EP1178791A2 - Utilisation d'un inhibiteur de trajet de proteine tyrosine kinase dans le traitement des troubles oculaires - Google Patents

Utilisation d'un inhibiteur de trajet de proteine tyrosine kinase dans le traitement des troubles oculaires

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Publication number
EP1178791A2
EP1178791A2 EP00932108A EP00932108A EP1178791A2 EP 1178791 A2 EP1178791 A2 EP 1178791A2 EP 00932108 A EP00932108 A EP 00932108A EP 00932108 A EP00932108 A EP 00932108A EP 1178791 A2 EP1178791 A2 EP 1178791A2
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EP
European Patent Office
Prior art keywords
group
inhibitor
tyrosine kinase
protein tyrosine
kinase pathway
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP00932108A
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German (de)
English (en)
Inventor
Eugene De Juan, Jr.
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Johns Hopkins University
School of Medicine of Johns Hopkins University
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Johns Hopkins University
School of Medicine of Johns Hopkins University
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Publication date
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Publication of EP1178791A2 publication Critical patent/EP1178791A2/fr
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/35—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom
    • A61K31/352—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom condensed with carbocyclic rings, e.g. methantheline 
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P27/00—Drugs for disorders of the senses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P27/00—Drugs for disorders of the senses
    • A61P27/02—Ophthalmic agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

  • the present invention relates to a method for the prophylactic and therapeutic treatment of age-related macular degeneration, as well as methods for the prophylactic and therapeutic treatment of degeneration of the retina, degeneration of the choroid, and thickening of Bruch's membrane.
  • Age-related macular degeneration is a progressive, degenerative disorder of the eye resulting in loss of visual acuity. Symptoms of age-related macular degeneration include blurred vision, decreased ability to read, especially in dim light, trouble with dark adaptation and, in relatively few cases, abrupt vision loss. Complications associated with advanced age-related macular degeneration are divided into two categories, atrophic and exudative. Atrophic complications are associated with retinal pigment epithelial cell loss resulting in atrophy of the retinal pigment epithelium (RPE) . Exudative complications, which appear in approximately 10% of age-related macular degeneration cases, include disciform scars (i.e., scarring involving fibrous elements) and neovascularization . Ultimately, blindness from age-related macular degeneration stems from degeneration of the RPE and the subsequent death of photoreceptors .
  • RPE retinal pigment epithelium
  • Risk factors associated with age-related macular degeneration include age, heredity, systemic disease, environmental factors, such as smoking and light exposure (see e.g., Chesapeake Bay Waterman Study, Taylor et al . , Arch . Ophthal ol . 110: 99-104 (1992)), and nutritional deficiency. Hyperopia and iris color also have been linked to the disease. Age-related macular degeneration has been correlated to light-colored irises, perhaps due to chronic exposure to damaging light which is normally absorbed by dark-colored irises. The disease also appears more often in women than men.
  • AMD age-related macular degeneration
  • laser photocoagulation is used to treat choroidal neovascularization associated with age-related macular degeneration. Such treatment has been proven to reduce the risk of severe vision loss .
  • Laser photocoagulation also has been used to treat drusen.
  • laser treatment may cause permanent blind spots corresponding to the treated areas, leading to a decrease in visual acuity.
  • Laser treatment may also cause persistent or recurrent hemorrhage and increase the risk of sensory retinal detachment. Many patients eventually experience severe vision loss in spite of treatment.
  • the present invention is directed to a method for the prophylactic and therapeutic treatment of age-related macular degeneration, including treatment of the atrophic and exudative complications associated with the disease.
  • the present invention is also directed to a method for the prophylactic and therapeutic treatment of an animal for degeneration of the retina.
  • a method of prophylactically or therapeutically treating an animal for degeneration of the choroid is also provided, as is a method of prophylactically or therapeutically treating an animal for thickening of Bruch's membrane.
  • the methods involve the administration of an inhibitor of the protein tyrosine kinase pathway.
  • the inhibitor of the protein tyrosine kinase pathway is a compound of formula :
  • the alkoxy is a C ⁇ - Cs alkoxy.
  • the halo is fluorine, chlorine or bromine.
  • the ester is a C ⁇ -C 3 ester.
  • the ether is a C] . -C 6 ether.
  • Preferred pharmaceutically acceptable salts of the carboxylic acid group include sodium and potassium salts.
  • the alkyl groups are C J .-C6 alkyl groups.
  • the protein tyrosine kinase pathway inhibitor is genistein.
  • the present invention is predicated on the discovery that an inhibitor of the protein tyrosine kinase pathway, specifically genistein, is effective in treating prophylactically and therapeutically age-related macular degeneration, including the exudative and atrophic complications associated with age-related macular degeneration, and ocular disorders, such as degeneration of the retina, degeneration of the choroid and thickening of Bruch's membrane. Accordingly, the present invention provides a method for the prophylactic and therapeutic treatment of age-related macular degeneration.
  • prophylactic is meant the protection, in whole or in part, against age-related macular degeneration, in particular choroidal neovascularization and retinal pigment epithelium atrophy.
  • therapeutic is meant the amelioration of age-related macular degeneration, itself, and the protection, in whole or in part, against further age-related macular degeneration, in particular choroidal neovascularization and retinal pigment epithelium atrophy.
  • age-related macular degeneration is that which results from age, hyperopia, systemic disease, such as cardiovascular disease or hypertension, smoking, light exposure or nutritional deficiency.
  • the method comprises the administration of an inhibitor of the protein tyrosine kinase pathway in an amount sufficient to treat the macula for age-related macular degeneration prophylactically or therapeutically.
  • Any inhibitor of the protein tyrosine kinase (PTK) pathway can be used in the method of the present invention as long as it is safe and efficacious.
  • the present invention additionally provides a method for the prophylactic and therapeutic treatment of both atrophic and exudative complications associated with age- related macular degeneration.
  • Atrophic complications include pigmentary disturbance of the retinal pigment epithelium, hard, soft and/or confluent drusen, basal laminar deposits, a thickening of Bruch's membrane, and RPE atrophy.
  • Drusen are yellow or white excresences between the basement membrane of the RPE and Bruch's membrane which are often precursors for neovascularization.
  • Exudative complications include choroidal neovascularization, RPE detachment, RPE tears, disciform scarring, vitreous hemorrhage and subretinal hemorrhage.
  • Prophylactic and therapeutic treatment of exudative complications can be effected by prevention or inhibition of disruption of the integrity of the basement membrane .
  • the method comprises the administration of an inhibitor of the PTK pathway in an amount sufficient to treat an exudative or atrophic complication of age- related macular degeneration prophylactically or therapeutically. Any safe and efficacious PTK inhibitor can be used.
  • the present invention further provides a method for the prophylactic and therapeutic treatment of an animal for degeneration of the retina, in particular that which is due to aging.
  • degeneration of the retina in particular that which is due to aging, includes, for example, pigment epithelial abnormalities and ganglion cell loss.
  • Degeneration of the retina also includes loss of photoreceptor cells, which can result in decreased contrast sensitivity and vision loss.
  • prophylactic is meant the protection, in whole or in part, against further degeneration of the retina.
  • therapeutic is meant the amelioration of degeneration of the retina, itself, and the protection, in whole or in part, against further degeneration of the retina.
  • the method comprises the administration of an inhibitor of the PTK pathway in an amount sufficient to treat degeneration of the retina, in particular that which is due to aging, prophylactically or therapeutically. As indicated above, any PTK pathway inhibitor can be used in this method as long as it is safe and efficacious.
  • the present invention provides a method for the prophylactic and therapeutic treatment of an animal for degeneration of the choroid, in particular that which is due to aging.
  • Degeneration of the choroid, in particular that which is due to aging includes, for example, flattening of the choroid.
  • Degeneration of the choroid due to aging also includes atrophy of choriocapillaries .
  • prophylactic is meant the protection, in whole or in part, against degeneration of the choroid.
  • therapeutic is meant the amelioration of degeneration of the choroid, itself, and the protection, in whole or in part, against further degeneration of the choroid.
  • the method comprises the administration of an inhibitor of the PTK pathway in an amount sufficient to treat degeneration of the choroid, in particular that which is due to aging, prophylactically or therapeutically. Any safe and efficacious PTK pathway inhibitor can be used.
  • Ocular disorders further include thickening of Bruch's membrane, which is located between the retina and the choroid, in particular thickening of Bruch's membrane as a result of aging.
  • Thickening of Bruch's membrane can interfere with vision by separating photoreceptor cells from the vascular-rich choroid and causing abnormalities in the retina.
  • the present invention provides a method for the prophylactic and therapeutic treatment of an animal for thickening of Bruch' s membrane.
  • prophylactic is meant the protection, in whole or in part, against thickening of Bruch's membrane.
  • therapeutic is meant the amelioration of thickening of Bruch's membrane, itself, and the protection, in whole or in part, against further thickening of Bruch's membrane .
  • the method comprises the administration of an inhibitor of the PTK pathway in an amount sufficient to treat Bruch's membrane for thickening prophylactically or therapeutically.
  • Any safe and efficacious inhibitor of the PTK pathway can be used.
  • PTK inhibitor will be used to refer to such compounds and is intended to encompass any and all compounds that inhibit the PTK pathway, irrespective of at which point in the pathway the compound effects inhibition.
  • PTK inhibitors are known in the art; others can be identified in accordance with assays known in the art.
  • partial inhibition of the PTK pathway can be sufficient to achieve a prophylactic or therapeutic effect in the context of the present invention .
  • the PTK inhibitor is genistein (5,7- dihydroxy-3 - (4-hydroxyphenyl) -4H-l-benzopyran-4 -one) or a pharmaceutically acceptable, PTK pathway-inhibiting analogue or prodrug thereof or a pharmaceutically acceptable salt of any of the foregoing.
  • the PTK inhibitor can be a compound of the following formula :
  • the alkoxy is a C ⁇ -C 6 alkoxy.
  • the halo is fluorine, chlorine or bromine.
  • the ester is a C ⁇ -C 6 ester.
  • the ether is a C ⁇ -C 3 ether.
  • Preferred pharmaceutically acceptable salts of the carboxylic acid group include sodium and potassium salts.
  • the alkyl groups are C ⁇ -C 6 alkyl groups.
  • the PTK pathway inhibitor is genistein.
  • the prodrug can be any pharmaceutically acceptable prodrug of genistein, a PTK pathway-inhibiting analogue of genistein, or a pharmaceutically acceptable salt of either of the foregoing.
  • the prodrug used must be one that can be converted to an active PTK inhibitor in or around the macula, retina, choroid or Bruch's membrane.
  • a preferred prodrug is a prodrug that increases the lipid solubility of genistein, a PTK pathway- inhibiting analogue of genistein, or a pharmaceutically acceptable salt of either of the foregoing.
  • a preferred prodrug is one in which one or more of V, W and X are independently derivatized with an ester, such as pivalic acid.
  • analogue, prodrug or pharmaceutically acceptable salt of a compound in accordance with the present invention can treat macular degeneration, degeneration of the retina, degeneration of the choroid, or thickening of Bruch's membrane, any one of which can be due to aging, prophylactically or therapeutically can be determined by its effect in the mouse model used in Examples 2 and 4-6.
  • analogues, prodrugs and pharmaceutically acceptable salts of inhibitors of the PTK pathway can be tested by in vi tro assays such as, for example, the method set forth in Example 1.
  • color Doppler imaging can be used to evaluate the action of a drug in ocular pathology (Valli et al., Ophthalmologi ca 209(13) : 115-121 (1995)) .
  • Color Doppler imaging is a recent advance in ultrasonography, allowing simultaneous two-dimensional imaging of structures and the evaluation of blood flow. Accordingly, atrophic complications, such as retinal pigment epithelium atrophy, and exudative complications, such as choroidal neovascularization, can be analyzed using such technology.
  • complications associated with degeneration of the retina such as photoreceptor loss and ganglion cell loss, as well as complications associated with degeneration of the choroid, such as atrophy of the choriocapillaries and flattening of the choroid, can be analyzed using color Doppler imaging.
  • a PTK inhibitor can be bound to a suitable matrix, such as a polymeric matrix, if desired, for use in the present inventive method.
  • a suitable matrix such as a polymeric matrix
  • Any of a wide range of polymers can be used in the context of the present invention provided that, if the polymer-bound compound is to be used in vivo, the polymer is biologically acceptable (see, e.g., U.S. Patent Nos . 5,384,333 and 5, 164, 188) .
  • genistein is very safe and efficacious. For example, when genistein was orally administered to Zucker diabetic fatty rats, genistein was found to be nontoxic to the retina at dosages ranging from 75 mg/kg/day to 300 mg/kg/day over a period of six months as measured by electroretinography . In addition, oral administration of genistein was found to have no effect on food intake and body weight for male and female rats. Also, no effect of orally administered genistein was found with respect to the weight of the ovaries and the uterus in female rats.
  • the PTK inhibitor which is preferably genistein, a PTK pathway- inhibiting analogue of genistein, a PTK pathway- inhibiting prodrug of genistein, or a pharmaceutically acceptable salt of any of the foregoing, can be administered in accordance with the present inventive methods by any suitable route.
  • Suitable routes of administration include systemic, such as orally or by injection, topical, intraocular, periocular (e.g., subTenon's), subconjunctival , subretinal, suprachoroidal and retrobulbar.
  • the manner in which the PTK inhibitor is administered is dependent, in part, upon whether the treatment of age-related macular degeneration, degeneration of the retina, degeneration of the choroid, or thickening of Bruch's membrane is prophylactic or therapeutic.
  • the manner in which the PTK inhibitor is administered for therapeutic treatment of age-related macular degeneration is dependent, in part, upon the cause of the disease.
  • the PTK inhibitor can be administered prophylactically as soon as drusen and RPE hyperpigmentation are detected.
  • the PTK inhibitor is preferably administered systemically, e.g., orally or by injection.
  • the PTK inhibitor can be administered systemically, e.g., orally or by injection, intraocularly, topically, subconjunctivally or periocularly (e.g., subTenon's), for example .
  • the PTK inhibitor is preferably administered as soon as possible after it has been determined that an animal, such as a mammal, specifically a human, is at risk for age-related macular degeneration (prophylactic treatment) or has begun to develop age-related macular degeneration (therapeutic treatment) .
  • Treatment will depend, in part, upon the particular PTK inhibitor used, the amount of the PTK inhibitor administered, the route of administration, and the cause and extent, if any, of macular degeneration realized.
  • the PTK inhibitor is preferably administered as soon as possible after it has been determined that an animal, specifically a human, is at risk for retinal or choroidal degeneration or thickening of Bruch's membrane (prophylactic treatment) or has begun to develop degeneration of the retina or choroid or thickening of Bruch's membrane (therapeutic treatment) .
  • an animal specifically a human
  • suitable methods of administering a PTK inhibitor are available.
  • more than one route can be used to administer a particular PTK inhibitor, a particular route can provide a more immediate and more effective reaction than another route. Accordingly, the described routes of administration are merely exemplary and are in no way limiting .
  • the dose administered to an animal, particularly a human, in accordance with the present invention should be sufficient to effect the desired response in the animal over a reasonable time frame.
  • dosage will depend upon a variety of factors, including the strength of the particular PTK inhibitor employed, the age, species, condition or disease state, and body weight of the animal, as well as the amount of the macula, retina or choroid about to be affected or actually affected by degeneration or the amount of Bruch's membrane about to be affected or actually affected by thickening.
  • the size of the dose also will be determined by the route, timing and frequency of administration as well as the existence, nature, and extent of any adverse side effects that might accompany the administration of a particular PTK inhibitor and the desired physiological effect . It will be appreciated by one of ordinary skill in the art that various conditions or disease states, in particular, chronic conditions or disease states, may require prolonged treatment involving multiple administrations.
  • Suitable doses and dosage regimens can be determined by conventional range-finding techniques known to those of ordinary skill in the art . Generally, treatment is initiated with smaller dosages, which are less than the optimum dose of the compound. Thereafter, the dosage is increased by small increments until the optimum effect under the circumstances is reached.
  • the present inventive method will typically involve the administration of from about 1 mg/kg/day to about 100 mg/kg/day, preferably from about 15 mg/kg/day to about 50 mg/kg/day, if administered systemically. Intraocular administration typically will involve the administration of from about 0.1 mg total to about 5 mg total, preferably from about 0.5 mg total to about 1 mg total .
  • a preferred concentration for topical administration is
  • compositions for use in the present inventive method preferably comprise a pharmaceutically acceptable carrier and an amount of a PTK inhibitor sufficient to treat age- related macular degeneration and/or an atrophic or exudative complication thereof prophylactically or therapeutically.
  • compositions for use in the present inventive method of treating degeneration of the retina such as that which is due to aging, degeneration of the choroid, such as that which is due to aging, or thickening of Bruch's membrane, such as that which is due to aging, preferably comprise a pharmaceutically acceptable carrier and an amount of a PTK inhibitor sufficient to treat degeneration of the retina, degeneration of the choroid or thickening of Bruch's membrane, respectively, prophylactically or therapeutically.
  • the carrier can be any of those conventionally used and is limited only by chemico- physical considerations, such as solubility and lack of reactivity with the compound, and by the route of administration.
  • the PTK inhibitor can be formulated as polymeric compositions, inclusion complexes, such as cyclodextrin inclusion complexes, liposomes, microspheres, microcapsules and the like (see, e.g., U.S. Patent Nos. 4,997,652, 5,185,152 and 5,718,922) .
  • the PTK inhibitor can be formulated as a pharmaceutically acceptable acid addition salt.
  • pharmaceutically acceptable acid addition salts for use in the pharmaceutical composition include those derived from mineral acids, such as hydrochloric, hydrobromic, phosphoric, metaphosphoric , nitric and sulfuric acids, and organic acids, such as tartaric, acetic, citric, malic, lactic, fumaric, benzoic, glycolic, gluconic, succinic, and arylsulphonic , for example p-toluenesulphonic , acids.
  • pharmaceutically acceptable excipients described herein for example, vehicles, adjuvants, carriers or diluents, are well-known to those who are skilled in the art and are readily available to the public. It is preferred that the pharmaceutically acceptable carrier be one which is chemically inert to the PTK inhibitor and one which has no detrimental side effects or toxicity under the conditions of use.
  • excipient will be determined in part by the particular PTK inhibitor, as well as by the particular method used to administer the composition. Accordingly, there is a wide variety of suitable formulations of the pharmaceutical composition of the present invention. The following formulations are merely exemplary and are in no way limiting.
  • injectable formulations are among those that are preferred in accordance with the present inventive method.
  • the requirements for pharmaceutically effective carriers for injectable compositions are well-known to those of ordinary skill in the art (see Pharmaceutics and Pharmacy Practice, J.B. Lippincott Co., Philadelphia, PA, Banker and Chalmers, eds., pages 238-250 (1982), and ASHP Handbook on Injectable Drugs , Toissel, 4 th ed., pages 622- 630 (1986)). It is preferred that such injectable compositions be administered intramuscularly, intravenously, or intraperitoneally .
  • Topical formulations are well-known to those of skill in the art. Such formulations are suitable in the context of the present invention for application to the skin.
  • patches see, e.g., U.S. Patent No. 5,185,152
  • ophthalmic solutions see, e.g., U.S. Patent No. 5,710,182
  • ointments e.g., eye drops
  • Formulations suitable for oral administration can consist of (a) liquid solutions, such as an effective amount of the compound dissolved in diluents, such as water, saline, or orange juice; (b) capsules, sachets, tablets, lozenges, and troches, each containing a predetermined amount of the active ingredient, as solids or granules; (c) powders; (d) suspensions in an appropriate liquid; and (e) suitable emulsions.
  • Liquid formulations may include diluents, such as water and alcohols, for example, ethanol, benzyl alcohol, and the polyethylene alcohols, either with or without the addition of a pharmaceutically acceptable surfactant, suspending agent, or emulsifying agent.
  • Capsule forms can be of the ordinary hard- or soft -shelled gelatin type containing, for example, surfactants, lubricants, and inert fillers, such as lactose, sucrose, calcium phosphate, and corn starch.
  • Tablet forms can include one or more of lactose, sucrose, mannitol, corn starch, potato starch, alginic acid, microcrystalline cellulose, acacia, gelatin, guar gum, colloidal silicon dioxide, croscarmellose sodium, talc, magnesium stearate, calcium stearate, zinc stearate, stearic acid, and other excipients, colorants, diluents, buffering agents, disintegrating agents, moistening agents, preservatives, flavoring agents, and pharmacologically compatible excipients.
  • Lozenge forms can comprise the active ingredient in a flavor, usually sucrose and acacia or tragacanth, as well as pastilles comprising the active ingredient in an inert base, such as gelatin and glycerin, or sucrose and acacia, emulsions, gels, and the like containing, in addition to the active ingredient, such excipients as are known in the art .
  • an inert base such as gelatin and glycerin, or sucrose and acacia, emulsions, gels, and the like containing, in addition to the active ingredient, such excipients as are known in the art .
  • Formulations suitable for parenteral administration include aqueous and non-aqueous, isotonic sterile injection solutions, which can contain anti-oxidants , buffers, bacteriostats , and solutes that render the formulation isotonic with the blood of the intended recipient, and aqueous and non-aqueous sterile suspensions that can include suspending agents, solubilizers , thickening agents, stabilizers, and preservatives.
  • the inhibitor can be administered in a physiologically acceptable diluent in a pharmaceutical carrier, such as a sterile liquid or mixture of liquids, including water, saline, aqueous dextrose and related sugar solutions, an alcohol, such as ethanol, isopropanol, or hexadecyl alcohol, glycols, such as propylene glycol or polyethylene glycol, dimethylsulfoxide, glycerol ketals, such as 2 , 2 -dimethyl - 1 , 3 -dioxolane-4 -methanol , ethers, such as poly (ethyleneglycol) 400, an oil, a fatty acid, a fatty acid ester or glyceride, or an acetylated fatty acid glyceride, with or without the addition of a pharmaceutically acceptable surfactant, such as a soap or a detergent, suspending agent, such as pectin, carbomers, methylcellulose , hydroxypropylmethyl
  • Oils which can be used in parenteral formulations include petroleum, animal, vegetable, or synthetic oils. Specific examples of oils include peanut, soybean, sesame, cottonseed, corn, olive, petrolatum, and mineral. Suitable fatty acids for use in parenteral formulations include oleic acid, stearic acid, and isostearic acid. Ethyl oleate and isopropyl myristate are examples of suitable fatty acid esters.
  • Suitable soaps for use in parenteral formulations include fatty alkali metals, ammonium, and triethanolamine salts, and suitable detergents include
  • cationic detergents such as, for example, dimethyl dialkyl ammonium halides, and alkyl pyridinium halides,
  • anionic detergents such as, for example, alkyl, aryl, and olefin sulfonates, alkyl, olefin, ether, and monoglyceride sulfates, and sulfosuccinates
  • nonionic detergents such as, for example, fatty amine oxides, fatty acid alkanolamides, and polyoxyethylenepolypropylene copolymers
  • amphoteric detergents such as, for example, alkyl-p- aminopropionates , and 2-alkyl-imidazoline quaternary ammonium salts, and (e) mixtures thereof.
  • the parenteral formulations will typically contain from about 0.5 to about 25% by weight of the active ingredient in solution. Preservatives and buffers may be used. In order to minimize or eliminate irritation at the site of injection, such compositions may contain one or more nonionic surfactants having a hydrophile- lipophile balance (HLB) of from about 12 to about 17. The quantity of surfactant in such formulations will typically range from about 5 to about 15% by weight. Suitable surfactants include polyethylene sorbitan fatty acid esters, such as sorbitan monooleate and the high molecular weight adducts of ethylene oxide with a hydrophobic base, formed by the condensation of propylene oxide with propylene glycol.
  • HLB hydrophile- lipophile balance
  • parenteral formulations can be presented in unit-dose or multi-dose sealed containers, such as ampules and vials, and can be stored in a freeze-dried (lyophilized) condition requiring only the addition of the sterile liquid excipient, for example, water, for injections, immediately prior to use.
  • sterile liquid excipient for example, water
  • Extemporaneous injection solutions and suspensions can be prepared from sterile powders, granules, and tablets of the kind previously described.
  • compositions can be formulated as intraocular formulations, sustained-release formulations or devices (see, e.g., U.S. Patent No. 5,378,475).
  • gelantin, chondroitin sulfate, a polyphosphoester, such as bis-2-hydroxyethyl-terephthalate (BHET) , or a polylactic-glycolic acid (in various proportions) can be used to formulate sustained-release formulations.
  • Implants see, e.g., U.S. Patent Nos. 5,443,505, 4,853,224 and 4,997,652
  • devices see, e.g., U.S. Patent Nos.
  • an implantable device e.g., a mechanical reservoir
  • an intraocular device or an extraocular device with an intraocular conduit e.g., 100 ⁇ - 1 mm in diameter
  • an implant or a device comprised of a polymeric composition as described above can be used.
  • the present inventive method also can involve the co-administration of other pharmaceutically active compounds.
  • co-administration is meant administration before, concurrently with, e.g., in combination with the PTK inhibitor in the same formulation or in separate formulations, or after administration of a PTK inhibitor as described above.
  • corticosteroids e.g., prednisone, methylprednisolone, dexamethasone, or triamcinalone acetinide
  • noncorticosteroid anti- inflammatory compounds such as ibuprofen or flubiproben
  • vitamins and minerals e.g., zinc
  • anti-oxidants e.g., carotenoids (such as a xanthophyll carotenoid like zeaxanthin or lutein)
  • micronutrients can be co-administered.
  • inhibitors of the protein tyrosine kinase pathway which include natural protein tyrosine kinase inhibitors like quercetin, lavendustin A, erbstatin and herbimycin A, and synthetic protein tyrosine kinase inhibitors like tyrphostins (e.g., AG490, AG17, AG213 (RG50864) , AG18, AG82, AG494, AG825, AG879, AG1112, AG1296, AG1478, AG126, RG13022, RG14620 and G555), dihydroxy- and dimethoxybenzylidene malononitrile, analogs of lavendustin A (e.g., AG814 and AG957) , quinazolines (e.g., AG1478), 4 , 5-dianilinophthalimides, and thiazolidinediones , can be co-administered with genistein or an analogue, prodrug
  • genistein include those set forth in Mazurek et al . , U.S. Patent No. 5,637,703.
  • Neutralizing proteins to growth factors such as a monoclonal antibody that is specific for a given growth factor, e.g., VEGF (for an example, see Aiello et al . , PNAS USA 92: 10457-10461 (1995)), or phosphotyrosine (Dhar et al . , Mol . Pharmacol .
  • senors of protein kinase C see, e.g., U.S. Patent Nos. 5,719,175 and 5,710,145
  • cytokine modulators an endothelial cell-specific inhibitor of proliferation, e.g., thrombospondins , an endothelial cell-specific inhibitory growth factor, e.g., TNF , an anti-proliferative peptide, e.g., SPARC and prolferin- like peptides, a glutamate receptor antagonist, aminoguanidine, an angiotensin-converting enzyme inhibitor, e.g., angiotensin II, calcium channel blockers, ⁇ -tectorigenin, ST638, somatostatin analogues, e.g., SMS 201-995, monosialoganglioside GM1 , ticlopidine,
  • thalidomide nicardipine hydrochloride
  • aspirin piceatannol, staurosporine, adriamycin, epiderstatin, (+) -aeroplysinin-1
  • phenazocine halomethyl ketones
  • anti-lipidemic agents e.g., etofibrate, chlorpromazine and spinghosines
  • aldose reductase inhibitors such as tolrestat, SPR-210, sorbinil or oxygen, and retinoic acid and analogues thereof (Burke et al .
  • Matrigel Collaborative Research, Bedford, MA
  • bFGF fetal growth factor
  • genistein 0.2 mg/100 ml
  • Matrigel is derived from basement membrane-producing tumor tissue and is comprised of type IV collagen and laminin as is the retinal basement membrane, differing only in the relative proportions of the components.
  • This example illustrates the ability of genistein to inhibit disruption of the integrity of and the subsequent retinal capillary endothelial cell invasion of a basement membrane .
  • EXAMPLE 2 This example demonstrates the ability of genistein to inhibit photoreceptor loss as associated with age- related macular degeneration and degeneration of the retina associated with aging.
  • SAM9 mice senile accelerated mice strain 9 (SAM9) and resistant mice strain 4 (R4) (both strains were gifts from Kyoto University, Japan and are currently maintained at Johns Hopkins University) , were exposed to a light source in order to determine the effect of genistein on light -induced damage of the macula.
  • SAM9 mice are prone to accelerated age-associated changes in the skin and eye.
  • R4 mice are identical to S M9 , except that R4 mice are resistant to physical changes associated with accelerated aging.
  • mice of each strain were divided into control and treatment groups .
  • the treatment groups received genistein (150 mg/kg food) by oral lavage once daily up to about 4 weeks. Mice were sacrificed at 1, 2 and 3 weeks following light exposure. Eyes were enucleated and cut serially for histological study. Specifically, the photoreceptor nuclei were counted to determine the degree of photoreceptor loss over specific areas of the posterior and peripheral retina. At week 1, an average of six layers of photoreceptor nuclei were observed in both the treated and control groups for both strains of mice . There was no significant difference in the amount of light-induced damage between the control and treatment groups.
  • genistein had significantly reduced the amount of light -induced damage in the treatment groups of both strains .
  • An average of two to three layers of photoreceptor nuclei were observed in the SAM9 mice and the R4 mice treated with genistein. Approximately 0-1 layer of photoreceptor nuclei was observed in control groups.
  • an average of 0-1 layers of photoreceptor nuclei was observed in both treated and untreated animals of both strains .
  • An additional strain of senile accelerated mice, strain 8 (SAM8) , along with resistant strain 1 (RI) were exposed to a light source in order to determine the effect of genistein on light-induced photoreceptor cell loss.
  • mice All subjects were exposed to constant, white fluorescent light of 800-lux, after dark adaptation for 24 hours.
  • Each of the SAM8 and RI strains of mice was divided into two groups: the treated group, which received genistein (50 mg/kg body weight/day) orally by the lavage method, and the control group, which received no treatment.
  • the thickness and cell count in the outer nuclear layer (ONL) was greater in the genistein treated groups of both SAM8 and RI , than in the control groups.
  • the ONL thickness was greater in the genistein treated RI than in the corresponding control group.
  • the ONL thickness was greater in the genistein treated RI than in the corresponding control group.
  • the example illustrates the ability of genistein to inhibit photoreceptor loss, such as that associated with degeneration of the retina, such as that which is due to aging, and age-related macular degeneration.
  • This example demonstrates the ability of genistein to inhibit the progression of age-related macular degeneration after disruption of Bruch's membrane.
  • Bruch's membrane in three cynomolgus monkeys was disrupted using a laser beam and subsequent choroidal neovascularization was evaluated.
  • Genistein was administered to two monkeys via a single intraocular injection of 100 mg before laser-induced disruption of Bruch's membrane. Thirteen of seventeen lesions developed neovascularization.
  • One monkey was administered genistein orally (300 mg/kg body weight), in addition to a single intraocular injection (100 mg) , every other day starting two days prior to laser treatment, for a total of three doses. Of eighteen lesions resulting from laser treatment, only two developed choroidal neovascularization.
  • This example describes a method of determining the usefulness of a PTK pathway inhibitor as described herein to inhibit or ameliorate degeneration of the retina, such as that which is due to aging.
  • SAMP mice senile accelerated prone strain
  • SAMR mice resistant strain
  • mice are bred under specific pathogen-free conditions with a high efficiency particulate device with a temperature- and a light- controlled regimen (68-72° F and a light/dark cycle with lights on at 7:00 a.m. to 9:00 p.m.) and free access to food (PMI Nutrition International, Inc , 1401, St. Louis, MO) ad libitum and water from an automated filtered system.
  • the treatment groups receive genistein (50 mg/kg/day) by oral lavage once daily or, alternatively, genistein is incorporated into food (150 mg/kg food) .
  • eyes are enucleated and, optionally, cut serially for histological study.
  • eye cups are fixed for 2 hours in 2% osmium tetroxide in phosphate buffer, alcohol dehydrated and embedded in epoxy resin.
  • Two micron thick sections are stained with toluidine blue and are used for light microscopy.
  • electron microscopy thin sections are stained with lead citrate and uranyl acetate and examined in a JOEL JEM-100 CX 2 electron microscope (Hitachi, Tokyo, Japan) .
  • Ganglion cell loss and retinal pigment epithelium changes in control and treated subjects are then examined. Specifically, if desired, the ganglion cell nuclei are counted to determine the degree of ganglion cell loss.
  • This example describes a method of determining the usefulness of a PTK pathway inhibitor as described herein to inhibit or ameliorate degeneration of the choroid, such as that which is due to aging.
  • mice Two strains of mice, a senile accelerated prone strain (SAMP) and a resistant strain (SAMR) , obtained from Takeda Chemical Industries Ltd. , Osaka, Japan, are employed to analyze the effect of genistein on degeneration of the choroid. The animals are kept as described in Example 4. Changes in the choriocapillaries, including atrophy of the choriocapillaries, are examined via light and electron microscopy, as described in Example 4.
  • SAMP senile accelerated prone strain
  • SAMR resistant strain
  • Choroidal vascular casts are also useful in analyzing the extent of choriocapillary atrophy.
  • Subjects are anaesthetized with an intramuscular injection of 50 mg/kg body weight of Ketamine + Xylazine.
  • the left ventricle is perfused with 50 ml of heparinized lactated Ringer's solution.
  • the mice are then sacrificed prior to injecting mercox solution (Ladd Research Industries, Burlington, VT) through the left ventricle.
  • the eyes are enucleated and the anterior segment is separated by micro-dissection.
  • Corrosion casts of the posterior segment are made in 0.1 mol KOH .
  • the retinal vessels are separated from the choroidal vasculature by careful micro-dissection under water.
  • Choroidal vascular casts are mounted on aluminum tubs and sputter-coated with gold palladium prior to scanning electron microscopy (JOEL JSM-840A scanning electron microscope, Hitachi, Tokyo, Japan) .
  • Quantitative analysis of the choroidal vascular bed is performed by recording random areas in the posterior pole of each eye at 400 X magnification.
  • Microplan II image analysis program (Laboratory Computer Systems Inc., MA) is used for measuring the area of choroidal vascular bed in each 400x photograph by tracing the area of choriocapillaries. The resultant values are tabulated and analyzed by paired student's t test. P values less than 0.05 are typically regarded as significant.
  • This example describes a method of determining the usefulness of a PTK pathway inhibitor as described herein to inhibit or ameliorate thickening of Bruch's membrane, which is often associated with aging.
  • mice Two strains of mice, a senile accelerated prone strain (SAMP) and a resistant strain (SAMR) , are obtained from Takeda Chemical Industries Ltd., Osaka, Japan, and employed to analyze the effect of genistein on thickening of Bruch's membrane. The animals are kept as described in Example 4. Changes in Bruch's membrane, including thickening of Bruch's membrane, are examined via light and electron microscopy, as described in Example 4.
  • SAMP senile accelerated prone strain
  • SAMR resistant strain

Abstract

L'invention concerne un procédé de traitement prophylactique et thérapeutique pour la dégénérescence maculaire liée au vieillissement, ainsi que des procédés de traitement prophylactique et thérapeutique pour les complications exsudatives et atrophiques de ladite dégénérescence. Ces procédés consistent à administrer un inhibiteur de trajet de protéine tyrosine kinase à un animal, du type mammifère, en particulier à un être humain, en quantité suffisante pour les besoins du traitement prophylactique ou thérapeutique de la dégénérescence ou des complications considérées, respectivement. L'invention concerne en outre un procédé de traitement prophylactique et thérapeutique pour la dégénérescence rétinienne, un procédé de traitement prophylactique et thérapeutique pour la dégénérescence choroïdienne, et un procédé de traitement prophylactique et thérapeutique pour l'épaississement de la membrane de Bruch. Ces procédés consistent à administrer un inhibiteur de trajet de protéine tyrosine kinase à un animal, du type mammifère, en particulier à un être humain, en quantité suffisante pour les besoins du traitement prophylactique ou thérapeutique de la dégénérescence maculaire, rétinienne ou choroïdienne, ou bien de l'épaississement de la membrane de Bruch, respectivement. De préférence, cet inhibiteur est de la génistéine ou bien un analogue ou un promédicament correspondant, ou encore un sel pharmaceutiquement acceptable de l'un quelconque de ces produits.
EP00932108A 1999-05-07 2000-05-05 Utilisation d'un inhibiteur de trajet de proteine tyrosine kinase dans le traitement des troubles oculaires Withdrawn EP1178791A2 (fr)

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US7771742B2 (en) * 2004-04-30 2010-08-10 Allergan, Inc. Sustained release intraocular implants containing tyrosine kinase inhibitors and related methods
TW200640443A (en) * 2005-02-23 2006-12-01 Alcon Inc Methods for treating ocular angiogenesis, retinal edema, retinal ischemia, and diabetic retinopathy using selective RTK inhibitors
US20070149593A1 (en) * 2005-12-23 2007-06-28 Alcon, Inc. PHARMACEUTICAL FORMULATION FOR DELIVERY OF RECEPTOR TYROSINE KINASE INHIBITING (RTKi) COMPOUNDS TO THE EYE
EP3744254A4 (fr) * 2018-01-25 2021-11-03 Osaka University Procédé de détection d'état de stress et dispositif de détection de stress
CN114931574A (zh) * 2022-06-14 2022-08-23 深圳爱尔眼科医院 一种铁死亡抑制剂及其应用

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AU774495B2 (en) 2004-07-01
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