EP2099439A2 - Verfahren zur behandlung einer entzündlichen krankheit durch verabreichung von aldehyden und seinen derivaten - Google Patents

Verfahren zur behandlung einer entzündlichen krankheit durch verabreichung von aldehyden und seinen derivaten

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Publication number
EP2099439A2
EP2099439A2 EP07709271A EP07709271A EP2099439A2 EP 2099439 A2 EP2099439 A2 EP 2099439A2 EP 07709271 A EP07709271 A EP 07709271A EP 07709271 A EP07709271 A EP 07709271A EP 2099439 A2 EP2099439 A2 EP 2099439A2
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Prior art keywords
substituted
compound
inflammatory
disease
derivative
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French (fr)
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Carlos C. ROMÃO
Marta Norton De Matos
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Alfama - Investigacao E Desenvolvimento De Produto
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Alfama - Investigacao E Desenvolvimento De Produto
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    • 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
    • A61K31/11—Aldehydes
    • 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
    • A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
    • A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
    • A61K31/22—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin
    • 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
    • A61K31/275—Nitriles; Isonitriles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00—Drugs for disorders of the respiratory system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00—Drugs for dermatological disorders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A61P19/02—Drugs for skeletal disorders for joint disorders, e.g. arthritis, arthrosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/14—Drugs for disorders of the nervous system for treating abnormal movements, e.g. chorea, dyskinesia
    • A61P25/16—Anti-Parkinson drugs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P37/00—Drugs for immunological or allergic disorders
    • A61P37/02—Immunomodulators
    • A61P37/06—Immunosuppressants, e.g. drugs for graft rejection
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00—Drugs for disorders of the cardiovascular system
    • A61P9/10—Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis

Definitions

  • the field relates to organic aldehydes and derivatives thereof, and in particular to methods of administering pharmaceutical compositions containing such compounds to treat inflammatory diseases.
  • Rheumatoid arthritis is a well known example of an inflammatory disease for which improved treatments are needed (Saravanan et al., Expert Opin. Pharmacother. 3:845-56 (2002); O'Dell, N. Engl. J. Med. 350:2591-602 (2004)).
  • rheumatoid arthritis patients are first treated with nonsteroidal anti-inflammatory drags (NS AIDs), such as aspirin, indomethacin, ibuprofen and many others (Steinmeyer, J Arthritis Res. 2:379-85 (2000)).
  • NS AIDs nonsteroidal anti-inflammatory drags
  • NSAIDs provide only symptomatic relief from the pain and inflammation associated with the disease, and do not arrest the progression of pathological injury to the joints.
  • the use of these drugs is limited by side effects, in particular gastrointestinal ulcers that are thought to be caused by the inhibition of COX-I .
  • More recently developed selective COX-2 inhibitors have fewer gastrointestinal side effects, but increase the risk of myocardial infarction (Ardoin et al., Curr. Opin. Rheumatol 18:221-226 (2006)).
  • glucocorticoids are potent suppressors of immune responses and inflammation.
  • the continued use of glucocorticoids at supraphysiological doses is associated with many adverse effects, some of which are severe, such as hypertension, increased susceptibility to infections, osteoporosis, growth arrest and behavioural disturbances.
  • Withdrawal from corticosteroid therapy can lead to disease flare-up and also acute adrenal insufficiency.
  • DMARDs disease modifying anti-rheumatic drugs
  • examples include methotrexate, chloroquine, sulfasalazine, gold salts, D- penicillamine, azathioprine, leflunomide and cyclosporine.
  • DMARDs are now often used earlier in the course of disease (Scott, Arthritis Res. Ther. 6:15-8 (2004)). While these drugs may arrest or reduce the progression of joint destruction, they have a variety of adverse effects, some of which may be severe, leading to the withdrawal of the drug from the treatment schedule.
  • a significant improvement in the treatment of rheumatoid arthritis has been achieved with a novel class of DMARDs often referred to as biologies (Olsen et al., N. Engl. J. Med. 350:2167-2179 (2004)).
  • Biologies are therapeutically effective proteins that are engineered and expressed using recombinant DNA technologies.
  • Some important biologies currently used for the treatment of rheumatoid arthritis are tumor necrosis factor (TNF) neutralizing antibodies and TNF receptor constructs.
  • TNF tumor necrosis factor
  • These new anti-rheumatic drugs have a quicker onset of action than the traditional DMARDs, and suppress the progression of joint erosions.
  • this class of drugs must be parenterally administered and is quite costly.
  • TNF neutralizing biologies has revealed adverse effects, such as reactivation of tuberculosis, increased susceptibility to infections, and an increased risk for development of malignant diseases (Mikuls et al., Drug Saf. 26:23-32 (2003)).
  • Carbon monoxide (CO) is an endogenous metabolite with pleiotropic effects that are integrated into adaptive responses of the body to various types of stress (Ryter et al., Bioessays, 26: 270-80 (2004)). CO inhibits TNF production in vitro and in vivo, and has shown impressive anti-inflammatory effects in animal models (Otterbein, Antioxid. Redox. Signal. 4:309-319 (2002); Ryter et al., Bioessary 26:270-280 (2004)). In addition to inhibiting TNF production, CO has other anti-inflammatory effects. It inhibits the production of other proinflammatory cytokines, such as IL-I, IL-6 and MIP-I (Otterbein et al., Nat. Med.
  • endogenous carbon monoxide does not provide its full potential of beneficial effects, because its production is delayed or reduced under pathological conditions.
  • therapeutic effects may be achieved by administration of exogenous carbon monoxide.
  • Exogenous CO may also induce the expression of hemoxygenase-1 (HO-I) (Sawle et al., Br. J. Pharmacol. 145(6):800-810 (2005); Lee et al., Nat. Med 8:240-246 (2002)).
  • HO-I is known to have a wide variety of protective functions (Otterbein et al., Trends Immunol.
  • ROS Reactive oxygen species
  • ROS include, without limitation, oxygen ions, superoxide, peroxynitrite, free radicals and peroxides, both inorganic and organic.
  • a variety of highly reactive ROS are generated from superoxide (Hogg, Semin. Reprod. Endocrinol. 16:241-8 (1998)). These molecules are generated at low levels in many tissues, and have important roles in various signal transduction pathways (Droge, Physiol. Rev., 82:47-95 (2002)).
  • excessive production of ROS occurs in many pathological conditions. While a variety of mechanisms have evolved to prevent damage by excessive amounts of ROS, conditions in which production of these highly reactive molecules exceeds the capacity to neutralize them are referred to as oxidative stress.
  • Oxidative stress is a medical term for the damage to animal or plant cells caused by reactive oxygen species.
  • Oxidative stress is a hallmark of many diseases (Spector, J. Ocul Pharmacol Ther. 2:193-201(2000)). These include inflammatory diseases, such as rheumatoid arthritis (Bauerova et al., Gen. Physiol. Biophys. 18 Spec No:15-20 (1999); Hadjigogos, Panminerva Med. 45:7-13 (2003); Hitchon et al., Arthritis Res. Ther. 6:265-78 (2004)), asthma (Andreadis et al., Free Radio. Biol. Med. 35:213-25 (2003); Henricks et al., PuIm. Pharmacol. Ther.
  • an aldehyde exhibit anti-inflammatory properties, at least in part by release of carbon monoxide (CO) in normal or inflamed tissues, or both.
  • CO carbon monoxide
  • an aldehyde is administered in the form of a derivative, e.g., in a protected form that provides, for example, improved in vivo stability, bioavailability, and/or delivery in vivo.
  • one aspect provides a method for treating inflammatory disease.
  • the method includes administering to an animal in need thereof a pharmaceutical composition including an anti-inflammatory effective amount of an organic aldehyde compound or a derivative thereof in a pharmaceutically acceptable vehicle.
  • the organic aldehyde releases CO in the animal, thereby providing an anti-inflammatory effect.
  • the organic aldehyde is a compound of formula I:
  • R 1 , R 2 and R 3 are each independently selected from alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, heterocyclyl, substituted heterocyclyl, alkylheterocyclyl, substituted alkylheterocyclyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, alkylaryl, substituted alkylaryl, hydroxy, alkoxy, amino, alkylamino, mercapto, alkylmercapto, aryloxy, substituted aryloxy, heteroaryloxy, substituted heteroaryloxy, alkoxycarbonyl, acyl, acyloxy, acylamino, alkylsulfonyl, alkylsulfinyl, F, Cl, Br, NO 2 and cyano; or two or more OfR 1 , R 2 and R 3 are taken together to form a substituted or unsubstitute
  • R 1 , R 2 and R 3 are each independently selected from alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, and substituted alkenyl.
  • the compound of formula I is trimethylacetaldehyde, 2,2-dimethyl-4- pentenal, 4-ethyl-4-formyl-hexanenitrile, 3-hydroxy-2,2-dimethylpropanal, 2-formyl-2-methyl- propylmethanoate or 2-ethyl-2-methyl-propionaldehyde.
  • R 1 and R 2 are each independently selected from alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, and substituted alkenyl
  • R 3 is selected from aryl, substituted aryl, heteroaryl, substituted heteroaryl, alkylaryl, and substituted alkylaryl.
  • the compound of formula I is 2,2-dimethyl-3-(p- methylphenyl)propanal or 2-methyl-2-phenylpropionaldehyde.
  • a derivative of a compound of formula I is employed.
  • the derivative is an acetal, hemiacetal, aminocarbinol, aminal, imine, enaminone, imidate, amidine, iminium salt, sodium bissulfite adduct, hemimercaptal, dithioacetal, 1,3-dioxepane, 1,3-dioxane, 1,3-dioxalane, 1,3-dioxetane, ⁇ -hydroxy-1,3- dioxepane, ⁇ -hydroxy-l,3-dioxane, ⁇ -hydroxy- 1,3-dioxalane, ⁇ -keto- 1,3-dioxepane, ⁇ -keto- 1,3-dioxane, ⁇ -keto- 1,3-dioxalane, ⁇ -keto-l,3-dioxetane, macrocyclic este
  • the compound of formula I is linked to an amino acid or protein.
  • the compound of formula I or derivative thereof is administered concomitantly with a second anti-inflammatory agent.
  • the compound of formula I or derivative thereof is administered in the form of a pharmaceutically acceptable salt.
  • the pharmaceutical composition is a tablet, dragee, capsule, pill, powder, troche or granule.
  • the pharmaceutical composition is a suspension, emulsion, solution, syrup or elixir.
  • the pharmaceutical composition is formulated for parenteral administration.
  • the inflammatory disease is arthritis, for example, rheumatoid arthritis, juvenile idiopathic arthritis, osteoarthritis or psoriatic arthritis.
  • the inflammatory disease is Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis or multiple sclerosis.
  • the inflammatory disease is an inflammatory lung disease.
  • the inflammatory disease is an inflammatory bowl disease.
  • the inflammatory disease is an inflammatory skin disease.
  • the inflammatory disease is atherosclerosis, myocardial infarction, stroke or transplant rejection.
  • the inflammatory disease is gram-positive or gram negative shock, sepsis, septic shock, hemorrhagic or anaphylactic shock or systemic inflammatory response syndrome.
  • Figures IA-D are plots showing the CO release behavior of trimethylacetaldehyde
  • Figure 2 is a plot showing the kinetics of CO release of 2,2-dimethyl-4-pentenal
  • Figure 3 is a plot showing the kinetics of CO release of 4-ethyl-4-formyl- hexanenitrile (compound 3) in TBHP, pH 2 and rpmi solutions.
  • Figure 4 is a plot showing the kinetics of CO release of 3-hydroxy-2,2- dimethylpropanal (compound 4) in TBHP solution.
  • Figure 5 is a plot showing the kinetics of CO release of 2-formyl-2-mefhyl- propylmethanoate (compound 5) in TBHP solution.
  • Figure 6 is a plot showing the kinetics of CO release of 2,2-dimethyl-3-(p- methylphenyl)propanal (compound 6) in TBHP, H 2 O 2 , pH 2 and rpmi solutions.
  • Figure 7 is a plot showing the kinetics of CO release of 2-methyl-2- phenylpropionaldehyde (compound 7) in TBHP, H 2 O 2 and pH 2 solutions.
  • Figure 8 is an overview plot showing the kinetics of CO release for compounds 1-7 in the first 6 hours in TBHP solutions.
  • Figure 9 presents an overview of the data on the kinetics of CO release for compounds 1-7 after 24 hours in different media.
  • Figure 10 is a plot showing the changes in body weight in untreated (control) and treated (compound 1 or compound 2) Sprague Dawley rats after the induction of adjuvant arthritis.
  • Figures 1 IA-D are plots showing the changes in the volume of the right paw (1 IA) and the left paw (1 IB), and of the circumference of the right paw (HC) and the left paw (1 ID) in untreated (control) and treated (compound 1 or compound 2) Sprague Dawley rats after the induction of adjuvant arthritis.
  • Figure 12 is a plot showing changes in the arthritic index in untreated (control) and treated (compound 1 or compound 2) Sprague Dawley rats after the induction of adjuvant arthritis.
  • Figure 13 is a plot showing changes of body weight in untreated and treated Lewis rats after induction of adjuvant arthritis.
  • the treatment groups included compound 1 (100 mg/kg), compound 1 (25 mg/kg), compound 7 (100 mg/kg), compound 7 (25 mg/kg), dexamethasone, and vehicle (carboxymethylcellulose/Tween 80).
  • Figure 14 is a plot showing changes in paw volume in untreated and treated Lewis rats after the induction of adjuvant arthritis.
  • the treatment groups included compound 1 (100 mg/kg), compound 1 (25 mg/kg), compound 7 (100 mg/kg), compound 7 (25 mg/kg), dexamethasone, and vehicle (carboxymethylcellulose/Tween 80).
  • Figure 15 is a plot showing changes in arthritic index in untreated and treated Lewis rats after the induction of adjuvant arthritis.
  • the treatment groups included compound 1 (100 mg/kg), compound 1 (25 mg/kg), compound 7 (100 mg/kg), compound 7 (25 mg/kg), dexamethasone, and vehicle (carboxymethylcellulose/Tween 80).
  • Figure 16 is a plot showing the kinetics of CO release of 2-tert-butyl-thiazolidine-4- carboxylic acid (compound 9) in TBHP plus rpmi solution.
  • Figure 17 is a plot showing the kinetics of CO release of 2-tert-butyl-thiazolidine-4- carboxylic acid methyl ester (compound 10) in TBHP plus rpmi solution.
  • Figure 18 is a plot showing the kinetics of CO release of 2-tert-butyl-thiazolidine
  • Figure 19 is a plot showing the kinetics of CO release of 2-tert-butyl-[l ,3]thiazinane-
  • CO carbon monoxide
  • the aldehydes or derivatives thereof generate CO exclusively or preferentially in the presence of reactive oxygen species (ROS), and thus are expected to have beneficial effects in diseases associated with oxidative stress.
  • ROS reactive oxygen species
  • R 1 , R 2 and R 3 are each independently selected from H, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, heterocyclyl, substituted heterocyclyl, alkylheterocyclyl, substituted alkylheterocyclyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, alkylaryl, substituted alkylaryl, hydroxy, alkoxy, amino, alkylamino, mercapto, alkylmercapto, aryloxy, substituted aryloxy, heteroaryloxy, substituted heteroaryloxy, alkoxycarbonyl, acyl, acyloxy, acylamino, alkylsulfonyl, alkylsulfinyl, F, Cl, Br, NO 2 and cyano; or two or more OfR 1 , R 2 and R 3 are taken together to form a substituted or unsubstid
  • Alkyl refers to straight or branched chain saturated hydrocarbyl groups having up to 20 carbon atoms
  • substituted alkyl refers to alkyl groups bearing one or more substituents selected from amino, alkylamino, hydroxy, alkoxy, mercapto, alkylmercapto, aryl, aryloxy, alkoxycarbonyl, acyl, acyloxy, acylamino, F, Cl, Br, NO 2 , cyano, sulfonyl, sufinyl and similar substituents known to those of skill in the art.
  • Cycloalkyl refers to saturated hydrocarbyl groups containing one or more rings and having in the range of 3 to 12 carbon atoms
  • substituted cycloalkyl refers to cycloalkyl groups further bearing one or more substituents as set forth above
  • Heterocyclyl refers to cyclic groups containing one or more rings including one or more heteroatoms ⁇ e.g., N, O or S) as part of the ring structure and having in the range of 3 to 12 ring atoms
  • substituted heterocyclyl refers to heterocyclyl groups further bearing one or more substituents as set forth above.
  • Alkylheterocyclyl refers to alkyl-substituted heterocyclyl groups, and "substituted alkylheterocyclyl” refers to alkylheterocyclyl groups further bearing one or more substituents as set forth above.
  • Alkenyl refers to straight or branched chain hydrocarbyl groups having at least one carbon-carbon double bond, and having in the range of 2 to 20 carbon atoms, and “substituted alkenyl” refers to alkenyl groups further bearing one or more substituents as set forth above.
  • Aryl refers to aromatic groups having in the range of 6 up to about 14 carbon atoms
  • substituted aryl refers to aryl groups further bearing one or more substituents as set forth above
  • Heteroaryl refers to aromatic groups containing one or more heteroatoms (e.g., N, O or S) as part of the ring structure, and having in the range of 5 up to about 13 carbon atoms
  • substituted heteroaryl refers to heteroaryl groups further bearing one or more substituents as set forth above.
  • Alkylaryl refers to alkyl-substituted aryl groups, and “substituted alkylaryl” refers to alkylaryl groups further bearing one or more substituents as set forth above.
  • Hydrooxy refers to the group OH.
  • Alkoxy refers to a group -OR, wherein R is an alkyl group as defined above.
  • Amino refers to the group NH 2 .
  • Alkylamino refers to a group -NHR or -NRR', where R and R 1 are independently chosen from alkyl or cycloalkyl groups as defined above.
  • Mercapto refers to the group SH.
  • Alkylmercapto refers to the group S-R, where R represents an alkyl or cycloalkyl group as defined above.
  • Aryloxy refers to a group -OAr, wherein Ar is an aryl group as defined above, and “substituted aryloxy” refers to aryloxy groups further bearing one or more substituents as set forth above.
  • Heteroaryloxy refers to a group -OHt, wherein Ht is a heteroaryl group as defined above, and “substituted heteroaryloxy” refers to heteroaryloxy groups further bearing one or more substituents as set forth above.
  • Alkoxycarbonyl refers to a group -C(O)-OR, wherein R is an alkyl group as defined above.
  • Acyl refers to a group -C(O)-R, where R is H, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl or substituted heteroaryl, as defined above.
  • Acyloxy refers to a group -0-C(O)-R, where R is H, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl or substituted heteroaryl, as defined above.
  • Acylamino refers to a group -NR 1 C(O)R, where R and R' are each independently chosen from H, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl or substituted heteroaryl, as defined above.
  • Alkylsulfonyl refers to a group - S(O) 2 R, where R represents an alkyl or cycloalkyl group as defined above.
  • Alkylsulfmyl refers to a group -S(O)R, where R represents an alkyl or cycloalkyl group as defined above.
  • aldehydes of the general formula I include the following: trimethylacetaldehyde (compound 1)
  • tertiary radicals which are more stable than primary or secondary radicals due to resonance stabilization by hyperconjugation.
  • Hyperconjugation includes the stabilization that results from the interaction of electrons in a ⁇ -bond (usually C-H or C-C) with an adjacent empty (or partially filled) p-orbital or ⁇ -orbital to give an extended molecular orbital that increases the stability of the system.
  • decarbonylation is favored in tertiary aldehydes, as compared to primary and secondary aldehydes.
  • the tertiary aldehydes disclosed herein advantageously release CO in the presence of certain reactive oxygen species at room temperature, and thus are expected to be capable of targeting and releasing therapeutic CO into inflamed tissues.
  • many of the tertiary aldehydes disclosed herein do not release CO in water, which is also expected to be useful for purposes of targeting inflamed tissue.
  • tertiary aldehydes such as those disclosed herein are expected to have potentially fewer side effects than primary or secondary aldehydes.
  • tertiary aldehydes having a higher branching and a less electrophilic carbonyl group, are less reactive towards nucleophiles, and therefore less prone to interact with nucleophilic biomolecules (E. Schauenstein, H. Eserbauer & H. Zollner, Aldehydes in Biological Systems, Their Natural Occurrence and Biological Activity, Pion Limited, 1977, Ch. 1-2). Indeed, tertiary aldehydes reportedly are less likely than primary and secondary aldehydes to interfere with DNA or inactivate cytochrome P450 (Adam et al., Free Radical Biol Med, 26:566-79 (1999); Raner et al., Biochem.
  • Equation 1 shows a proposed mechanism for the decarbonylation of tertiary aldehydes (exemplified by trimethylacetaldehyde (compound I)) by reactive oxygen species, generating carbon monoxide and a stabilized tertiary radical:
  • the aldehyde is a tertiary aldehyde.
  • the aldehyde is a compound of the above formula I in which R 1 , R 2 and R 3 are each independently selected from alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, heterocyclyl, substituted heterocyclyl, alkylheterocyclyl, substituted alkylheterocyclyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, alkylaryl, substituted alkylaryl, hydroxy, alkoxy, amino, alkylamino, mercapto, alkylmercapto, aryloxy, substituted aryloxy, heteroaryloxy, substituted heteroaryloxy, alkoxycarbonyl, acyl, acyloxy, acylamino, alkylsulfonyl,
  • the aldehyde is an optionally substituted alkyl or alkenyl tertiary aldehyde.
  • the aldehyde is a compound of formula I in which R 1 , R 2 and R 3 are each independently selected from alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, and substituted alkenyl.
  • Non-limiting examples include the above-identified compound 1 (simple alkyl), compound 2 (simple alkenyl), compound 3 (cyano-substituted alkyl), compound 4 (hydroxyl-substituted alkyl), compound 5 (acyloxy-substituted alkyl) and compound 8 (simple alkyl).
  • the aldehyde is an alkyl or alkenyl tertiary aldehyde with one aromatic or alkylaromatic substituent.
  • the aldehyde is a compound of formula I in which R 1 and R 2 are each independently selected from alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, and substituted alkenyl, and R 3 is selected from aryl, substituted aryl, heteroaryl, substituted heteroaryl, alkylaryl, and substituted alkylaryl.
  • R 1 and R 2 are each independently selected from alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, and substituted alkenyl
  • R 3 is selected from aryl, substituted aryl, heteroaryl, substituted heteroaryl, alkylaryl, and substituted alkylaryl.
  • Non-limiting examples include the above-identified compound 6 (alkylaryl), and
  • the aldehyde is a trialkyl or triaryl substituted aldehyde.
  • the aldehyde is a compound of formula I in which R 1 , R 2 and R 3 are alkyl, or in which R 1 , R 2 and R 3 are aryl.
  • the aldehyde is administered in the form of a derivative, or a protected form thereof.
  • the derivative serves as a source of the free or unmodified aldehyde in vivo and/or releases CO in vivo itself.
  • an aldehyde derivative is generated that acts as a prodrug, a pharmacologically inactive chemical entity that, when chemically transformed or metabolised in an animal, is converted into a pharmacologically active substance.
  • the generation of the therapeutically effective molecule (i.e., the aldehyde) from the prodrug occurs prior to, during or after reaching the site of action within the body (Bundgaard et al., Int. J. Pharm. 13:89-98 (1983)). Release of the aldehyde from the prodrug generally occurs via chemical or enzymatic lability, or both, within the body system.
  • the carrier is modified with electron withdrawing or donating groups.
  • organic aldehydes are protected by conversion to the corresponding acetal, hemiacetal, aminocarbinol, aminal, imine, enaminone, imidate, amidine, iminium salt, sodium bissulfite adduct, hemimercaptal, dithioacetal, 1,3-dioxepane, 1,3-dioxane, 1,3-dioxalane, 1,3- dioxetane, ⁇ -hydroxy- 1,3-dioxepane, ⁇ -hydroxy- 1,3-dioxane, ⁇ -hydroxy- 1,3-dioxalane, ⁇ -keto- 1,3-dioxe ⁇ ane, ⁇ -keto- 1,3-dioxane, ⁇ -keto-l,3-dioxalane, ⁇ -keto-l,3-dioxetane, macrocyclic ester/i
  • the protected organic aldehyde is an imine.
  • Those skilled in the art recognize that such derivatives are obtained in a variety of ways, such as, for example, by the methods described by Deaton et al., Bioorg. Med. Chem. Lett. 16: 978-983 (2006), or WO2006/012215, by reaction of an organic aldehyde with an amine as in equation 2:
  • each OfR 1 , R 2 and R 3 is independently selected from H, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, heterocyclyl, substituted heterocyclyl, alkylheterocyclyl, substituted alkylheterocyclyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, alkylaryl, substituted alkylaryl, hydroxy, alkoxy, amino, alkylamino, mercapto, alkylmercapto, aryloxy, substituted aryloxy, heteroaryloxy, substituted heteroaryloxy, alkoxycarbonyl, acyl, acyloxy, acylamino, alkylsulfonyl, alkylsulfinyl, F, Cl, Br, NO 2 and cyano; or two or more OfR 1 , R 2 and R 3 are taken together to form a substituted or un
  • R 1 is selected from H, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl and substituted heteroaryl.
  • the protected organic aldehyde is an iminium salt.
  • Those skilled in the art recognize that such derivatives can be obtained in a variety of ways, such as, for example, by the methods described by Paukstelis et al, J. Org. Chem. 28:3021-3024 (1963), by reaction of an organic aldehyde with a secondary amine salt as in equation 3:
  • R" is selected from H, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl and substituted heteroaryl.
  • X represents any suitable and pharmaceutically acceptable counter anion, such as chloride, bromide, phosphate, carbonate, sulfate, acetate or any other non-toxic, physiologically compatible anion.
  • the protected organic aldehyde is a hydrazone.
  • each OfR 1 , R 2 , R 3 and R 1 is as defined above with respect to equation 2.
  • the protected organic aldehyde is a carbazone.
  • Those skilled in the art recognize that such derivatives can be obtained in a variety of ways such as, for example, using methods described by Herrmann et al., Chem. Commun. 2965-2967 (2006) by reaction of an organic aldehyde with a hydrazide (or acyl hydrazine) as in equation 5:
  • the protected organic aldehyde is a semicarbazone or thiosemicarbazone.
  • Those skilled in the art recognize that such derivatives can be obtained in a variety of ways, such as, for example, using the methods described by Deaton et al., Bioorg. Med. Chem. Lett. 16:978-983 (2006) or by the methods disclosed in U.S. Patent No. 6,458,843, for example, by reaction of an organic aldehyde with a semicarbazine or thiosemicarbazine as in equation 6:
  • the protected organic aldehyde is an oxime.
  • oxime a group consisting of oxime-ones
  • each OfR 1 , R 2 , R 3 and R is as defined above with respect to equation 2.
  • the protected organic aldehyde is an acetal or hemiacetal.
  • Those skilled in the art recognize that such derivatives can be prepared in a variety of ways, such as, for example, by reaction of an aldehyde with one or more alcohols as in equation 8:
  • the protected organic aldehyde is an ⁇ -hydroxy-1,3- dioxepane (or ⁇ -hydroxy-l,3-dioxane or ⁇ -hydroxy-l,3-dioxalane).
  • ⁇ -hydroxy-1,3- dioxepane or ⁇ -hydroxy-l,3-dioxane or ⁇ -hydroxy-l,3-dioxalane.
  • each of R 1 , R 2 and R 3 is as defined above with respect to equation 2; each OfR 4 and R 5 is independently selected from H, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, heterocyclyl, substituted heterocyclyl, alkylheterocyclyl, substituted alkylheterocyclyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, alkylaryl, substituted alkylaryl, hydroxy, alkoxy, amino, alkylamino, mercapto, alkylmercapto, aryloxy, substituted aryloxy, heteroaryloxy, substituted heteroaryloxy, alkoxycarbonyl, acyl, acyloxy, acylamino, alkylsulfonyl, alkylsulfinyl, F, Cl, Br, NO 2 and cyano; or R 4 and R 5 are taken together
  • the reaction shown in equation 9 is an energetically favorable cyclization (dimerization) that occurs spontaneously when the compounds are cooled together (1 :1) to room temperature. When heated (e.g., to physiological temperatures), they separate again.
  • Compound 4 is an example of a compound that forms a dimer upon cooling to room temperature.
  • the protected organic aldehyde is an ⁇ -keto-1,3- dioxepane (or ⁇ -keto-l,3-dioxane, ⁇ -keto-l,3-dioxalane or ⁇ -keto-l,3-dioxetane).
  • each OfR 1 , R 2 and R 3 is as defined above with respect to equation 2; and n is 0, 1, 2, or 3.
  • the protected organic aldehyde is a macrocyclic ester/imine.
  • Those skilled in the art recognize that such derivatives can be obtained in a variety of ways, such as, for example, as described in U.S. Patent No. 6,251,927, by reaction of a hydroxy substituted organic aldehyde with a compound of the formula HOOC-(CH 2 ) m -NH 2 , thereby forming a protected aldehyde, as in equation 11 :
  • the protected organic aldehyde is a macrocyclic ester/hemiacetal.
  • Those skilled in the art recognize that such derivatives can be obtained in a variety of ways, such as, for example, as described in U.S. Patent No. 6,251,927 by reaction of a hydroxy substituted organic aldehyde with a hydroxy acid having the structure HOOC-(CH 2 ) m -OH, thereby forming a protected aldehyde, as in equation 12:
  • Hydrolysis of the compound formed in equation 12 occurs by chemical hydrolysis through the ketal, or enzymatic hydrolysis through the ester group.
  • the protected organic aldehyde is a thiazolidine or a tetrahydro-l,3-thiazine.
  • thiazolidine or a tetrahydro-l,3-thiazine.
  • each OfR 1 , R 2 , R 3 and R 4 is independently selected from H, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, heterocyclyl, substituted heterocyclyl, alkylheterocyclyl, substituted alkylheterocyclyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, alkylaryl, substituted alkylaryl, hydroxy, alkoxy, amino, alkylamino, mercapto, alkylmercapto, aryloxy, substituted aryloxy, heteroaryloxy, substituted heteroaryloxy, alkoxycarbonyl, acyl, acyloxy, acylamino, alkylsulfonyl, alkylsulfinyl, F, Cl, Br, NO 2 , and cyano; or two or more OfR 1 , R 2 and R 3 are taken together to form
  • A is selected from H, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, alkylaryl, substituted alkylaryl, alkoxycarbonyl, acyl, acyloxy, acylamino, alkylsulfonyl and alkylsulfinyl; and n is 1 or 2.
  • the protected organic aldehyde is an oxazolidine or a tetrahydro-l,3-oxazine.
  • oxazolidine or a tetrahydro-l,3-oxazine are represented by formula III:
  • the protected organic aldehyde is an imidazolidine or a 1,3-hexahydro-pyrimidine.
  • the protected organic aldehyde is an imidazolidine or a 1,3-hexahydro-pyrimidine.
  • Those skilled in the art recognize that such derivatives can be obtained in a variety of ways, such as, for example, by employing the methods described by Lambert, J. Org. Chem. 52:68-71 (1987) or F ⁇ l ⁇ p, J. Org. Chem. 67:4734-4741 (2002).
  • Certain imidazolidines and 1,3-hexahydro-pyrimidines contemplated for use as described herein are represented by formula IV:
  • the protected organic aldehyde is an imidazolidinone.
  • imidazolidinones contemplated for use as described herein are represented by formula V:
  • the protected organic aldehyde is an acyloxyalkyl ester or O- acyloxyalkyl derivative.
  • acyloxyalkyl ester or O- acyloxyalkyl derivative can be obtained in a variety of ways, such as, for example, by employing the methods described by Nudelman et al., Eur J. Med. J. Chem. 36: 63-74 (2001), Nudelman et al., J. Med Chem. 48:1042-1054 (2005), or Swedish Patent No. SE9301115.
  • Certain acyloxyalkyl esters contemplated for use as described herein are represented by formula VI:
  • each OfR 1 , R 2 , and R 3 is as defined above with respect to formula II, and each of R' and R" is selected independently from H, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl, and substituted heteroaryl.
  • an acyloxyalkyl ester derivative in addition to releasing the active aldehyde upon metabolic hydrolysis in vivo, an acyloxyalkyl ester derivative also releases butyric acid.
  • Butyric acid prodrugs have been reported to provide increased aqueous solubility and permeability across cell membranes (Nudelman et al., Eur J. Med. J. Chem. 36: 63-74 (2001)).
  • the protected organic aldehyde is an N-acyloxyalkyl derivative.
  • N-acyloxyalkyl derivatives can be obtained in a variety of ways, such as, for example, by employing the methods described by Bundgaard et al., Int. J. Pharm. 22:454-456 (1984) and Bundgaard et al., Int. J. Pharm. 13:89-98 (1983).
  • Certain N-acyloxyalkyl derivatives contemplated for use as described herein are represented by formula VII:
  • each OfR 1 , R 2 , R 3 , R' and R" is as described above with respect to formulas II and VI; and R'" is selected from H, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl, and substituted heteroaryl.
  • the protected organic aldehyde is the salt of an N-acyloxyalkyl derivative.
  • N-acyloxyalkyl derivatives contemplated for use as described herein are represented by formula VIII:
  • R" is selected from H, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, substituted alkenyl, aryl, substituted aryl, heteroaryl, and substituted heteroaryl;
  • X represents a suitable and pharmaceutically acceptable counter anion, as described above with respect to equation 3.
  • the protected organic aldehyde is a 5-oxazolidinone.
  • a 5-oxazolidinone Those skilled in the art recognize that such derivatives can be obtained in a variety of ways, such as, for example, by employing the methods described by Bundgaard et al., Int. J. Pharma. Chem. 46:159-167 (1988) or Ishai-Ben, J. Am. Chem. Soc. 79:5736-38 (1957).
  • Certain 5-oxazolidinones contemplated for use as described herein are represented by formula IX:
  • the organic aldehydes and their derivatives disclosed herein are administered to treat inflammatory disease in animals, such as mammals, including but not limited to human patients.
  • "Inflammatory disease” as used herein refers to a disease or condition characterized by inflammation. Inflammation encompasses the first response of the immune system to infection or irritation, and is sometimes referred to as the innate cascade. Inflammation typically is characterized by one or more of the following symptoms: redness, heat, swelling, pain, and dysfunction of the organs involved.
  • Treatment encompasses prevention of a disease or its progression, reduction of one or more symptoms (e.g., pain) associated with a disease or condition, and/or amelioration or curing of the underlying disease state or condition.
  • An "anti-inflammatory effective amount" of an aldehyde or its derivative is an amount sufficient for treatment of an inflammatory disease.
  • inflammatory diseases treatable as described herein include without limitation transplant rejection; chronic inflammatory disorders of the joints, such as arthritis, rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, osteoarthritis and bone diseases associated with increased bone resorption; inflammatory bowel diseases, such as ileitis, ulcerative colitis, Barrett's syndrome, and Crohn's disease; inflammatory lung disorders, such as asthma, adult respiratory distress syndrome (ARDS), chronic obstructive pulmonary disease (COPD) or chronic obstructive airway disease; inflammatory disorders of the eye, such as corneal dystrophy, trachoma, onchocerciasis, uveitis, sympathetic ophthalmitis and endophthalmitis; chronic inflammatory disorders of the gum, such as gingivitis and periodontitis; tuberculosis; leprosy; inflammatory diseases of the kidney, such as uremic complications, glomerulonephritis and
  • Inflammatory diseases treatable as described herein further include systemic inflammations of the body.
  • systemic inflammation include but are not limited to gram-positive or gram negative shock, sepsis, septic shock, hemorrhagic or anaphylactic shock, and systemic inflammatory response syndrome.
  • Further examples of inflammatory disease include circulatory shock, hemorrhagic shock and cardiogenic shock.
  • the inflammatory disease is a chronic inflammatory disease, such as rheumatoid arthritis.
  • the inflammatory disease is a disease associated with a chronic inflammatory reaction, such as atherosclerosis or Alzheimer's disease; or with ischemia/reperfusion injury, such as myocardial infarction, stroke, sleep apnea or transplantation.
  • the inflammatory disease is an infectious disease, such as septic shock.
  • the compositions include a pharmaceutically acceptable salt of the aldehyde or derivative, for example, a pharmaceutically acceptable salt of a compound having the general formula I above.
  • a pharmaceutically acceptable salt form of compounds in formulating pharmaceutical compositions are administered in a variety of forms, adapted to the chosen route of administration. Suitable routes of administration include without limitation oral, rectal, transdermal, topical, and parenteral, e.g., intravenous (i.v.), subcutaneous, intramuscular, intrapleural, intraperitoneal, intrafocal and perifocal administration.
  • compositions typically contain an organic aldehyde or its derivative as disclosed herein, or a pharmaceutically acceptable salt thereof, as an active agent in a non-toxic, pharmaceutically acceptable vehicle.
  • the composition is an admixture of the active agent and a carrier in solid, semisolid, or liquid form.
  • the active agent is provided in an encasing composition, for example, a capsule, a tablet coating, a bag, or some other container for the active agent.
  • the vehicle includes one or more additional formulating agents, flavoring agents, coloring agents, or preservatives.
  • compositions for oral administration include, for example, tablets, dragees, capsules, pills, powders, troches, granules, suspensions, emulsions, solutions, syrups and elixirs.
  • the pharmaceutical composition is a solid dosage form including a carrier that contains at least one inert diluent, such as, for example, sucrose, lactose or starch.
  • such carriers also include one or more additional formulating substances, e.g., lubricating agents such as magnesium stearate.
  • capsules, tablets, troches or pills are prepared with a carrier that also includes one or more buffering agents.
  • vehicles such as tablets, pills, or granules are prepared with enteric coatings.
  • tablets are prepared including the active agent and one or more of the following: an inert diluent, such as, for example, calcium carbonate, calcium phosphate, sodium phosphate, or lactose; a granulation or distributing agent, such as corn starch or alginate; a binder, such as amylose, gelatin, or acacia gum; and a lubricant, such as aluminum stearate, magnesium stearate, talc, or silicone oil.
  • an inert diluent such as, for example, calcium carbonate, calcium phosphate, sodium phosphate, or lactose
  • a granulation or distributing agent such as corn starch or alginate
  • a binder such as amylose, gelatin, or acacia gum
  • a lubricant such as aluminum stearate, magnesium stearate, talc, or silicone oil.
  • tablets are provided with a coating that effects a delayed dissolution and reabsorption of the active agent in the gastrointestinal tract and thus, for example, provides improved compatibility or a longer duration of effectiveness.
  • gelatin capsules are prepared containing the active agent in a mixture with a solid diluent (e.g., calcium carbonate or kaolin), or an oily diluent (e.g., olive, peanut, or paraffin oil).
  • liquid dosage forms are prepared with inert diluents commonly used in the art, such as water.
  • compositions further include one or more additional components including adjuvants, such as dispersing and wetting agents, emulsifying and suspending agents, sweetening and flavoring agents, and/or preservatives.
  • adjuvants such as dispersing and wetting agents, emulsifying and suspending agents, sweetening and flavoring agents, and/or preservatives.
  • Suitable suspension agents include, for example, sodium carboxymethylcellulose, methylcellulose, hydroxypropylcellulose, sodium alginate, polyvinylpyrrolidone, tragacanth gum and acacia gum.
  • Non-limiting examples of suitable dispersing and wetting agents include polyoxyethylene stearate, heptadecaethyleneoxycetanol, polyoxyethylene, sorbitol monooleate, polyoxyethylene sorbitan monooleate or lecithin.
  • Suitable preservatives include, for example, methyl or propyl hydroxybenzoate.
  • suitable flavoring agents and sweeteners include sucrose, lactose, dextrose or sugar syrup.
  • oily suspensions are prepared including, for example, peanut, olive, sesame, coconut, or paraffin oil, and optionally one or more thickeners, such as beeswax, hard paraffin or cetyl alcohol, sweeteners, flavoring agents and/or anti-oxidants.
  • emulsions are prepared including, for example, olive, peanut, or paraffin oil in addition to one or more emulsifiers, such as acacia gum, tragacanth gum, phosphatides, sorbitan monooleate or polyoxyethylene sorbitan monooleate, and optionally one or more sweeteners and/or flavoring agents.
  • water dispersible powders or granules are prepared containing the active agent in a mixture with one or more dispersing, wetting, or suspension agents, e.g., the aforementioned materials and/or dimethyl sulfoxide, as well as optionally one or more sweeteners, flavoring agents and/or coloring agents.
  • the organic aldehydes are administered parenterally as sterile isotonic sodium chloride solutions or other solutions.
  • a solubilizer is added, such as dimethyl sulfoxide.
  • Pharmaceutically acceptable carriers for intravenous administration include, without limitation, solutions containing pharmaceutically acceptable salts or sugars.
  • Pharmaceutically acceptable carriers for intramuscular or subcutaneous injection include, without limitation, salts, oils, or sugars.
  • carriers such as solvents, water, buffers, alkanols, cyclodextrins and aralkanols are used.
  • Other optional auxiliary, non-toxic ingredients include, for example, polyethylene glycols or wetting agents.
  • an injectable solution is formulated with a buffer such as, for example, sodium bicarbonate or tris(hydroxymethyl)aminomethane.
  • the formulation has a pH between about 4 and about 7, for example, between about 5.0 and about 5.5.
  • compositions for topical administration include, without limitation, dimethyl sulfoxide, alcohol, and propylene glycol.
  • topical compositions are applied using patches or other liquid retaining material to hold the pharmaceutical composition in contact with the skin.
  • Suitable compositions for rectal administration include, without limitation, suppositories produced with one or more binders that melt at rectal temperature, for example, cocoa butter or polyethylene glycols.
  • the organic aldehyde composition is formulated to provide sustained release or delayed release.
  • carriers based on nanoparticles or nanoencapsulates are used, e.g., to protect the active agent and provide for its slow release in the organism or specific tissues.
  • the organic aldehydes and their derivatives disclosed herein are administered concomitantly with another active agent, such as another anti-inflammatory or immunosuppressive drug, including but not limited to aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs), steroids or methotrexate and other disease modifying antirheumatic drugs (DMARDs).
  • another active agent such as another anti-inflammatory or immunosuppressive drug, including but not limited to aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs), steroids or methotrexate and other disease modifying antirheumatic drugs (DMARDs).
  • the multiple active agents are administered as part of a single dosage form, or in multiple dosage forms administered at the same time or at different times.
  • the organic aldehyde is linked to a second therapeutic agent such as, for instance, an anti-inflammatory agent.
  • the second agent is selected based on its known capacity to target the site/tissue in which a therapeutic effect is desired.
  • an anti-inflammatory agent is selected for its known capacity to accumulate in an inflammatory lesion.
  • Anti-inflammatory drugs that accumulate in inflamed tissues include, without limitation, aspirin, indomethacin, and other nonsteroidal anti-inflammatory drugs that are organic acids.
  • the organic aldehyde is targeted to a particular tissue or cell type by linking it to a protein carrier.
  • Carrier proteins include but are not limited to antibodies specific for a cell surface protein or a component of the extracellular matrix.
  • the aldehyde is linked to an amino acid such as, for example, cysteine.
  • an aldehyde is derivatized to target the bones by introducing a phosphonic acid moiety.
  • Equation 13 illustrates a reaction scheme for introduction of a phosphonic acid moiety to 3-hydroxy ⁇ 2,2-diniethylpropanal (compound 4).
  • the phosphonic acid is introduced using POCl 3 ZEt 3 N followed by basic hydrolysis.
  • Equation 14 illustrates a reaction scheme for introduction of an amino acid, through the acid function, to 3-hydroxy-2,2-dimethylpropanal (compound 4).
  • the N-protected amino acid e.g., JV-Boc-glycine
  • DCC diclohexylcarbodiimide
  • the active agent content in the pharmaceutical compositions is ordinarily about 0.01% to about 95% by weight, for example, about 0.1% to about 85% by weight, about 1% to about 70% by weight, or about 5% to about 50% by weight, based on the final pharmaceutical formulation, hi various embodiments, the desired daily dose is administered in a single dose, or as divided doses at appropriate intervals, for example, as two, three, four or more sub-doses per day.
  • the sub-dose itself may be divided further into a number of discrete loosely spaced administrations.
  • the pharmaceutical compositions When administered in a unit dosage form, the pharmaceutical compositions typically contain between about 1 mg and about 10,000 mg, for example, between about 5 mg and about 7,500 mg, between about 10 mg and about 2,000 mg, between about 20 mg and about 1,000 mg, between about 20 mg and about 500 mg, or between about 20 mg and about 300 mg of active agent.
  • an aldehyde or its derivative is administered in a daily dose ranging between about 1 mg and about 20,000 mg, for example, between about 5 mg and about 10,000 mg, between about 10 mg and about 5,000 mg, between about 20 mg and about 1,000 mg, between about 40 nig and about 500 mg, or between about 40 nig and about 300 mg of active agent.
  • the dosage level of active agent in the composition is chosen to provide an amount of active agent that affords the desired therapeutic effect in accordance with the desired method of administration.
  • the amount of the composition required for use in treatment varies not only with the particular compound selected, but also with the route of administration, the nature of the condition being treated, and the age and condition of the patient, and will be ultimately at the discretion of the attendant physician.
  • useful dosages of organic aldehyde compositions are determined by assessing their in vitro activity and in vivo activity in animal models. Methods for extrapolation of effective dosages in mice and other animals to humans are known to those skilled in the art. (See, e.g., U.S. Patent No. 4,938,949 and National Institute of Environmental Health Sciences, U.S. Public Health Service, Guidance Document on Using In Vitro Data to Estimate In Vivo Starting Doses for Acute Toxicity.)
  • the therapeutic aldehydes disclosed herein generate CO after administration to the body. Although in at least some instances CO is generated preferentially at sites of inflammation, some of the CO generated will bind to hemoglobin in red blood cells. Thus, dose- finding studies can be guided by measurement of carboxyhemoglobin (COHb) levels in the blood. Methods for the measurement of COHb levels in the blood are known in the art. In normal healthy humans, COHb levels are about 0.5% in healthy nonsmokers and up to 9% in smokers. In one embodiment, the dose level of the compositions described herein is such that no significant rise in COHb levels is observed. However, in some applications, a transient rise in COHb levels up to about 10% may be tolerated. This level of COHb is not associated with any symptoms.
  • COHb carboxyhemoglobin
  • RPMI aqueous tissue culture medium developed by Moore et. al at Roswell Park Memorial Institute (commercially available from Sigma). The abbreviation rpmi is used for RPMI- 1630 media supplemented with 10% fetal calf serum.
  • TBHP refers to tert-butyl hydroperoxide, T-HYDRO® solution, 70% wt in water.
  • H 2 O 2 refers to hydrogen peroxide solution, 35% in water.
  • pH 2 refers to an aqueous solution with pH between 2 and 2.5.
  • Eq refers to the number of equivalents of carbon monoxide.
  • Example 1 CO release from trimethylacetaldehyde (compound 1) in different media
  • Example 2 CO release from 2,2-dimethyl-4-pentenal (compound 2) in different media
  • Example 3 CO release from 4-ethyl-4-formyl-hexanenitrile (compound 3) in different media
  • Example 5 Preparation of 2-formyl-2-methyl-propylmethanoate (compound 5) and CO release from 2-formyl-2-methyl-propylmethanoate in different media
  • Example 7 Preparation of 2-methyl-2-phenylpropionaldehyde (compound 7) and CO release from -methyl-2-phenylpropionaldehyde in different media
  • FIGs 8 and 9 summarize the kinetics of CO release for the aldehydes tested as described in Examples 1-7.
  • the aldehydes showed different CO release abilities. They all released CO in the presence of tert-butyl-hydroperoxide medium (TBHP) ( Figure 8).
  • TBHP was always present in excess, above 16 equivalents. As explained above in Example 1, the excess TBHP did not affect CO release for concentrations above 8 equivalents.
  • TBHP is a very efficient radical initiator that abstracts the hydrogen atom of the aldehydic function, and initiates the radical decarbonylation process (Berman et al., J. Am. Chetn. Soc. 85:4010-4013 (1963)).
  • Adjuvant arthritis was induced in outbred Sprague-Dawley rats by intradermal injection into the subplantar area of the right hind paw of 0.1 ml of a 10 mg/ml suspension of Mycobacterium butyricum, killed and dried in Freund's incomplete adjuvant. Treatment was initiated 10 days after disease induction at the time of disease onset. Groups of 7 rats received intraperitoneal injections of compound 1 and compound 2 in 1 ml PBS, each at a dose of 100 mg/kg/day for 20 days. A control group of 7 rats received no treatment.
  • Progression of arthritis was monitored by daily measurements of right and left paw volumes by a water displacement method using a plethysmometer, by daily measurements of the ankle circumference with a flexible strip, and by determination of the arthritic index based on levels of erythema and oedema of the entire paws and digits, number of joints involved, spondylosis, lesions on the tail, movement capacity and infections.
  • the maximum possible score was 11.
  • untreated control rats lost body weight after the onset of the disease on day 10 after disease induction. No loss of body weight was observed in the rats treated with compounds 1 and 2.
  • Adjuvant arthritis was induced in Lewis rats by a single intradermal injection (0.1 ml) of heat killed Mycobacterium tuberculosis H37Ra (0.3 mg) in Freund's incomplete adjuvant into the right footpad. Treatments were initiated at day 10 after disease induction, and consisted of daily injections for 30 consecutive days.
  • Groups of 11 rats were treated with compound 1 (100 mg/kg), compound 1 (25 mg/kg), compound 7 (100 m/kg), compound 7 (25 mg/kg), vehicle (carboxymethyl cellulose, 0.5% and Tween 80 (polyoxyethylene-20 sorbitan monooleate), 0.5%), dexamethasone (DEX, a glucocorticoid anti-inflammatory agent, 0.3mg/kg), and one group remained untreated.
  • the body weight was determined daily.
  • the course of the disease was monitored by measurement of paw volume using plethysmometry on a weekly basis, and by macroscopic assessment of the levels of erythema and oedema of the entire paws and digits and number of joints involved.
  • the arthritic index was calculated for each rat by adding the 4 scores of individual paws.
  • Example 10 Preparation of 2-tgrt-butyl-thiazolidine-4-carboxylic acid (compound 9) and CO release from 2-terf-butyl-thiazolidme-4-carboxylic acid in TBHP
  • Example 11 Preparation of 2-ferf-butyl-thiazolidine-4-carboxylic acid methyl ester (compound 10) and CO release from 2-fert-butyl-thiazolidine-4-carboxylic acid methyl ester in TBHP
  • Example 12 Preparation of 2-fert-butyl-thiazolidine (compound 11) and CO release from 2-tert- butyl-thiazolidine in TBHP
  • Example 13 Preparation of 2(RS)-fert-butyl-[ " l,31thiazinane-4(RS)-carboxylic acid (compound 12) and CO release from 2-tgrt-butyl-[L3]thiazinane-4-carboxylic acid in TBHP
  • Table 1 summarizes the results of CO release experiments on various aldehyde prodrug compounds. The experiments were performed as described in Example 10. The results for compounds 9-12, generated as detailed in Examples 10-13, are included. Table 1

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