, *10 12 /liter   6.2   6.9           Color index   0.92   0.98           Leukocytes, *10 9 /liter   7.0   6.2           Eosinophils, %   4.7   4.0           Neutrophils:           Stab, %   6.0   5.7           Segmented, %   62.0   65.5           Lymphocytes, %   19.9   26.3           Monocytes, %   2.7   2.0           ESR, mm/h   37   16.0            Biochemical blood test                Iron, mg/dl   114.4   125.5           Glucose, mmol/liter   5.4   5.9           Urea, mg/dl   12.9   11.9           Uric acid, mg/dl   3.2   4.15           Albumin, g/liter   46.5   57.1           Protein, g/liter   76.2   77.7           Cholesterol, mg/dl   209.0   200.6           Triglycerides, mg/dl   167.0   172.2           Total bilirubin, mg/dl   0.85   0.65           Creatinine, mg/dl   0.90   0.85           Alkaline pliosphatase, U/liter   209.0   221.0           Creatine kinase, U/liter   31.5   37.5           Aspartate transaminase, U/l   30.5   27.3           Alanine transaminase, U/liter   80.1   58.5           g-Glutamyltransferase, U/liter   93.1   95.2           Lactate dehydrogenase, U/liter   210.5   229.6            Cellular and humoral immunity tests                Immunoglobulin A, g/liter   2.20   2.47           Immunoglobulin M, g/liter   1.80   2.31           Immunoglobulin G, g/liter   13.0   13.7           T-lymphocytes, %   57.7   60.3           B-lymphocytes, %   26.2   25.0           Latex phagocytosis, %   60.6   83.4           TNF   16.5   24.4           T-helpers, %   19.0   31.2           T-suppressors, %   18.2   20.1