EP1644033A2 - Use of inhibitors of enzymes with aminopeptidase n and/or dipeptidylpeptidase iv activity and pharmaceutical preparations of said inhibitors for the treatment and prevention of dermatological diseases involving the hyperproliferation and modified differentiation conditions of fibroblasts - Google Patents

Use of inhibitors of enzymes with aminopeptidase n and/or dipeptidylpeptidase iv activity and pharmaceutical preparations of said inhibitors for the treatment and prevention of dermatological diseases involving the hyperproliferation and modified differentiation conditions of fibroblasts

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Publication number
EP1644033A2
EP1644033A2 EP04740701A EP04740701A EP1644033A2 EP 1644033 A2 EP1644033 A2 EP 1644033A2 EP 04740701 A EP04740701 A EP 04740701A EP 04740701 A EP04740701 A EP 04740701A EP 1644033 A2 EP1644033 A2 EP 1644033A2
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Prior art keywords
inhibitors
xaa
apn
derivatives
enzymes
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EP04740701A
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German (de)
French (fr)
Inventor
Siegfried Ansorge
Harald Gollnick
Uwe Lendeckel
Klaus Martin-Luther-Univ. Biochemi/Tech. NEUBERT
Dirk Uni. Magdeburg Inst. Immunologie REINHOLD
Robert Uni. Magdeburg VETTER
B. Uni. Magdeburg Inst. Immunologie SCHRAVEN
Anja Uni. Magdeburg THIELITZ
Jürgen Martin-Luther-Universität FAUST
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IMTM GmbH
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IMTM GmbH
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00Drugs for disorders of the respiratory system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00Drugs for genital or sexual disorders; Contraceptives
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00Drugs for dermatological disorders
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00Drugs for dermatological disorders
    • A61P17/02Drugs for dermatological disorders for treating wounds, ulcers, burns, scars, keloids, or the like
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00Drugs for dermatological disorders
    • A61P17/14Drugs for dermatological disorders for baldness or alopecia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00Drugs for skeletal disorders
    • A61P19/04Drugs for skeletal disorders for non-specific disorders of the connective tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P21/00Drugs for disorders of the muscular or neuromuscular system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00Antineoplastic agents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P37/00Drugs for immunological or allergic disorders
    • A61P37/02Immunomodulators
    • A61P37/06Immunosuppressants, e.g. drugs for graft rejection
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

  • the invention describes the inhibition of the DNA synthesis of fibroblasts necessary for the proliferation and differentiation by the action of inhibitors of aminopeptidase N (APN, EC 3.4.11.2, CD13) or / and dipeptidyl peptidase IV (DP IV, EC 3.4.14.5, CD26) as a result of the individual, simultaneous or immediately sequential application of respectively specific inhibitors of these enzymes or of inhibitors of enzymes of the same substrate specificity (APN- and / or DP IV-analogous enzyme activity) on the basis of amino acid derivatives, peptides or peptide derivatives, by which the proliferation (DNA synthesis) and differentiation of fibroblasts is suppressed and modulated.
  • APN aminopeptidase N
  • DP IV dipeptidyl peptidase IV
  • a number of dermatological diseases are associated with hyperproliferation and changes in the differentiation states of fibroblasts. They include both benign fibroblastic hyperproliferative conditions (here in particular post-infectious, post-inflammatory and post-traumatic: hypertrophic scars, keloids, angiofibromas, dermatofibromas, fibrolipomas, ulcer scars), which also occur in the context of disseminated (myo-) fibromatoses (e.g. congenital fibromatosis) also malignant fibroblastic hyperproliferative states (e.g.
  • fibrosarcomas mixed tumors such as atypical fibroxanthoma, malignant fibrous histiocytoma, aggressive angiomyxoma, paraneoplasias).
  • Fibrous autoimmune diseases such as localized and systemic scleroderma in its various forms (circumscript S., progressive-systemic S., CREST syndrome), dermatosclerosis in other collagenoses and the cutaneous variant of the graft-versus-host disease. Changes in the differentiation states of the fibroblasts are an expression of various fibrosing diseases with a currently largely unexplained atiology.
  • pseudoscleroderma such as eosinophilic / proliferating fasciitis, exogenously caused pseudoscleroderma such as toxic oil syndrome, silicosis, porphyrias, eosinophilia-myalgia syndrome, Liehen associated myxoedema syndrome.
  • stasis fibrosis for chronic venous insufficiency and lipolymphedema, late fibrosis of alopecia androgenetica, and rare localized fibroblastic diseases (Dupuytren disease, Ledderhose disease, "knuckle pads", induration penis plastica).
  • Peptidases such as dipeptidyl petidase IV and aminopeptidase N or enzymes with a similar effect are particularly interesting for the regulation or modulation of interactions between cells, since they are partly located as ectoenzymes in the plasma membrane of the cells, interact with other extracellular structures, peptide messengers activate or inactivate by enzyme-catalyzed hydrolysis and are therefore important for cell-cell communication [Yaron A, et al .: Proline-dependent structural and biological properties of peptides and proteins. Grit Rev Biochem Mol Biol 1993; 28: 31-81; Vanhoof G, et al .: Proline motifs in peptides and their biological processing. FASEB J 1995; 9: 736-744].
  • membrane-active peptidases such as DP IV or APN play a key role in the process of activation and clonal expansion of immune cells, in particular T lymphocytes
  • T lymphocytes T lymphocytes
  • Fleischer B CD26 a surface protease involved in T-cell activation. Immunology Today 1994; 15: 180-184; Lendeckel U et al .: Role of alanyl aminopeptidase in growth and function of human T cells. International Journal of Molecular Medicine 1999; 4: 17-27; Riemann D et al .: CD13 - not just a marker in leukemia typing. Immunology Today 1999; 20: 83-88].
  • mitogen-stimulated mononuclear cells or enriched T lymphocytes
  • DNA synthesis production and secretion of immunostimulatory cytokines (IL-2, IL-6, IL-12, IFN- ⁇ ) and helper functions for B cells ( IgG and IgM synthesis)
  • IL-2, IL-6, IL-12, IFN- ⁇ immunostimulatory cytokines
  • helper functions for B cells IgG and IgM synthesis
  • Inhibitors and antibodies against dipeptidyl peptidase IV suppress lymphocyte proliferation and immunoglobulin synthesis in vitro.
  • the invention is based on the surprising finding that the individual or simultaneous effect of inhibitors of on or in fibroblasts expressed dipeptidyl peptidase IV / DP IV or CD26 or of inhibitors of enzymes with the same substrate specificity (DP IV-analogous enzyme activity) and of inhibitors of aminopeptidase N / APN or CD13 or of inhibitors of enzymes with the same substrate specificity (APN-analogous enzyme activity), inhibits the proliferation (DNA synthesis) of fibroblasts.
  • Our invention shows that for the therapy and prevention of dermatological diseases with fibroblastic hyperproliferation and changed differentiation states, for their development the proliferation and the differentiated regulation of the DNA synthesis of fibroblasts is of central importance, the single or simultaneous application of inhibitors of DP IV and the APN or inhibitors of enzymes of the same substrate specificity (APN- and / or DP IV-analogous enzyme activity) or corresponding preparations and dosage forms thereof are suitable.
  • the invention is based on the findings that the DNA synthesis of fibroblasts is significantly inhibited by the administration of inhibitors of dipeptidyl peptidase IV or of inhibitors of enzymes with the same substrate specificity or / and of inhibitors of aminopeptidase N or of inhibitors of enzymes with the same substrate specificity becomes.
  • inhibitors of dipeptidyl peptidase IV applied according to the invention or inhibitors of enzymes with the same substrate specificity (DP IV-analogous enzyme activity) or / and inhibitors of aminopeptidase N or inhibitors of enzymes of the same substrate specificity (APN-analogous enzyme activity) can be used in pharmaceutically acceptable formulation complexes as inhibitors, substrates, Pseudo substrates, inhibitory peptides and peptide derivatives and as antibodies of these enzymes are used.
  • the inhibitors according to the invention are used alone or in combination of several of them, preferably in combination of two of them.
  • dipeptide boronic acids
  • TSL Tryptophan-1, 2,3,4-tetrahydroisoquinoline-3-carboxylic acid derivatives
  • (2S, 2S ', 2S ") 2- [2' - [2" -amino-3 " - (indol-3 " '-yl) -1 " - oxoprolyl] -r, 2', 3 ' , 4'-tetrahydro-6 ' 8 ' -dihydroxy-7-methoxyisoquinol-3-yl- carbonyl-amino] -4-hydromethyl-5-hydropentanoic acid (TMC-2A) used become.
  • An exemplary, advantageously usable inhibitor of DP IV is Lys [Z (NO 2 ] thiazolidide, in which Lys stands for an L-lysine residue and Z (NO 2 ) stands for 4-nitrobenzyloxycarbonyl (cf. DD-A 296075) ,
  • inhibitors of alanyl aminopeptidase include, for example, actinonin, leuhistin, phebestin, amastatin, bestatin, probestin, ß-aminothiols, ⁇ -aminophosphinic acids, ⁇ -aminophosphinic acid derivatives, preferably D-Phe- ⁇ -PO ( OH) -CH 2 ] -Phe-Phe and their salts.
  • Preferred inhibitors for alanyl aminopeptidase are Bestatin (Ubenimex), Actinonin, Probestin, Phebestin, RB3014 or Leuhistin.
  • the inhibitors or pharmaceutical preparations containing them are administered simultaneously with known carriers. Included in the invention 'are also pharmaceutical preparations containing two or more of the inhibitors of DP IV or of inhibitors of enzymes having DP IV-analogous enzyme activity and / or the APN or inhibitors of enzymes having APN-analogous enzyme activity in spaced formulation in Combination with known carrier, auxiliary and / or additives for simultaneous or immediately sequential administration with the aim of a common effect.
  • the administration takes place on the one hand as a topical application in the form of, for example, creams, ointments, pastes, gels, solutions, sprays, liposomes and nanosomes, shaking mixtures, "pegylated” formulations, degradable (ie degradable under physiological conditions) depot matrices, hydrocolloid dressings, Patches, micro swarms, prepolyomers and similar new carrier substrates, jet injection or other dermatological bases / vehicles including instillative application, and on the other hand as a systemic application for oral, transdermal, intravenous, subcutaneous, intracutaneous, intramuscular use in suitable formulations or in suitable galenics ,
  • the inhibitor (s) according to the invention and preparations which contain one or more of the inhibitors mentioned and, if appropriate, further components such as further inhibitors, as well as pharmaceutically acceptable additives, auxiliaries or carriers, come from a large number of dermatological diseases or conditions with hyperproliferation and changed differentiation states of fibroblasts as
  • fibrosing and sclerosing diseases such as post-infectious and post-traumatic: hypertrophic scars, keloids, dermatofibromas, fibrolipomas as well as disseminated (myo) fibromatoses
  • malignant fibroblastic hyperproliferative conditions such as mixed fibrosis, such as mixed fibroids atypical fibroxanthoma, malignant fibrous histiocytoma, aggressive angiomyxoma, paraneoplasias), of fibrosing autoimmune diseases such as scleroderma (circumscribed scleroderma, progressive-systemic scleroderma, CREST syndrome), dermatosclerosis and host disease, other collagen desigenosis, lie-graft disease scierosus et atrophicus and the heterogeneous group of pseudoscleroderma (such as eosinophilic / proliferating fasciitis, exogenously caused
  • the invention also relates to a method for the therapy and prevention of dermatological diseases with hyperproliferation and changed differentiation states of fibroblasts, which involves the administration of Inhibitors of dipeptidyl peptidase IV (DP IV) and of inhibitors of enzymes with the same substrate specificity (DP IV-analogous enzyme activity) or / and of inhibitors of alanyl aminopeptidase (aminopeptidase N, APN) and of inhibitors of enzymes of the same substrate specificity (APN-analogous enzyme activity ) to a patient who needs treatment for the prevention and / or therapy of the abovementioned dermatological diseases.
  • DP IV dipeptidyl peptidase IV
  • APN alanyl aminopeptidase
  • the inhibitors and, where appropriate, their combinations and pharmaceutical preparations containing them are used in the prevention and therapy of diseases and / or conditions with hyperproliferation and changed differentiation states of fibroblasts.
  • prevention and therapy of both benign fibrosing and sclerosing diseases here in particular post-infectious and post-traumatic: hypertrophic scars, keloids, dermatofibromas, fibrolipomas as well as disseminated (myo) fibromatoses
  • malignant fibroblastic hyperproliferative conditions such as mixed fibrosis, such as mixed fibroids atypical fibroxanthoma, malignant fibrous histiocytoma, aggressive angiomyxoma, paraneoplasias), of fibrosing autoimmune diseases such as scleroderma (circumscribed scleroderma, progressive-systemic scleroderma, CREST syndrome), dermatosclerosis and host disease, other collagen desigenosis,
  • Pseudoscleroderms such as toxic oil syndrome, silicosis, porphyria, eosinophilia-myalg e syndrome, lying myxoedematosus or borrelia-associated fibrosis), of secondary sclerotherapy such as e.g. in the context of stasis fibrosis in chronic venous insufficiency and lipolymphedema, in the fibrosing late stage of alopecia androgenetica and in rare localized fibroblastic diseases (M. Dupuytren, M. Ledderhose, "knuckle pads", induration penis plastica).
  • one or more of the DP IV and / or APN inhibitors mentioned are used in such a way that two or more the inhibitors of DP IV or inhibitors of enzymes with DP IV-analogous enzyme activity or / and inhibitors of APN or inhibitors of enzymes with APN-analogous enzyme activity in spatially separated formulations in combination with known carrier, auxiliary and / or Additives are administered simultaneously or immediately in succession with the aim of a common effect.
  • the administration takes place as a systemic application for oral, transdermal, percutaneous, intravenous, subcutaneous, intracutaneous, intramuscular, rectal, vaginal, sublingual application together with carrier, auxiliary and / or additives known per se and / or as a topical application in the form of Creams, ointments, pastes, gels, solutions, sprays, liposomes or nanosomes, "pegylated" formulations, degradable depot matrices, shaking mixtures, hydrocolloid dressings, plasters, microsponges, prepolyomers and similar new carrier substrates, jet injections and other dermatological bases for vehicles , including instillative application.

Abstract

The invention relates to a method for inhibiting the DNA synthesis of human fibroblasts that is necessary for proliferation, by the individual or combined action of inhibitors of alanyl-aminopeptidase (APN) and dipeptidylpeptidase IV (DP IV) that is expressed by said cells. The DNA synthesis (proliferation) of human fibroblasts is inhibited by a dosage-dependent administration of the APN and/or the DP IV. According to the invention, the application of inhibitors of the aforementioned enzyme or of preparations and administrable forms containing said inhibitors is eminently suitable for the treatment and prevention of dermatological diseases involving fibroblastic hyperproliferation and modified differentiation conditions of fibroblasts.

Description

Verwendung der Inhibitoren von Enzymen mit Aktivitäten der Aminopeptidase N und/oder der Dipeptidylpeptidase IV und pharmazeutischen Zubereitungen daraus zur Therapie und Prävention dermatologischer Erkrankungen mit Hyperproliferation und veränderten Differenzierungszuständen von Fibroblasten Use of the inhibitors of enzymes with activities of the aminopeptidase N and / or the dipeptidyl peptidase IV and pharmaceutical preparations therefrom for the therapy and prevention of dermatological diseases with hyperproliferation and changed differentiation states of fibroblasts
Beschreibungdescription
Die Erfindung beschreibt die Hemmung der für die Proliferation und Differenzierung notwendigen DNA-Synthese von Fibroblasten durch die Wirkung von Inhibitoren der Aminopeptidase N (APN, EC 3.4.11.2, CD13) oder/und der Dipeptidylpeptidase IV (DP IV, EC 3.4.14.5, CD26) im Ergebnis der einzelnen, simultanen oder zeitlich unmittelbar aufeinanderfolgenden Applikation von jeweils spezifischen Inhibitoren dieser Enzyme oder von Inhibitoren von Enzymen gleicher Substratspezifität (APN- oder/und DP IV- analoge Enzymaktivität) auf der Basis von Aminosäurederivaten, Peptiden oder Peptidderivaten, durch welche die Proliferation (DNA-Synthese) und Differenzierung von Fibroblasten supprimiert und moduliert wird.The invention describes the inhibition of the DNA synthesis of fibroblasts necessary for the proliferation and differentiation by the action of inhibitors of aminopeptidase N (APN, EC 3.4.11.2, CD13) or / and dipeptidyl peptidase IV (DP IV, EC 3.4.14.5, CD26) as a result of the individual, simultaneous or immediately sequential application of respectively specific inhibitors of these enzymes or of inhibitors of enzymes of the same substrate specificity (APN- and / or DP IV-analogous enzyme activity) on the basis of amino acid derivatives, peptides or peptide derivatives, by which the proliferation (DNA synthesis) and differentiation of fibroblasts is suppressed and modulated.
Eine Reihe dermatologischer Erkrankungen gehen mit Hyperproliferation und veränderten Differenzierungszuständen von Fibroblasten einher. Zu ihnen gehören sowohl benigne fibroblastäre Hyperproliferationszuslände (hier insbesondere postinfektiös, postinflammatorisch und posttraumatisch: hypertrophe Narben, Keloide, Angiofibrome, Dermatofibrome, Fibrolipome, Ulcusnarben), die auch auch im Rahmen disseminierter (Myo-)Fibromatosen auftreten (z.B. kongenitale disseminierte Fibromatose), als auch maligne fibroblastäre Hyperproliferationszustände (z.B. Fibrosarkome, Mischtumoren wie atypisches Fibroxanthom, malignes fibröses Histiozytom, aggressives Angiomyxom, Paraneoplasien). Eine weitere Erkrankungsgruppe bilden fibrosierende Autoimmunerkrankungen wie die lokalisierte und systemische Sklerodermie in ihren verschiedenen Ausprägungen (zirkumskripte S., progressiv-systemische S., CREST-Syndrom), die Dermatosklerose bei anderen Kollagenosen und die cutane Variante der Graft-versus-Host- Erkrankung. Veränderte Differenzierungszustände der Fibroblasten sind Ausdruck verschiedener fibrosierender Erkrankungen mit derzeit noch weitgehend ungeklärter Atiologie. Hierzu zählen der Liehen scierosus et atrophicus und die heterogene Gruppe der Pseudosklerodermien (wie z.B. die eosinophile/proliferierende Fasciitis, exogen verursachte Pseudosklerodermien wie Toxic oil syndrome, Silikose, Porphyrien, Eosinophilie-Myalgie-Syndrom, Liehen myxödematosus oder Borrelien-assoziierte Fibrosierungen). Weiterhin gibt es sekundäre Sklerosierungen wie z.B. im Rahmen einer Stauungsfibrose bei chronisch venöser Insuffizienz und bei Lipolymphödemen, im fibrosierenden Spätstadium der Alopecia androgenetica und seltene lokalisierte fibroblastäre Erkrankungen (M. Dupuytren, M. Ledderhose, "Knuckle pads", Induratio penis plastica).A number of dermatological diseases are associated with hyperproliferation and changes in the differentiation states of fibroblasts. They include both benign fibroblastic hyperproliferative conditions (here in particular post-infectious, post-inflammatory and post-traumatic: hypertrophic scars, keloids, angiofibromas, dermatofibromas, fibrolipomas, ulcer scars), which also occur in the context of disseminated (myo-) fibromatoses (e.g. congenital fibromatosis) also malignant fibroblastic hyperproliferative states (e.g. fibrosarcomas, mixed tumors such as atypical fibroxanthoma, malignant fibrous histiocytoma, aggressive angiomyxoma, paraneoplasias). Form another group of diseases Fibrous autoimmune diseases such as localized and systemic scleroderma in its various forms (circumscript S., progressive-systemic S., CREST syndrome), dermatosclerosis in other collagenoses and the cutaneous variant of the graft-versus-host disease. Changes in the differentiation states of the fibroblasts are an expression of various fibrosing diseases with a currently largely unexplained atiology. These include the Liehen scierosus et atrophicus and the heterogeneous group of pseudoscleroderma (such as eosinophilic / proliferating fasciitis, exogenously caused pseudoscleroderma such as toxic oil syndrome, silicosis, porphyrias, eosinophilia-myalgia syndrome, Liehen associated myxoedema syndrome). There are also secondary sclerotherapy such as stasis fibrosis for chronic venous insufficiency and lipolymphedema, late fibrosis of alopecia androgenetica, and rare localized fibroblastic diseases (Dupuytren disease, Ledderhose disease, "knuckle pads", induration penis plastica).
Peptidasen wie die Dipeptidylpetidase IV und die Aminopeptidase N oder ähnlich wirkende Enzyme sind für die Regulation bzw. Modulation von Wechselwirkungen zwischen Zellen besonders interessant, da sie zum Teil als Ektoenzyme in der Plasmamembran der Zellen lokalisiert sind, Interaktionen mit anderen extrazellulären Strukturen eingehen, peptiderge Botenstoffe durch enzymkatalysierte Hydrolyse aktivieren bzw. inaktivieren und dadurch wichtig für die Zell-Zell-Kommunikation sind [Yaron A, et al.: Proline-dependent structural and biological properties of peptides and proteins. Grit Rev Biochem Mol Biol 1993;28:31-81 ; Vanhoof G, et al.: Proline motifs in peptides and their biological processing. FASEB J 1995;9:736-744].Peptidases such as dipeptidyl petidase IV and aminopeptidase N or enzymes with a similar effect are particularly interesting for the regulation or modulation of interactions between cells, since they are partly located as ectoenzymes in the plasma membrane of the cells, interact with other extracellular structures, peptide messengers activate or inactivate by enzyme-catalyzed hydrolysis and are therefore important for cell-cell communication [Yaron A, et al .: Proline-dependent structural and biological properties of peptides and proteins. Grit Rev Biochem Mol Biol 1993; 28: 31-81; Vanhoof G, et al .: Proline motifs in peptides and their biological processing. FASEB J 1995; 9: 736-744].
Es ist gezeigt worden, dass im Prozess der Aktivierung und klonalen Expansion von Immunzellen, insbesondere von T-Lymphozyten, membranständige Peptidasen wie DP IV oder APN eine Schlüsselrolle spielen [Fleischer B: CD26 a surface protease involved in T-cell activation. Immunology Today 1994; 15:180-184; Lendeckel U et al.: Role of alanyl aminopeptidase in growth and function of human T cells. International Journal of Molecular Medicine 1999; 4:17-27; Riemann D et al.: CD13 - not just a marker in leukemia typing. Immunology Today 1999; 20:83-88]. Verschiedene Funktionen Mitogen- stimulierter mononukleärer Zellen (MNZ) oder angereicherter T-Lymphozyten wie DNA-Synthese, Produktion und Sekretion von immunstimulierenden Zytokinen (IL-2, IL-6, IL-12, IFN-γ) und Helferfunktionen für B-Zellen (IgG- und IgM-Synthese) können in Gegenwart von spezifischen Inhibitoren der DP IV oder der APN gehemmt werden [Schön E et al.: The dipeptidyl peptidase IV, a membrane enzyme involved in the proliferation of T lymphocytes. Biomed. Biochim. Acta 1985; 2: K9-K15; Schön E et al.: The role of dipeptidyl peptidase IV in human T lymphocyte activation. Inhibitors and antibodies against dipeptidyl peptidase IV suppress lymphocyte proliferation and immunoglobulin synthesis in vitro. Eur. J. Immunol. 1987; 17: 1821-1826; Reinhold D et al.: Inhibitors of dipeptidyl peptidase IV induce secretion of transforming growth factor ß1 in PWM-stimulated PBMNC and T cells. Immunology 1997; 91 : 354- 360; Lendeckel U et al.: Induction of the membrane alanyl aminopeptidase gene and surface expression in human T-cells by mitogenic activation. Biochem. J. 1996; 319: 817-823; Kähne T et al.: Dipeptidyl peptidase IV: A cell surface peptidase involved in regulating T cell growth (Review). Int. J. Mol. Med. 1999; 4: 3-15; Lendeckel U et al.: Role of alanyl aminopeptidase in growth and function of human T cells (Review). Int. J. Mol. Med. 1999; 4: 17-27].It has been shown that membrane-active peptidases such as DP IV or APN play a key role in the process of activation and clonal expansion of immune cells, in particular T lymphocytes [Fleischer B: CD26 a surface protease involved in T-cell activation. Immunology Today 1994; 15: 180-184; Lendeckel U et al .: Role of alanyl aminopeptidase in growth and function of human T cells. International Journal of Molecular Medicine 1999; 4: 17-27; Riemann D et al .: CD13 - not just a marker in leukemia typing. Immunology Today 1999; 20: 83-88]. Various functions of mitogen-stimulated mononuclear cells (MNZ) or enriched T lymphocytes such as DNA synthesis, production and secretion of immunostimulatory cytokines (IL-2, IL-6, IL-12, IFN-γ) and helper functions for B cells ( IgG and IgM synthesis) can be inhibited in the presence of specific inhibitors of DP IV or APN [Schön E et al .: The dipeptidyl peptidase IV, a membrane enzyme involved in the proliferation of T lymphocytes. Biomed. Biochim. Acta 1985; 2: K9-K15; Schön E et al .: The role of dipeptidyl peptidase IV in human T lymphocyte activation. Inhibitors and antibodies against dipeptidyl peptidase IV suppress lymphocyte proliferation and immunoglobulin synthesis in vitro. Eur. J. Immunol. , 1987; 17: 1821-1826; Reinhold D et al .: Inhibitors of dipeptidyl peptidase IV induce secretion of transforming growth factor ß1 in PWM-stimulated PBMNC and T cells. Immunology 1997; 91: 354-360; Lendeckel U et al .: Induction of the membrane alanyl aminopeptidase gene and surface expression in human T-cells by mitogenic activation. Biochem. J. 1996; 319: 817-823; Kähne T et al .: Dipeptidyl peptidase IV: A cell surface peptidase involved in regulating T cell growth (review). Int. J. Mol. Med. 1999; 4: 3-15; Lendeckel U et al .: Role of alanyl aminopeptidase in growth and function of human T cells (review). Int. J. Mol. Med. 1999; 4: 17-27].
Es ist bereits bekannt, daß die Behandlung von Autoimmunerkrankungen und Transplantatabstoßung durch Hemmung der auf Immunzellen lokalisierten Dipeptidylpetidase IV mit Hilfe von synthetischen Inhibitoren möglich ist (z. B. EP-A 0 764151 , WO095/29691 , EP-A 0 731 789, EP-A 0 528 858).It is already known that the treatment of autoimmune diseases and graft rejection is possible by inhibiting the dipeptidyl petidase IV localized on immune cells with the aid of synthetic inhibitors (e.g. EP-A 0 764151, WO095 / 29691, EP-A 0 731 789, EP -A 0 528 858).
Der Erfindung liegt der überraschende Befund zugrunde, dass die einzelne oder gleichzeitige Wirkung von Inhibitoren der auf bzw. in Fibroblasten exprimierten Dipeptidylpeptidase IV / DP IV bzw. CD26 oder von Inhibitoren von Enzymen mit gleicher Substratspezifität (DP IV-analoge Enzymaktivität) und von Inhibitoren der Aminopeptidase N / APN bzw. CD13 oder von Inhibitoren von Enzymen mit gleicher Substratspezifität (APN-analoge Enzymaktivität), die Proliferation (DNA-Synthese) von Fibroblasten hemmt.The invention is based on the surprising finding that the individual or simultaneous effect of inhibitors of on or in fibroblasts expressed dipeptidyl peptidase IV / DP IV or CD26 or of inhibitors of enzymes with the same substrate specificity (DP IV-analogous enzyme activity) and of inhibitors of aminopeptidase N / APN or CD13 or of inhibitors of enzymes with the same substrate specificity (APN-analogous enzyme activity), inhibits the proliferation (DNA synthesis) of fibroblasts.
Unsere Erfindung zeigt, dass zur Therapie und zur Prävention von dermatologischen Erkrankungen mit fibroblastärer Hyperproliferation und veränderten Differenzierungszuständen, für deren Enstehung die Proliferation und die differenzierte Regelung der DNA-Synthese von Fibroblasten eine zentrale Bedeutung hat, die einzelne oder gleichzeitige Applikation von Hemmstoffen der DP IV und der APN oder von Hemmstoffen von Enzymen gleicher Substratspezifität (APN- oder/und DP IV-analoge Enzymaktivität) bzw. entsprechender Zubereitungen und Darreichungsformen daraus geeignet sind.Our invention shows that for the therapy and prevention of dermatological diseases with fibroblastic hyperproliferation and changed differentiation states, for their development the proliferation and the differentiated regulation of the DNA synthesis of fibroblasts is of central importance, the single or simultaneous application of inhibitors of DP IV and the APN or inhibitors of enzymes of the same substrate specificity (APN- and / or DP IV-analogous enzyme activity) or corresponding preparations and dosage forms thereof are suitable.
Im einzelnen liegen der Erfindung die Befunde zugrunde, dass die DNA- Synthese von Fibroblasten durch die Gabe von Inhibitoren der Dipeptidylpeptidase IV oder von Inhibitoren von Enzymen mit gleicher Substratspezifität oder/und von Inhibitoren der Aminopeptidase N oder von Inhibitoren von Enzymen mit gleicher Substratspezifität signifikant inhibiert wird.In particular, the invention is based on the findings that the DNA synthesis of fibroblasts is significantly inhibited by the administration of inhibitors of dipeptidyl peptidase IV or of inhibitors of enzymes with the same substrate specificity or / and of inhibitors of aminopeptidase N or of inhibitors of enzymes with the same substrate specificity becomes.
Die oben genannten Erkrankungen werden bisher topisch und/oder systemisch mit Immunsuppressiva, Glukokortikosteroiden, unspezifischen Antiinflammativa und Emollientien sowie symptomatisch mit Physiotherapie behandelt. Insbesondere bei den systemischen Medikationen treten häufig unerwünschte Nebenwirkungen auf. Dies sind u. a. Cushing Syndrom, Osteoporose, Infektionen oder Diabetes mellitus. Bei der Lokaltherapie stehen eine örtliche Hautatrophie und erhöhte Hautverletzlichkeit im Vordergrund. Sowohl bei der systemischen als auch bei der lokalen immunsuppressiven Therapie können Hauttumoren propagiert werden. Der Einsatz von DP IV- oder/und APN-Inhibitoren würde bei den genannten Erkrankungen vor allem in den frühen Stadien eine gänzlich neuartige, vorraussichtlich sehr effektive, möglicherweise kostengünstige Therapieform und einen wertvollen alternativen Bestandteil der bestehenden Therapiekonzepte darstellen.The above-mentioned diseases have hitherto been treated topically and / or systemically with immunosuppressants, glucocorticosteroids, non-specific anti-inflammatory agents and emollients, and symptomatically with physiotherapy. In systemic medications in particular, undesirable side effects often occur. These include Cushing's syndrome, osteoporosis, infections or diabetes mellitus. Local therapy focuses on local skin atrophy and increased skin vulnerability. Skin tumors can be propagated in both systemic and local immunosuppressive therapy. The use of DP IV or / and APN inhibitors would represent a completely new, probably very effective, possibly inexpensive form of therapy and a valuable alternative component of the existing therapy concepts, especially in the early stages.
Die erfindungsgemäß applizierten Inhibitoren der Dipeptidylpeptidase IV oder Inhibitoren von Enzymen mit gleicher Substratspezifität (DP IV-analoge Enzymaktivität) oder/und Inhibitoren der Aminopeptidase N oder Inhibitoren von Enzymen gleicher Substratspezifität (APN-analoge Enzymaktivität) können in pharmazeutisch anwendbaren Formulierungskomplexen als Inhibitoren, Substrate, Pseudosubstrate, inhibitorisch wirkende Peptide und Peptidderivate sowie als Antikörper dieser Enzyme zur Anwendung kommen. Die Inhibitoren gemäß der Erfindung werden allein oder in Kombination von mehreren von Ihnen, vorzugsweise in Kombination von zweien von ihnen, eingesetzt.The inhibitors of dipeptidyl peptidase IV applied according to the invention or inhibitors of enzymes with the same substrate specificity (DP IV-analogous enzyme activity) or / and inhibitors of aminopeptidase N or inhibitors of enzymes of the same substrate specificity (APN-analogous enzyme activity) can be used in pharmaceutically acceptable formulation complexes as inhibitors, substrates, Pseudo substrates, inhibitory peptides and peptide derivatives and as antibodies of these enzymes are used. The inhibitors according to the invention are used alone or in combination of several of them, preferably in combination of two of them.
Bevorzugte Effektoren sind für die DP IV Xaa-Pro-Dipeptide, entsprechende Derivate, vorzugsweise Dipeptidphosphonsäurediarylester, Dipeptidboron- säuren (z. B. Pro-boro-Pro) und deren Salze, Xaa-Xaa-(Trp)-Pro-(Xaa)n- Peptide (n = 0 bis 10), entsprechende Derivate und deren Salze bzw. Aminosäure (Xaa)-amide, entsprechende Derivate und deren Salze, wobei Xaa eine α-Aminosäure/lminosäure bzw. ein -Aminosäurederivat/lmino- säurederivat, vorzugsweise Nε-4-Nitrobenzyl-oxycarbonyl-L-Lysin, L-Prolin, L- Tryptophan, L-Isoleucin, L-Valin ist und als Amidstruktur cyclische Amine, z.B. Pyrrolidin, Piperidin, Thiazolidin und deren Derivate fungieren. Derartige Verbindungen und deren Herstellung wurden in einem früheren Patent beschrieben (K. Neubert et al. DD296075A5). Weiter können als Effektoren für die DP IV mit Vorteil Tryptophan-1 ,2,3,4-tetrahydroisochinolin-3-carbonsäure- derivate (TSL) und (2S,2S',2S")-2-[2'-[2"-amino-3"-(indol-3"'-yl)-1 "- oxoprolyl]-r,2',3',4'-tetrahydro-6'8'-dihydroxy-7-methoxyisochinol-3-yl- carbonyl-amino]-4-hydromethyl-5-hydropentansäure (TMC-2A) verwendet werden. Ein beispielhafter, mit Vorteil verwendbarer Inhibitor von DP IV ist Lys[Z(NO2]-thiazolidid, worin Lys für einen L-Lysin-Rest steht und Z(NO2) für 4- Nitrobenzyloxycarbonyl steht (vgl. DD-A 296075).Preferred effectors for the DP IV are Xaa-Pro dipeptides, corresponding derivatives, preferably dipeptide phosphonic acid diaryl esters, dipeptide boronic acids (e.g. Pro-boro-Pro) and their salts, Xaa-Xaa- (Trp) -Pro- (Xaa) n-peptides (n = 0 to 10), corresponding derivatives and their salts or amino acid (Xaa) amides, corresponding derivatives and their salts, where Xaa is preferably an α-amino acid / amino acid or an -amino acid derivative / amino acid derivative N ε -4-nitrobenzyloxycarbonyl-L-lysine, L-proline, L-tryptophan, L-isoleucine, L-valine and cyclic amines, for example pyrrolidine, piperidine, thiazolidine and their derivatives, act as the amide structure. Such compounds and their preparation have been described in a previous patent (K. Neubert et al. DD296075A5). Tryptophan-1, 2,3,4-tetrahydroisoquinoline-3-carboxylic acid derivatives (TSL) and (2S, 2S ', 2S ") - 2- [2' - [2" -amino-3 " - (indol-3 " '-yl) -1 " - oxoprolyl] -r, 2', 3 ' , 4'-tetrahydro-6 ' 8 ' -dihydroxy-7-methoxyisoquinol-3-yl- carbonyl-amino] -4-hydromethyl-5-hydropentanoic acid (TMC-2A) used become. An exemplary, advantageously usable inhibitor of DP IV is Lys [Z (NO 2 ] thiazolidide, in which Lys stands for an L-lysine residue and Z (NO 2 ) stands for 4-nitrobenzyloxycarbonyl (cf. DD-A 296075) ,
Als Inhibitoren der Alanyl-aminopeptidase (Aminopeptidase N, APN) kommen erfindungsgemäß beispielsweise Actinonin, Leuhistin, Phebestin, Amastatin, Bestatin, Probestin, ß-Aminothiole, α-Aminophosphinsäuren, α-Aminophos- phinsäurederivate, vorzugsweise D-Phe-ψ-PO(OH)-CH2]-Phe-Phe und deren Salze in Betracht. Bevorzugte Inhibitoren für die Alanyl-Aminopeptidase sind Bestatin (Ubenimex), Actinonin, Probestin, Phebestin, RB3014 oder Leuhistin.According to the invention, inhibitors of alanyl aminopeptidase (aminopeptidase N, APN) include, for example, actinonin, leuhistin, phebestin, amastatin, bestatin, probestin, ß-aminothiols, α-aminophosphinic acids, α-aminophosphinic acid derivatives, preferably D-Phe-ψ-PO ( OH) -CH 2 ] -Phe-Phe and their salts. Preferred inhibitors for alanyl aminopeptidase are Bestatin (Ubenimex), Actinonin, Probestin, Phebestin, RB3014 or Leuhistin.
Die Inhibitoren oder diese enthaltende pharmazeutische Zubereitungen werden simultan mit bekannten Trägerstoffen verabreicht. Von der Erfindung' umfaßt sind auch pharmazeutische Zubereitungen, die zwei oder mehrere der Inhibitoren der DP IV bzw. Inhibitoren von Enzymen mit DP IV-analoger Enzymaktivität oder/und der APN bzw. Inhibitoren von Enzymen mit APN- analoger Enzymaktivität in räumlich getrennter Formulierung in Kombination mit an sich bekannten Träger-, Hilfs- und/oder Zusatzstoffen zur gleichzeitigen oder zeitlich unmittelbar aufeinanderfolgenden Verabreichung mit dem Ziel einer gemeinsamen Wirkung umfassen.The inhibitors or pharmaceutical preparations containing them are administered simultaneously with known carriers. Included in the invention 'are also pharmaceutical preparations containing two or more of the inhibitors of DP IV or of inhibitors of enzymes having DP IV-analogous enzyme activity and / or the APN or inhibitors of enzymes having APN-analogous enzyme activity in spaced formulation in Combination with known carrier, auxiliary and / or additives for simultaneous or immediately sequential administration with the aim of a common effect.
Die Verabreichung erfolgt einerseits als topische Applikation in Form von z.B. Cremes, Salben, Pasten, Gelen, Lösungen, Sprays, Liposomen und Nano- somen, Schüttelmixturen, "pegylierten" Formulierungen, degradierbaren (d. h. unter physiologischen Bedingungen abbaubaren) Depot-Matrices, Hydrokolloidverbänden, Pflastern, Mikroschwärnmen, Prepolyomeren und ähnlichen neuen Trägersubstraten, Jet-Injektion bzw. anderen dermatologischen Grundlagen/Vehikeln einschließlich instillativer Applikation, und andererseits als systemische Applikation zur oralen, transdermalen, intravenösen, subcutanen, intracutanen, intramuskulären Anwendung in geeigneten Rezepturen bzw. in geeigneter Galenik. Der/die lnhibitor(en) gemäß der Erfindung sowie Zubereitungen, die einen oder mehrere von den genannten Inhibitoren und gegebenenfalls noch weitere Komponenten wie weitere Inhibitoren, sowie pharmazeutisch verträgliche Zusatz-, Hilfs- oder Trägerstoffe enthalten, kommen bei einer ganzen Anzahl von dermatologischen Erkrankungen bzw. Zuständen mit Hyperproliferation und veränderten Differenzierungszuständen von Fibroblasten vorbeugend oder therapierend zur Anwendung. Beispielhaft können genannt werden eine Vorbeugung und Therapie von sowohl benignen fibrosierenden und sklerosierenden Erkrankungen (hier insbesondere postinfektiös und posttraumatisch: hypertrophe Narben, Keloide, Dermatofibrome, Fibrolipome wie auch disseminierte (Myo)-Fibromatosen) als auch malignen fibroblastären Hyperproliferationszuständen (z.B. Fibrosarkome, Mischtumoren wie atypisches Fibroxanthom, malignes fibröses Histiozytom, aggressives Angiomyxom, Paraneoplasien), von fibrosierenden Autoimmunerkrankungen wie der Sklerodermie (zirkumskripte Sklerodermie, progressiv-systemische Sklerodermie, CREST-Syndrom), der Dermatosklerose bei anderen Kollagenosen und der Graft-versus-Host-Erkrankung, des Liehen scierosus et atrophicus und der heterogenen Gruppe der Pseudosklerodermien (wie z.B. die eosinophile/proliferierende Fasciitis, exogen verursachte Pseudosklerodermien wie Toxic oil syndrome, Silikose, Porphyrien, Eosinophilie-Myalgie-Syndrom, Liehen myxödematosus oder Borrelien-assoziierte Fibrosierungen), von sekundären Sklerosierungen wie z.B. im Rahmen einer Stauungsfibrose bei chronisch venöser Insuffizienz und bei Lipolymphödemen, im fibrosierenden Spätstadium der Alopecia androgenetica und von seltenen lokalisierten fibroblastären Erkrankungen (M. Dupuytren, M. Ledderhose, "Knuckle pads", Induratio penis plastica).The administration takes place on the one hand as a topical application in the form of, for example, creams, ointments, pastes, gels, solutions, sprays, liposomes and nanosomes, shaking mixtures, "pegylated" formulations, degradable (ie degradable under physiological conditions) depot matrices, hydrocolloid dressings, Patches, micro swarms, prepolyomers and similar new carrier substrates, jet injection or other dermatological bases / vehicles including instillative application, and on the other hand as a systemic application for oral, transdermal, intravenous, subcutaneous, intracutaneous, intramuscular use in suitable formulations or in suitable galenics , The inhibitor (s) according to the invention and preparations which contain one or more of the inhibitors mentioned and, if appropriate, further components such as further inhibitors, as well as pharmaceutically acceptable additives, auxiliaries or carriers, come from a large number of dermatological diseases or conditions with hyperproliferation and changed differentiation states of fibroblasts as a preventive or therapeutic application. For example, prevention and therapy of both benign fibrosing and sclerosing diseases (here in particular post-infectious and post-traumatic: hypertrophic scars, keloids, dermatofibromas, fibrolipomas as well as disseminated (myo) fibromatoses) as well as malignant fibroblastic hyperproliferative conditions such as mixed fibrosis, such as mixed fibroids atypical fibroxanthoma, malignant fibrous histiocytoma, aggressive angiomyxoma, paraneoplasias), of fibrosing autoimmune diseases such as scleroderma (circumscribed scleroderma, progressive-systemic scleroderma, CREST syndrome), dermatosclerosis and host disease, other collagen desigenosis, lie-graft disease scierosus et atrophicus and the heterogeneous group of pseudoscleroderma (such as eosinophilic / proliferating fasciitis, exogenously caused pseudoscleroderma such as toxic oil syndrome, silicosis, porphyrias, eosinophilia-myalgia syndrome, bile myxoedematosus or borrelia -associated fibrosis), secondary sclerosis such as congestion fibrosis in chronic venous insufficiency and lipolymphedema, late fibrosis of alopecia androgenetica and rare localized fibroblastic diseases (M. Dupuytren, M. Ledderhose, "Knuckle pads", Induratio penis plastica).
Die Erfindung betrifft auch ein Verfahren zur Therapie und Prävention dermatologischer Erkrankungen mit Hyperproliferation und veränderten Differenzierungszuständen von Fibroblasten, das die Verabreichung von Inhibitoren der Dipeptidylpeptidase IV (DP IV) sowie von Inhibitoren von Enzymen mit gleicher Substratspezifität (DP IV-analoge Enzymaktivität) oder/und von Inhibitoren der Alanyl-Aminopeptidase (Aminopeptidase N, APN) sowie von Inhibitoren von Enzymen gleicher Substratspezifität (APN-analoge Enzymaktivität) an einen Patienten umfaßt, der zur Prävention und/oder Therapie der obengenannten dermatologischen Erkrankungen einer Behandlung bedarf.The invention also relates to a method for the therapy and prevention of dermatological diseases with hyperproliferation and changed differentiation states of fibroblasts, which involves the administration of Inhibitors of dipeptidyl peptidase IV (DP IV) and of inhibitors of enzymes with the same substrate specificity (DP IV-analogous enzyme activity) or / and of inhibitors of alanyl aminopeptidase (aminopeptidase N, APN) and of inhibitors of enzymes of the same substrate specificity (APN-analogous enzyme activity ) to a patient who needs treatment for the prevention and / or therapy of the abovementioned dermatological diseases.
In besonders bevorzugten Ausführungsformen der Erfindung werden an einen unter einer oder mehreren der nachfolgend im einzelnen genannten dermatologischen Erkrankungen leidenden oder einer Prävention der nachfolgend genannten Krankheiten bedürfenden Patienten ein Inhibitor oder mehrere Inhibitoren der genannten Enzyme oder eine oder mehrere, diese Inhibitoren einzeln oder bevorzugt in Kombination enthaltende pharmazeutische Zubereitung(en) verabreicht, die gewählt sind aus Inhibitoren der DP IV und besonders bevorzugt aus Xaa-Pro-Dipeptiden (Xaa = α- Aminosäure bzw. seitenkettengeschütztes Derivat), entsprechenden Derivaten, vorzugsweise Dipeptidphosphonsäurediarylestern, Dipeptidboronsäuren (z.B. Pro-boro-Pro) und deren Salzen, Xaa-Xaa-(Trp)-Pro-(Xaa)n-Peptiden (Xaa = α- Aminosäure, n = 0 bis 10), entsprechenden Derivaten und deren Salzen, Aminosäure (Xaa)-amiden, entsprechende Derivaten und deren Salzen, wobei Xaa eine α-Aminosäure bzw. ein seitenkettengeschütztes Derivat, vorzugsweise Nε-4-Nitrobenzyloxycarbonyl-L-Lysin, L-Isoleucin, L-Valin, L- Tryptophan, L-Prolin, ist und als Amidstruktur cyclische Amine, z.B. Pyrrolidin, Piperidin, Thiazolidin und deren Derivate fungieren, und/oder Tryptophan- 1 ,2,3,4-tetrahydroisochinolin-3-carbonsäure-derivate (TSL) und (2S,2S',2S")- 2-[2'-[2"-amino-3"-(indol-3'"-yl)-1 "-oxoprolyl]-r,2',3',4'-tetrahydro-6'8'- dihydroxy-7-methoxyisochinol-3-yl-carbonyl-amino]-4-hydromethyl-5- hydropentansäure (TMC-2A), und Inhibitoren der APN, besonders bevorzugt Actinonin, Leuhistin, Phebestin, Amastatϊn, Bestatin, Probestin, ß-Aminothiolen, α-Aminophosphinsäuren, -Aminophosphinsäurederivaten, vorzugsweise D-ψ- Phe-PO(OH)-CH2]-Phe-Phe, und deren Salzen.In particularly preferred embodiments of the invention, an inhibitor or more inhibitors of the enzymes mentioned or one or more, these inhibitors, individually or preferably in combination, are administered to a patient suffering from one or more of the dermatological diseases mentioned in detail below or in need of prevention of the diseases mentioned below Containing pharmaceutical preparation (s) administered, which are selected from inhibitors of DP IV and particularly preferably from Xaa-Pro dipeptides (Xaa = α-amino acid or side chain-protected derivative), corresponding derivatives, preferably dipeptide phosphonic acid diaryl esters, dipeptide boronic acids (eg Pro-boro- Pro) and their salts, Xaa-Xaa- (Trp) -Pro- (Xaa) n-peptides (Xaa = α-amino acid, n = 0 to 10), corresponding derivatives and their salts, amino acid (Xaa) -amides, corresponding Derivatives and their salts, where Xaa is an α-amino acid or a side chain-protected derivative t, preferably N ε -4-nitrobenzyloxycarbonyl-L-lysine, L-isoleucine, L-valine, L-tryptophan, L-proline, and cyclic amines, for example pyrrolidine, piperidine, thiazolidine and their derivatives, act as amide structure, and / or tryptophan-1, 2,3,4-tetrahydroisoquinoline-3-carboxylic acid derivatives (TSL) and (2S, 2S ' , 2S " ) - 2- [2' - [2 " -amino-3 "- (indole- 3 '"- yl) -1" -oxoprolyl] -r, 2', 3 ', 4 ' -tetrahydro-6'8 ' - dihydroxy-7-methoxyisoquinol-3-yl-carbonylamino] -4-hydromethyl- 5-hydropentanoic acid (TMC-2A), and APN inhibitors, particularly preferably actinonin, leuhistin, phebestin, amastatin, bestatin, probestin, β-aminothiols, α-aminophosphinic acids, -aminophosphinic acid derivatives, preferably D-ψ-Phe-PO (OH) -CH 2 ] -Phe-Phe, and their salts.
In weiteren bevorzugten Verfahren gemäß der Erfindung kommen die Inhibitoren und gegebenenfalls ihre Kombinationen und diese enthaltende pharmazeutische Zubereitungen zur Anwendung bei der Prävention und Therapie von Erkrankungen und bzw. Zuständen mit Hyperproliferation und veränderten Differenzierungszuständen von Fibroblasten. Beispielhaft können genannt werden eine Vorbeugung und Therapie von sowohl benignen fibrosierenden und sklerosierenden Erkrankungen (hier insbesondere postinfektiös und posttraumatisch: hypertrophe Narben, Keloide, Dermatofibrome, Fibrolipome wie auch disseminierte (Myo)-Fibromatosen) als auch malignen fibroblastären Hyperproliferationszuständen (z.B. Fibrosarkome, Mischtumoren wie atypisches Fibroxanthom, malignes fibröses Histiozytom, aggressives Angiomyxom, Paraneoplasien), von fibrosierenden Autoimmunerkrankungen wie der Sklerodermie (zirkumskripte Sklerodermie, progressiv-systemische Sklerodermie, CREST-Syndrom), der Dermatosklerose bei anderen Kollagenosen und der Graft-versus-Host-Erkrankung, des Liehen scierosus et atrophicus und der heterogenen Gruppe der Pseudosklerodermien (wie z.B. die eosinophile/proliferierende Fasciitis, exogen verursachteIn further preferred methods according to the invention, the inhibitors and, where appropriate, their combinations and pharmaceutical preparations containing them are used in the prevention and therapy of diseases and / or conditions with hyperproliferation and changed differentiation states of fibroblasts. For example, prevention and therapy of both benign fibrosing and sclerosing diseases (here in particular post-infectious and post-traumatic: hypertrophic scars, keloids, dermatofibromas, fibrolipomas as well as disseminated (myo) fibromatoses) as well as malignant fibroblastic hyperproliferative conditions such as mixed fibrosis, such as mixed fibroids atypical fibroxanthoma, malignant fibrous histiocytoma, aggressive angiomyxoma, paraneoplasias), of fibrosing autoimmune diseases such as scleroderma (circumscribed scleroderma, progressive-systemic scleroderma, CREST syndrome), dermatosclerosis and host disease, other collagen desigenosis, lie-graft disease scierosus et atrophicus and the heterogeneous group of pseudoscleroderma (such as eosinophilic / proliferating fasciitis, exogenously
Pseudoskleroderm en wie Toxic oil syndrome, Silikose, Porphyrien, Eosinophilie-Myalg e-Syndrom, Liehen myxödematosus oder Borrelien- assoziierte Fibrös erungen), von sekundären Sklerosierungen wie z.B. im Rahmen einer Stauungsfibrose bei chronisch venöser Insuffizienz und bei Lipolymphödemen, im fibrosierenden Spätstadium der Alopecia androgenetica und von seltenen lokalisierten fibroblastären Erkrankungen (M. Dupuytren, M. Ledderhose, "Knuckle pads", Induratio penis plastica).Pseudoscleroderms such as toxic oil syndrome, silicosis, porphyria, eosinophilia-myalg e syndrome, lying myxoedematosus or borrelia-associated fibrosis), of secondary sclerotherapy such as e.g. in the context of stasis fibrosis in chronic venous insufficiency and lipolymphedema, in the fibrosing late stage of alopecia androgenetica and in rare localized fibroblastic diseases (M. Dupuytren, M. Ledderhose, "knuckle pads", induration penis plastica).
In erfindungsgemäß besonders bevorzugten Präventions- und/oder Therapieverfahren werden einer oder mehrere der genannten Inhibitoren der DP IV und/oder APN in der Weise zur Anwendung gebracht, daß zwei oder mehrere der Inhibitoren der DP IV bzw. Inhibitoren von Enzymen mit DP IV-analoger Enzymaktivität oder/und Inhibitoren der APN bzw. Inhibitoren von Enzymen mit APN-analoger Enzymaktivität in räumlich getrennter Formulierung in Kombination mit an sich bekannten Träger-, Hilfs- und/oder Zusatzstoffen gleichzeitig oder zeitlich unmittelbar aufeinander folgend mit dem Ziel einer gemeinsamen Wirkung verabreicht werden. Die Verabreichung erfolgt als systemische Anwendung zur oralen, transdermalen, percutanen, intravenösen, subcutanen, intracutanen, intramuskulären, rektalen, vaginalen, sublingualen Applikation zusammen mit an sich bekannten Träger-, Hilfs- und/oder Zusatzstoffen und/oder als topische Anwendung in Form von Cremes, Salben, Pasten, Gelen, Lösungen, Sprays, Liposomen bzw. Nanosomen, "pegylierten" Formulierungen, degradierbaren Depot-Matrices, Schüttelmixturen, Hydrokolloidverbänden, Pflastern, Mikroschwämmen, Prepolyomeren und ähnlichen neuen Trägersubstraten, Jet-Injektionen bzw. anderen dermatologischen Grundlagen Vehikeln, einschließlich instillativer Applikation.In prevention and / or therapy methods which are particularly preferred according to the invention, one or more of the DP IV and / or APN inhibitors mentioned are used in such a way that two or more the inhibitors of DP IV or inhibitors of enzymes with DP IV-analogous enzyme activity or / and inhibitors of APN or inhibitors of enzymes with APN-analogous enzyme activity in spatially separated formulations in combination with known carrier, auxiliary and / or Additives are administered simultaneously or immediately in succession with the aim of a common effect. The administration takes place as a systemic application for oral, transdermal, percutaneous, intravenous, subcutaneous, intracutaneous, intramuscular, rectal, vaginal, sublingual application together with carrier, auxiliary and / or additives known per se and / or as a topical application in the form of Creams, ointments, pastes, gels, solutions, sprays, liposomes or nanosomes, "pegylated" formulations, degradable depot matrices, shaking mixtures, hydrocolloid dressings, plasters, microsponges, prepolyomers and similar new carrier substrates, jet injections and other dermatological bases for vehicles , including instillative application.
Die Erfindung wird anhand der nachfolgenden Beispiele näher erläutert. Die Beispiele zeigen bevorzugte Ausführungsformen der Erfindung. Die Erfindung ist jedoch nicht auf die bevorzugten Ausführungsformen beschränkt.The invention is illustrated by the following examples. The examples show preferred embodiments of the invention. However, the invention is not limited to the preferred embodiments.
BeispieleExamples
Äusführungsbeispiel 1Example 1
Unsere Untersuchungen zeigen, dass die DNA-Synthese humaner Fibroblasten durch die Administration von Inhibitoren der DP IV (Lys[Z(Nθ2)]-thiazolidid) oder/und der APN (Actinonin) dosisabhängig gehemmt wird.Our investigations show that the DNA synthesis of human fibroblasts is inhibited in a dose-dependent manner by the administration of inhibitors of DP IV (Lys [Z (Nθ 2 )] thiazolidide) and / or APN (actinonin).
Humane Fibroblasten exprimieren stark DP IV und APN (Figur 1). Die Enzymaktivität der DP IV von vitalen Zellen beträgt 57,3 + 12,4 pkat 106 Zellen, die der APN beträgt 380,5 + 48,2 pkat/106 Zellen (n = 4). Entsprechend ist die mRNA von APN und DP IV auf diesen Zellen nachweisbar (Figur 2).Human fibroblasts strongly express DP IV and APN (Figure 1). The enzyme activity of the DP IV of vital cells is 57.3 + 12.4 pkat 10 6 cells, that of the APN is 380.5 + 48.2 pkat / 10 6 cells (n = 4). Accordingly, the mRNA of APN and DP IV can be detected on these cells (FIG. 2).
Fibroblasten gesunder Spender wurden 48 h mit den oben genannten Inhibitoren inkubiert und anschließend über die Messung der 3[H]-Thymidin- Inkorporation die DNA-Synthese bestimmt, wie bei Reinhold et al. beschrieben (Reinhold D et al.: Inhibitors of dipeptidyl peptidase IV induce secretion of transforming growth factor ß1 in PWM-stimulated PBMNC and T cells. Immunology 1997; 91 : 354-360). Figur 3 zeigt die dosisabhängige Hemmung der DNA-Synthese.Fibroblasts from healthy donors were incubated for 48 h with the above-mentioned inhibitors and the DNA synthesis was then determined by measuring the 3 [H] thymidine incorporation, as described by Reinhold et al. (Reinhold D et al .: Inhibitors of dipeptidyl peptidase IV induce secretion of transforming growth factor β1 in PWM-stimulated PBMNC and T cells. Immunology 1997; 91: 354-360). Figure 3 shows the dose-dependent inhibition of DNA synthesis.
Zur Messung des dosisabhängigen Effekts von Inhibitoren der DP IV (Lys[Z(N02)]-thiazolidid) und der Aminopeptidase N (Actinonin) auf die DNA- Synthese humaner Fibroblasten wurden die Zellen über 48 Stunden mit den angegebenen Konzentrationen der Inhibitoren inkubiert. Anschließend wurde dem Kulturmedium 3[H]-Methyl-Thymidin zugesetzt und nach weiteren 6 Stunden die in die DNA eingebaute Menge an 3[H]-Thymidin gemessen. Die Ergebnisse zeigt Figur 3. To measure the dose-dependent effect of DP IV (Lys [Z (N0 2 )] thiazolidide) and aminopeptidase N (actinonin) inhibitors on the DNA synthesis of human fibroblasts, the cells were incubated for 48 hours with the indicated concentrations of the inhibitors. Then 3 [H] -methyl-thymidine was added to the culture medium and after a further 6 hours the amount of 3 [H] -thymidine incorporated into the DNA was measured. The results are shown in FIG. 3.

Claims

Patentansprüche claims
1. Verwendung von Inhibitoren der Dipeptidylpeptidase IV (DP IV) sowie von Inhibitoren von Enzymen mit gleicher Substratspezifität (DP IV-analoge Enzymaktivität) oder/und von Inhibitoren der Alanyl-Aminopeptidase (Aminopeptidase N, APN) sowie von Inhibitoren von Enzymen gleicher Substratspezifität (APN-analoge Enzymaktivität) zur Hemmung der Proliferation (DNA-Synthese) humaner Fibroblasten.1. Use of inhibitors of dipeptidyl peptidase IV (DP IV) and of inhibitors of enzymes with the same substrate specificity (DP IV-analogous enzyme activity) or / and of inhibitors of alanyl aminopeptidase (aminopeptidase N, APN) and of inhibitors of enzymes of the same substrate specificity ( APN-analogous enzyme activity) to inhibit the proliferation (DNA synthesis) of human fibroblasts.
2. Verwendung nach Anspruch 1 , worin die Inhibitoren der DP IV Xaa-Pro- Dipeptide (Xaa = α-Aminosäure bzw. seitenkettengeschütztes Derivat), entsprechende Derivate, vorzugsweise Dipeptidphosphonsäurediarylester, Dipeptidboronsäuren (z.B. Pro-boro-Pro) und deren Salze, Xaa-Xaa-(Trp)- Pro-(Xaa)n-Peptide (Xaa = α-Aminosäure, n = 0 bis 10), entsprechende Derivate und deren Salze, Aminosäure (Xaa)-amide, entsprechende Derivate und deren Salze, wobei Xaa eine α-Aminosäure bzw. ein seitenkettengeschütztes Derivat, vorzugsweise Nε-4-Nitrobenzyloxycarbonyl- L-Lysin, L-Isoleucin, L-Valin, L-Tryptophan, L-Prolin, ist und als Amidstruktur cyclische Amine, z.B. Pyrrolidin, Piperidin, Thiazolidin und deren Derivate fungieren, und/oder Tryptophan-1 ,2,3,4-tetrahydroisochinolin-3-carbonsäure- derivate (TSL) und (2S,2S',2S")-2-[2'-[2"-amino-3"-(indol-3'"-yl)-1 "- oxoprolyl]- ,2',3",4'-tetrahydro-6'8'-dihydroxy-7-methoxyisochinol-3-yl- carbonyl-amino]-4-hydromethyl-5-hydropentansäure (TMC-2A) sind.2. Use according to claim 1, wherein the inhibitors of the DP IV Xaa-Pro dipeptides (Xaa = α-amino acid or side chain-protected derivative), corresponding derivatives, preferably dipeptide phosphonate diaryl esters, dipeptide boronic acids (eg Pro-boro-Pro) and their salts, Xaa -Xaa- (Trp) - Pro (Xaa) n peptides (Xaa = α-amino acid, n = 0 to 10), corresponding derivatives and their salts, amino acid (Xaa) amides, corresponding derivatives and their salts, where Xaa is an α-amino acid or a side-chain-protected derivative, preferably N ε -4-nitrobenzyloxycarbonyl-L-lysine, L-isoleucine, L-valine, L-tryptophan, L-proline, and the amide structure is cyclic amines, for example pyrrolidine, piperidine, Thiazolidine and its derivatives act, and / or tryptophan-1, 2,3,4-tetrahydroisoquinoline-3-carboxylic acid derivatives (TSL) and (2S, 2S ' , 2S " ) -2- [2 ' - [2 " - amino-3 " - (indol-3 '" -yl) -1 " - oxoprolyl] -, 2 ' , 3", 4'-tetrahydro-6'8'-dihydroxy-7-methoxyisoquinol-3-yl-carbonyl- amino] -4-methyl-5-hydro hydropent acid (TMC-2A).
3. Verwendung nach Anspruch 1 , worin Aminosäureamide, bevorzugt Nε-4- Nitrobenzyloxycarbonyl-L-Lysin-thiazolidid, -pyrrolidid und -piperidid sowie das entsprechende 2-Cyanothiazolidid-, 2-Cyanopyrrolidid- und 2- Cyanopiperididderivat, als DP IV-lnhibitoren eingesetzt werden. 3. Use according to claim 1, wherein amino acid amides, preferably N ε -4-nitrobenzyloxycarbonyl-L-lysine thiazolidide, pyrrolidide and piperidide, and the corresponding 2-cyanothiazolidide, 2-cyanopyrrolidide and 2-cyanopiperidide derivative, as DP IV- Inhibitors are used.
4. Verwendung nach Anspruch 1 , wobei als Inhibitoren der APN Actinonin, Leuhistin, Phebestin, Amastatin, Bestatin, Probestin, ß-Aminothiole, α- Aminophosphinsäuren, α-Aminophosphinsäurederivate, vorzugsweise D-ψ- Phe-PO(OH)-CH2]-Phe-Phe, und deren Salze fungieren.4. Use according to claim 1, wherein as inhibitors of APN actinonin, leuhistin, phebestin, amastatin, bestatin, probestin, ß-aminothiols, α-aminophosphinic acids, α-aminophosphinic acid derivatives, preferably D-ψ-Phe-PO (OH) -CH 2 ] -Phe-Phe, and their salts act.
5. Verwendung von Inhibitorkombinationen nach einem der Ansprüche 1 bis 4 zur Vorbeugung und Therapie von sowohl benignen fibrosierenden und sklerosierenden Erkrankungen (hier insbesondere postinfektiös und posttraumatisch: hypertrophe Narben, Keloide, Dermatofibrome, Fibrolipome wie auch disseminierte (Myo)-Fibromatosen) als auch malignen fibroblastären Hyperproliferationszuständen (z.B. Fibrosarkome, Mischtumoren wie atypisches Fibroxanthom, malignes fibröses Histiozytom, aggressives Angiomyxom, Paraneoplasien), von fibrosierenden Autoimmunerkrankungen wie der Sklerodermie (zirkumskripte S., progressiv- systemische S., CREST-Syndrom), der Dermatosklerose bei anderen Kollagenosen und der Graft-versus-Host-Erkrankung, des Liehen scierosus et atrophicus und der heterogenen Gruppe der Pseudosklerodermien (wie z.B. die eosinophile/proliferierende Fasciitis, exogen verursachte Pseudosklerodermien wie Toxic oil syndrome, Silikose, Porphyrien, Eosinophilie-Myalgie-Syndrom, Liehen myxödematosus oder Borrelien- assoziierte Fibrosierungen), von sekundären Sklerosierungen wie z.B. im Rahmen einer Stauungsfibrose bei chronisch venöser Insuffizienz und bei Lipolymphödemen, im fibrosierenden Spätstadium der Alopecia androgenetica und von seltenen lokalisierten fibroblastären Erkrankungen (M. Dupuytren, M. Ledderhose, "Knuckle pads", Induratio penis plastica).5. Use of inhibitor combinations according to one of claims 1 to 4 for the prevention and therapy of both benign fibrosing and sclerosing diseases (here in particular post-infectious and post-traumatic: hypertrophic scars, keloids, dermatofibromas, fibrolipomas as well as disseminated (myo) fibromatoses) as well as malignancies fibroblastic hyperproliferative states (e.g. fibrosarcomas, mixed tumors such as atypical fibroxanthoma, malignant fibrous histiocytoma, aggressive angiomyxoma, paraneoplasias), fibrosis autoimmune diseases such as scleroderma (circumscribed S., progressive-systemic S., dermatosis, dermatosis, CREST Graft-versus-host disease, the lying scierosus et atrophicus and the heterogeneous group of pseudoscleroderma (such as eosinophilic / proliferating fasciitis, exogenously caused pseudoscleroderma such as toxic oil syndrome, silicosis, porphyria, eosinophilia-myalgia syndrome, liehen ematosus or Borrelia-associated fibrosis), from secondary sclerotherapy such as in the context of stasis fibrosis in chronic venous insufficiency and lipolymphedema, in the fibrosing late stage of alopecia androgenetica and in rare localized fibroblastic diseases (M. Dupuytren, M. Ledderhose, "knuckle pads", induration penis plastica).
6. Pharmazeutische Zubereitungen, umfassend Inhibitoren der Dipeptidylpeptidase IV (DP IV) oder Inhibitoren von Enzymen mit DP IV- analoger Enzymaktivität oder/und Inhibitoren der Alanyl-Aminopeptidase (Aminopeptidase N, APN) oder Inhibitoren von Enzymen mit APN-analoger Enzymaktivität in Kombination mit an sich bekannten Träger-, Zusatz- und/oder Hilfsstoffen.6. Pharmaceutical preparations comprising inhibitors of dipeptidyl peptidase IV (DP IV) or inhibitors of enzymes with DP IV-analogous enzyme activity and / or inhibitors of alanyl aminopeptidase (aminopeptidase N, APN) or inhibitors of enzymes with APN-analogous Enzyme activity in combination with carriers, additives and / or auxiliary substances known per se.
7. Pharmazeutische Zubereitungen nach Anspruch 6, umfassend als Inhibitoren der DP IV Xaa-Pro-Dipeptide (Xaa = α-Aminosäure bzw. seitenketten-geschützte Derivate), entsprechende Derivate, vorzugsweise Dipeptidphosphonsäurediarylester, Dipeptidboronsäuren (z. B. Pro-boro-Pro) und deren Salze, Xaa-Xaa-(Trp)-Pro-(Xaa)n-Peptide (Xaa = α-Aminosäuren, n=0-10), entsprechende Derivate und deren Salze bzw. Aminosäure (Xaa)- amide, entsprechende Derivate und deren Salze, wobei Xaa eine α- Aminosäure bzw. seitenkettengeschütztes Derivat, vorzugsweise Nε-4- Nitrobenzyloxycarbonyl-L-Lysin, L-Isoleucin, L-Valin, L-Tryptophan, L-Prolin ist und als Amidstruktur cyclische Amine, z.B. Pyrrolidin, Piperidin, Thiazolidin und deren Derivate fungieren.7. Pharmaceutical preparations according to claim 6, comprising as inhibitors of the DP IV Xaa-Pro dipeptides (Xaa = α-amino acid or side chain-protected derivatives), corresponding derivatives, preferably dipeptide phosphonic acid diaryl esters, dipeptide boronic acids (e.g. Pro-boro-Pro ) and their salts, Xaa-Xaa- (Trp) -Pro- (Xaa) n-peptides (Xaa = α-amino acids, n = 0-10), corresponding derivatives and their salts or amino acids (Xaa) - amides, corresponding Derivatives and their salts, where Xaa is an α-amino acid or a side-chain protected derivative, preferably N ε -4-nitrobenzyloxycarbonyl-L-lysine, L-isoleucine, L-valine, L-tryptophan, L-proline, and cyclic amines as the amide structure, eg pyrrolidine, piperidine, thiazolidine and their derivatives act.
8. Pharmazeutische Zubereitungen nach Anspruch 6, umfassend als Inhibitoren der DP IV vorzugswe se Aminosäureamide, z.B. Nε-4- Nitrobenzyloxycarbonyl-L-Lysin-thiazol did, -pyrrolidid und -piperidid sowie das entsprechende 2-Cyanothiazolid d-, 2-Cyanopyrrolidid- und 2-Cyano- piperididderivat.8. Pharmaceutical preparations according to claim 6, comprising as inhibitors of DP IV preferably amino acid amides, for example N ε -4-nitrobenzyloxycarbonyl-L-lysine-thiazole did, pyrrolidide and piperidide and the corresponding 2-cyanothiazolide d, 2-cyanopyrrolidide - and 2-cyano-piperidide derivative.
9. Pharmazeutische Zubereitungen nach Anspruch 6, umfassend als Inhibitoren der APN Actinonin, Leuhistin, Phebestin, Amastatin, Bestatin, Probestin, ß-Aminothiole, oc-Aminophosphinsäuren, «x-Aminophosphin- säurederivate, bevorzugt D-Phe-ψ[PO(OH)-CH2J-Phe-Phe und deren Salze.9. Pharmaceutical preparations according to claim 6, comprising as inhibitors of APN actinonin, leuhistine, phebestin, amastatin, bestatin, probestin, ß-aminothiols, oc-aminophosphinic acids, "x-aminophosphinic acid derivatives, preferably D-Phe-ψ [PO (OH ) -CH 2 J-Phe-Phe and their salts.
10. Pharmazeutische Zubereitungen nach einem der Ansprüche 6 bis 9, umfassend zwei oder mehrere der Inhibitoren der DP IV bzw. Inhibitoren von Enzymen mit DP IV-analoger Enzymaktivität oder/und Inhibitoren der APN bzw. Inhibitoren von Enzymen mit APN-analoger Enzymaktivität in räumlich getrennter Formulierung in Kombination mit an sich bekannten Träger-, Hilfs- und/oder Zusatzstoffen zur gleichzeitigen oder zeitlich unmittelbar aufeinanderfolgenden Verabreichung mit dem Ziel einer gemeinsamen Wirkung.10. Pharmaceutical preparations according to one of claims 6 to 9, comprising two or more of the inhibitors of DP IV or inhibitors of enzymes with DP IV-analogous enzyme activity and / or inhibitors of APN or inhibitors of enzymes with APN-analogous enzyme activity in space separate formulation in combination with known Carriers, auxiliaries and / or additives for simultaneous or immediately sequential administration with the aim of a common effect.
11. Pharmazeutische Zubereitungen gemäß Ansprüchen 6 bis 9 für die systemische Anwendung zur oralen, transdermalen, percutanen, intravenösen, subcutanen, intracutanen, intramuskulären, rektalen, vaginalen, sublingualen Applikation zusammen mit an sich bekannten Träger-, Hilfs- und/oder Zusatzstoffen.11. Pharmaceutical preparations according to claims 6 to 9 for systemic use for oral, transdermal, percutaneous, intravenous, subcutaneous, intracutaneous, intramuscular, rectal, vaginal, sublingual application together with known carrier, auxiliary and / or additives.
12. Pharmazeutische Zubereitungen gemäß Ansprüchen 6 bis 10 für die topische Anwendung in Form von Cremes, Salben, Pasten, Gelen, Lösungen, Sprays, Liposomen bzw. Nanosomen, "pegylierten" Formulierungen, degradierbaren Depot-Matrices, Schüttelmixturen, Hydrokolloidverbänden, Pflastern, Mikroschwämmen, Prepolyomeren und ähnlichen neuen Trägersubstraten, Jet-Injektionen bzw. anderen dermatologischen GrundlagenΛ ehikeln, einschließlich instillativer Applikation.12. Pharmaceutical preparations according to claims 6 to 10 for topical use in the form of creams, ointments, pastes, gels, solutions, sprays, liposomes or nanosomes, "pegylated" formulations, degradable depot matrices, shake mixtures, hydrocolloid dressings, plasters, microsponges , Prepolyomers and similar new carrier substrates, jet injections or other dermatological basics, including instillative application.
13. Verfahren zur Therapie und Prävention dermatologischer Erkrankungen mit Hyperproliferation und veränderten Differenzierungszuständen von Fibroblasten, umfassend die Verabreichung von Inhibitoren der Dipeptidylpeptidase IV (DP IV) sowie von Inhibitoren von Enzymen mit gleicher Substratspezifität (DP IV-analoge Enzymaktivität) oder/und von Inhibitoren der Alanyl-Aminopeptidase (Aminopeptidase N, APN) sowie von Inhibitoren von Enzymen gleicher Substratspezifität (APN-analoge Enzymaktivität).13. A method for the therapy and prevention of dermatological diseases with hyperproliferation and changed differentiation states of fibroblasts, comprising the administration of inhibitors of dipeptidyl peptidase IV (DP IV) and of inhibitors of enzymes with the same substrate specificity (DP IV-analogous enzyme activity) and / or of inhibitors of Alanyl aminopeptidase (aminopeptidase N, APN) and inhibitors of enzymes of the same substrate specificity (APN-analogous enzyme activity).
14. Verfahren nach Anspruch 13, worin ein Inhibitor oder mehrere Inhibitoren der genannten Enzyme oder eine oder mehrere, diese Inhibitoren einzeln oder bevorzugt in Kombination enthaltende pharmazeutische Zubereitung(en) an einen Patienten verabreicht werden, die gewählt sind aus Inhibitoren der DP IV und besonders bevorzugt aus Xaa-Pro- Dipeptiden (Xaa = α-Aminosäure bzw. seitenkettengeschütztes Derivat), entsprechenden Derivaten, vorzugsweise Dipeptidphosphonsäurediaryl- estern, Dipeptidboronsäuren (z.B. Pro-boro-Pro) und deren Salzen, Xaa- Xaa-(Trp)-Pro-(Xaa)n-Peptiden (Xaa = α-Aminosäure, n = 0 bis 10), entsprechenden Derivaten und deren Salzen, Aminosäure (Xaa)-amiden, entsprechende Derivaten und deren Salzen, wobei Xaa eine α-Aminosäure bzw. ein seitenkettengeschütztes Derivat, vorzugsweise Nε-4- Nitrobenzyloxycarbonyl-L-Lysin, L-Isoleucin, L-Valin, L-Tryptophan, L- Prolin, ist und als Amidstruktur cyclische Amine, z.B. Pyrrolidin, Piperidin, Thiazolidin und deren Derivate fungieren, und/oder Tryptophan-1 , 2,3,4- tetrahydroisochinolin-3-carbonsäure-derivate (TSL) und (2S,2S',2S")-2-[2'- [2"-amino-3"-(indol-3'"-yl)-1 "-oxoprolyl]-1 ',2',3',4'-tetrahydro-6'8'- dihydroxy-7-methoxyisochinol-3-yl-carbonyl-amino]-4-hydromethyl-5- hydropentansäure (TMC-2A), und Inhibitoren der APN, besonders bevorzugt Actinonin, Leuhistin, Phebestin, Amastatin, Bestatin, Probestin, ß-Aminothiolen, α-Aminophosphinsäurβn, α-Aminophosphinsäurederivaten, vorzugsweise D-ψ-Phe-PO(OH)-CH2]-Phe-Phe, und deren Salzen. 14. The method according to claim 13, wherein one or more inhibitors of said enzymes or one or more pharmaceuticals containing these inhibitors individually or preferably in combination Preparation (s) are administered to a patient, which are selected from inhibitors of DP IV and particularly preferably from Xaa-pro dipeptides (Xaa = α-amino acid or side-chain-protected derivative), corresponding derivatives, preferably dipeptide phosphonic acid diaryl esters, dipeptide boronic acids (e.g. Pro-boro-Pro) and their salts, Xaa- Xaa- (Trp) -Pro- (Xaa) n-peptides (Xaa = α-amino acid, n = 0 to 10), corresponding derivatives and their salts, amino acid (Xaa) amides, corresponding derivatives and their salts, where Xaa is an α-amino acid or a side-chain-protected derivative, preferably N ε -4-nitrobenzyloxycarbonyl-L-lysine, L-isoleucine, L-valine, L-tryptophan, L-proline and cyclic amines, for example pyrrolidine, piperidine, thiazolidine and their derivatives, and / or tryptophan-1, 2,3,4-tetrahydroisoquinoline-3-carboxylic acid derivatives (TSL) and (2S, 2S ', 2S " ) act as the amide structure -2- [2 ' - [2 " -amino-3 " - (indole-3 ' "-yl) -1" -oxoprolyl] -1 ' , 2 ' , 3 ' , 4'-tetrahydro- 6 ' 8'-dihydroxy-7-methoxyisoquinol-3-yl-carbonylamino] -4-hydromethyl-5-hydropentanoic acid (TMC-2A), and inhibitors of APN, particularly preferably actinonine, leuhistine, phebestin, amastatin, bestatin, Probestin, ß-aminothiols, α-aminophosphinic acids, α-aminophosphinic acid derivatives, preferably D-ψ-Phe-PO (OH) -CH 2 ] -Phe-Phe, and their salts.
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CN100560129C (en) 2009-11-18
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JP2009513520A (en) 2009-04-02
US20070042938A1 (en) 2007-02-22
DE10330842A1 (en) 2005-02-10
CN1819840A (en) 2006-08-16

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