A compound having structural Formula I: I Z 1 -Y 1 -(CH 2) n1 -R-(CH 2) n2 -Y 2 -Z 2 and pharmaceutically acceptable salts thereof wherein: n1 and n2 can be individually either 0 or 1; R represents a fused bicyclic or spirocyclic aliphatic diamine having one of the following structures: wherein R-I represents a 9-11-membered saturated bicyclic heterocyclic ring system sharing 1 carbon atom, and R-II represents a 8-10-membered saturated bicyclic heterocyclic ring system sharing 2 carbon atoms, wherein each ring of R-I and each ring of R-II has 1 Nitrogen atom; R 5 is -H, -F with the proviso that -F is not attached to a carbon that is also attached to nitrogen, -CH 3, -CF 3, -CHF 2, -CH 2 F, or -CH 2 OH, or R 5 represents di-substitution on a single carbon with two of -F with the proviso that -F is not attached to a carbon that is also attached to nitrogen or two of -CH 3; Z 1 is: Z 2 is: one of W 1 and W 2 is N and the other is CH; R 1 and R 2 are each independently -H, -F, -Cl, -Br, cyclopropyl, -C 1-3 alkyl optionally substituted with 1-3 of -F, or -OC 1-3 alkyl optionally substituted with 1-3 of -F; one of R 3a and R 3b is -CN, tetrazolyl, or -S 2 C alkyl and the other is -H, -F, -Cl, -Br, -S-CH3, -NH-CH 3, -O-cyclopropyl, -C 1-3 alkyl optionally substituted with 1-3 of-F, or -OC 1-3 alkyl optionally substituted with 1-3 of -F; one of R 4a and R 4b is CN, tetrazolyl, or -S 2 C alkyl and the other is -H, -F, -Cl, -Br, -S-CH 3, -NH-CH 3, -O-cyclopropyl, -C 1-3 alkyl optionally substituted with 1-3 of -F, or -OC 1-3 alkyl optionally substituted with 1-3 of -F; R a, R aa, R b and R bb are each independently -H, -F, -Cl, -C 1-3 alkyl optionally substituted with 1 to 3 of-F, or -OC 1-3 alkyl optionally substituted with 1 to 3 of -F; R c and R d are each independently -H, -F, -Cl, -C 1-3 alkyl optionally substituted with 1 to 3 of -F, or -OC 1-3 alkyl optionally substituted with 1 to 3 of -F; and one of Y 1 or Y 2 is -CH -; and the other is -CH -; -C -; or -S 2 -; provided that where Y 1 or Y 2 is -C - or -S 2 -, then the adjacent n1 or n2, respectively, is 0; and provided further that where n1 or n2 is 0, the adjacent Y 1 or Y 2 is -C - or -S 2 -. n1 and n2 can be individually either 0 or 1; R represents a fused bicyclic or spirocyclic aliphatic diamine having one of the following structures: wherein R-I represents a 9-11-membered saturated bicyclic heterocyclic ring system sharing 1 carbon atom, and R-II represents a 8-10-membered saturated bicyclic heterocyclic ring system sharing 2 carbon atoms, wherein each ring of R-I and each ring of R-II has 1 Nitrogen atom; R 5 is -H, -F with the proviso that -F is not attached to a carbon that is also attached to nitrogen, -CH 3, -CF 3, -CHF 2, -CH 2 F, or -CH 2 OH, or R 5 represents di-substitution on a single carbon with two of -F with the proviso that -F is not attached to a carbon that is also attached to nitrogen or two of -CH 3; Z 1 is: Z 2 is: one of W 1 and W 2 is N and the other is CH; R 1 and R 2 are each independently -H, -F, -Cl, -Br, cyclopropyl, -C 1-3 alkyl optionally substituted with 1-3 of -F, or -OC 1-3 alkyl optionally substituted with 1-3 of -F; one of R 3a and R 3b is -CN, tetrazolyl, or -S 2 C alkyl and the other is -H, -F, -Cl, -Br, -S-CH3, -NH-CH 3, -O-cyclopropyl, -C 1-3 alkyl optionally substituted with 1-3 of-F, or -OC 1-3 alkyl optionally substituted with 1-3 of -F; one of R 4a and R 4b is CN, tetrazolyl, or -S 2 C alkyl and the other is -H, -F, -Cl, -Br, -S-CH 3, -NH-CH 3, -O-cyclopropyl, -C 1-3 alkyl optionally substituted with 1-3 of -F, or -OC 1-3 alkyl optionally substituted with 1-3 of -F; R a, R aa, R b and R bb are each independently -H, -F, -Cl, -C 1-3 alkyl optionally substituted with 1 to 3 of-F, or -OC 1-3 alkyl optionally substituted with 1 to 3 of -F; R c and R d are each independently -H, -F, -Cl, -C 1-3 alkyl optionally substituted with 1 to 3 of -F, or -OC 1-3 alkyl optionally substituted with 1 to 3 of -F; and one of W 1 and W 2 is N and the other is CH; R 1 and R 2 are each independently -H, -F, -Cl, -Br, cyclopropyl, -C 1-3 alkyl optionally substituted with 1-3 of -F, or -OC 1-3 alkyl optionally substituted with 1-3 of -F; one of R 3a and R 3b is -CN, tetrazolyl, or -S 2 C alkyl and the other is -H, -F, -Cl, -Br, -S-CH3, -NH-CH 3, -O-cyclopropyl, -C 1-3 alkyl optionally substituted with 1-3 of-F, or -OC 1-3 alkyl optionally substituted with 1-3 of -F; one of R 4a and R 4b is CN, tetrazolyl, or -S 2 C alkyl and the other is -H, -F, -Cl, -Br, -S-CH 3, -NH-CH 3, -O-cyclopropyl, -C 1-3 alkyl optionally substituted with 1-3 of -F, or -OC 1-3 alkyl optionally substituted with 1-3 of -F; R a, R aa, R b and R bb are each independently -H, -F, -Cl, -C 1-3 alkyl optionally substituted with 1 to 3 of-F, or -OC 1-3 alkyl optionally substituted with 1 to 3 of -F; R c and R d are each independently -H, -F, -Cl, -C 1-3 alkyl optionally substituted with 1 to 3 of -F, or -OC 1-3 alkyl optionally substituted with 1 to 3 of -F; and one of Y 1 or Y 2 is -CH -; and the other is -CH -; -C -; or -S 2 -; provided that where Y 1 or Y 2 is -C - or -S 2 -, then the adjacent n1 or n2, respectively, is 0; and provided further that where n1 or n2 is 0, the adjacent Y 1 or Y 2 is -C - or -S 2 -.