NL2006621C2 - New medical use for acidic cannabinoids. - Google Patents

New medical use for acidic cannabinoids. Download PDF

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Publication number
NL2006621C2
NL2006621C2 NL2006621A NL2006621A NL2006621C2 NL 2006621 C2 NL2006621 C2 NL 2006621C2 NL 2006621 A NL2006621 A NL 2006621A NL 2006621 A NL2006621 A NL 2006621A NL 2006621 C2 NL2006621 C2 NL 2006621C2
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acid
cannabis
therapy
animal
plant extract
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NL2006621A
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Dutch (nl)
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Henricus Adriaan Anne Jacobus Korthout
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Fytagoras B V
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Priority to NL2006621A priority Critical patent/NL2006621C2/en
Priority to PCT/NL2012/050241 priority patent/WO2012144892A1/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/185Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19Carboxylic acids, e.g. valproic acid
    • A61K31/192Carboxylic acids, e.g. valproic acid having aromatic groups, e.g. sulindac, 2-aryl-propionic acids, ethacrynic acid 
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/335Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/35Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom
    • A61K31/352Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom condensed with carbocyclic rings, e.g. methantheline 
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00Drugs for disorders of the metabolism
    • A61P3/08Drugs for disorders of the metabolism for glucose homeostasis
    • A61P3/10Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/04Antibacterial agents
    • 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • A61P9/10Drugs 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

Description

P94181NL00
Title: New medical use for acidic cannabinoids
The invention relates to the field of medicine, more particularly the field of immunology, stress and infection. In particular, the invention relates to increasing the natural resistance of animals by administering medicinal acidic cannabinoids.
5
BACKGROUND
A9-Tetrahydrocannabinol (THC) is naturally found in cannabis. THC has been reported to have use as an analgesic, for instance for patients suffering from rheumatoid arthritis. A side effect of THC is its psychoactive 10 activity. Further, conventionally THC is administered by smoking, which may be detrimental to general health, in particular to the lungs and the coronary system.
WO 89/01332 describes an acidic metabolite of THC, wherein the methyl group at the 9-position, a major metabolite formed in humans and 15 other mammals, is substituted by a carboxyl group. This metabolite is reported to be non-psychoactive. Its use as a therapeutic agent for such purposes as the treatment of chronic pain and tissue inflammation often associated with illnesses such as rheumatoid arthritis is suggested; The Examples show a mouse hot plate test for analgesia, which indicates that, in mice, the 20 metabolite shows about the same analgesic activity as THC and a somewhat lower activity than naproxen. The Examples further indicate that the metabolite does not induce the formation of gastric lesions in an animal test under conditions wherein aspirin does.
In a review by Bhargava (Gen. Pharmac. Vol 9 (1978), No 4, pages 25 195-213), potential uses of cannabinoids are mentioned in rather general terms. Bhargava mentions that several cannabinoids have been pharmacologically tested, without disclosing in any detail, a specific medical activity for carboxylated cannabinoids (THC acids), such as A9- 2 tetrahydrocannabinolic acid or the like. In addition, reference is made to the analgesic activity of THC and several other cannabinoids compared to morphine. THC is reported to perform equi-analgesic with morphine, but other tested cannabinoids are reported to be much less potent or even inactive.
5 Williamson and Evans (Drugs 2000, Dec. 60(6):1303-1314 discuss in general terms a potential clinical use of cannabis. The specific use of THC acids, such as A9-tetrahydrocannabinolic acid or the like, as the active pharmaceutical ingredient, is not disclosed.
GB-A 2 384 707 relates to the use of a cannobinoid acid, in 10 particular cannabidiol (CBD) and cannabidiol acid (CBDA) for use as an active pharmaceutical substance in the treatment of nausea, vomiting, emesis and motion sickness. The compounds may be obtained by extraction from cannabis. As a result of the extraction, relatively small amounts of THC-acids may be present in the extract, but the use of a THC-acid as an active pharmaceutical 15 substance is not mentioned.
WO 2005/072719 describes medical uses of novel acidic cannabinoids obtained from plants for relieving pain, for suppression of an inflammatory response, preferably for suppressing release of a pro-inflammatory cytokine (such as TNF-a), and/or stimulating the release of an anti-inflammatory 20 cytokine (such as IL-10).
Appendino et al. (J. Nat. prod. 2008, 71:1427-1430) describe the antibacterial effect of cannabinoids, amongst which also acidic cannabinoids such as THC-acid, cannabidiolic acid (CBDA) and cannabigerolic acid (CBGA), which proved effective in particular against Staphylococcus aureus (MRSA).
25 There remains a continuing desire for alternative therapeutics. It is therefore an object of the invention to provide such a therapeutic.
30 SUMMARY OF THE INVENTION
3
The present inventors now have discovered that acidic cannabinoids are able to induce the expression of heat shock proteins, in particular Hsp70. The invention thus comprises the acidic cannabinoids of Formula la, lb or Ic, as 5 defined in claim 1 for use in increasing the natural resistance of an animal, for use in enhancing cellular resistance, for use in therapy of diabetes, for use in therapy of atherosclerosis, reduce the decline in stress response found in ageing or for use in decreasing the necessity for antibiotic treatment. Preferably, said acidic cannabinoid is selected from the group consisting of A9-10 tetrahydrocannabinolic acid or THC acid (THCA), cannabidiolic acid (CBD-A), cannabidiol (CBD), cannabigerolic acid (CBGA), cannabigerol (CBG), cannabinolic acid (CBN-A) and cannabinol (CBN), cannabichromenic acid (CBC-A) and cannabichromene (CBC), more preferably said acidic cannabinoid is THCA.
15 Also comprised in the invention is a plant extract, comprising at least one acidic cannabinoid as defined claim 1, wherein the amount of A9-tetrahydrocannabinol as a weight percentage of the total dry weight of the extract is 0-5 wt%, for use in increasing the natural resistance of an animal subject, for use in enhancing cellular resistance, for use in therapy of diabetes, 20 for use in therapy of atherosclerosis, and to reduce the decline in stress response found in ageing. Preferably said plant extract comprises at least one compound selected from the group consisting of A9-tetrahydrocannabinolic acid or THC acid (THCA), cannabidiolic acid (CBD-A), cannabidiol (CBD), cannabigerolic acid (CBGA), cannabigerol (CBG), cannabinolic acid (CBN-A) 25 and cannabinol (CBN), cannabichromenic acid (CBC-A) and cannabichromene (CBC), more preferably said compound is A9-tetrahydrocannabinolic acid (THCA).
Further comprised in the invention is a method of treating an animal subject with an acidic cannabinoid as defined above or a plant extract as defined 30 above, which treatment comprises administering the acid cannabinoid in acidic 4 form, wherein the treatment comprises increasing the natural resistance of a mammalian subject, enhancing cellular resistance, therapy of diabetes, therapy of atherosclerosis, or reducing the decline in stress response found in ageing. Preferably, in such a method the animal subject is chosen from the 5 group consisting of a human, a cow, a sheep, a pig, a horse, a fish and a culture of other animals (shrimps, lobster, bivalves).
Further comprised in the invention is a pharmaceutical composition comprising an acidic cannabinoid as defined above or a plant extract as defined above and an immunosuppressant. Preferably said pharmaceutical 10 composition comprises an acidic cannabinoid or a plant extract and (5R)-5-hydroxytriptolyde.
The invention also relates to the use of an acidic cannabinoid as defined above or a plant extract as defined above in additional therapy of EAE.
The invention also relates to a method to induce expression of Hsp70 in a cell 15 by contacting the cell with an acidic cannabinoid as defined above or with a plant extract as defined above.
20 LEGENDS TO THE FIGURES
Figure 1. Effect of different concentrations of THC-acid on the activation of the human DNAJB1 (Hsp40) promoter in a 023 reporter cell line in the presence of different concentrations of arsenite. The DNAJBl promotor was coupled to a luciferase reporter gene to measure promoter activation. In 25 this experiment the 023 cells were stressed with sodium arsenite (according to Wieten et al 2010).
30 DETAILED DESCRIPTION OF THE INVENTION
5
Within the context of the invention, the term “acidic” is used to describe a compound having a carboxyl group, unless specified otherwise. In general, an acidic precursor of THC is transformable into THC by decarboxylation, optionally in combination with one or more other reactions, 5 such as a cyclisation of a precursor having two of the rings forming the core of the THC to form the third ring, (de)alkylation, (de)hydroxylation and the like. Besides the compounds of formula la and of lb, examples of acidic THC precursors are cannabidiolic acid (CBDA), cannabichromenic acid (CBCA), cannabinorolic acid (CBNRA), cannabigerolic acid (CBGA), cannabinolic acid 10 (CBNA) and functional and structural analogues thereof. It is known from e.g. WO 2005/072719 that a compound according to the invention is only lowly psychoactive or even non-psychoactive. Besides, it is expected that the risk for gastro-intestinal damage as a result of using a compound according to the invention is low, and in particular less than for at least some commercially 15 very successful drugs, e.g. aspirin.
More in particular, the present invention relates to an acidic
cannabinoid represented by formula la, lb or Ic R
X
A
Formula la 20 6
R
A,
X
-! XX,
D HO Z
A
Formula lb 5
R
A,
*h X
A
Formula Ic for use in increasing the natural resistance of an animal subject for use in enhancing cellular resistance, for use in therapy of diabetes, for use in 10 therapy of atherosclerosis, and to reduce the decline in stress response found in ageing. Since this use also comprises increasing the natural resistance, this also means that less biocidal compounds are needed to suppress infections in anaimals that have been treated with the acid cannabinoids of the present invention. These acid cannabinoids can thus also be used to decrease the use of 15 biocidal treatments, especially antibacterial treatments, which is especially advantageous for humans and farm animals.
7
In these formulae X, Z and A each represent a different group selected from the groups -OH, hydrogen and a first alkyl; accordingly, each of these four groups are present in the compound. The first alkyl is preferably a Cl-CIO linear or branched alkyl, more preferably a C4-C7 linear or branched 5 alkyl, even more preferably n-pentyl. The first alkyl is preferably Z.
D represents -OH or alkyl, preferably a C1-C3 linear or branched alkyl, in particular a methyl.
R represents a hydrogen, a CnHan-OH, a CnH2n-COOH or a second alkyl; The n in these groups is an integer, preferably 0, 1 or 2. R is preferably a 10 C1-C3 linear or branched alkyl, more preferably -CH3.
Preferably, the acidic cannobinoid of the present invention is A9-tetrahydrocannabinolic acid, THC acid (THCA), i.e. the structure of formula la, in which X is OH, D and R are methyl, A is hydrogen, and Z is n-pentyl, or cannabidiolic acid, CBD acid (CBDA), i.e. the structure of formula Ic, in which 15 X is OH, R is methyl, A is hydrogen and Z is n-pentyl.
In principle, it is possible to synthesise a compound according to the invention (biochemically. The skilled person will know how to perform such synthesis based upon common general knowledge and the present disclosure. 20 It is however an advantage of the invention that an acidic cannabinoid — in particular a compound wherein the first alkyl at the aromatic ring is n-pentyl (such as Z in formula la, lb or Ic, or in the equivalent position in an acidic precursor of THC in general) - may be derived from a natural source, such as cannabis. An acidic cannabinoid can be used (to treat a medical 25 indication) directly without further chemical modifications, such as decarboxylising the compound into THC and subsequently metabolising the THC.
A compound according to the invention may be used in isolated form or in an extract from a natural source, in particular from flower tops of 30 cannabis. Particular suitable is a plant or a part thereof, comprising at least 5 8 wt. % of acidic cannabinoids, e.g. 5-15 wt. %. Very good results have been achieved with Cannabis sativa, Cannabis indica. . Suitable methods to extract an acidic compound according to the invention are known in the art and include liquid extraction, e.g. with an apolar phase, such as chloroform and a 5 polar phase, in particular an aliphatic alcohol, such as methanol or ethanol. In such an extraction the acidic cannabinoid typically is found in the apolar phase, especially if the extraction procedure is carried out at pH lower than 7. The skilled person will know how to carry out a suitable extraction and further process the acidic cannabinoid, based on common general knowledge and the 10 information disclosed herein. It has been found that an extract according to the invention, comprising an acidic cannabinoid is effective in inducing heat shock proteins, in particular hsp70 (see Example).
Heat shock proteins (Hsps) are intracellular proteins important for maintenance of cellular and immune homeostasis (Lindquist and Craig, 1988, 15 Ann. Rev. Genet. 22:631-677). Through their chaperone and refolding capacity, Hsps assist in transport and refolding of damaged proteins, processes that are essential to maintain cellular integrity during stress (Fink, A.L., 1999, Physiol. Rev. 79:425-449; Hartl, F.U., 1996, Nature 381:571-579). Hsps are up-regulated in response to various forms of stress, like oxidative, heat, and 20 inflammatory stress (Hartl et al. 1992, Ann. Rev. Biophys. Biomol. Struct. 21:293-322). Based on their molecular weight, Hsps are divided into multiple families and expression of family members can be either constitutive or stress inducible. The Hsp70 family consists of 13 members among which HspAlA and HspAlB (here further referred to as Hsp70) are the best known inducible 25 Hsp70 family members. Also, some members of the DNAJ (Hsp40) and Hsp90 families are highly stress inducible (Kampinga et al. 2009, Cell Stress Chaperones 14:105-111; Daugaard et al. 2007, FEBS Lett. 581:3702-3710). Transcription of inducible Hsp is initiated by binding of heat shock factor 1 (HSFl) to heat shock binding elements (HSE) in the promoter region 30 (Morimoto, R.I., 1993, Science 259:1409-1410). The expression of inducible Hsp 9 family members is increased in cells in inflamed tissue. The immunoregulatory potential of stress proteins is becoming increasingly clear (Cohen, I.R., 2007, J. Autoimmun. 29:246-249; van Eden et al. 1988, Nature 331:171-173; van Eden et al., 2007, Ann. NY Acad. Sci. 1113:217-237). In experimental models of 5 inflammatory disease, like diabetes, and atherosclerosis, administration of exogenous Hsp or Hsp peptides suppressed disease via the induction of T-cells that specifically recognized Hsp60 or Hsp70 (for review, see van Eden et al. (2005, Nat. Rev. Immunol. 5:318-330).
Thus, by the effect on inducing expression of het shock proteins, 10 especially Hsp70, the acidic cannabinoid(s) of the invention, more particularly THCA, is able to enhance the cellular resistance to stress and to increase the natural resistance of a subject. Further use of the compound of the invention can be found in therapy of diabetes, in therapy of atherosclerosis, and to reduce the decline in stress response found in ageing. Further, by increasing 15 the natural resistance of the subject its need for biocidal, e.g. antibacterial treatment will be decreased, which is particularly advantageous in human or farm animal subjects.
For this purpose, the acidic cannabinoid of the invention can be provided as an isolated compound, or in an extract from a natural source.
20
The preparation of the extract in accordance with the invention is generally carried out under essentially non-decarboxylising conditions to avoid an excessive formation of THC, which may be undesired for its psycho-active side effects and/or for legal reasons, THC at present being illicit in many 25 states. In practice, it is therefore preferred to perform the extraction at a temperature not exceeding 95 °C, more preferably at a temperature of less then about 50 °C, even more preferably of less than about 25 °C. Very good results have been achieved with extraction at a temperature not exceeding about 4 °C. The lower limit for the temperature is not particularly critical, as 30 long as the extraction medium remains fluid.
10
The extract may then be further processed in any way, without excessive exposure to heat to maintain essentially non-decarboxylising conditions and thus avoid excessive formation of THC. In particular such conditions are met if the extract is not excessively exposed to temperatures of 5 about 200 °C or more. Preferably the extract is processed at a temperature not exceeding about 50 °C. More preferably any further processing of the extract takes place at a temperature of about 25 °C or less. Accordingly, the solvent of the extract is preferably removed by lyophilisation.
In practice, conditions are considered to be essentially non-10 decarboxylising heat treatment is considered to be non-excessive when the amount of THC as a percentage of the total dry weight of the extract is less than 5 wt. %, preferably less than 2 wt. %, even more preferably less than 0.5 wt. %. For practical reasons the amount of THC is preferably less than the maximum allowable amount to allow use as a non-prescription medicament, as 15 determined by law. In this respect it is interesting to note that the present invention allows for the preparation of extracts with less than about 0.15 wt. % as a percentage of the dry weight without a need for selective removal of THC from the extract.
THC may be totally absent (i.e. non-determinable by a conventional 20 analytical technique) in an extract or other composition according to the invention. For practical reasons some THC may be present, such as about 0.01 wt. % as a percentage of the dry weight or more.
Good results with respect to its pharmaceutical properties and low side effects have been achieved with an extract or other composition according 25 to the invention wherein the amount of THC as a weight percentage of the amount of the at least one acidic cannabinoid is 0- 2 wt. %, preferably less than about 1 wt. %. As indicated above, THC may be absent, although some THC may be present; as such, for practical reasons a preferred lower limit for the amount of THC as a weight percentage of the amount of the at least one acidic 30 cannabinoid is about 0.01 wt. %, more in particular about 0.1 wt. %.
11
Good results have inter alia been achieved with an extract - in particular a cannabis extract - comprising at least about 10 mg/ g based upon the dry weight, preferably at least about 15 mg/g based upon the dry weight, of the acidic cannabinoid. Very good results have been achieved with an 5 extract comprising at least about 20 mg/g based upon the dry weight of the acidic cannabinoid. The upper limit is not particularly critical. For practical reasons the upper limit is preferably about 500 mg/g, more preferably 250 mg/g dry weight.
Preferably, a composition according to the invention, such as a 10 (cannabis) extract, comprises at least one compound selected from the group consisting of A9-tetrahydrocannabinolic acid (THCA), cannabidiolic acid (CBD- A), cannabidiol (CBD), cannabigerolic acid (CBGA), cannabigerol (CBG), cannabinolic acid (CBN-A) and cannabinol (CBN), cannabichromenic acid(CBC-A) and cannabichromene (CBC). The amount of the compounds of 15 this group may be chosen within wide hmits. Good results have inter alia been achieved with a composition, in particular an extract, wherein the total amount is in the range of about 0.01-200 %, more in particular about 1-100 wt. % based upon the amount of the at least one acidic cannabinoid. In particular in this range indications exist that synergy occurs.
20 An extract according to the invention may be employed in any form.
It may for instance very suitably be in a dry form or in a liquid form, in particular solubilised in ethanol, water, a vegetable oil or a liquid comprising any of these compounds alone or in a combination. Particularly combinations of the compound(s) or extract of the invention with medicinal herbs and/or 25 pharmaceutical compounds.
An extract may very suitably be present in the form of a paste, cream or ointment. Such form is in particular attractive for topical applications, e.g. for treating a dermal inflammation.
An acidic compound or extract according to the invention may very 30 suitably be present in a pharmaceutical preparation, further comprising a 12 pharmaceutically acceptable carrier. A preparation may for instance have the form of a tincture, an ointment, a spray, an inhalant, a powder, a granulate, a suppository, a tablet or a capsule.
Of particular interest is administration as a liquid preparation for 5 oral use or dermal application as a cream or ointment. Applications via the nasal or inhalatory route are in particular attractive for purified acids.
The skilled person will know how to determine a particular dosage regime, depending upon the medical indication, the condition of the subject and the type of administration.
10 The invention further relates to a method of enhancing the natural resistance by treating an animal, preferably a human, with an acidic cannabinoid, which treatment comprises administering the acidic cannabonoid in acidic form. This means in particular that the cannabinoid is administered under essentially non-decarboxylising conditions, in contrast to 15 conventional ways of administering cannabinoids, i.e. by smoking (heating and inhaling) dried flower tops of cannabis plants. Besides avoiding the psychoactive side-effects (as a result of the formation of THC during heating), the present form of administration does not impose any health risks normally associated with smoking. Suitable forms of administration include oral 20 administration (such as ingestion or inhalation) and any other conventional medical ways of administering a medicament. In case of a combination of the cannabinoids of the present invention with herbs, these herbs can be administered in the same way.
Accordingly, the invention further relates to the use of an acidic 25 cannabinoid, optionally in the form of an extract or a pharmaceutical preparation as described herein, in the manufacture of a medicament for enhancing the natural resistance in a subject.
With respect to the present invention, the subject is an animal, preferably a human, a mammalian animal (preferably a farm animal or a pet), 13 a vertebrate, such as fish, or an insect. Preferably the animal has some kind of innate immune system.
Due to the general resistance increasing effect of the compounds of the invention, administration of these compounds is especially advantageous 5 for animals that are treated with antibiotics, either to prevent infections or for growth enhancing effects, such as farm animals (cows, sheep, pigs, horses), fish in fish cultures (salmon, trout, tilapia, pangasius, abalone) and other animal cultures (shrimps, lobster, bivalves).
10 Further, the compounds and extracts of the present invention are useful as addition to known therapies, in case these therapies inflict stress on cells of the subject, or in case such therapies impair the natural resistance of the subject.
A main beneficial effect of a combination of the compounds and 15 extracts of the invention with existing therapies, is that the acidic cannabinoids of the invention also have been proven to have antibacterial (see e.g. Appendino G. et al., 2008, J. Nat. Prod. 71:1427-1430) and antiinflammatory effects (see e.g. WO 2005/072719).
One of the specific applications is a combination of an acidic 20 cannabinoid of the present invention with a compound used for suppressing experimental autoimmune encephalomyelitis (EAE). As has been described by Fu et al., (2006, J. Neuroimmunol. 175:142-151) (5R)-5-hydroxytriptolyde (LLDT-8) is a suppressor of EAE, acting as an immunosuppressor. Combined therapy of LLDT-8, or any other immunosuppressor, with an acidic 25 cannabinoid would prevent the disadvantageous effect of the immunosuppressor on the general (immune) resistance of the subject.
Next to the treatment of EAE, immunosuppressors are also applied to prevent rejection of transplanted organs, in the treatment of graft-versus-host disease, in cancer chemotherapy, and in therapy of allergic asthma, HIV 30 and SLE (systemic lupus erythomatosus). It is envisaged that the general 14 immunostimulating action of the acidic cannabinoid will inhibit the disadvantageous general effects of the immunosuppressing compound.
Thus, also part of the invention is a combined pharmaceutical preparation comprising an immunosuppressant drug and an acidic 5 cannabinoid according to the present invention.
An immunosuppressant drug can be chosen from the group of glucocorticoids, cytostatics, opioids, interferons, calcineurin inhibitors, like ciclosporin, myriocin, tacrolimus, vodosporin, cytotoxic antibiotics (such as dactinomycin, anthracycline, mitomycin C, bleomycin or mitramycin), integrin 10 enhancers (such as fingolimod), purine syntheis inhibitors (like azathioprine, mercaptopurine or mycophenolic acid), pyrimidine syntheis inhibitors (like leflunomide or terflunomide), antifolates, like methotrexate, macrolides (like sirolimus, pimecrolimus, abetimus or gusperimus), TNFa inhibitors (like elanercept, pegsunercept, thalidomide and lenalidomide), IL-1 receptor 15 antagonists, like anakinra, mTOR-active compounds (like sirolimus, deforolimus, everolimus, temsirolimus, zotarolimus and biolimus A9), anti-immune antibodies (like polyclonal antibody preparations (Atgam or thymoglobuline), and monoclonal antibodies, like infiximab, adalimumab, certolizumab, afelimonab, golimumab, mepolizumab, omalzumab, 20 nerelimomab, faralimomab, elslimomab, lebrikizumab, ustekinumab, muromonab-CD3, otelixizumab, teplizumab, visilizumab, clenoliximab, keliximab, zanolimumab, efalizumab, erlizumab, afutuzumab, rituximab, ocrelizumab, pascolizumab, lumiliximab, teneliximab, toralizumab, aselizumab, galiximab, gavilimomab, ruplizumab, belimumab, ipilimumab, 25 tremelimumab, bertilimumab, lerdelimumab, metelimumab, natalizumab, tocilizumab, odulimomab, basiliximab, daclizumab, inolimomab, zolimomab aritox, aterolimumab, cedelizumab, dorlixizumab, fontolizumab, gantenerumab, gomiliximab, maslimomab, morolimumab, pexelizumab, reslizumab, rovelizumab, siplizumab, talizumab, telimomab aritox, 30 vapaliximab, vepalimomab), 15
The invention will now be illustrated by the following examples.
5
Example
To test whether THCA sensitizes cells to stress or enhances hsp70 expression in stressed cells, we used arsenite as a stresser and 023 cells 10 carrying a luciferase reporter gene driven by the DNAJBl (hsp40) promoter. Arsenite was chosen because it is experimentally easier to control the level of stress by adjusting the concentration of arsenite than by changing the severity of a heat shock; a luciferase reporter system was selected because it is quantitative; the DNAJBl promoter was selected as we found that the 15 DNAJBl mRNA level is more sensitive to inhibition of HSF-1 than the level of hsp70 mRNA.
Material and methods A fragment containing the sequence from -500 to +41 of the human DNAJBl (hsp40) gene was amplified from genomic DNA using the primers 20 aagtcgaccagacacaggttaggtagttcgtcc and accatggcccctcctgcggcccgccga and cloned Sall/Ncol in the Xhol and Ncol sites of pGL#basic (Promega). The Nhel/BamHl fragment of DNAJBl-luc was cotransfected with a TK-hygromycin construct into 023 cells. Stable transfectants were selected and single clones were tested for inducible expression of luciferase. DNAJBl-luc-25 023 cells were kept in culture at 37°C in DMEM containing 10% FBS, 100 units/ml penicillin, 100 pg/ml streptomycin (Gibco BRL, Gaithersburg, MD USA) and 1 mg ml’1 hygromycin (Roche Diagnostic). For the DNAJBa-luciferase assay, DNAJBl-luc-023 cells were seeded at 5*104 cells per well into 96-well white pClear-plates (Greiner Bio-One) and cultured at 37 °C in DMEM 30 containing 10% FBS and p/s without hygromycin. On the next day arsenite 16 and THCA were added to the indicated concentrations. After 16 hours overnight incubation, luminescence was measured with the Promega Steady-Glo Luciferase Assay System and counted on a 6-detector Wallac 1450 MicroBeta liquid scintillation counter. Data are expressed as 106 counts per 5 minute (106 cpm).
Results
It was found that THCA dose-depently enhanced the luciferase activity induced by arsenite exposure (Figure 1). For THCA to act at least some stress is needed: no effect is seen at 10 pM arsenite, while at 20 pM 10 arsenite the luciferase signal is nearly doubled with the highest concentrations of the THCA extract. These data suggest that THCA (like the positive control carvacrol) does not sensitize the cells to stress, but enhances the response to stress.

Claims (11)

1. Een cannabiszuur voorgesteld door formule Ia, Ib of Ic R X d AA cannabis acid represented by formula Ia, Ib or Ic R X d A 2. Cannabiszuur volgens conclusie 1, waarbij genoemd cannabiszuur is gekozen uit de groep bestaande uit A9-tetrahydrocannabinol zuur of THC 20 zuur (THCA), cannabidiol zuur (CBD-A), cannabidiol (CBD), cannabigerol zuur (CBGA), cannabigerol (CBG), cannabinol zuur (CBN-A) en cannabinol (CBN), cannabichromeen zuur (CBC-A) en cannabichromeen (CBC).2. Cannabis acid according to claim 1, wherein said cannabis acid is selected from the group consisting of A9-tetrahydrocannabinol acid or THC acid (THCA), cannabidiol acid (CBD-A), cannabidiol (CBD), cannabigerol acid (CBGA), cannabigerol ( CBG), cannabinol acid (CBN-A) and cannabinol (CBN), cannabichromic acid (CBC-A) and cannabichromene (CBC). 3. Cannabiszuur volgens conclusie 1 of 2, waarbij genoemd cannabiszuur TH CA is.The cannabis acid according to claim 1 or 2, wherein said cannabis acid is TH CA. 4. Plantenextract, omvattende ten minste een cannabiszuur zoals 30 gedefinieerd in een der voorgaande conclusies, waarbij de hoeveelheid A9- tetrahydrocannabinol als een gewichtspercentage van het totale drooggewicht van het extract 0-5 gew% is, voor toepassing bij het verhogen van de natuurlijke weerstand van een dier, bij toepassing voor het verhogen van de cellulaire weerstand, bij toepassing in de therapie van diabetes, bij toepassing 5 in de therapie van atherosclerose, om de afname in de respons tegen stress bij veroudering tegen te gaan of voor toepassing in het verlagen van de noodzaak voor behandeling met antibiotica.4. Plant extract comprising at least one cannabis acid as defined in any one of the preceding claims, wherein the amount of A9 tetrahydrocannabinol as a weight percentage of the total dry weight of the extract is 0-5 wt%, for use in increasing the natural resistance of an animal, for use in increasing cellular resistance, for use in the therapy of diabetes, for use in the therapy of atherosclerosis, to prevent the decrease in the response to stress in aging or for use in reducing of the need for antibiotic treatment. 5. Plantenextract volgens conclusie 4, omvattende ten minste een verbinding gekozen uit de groep bestaande uit A9-tetrahydrocannabinol zuur of THC zuur (THCA), cannabidiol zuur (CBD-A), cannabidiol (CBD), cannabigerol zuur (CBGA), cannabigerol (CBG), cannabinol zuur (CBN-A) en cannabinol (CBN), cannabichromeen zuur (CBC-A) en cannabichromeen 15 (CBC), bij grotere voorkeur waarbij genoemde verbinding A9-tetrahydrocannabinol zuur (THCA) is.The plant extract according to claim 4, comprising at least one compound selected from the group consisting of A9 tetrahydrocannabinol acid or THC acid (THCA), cannabidiol acid (CBD-A), cannabidiol (CBD), cannabigerol acid (CBGA), cannabigerol ( CBG), cannabinolic acid (CBN-A) and cannabinol (CBN), cannabichromic acid (CBC-A) and cannabichromic (CBC), more preferably wherein said compound is A9-tetrahydrocannabinolic acid (THCA). 5 Formule Ia R X -I XX, D HO Z A Formule Ib R L1h i A Formule Ic 10 waarin X, Z en A elke een verschillende groep voorstellen, gekozen uit de groepen -OH, waterstof en een eerst alkyl, waarbij genoemde eerste alkyl bij voorkeur een C1-C10 lineaire of vertakte alkyl is, bij grotere voorkeur een C4-C7 5 lineaire of vertakte alkyl, bij nog grotere voorkeur n-pentyl, D -OH of alkyl voorstelt, bij voorkeur een C1-C3 lineaire of vertakte alkyl, in het bijzonder methyl, R een waterstof, een CnH2n-OH, een CnH2n-COOH of een tweede alkyl voorstelt, waarbij n in deze groepen een geheel getal is, bij voorkeur 0, 1 of 2; 10 waarin bij voorkeur een C1-C3 lineaire of vertakte alkyl is, bij grotere voorkeur -CH3, voor toepassing bij het verhogen van de natuurlijke weerstand van een dier, bij toepassing voor het verhogen van de cellulaire weerstand, bij toepassing in de therapie van diabetes, bij toepassing in de therapie van atherosclerose, om de 15 afname in de respons tegen stress bij ouderdom tegen te gaan of voor toepassing in het verlagen van de noodzaak voor behandeling met antibiotica.Formula Ia RX -I XX, D HO ZA Formula Ib R L1h i A Formula Ic wherein X, Z and A each represent a different group selected from the groups -OH, hydrogen and a first alkyl, said first alkyl being is preferably a C 1 -C 10 linear or branched alkyl, more preferably a C 4 -C 7 linear or branched alkyl, even more preferably represents n-pentyl, D-OH or alkyl, preferably a C 1 -C 3 linear or branched alkyl, in particular methyl, R represents a hydrogen, a C n H 2n-OH, a C n H 2n-COOH or a second alkyl, wherein n in these groups is an integer, preferably 0, 1 or 2; Wherein preferably C 1 -C 3 is linear or branched alkyl, more preferably -CH 3, for use in increasing the natural resistance of an animal, for use in increasing the cellular resistance, for use in the therapy of diabetes when used in the therapy of atherosclerosis to counteract the decrease in the response to stress in old age or when used in reducing the need for antibiotic treatment. 6. Werkwijze voor het behandelen van een dier met een cannabiszuur 20 zoals gedefinieerd in een der conclusies 1 - 3 of een plantenextract zoals gedefinieerd in een der conclusies 4 of 5, welke behandeling omvat het toedienen van het cannabiszuur in zure vorm, waarbij de behandeling omvat het verhogen van de natuurlijke weerstand van een dier, het verhogen van de cellulaire weerstand, therapie van diabetes, therapie van atherosclerose of om 25 de afname in de respons tegen stress bij veroudering tegen te gaan.A method of treating an animal with a cannabis acid as defined in any one of claims 1 to 3 or a plant extract as defined in any one of claims 4 or 5, which treatment comprises administering the cannabis acid in acid form, the treatment includes increasing the natural resistance of an animal, increasing cellular resistance, therapy of diabetes, therapy of atherosclerosis or to counteract the decrease in the response to stress in aging. 7. Werkwijze volgens conclusie 6, waarbij het dier is gekozen uit de groep bestaande uit een mens, een koe, een schaap, een varken, een paard, een vis of een dierlijke kweek (garnalen, kreeft, tweekleppigen). 30The method of claim 6, wherein the animal is selected from the group consisting of a human, a cow, a sheep, a pig, a horse, a fish, or an animal culture (shrimp, lobster, bivalves). 30 8. Farmaceutische samenstelling omvattende een cannabiszuur zoals gedefinieerd in een der conclusies 1 - 3 of een plantenextract volgens conclusie 4 of 5 en een immuunonderdrukker. 5A pharmaceutical composition comprising a cannabis acid as defined in any one of claims 1 to 3 or a plant extract according to claim 4 or 5 and an immunosuppressant. 5 9. Farmaceutische samenstelling omvattende een cannabiszuur zoals gedefinieerd in een der conclusies 1 - 3 of een plantenextract volgens conclusie 4 of 5 en (5i?)-5-hydroxytriptolyde. 10A pharmaceutical composition comprising a cannabis acid as defined in any one of claims 1 to 3 or a plant extract according to claim 4 or 5 and (5i?) - 5-hydroxytriptolyde. 10 10. Een cannabiszuur zoals gedefinieerd in een der conclusies 1 - 3 of een plantenextract volgens conclusie 4 of 5 voor toepassing in additionele therapie van EAE. 15A cannabis acid as defined in any one of claims 1 to 3 or a plant extract according to claim 4 or 5 for use in additional therapy of EAE. 15 11. Werkwijze om expressie van Hsp70 in een cel te induceren door de cel in contact te brengen met een cannabiszuur zoals gedefinieerd in een der conclusies 1 - 3 of een plantenextract volgens conclusie 4 of 5.A method of inducing Hsp70 expression in a cell by contacting the cell with a cannabis acid as defined in any one of claims 1 to 3 or a plant extract according to claim 4 or 5.
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