EP4135694A1 - Bromodomain inhibitors for the prevention and/or treatment of coronavirus infections and diseases caused thereby - Google Patents
Bromodomain inhibitors for the prevention and/or treatment of coronavirus infections and diseases caused therebyInfo
- Publication number
- EP4135694A1 EP4135694A1 EP21720218.3A EP21720218A EP4135694A1 EP 4135694 A1 EP4135694 A1 EP 4135694A1 EP 21720218 A EP21720218 A EP 21720218A EP 4135694 A1 EP4135694 A1 EP 4135694A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- infection
- inhibitor
- sars
- cov
- coronavirus
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/4353—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom ortho- or peri-condensed with heterocyclic ring systems
- A61K31/437—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom ortho- or peri-condensed with heterocyclic ring systems the heterocyclic ring system containing a five-membered ring having nitrogen as a ring hetero atom, e.g. indolizine, beta-carboline
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/55—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
- A61K31/551—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole having two nitrogen atoms, e.g. dilazep
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/12—Antivirals
- A61P31/14—Antivirals for RNA viruses
Definitions
- the present invention relates to a new active ingredient for the prophylactic and therapeutic treatment of a coronavirus infection and / or a disease caused by this infection, a pharmaceutical composition containing this active ingredient and a method for the prophylactic and / or therapeutic treatment of a coronavirus infection and / or any illness caused by this infection.
- the present invention relates to the field of molecular medicine, in particular the field of antiviral substances.
- coronaviruses colloquially also called coronaviruses, are a virus family within the order Nidovirales. Their representatives cause very different diseases in different vertebrates such as mammals, birds and fish. The first coronaviruses were described as early as the mid-1960s. Coronaviruses are genetically highly variable. Individual species from the Coronaviridae family can also infect several species of hosts by overcoming the species barrier. By overcoming the species barrier, infections with the SARS-associated coronavirus (SARS-CoV, sometimes also referred to as SARS-CoV-1) - the causative agent of the SARS pandemic 2002/2003 - as well as the 2012 new one are among other things Middle East respiratory syndrome coronavirus (MERS-CoV).
- SARS-CoV SARS-associated coronavirus
- the COVID-19 pandemic emanating from the Chinese city of Wuhan is attributed to a previously unknown coronavirus that was given the name SARS-CoV-2.
- the virus causes the viral disease COVID-19 (for corona virus disease 2019) and was the trigger of the COVID-19 pandemic, which the World Health Organization (WHO) identified on January 30, 2020 as a "health emergency of international concern" and on March 11 2020 was classified as a pandemic.
- WHO World Health Organization
- the course of the disease is unspecific, diverse and varies greatly. In addition to asymptomatic infections, predominantly mild to moderate courses were observed, but also severe ones with bilateral pneumonia up to lung failure and death.
- the invention is based on the object of providing an active ingredient which reduces the disadvantages of the prior art, preferably avoids.
- an active ingredient is to be provided that preferably also in low concentrations of infection with Coronaviruses can counteract and thus is suitable for the production of a medicament for the prophylaxis and / or treatment of a coronavirus infection and / or a disease caused by this infection.
- the present invention addresses these and other needs.
- This object is achieved by providing an inhibitor of the bromodomain-containing protein (BRD) for the prophylaxis and / or treatment of a coronavirus infection and / or a disease caused by this infection.
- BBD bromodomain-containing protein
- coronaviruses include all species that belong to the virus family Coronavirusidae, in particular SARS-CoV-2 (Sars-CoV-2, severe acute respiratory syndrome Coronavirus 2, “Severe acute respiratory syndrome Coronavirus 2”).
- SARS-CoV-2 Sars-CoV-2, severe acute respiratory syndrome Coronavirus 2, “Severe acute respiratory syndrome Coronavirus 2”.
- treatment of an infection or disease is understood to mean, in particular, a therapeutic intervention with the aim of positively influencing the overall health of the living being treated, which is determined by the infection and / or disease.
- the treatment comprises alleviating and / or relieving symptoms of the disease, reducing the viral load, eliminating the virus and / or curing the disease.
- prophylaxis of an infection or disease is understood in particular as a measure which serves to counteract an impairment of the overall health of the living being treated, which is determined by the infection and / or disease.
- prophylaxis includes preventing a disease.
- bromodomain or bromodomain is a protein domain of approximately 110 amino acids that recognizes acetylated lysine residues, such as those on the N-terminal tails of histones. As “readers” of lysine acetylation, bromodomains are responsible for transducing the signal transmitted by acetylated lysine residues and converting it into various normal or abnormal phenotypes. "Bromodomain-containing proteins” (BRD) can exert a multitude of biological functions, ranging from histone acetyltransferase activity and chromatin remodeling to transcription mediation and co-activation. Of the 43 BRD known in 2015, 11 had two bromodomains and one protein had 6 bromodomains.
- the so-called BET family (bromodomain and extra-terminal domain), a subgroup of the bromodomain family, includes, for example, the members BRD2, BRD3, BRD4 and BRDT.
- BRD2, BRD3, BRD4 and BRDT Production, biochemical analysis and structure determination of the bromodomain-containing proteins have been described in detail. Ren et al. (2016), Preparation, Biochemical Analysis, and Structure Determination of the Bromodomain, an Acetyl-Lysine Binding Domain, Methods in Enzymology 573: 321-43. According to the invention, all bromomain-containing proteins are included.
- an "inhibitor" of the FRG which is also referred to synonymously as a FRG inhibitor, is understood to mean an agent which leads to a selective and specific inhibition of the FRG.
- BRD inhibitors are described, for example, in Bechter and Schöffski (2020), Make your best BET the emerging role of BET inhibitor treatment in malignant tumors, Pharmacology & Therapeutics 208: 107479, but exclusively there under the synonymous name BET inhibitors for their anti-tumor activity.
- the inhibition can take place by reducing the activity, functionality, expression or other phenomena which lead to an inhibition of BRD.
- the agent can be in any conceivable material form, such as a small molecule, a peptide, an antibody, a nucleic acid molecule, etc.
- the inventors were able to surprisingly show experimentally that BRD inhibitors not only prevent the cytopathic effect caused by the virus but also reduce the viral load and the number of virus-infected cells. These effects are already evident at very low concentrations, which are in the nanomolar range.
- the BRD inhibitor is therefore used in a concentration which at the cellular level (for example in human cells of the lung epithelium) in the range of ⁇ 1 mM, preferably ⁇ 0.5 mM, more preferably ⁇ 0.4 pM, more preferably 0.3 pM, more preferably 0.2 pM.
- the infection and disease is an infection with a SARS-associated coronavirus (SARS-CoV) and a disease caused by this infection, preferably a SARS-CoV-2 infection and / or about COVID-19.
- SARS-CoV SARS-associated coronavirus
- an active substance is provided in an advantageous manner, which, according to the inventors' findings, is superior to the substances currently being tested and some of which have already been clinically tested. This is an advantageous way of meeting the urgent need for active ingredients to combat COVID-19.
- the inhibitor is an inhibitor of the bromodomain-containing protein 2 (BRD2).
- the inhibitor is an inhibitor of the bromodomain-containing protein 4 (BRD4).
- BRD4 bromodomain-containing protein 4
- a BRD2 inhibitor and a BRD4 inhibitor can be two substances.
- it can also be a substance that inhibits both target structures and is referred to, for example, as a BRD2 / 4 inhibitor.
- the "BRD4" protein is encoded by the BRD4 gene in humans. It has two bomodomains called BD1 and BD2. It is homologous to the mouse protein MCAP, which associates with chromosomes during mitosis, and homologous to the human BRD2 (RING3) protein, a serine / threonine kinase. Each of these proteins contains two bromodomains, a conserved sequence motif that can be involved in chromatin targeting. BRD4 is often required for the expression of Myc and other "tumor-driving" oncogenes in hematologic cancers, including multiple myeloma, acute myeloid leukemia, and acute lymphoblastic leukemia.
- the "BRD2" protein is encoded by the BRD2 gene in humans. Early descriptions indicated that the BRD2 gene product is a mitogen-activated kinase that resides in the nucleus. The gene is mapped to the class II region of the major histocompatibility complex (MHC) on chromosome 6p21.3, but sequence comparison suggests that the protein is not involved in the immune response. The homology to the female sterile homeotic of the Drosophila gene suggests that this human gene may be part of a signal transduction pathway involved in growth control. BRD2 is involved in cancer and forms of obesity.
- MHC major histocompatibility complex
- BRD2 and / or BRD4 inhibitors are still effective even in a particularly low concentration in the nanomolar range, whereas no effect whatsoever is observed with active substances such as chloroquine.
- active substances such as chloroquine.
- the inventors were able to demonstrate this for two low molecular weight compounds in a cell culture experiment.
- the inhibitor is a low molecular weight compound.
- a class of substances with low molecular weight is referred to as a low molecular compound (English small molecule). They form the opposite group to larger, high molecular substances, for example long-chain polymers. It comprises active ingredients whose molecular mass does not exceed about 800 g-mol -1 Due to their small size, low-molecular compounds are partially able to penetrate cells and develop their effects there.
- the inhibitor is GSK2820151 (IBET151).
- the inhibitor is R06870810 / TEN-010 (CPI203).
- Another object of the present invention relates to a pharmaceutical composition for the prophylaxis and / or treatment of a coronavirus infection and / or a disease caused by this infection, which has the inhibitor according to the invention and a pharmaceutically acceptable carrier.
- Pharmaceutically acceptable carriers are well known in the art. They include, for example, binders, disintegrants, fillers, lubricants as well as buffers, salts and other substances suitable for the formulation of medicaments; see Rowe et al. (2012), Handbook of Pharmaceutical Excipients, 7 th Edition Pharmaceutical Press; or Bauer et al. (2017), Textbook of Pharmaceutical Technology, 10th edition, Academicliche Verlagsgesellschaft Stuttgart mbH. The content of the present publications is part of the present application by reference.
- the inhibitor is present per dosage unit in a concentration which, after administration into a living being, leads to a concentration which counteracts the coronavirus infection and / or a disease caused by this infection.
- the inhibitor is present per dosage unit in a concentration which, after administration into a living being, leads to a concentration in the coronavirus-infected cells, preferably the lung epithelial cells, which is approximately ⁇ 10 mM, preferably approximately ⁇ 1 pM, more preferably approximately ⁇ 500 nM, more preferably approximately ⁇ 400 nM, more preferably approximately ⁇ 300 nM.
- the inventors' knowledge is taken into account in an advantageous manner that the BRD inhibitor shows prophylactic or therapeutic effect in the case of a coronavirus infection even in very low concentrations. Side effects can thereby be reduced or even avoided if necessary. This measure also contributes to the cost-effective production of the pharmaceutical composition.
- composition according to the invention has, in addition to the inhibitor according to the invention, a further active ingredient, preferably a further antiviral active ingredient.
- inhibitor according to the invention can be present as the sole active ingredient, this measure has the advantage that additive and possibly synergistic effects can lead to an increase in the prophylactic and therapeutic success.
- Another object of the present invention relates to a method for the prophylactic and / or therapeutic treatment of a coronavirus infection and / or a disease caused by this infection, characterized by the administration of the inhibitor according to the invention and / or the pharmaceutical composition according to the invention to a Living being, preferably a human.
- Fig. 1 Brightfield microscopy images of Calu3 cells that remained untreated (mock), infected with SARS-CoV-2 (SARS-CoV-2) and in addition to the SARS-CoV-2 infection with 10 mM and 1 pM of the BRD2 / 4 inhibitor BET151.
- Fig. 2 Brightfield microscopy images of Calu3 cells that have remained untreated (mock), infected with SARS-CoV-2 (SARS-CoV-2) and in addition to the SARS-CoV-2 infection with 10 pM and 1 pM of the BRD2 / 4 inhibitor CPI203.
- Fig. 3 Brightfield microscopy images of Calu3 cells that remained untreated (mock), infected with SARS-CoV-2 (SARS-CoV-2) and in addition to the SARS-CoV-2 infection with 10 pM and 1 pM of the CDK inhibitor RCB were treated.
- 4 Brightfield microscopic images of Calu3 cells that remained untreated (mock), infected with SARS-CoV-2 (SARS-CoV-2) and in addition to the SARS-CoV-2 infection with 10 mM and 1 pM of the CDK inhibitor ACB were treated.
- Fig. 5 Brightfield microscopy images of Calu3 cells that remained untreated (mock), infected with SARS-CoV-2 (SARS-CoV-2) and in addition to the SARS-CoV-2 infection with 10 pM and 1 pM hydroxychloroquine (HChl) were treated.
- Fig. 6 Brightfield microscopy images of Calu3 cells that have remained untreated (mock), infected with SARS-CoV-2 (inf) and in addition to the SARS-CoV-2 infection with 10 pM, 5 pM and 2, 5 pM of I BET 151, CPI203 and HChl were treated.
- FIG. 8 Effects of BRD2 / 4 inhibitors on SARS-CoV-2 infection.
- Calu3 cells were infected with SARS-CoV-2 and treated with IBET151, CPI203 or hydroxychloroquin (HChl). 24 hpi (hours after infection) the cells were fixed with 80% acetone and stained with DAPI and immunofluorescence against SARS-CoV-2. The number of cells was analyzed with a Cytation3 multiplication imager.
- FIG. 10 Diagram illustrating the effect of BRD2 / 4 inhibitors on the total number or the survival of Calu3 cells after a SARS-CoV-2 infection.
- Lung epithelial cells Calu3 show a flat structure in the cell culture under the microscope. After infection of the cells with SARS-CoV-2 (recordings titled "SARS-CoV-2" or “inf '), a clear cytopathic effect becomes apparent, which is visible in the morphological change in the cell formations in the form of" clumps ", see e.g. Fig. 1-5, second column.
- the BRD2 / 4 inhibitors IBET151 and CPI203 show at concentrations of 10 and 1 mM a significant reduction in the cytopathic effect caused by the virus infection (compared to mock / uninfected and SARS-CoV-2 infected); see Figures 1 and 2, 3rd and 4th columns. In contrast, show equal concentrations of Hyrdoxychloroquine
- DMEM + 5% FCS (infection medium) per well 170 ⁇ l DMEM + 5% FCS (infection medium) per well. Creation of inhibitor dilutions so that the desired final concentration is achieved after adding 20 ⁇ l of the dilution. Then add 10 - 5 ml of virus stock (1:20, MOLO, 4 - 1:40, MOLO.2) to the total volume of 200 ml. Incubation for an additional 24-48 h. After 24 and 48 h, recording of transmitted light images via automatic microscopy (4x magnification) using a multiplate reader. Evaluation of the cytopathic effect of the virus infection by visual assessment of the cell lawn.
- the BRD2 / 4 inhibitors IBET151 and CPI203 show at concentrations of 10 and 1 mM a significant reduction in the cytopathic effect caused by the virus infection (compared to mock / uninfected and SARS-CoV-2 infected); see Figures 1 and 2, 3rd and 4th columns.
- the same concentrations of hydroxychloroquine (HChl, FIG. 5) and the clinically approved CDK inhibitors ribociclib (RCB; FIG. 3) and abemaciclib (ACB; FIG. 4) show no inhibitory effects. 15th
- MOI 2
- the inventors could not find any reduction in infected cells or in the total amount of viral protein, although the virus-induced cytopathic effects were completely blocked.
- the infection rate was reduced (FIG. 8B). This suggests that BRD proteins do not affect virus entry and infection or production of virus proteins, but could affect the late steps of virus replication. This assumption is consistent with a possible role for the E protein in the assembly and release of coronaviruses.
- a SARS-CoV-2 infection appears to induce an apoptotic signal cascade, which is evident from the induction of caspase 6/7 cleavage and AKT phosphorylation. All of these events are specifically addressed by BRD2 / 4-ln- 16 inhibitor inhibitors are blocked, which may explain the lack of SARS-CoV-2-induced cell death in the treatment with the compounds (FIG. 9).
- FIG. 10 the effect of the BRD2 / 4 inhibitors on the total number or the survival of the Calu3 cells after a SARS-CoV-2 infection is illustrated again in summary.
- Calu-3 cells were infected or mock-infected with the clinical SARS-CoV-2 isolate.
- the cells were treated with the two BRD2 / 4 inhibitors IBET151 and CPI203 and hydroxychloroquine (HCQN) as the reference active ingredient in the given concentrations.
- HQN hydroxychloroquine
- the average number of mock and infected cells is indicated with a dotted line. It turns out that in the experiments carried out, positive effects on the total number or survival of the Calu3 cells occur after a SARS-CoV-2 infection from a concentration of the BRD2 / 4 inhibitors of approx. 20 nM. This is not observed in HQCN-treated cells. This observation was confirmed by the inventors in further experiments (not shown).
- BBD bromodomain-containing protein
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PCT/EP2021/059898 WO2021209594A1 (en) | 2020-04-17 | 2021-04-16 | Bromodomain inhibitors for the prevention and/or treatment of coronavirus infections and diseases caused thereby |
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