Patent Description:
The present invention relates in general to the field of novel tetracycline derivatives with reduced antimicrobial activity for use in treating disorders of the central nervous system.

Without limiting the scope of the invention, its background is described in connection with modified tetracyclines.

Alcohol use disorder (AUD) or alcoholism is a condition that affects roughly <NUM>% of individuals worldwide. AUD is characterized by an increased tolerance to alcohol and a physical dependence on alcohol making it hard for an individual to control intake. Some of the long-term effects of ingesting ethanol include cognitive and psychological changes, liver cirrhosis, gastritis, cardiomyopathy, anemia, and certain types of cancers. Alcoholism is caused by a complex mixture of genetic and environmental factors. There have been several genes linked to the way people metabolize alcohol and the development of AUD. The availability of alcohol also contributed to the number of people with AUD. Alcohol is the most available and widely abused recreational drug with beer being the third-most popular drink behind water and tea. There are currently very few methods for treating alcoholism outside of rehabilitation therapy which can be costly and very public. There is an unsatisfied need for a pharmaceutical component that is able to help combat the debilitating effects of AUD.

One such modified tetracycline derivative is taught in<CIT>, and entitled "Method for the synthesis of A-ring aromatized acetyl minocyclines". Briefly, these applicants are said to teach a less complex method for the production of A-ring aromatized acetyl minocyclines of the formula:
<CHM>
wherein R1 to R5 are acetyl and/or H, in which minocycline hydrochloride is reacted with acetic anhydride in the presence of a proton catcher and the reaction product is subjected to chromatographic filtration using a carrier material and an eluant. The eluant is distilled off, and the product is subsequently cleaned by recrystallization. However, this application is silent on the treatment of dependency disorders and only teaches the treatment of neurodegeneration.

Another such modified tetracycline derivative is taught in Patent Publication No. <CIT>, entitled "Method for the synthesis of A-ring aromatized acetyl minocyclines". The application is said to teach a method for the production of A-ring aromatized acetyl minocyclines that is less complex. The method for the production of A-ring aromatized acetyl minocyclines of the formula (I), wherein R1 to R5 = acetyl and/or H is achieved when minocycline hydrochloride is reacted with acetic anhydride in the presence of a proton catcher. The reaction product is then subjected to chromatographic filtration using a carrier material and an eluant, the eluant is distilled off. The product is subsequently cleaned by recrystallization. Like the application described hereinabove, this application is also silent on the treatment of dependency disorders and only teaches the treatment of neurodegeneration. <CIT> describes methods and compounds for treating diseases with tetracycline compounds having a target therapeutic activity. <CIT> describes <NUM>, <NUM>, and/or 12a-substituted tetracycline compounds. <NPL>) describe the effect of a neuroimmune modulator drug on alcohol drinking. <NPL>) describe the effective reduction in high ethanol drinking by semisynthetic tetracycline derivatives. <CIT> describes <NUM>-substituted tetracycline compounds and methods of use thereof. <CIT> describes therapeutic activities of tetracycline compounds.

However, a need remains for novel molecules for the treatment of alcohol consumption, including, but not limited to high drinking levels, withdrawal symptoms and increased sensitization and duration of pain, the alteration of innate immune responses, and reduction of tobacco consumption and the addiction process of other drugs subject to abuse, including opioids (<NPL>).

Any embodiment described in the present description which is not encompassed by the scope of the claims is provided for information purposes only. In one embodiment described herein, a method of treating Alcohol Use Disorder (AUD), Substance Use Disorder (SUD), tobacco use, pain, or proinflammatory disorders comprises: providing a subject with an effective amount of a modified tetracycline or derivative thereof to ameliorate or eliminate the AUD, SUD, tobacco use, pain, or proinflammatory disorder, and wherein the modified tetracycline or derivative thereof has reduced binding to a microbial ribosome and has the formula:
<CHM>.

wherein R<NUM> is methyl, ethyl, propyl, butyl, acetyl, alkyl, R<NUM> is OH or acetyl, R<NUM> is <NUM>, OH, acetyl, R<NUM> is H or acetyl, and R5 is H or acetyl, or has the formula:
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
or
<CHM>.

In another aspect, the modified tetracycline has moderate to no antibacterial activity. In another aspect, the modified tetracycline has moderate to no antifungal activity. In another aspect, the modified tetracycline is a doxycycline, minocycline, or tigecycline. In another aspect, the ribosome is a bacterial ribosome. In another aspect, the modification at least one of: produces steric hindrance, blocks hydrogen bonding, or change coordination with divalent cations. In another aspect, the modified tetracycline further comprises a pharmaceutically acceptable buffer, excipient, filler, or carrier. In another aspect, the modified tetracycline is adapted for administration orally, enterally, parenterally, intramuscularly, intravenously, or intraperitoneally.

In another embodiment described herein, a method of evaluating a candidate drug believed to be useful in treating Alcohol Use Disorder (AUD), Substance Use Disorder (SUD, including for opioids, tobacco use, pain, or proinflammatory disorders comprises: a) measuring the Alcohol Use Disorder (AUD), Substance Use Disorder (SUD, tobacco use, pain, or proinflammatory disorders from a set of patients; b) administering a candidate drug to a first subset of the patients, and a placebo to a second subset of the patients, wherein the candidate drug is a C6' modified tetracycline that has the formula:
<CHM>.

wherein R<NUM> is methyl, ethyl, propyl, butyl, acetyl, alkyl, R<NUM> is OH or acetyl, R<NUM> is <NUM>, OH, acetyl, R<NUM> is H or acetyl, and R5 is H or acetyl; c) repeating step a) after the administration of the candidate drug or the placebo; and d) determining if the candidate drug reduces the Alcohol Use Disorder (AUD), Substance Use Disorder (SUD, pain, or proinflammatory disorders that is statistically significant as compared to any reduction occurring in the second subset of patients, wherein a statistically significant reduction indicates that the candidate drug is useful in treating Alcohol Use Disorder (AUD), Substance Use Disorder (SUD, tobacco use, pain, or proinflammatory disorders. In one aspect, the modified tetracycline has the formula:
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
or
<CHM>.

In another aspect, the molecule has moderate to no antibacterial activity. In another aspect, the molecule has moderate to no antifungal activity. In another aspect, the molecule inhibits Alcohol Use Disorder (AUD), Substance Use Disorder (SUD, pain and disorders involving potential inflammatory processes. In another aspect, the modified molecule is a doxycycline, minocycline, or tigecycline. In another aspect, the modified tetracycline further comprises a pharmaceutically acceptable buffer, excipient, filler, or carrier. In another aspect, the ribosome is a bacterial ribosome. In another aspect, the modification at least one of: produces steric hindrance, blocks hydrogen bonding, or change coordination with divalent cations.

In another embodiment described herein, a method of treating Alcohol Use Disorder (AUD), Substance Use Disorder (SUD, tobacco use, pain, or proinflammatory disorders comprises: identifying a subject in need of treatment for at least one of AUD, Substance Use Disorder (SUD, tobacco use, pain, or a proinflammatory disorder; and providing the subject with an effective amount of a modified tetracycline or derivative thereof to ameliorate or eliminate the AUD, Substance Use Disorder (SUD, tobacco use, pain, or proinflammatory disorder, and wherein the modified tetracycline or derivative thereof has reduced binding to a microbial ribosome and has the formula:
<CHM>.

R<NUM> is methyl, ethyl, propyl, butyl, acetyl, alkyl, R<NUM> is OH or acetyl, R<NUM> is <NUM>, OH, acetyl, R<NUM> is H or acetyl, and R5 is H or acetyl, in a pharmaceutically acceptable carrier. In one aspect, the modified tetracycline has the formula:
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
<CHM>
or
<CHM>.

In another aspect, the modified tetracycline has moderate to no antibacterial activity. In another aspect, the modified tetracycline has moderate to no antifungal activity. In another aspect, the modified tetracycline is a doxycycline, minocycline, or tigecycline. In another aspect, the ribosome is a bacterial ribosome. In another aspect, the modification at least one of: produces steric hindrance, blocks hydrogen bonding, or change coordination with divalent cations. In another aspect, the modified tetracycline further comprises a pharmaceutically acceptable buffer, excipient, filler, or carrier. In another aspect, the modified tetracycline is adapted for administration orally, enterally, intramuscularly, parenterally, intravenously, or intraperitoneally.

For a more complete understanding of the features and advantages described herein, reference is now made to the detailed description of the disclosure along with the accompanying figures and in which:.

While the making and using of various embodiments described herein are discussed in detail below, it should be appreciated that the present disclosure provides many applicable inventive concepts that can be embodied in a wide variety of specific contexts. The specific embodiments discussed herein are merely illustrative of specific ways to make and use the disclosure and do not delimit the scope of the invention.

To facilitate the understanding of this disclosure, a number of terms are defined below. Terms defined herein have meanings as commonly understood by a person of ordinary skill in the areas relevant to the present disclosure. Terms such as "a", "an" and "the" are not intended to refer to only a singular entity, but include the general class of which a specific example may be used for illustration. The terminology herein is used to describe specific embodiments described herein, but their usage does not limit the invention, except as outlined in the claims.

The present disclosure overcomes the problems associates with tetracyclines when used to treat, e.g., Alcohol Use Disorder (AUD). By eliminating the antibiotic properties of tetracyclines (e.g., doxycycline, minocycline, and tigecycline), the present disclosure allows for an increase in drug utilization and/or dosage as a pharmacotherapy for alcohol use disorder related problems, pain, and any other disorders with inflammatory components, as well as tobacco use.

Only three pharmacotherapeutic treatments for Alcohol Use Disorder (AUD) are FDA approved and none are widely used (<<NUM>% of AUD patients) or show a strong effect to reduce risky- or dependence-based drinking in the long-term (<<NUM>% see sustained decreased drinking outcomes). Unfortunately, approximately <NUM>% of the US population suffers from AUD and over <NUM>% of all medical morbidities share risky ethanol consumption as an underlying issue. As a consequence, intoxication, in general, and `alcohol addiction' (severe AUD), in particular, are important clinical problems. Given the limited pharmacotherapeutic choice, there is a compelling need for continued development of new treatments across the AUD spectrum (mild to severe DSM-V classification). In fact, improved treatments targeting high alcohol consumption and withdrawal-related symptoms are desirable as precipitating withdrawal can be a medical emergency with risk for death. To date, drugs targeting drinking do not protect against withdrawal, and drugs used to reduce withdrawal symptoms are often co-addictive with alcohol.

The present inventors recently showed that tetracycline analogs were preclinically efficacious to reduce high alcohol consumption, withdrawal symptoms and alcohol-mediated pain sensitization and now have exciting preliminary data showing efficacy for an improved chemically modified minocycline (CMM) (Bergeson, Blanton, et al. <NUM>; Martinez et al. <NUM>; Bergeson, Nipper, et al. <NUM>; Syapin, Martinez, Curtis, Marquardt, Allison, Groot, Baby, Al-Hasan, Segura, et al. Further, the inventors have previously found tetracycline analogs, including doxycycline, minocycline, and tigecycline to be efficacious against various aspects of Alcohol Use Disorder (AUD), including cessation of drinking, withdrawal symptoms and sensitization and increased duration of pain (Bergeson, Blanton, et al. <NUM>; Martinez et al. <NUM>; Bergeson, Nipper, et al. <NUM>; Syapin, Martinez, Curtis, Marquardt, Allison, Groot, Baby, Al-Hasan, Segura-Ulate, et al. <NUM>; Agrawal et al. <NUM>; Agrawal et al. However, despite these encouraging results, the present inventors have found that the effect of these tetracyclines was through a central nervous system (CNS) function and not mediated in any part by changes in resident bacteria; see <FIG>. The data shown is key to understanding that the tetracyclines could be modified to remove the antibiotic property and still remain useful for AUD treatment. Other literature suggests that alcohol effects may be mediated, at least in part, by bacteria or their components (Blednov et al. <NUM>); for a recent review, see (Montesinos, Alfonso-Loeches, and Guerri <NUM>). However, despite this controversy in the literature, the present invention is the first to show that the action of the known CMMs does not require antibiotic properties.

<FIG> is a graph that shows that "sterilization" of the GI microbiome had no apparent effect on DID ethanol consumption or efficacy of tigecycline to reduce drinking. Given the ability of the gut microbiome to change behavior, the present inventors determined whether tigecycline, a broad spectrum antibiotic, might work through modulation of the gut bacterial flora. A ten-day "sterilization" treatment with ampicillin, neomycin, metronidozale and vancomycin was used. Bedding was changed daily to avoid repopulation. DID was started on day <NUM> after one day of no metronidazole. Tigecycline was given at <NUM>/kg intraperitoneal (i. ) n = <NUM>, mean ± SEM. No significant difference was found for either DID alone or tigecycline treatment suggesting no role for microbiota signaling in alcohol consumption or tigecycline efficacy.

<FIG> is a graph that shows that intracerebroventricular (ICV) Tigecycline reduced DID consumption. To test the hypothesis that tigecycline works at the level of the CNS, rather than the PNS, <NUM> ul of drug (<NUM>/ml) was given icv <NUM> hrs prior to DID testing. n = <NUM>-<NUM>, mean ± SEM, **p < <NUM>. The results suggest that tigecycline acts via the CNS to reduce alcohol consumption.

Thus, the present inventors recognized for the first time that the mechanism of action of the CMM for use in Alcohol Use Disorder, pain and other disorders involving potential inflammatory processes does not involve tetracycline's general antibiotic properties. Thus, the present inventors tested several tetracyclines to determine structural or functional components that contributed to the AUD treatment efficacy. As shown in Table <NUM>, it appears that the C6' hydrogen is, at least in part necessary to convey the positive action on AUD-related traits, but not those known to bind to the A-site of the bacterial ribosome (Schedlbauer et al.

Table <NUM>. Of seven tetracyclines tested against AUD traits (Syapin, Martinez, Curtis, Marquardt, Allison, Groot, Baby, Al-Hasan, Segura-Ulate, et al. <NUM>) only doxycycline, minocycline and tigecycline were effective. Shown in grey highlight is that the R6' group is the only difference between the effective and non-effective tetracycline drugs, and together with our unpublished data in <FIG>, indicated that the structure of the molecule could be modified to lose its bacterial ribosome binding component. Removal of anti-microbial properties should reduce side effects and avoid increased drug resistance.

Next, the inventors modified minocycline by acetylation (<FIG>) and determined its loss of antibiotic properties, see <FIG>. In addition, the inventors tested the CMM1 compound in mice using the Drinking In the Dark model (Rhodes et al. <NUM>) to show that the ability to reduce alcohol consumption was retained (<FIG>). Ability to reduce alcohol withdrawal symptoms was detected and is shown in <FIG>. Finally, efficacy of <NUM>/kg per os (p. ) to reduce high drinking was confirmed in swine (<FIG>).

These initial findings with acetylation of minocycline can be expanded to further substitutions at the various positions (R1 to R5) following the teachings of the present disclosure. Briefly, the process taught herein is an example of modifications that change the affinity of tetracycline analogs to bind the bacterial ribosome. Thus, any such modification could include changes to produce steric hindrance, block hydrogen bonding, change coordination with divalent cations, or any other means to change affinity for ribosomal binding. <FIG> includes a list of molecules for use with the present disclosure.

<FIG> shows the structures of acetylated CMM1 and CMM2, in which all R=acetate for CMM1, and for CMM2 all R=acetate, except R4=H.

<FIG> show that Minocycline acetate derivatives eliminated E. coli bactericidal action. Minocycline and two acetylated derivatives, CMM1 (B) and CMM2 (Y), were tested in a dose response manner for A) zone of inhibition (ZOI) and B) recovered colony forming units (CFU) per disk. Data indicate a loss of antibiotic activity even at high doses.

<FIG> are graphs that show that CMM1 - Acetylated minocycline derivative reduced ethanol consumption. Using a standard Drinking In the Dark (DID) murine model of binge drinking, we tested the effect of <NUM>, <NUM>, <NUM>, <NUM> and <NUM>/kg per os (p. ) acetylated minocycline (derivative Y, or CMM1) vs control. As shown above, the derivative significantly reduced drinking (n=<NUM>/group, p=<NUM>). The results show that acetylated minocycline, CMM1, reduced alcohol consumption in a dose-dependent response.

<FIG> are graphs that show that acetylated minocycline, CMM1, reduced alcohol withdrawal symptoms. Female and male DBA/2J mice were tested with CMM1, <NUM>/kg p. , at <NUM> hrs following <NUM>/kg <NUM>% ethanol in saline. Shown are the Handling Induced Convulsion scores, background subtracted and summed over <NUM> hours. CMM1 was more effective in females, and reduced onset, peak and duration of withdrawal symptoms. Note, that CMM1 was more effective than the parent drug, minocycline. Mean ± SEM, n=<NUM>/group.

<FIG> is a graph that shows that CMM1 reduced alcohol consumption and preference in swine. Large White x Landrace hybrid swine were given a water vs <NUM>% ethanol in a two-bucket choice. Total ethanol consumption and alcohol preference was reduced by CMM1. Mean ± SEM, n=<NUM>/group.

Acetylated tetracycline with a hydrogen R-group at R6' has a loss of antibiotic properties with retention of the ability to reduce alcohol consumption in mice. These data demonstrate that that, in addition to acetylated minocycline, the modification effects also extend to doxycycline and tigecycline. Specifically, the present disclosure includes any modification that removes the ability of the tetracycline class molecules to bind to the bacterial ribosome, with retention of anti-AUD or SUD activity or an innate immune modulatory function. The traits include, but are not limited to: reduction of alcohol consumption (both binge and dependence related drinking), suppression of alcohol withdrawal symptoms, relief of alcohol-mediated pain and emotional distress.

Table <NUM> includes a list that compares the minocycline derivatives described herein to minocycline and its HCl salt. Note that the minocycline derivatives which are not falling under the claimed general formula do not form part of the present invention.

<FIG> show the activity of Methyl Ether Minocycline ( <NUM>,<NUM>-Bis-dimethylamino-<NUM>,<NUM>,12a-trihydroxy-<NUM>-methoxy-<NUM>,<NUM>-dioxo-<NUM>,<NUM>,4a,<NUM>,5a,<NUM>,<NUM>,12a-octahydro-naphthacene-<NUM>-carboxylic acid amide, Hydrochloride), as shown with <FIG> E coli MM294 GFP zone of inhibition, <FIG> E coli MM294 GFP CFU/disc, and <FIG> reduction of binge ethanol consumption.

<FIG> show the activity of Ethyl Ether Minocycline (<NUM>,<NUM>-Bis-dimethylamino-<NUM>-ethoxy-<NUM>,<NUM>,12a-trihydroxy-<NUM>,<NUM>-dioxo-<NUM>,<NUM>,4a,<NUM>,5a,<NUM>,<NUM>,12a-octahydro-naphthacene-<NUM>-carboxylic acid amide, and the Hydrochloride salt), as shown with <FIG> E. coli MM294 GFP zone of inhibition, <FIG> E. coli MM294 GFP CFU/disc, <FIG> E. coli MM294 GFP zone of inhibition with the hydrochloride salt, <FIG> E. coli MM294 GFP CFU/disc inhibition with the hydrochloride salt, and <FIG> reduction of binge ethanol consumption.

<FIG> show the activity of Propyl Ether Minocycline (<NUM>,<NUM>-Bis-dimethylamino-<NUM>,<NUM>,12a-trihydroxy-<NUM>,<NUM>-dioxo-<NUM>-propoxy-<NUM>,<NUM>,4a,<NUM>,5a,<NUM>,<NUM>,12a-octahydro-naphthacene-<NUM>-carboxylic acid amide, and the Hydrochloride salt), as shown with <FIG> E. coli MM294 GFP zoned of inhibition, <FIG> E. coli MM294 GFP CFU/disc, <FIG> E. coli MM294 GFP zone of inhibition with the hydrochloride salt, <FIG> E. coli MM294 GFP CFU/disc inhibition with the hydrochloride salt, and <FIG> reduction of binge ethanol consumption.

<FIG> show the activity of Butyl Ether Minocycline (<NUM>-Butoxy-<NUM>,<NUM>-bis-dimethylamino-<NUM>,<NUM>,12a-trihydroxy-<NUM>,<NUM>-dioxo-<NUM>,<NUM>,4a,<NUM>,5a,<NUM>,<NUM>,12a-octahydro-naphthacene-<NUM>-carboxylic acid amide, and the Hydrochloride salt), as shown with <FIG> E. coli MM294 GFP zone of inhibition, <FIG> E. coli MM294 GFP CFU/disc, and <FIG> reduction of binge ethanol consumption.

<FIG> show the activity of De Methyl Diacetate Minocycline (Acetic acid <NUM>-acetylcarbamoyl-<NUM>-dimethylamino-<NUM>,<NUM>,<NUM>-trihydroxy-<NUM>-oxo-S,Sa,<NUM>,<NUM>-tetrahydro-naphthacen-<NUM>-yl ester), as shown with <FIG> E. coli MM294 GFP zone of inhibition, <FIG> E. coli MM294 GFP CFU/disc, and <FIG> reduction of binge ethanol consumption.

<FIG> show the activity of Tetra Acetyl Minocycline (Acetic acid <NUM>,<NUM>-diacetoxy-<NUM>-acetylcarbamoyl-<NUM>,<NUM>-bis-dimethylamino- <NUM>-hydroxy-<NUM> -oxo-<NUM>,5a,<NUM>,<NUM>-tetrahydro-naphthacen-<NUM>-yl ester), as shown with <FIG> E. coli MM294 GFP zone of inhibition, <FIG> E. coli MM294 GFP CFU/disc, and <FIG> reduction of binge ethanol consumption.

<FIG> show the activity of Penta Acetyl Minocycline (Acetic acid <NUM>,<NUM>,<NUM>-triacetoxy-<NUM>-acetylcarbamoyl-<NUM>,<NUM>-bis-dimethylamino-<NUM>-oxo-<NUM>,5a,<NUM>,<NUM>-tetrahydro-naphthacen-<NUM>-yl ester), as shown with <FIG> E. coli MM294 GFP zone of inhibition, <FIG> E. coli MM294 GFP CFU/disc, and <FIG> reduction of binge ethanol consumption.

<FIG> show the activity of Methyl Ether N-Monoacetate Minocycline (<NUM>,<NUM>-Bis-dimethylamino-<NUM>,<NUM>,<NUM>-trihydroxy-<NUM>-methoxy-<NUM> -oxo-<NUM>,5a,<NUM>,<NUM> -tetrahydro-naphthacene-<NUM>-carboxylic acid acetyl-amide) and Methyl Ether Tri Acetate Minocycline (Acetic acid <NUM>-acetoxy-<NUM>-acetylcarbamoyl-<NUM>,<NUM>-bis-dimethylamino-<NUM>-hydroxy-<NUM>-methoxy-<NUM>-oxo-<NUM>,<NUM>,11a,<NUM>-tetrahydro-naphthacen-<NUM>-yl ester), as shown with <FIG> E. coli MM294 GFP zone of inhibition, <FIG> E. coli MM294 GFP CFU/disc, and <FIG> reduction of binge ethanol consumption.

It is contemplated that any embodiment discussed in this specification can be implemented with respect to any method, kit, reagent, or composition described herein, and vice versa. Furthermore, compositions described herein can be used to achieve methods described herein.

All publications and patent applications mentioned in the specification are indicative of the level of skill of those skilled in the art to which this disclosure pertains.

The use of the word "a" or "an" when used in conjunction with the term "comprising" in the claims and/or the specification may mean "one," but it is also consistent with the meaning of "one or more," "at least one," and "one or more than one. " The use of the term "or" in the claims is used to mean "and/or" unless explicitly indicated to refer to alternatives only or the alternatives are mutually exclusive, although the disclosure supports a definition that refers to only alternatives and "and/or. " Throughout this application, the term "about" is used to indicate that a value includes the inherent variation of error for the device, the method being employed to determine the value, or the variation that exists among the study subjects.

In embodiments of any of the compositions and methods provided herein, "comprising" may be replaced with "consisting essentially of" or "consisting of". As used herein, the phrase "consisting essentially of" requires the specified integer(s) or steps as well as those that do not materially affect the character or function of the claimed invention. As used herein, the term "consisting" is used to indicate the presence of the recited integer (e.g., a feature, an element, a characteristic, a property, a method/process step or a limitation) or group of integers (e.g., feature(s), element(s), characteristic(s), property(ies), method/process steps or limitation(s)) only.

The term "or combinations thereof' as used herein refers to all permutations and combinations of the listed items preceding the term. For example, "A, B, C, or combinations thereof' is intended to include at least one of: A, B, C, AB, AC, BC, or ABC, and if order is important in a particular context, also BA, CA, CB, CBA, BCA, ACB, BAC, or CAB. Continuing with this example, expressly included are combinations that contain repeats of one or more item or term, such as BB, AAA, AB, BBC, AAABCCCC, CBBAAA, CABABB, and so forth.

As used herein, words of approximation such as, without limitation, "about", "substantial" or "substantially" refers to a condition that when so modified is understood to not necessarily be absolute or perfect but would be considered close enough to those of ordinary skill in the art to warrant designating the condition as being present. The extent to which the description may vary will depend on how great a change can be instituted and still have one of ordinary skill in the art recognize the modified feature as still having the required characteristics and capabilities of the unmodified feature. In general, but subject to the preceding discussion, a numerical value herein that is modified by a word of approximation such as "about" may vary from the stated value by at least ±<NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> or <NUM>%.

All of the compositions and/or methods disclosed and claimed herein can be made and executed without undue experimentation in light of the present disclosure. While the compositions and methods described herein have been described in terms of preferred embodiments, it will be apparent to those of skill in the art that variations may be applied to the compositions and/or methods and in the steps or in the sequence of steps of the method described herein without departing from the concept, spirit and scope of the invention. All such similar substitutes and modifications apparent to those skilled in the art are deemed to be within the spirit, scope and concept of the invention as defined by the appended claims.

For each of the claims, each dependent claim can depend both from the independent claim and from each of the prior dependent claims for each and every claim so long as the prior claim provides a proper antecedent basis for a claim term or element.

Claim 1:
A composition for use in a method of treating a Substance Use Disorder (SUD) comprising:
an effective amount of a modified tetracycline to ameliorate or eliminate the SUD and wherein the modified tetracycline has reduced binding to a microbial ribosome and has the formula:
<CHM>
R<NUM> is methyl, ethyl, propyl, butyl, acetyl, alkyl, R<NUM> is H or acetyl, R<NUM> is H or acetyl, R<NUM> is H or acetyl, and R<NUM> is H or acetyl.