TW201313732A - 旋轉酶(gyrase)及拓樸異構酶抑制劑之磷酸酯 - Google Patents
旋轉酶(gyrase)及拓樸異構酶抑制劑之磷酸酯 Download PDFInfo
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- TW201313732A TW201313732A TW101122096A TW101122096A TW201313732A TW 201313732 A TW201313732 A TW 201313732A TW 101122096 A TW101122096 A TW 101122096A TW 101122096 A TW101122096 A TW 101122096A TW 201313732 A TW201313732 A TW 201313732A
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Abstract
本發明係關於抑制細菌旋轉酶(gyrase)及/或拓樸異構酶IV之化合物之磷酸酯及其醫藥組合物。該等磷酸酯可用於治療細菌感染。
Description
本申請案在35 U.S.C.§119下主張2011年6月20日提出申請之美國臨時專利申請案第61/499,144號之權利;其全部內容以引用方式併入本文中。
業內早已認識到細菌對抗生素之抗性,且當前已將其視為嚴重之世界性健康問題。由於該抗性,難以使用抗生素治療一些細菌感染或甚至不能治療。隨著最近在諸如肺炎鏈球菌(Streptococcus pneumoniae)(SP)、結核分枝桿菌(Mycobacterium tuberculosis)及腸道球菌屬(Enterococcus)等某些細菌菌株中產生多種藥物抗性,此問題變得尤其嚴重。抵抗萬古黴素(Vancomycin)之腸道球菌屬之出現尤其令人擔憂,此乃因萬古黴素先前係用於治療此感染之唯一有效抗生素,且對於許多感染而言已視為「最後手段」之藥物。儘管許多其他藥物抗性細菌並不引起危及生命之疾病(例如腸球菌(enterococci)),但擔心誘導抗性之基因可擴散至更致命之有機體(例如金黃色葡萄球菌(Staphylococcus aureus),其中甲氧苯青黴素(methicillin)抗性已較為普遍)(De Clerq等人,Current Opinion in Anti-infective Investigational Drugs,1999,1,1;Levy,「The Challenge of Antibiotic Resistance」,Scientific American,March,1998)。
另一憂慮係抗生素抗性可快速擴散之程度。舉例而言,
直至1960年代為止,SP普遍地對青黴素(penicillin)敏感,且在1987年,在美國僅0.02%之SP菌株具有抗性。然而,截至1995,據報導,對於青黴素之SP抗性為約7%且在美國之一些地區高達30%(Lewis,FDA Consumer magazine(1995年9月);Gershman in The Medical Reporter,1997)。
特定而言,醫院用作形成及傳播藥物抗性有機體之中心。發生於醫院中之感染(稱為院內感染)正變為愈加嚴重之問題。在每年在醫院中感染之兩百萬美國人中,該等感染中之一半以上抵抗至少一種抗生素。疾病控制中心(Center for Disease Control)報導,在1992年,超過13,000名之醫院患者死於抵抗抗生素治療之細菌感染(Lewis,「The Rise of Antibiotic-Resistant Infections」,FDA Consumer magazine,1995年9月)。
因需要克服藥物抗性細菌及增加之可用藥物失效,故研究新抗生素之興趣有所復蘇。一種用於研發新抗生素之具有吸引力之策略係抑制DNA旋轉酶(gyrase)及/或拓樸異構酶IV,該等酶係DNA複製所需及由此細菌細胞生長及分裂所需之細菌酶。旋轉酶及/或拓樸異構酶IV活性亦與DNA轉錄、修復及重組中之事件有關。
旋轉酶係一種拓樸異構酶,拓樸異構酶係催化DNA之拓樸異構體之互變之酶群(通常參見Kornberg及Baker,DNA Replication,第2d版,第12章,1992,W.H.Freeman and Co.;Drlica,Molecular Microbiology,1992,6,425;Drlica及Zhao,Microbiology and Molecular Biology Reviews,
1997,61,第377-392頁)。旋轉酶自身控制DNA超螺旋並減輕在複製過程期間親代雙鏈之DNA鏈解開時出現之拓撲應力。旋轉酶亦催化鬆弛之閉合環狀雙鏈DNA向負超螺旋形式之轉化,此將更有利於重組。超螺旋反應之機制涉及旋轉酶圍繞DNA之一個區域纏繞,使該區域中之雙鏈斷裂,該DNA之第二區域穿過該斷裂,及再連結斷裂鏈。此一裂解機制係II型拓樸異構酶之特性。藉由ATP與旋轉酶之結合來驅動超螺旋反應。然後ATP在反應期間水解。此ATP結合及隨後水解使得在結合DNA之旋轉酶中發生其活性所需之構形變化。亦已發現,DNA超螺旋(或鬆弛)之程度取決於ATP/ADP比率。在不存在ATP下,旋轉酶僅能夠鬆弛超螺旋DNA。
細菌DNA旋轉酶係由兩個A亞單位(GyrA)及兩個B亞單位(GyrB)組成之400千道爾頓(kilodalton)蛋白質四聚體。DNA之結合及裂解與GyrA有關,而藉由GyrB蛋白結合及水解ATP。GyrB係由具有ATPase活性之胺基-末端結構域及與GyrA及DNA相互作用之羧基-末端結構域組成。與之相比,真核II型拓樸異構酶係可鬆弛負超螺旋及正超螺旋但不能引入負超螺旋之同源二聚體。理想地,基於抑制細菌DNA旋轉酶及/或拓樸異構酶IV之抗生素可選擇用於該等酶且其對於真核II型拓樸異構酶係相對惰性。
拓撲異構酶IV主要在DNA複製結束時解開連接之染色體二聚體。
廣泛使用之喹諾酮(quinolone)抗生素抑制細菌DNA旋轉
酶(GyrA)及/或拓樸異構酶IV(ParC)。喹諾酮之實例包含早期化合物(例如萘啶酸(nalidixic acid)及奧索利酸(oxolinic acid))以及後來之更有效氟喹諾酮(例如諾氟沙星(norfloxacin)、環丙沙星(ciprofloxacin)及曲伐沙星(trovafloxacin))。該等化合物與GyrA及/或ParC結合並穩定裂解之複合物,由此抑制總體旋轉酶功能並導致細胞死亡。氟喹諾酮抑制催化旋轉酶(GyrA)及/或拓樸異構酶IV(Par C)之亞單位(參見Drlica及Zhao,Microbiology and Molecular Biology Reviews,1997,61,377-392)。然而,亦將藥物抗性視為此類化合物之問題(WHO報導,「Use of Quinolones in Food Animals and potential Impact on Human Health」,1998)。如同其他種類之抗生素,在使用喹諾酮時,暴露於較早化合物之細菌通常對於相同種類中之更有效化合物快速產生交叉抗性。
負責經由ATP水解供應酶之催化轉換/復位所需之能量之有關亞單位分別係GyrB(旋轉酶)及ParE(拓撲異構酶IV)(參見Champoux,J.J.,Annu.Rev.Biochem.,2001,70,第369-413頁)。靶向GyrB及ParE亞單位中之該等相同ATP結合位點之化合物用於治療各種細菌感染(參見Charifson等人,J.Med.Chem.,2008,51,第5243-5263頁)。
存在較少與GyrB結合之已知抑制劑。實例包含香豆素(coumarin)、新生黴素(novobiocin)及香豆黴素A1(coumermycin A1)、環噻利丁(cyclothialidine)、西諾丁(cinodine)及殺郭蟲菌素(clerocidin)。香豆素已展示極其緊
密地結合至GyrB。舉例而言,新生黴素與蛋白質及若干疏水性觸點構成氫鍵網絡。儘管新生黴素及ATP似乎在ATP結合位點內結合,但該兩種化合物之結合取向具有最小重疊。重疊部分係新生黴素之糖單元及ATP腺嘌呤(Maxwell,Trends in Microbiology,1997,5,102)。
對於香豆素抗性細菌而言,大部分常見點突變位於結合至香豆素環之羰基之表面精胺酸殘基(大腸桿菌(E.coli)GyrB中之Arg136)處。儘管具有此突變之酶展示較低超螺旋及ATPase活性,但其亦對於香豆素藥物抑制較不敏感(Maxwell,Mol.Microbiol.,1993,9,681)。
儘管香豆素係旋轉酶超螺旋之有效抑制劑,但其尚未廣泛用作抗生素。其通常因低細菌滲透性、真核毒性及較差水溶性而並不適宜(Maxwell,Trends in Microbiology,1997,5,102)。期望克服該等缺點且較佳地其活性並不依賴於與Arg136之結合之新有效GyrB及ParE抑制劑。此一抑制劑將成為具有吸引力之抗生素候選者,且並無困擾其他種類抗生素之抗性問題史。
因對於抗生素之細菌抗性已變為重要之公共健康問題,故持續需要研發更新且更有效之抗生素。更特定而言,需要代表先前並未用於治療細菌感染之新化合物種類之抗生素。靶向GyrB(旋轉酶)及ParE(拓撲異構酶IV)中之亞單位ATP結合位點之化合物用於治療各種細菌感染。該等化合物尤其用於治療醫院(其中抗性細菌之形成及傳播變得愈加普遍)中之院內感染。另外,需要具有廣譜活性以及有
利毒理學性質之新抗生素。
本發明係關於用作旋轉酶及/或拓樸異構酶IV抑制劑之化合物及其醫藥上可接受之鹽、組合物。本發明之旋轉酶及/或拓樸異構酶IV抑制劑可由式(I)或其鹽代表:
其中X係-PO(OH)O-R1或-PO(O-M+)O-R1;M+係醫藥上可接受之單價陽離子;R1係(C1-C20)-烷基、(C2-C20)-烯基、-(CH2CH2O)nCH3或R2;其中該烷基或烯基視情況經R2、-OR9、-N(R9)2、-CN、-C(O)OR9、-C(O)N(R9)2、-N(R9)-C(O)-R9、鹵素、-CF3或-NO2取代;各R2獨立地係5-6員碳環或雜環脂肪族環系統;其中該等雜環系統中之任一者含有一或多個選自O、N及N(R9)之雜原子;且其中該等環系統中之任一者視情況含有1至4個獨立地選自-OH、C1-C4烷基及-O-(C1-C4)-烷基之取代基;各R9獨立地係H或C1-C4烷基;且n為1至5之整數。式(I)化合物係化合物(R)-1-乙基-3-(6-氟-5-(2-(2-羥基丙-2-基)嘧啶-5-基)-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-2-基)脲(其具有寬範圍抗細菌活性及
有利毒理學性質)之磷酸酯前藥。
除本文所提供之化合物外,本發明進一步提供醫藥組合物,其包括式(I)化合物或其醫藥上可接受之鹽及醫藥上可接受之載劑、佐劑或媒劑。
在另一實施例中,本發明係關於醫藥組合物,其包括式(I)化合物或其醫藥上可接受之鹽;醫藥上可接受之載劑、佐劑或媒劑;及選自以下之其他治療劑:抗生素、抗炎劑、基質金屬蛋白酶抑制劑、脂氧合酶抑制劑、細胞因子拮抗劑、免疫阻抑劑、抗癌劑、抗病毒劑、細胞因子、生長因子、免疫調節劑、前列腺素或抗血管過度增殖化合物。
在另一實施例中,本發明係關於治療患者之細菌感染、控制或減小其發展、嚴重性或效應之方法,其包括向該患者投與治療有效量之式(I)化合物或其醫藥上可接受之鹽。
在另一實施例中,本發明係關於治療患者之細菌感染、控制或減小其發展、嚴重性或效應之方法,其包括向該患者投與治療有效量之式(I)化合物或其醫藥上可接受之鹽及抗生素、抗炎劑、基質金屬蛋白酶抑制劑、脂氧合酶抑制劑、細胞因子拮抗劑、免疫阻抑劑、抗癌劑、抗病毒劑、細胞因子、生長因子、免疫調節劑、前列腺素或抗血管過度增殖化合物(作為與該化合物一起之多元劑型之一部分或作為各別劑型)。
在另一實施例中,本發明係關於預防、控制、治療哺乳動物之細菌感染或減小其發展、嚴重性或效應之方法,其
包括向該哺乳動物投與治療有效量之式(I)化合物或其醫藥上可接受之鹽。
本發明化合物係其母體化合物(R)-1-乙基-3-(6-氟-5-(2-(2-羥基丙-2-基)嘧啶-5-基)-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-2-基)脲之前藥。因此,在投與前藥後展現之活性主要係由存在源於前藥裂解之母體化合物所致。
術語「前藥」係指作為藥物前體之化合物,其在投與及吸收後在活體內經由一些代謝過程釋放藥物。一般而言,前藥之生物活性小於其母體藥物。前藥亦可改良母體藥物之物理性質及/或其亦可改良總體藥物效能,例如藉由控制其吸收、血液濃度、代謝分佈及細胞攝取來減小藥物之毒性及不期望效應。
術語「母體化合物」或「母體藥物」係指經由代謝或分解代謝過程之酶作用或經由在投與前藥後之化學過程釋放之生物活性實體。母體化合物亦可為用於製備其相應前藥之起始材料。
藉由M+定義之單價陽離子包含銨、鹼金屬離子(例如鈉、鋰及鉀離子)、二環己基胺離子及N-甲基-D-葡萄糖胺離子。亦包含胺基酸陽離子,例如精胺酸、離胺酸、鳥胺酸之離子等等。另外,鹼性含氮基團可使用例如以下試劑四級銨化:低碳烷基鹵化物,例如甲基、乙基、丙基及丁基之氯化物、溴化物及碘化物;硫酸二烷基酯,例如硫酸二甲酯、硫酸二乙酯、硫酸二丁酯、硫酸二戊酯;長鏈鹵
化物,例如癸基、月桂基、肉豆蔻基及硬脂醯基之氯化物、溴化物及碘化物;芳烷基鹵化物,例如苄基溴及其他。
片語「視情況經取代」可與片語「經取代或未經取代」互換使用。除非另外指定,否則視情況經取代之基團可在基團之各可取代位置具有取代基,且各取代彼此獨立。
術語「烷基」(單獨或作為較大部分之一部分使用)係指可為直鏈或具支鏈且具有指定碳原子數之烴基團(亦即「(C1-C20)」意指具有1至20個碳,「(C1-C4)」或「C1-C4」意指具有1至4個碳等)。術語「烯基」(單獨或作為較大部分之一部分使用)係指可為直鏈或具支鏈且具有指定碳原子數之不飽和烴基團(亦即「(C1-C20)」意指具有1至20個碳,「(C1-C4)」或「C1-C4」意指具有1至4個碳等)。
術語「鹵基」或「鹵素」(本身或作為取代基之一部分)係指氟、氯、溴及碘原子。
本文所用之術語「碳環」意指完全飽和或含有一或多個不飽和單元之環狀烴基團,其與分子之其他部分具有單一附接點。術語「5-6員碳環」係指完全飽和或含有一或多個不飽和單元但並非芳族之C5或C6環狀烷基。適宜「5-6員碳環」基團包含環戊基、環己基、環戊烯基、環己烯基、環戊基甲基及諸如此類。
術語「雜環(heterocycle、heterocyclic)」、「雜環基」或「雜環脂肪族環系統」係指含有至少一個選自氮、氧或硫之雜原子(通常為1至4個雜原子)之飽和或不飽和非芳族
環。較佳地,該等基團含有0-4個氮原子、0-2個硫原子及0-2個氧原子。更佳地,該等基團含有0-3個氮原子、0-1個硫原子及0-1個氧原子。雜環基團之實例包含吡咯啶、六氫吡啶、咪唑啶、吡唑啶、丁內醯胺、戊內醯胺、咪唑啶酮、乙內醯脲、二氧雜環戊烷、六氫吡啶、1,4-二噁烷、嗎啉、硫代嗎啉、硫代嗎啉-S-氧化物、硫代嗎啉-S,S-二氧化物、六氫吡嗪、吡喃、吡啶酮、3-吡咯啶、噻喃、吡喃酮、四氫呋喃、四氫噻吩及諸如此類。
本文亦包含式(I)化合物之同位素標記形式,其中一或多個原子由原子質量或質量數不同於自然界中通常發現之原子質量或質量數之原子代替。可納入本發明化合物中之同位素之實例包含氫、碳、氮、氧及氟之同位素,例如2H、3H、13C、14C、15N、18O及17O。該等同位素標記及穩定同位素標記之化合物可用作(例如)具有改良治療特徵之研究或診斷工具或旋轉酶及/或拓樸異構酶IV抑制劑。若適宜,該等結構亦涵蓋化合物或鹽之兩性離子形式。
本發明之各種實施例包含如下文所闡述式(I)之化合物或鹽:(1)化合物,其中X係(a)-PO(OH)O-R1;或(b)-PO(O-M+)O-R1;(2)化合物,其中M+係(a)Li+、Na+、K+、N-甲基-D-葡萄糖胺或N(R9)4 +;或(b)Na+或NH4 +;
(3)化合物,其中R1係(a)(C1-C20)-烷基、(C2-C20)-烯基或-O(CH2CH2O)nCH3(其中n為整數1、2或3)、嗎啉基乙基、4-乙基四氫-2H-吡喃基、六氫吡啶基乙基、六氫吡嗪基乙基或吡咯啶基乙基;(b)嗎啉基乙基、4-乙基四氫-2H-吡喃基、六氫吡啶基乙基、六氫吡嗪基乙基或吡咯啶基乙基;(c)(C1-C20)-烷基;或(d)-O(CH2CH2O)nCH3,其中n為整數1、2或3;(4)(R)-2-(5-(2-(3-乙基脲基)-6-氟-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基2-(2-甲氧基乙氧基)乙基磷酸氫酯;(5)(R)-2-(5-(2-(3-乙基脲基)-6-氟-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基2-(2-甲氧基乙氧基)乙基磷酸銨;(6)(R)-2-(5-(2-(3-乙基脲基)-6-氟-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基十六烷基磷酸氫酯;(7)(R)-2-(5-(2-(3-乙基脲基)-6-氟-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基十六烷基磷酸銨;及(8)2-(5-(2-(3-乙基脲基)-6-氟-7-((R)-四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基2-嗎啉基乙基磷酸氫酯。
應理解,可藉由需要上文(1)至(3)中所列示替代實施例中之一或多者來選擇式(I)之化合物或鹽之各種替代實施
例。舉例而言,可藉由組合以下來獲得本發明之其他實施例:(1)(a)及(3)(a);(1)(a)及(3)(b);(1)(a)及(3)(c);(1)(a)及(3)(d);(1)(b)、(2)(a)及(3)(a);(1)(b)、(2)(a)及(3)(b);(1)(b)、(2)(a)及(3)(c);(1)(b)、(2)(a)及(3)(d);(1)(b)、(2)(b)及(3)(a);(1)(b)、(2)(b)及(3)(b);(1)(b)、(2)(b)及(3)(c);(1)(b)、(2)(b)及(3)(d);及諸如此類。
本發明之前藥之特徵在於格外高之水溶性。此溶解性促進較高劑量前藥之投與,從而在每單位劑量中得到較大藥物載量。
本發明之一實施例係關於治療患者之細菌感染、控制或減小其發展、嚴重性或效應之方法,其包括向該患者投與治療有效量之具有式(I)之化合物或其醫藥上可接受之鹽。
根據另一實施例,本發明提供降低或抑制生物試樣中之細菌量之方法。此方法包括使該生物試樣與式(I)化合物或其醫藥上可接受之鹽接觸。
本文所用之術語「生物試樣」包含細胞培養物或其提取物;自哺乳動物獲得之活體組織檢查材料或其提取物;及血液、唾液、尿、糞便、精液、眼淚或其他體液或其提取物。術語「生物試樣」亦包含活有機體,在該情形下,「使本發明化合物與生物試樣接觸」與術語「將該化合物或包括該化合物之組合物投與哺乳動物」係同義的。
一實施例包括使該生物試樣與(R)-1-乙基-3-(6-氟-5-(2-(2-羥基丙-2-基)嘧啶-5-基)-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-2-基)脲之磷酸酯前藥(如由式(I)所定義)接觸。下文
闡述用於該等方法之醫藥組合物。
可將本發明之旋轉酶及/或拓樸異構酶IV抑制劑或其醫藥鹽調配成醫藥組合物以用於投與動物或人類。該等醫藥組合物係本發明之另一實施例,其可有效治療或預防細菌感染且包括旋轉酶及/或拓樸異構酶IV抑制劑(以足以可量測地降低細菌量之量)及醫藥上可接受之載劑、佐劑或媒劑。本文所用之術語「可量測地降低細菌量」意指含有該抑制劑之試樣與僅含細菌之試樣間的細菌數量具有可量測變化。
已知增加細菌有機體對於抗生素之敏感性之藥劑。舉例而言,美國專利第5,523,288號、美國專利第5,783,561號及美國專利第6,140,306號闡述使用殺菌/滲透性增加蛋白(BPI)來增加革蘭氏陽性(gram-positive)及革蘭氏陰性(gram-negative)細菌之抗生素敏感性之方法。增加細菌有機體之外膜滲透性之藥劑已由Vaara,M.在Microbiological Reviews(1992)第395-411頁中予以闡述,且革蘭氏陰性細菌之敏化已由Tsubery,H.等人在J.Med.Chem.(2000)第3085-3092頁中予以闡述。
本發明之另一實施例係關於如上文所闡述治療患者之細菌感染、控制或減小其發展、嚴重性或效應之方法,但進一步包括向該患者投與增加細菌有機體對於抗生素之敏感性之藥劑之步驟。
根據另一實施例,本發明方法用於治療獸醫領域(包含但不限於動物園、實驗室)中之患者、人類伴侶及農場動
物(包含靈長類動物、齧齒類動物、爬行動物及鳥)。該等動物之實例包含但不限於天竺鼠、倉鼠、沙鼠、大鼠、小鼠、兔、狗、貓、馬、豬、綿羊、牛、山羊、鹿、恒河猴、猴、羅望子、猿、狒狒、大猩猩、黑猩猩、猩猩、長臂猿、鴕鳥、雞、火雞、鴨及鵝。
根據另一實施例,本發明提供降低或抑制生物試樣中之以下細菌量之方法:肺炎鏈球菌、表皮葡萄球菌(Staphylococcus epidermidis)、糞腸球菌(Enterococcus faecalis)、屎腸球菌(Enterococcus faecium)、金黃色葡萄球菌、困難梭菌(Clostridium difficile)、黏膜炎莫拉菌(Moraxella catarrhalis)、淋病奈瑟球菌(Neisseria gonorrhoeae)、腦膜炎奈瑟球菌(Neisseria meningitidis)、結核分枝桿菌、禽型複合分枝桿菌(Mycobacterium avium complex)、膿腫分枝桿菌(Mycobacterium abscessus)、堪薩斯分枝桿菌(Mycobacterium kansasii)、潰瘍分枝桿菌(Mycobacterium ulcerans)、肺炎披衣菌(Chlamydophila pneumoniae)、沙眼披衣菌(Chlamydia trachomatis)、流感嗜血桿菌(Haemophilus influenzae)、釀膿鏈球菌(Streptococcus pyogenes)或β-溶血性鏈球菌(β-haemolytic streptococci),其包括使該生物試樣與式(I)化合物或其醫藥上可接受之鹽接觸。
本發明之醫藥組合物及方法通常用於控制活體內之細菌感染。可藉由本發明之組合物及方法控制之細菌有機體之實例包含但不限於下列有機體:肺炎鏈球菌、釀膿鏈球
菌、糞腸球菌、屎腸球菌、肺炎克雷伯氏菌(Klebsiella pneumoniae)、腸桿菌屬(Enterobacter spp.)、變形菌屬(Proteus spp.)、綠膿桿菌(Pseudomonas aeruginosa)、大腸桿菌、黏質沙雷菌(Serratia marcescens)、金黃色葡萄球菌、凝結酶陰性葡萄球菌(Coag.Neg.Staphylococci)、流感嗜血桿菌、炭疽芽孢桿菌(Bacillus anthracis)、肺炎支原體(Mycoplasma pneumoniae)、黏膜炎莫拉菌、肺炎披衣菌(Chlamydophila pneumoniae)、沙眼披衣菌、侵肺軍團菌(Legionella pneumophila)、結核分枝桿菌、幽門螺旋桿菌(Helicobacter pylori)、腐生性葡萄球菌(Staphylococcus saprophyticus)、表皮葡萄球菌、土拉熱弗朗西斯菌(Francisella tularensis)、鼠疫耶爾森菌(Yersinia pestis)、困難梭菌、淋病奈瑟球菌、腦膜炎奈瑟球菌、禽型複合分枝桿菌、膿腫分枝桿菌、堪薩斯分枝桿菌及潰瘍分枝桿菌。
該等組合物及方法由此用於治療院內或非院內感染、控制或減小其發展、嚴重性或效應。院內及非院內感染之實例包含但不限於上呼吸道感染、下呼吸道感染、耳部感染、胸膜肺及支氣管感染、複雜性泌尿道感染、非複雜性泌尿道感染、腹內感染、心血管感染、血流感染、敗血病、菌血症、CNS感染、皮膚及軟組織感染、GI感染、骨及關節感染、生殖器感染、眼部感染或肉芽腫感染。具體細菌感染之實例包含但不限於非複雜性皮膚及皮膚結構感染、複雜性皮膚及皮膚結構感染(cSSSI)、導管感染、咽
炎、竇炎、外耳炎、中耳炎、支氣管炎、膿胸、肺炎、社區獲得性肺炎(CAP)、醫院獲得性肺炎、醫院細菌肺炎、糖尿病足感染、萬古黴素抗性腸球菌感染、膀胱炎及腎盂腎炎、腎結石、前列腺炎、腹膜炎及其他腹內感染、透析相關性腹膜炎、內臟膿腫、心內膜炎、心肌炎、心包炎、輸血相關性敗血病、腦膜炎、腦炎、腦膿腫、骨髓炎、關節炎、生殖器潰瘍、尿道炎、陰道炎、子宮頸炎、齒齦炎、結膜炎、角膜炎、眼內炎、囊性纖維化患者之感染或發熱性嗜中性白血球過低患者之感染。
術語「非院內感染」亦稱為社區獲得性感染。
在一實施例中,組合物及方法由此用於治療以下疾病、控制或減小其發展、嚴重性或效應:社區獲得性肺炎(CAP)、醫院獲得性肺炎、醫院細菌肺炎、菌血症、糖尿病足感染、導管感染、非複雜性皮膚及皮膚結構感染、複雜性皮膚及皮膚結構感染(cSSSI)、萬古黴素抗性腸球菌感染或骨髓炎。
在另一實施例中,組合物及方法由此用於治療以下疾病、控制或減小其發展、嚴重性或效應:上呼吸道感染、下呼吸道感染、耳部感染、胸膜肺及支氣管感染、複雜性泌尿道感染、非複雜性泌尿道感染、腹內感染、心血管感染、血流感染、敗血病、菌血症、CNS感染、皮膚及軟組織感染、GI感染、骨及關節感染、生殖器感染、眼部感染或肉芽腫感染、非複雜性皮膚及皮膚結構感染、複雜性皮膚及皮膚結構感染(cSSSI)、導管感染、咽炎、竇炎、外耳
炎、中耳炎、支氣管炎、膿胸、肺炎、社區獲得性肺炎(CAP)、醫院獲得性肺炎、醫院細菌肺炎、糖尿病足感染、萬古黴素抗性腸球菌感染、膀胱炎及腎盂腎炎、腎結石、前列腺炎、腹膜炎及其他腹內感染、透析相關性腹膜炎、內臟膿腫、心內膜炎、心肌炎、心包炎、輸血相關性敗血病、腦膜炎、腦炎、腦膿腫、骨髓炎、關節炎、生殖器潰瘍、尿道炎、陰道炎、子宮頸炎、齒齦炎、結膜炎、角膜炎、眼內炎、囊性纖維化患者之感染或發熱性嗜中性白血球過低患者之感染。
在另一實施例中,細菌感染之特徵在於存在以下中之一或多者:肺炎鏈球菌、釀膿鏈球菌、糞腸球菌、屎腸球菌、金黃色葡萄球菌、凝結酶陰性葡萄球菌、炭疽芽孢桿菌、表皮葡萄球菌、腐生性葡萄球菌或結核分枝桿菌。
在另一實施例中,細菌感染之特徵在於存在肺炎鏈球菌、糞腸球菌或金黃色葡萄球菌中之一或多者。
在另一實施例中,細菌感染之特徵在於存在大腸桿菌、黏膜炎莫拉菌或流感嗜血桿菌中之一或多者。
在另一實施例中,細菌感染之特徵在於存在以下中之一或多者:困難梭菌、淋病奈瑟球菌、腦膜炎奈瑟球菌、結核分枝桿菌、禽型複合分枝桿菌、膿腫分枝桿菌、堪薩斯分枝桿菌、潰瘍分枝桿菌、肺炎披衣菌及沙眼披衣菌。
在另一實施例中,細菌感染之特徵在於存在以下中之一或多者:肺炎鏈球菌、表皮葡萄球菌、糞腸球菌、金黃色葡萄球菌、困難梭菌、黏膜炎莫拉菌、淋病奈瑟球菌、腦
膜炎奈瑟球菌、結核分枝桿菌、禽型複合分枝桿菌、膿腫分枝桿菌、堪薩斯分枝桿菌、潰瘍分枝桿菌、肺炎披衣菌、沙眼披衣菌、流感嗜血桿菌、釀膿鏈球菌或β-溶血性鏈球菌。
在一些實施例中,細菌感染之特徵在於存在以下中之一或多者:甲氧苯青黴素抗性金黃色葡萄球菌、氟喹諾酮抗性金黃色葡萄球菌、萬古黴素中間體抗性金黃色葡萄球菌、利奈唑胺(Linezolid)抗性金黃色葡萄球菌、青黴素抗性肺炎鏈球菌、大環內酯(Macrolide)抗性肺炎鏈球菌、氟喹諾酮抗性肺炎鏈球菌、萬古黴素抗性糞腸球菌、利奈唑胺抗性糞腸球菌、氟喹諾酮抗性糞腸球菌、萬古黴素抗性屎腸球菌、利奈唑胺抗性屎腸球菌、氟喹諾酮抗性屎腸球菌、胺苄西林(Ampicillin)抗性尿腸球菌、大環內酯抗性流感嗜血桿菌、β-內醯胺抗性流感嗜血桿菌、氟喹諾酮抗性流感嗜血桿菌、β-內醯胺抗性黏膜炎莫拉菌、甲氧苯青黴素抗性表皮葡萄球菌、甲氧苯青黴素抗性表皮葡萄球菌、萬古黴素抗性表皮葡萄球菌、氟喹諾酮抗性表皮葡萄球菌、大環內酯抗性肺炎支原體、異煙肼(Isoniazid)抗性結核分枝桿菌、利福平(Rifampin)抗性結核分枝桿菌、甲氧苯青黴素抗性凝固酶陰性葡萄球菌(Coagulase negative staphylcoccus)、氟喹諾酮抗性凝固酶陰性葡萄球菌、糖肽中間體抗性金黃色葡萄球菌、萬古黴素抗性金黃色葡萄球菌、異質性萬古黴素中間體抗性金黃色葡萄球菌、異質性萬古黴素抗性金黃色葡萄球菌、大環內酯-林可醯胺-鏈陽
菌素(Macrolide-Lincosamide-Streptogramin)抗性葡萄球菌、β-內醯胺抗性糞腸球菌、β-內醯胺抗性屎腸球菌、酮內酯(Ketolide)抗性肺炎鏈球菌、酮內酯抗性釀膿鏈球菌、大環內酯抗性釀膿鏈球菌、萬古黴素抗性表皮葡萄球菌、氟喹諾酮抗性淋病奈瑟球菌、多種藥物性綠膿桿菌或頭孢菌素(Cephalosporin)抗性淋病奈瑟球菌。
根據另一實施例,甲氧苯青黴素抗性葡萄球菌係選自甲氧苯青黴素抗性金黃色葡萄球菌、甲氧苯青黴素抗性表皮葡萄球菌或甲氧苯青黴素抗性凝固酶陰性葡萄球菌。
在一些實施例中,使用式(I)化合物之形式治療社區獲得性MRSA(亦即,cMRSA)。
在其他實施例中,使用式(I)化合物之形式之治療包含但不限於達托黴素抗性屎腸球菌及達托黴素抗性金黃色葡萄球菌之達托黴素(daptomycin)抗性有機體。
根據另一實施例,氟喹諾酮抗性葡萄球菌係選自氟喹諾酮抗性金黃色葡萄球菌、氟喹諾酮抗性表皮葡萄球菌或氟喹諾酮抗性凝固酶陰性葡萄球菌。
根據另一實施例,糖肽抗性葡萄球菌係選自糖肽中間體抗性金黃色葡萄球菌、萬古黴素抗性金黃色葡萄球菌、萬古黴素中間體抗性金黃色葡萄球菌、異質性萬古黴素中間體抗性金黃色葡萄球菌或異質性萬古黴素抗性金黃色葡萄球菌。
根據另一實施例,大環內酯-林可醯胺-鏈陽菌素抗性葡萄球菌係大環內酯-林可醯胺-鏈陽菌素抗性金黃色葡萄球
菌。
根據另一實施例,利奈唑胺抗性腸球菌係選自利奈唑胺抗性糞腸球菌或利奈唑胺抗性屎腸球菌。
根據另一實施例,糖肽抗性腸球菌係選自萬古黴素抗性屎腸球菌或萬古黴素抗性糞腸球菌。
根據另一實施例,β-內醯胺抗性糞腸球菌係β-內醯胺抗性屎腸球菌。
根據另一實施例,青黴素抗性鏈球菌係青黴素抗性肺炎鏈球菌。
根據另一實施例,大環內酯抗性鏈球菌係大環內酯抗性肺炎鏈球菌。
根據另一實施例,酮內酯抗性鏈球菌係選自大環內酯抗性肺炎鏈球菌及酮內酯抗性釀膿鏈球菌。
根據另一實施例,氟喹諾酮抗性鏈球菌係氟喹諾酮抗性肺炎鏈球菌。
根據另一實施例,β-內醯胺抗性嗜血桿菌(Haemophilus)係β-內醯胺抗性流感嗜血桿菌。
根據另一實施例,氟喹諾酮抗性嗜血桿菌係氟喹諾酮抗性流感嗜血桿菌。
根據另一實施例,大環內酯抗性嗜血桿菌係大環內酯抗性流感嗜血桿菌。
根據另一實施例,大環內酯抗性支原體(Mycoplasma)係大環內酯抗性肺炎支原體。
根據另一實施例,異煙肼抗性分枝桿菌(Mycobacterium)
係異煙肼抗性結核分枝桿菌。
根據另一實施例,利福平抗性分枝桿菌係利福平抗性結核分枝桿菌。
根據另一實施例,β-內醯胺抗性莫拉菌(Moraxella)係β-內醯胺抗性黏膜炎莫拉菌。
根據另一實施例,細菌感染之特徵在於存在下列中之一或多者:甲氧苯青黴素抗性金黃色葡萄球菌、氟喹諾酮抗性金黃色葡萄球菌、萬古黴素中間體抗性金黃色葡萄球菌、利奈唑胺抗性金黃色葡萄球菌、青黴素抗性肺炎鏈球菌、大環內酯抗性肺炎鏈球菌、氟喹諾酮抗性肺炎鏈球菌、萬古黴素抗性糞腸球菌、利奈唑胺抗性糞腸球菌、氟喹諾酮抗性糞腸球菌、萬古黴素抗性屎腸球菌、利奈唑胺抗性屎腸球菌、氟喹諾酮抗性屎腸球菌、胺苄西林抗性屎腸球菌、大環內酯抗性流感嗜血桿菌、β-內醯胺抗性流感嗜血桿菌、氟喹諾酮抗性流感嗜血桿菌、β-內醯胺抗性黏膜炎莫拉菌、甲氧苯青黴素抗性表皮葡萄球菌、甲氧苯青黴素抗性表皮葡萄球菌、萬古黴素抗性表皮葡萄球菌、氟喹諾酮抗性表皮葡萄球菌、大環內酯抗性肺炎支原體、異煙肼抗性結核分枝桿菌、利福平抗性結核分枝桿菌、氟喹諾酮抗性淋病奈瑟球菌或頭孢菌素抗性淋病奈瑟球菌。
根據另一實施例,細菌感染之特徵在於存在下列中之一或多者:甲氧苯青黴素抗性金黃色葡萄球菌、甲氧苯青黴素抗性表皮葡萄球菌、甲氧苯青黴素抗性凝固酶陰性葡萄球菌、氟喹諾酮抗性金黃色葡萄球菌、氟喹諾酮抗性表皮
葡萄球菌、氟喹諾酮抗性凝固酶陰性葡萄球菌、萬古黴素抗性金黃色葡萄球菌、糖肽中間體抗性金黃色葡萄球菌、萬古黴素抗性金黃色葡萄球菌、萬古黴素中間體抗性金黃色葡萄球菌、異質性萬古黴素中間體抗性金黃色葡萄球菌、異質性萬古黴素抗性金黃色葡萄球菌、萬古黴素抗性屎腸球菌、萬古黴素抗性糞腸球菌、青黴素抗性肺炎鏈球菌、大環內酯抗性肺炎鏈球菌、氟喹諾酮抗性肺炎鏈球菌、大環內酯抗性釀膿鏈球菌或β-內醯胺抗性流感嗜血桿菌。
根據另一實施例,細菌感染之特徵在於存在下列中之一或多者:甲氧苯青黴素抗性金黃色葡萄球菌、萬古黴素抗性屎腸球菌、萬古黴素抗性糞腸球菌、萬古黴素抗性金黃色葡萄球菌、萬古黴素中間體抗性金黃色葡萄球菌、異質性萬古黴素中間體抗性金黃色葡萄球菌、異質性萬古黴素抗性金黃色葡萄球菌、多種藥物抗性綠膿桿菌、異煙肼抗性結核分枝桿菌或利福平抗性結核分枝桿菌。
本發明化合物之醫藥上可接受之鹽包含彼等源自醫藥上可接受之無機酸與鹼及有機酸與鹼者。適宜酸鹽之實例包含乙酸鹽、己二酸鹽、藻酸鹽、天冬胺酸鹽、苯甲酸鹽、苯磺酸鹽、硫酸氫鹽、丁酸鹽、檸檬酸鹽、樟腦酸鹽、樟腦磺酸鹽、環戊烷丙酸鹽、雙葡萄糖酸鹽、十二烷基硫酸鹽、乙烷磺酸鹽、甲酸鹽、富馬酸鹽、葡庚糖酸鹽、甘油磷酸鹽、羥乙酸鹽、半硫酸鹽、庚酸鹽、已酸鹽、鹽酸鹽、氫溴酸鹽、氫碘酸鹽、2-羥基乙烷磺酸鹽、乳酸鹽、
馬來酸鹽、丙二酸鹽、甲烷磺酸鹽、2-萘磺酸鹽、菸鹼酸鹽、硝酸鹽、雙羥萘酸鹽、果膠酸鹽、過硫酸鹽、3-苯基丙酸鹽、磷酸鹽、苦味酸鹽、新戊酸鹽、丙酸鹽、水楊酸鹽、琥珀酸鹽、硫酸鹽、酒石酸鹽、硫氰酸鹽、甲苯磺酸鹽及十一烷酸鹽。其他酸(例如草酸)儘管自身並非醫藥上可接受之,但也可用於製備在本發明化合物及其醫藥上可接受之酸加成鹽之獲得中用作中間體的鹽。
衍生自適宜鹼之鹽包含鹼金屬(例如,鈉及鉀)鹽、鹼土金屬(例如鎂)鹽、銨鹽及N+(C1-4烷基)4鹽。本發明亦期望本文所揭示化合物之任一鹼性含氮基團之四級銨化作用。藉由該四級銨化作用,可獲得水或油可溶性或可分散性產物。
本發明之醫藥組合物包括式(I)化合物或其醫藥上可接受之鹽及醫藥上可接受之載劑。該等組合物可視情況包括其他治療劑。該等藥劑包含但不限於抗生素、抗炎劑、基質金屬蛋白酶抑制劑、脂氧合酶抑制劑、細胞因子拮抗劑、免疫阻抑劑、抗癌劑、抗病毒劑、細胞因子、生長因子、免疫調節劑、前列腺素或抗血管過度增殖化合物。
術語「醫藥上可接受之載劑」係指可與本發明化合物一起投與患者且並不破壞其藥理學活性之無毒載劑。
可用於本發明醫藥組合物中之醫藥上可接受之載劑包含但不限於離子交換劑、氧化鋁、硬脂酸鋁、卵磷脂、血清蛋白(例如人類血清白蛋白)、緩衝物質(例如磷酸鹽)、甘胺酸、山梨酸、山梨酸鉀、飽和植物脂肪酸之偏甘油酯混
合物、水、鹽或電解質(例如硫酸魚精蛋白、磷酸氫二鈉、磷酸氫鉀、氯化鈉、鋅鹽、膠質二氧化矽、三矽酸鎂)、聚乙烯基吡咯啶酮、基於纖維素之物質、聚乙二醇、羧甲基纖維素鈉、聚丙烯酸酯、蠟、聚乙烯-聚氧丙烯-嵌段聚合物、羊毛脂及自乳化藥物遞送系統(SEDDS)(例如α-生育酚、聚乙二醇1000琥珀酸酯)或其他類似聚合物遞送基質)。
術語「醫藥有效量」係指治療或改善患者之細菌感染之有效量。術語「預防有效量」係指預防或實質上減弱患者之細菌感染之有效量。
端視擬治療或預防之特定病狀或疾病狀態,可與本發明之抑制劑一起投與通常投與以治療或預防該病狀之其他治療劑。該等治療劑包含但不限於抗生素、抗炎劑、基質金屬蛋白酶抑制劑、脂氧合酶抑制劑、細胞因子拮抗劑、免疫阻抑劑、抗癌劑、抗病毒劑、細胞因子、生長因子、免疫調節劑、前列腺素或抗血管過度增殖化合物。
本發明化合物可以習用方式用於控制活體內之細菌感染程度並用於治療疾病或減小由細菌介導之效應之發展或嚴重性。彼等熟習此項技術者可根據可用方法及技術選擇該等治療方法、其劑量值及需求。
舉例而言,可組合本發明化合物與醫藥上可接受之佐劑以用於以醫藥上可接受之方式且以有效減弱細菌感染或疾病嚴重性之量投與患有該感染或疾病的患者。
或者,本發明化合物可用於組合物及方法中以在延長時
段內治療或保護個體對抗細菌感染或疾病。該等化合物可單獨或與本發明其他化合物一起,以與酶抑制劑習知用於醫藥組合物中一致之方式,用於該等組合物中。舉例而言,本發明化合物可與常用於疫苗中之醫藥上可接受之佐劑組合,並以預防有效量投與以在延長時段內保護個體對抗細菌感染或疾病。
在一些實施例中,可以預防性方式使用式(I)化合物以預防細菌感染。在一些實施例中,可在牙科或外科手術之前、期間或之後使用式(I)化合物以預防伺機性感染,例如在細菌心內膜炎中遭遇者。在其他實施例中,可在牙科手術,包含(但不限於)拔牙、牙周病手術、植牙(dental implant placements)及牙髓(endodontic)外科手術中以預防性方式使用式(I)化合物。在其他實施例中,可在以下外科手術中以預防性方式使用式(I)化合物:包含(但不限於)一般外科手術、呼吸道外科手術(扁桃體切除術/腺樣增殖切除術)、胃腸道外科手術(上GI及選擇性小腸外科手術、食道硬化療法及擴張術、大腸切除術、急性闌尾切除術)、創傷外科手術(穿透性腹部外科手術)、泌尿生殖道外科手術(攝護腺切除術、尿道擴張術、膀胱鏡檢查、陰道或腹部子宮切除術、剖腹產)、移植外科手術(腎、肝、胰腺或腎移植)、頭頸外科手術(皮膚切除、頸部廓清術、喉切除術、頭頸癌外科手術、下頜骨折手術)、整形外科手術(全關節置換術、創傷開放性骨折手術)、血管外科手術(周邊血管手術)、心胸外科手術、冠狀動脈繞道(bypass)外科手
術、肺切除術及神經外科手術。
除非另外指定,否則本文所用之術語「預防細菌感染」意指預防性使用本發明之抗生素(例如旋轉酶及/或拓樸異構酶IV抑制劑)來預防細菌感染。使用旋轉酶及/或拓樸異構酶IV抑制劑之治療可以預防性方式進行以預防由對旋轉酶及/或拓樸異構酶IV抑制劑敏感之有機體引起之感染。一組可考慮預防性治療之常見情況係在個體較易受由例如以下因素所致之感染影響時:弱免疫性、外科手術、創傷、在機體中存在人工裝置(暫時性或永久性)、解剖缺陷、暴露於高濃度細菌或可能暴露於引起疾病之病原。可引起弱免疫性之因素之實例包含化學療法、放射療法、糖尿病、老年、HIV感染及移植。解剖缺陷之一實例係增加細菌心內膜炎風險之心瓣膜缺陷。人工裝置之實例包含人工關節、外科針、導管等。預防性使用旋轉酶及/或拓樸異構酶IV抑制劑可能適應之另一組情形係預防病原在個體之間擴散(直接或間接)。預防性使用以預防病原擴散之一具體實例係在健康護理機構(例如醫院或療養院)中之個體中使用旋轉酶及/或拓樸異構酶IV抑制劑。
亦可共投與式(I)化合物與其他抗生素以增加針對各種細菌感染之治療或預防效應。在組合療法中投與本發明化合物與其他藥劑時,可依序或同時將其投與患者。另一選擇為,本發明之醫藥或預防性組合物包括式(I)化合物及另一治療性或預防性藥劑之組合。
在一些實施例中,一或多種其他治療劑係選自以下之抗
生素:天然青黴素、青黴素酶抗性青黴素、抗假單胞菌青黴素、胺基青黴素、第一代頭孢菌素、第二代頭孢菌素、第三代頭孢菌素、第四代頭孢菌素、碳青黴烯(carbapenem)、頭黴素(cephamycin)、喹諾酮、氟喹諾酮、胺基糖苷、大環內酯、酮內酯、多黏菌素(polymyxin)、四環素(tetracycline)、糖肽、鏈陽菌素(streptogramin)、噁唑啶酮、利福黴素(rifamycin)或磺醯胺。
在一些實施例中,一或多種其他治療劑係選自青黴素、頭孢菌素、喹諾酮、胺基糖苷或噁唑啶酮之抗生素。
在其他實施例中,其他治療劑係選自:天然青黴素,包含苄星青黴素G(Benzathine penicillin G)、青黴素G及青黴素V;青黴素酶抗性青黴素,包含氯唑西林(Cloxacillin)、雙氯西林(Dicloxacillin)、萘夫西林(Nafcillin)及苯唑西林(Oxacillin);抗假單胞菌青黴素,包含羧苄青黴素(Carbenicillin)、美洛西林(Mezlocillin)、哌拉西林(Pipercillin)、哌拉西林/他唑巴坦(tazobactam)、替卡西林(Ticaricillin)及替卡西林/棒地酸鹽(Clavulanate);胺基青黴素,包含阿莫西林(Amoxicillin)、胺苄西林及胺苄西林/舒巴克坦(Sulbactam);第一代頭孢菌素,包含頭孢唑林(Cefazolin)、頭孢羥胺苄(Cefadroxil)、頭孢力新(Cephalexin)及頭孢拉定(Cephadrine);第二代頭孢菌素,包含頭孢克洛(Cefaclor)、頭孢克洛CD、頭孢孟多(Cefamandole)、頭孢羥苯磺唑(Cefonacid)、頭孢羅齊(Cefprozil)、氯碳頭孢(Loracarbef)及頭孢呋辛(Cefuroxime);
第三代頭孢菌素,包含頭孢地尼(Cefdinir)、頭孢克肟(Cefixime)、頭孢哌酮(Cefoperazone)、頭孢噻肟(Cefotaxime)、頭孢泊肟(Cefpodoxime)、頭孢他啶(Ceftazidime)、頭孢布烯(Ceftibuten)、頭孢唑肟(Ceftizoxme)及頭孢曲松(Ceftriaxone);第四代頭孢菌素,包含頭孢吡肟(Cefepime)、頭孢洛林(Ceftaroline)及頭孢吡普(Ceftobiprole);頭黴素,包含頭孢替坦(Cefotetan)及頭孢西丁(Cefoxitin);碳青黴烯,包含多尼培南(Doripenem)、亞胺培南(Imipenem)及美羅培南(Meropenem);單醯胺菌素,包含胺曲南(Aztreonam);喹諾酮,包含西諾沙星(Cinoxacin)、萘啶酸、歐索林酸(Oxolininc acid)及吡哌酸(Pipemidic acid);氟喹諾酮,包含貝西沙星(Besifloxacin)、環丙沙星、依諾沙星(Enoxacin)、加替沙星(Gatifloxacin)、格帕沙星(Grepafloxacin)、左氧氟沙星(Levofloxacin)、洛美沙星(Lomefloxacin)、莫西沙星(Moxifloxacin)、諾氟沙星、氧氟沙星(Ofloxacin)及司帕沙星(Sparfloxacin);胺基糖苷,包含阿米卡星(Amikacin)、慶大黴素(Gentamicin)、卡那黴素(Kanamycin)、新黴素(Neomycin)、奈替米星(Netilmicin)、大觀黴素(Spectinomycin)、鏈黴素(Streptomycin)及妥布黴素(Tobramycin);大環內酯,包含阿奇黴素(Azithromycin)、克拉黴素(Clarithromycin)及紅黴素(Erythromycin);酮內酯,包含泰利黴素(Telithromycin);四環素,包含氯四環素(Chlortetracycline)、地美環素(Demeclocycline)、多西
環素(Doxycycline)、米諾環素(Minocycline)及四環素;糖肽,包含奧利萬星(Oritavancin)、達貝萬星(Dalbavancin)、特拉萬星(Telavancin)、替考拉寧(Teicoplanin)及萬古黴素;鏈陽菌素,包含達福普汀(Dalfopristin)/奎奴普丁(quinupristin);噁唑啶酮,包含利奈唑胺;利福黴素,包含利福布丁(Rifabutin)及利福平;及其他抗生素,包含枯草菌素(bactitracin)、柯利黴素(colistin)、老虎黴素(Tygacil)、達托黴素、氯黴素(chloramphenicol)、氯林肯黴素(clindamycin)、異煙肼、甲硝唑(metronidazole)、莫匹羅星(mupirocin)、多黏菌素B、吡嗪醯胺(pyrazinamide)、甲氧苄胺嘧啶(trimethoprim)/磺胺甲基異噁唑(sulfamethoxazole)及磺胺異噁唑(sulfisoxazole)。
在其他實施例中,其他治療劑係選自:天然青黴素,包含青黴素G;青黴素酶抗性青黴素,包含萘夫西林及苯唑西林;抗假單胞菌青黴素,包含哌拉西林/他唑巴坦;胺基青黴素,包含阿莫西林;第一代頭孢菌素,包含頭孢力新;第二代頭孢菌素,包含頭孢克洛、頭孢克洛-CD及頭孢呋辛;第三代頭孢菌素,包含頭孢他啶及頭孢曲松;第四代頭孢菌素,包含頭孢吡肟;碳青黴烯,包含亞胺培南、美羅培南、厄它培南(Ertapenem)、多尼培南、帕尼培南(Panipenem)及比阿培南(Biapenem);氟喹諾酮,包含環丙沙星、加替沙星、左氧氟沙星及莫西沙星;胺基糖苷,包含妥布黴素;大環內酯,包含阿奇黴素及克拉黴素;四環素,包含多西環素;糖肽,包含萬古黴素;利福黴素,
包含利福平;及其他抗生素,包含異煙肼、吡嗪醯胺、老虎黴素、達托黴素或甲氧苄胺嘧啶/磺胺甲基異噁唑。
在一些實施例中,可投與式(I)化合物之固體形式以治療革蘭氏陽性感染。在一些實施例中,組合物係固體、液體(例如,懸浮液)或靜脈內(例如,將一定形式之式(I)化合物溶於液體中並經靜脈內投與)組合物。在一些實施例中,將包含式(I)化合物之組合物與例如以下其他抗生素藥劑組合投與:天然青黴素、青黴素酶抗性青黴素、抗假單胞菌青黴素、胺基青黴素、第一代頭孢菌素、第二代頭孢菌素、第三代頭孢菌素、第四代頭孢菌素、碳青黴烯、頭黴素、喹諾酮、氟喹諾酮、胺基糖苷、大環內酯、酮內酯、多黏菌素、四環素、糖肽、鏈陽菌素、噁唑啶酮、利福黴素或磺醯胺。在一些實施例中,經口投與包含式(I)化合物之固體形式之組合物,且經靜脈內投與其他抗生素藥劑,例如,天然青黴素、青黴素酶抗性青黴素、抗假單胞菌青黴素、胺基青黴素、第一代頭孢菌素、第二代頭孢菌素、第三代頭孢菌素、第四代頭孢菌素、碳青黴烯、頭黴素、喹諾酮、氟喹諾酮、胺基糖苷、大環內酯、酮內酯、多黏菌素、四環素、糖肽、鏈陽菌素、噁唑啶酮、利福黴素或磺醯胺。
在一些實施例中,可投與式(I)化合物之固體形式以治療革蘭氏陰性感染。在一些實施例中,組合物係固體、液體(例如,懸浮液)或靜脈內(例如,將一定形式之式(I)化合物
溶於液體中並經靜脈內投與)組合物。在一些實施例中,將包含式(I)化合物之組合物與選自以下之其他抗生素藥劑組合投與:天然青黴素、青黴素酶抗性青黴素、抗假單胞菌青黴素、胺基青黴素、第一代頭孢菌素、第二代頭孢菌素、第三代頭孢菌素、第四代頭孢菌素、碳青黴烯、頭黴素、單醯胺菌素、喹諾酮、氟喹諾酮、胺基糖苷、大環內酯、酮內酯、多黏菌素、四環素或磺醯胺。在一些實施例中,經口投與包含式(I)化合物之固體形式之組合物,且經口投與其他抗生素藥劑,例如,天然青黴素、青黴素酶抗性青黴素、抗假單胞菌青黴素、胺基青黴素、第一代頭孢菌素、第二代頭孢菌素、第三代頭孢菌素、第四代頭孢菌素、碳青黴烯、頭黴素、單醯胺菌素、喹諾酮、氟喹諾酮、胺基糖苷、大環內酯、酮內酯、多黏菌素、四環素或磺醯胺。在一些實施例中,經靜脈內投與其他治療劑。
上文所闡述之其他治療劑可自含有抑制劑之組合物單獨、作為多個劑量方案之一部分投與。另一選擇為,該等藥劑可為單一劑型,其與抑制劑一起混合於單一組合物中。
本發明之醫藥組合物可經口、非經腸、藉由吸入噴霧、經局部、經直腸、經鼻、經頰、經陰道或經由植入型藥盒投與。本發明之醫藥組合物可含有任一習用無毒之醫藥上可接受之載劑、佐劑或媒劑。在一些情形下,可使用醫藥上可接受之酸、鹼或緩衝劑來調節調配物之pH值以增強所調配化合物或其遞送形式的穩定性。本文所用之術語非經
腸包含皮下、皮內、靜脈內、肌內、關節內、滑膜內、胸骨內、鞘內、病灶內及顱內注射或輸注技術。
該等醫藥組合物可呈無菌可注射製劑形式,例如,作為無菌可注射水性或油性懸浮液。此懸浮液可根據業內已知技術使用適宜分散劑或潤濕劑(例如,Tween 80)及懸浮劑進行調配。無菌可注射製劑亦可為存於無毒非經腸可接受之稀釋劑或溶劑中之無菌可注射溶液或懸浮液,例如,呈存於1,3-丁二醇中之溶液。可採用之可接受之媒劑及溶劑係甘露醇、水、林格氏溶液(Ringer's solution)及等滲氯化鈉溶液。此外,通常採用無菌不揮發性油作為溶劑或懸浮介質。就此來說,可採用任何溫和不揮發性油,包含合成之甘油單酸酯或甘油二酸酯。脂肪酸(例如油酸及其甘油酯衍生物)可用於製備可注射物,例如天然之醫藥上可接受之油類,例如橄欖油或蓖麻油,其尤其呈其聚氧乙烯化形式。該等油溶液或懸浮液亦可含有長鏈醇稀釋劑或分散劑(例如彼等闡述於Pharmacopeia Helvetica中者)或類似醇。
本發明之醫藥組合物可以任何經口可接受劑型經口投與,該等劑型包含但不限於膠囊、錠劑及水性懸浮液及溶液。當為供口服使用錠劑時,通常使用之載劑包含乳糖及玉米澱粉。通常亦添加潤滑劑,例如硬脂酸鎂。對於以膠囊形式經口投與而言,有用稀釋劑包含乳糖及亁燥之玉米澱粉。在經口投與水性懸浮液及溶液及丙二醇時,將活性成份與乳化劑及懸浮劑組合。若需要,可添加某些甜味劑
及/或矯味劑及/或著色劑。
本發明之醫藥組合物亦可以供直腸投與之栓劑形式投與。該等組合物可藉由將本發明化合物與適宜非刺激性賦形劑混合而製得,該賦形劑在室溫下為固體,但在直腸溫度下為液體,且由此可在直腸中熔化而釋放出活性組份。該等材料包含但不限於可可油、蜂蠟及聚乙二醇。
當期望治療涉及局部施加容易觸及之區或器官時,局部投與本發明之醫藥組合物尤其有用。在局部施加至皮膚時,應將醫藥組合物調配成含有懸浮或溶解於載劑中之活性組份的適宜軟膏。用於本發明化合物局部投與之載劑包含但不限於礦物油、液體石油(liquid petroleum)、白凡士林(white petroleum)、丙二醇、聚氧乙烯聚氧丙烯化合物、乳化蠟及水。另一選擇為,可將醫藥組合物調配成適宜洗劑或乳霜,其含有懸浮或溶解於載劑中之活性化合物。適宜載劑包含但不限於礦物油、山梨醇酐單硬脂酸酯、聚山梨醇酯60、十六烷基酯蠟、鯨蠟醇、2-辛基十二烷醇、苯甲醇及水。本發明之醫藥組合物亦可以直腸栓劑調配物或適宜灌腸劑調配物局部施加於下腸道。局部投與之經真皮貼劑亦包含於本發明中。
本發明之醫藥組合物可藉由經鼻氣溶膠或吸入劑投與。該等組合物係根據醫藥調配領域熟知之技術來製得,且可將其製備成鹽水溶液,其採用苯甲醇或其他適宜防腐劑、吸收促進劑(以增強生物利用度)、碳氟化合物及/或業內已知之其他增溶劑或分散劑。
根據另一實施例,亦可藉由植入(例如,以外科方式)使用(例如)可植入或留置裝置遞送式(I)化合物。可植入或留置裝置可經設計以永久性或暫時性滯留於個體中。可植入或留置裝置之實例包含但不限於隱形眼鏡、中心靜脈導管及無針式接頭、氣管內管、子宮內裝置、機械心瓣膜、起搏器、腹膜透析導管、假關節(例如髖部及膝關節置換物)、鼓室通氣管、泌尿導管、語音假體、支架、遞送幫浦、血管濾器及可植入受控釋放組合物。生物膜可對具有可植入或留置醫學裝置之患者之健康有害,此乃因其在機體中引入人工底質並可引起持久性感染。因此,在可植入或留置裝置中或其上提供式(I)化合物可預防或減小生物膜之產生。此外,可植入或留置裝置可用作式(I)化合物之儲藏室或儲存器。可使用任一可植入或留置裝置來遞送式(I)化合物,前提係:a)該裝置、式(I)化合物及包含式(I)化合物之任一醫藥組合物生物相容,且b)該裝置可遞送或釋放有效量之式(I)化合物以賦予經治療患者治療效應。
業內已知經由可植入或留置裝置來遞送治療劑。例如參見「Recent Developments in Coated Stents」,Hofma等人,公開於Current Interventional Cardiology Reports 2001,3:28-36中,其全部內容(包含其中引用之參考文獻)以引用方式併入本文中。可植入裝置之其他闡述可參見美國專利第6,569,195號及第6,322,847號及美國專利申請案第2004/0044405號、第2004/0018228號、第2003/0229390號、第2003/0225450號、第2003/0216699號及第
2003/0204168號,該等專利中之每一者之全部內容皆以引用方式併入本文中。
在一些實施例中,可植入裝置係支架。在一具體實施例中,支架可包含聯鎖網格電纜。各電纜可包含用於結構支持之金屬絲及用於遞送治療劑之聚合絲。可藉由將聚合物浸漬於治療劑溶液中來投用聚合絲。另一選擇為,可在自聚合前體溶液形成絲期間將治療劑包埋於聚合絲中。
在其他實施例中,可使用包含治療劑之聚合塗層塗覆可植入或留置裝置。聚合塗層可經設計以控制治療劑之釋放速率。可利用各種技術來受控釋放治療劑。已知該等裝置具有納入存於聚合物質中之活性劑之異質性溶液及/或分散液之單片層或塗層,其中藥劑之擴散速率有限,此乃因藥劑擴散穿過聚合物而到達聚合物-流體界面且釋放至周圍流體中。在一些裝置中,可溶性物質亦溶解或分散於聚合材料中,從而在材料溶解之後留下額外之孔隙或通道。基質裝置通常亦具有擴散受限性,但該裝置之通道或其他內部幾何結構亦在藥劑至流體之釋放中發揮作用。通道可為預存在通道或由所釋放藥劑或其他可溶性物質留下之通道。
易侵蝕或可降解裝置通常具有以物理方式固定於聚合物中之活性劑。活性劑可溶解及/或分散於整個聚合材料中。聚合材料通常隨時間流逝經由不穩定鍵之水解以水解方式發生降解,從而使得聚合物侵蝕至流體中並將活性劑釋放至流體中。親水性聚合物之侵蝕速率通常快於疏水性
聚合物。據信,疏水性聚合物幾乎完全在表面擴散活性劑,其中自表面向內侵蝕。據信,親水性聚合物容許水滲透聚合物表面,從而使得不穩定鍵在表面下方水解,此可引起聚合物之均勻或整體侵蝕。
可植入或留置裝置塗層可包含聚合物摻合物,各聚合物具有不同之治療劑釋放速率。舉例而言,塗層可包含聚乳酸/聚環氧乙烷(PLA-PEO)共聚物及聚乳酸/聚已酸內酯(PLA-PCL)共聚物。聚乳酸/聚環氧乙烷(PLA-PEO)共聚物所展現之治療劑釋放速率可高於聚乳酸/聚已酸內酯(PLA-PCL)共聚物。可藉由控制較快釋放聚合物相對於較慢釋放聚合物之相對量來控制隨時間流逝所遞送治療劑之相對量及劑量速率。對於較高初始釋放速率而言,可相對於較慢釋放聚合物增加較快釋放聚合物之比例。若期望經經長時間段釋放大部分劑量,則大部分聚合物可為較慢釋放聚合物。可藉由使用聚合物、活性劑及溶劑之溶液或分散液將裝置噴霧來塗覆裝置。可蒸發溶劑,從而留下聚合物及活性劑之塗層。活性劑可溶解及/或分散於聚合物中。在一些實施例中,可藉由裝置擠出共聚物。
劑量值介於約0.01 mg/kg體重/天與約100 mg/kg體重/天之間、較佳地介於0.5 mg/kg體重/天與約75 mg/kg體重/天之間及最佳地介於約1 mg/kg體重/天與50 mg/kg體重/天之間之活性成份化合物可用於單一療法中以用於預防及治療細菌感染。
通常,本發明之醫藥醫藥組合物每天投與約1次至約5
次,或另一選擇為以連續輸注形式投與。另一選擇為,可以脈動調配物形式投與本發明組合物。該投與可用作慢性或急性療法。可與載劑材料組合以產生單一劑型之活性成份的量應端視所治療主體及特定投與模式而改變。典型製劑含有約5%至約95%之活性化合物(w/w)。較佳地,該等製劑含有約20%至約80%之活性化合物。
在本發明組合物包括式(I)化合物及一或多種其他治療性或預防性藥劑之組合時,化合物及其他藥劑二者應以介於在單一療法方案中通常所投與劑量之約10%至80%之間之劑量值存在。
當患者病狀好轉時,若需要,可投與維持劑量之本發明化合物、組合物或組合。隨後,可根據症狀將投與劑量或投與頻率或二者降低至可保持病狀好轉之程度,在症狀已減輕至期望程度時,應停止治療。然而,在產生任一復發或疾病症狀後,患者可能需要長期間歇治療。
如熟習此項技術者所瞭解,可能需要低於或高於彼等列舉於上文中之劑量之劑量。任一特定患者之具體劑量及治療方案應視各種因素而定,包含所用具體化合物之活性、年齡、體重、總體健康狀況、性別、飲食、投與時間、排泄速率、藥物組合、疾病、疾病之嚴重性及病程及患者對疾病之部署及治療醫師之判斷。
根據另一實施例,本發明提供治療或預防細菌感染或疾病狀態之方法,其包括向患者投與本文所闡述任一化合物、醫藥組合物或組合之步驟。本文所用之術語「患者」
意指動物,較佳係哺乳動物,且最佳係人類。
本發明化合物亦用作與酶-旋轉酶B及/或拓樸異構酶IV有效結合之商業試劑。作為商業試劑,本發明化合物及其衍生物可用於在生物化學或細胞分析中阻斷細菌旋轉酶B及/或拓樸異構酶IV或其同源物之旋轉酶B及/或拓樸異構酶IV活性,或可經衍生而與作為連接受質之穩定樹脂結合以用於親和層析應用。彼等熟習此項技術者已明瞭描述商業旋轉酶B及/或拓樸異構酶IV抑制劑之該等及其他使用。
可藉由首先根據彼等熟習此項技術者已知用於類似化合物之一般方法合成(R)-1-乙基-3-(6-氟-5-(2-(2-羥基丙-2-基)嘧啶-5-基)-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-2-基)脲(下文之化合物23)來製備本發明化合物,如美國專利第RE40245 E號、美國專利第7,495,014 B2號、美國專利第7,569,591 B2號、美國專利第7,582,641 B2號、美國專利第7,618,974 B2號及美國專利第7,727,992 B2號所教示。所有6個該專利皆如同完全闡述於本文中一般以引用方式併入本文中。用於製備本發明化合物之條件之細節進一步闡述於實例中。然後可根據下文之反應圖1將(R)-1-乙基-3-(6-氟-5-(2-(2-羥基丙-2-基)嘧啶-5-基)-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-2-基)脲23轉化成磷酸酯或磷酸鹽前藥。
試劑及條件:(a)R1OH,DIPEA,23℃,DCM;(b)23,四唑,MeCN,DMF,23℃;(c)mCPBA,0-23℃,DMF;(d)水性M+OH-;(e)水性H+。
可如反應圖1中所展示自化合物23製備式(I)化合物。在步驟1中,使用醇(R1OH)在二異丙基乙基胺(DIPEA)存在下處理3-((氯(二異丙基胺基)膦基)氧基)丙腈以原位提供反應性亞磷醯胺A。在步驟2中,依次使用亞磷醯胺A及四唑、間氯過氧苯甲酸(mCPBA)處理化合物23以提供氰基乙基磷酸酯B。在步驟3中,使用水性M+OH-處理氰基乙基磷酸酯B以提供陰離子形式之式(I)化合物(X=PO(O-M+)-OR1)。可藉由使用酸水溶液處理該陰離子形式來獲得游離酸形式之式(I)化合物(X=PO(OH)-OR1)。
為更全面地理解本發明,闡述下列實例。該等實例僅用於闡釋目的且不應理解為以任一方式限制本發明範圍。
下列定義闡述本文所使用之術語及縮寫:
Ac 乙醯基
實驗分析. 實施單獨碳、氫及氮(CHN)、氟(F)及磷(P)之元素分析。藉由燃燒分析使用Perkin-Elmer 2400元素分析儀來測定CHN百分比。藉由離子特效電極技術來測定F百分比。藉由感應耦合電漿光譜測定法使用Perkin-Elmer Optima ICP光譜儀來測定P百分比。
自市售材料製備化合物23之合成方法提供於下文之實驗程序中。化合物23係用於合成式(I)之磷酸酯之中間體。
2-(2-氟-6-硝基-苯基)-2,3-二氫呋喃(15A)及2-(2-氟-6-硝基-苯基)-2,5-二氫呋喃(15B)之製備。
將2-溴-1-氟-3-硝基-苯(14)(200.3 g,98%,892.3 mmol,Bosche F6657)、1,4-二噁烷(981.5 mL,Sigma-Aldrich 360481)及2,3-二氫呋喃(2)(341.1 mL,99%,4.462 mol,Aldrich 200018)裝填於反應燒瓶中,隨後裝填N,N-二異丙基乙基胺(155.4 mL,892.3 mmol,Sigma-Aldrich 550043)及溴(三-第三丁基膦)鈀(I)二聚體(6.936 g,8.923 mmol,Johnson Matthey C4099)。將混合物在回流下攪拌2 hr(HPLC展示98%之起始芳基溴消耗掉)。將其冷卻,藉由過濾去除沈澱物,使用EtOAc沖洗,並在真空中將濾液濃縮成暗紅褐色半固體油狀物。將此油狀物溶於CH2Cl2中,經由二氧化矽塞使用CH2Cl2洗脫,並在真空中濃縮以得到15A及15B之暗琥珀色油狀物形式之混合物(291.3 g)。粗產物未經進一步純化即用於下一步驟。主要產物係2-(2-氟-6-硝基-苯基)-2,3-二氫呋喃(15A)(96%):LCMS(C18管柱,經5分鐘使用10-90% CH3CN/水梯度洗脫,使用甲酸修飾
劑)M+1:210.23(3.13 min);1H NMR(300 MHz,CDCl3)δ 7.54(dt,J=8.0,1.2 Hz,1H),7.43(td,J=8.2,5.2 Hz,1H),7.32(ddd,J=9.7,8.3,1.3 Hz,1H),6.33(dd,J=4.9,2.4 Hz,1H),5.80(t,J=10.9 Hz,1H),5.06(q,J=2.4 Hz,1H),3.18-3.07(m,1H),2.94-2.82(m,1H)ppm。次要產物係2-(2-氟-6-硝基-苯基)-2,5-二氫呋喃(15B)(4%):GCMS(Agilent HP-5MS,30 m×250 μm×0.25 μm管柱,在60℃下加熱2 min,在15 min內加熱至300℃,使用1 mL/min之流速)M+1:210(11.95 min)。1H NMR(300 MHz,CDCl3)δ 7.47(d,J=8.0 Hz,1H),7.43-7.34(m,1H),7.30-7.23(m,1H),6.21-6.15(m,1H),6.11-6.06(m,1H),5.97-5.91(m,1H),4.89-4.73(m,2H)ppm。
3-氟-2-四氫呋喃-2-基-苯胺(16)之製備。
在氮下將5%碳載鈀(37.3 g,50%濕潤,8.76 mmol,Aldrich 330116)置於帕爾瓶(Parr bottle)中,隨後添加MeOH(70 mL,JT-Baker 909333)。添加溶於MeOH(117 mL)中之2-(2-氟-6-硝基-苯基)-2,3-二氫呋喃及2-(2-氟-6-硝基-苯基)-2,5-二氫呋喃(15A及15B)(186.6 g,892.1 mmol)之粗製混合物,隨後添加NEt3(124.3 mL,892.1 mmol,Sigma-
Aldrich 471283)。將器皿置於帕爾振盪器(Parr shaker)上並使用H2使其達到飽和。在添加45 psi H2後,振盪反應混合物直至起始材料完全消耗為止(HPLC及LCMS展示反應已完成)。使用氮吹掃反應混合物,經由矽藻土TM(CeliteTM)過濾並使用EtOAc沖洗。在旋轉蒸發器上濃縮濾液以得到褐色油狀物,將該褐色油狀物溶於Et2O中並使用水(2×)洗滌。使用1 N HCl水溶液(5×250 mL)萃取乙醚相,使用Et2O(3×)洗滌且然後使用6 N NaOH水溶液鹼化至pH 12-14。使用CH2Cl2(4×)萃取鹼性水相,並使用NH4Cl飽和水溶液洗滌合併之有機萃取物,藉由MgSO4乾燥,並經由使用CH2Cl2至25% EtOAc/己烷洗脫之二氧化矽墊過濾。在減壓下濃縮期望濾液以得到淺褐色油狀物16(121.8 g,84%之GCMS加NMR純度)。GCMS(Agilent HP-5MS,30 m×250 μm×0.25 μm管柱,在60℃下加熱2 min,在15 min內加熱至300℃,使用1 mL/min之流速)M+1:182.0(11.44 min)。LCMS(C18管柱,經5分鐘使用10-90% CH3CN/水梯度洗脫,使用甲酸修飾劑)M+1:182,10(2.61 min)。1H NMR(300 MHz,CDCl3)δ 6.97(td,J=8.1,6.3 Hz,1H),6.43-6.35(m,2H),5.21-5.13(m,1H),4.54(s,2H),4.16-4.07(m,1H),3.90-3.81(m,1H),2.23-2.00(m,4H)ppm。如下所述獲得其他批次:使用NaHCO3飽和水溶液、鹽水洗滌合併之乙醚相,藉由Na2SO4亁燥,傾析,並在減壓下濃縮。將油狀物真空蒸餾(約15托),收集101-108℃下之餾出物。在2℃下,向存於EtOH(1體積)中之蒸餾油狀物之攪
拌溶液中緩慢添加存於iPrOH中之5 M HCl(1當量)。使所得懸浮液達到室溫,使用EtOAc(3體積,vol/vol)稀釋,並攪拌2 hr。藉由過濾收集白色固體,使用EtOAc洗滌,並在減壓下乾燥以得到第二批HCl鹽形式之產物。將母液濃縮成漿液,使用EtOAc稀釋並藉由過濾收集固體,使用EtOAc洗滌,並在真空中亁燥以得到HCl鹽作為第三批產物。LCMS(C18管柱,經5分鐘使用10-90% CH3CN/水梯度洗脫,使用甲酸修飾劑)M+1:182.10(2.58 min)。1H NMR(300 MHz,CDCl3)δ 10.73(br.s,3H),7.66(d,J=8.1 Hz,1H),7.33(td,J=8.2,5.9 Hz,1H),7.13-7.05(m,1H),5.26(dd,J=9.0,6.5 Hz,1H),4.38-4.28(m,1H),4.00-3.91(m,1H),2.59-2.46(m,1H),2.30-1.95(m,3H)ppm。三批之總產率為76%。
4-溴-3-氟-2-四氫呋喃-2-基-苯胺(17)之製備。
向存於甲基第三丁基醚(1.456 L)及乙腈(485 mL)中且冷卻至-20℃之3-氟-2-四氫呋喃-2-基-苯胺(16)(131.9 g,92%,669.7 mmol)之攪拌溶液中分3份添加N-溴琥珀醯亞胺(120.4 g,99%,669.7 mmol,Aldrich B81255),同時將反應溫度維持於約-15℃以下。在完成添加之後,在-15℃至
-10℃下繼續攪拌30分鐘。經處理等分試樣之1H NMR展示96%之起始苯胺得以消耗,因此另外添加4.82 g NBS並在-10℃下再攪拌30分鐘。向反應混合物中添加1 N Na2S2O3水溶液(670 mL)。去除冷浴,將混合物攪拌20分鐘,然後使用EtOAc稀釋。分離各層且使用NaHCO3飽和水溶液(2x)、水、鹽水洗滌有機相,藉由Na2SO4亁燥,傾析,並在減壓下濃縮以得到暗琥珀色油狀物。使用己烷稀釋殘餘物並經由使用25% EtOAc/己烷至50% EtOAc/己烷洗脫之短二氧化矽塞進行洗脫。在真空中濃縮期望濾液以得到暗琥珀色油狀物17(182.9 g,產率為90%;86%之NMR純度)。LCMS(C18管柱,經5分鐘使用10-90% CH3CN/水梯度洗脫,使用甲酸修飾劑)M+1:260.12(3.20 min)。1H NMR(300 MHz,CDCl3)δ 7.15(dd,J=8.6,7.6 Hz,1H),6.30(dd,J=8.7,1.3 Hz,1H),5.19-5.12(m,1H),4.58(s,2H),4.16-4.07(m,1H),3.90-3.81(m,1H),2.23-1.99(m,4H)ppm。
N-(4-溴-3-氟-6-硝基-2-四氫呋喃-2-基-苯基)-2,2,2-三氟-乙醯胺(18)之製備。
經由加料漏斗在約20分鐘內(反應溫度升至13℃),向在
2℃下攪拌之三氟乙酸酐(565.3 mL,4.067 mol,Sigma-Aldrich 106232)中緩慢添加稠油狀物形式之純淨4-溴-3-氟-2-四氫呋喃-2-基-苯胺(17)(123.0 g,86%,406.7 mmol)。使用無水THF(35 mL)將剩餘油狀物沖洗至反應混合物中。去除冷浴且將反應液加熱至35℃,隨後經2.5 hr逐份添加NH4NO3(4.88 g×20份,1.22 mol,Sigma-Aldrich A7455),同時使用冰-水浴(僅根據需要,用以控制放熱)將反應溫度維持於30℃與41℃之間。完成添加後,將反應混合物再攪拌10分鐘(HPLC展示反應完成99%)。將其緩慢傾倒至碎冰(1.23 kg)中並攪拌1 hr以使得形成可過濾固體沈澱物,收集該可過濾固體沈澱物並使用水、少量飽和水溶液NaHCO3及水(再次)(至pH 7)洗滌。將產物在40℃下於對流烘箱中乾燥過夜且然後在50℃及減壓下於烘箱中乾燥過夜以得到灰棕色固體18(152.5 g,產率為90%;96%之HPLC純度)。LCMS(C18管柱,經5分鐘使用10-90% CH3CN/水梯度洗脫,使用甲酸修飾劑)M+1:401.30(3.41 min)。1H NMR(300 MHz,CDCl3)δ 10.56(s,1H),8.19(d,J=6.6 Hz,1H),5.22(dd,J=10.3,6.4 Hz,1H),4.22(dd,J=15.8,7.2 Hz,1H),3.99(dd,J=16.1,7.5 Hz,1H),2.50-2.38(m,1H),2.22-2.11(m,2H),1.86-1.71(m,1H)ppm。
4-溴-3-氟-6-硝基-2-四氫呋喃-2-基-苯胺(19)之製備。
向反應燒瓶中裝填N-(4-溴-3-氟-6-硝基-2-四氫呋喃-2-基-苯基)-2,2,2-三氟-乙醯胺(18)(242.3 g,604.1 mmol)、1,4-二噁烷(1.212 L)、2 M硫酸水溶液(362.4 mL,724.9 mmol),並在回流下攪拌5天(HPLC展示轉化98%)。冷卻,使用EtOAc稀釋,使用NaHCO3飽和水溶液中和,分離各層,並使用EtOAc(2×)再萃取水相。使用鹽水(2×)洗滌合併之有機相,藉由MgSO4乾燥,過濾並在真空中濃縮以得到綠褐色固體19(181.7 g,產率為94%;95%之HPLC純度)。產物未經進一步純化即用於下一步驟。LCMS(C18管柱,經5分鐘使用10-90% CH3CN/水梯度洗脫,使用甲酸修飾劑)M+1:305.20(3.63 min)。1H NMR(300 MHz,CDCl3)δ 8.35(d,J=7.3 Hz,1H),7.45(s,2H),5.23-5.16(m,1H),4.23-4.14(m,1H),3.93-3.84(m,1H),2.31-1.96(m,4H)ppm。
2-[5-(4-胺基-2-氟-5-硝基-3-四氫呋喃-2-基-苯基)嘧啶-2-基]丙-2-醇(20)之製備。
向4-溴-3-氟-6-硝基-2-四氫呋喃-2-基-苯胺(19)(525.0 g,1.721 mol,Bridge Organics Co.)於1,4-二噁烷(4.20 L,Sigma-Aldrich 360481)中之攪拌溶液中添加NaHCO3之1.2 M水溶液(4.302 L,5.163 mol)。將氮流鼓泡通過該攪拌混合物2 hr,隨後添加2-[5-(4,4,5,5-四甲基-1,3,2-二氧硼-2-基)嘧啶-2-基]丙-2-醇(7)(545.4 g,2.065 mol,Bridge Organics Co.)及1,1'-雙(二苯基膦基)二茂鐵二氯鈀二氯甲烷加合物(42.16 g,51.63 mmol,Strem 460450)。反應混合物在回流下攪拌過夜,冷卻,用EtOAc(8.4 L)稀釋,且分離各層。有機相用NH4Cl飽和水溶液洗,然後用鹽水洗。用EtOAc(4 L)再萃取水相,並用鹽水洗此有機萃取物。合併之有機相由MgSO4乾燥,經Florisil®短塞過濾,用EtOAc洗脫,並在旋轉蒸發器上濃縮濾液,得到暗褐色濕固體。將此固體溶於CH2Cl2中,裝載於矽膠墊上,用己烷、然後25% EtOAc/己烷、然後50% EtOAc/己烷洗脫。所欲濾液在旋轉蒸發器上濃縮成稠懸浮液,且藉由過濾收集固體,用MTBE研磨,並在真空中乾燥,得到亮黃色固體20(產率為55.8%,90-97%之HPLC純度)。濃縮濾液,且重複上述純化,得到第二批亮黃色固體20(產率為19.7%)。
再濃縮濾液,得到暗褐色油狀物,且將此暗褐色油狀物裝載於具有甲苯及極少CH2Cl2之二氧化矽管柱上。用EtOAc/己烷(0%至50%)洗脫。將所欲部分濃縮成漿液並用MTBE/己烷稀釋。藉由過濾收集固體,並用極少MTBE洗,得到第三批亮黃色固體20(產率為4.9%),三批之總產率為80%。LCMS(C18管柱,經5分鐘用10-90% CH3CN/水梯度洗脫,用甲酸修飾劑)M+1:363.48(2.95 min)。1H NMR(300 MHz,CDCl3)δ 8.84(d,J=1.6 Hz,2H),8.27(d,J=8.0 Hz,1H),7.62(s,2H),5.31-5.24(m,1H),4.63(s,1H),4.27-4.18(m,1H),3.97-3.87(m,1H),2.33-2.05(m,4H),1.64(s,6H)ppm。
2-[5-(4,5-二胺基-2-氟-3-四氫呋喃-2-基-苯基)嘧啶-2-基]丙-2-醇(21)之製備。
在氮下,將5%碳載鈀(14.21 g,50%濕潤,3.339 mmol,Aldrich 330116)置於帕爾瓶中,隨後添加MeOH(242 mL,JT-Baker 909333)及NEt3(46.54 mL,333.9 mmol,Sigma-Aldrich 471283)。將2-[5-(4-胺基-2-氟-5-硝基-3-四氫呋喃-
2-基-苯基)嘧啶-2-基]丙-2-醇(20)(121.0 g,333.9 mmol)溶於熱THF(360 mL)中,冷卻,添加至反應混合物中,並使用另一部分THF(124 mL)沖洗。將器皿置於帕爾振盪器上並使用H2使其達到飽和。添加45 psi H2並振盪直至完全消耗為止(HPLC及LCMS展示反應完成)。使用氮吹掃反應混合物,經由矽藻土TM過濾並使用EtOAc沖洗。經由紙(玻璃微纖維)再過濾並在真空中濃縮濾液。以相同規模重複反應三次以上且合併各批次以得到褐色固體21(447 g,產率為99%;93%之HPLC純度)。LCMS(C18管柱,經5分鐘使用10-90% CH3CN/水梯度洗脫,使用甲酸修飾劑)M+1:333.46(1.79 min)。1H NMR(300 MHz,CDCl3)δ 8.81(d,J=1.4 Hz,2H),6.69(d,J=7.3 Hz,1H),5.27-5.20(m,1H),4.73(s,1H),4.70(s,2H),4.23-4.14(m,1H),3.94-3.86(m,1H),3.22(s,2H),2.32-2.22(m,1H),2.18-1.99(m,3H),1.63(s,6H)ppm。
1-乙基-3-[6-氟-5-[2-(1-羥基-1-甲基-乙基)嘧啶-5-基]-7-四氫呋喃-2-基-1H-苯并咪唑-2-基]脲(22)之製備。
向2-[5-(4,5-二胺基-2-氟-3-四氫呋喃-2-基-苯基)嘧啶-2-基]丙-2-醇(21)(111.3 g,334.9 mmol)及1,4-二噁烷(556.5 mL,Sigma-Aldrich 360481)之攪拌懸浮液中依次添加1-乙基-3-(N-(乙基胺甲醯基)-C-甲基硫基-亞胺羰基)脲(10)(93.36 g,401.9 mmol,CB Research and Development))、pH 3.5緩衝劑(1.113 L)(藉由將NaOAc三水合物(158.1 g)溶於1N H2SO4水溶液(1.100 L)中製得)。將反應混合物在回流下攪拌過夜(HPLC展示轉化完全),冷卻至室溫,並逐份傾倒(起泡)至NaHCO3飽和水溶液(2.23 L)之攪拌溶液中以得到pH 8-9。將其攪拌30分鐘,藉由過濾收集固體,使用水充分洗滌至中性pH,且然後使用極少EtOH洗滌。在減壓下乾燥固體以得到灰白色/黃色固體22(135.2 g,產率為94%;99%之HPLC純度)。LCMS(C18管柱,經5分鐘使用10-90% CH3CN/水梯度洗脫,使用甲酸修飾劑)M+1:429.58(2.03 min)。1H NMR(300 MHz,MeOD)δ 8.95(d,J=1.6 Hz,2H),7.45(d,J=6.5 Hz,1H),5.38(br.s,1H),4.27(dd,J=14.9,7.1 Hz,1H),4.01(dd,J=15.1,7.0 Hz,1H),3.37-3.29(m,2H),2.55(br.s,1H),2.19-2.07(m,2H),2.02-1.82(br.s,1H),1.63(s,6H),1.21(t,J=7.2 Hz,3H)ppm。
(R)-1-乙基-3-(6-氟-5-(2-(2-羥基丙-2-基)嘧啶-5-基)-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-2-基)脲(23)之對掌性層析分離。
在使用DCM/MeOH/TEA(60/40/0.1)在25℃下洗脫之CHIRALPAK® IC®管柱(Chiral Technologies)上拆分1-乙基-3-[6-氟-5-[2-(1-羥基-1-甲基-乙基)嘧啶-5-基]-7-四氫呋喃-2-基-1H-苯并咪唑-2-基]脲(22)(133.60 g)之外消旋試樣以得到灰白色固體形式之期望對映異構體23(66.8 g,產率為45%;99.8%之HPLC純度,99+%之對映異構體過量)。分析型對掌性HPLC之滯留時間為7.7 min(CHIRALPAK® IC® 4.6×250 mm管柱,1 mL/min流速,30℃)。將固體懸浮於2:1 EtOH/Et2O(5體積)中,攪拌10分鐘,藉由過濾收集,使用2:1 EtOH/Et2O洗滌,並在減壓下乾燥以得到白色固體(60.6 g)。
藉由單晶x射線繞射分析證實23之結構及絕對立體化學。在配備有密封管Cu Kα源(Cu Kα放射,γ=1.54178 Å)及Apex II CCD檢測器之Bruker APEXII繞射儀上獲取單晶繞射數據。選擇尺寸為0.15×0.15×0.10 mm之晶體,使用礦物油清洗,安裝於MicroMount上並定中心於Bruker APEXII系統上。獲得在倒易空間中分離之3批40個框架以提供取向矩陣及初始晶胞參數。獲得最終晶胞參數並在完
成數據收集之後基於全資料集進行精修。基於系統消光及強度統計學,在離心P21空間群中拆分及精修結構。
使用0.5°步長以0.85 Å之解析度使用30 s暴露獲得各框架中倒易空間之繞射數據集合在100(2)K下收集數據。使用APEXII軟體對強度進行積分並精修晶胞參數在數據收集之後,觀察到晶體並未展示分解跡象。如圖1中所展示,在結構中存在兩個對稱獨立性分子且該兩個對稱獨立性分子皆係R異構體。
收集數據,使用Apex II軟體進行精修並簡化。使用SHELXS97(Sheldrick,1990)程式拆分結構且使用SHELXL97(Sheldrick,1997)程式精修結構。晶體展示具有P21空間群之單斜晶胞。晶格參數為a=9.9016(2)Å,b=10.9184(2)Å,c=19.2975(4)Å,β=102.826(1)°。體積=2034.19(7)Å3。
可自如反應圖1中所展示之化合物23根據下列實驗程序來製備前藥化合物X。
2-氰基乙基2-(5-(2-(3-乙基脲基)-6-氟-7-((R)-四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基2-(2-甲氧基乙氧基)乙基磷酸酯(30)之製備。
在23℃及N2下,向存於DCM(6 mL)中之DIPEA(366.3 mg,493.7 μL,2.834 mmol)之溶液中添加3-[氯-(二異丙基胺基)膦基]氧基丙腈(503.2 mg,474.3 μL,2.126 mmol),隨後添加2-(2-甲氧基乙氧基)乙醇(255.4 mg,252.9 μL,2.126 mmol)。在單獨燒瓶中,在N2下,使用四唑(存於MeCN中之0.45 M溶液,6.298 mL,2.834 mmol)處理存於DMF(6 mL)中之(R)-1-乙基-3-(6-氟-5-(2-(2-羥基丙-2-基)嘧啶-5-基)-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-2-基)脲(23)(607 mg,1.417 mmol)之懸浮液。在陳化10 min之後,經由注射器將亞磷醯胺溶液添加至(R)-1-乙基-3-(6-氟-5-(2-(2-羥基丙-2-基)嘧啶-5-基)-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-2-基)脲(23)及四唑之懸浮液中。將所得反應混合物攪拌3 h,之後將其冷卻至0℃,然後使用mCPBA(558.9 mg,
2.267 mmol)處理。將混合物在0℃下攪拌5 min然後在23℃下攪拌10 min,之後使用EtOAc(100 mL)稀釋粗製反應混合物並依次使用碳酸氫鈉飽和水溶液、10%亞硫酸氫鈉水溶液、碳酸氫鈉飽和水溶液及鹽水(各100 mL)洗滌,然後乾燥(硫酸鎂),過濾並在真空中濃縮。藉由MPLC使用ISCO COMBIFLASH品牌急驟層析純化系統(80 g二氧化矽管柱,存於DCM中之0-13% EtOH線性梯度,20個管柱體積,60 mL/min)純化殘餘物以得到澄清玻璃狀油狀物形式之2-氰基乙基2-(5-(2-(3-乙基脲基)-6-氟-7-((R)-四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基2-(2-甲氧基乙氧基)乙基磷酸酯(30)(734 mg,1.106 mmol,78.05%)。ESMS(M+1)=664.5;1H NMR展示一些峰因非對映異構體(立體磷酸酯)而加倍;1H NMR(300.0 MHz,CDCl3)δ 8.90(dd,J=1.1,4.9 Hz,2H),7.20-7.15(m,1H),5.31(s,1H),4.57-4.23(m,4H),4.16(br s,1H),3.92(dd,J=6.9,14.2 Hz,1H),3.79-3.74(m,2H),3.71-3.66(m,2H),3.58-3.53(m,2H),3.39(d,J=3.6 Hz,3H),3.33(br s,2H),3.04-2.85(m,2H),2.50-2.46(m,1H),2.04-1.80(m,9H)及1.20(t,J=6.9 Hz,3H)ppm。
(R)-2-(5-(2-(3-乙基脲基)-6-氟-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基2-(2-甲氧基乙氧基)乙基磷酸銨(X)之製備。
在23℃下,向存於MeOH(20 mL)中之2-氰基乙基2-(5-(2-(3-乙基脲基)-6-氟-7-((R)-四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基2-(2-甲氧基乙氧基)乙基磷酸酯(30)(734 mg,1.106 mmol)之溶液中添加氫氧化銨(430 μL,11.04 mmol)。在攪拌16小時之後,添加額外之氫氧化銨(1 mL)。再過4小時之後,在真空中濃縮反應混合物。將殘餘物溶於MeOH(7 mL)中並經由製備型HPLC(注入7次)使用Waters XBridge C18 5 μm OBD管柱(19×100 mm,使用具有0.1% NH4OH緩衝劑之10-90%水性MeCN梯度洗脫,15 min,20 mL/min流速)純化。彙集產物部分,冷凍並凍乾以得到白色固體形式之(R)-2-(5-(2-(3-乙基脲基)-6-氟-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基2-(2-甲氧基乙氧基)乙基磷酸銨(X)(443 mg,0.7010 mmol,63.38%)。ESMS(M+1)=611.5;1H NMR(300.0 MHz,CD3OD)δ 8.86(d,J=1.0 Hz,2H),7.30(d,J=6.3 Hz,1H),5.24(t,J=7.6 Hz,1H),4.23(dd,J=7.0,14.8,1H),4.13-4.05
(m,2H),3.94(dd,J=7.2,15.0 Hz,1H),3.72-3.64(m,4H),3.56-3.51(m,2H),3.35(s,3H),3.34-3.28(m,2H),2.52-2.42(m,1H),2.12-2.00(m,2H),1.90(d,J=1.6 Hz,6H),1.89-1.74(m,1H)及1.22(t,J=7.2 Hz,3H)ppm。C26H39FN7O8P之元素分析計算值(已針對4.73% w/w水進行校正,如藉由卡爾-費舍爾(Karl-Fischer)烘箱方法所測定):C,47.41;H,6.49;N,14.88;F,2.89;P,4.71。實驗值:C,47.71;H,6.27;N,14.08;F,2.93;P,5.15。
可自如反應圖1中所展示之化合物23根據下列實驗程序來製備前藥化合物Y。
2-氰基乙基[1-[5-[2-(乙基胺甲醯基胺基)-6-氟-7-[(2R)-四氫呋喃-2-基]-1H-苯并咪唑-5-基]嘧啶-2-基]-1-甲基-乙基]十六烷基磷酸酯(31)之製備。
在23℃及N2下,向存於DCM(6 mL)中之十六烷-1-醇(515.4 mg,2.126 mmol)及DIPEA(366.3 mg,493.7 μL,2.834 mmol)之溶液中添加3-[氯-(二異丙基胺基)膦基]氧基丙腈(503.2 mg,474.3 μL,2.126 mmol)。在單獨燒瓶中,在N2下,使用四唑(存於MeCN中之0.45 M溶液,6.298 mL,2.834 mmol)處理存於DMF(6 mL)中之(R)-1-乙基-3-(6-氟-5-(2-(2-羥基丙-2-基)嘧啶-5-基)-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-2-基)脲(23)(607 mg,1.417 mmol)之懸浮液。在陳化10 min之後,經由注射器將亞磷醯胺溶液添加至1-乙基-3-[6-氟-5-[2-(1-羥基-1-甲基-乙基)嘧啶-5-基]-7-[(2R)-四氫呋喃-2-基]-1H-苯并咪唑-2-基]脲(23)之懸浮液中。將所得反應混合物攪拌5小時,然後冷卻至0℃並使用mCPBA(558.9 mg,2.267 mmol)處理。將所得溶液在0℃下攪拌5 min,然後在23℃下攪拌30 min,之後使用EtOAc(100 mL)稀釋粗製反應混合物並依次使用碳酸氫鈉飽和水溶液及鹽水(各100 mL)洗滌,然後乾燥(硫酸鎂),過濾並
在真空中濃縮。藉由MPLC使用ISCO COMBIFLASH品牌急驟層析純化系統(40 g管柱,使用存於DCM中之0-8% EtOH線性梯度洗脫,24個管柱體積,40 mL/min流速)純化殘餘物以得到澄清玻璃狀油狀物形式之2-氰基乙基[1-[5-[2-(乙基胺甲醯基胺基)-6-氟-7-[(2R)-四氫呋喃-2-基]-1H-苯并咪唑-5-基]嘧啶-2-基]-1-甲基-乙基]十六烷基磷酸酯(31)(0.89 g,1.132 mmol,79.89%)。1H NMR展示一些峰因非對映異構體(立體磷酸酯)而加倍。ESMS(M+1)=786.6;1H NMR(300.0 MHz,CDCl3)δ 10.82(br s,1H),8.91(d,J=7.0 Hz,2H),7.18(dd,J=6.0,15.0 Hz,1H),5.31(br s,1H),4.60-4.55(m,1H),4.44-4.37(m,1H),4.16(td,J=13.3,6.7 Hz,3H),3.92(d,J=7.3 Hz,1H),3.34(d,J=4.8 Hz,2H),3.12-2.86(m,2H),2.57-2.46(m,1H),2.07-1.65(m,11H),1.45-1.12(m,31H)及0.89(t,J=6.0 Hz,3H)ppm。
(R)-2-(5-(2-(3-乙基脲基)-6-氟-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基十六烷基磷酸銨(Y)之製備。
在23℃下,向存於MeOH(40 mL)中之2-氰基乙基[1-[5-[2-(乙基胺甲醯基胺基)-6-氟-7-[(2R)-四氫呋喃-2-基]-1H-苯并咪唑-5-基]嘧啶-2-基]-1-甲基-乙基]十六烷基磷酸酯(31)(0.89 g,1.132 mmol)之溶液中添加氫氧化銨(2 mL,51.36 mmol)。在攪拌18小時之後,在真空中濃縮反應混合物。藉由MPLC使用ISCO COMBIFLASH品牌急驟層析純化系統(40 g二氧化矽管柱,使用存於DCM中之0-25%(2 M氨水,存於甲醇中)洗脫;線性梯度,24個管柱體積,40 mL/min流速)純化所得殘餘物。彙集產物部分並濃縮。將所得殘餘物溶1:1 MeCN:水(20 mL)中,冷凍並凍乾以得到白色固體形式之(R)-2-(5-(2-(3-乙基脲基)-6-氟-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基十六烷基磷酸銨(Y)(677 mg,0.8577 mmol,75.76%)。ESMS(M+1)=733.6;1H NMR(300.0 MHz,CD3OD)δ 8.90(d,J=1.4 Hz,2H),7.36(d,J=6.4 Hz,1H),5.29(t,J=7.6 Hz,
1H),4.24(dd,J=6.9,14.9 Hz,1H),4.00-3.86(m,3H),3.35-3.28(m,2H),2.50(dd,J=6.4,11.9 Hz,1H),2.13-2.03(m,2H),1.90(s,6H),1.84(dd,J=3.8,8.4 Hz,1H),1.62-1.53(m,2H),1.34-1.19(m,29H)及0.88(t,J=6.7 Hz,3H)ppm。C37H61FN7O6P之元素分析計算值(已針對3.16% w/w水進行校正,如藉由卡爾-費舍爾烘箱方法所測定):C,57.39;H,8.29;N,12.66;F,2.45;P,4.00。實驗值:C,57.15;H,8.19;N,12.27;F,2.50;P,4.39。
可自如反應圖1中所展示之化合物23根據下列實驗程序來製備前藥化合物Z。
2-氰基乙基[1-[5-[2-(乙基胺甲醯基胺基)-6-氟-7-[(2R)-四氫呋喃-2-基]-1H-苯并咪唑-5-基]嘧啶-2-基]-1-甲基-乙基]2-嗎啉基乙基磷酸酯(32)之製備。
在23℃及N2下,向存於DCM(6 mL)中之DIPEA(366.3 mg,493.7 μL,2.834 mmol)之溶液中添加3-[氯-(二異丙基胺基)膦基]氧丙腈(503.2 mg,474.3 μL,2.126 mmol),隨後添加2-嗎啉基乙醇(278.9 mg,257.5 μL,2.126 mmol)。在單獨燒瓶中,在N2下,使用四唑溶液(0.45 M,存於MeCN中,6.298 mL,2.834 mmol)處理存於DMF(6 mL)中之(R)-1-乙基-3-(6-氟-5-(2-(2-羥基丙-2-基)嘧啶-5-基)-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-2-基)脲(23)(607 mg,1.417 mmol)之懸浮液。在陳化10 min之後,經由注射器向懸浮液中添加亞磷醯胺溶液。將所得反應混合物攪拌5小時,之後將其冷卻至0℃,然後使用mCPBA(558.9 mg,2.267 mmol)處理。將所得溶液在0℃下攪拌15 min然後在23℃下攪拌30 min,之後使用EtOAc(100 mL)稀釋粗製反應混合物並依次使用碳酸氫鈉飽和水溶液及鹽水(各100 mL)洗滌,然後乾燥(硫酸鎂),過濾並在真空中濃縮。藉由MPLC使用ISCO COMBIFLASH品牌急驟層析純化系統(40
g二氧化矽管柱,使用存於DCM中之0-20% EtOH線性梯度洗脫,24 CV,40 mL/min)純化殘餘物以得到澄清玻璃狀油狀物形式之2-氰基乙基[1-[5-[2-(乙基胺甲醯基胺基)-6-氟-7-[(2R)-四氫呋喃-2-基]-1H-苯并咪唑-5-基]嘧啶-2-基]-1-甲基-乙基]2-嗎啉基乙基磷酸酯(32)(588 mg,0.8715 mmol,61.51%)。1H NMR展示一些峰因非對映異構體(立體磷酸酯)而加倍。ESMS(M+1)=675.5;1H NMR(300.0 MHz,CDCl3)δ 10.76(br s,1H),8.82(d,J=1.0 Hz,2H),7.12(dd,J=6.4,9.7 Hz,1H),5.22(br s,1H),4.50-4.02(m,5H),3.89-3.77(m,1H),3.65-3.61(m,4H),3.24(br s,1H),2.96-2.75(m,2H),2.63(t,J=6.0 Hz,2H),2.48-2.40(m,5H),1.95-1.60(m,10H)及1.11(t,J=6.0 Hz,3H)ppm。
2-(5-(2-(3-乙基脲基)-6-氟-7-((R)-四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基2-嗎啉基乙基磷酸氫酯(Z)之製備。
在23℃下,向存於MeOH(25 mL)中之2-氰基乙基[1-[5-[2-(乙基胺甲醯基胺基)-6-氟-7-[(2R)-四氫呋喃-2-基]-1H-苯并咪唑-5-基]嘧啶-2-基]-1-甲基-乙基]2-嗎啉基乙基磷酸酯(32)(588 mg,0.8715 mmol)之溶液中添加氫氧化銨(1 mL,25.68 mmol)。在攪拌18小時之後,在真空中濃縮反應混合物。將所得殘餘物溶於MeOH(7 mL)中並經由製備型HPLC(注入7次)使用Waters XBridge C18 5 μm OBD管柱(19×100 mm,使用具有0.1% NH4OH之10-90%水性MeCN梯度洗脫,15 min,20 mL/min流速)純化。彙集產物部分,冷凍並凍乾以得到白色固體形式之2-(5-(2-(3-乙基脲基)-6-氟-7-((R)-四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基2-嗎啉基乙基磷酸氫酯(Z)(400 mg,0.5998 mmol,68.83%)。ESMS(M+1)=622.2;1H NMR(300.0 MHz,CD3OD)δ 8.96-8.91(m,2H),7.44(d,J=6.5 Hz,1H),5.41-5.36(m,1H),4.31-4.24(m,3H),4.00(dd,J=7.0,15.0 Hz,1H),3.87(br s,4H),3.37-3.26(m,4H),2.60-2.47(m,1H),2.14(dd,J=6.6,14.6 Hz,2H),1.91(s,6H)及1.21(t,J=7.2 Hz,3H)ppm。C27H37FN7O7P之元素分析計算值(已針對5.28% w/w水進行校正,如藉由卡爾-費舍爾烘箱方法所測定):C,49.42;H,6.27;N,14.94;F,2.90;P,4.72。實驗值:C,48.87;H,6.16;N,14.98;F,2.78;P,5.05。
在下文所闡述之實驗中測定所選本發明化合物之酶抑制活性:
藉由使ADP之產生(經由丙酮酸激酶/乳酸脫氫酶)與NADH之氧化偶合來量測金黃色葡萄球菌DNA旋轉酶之ATP水解活性。先前已闡述此方法(Tamura及Gellert,1990,J.Biol.Chem.,265,21342)。
在30℃下於含有100 mM TRIS pH 7.6、1.5 mM MgCl2、150 mM KCl之緩衝溶液中實施ATPase分析。偶合系統含有(最終濃度)2.5 mM磷酸烯醇-丙酮酸酯、200 μM菸醯胺腺嘌呤二核苷酸(NADH)、1 mM DTT、30 μg/ml丙酮酸激酶及10 μg/ml乳酸脫氫酶。添加酶(90 nM之最終濃度)及所選化合物之DMSO溶液(3%之最終濃度)。將反應混合物在30℃下培育10分鐘。藉由添加ATP至最終濃度為0.9 mM來開始反應,且在340奈米下於10分鐘過程中監測NADH之消失速率。自速率對濃度特徵曲線測定Ki值。
發現所選本發明化合物可抑制金黃色葡萄球菌DNA旋轉酶。表1展示該等化合物在金黃色葡萄球菌DNA旋轉酶抑制分析中之抑制活性。
使ATP至ADP之轉化(藉由金黃色葡萄球菌TopoIV酶)與NADH至NAD+之轉化偶合,且藉由340 nm下之吸光度變
化量測反應之進展。將TopoIV(64 nM)與所選化合物(最終3%之DMSO)在30℃下於緩衝液中一起培育10分鐘。緩衝劑液由以下部分組成:100 mM Tris 7.5、1.5 mM MgCl2、200 mM麩胺酸鉀、2.5 mM磷酸烯醇丙酮酸酯、0.2 mM NADH、1 mM DTT、5 μg/mL線性化DNA、50 μg/mL BSA、30 μg/mL丙酮酸激酶及10 μg/mL乳酸脫氫酶(LDH)。使用ATP開始反應,且在30℃下於20分鐘內在Molecular Devices SpectraMAX板讀數儀上連續監測速率。自速率對所選化合物之濃度之繪圖(擬合至用於緊密結合抑制劑之莫裏森等式(Morrison Equation))測定抑制常數Ki。
發現所選本發明化合物可抑制金黃色葡萄球菌DNA Topo IV。表2展示該等化合物在金黃色葡萄球菌DNA旋轉酶抑制分析中之抑制活性。
根據下列程序測定化合物23、X、Y及Z水溶性。
試樣製備. 如下所述來製備各化合物之水性試樣。將化合物稱重(20-30 mg化合物)至4 ml澄清小瓶中,然後添加水(0.5 mL)並藉由磁力攪拌器攪拌。向懸浮液中添加1.0 N HCl以將pH調節至期望範圍。在室溫下攪拌96小時之後,
經由0.22微米過濾器(Millipore,Ultrafree離心過濾器,Durapore PVDF,0.22 μm,編號:UFC30GVNB)過濾懸浮液。收集濾液並使用pH計量測pH。將含有化合物X及Z之濾液分別稀釋100倍及400倍以提供用於HPLC分析之適當濃度。含有化合物23及Y之濾液無需稀釋。
標準溶液之製備. 根據下列程序製備各化合物之標準溶液。將1 mg至2 mg各化合物精確稱重至10 mL容量瓶中且添加水(對於化合物X及Z而言)、甲醇(對於化合物Y而言)或1:1甲醇:0.1 N HCl(對於化合物23而言)以完全溶解化合物。對化合物23實施超音波處理以有助於其溶於1:1甲醇:0.1 N HCl中。在所有固體皆溶解後,添加額外溶劑以將各溶液之體積調節至10 ml。充分混合所得溶液以得到各化合物之標準溶液。然後使用溶劑將各標準溶液稀釋2倍、10倍及100倍。
溶解度分析. 藉由HPLC分析(Agilent 1100,注入體積為10 μL,波長為271 nm,管柱為5 μm XTerra® Phenyl,4.6×50 mm,部件編號:186001144,固定相:A:於水中之0.1% TFA,於AcN中之0.1% TFA)分析各試樣及各標準溶液之等分試樣。將各標準溶液注入三次,且將各試樣注入兩次。藉由對來自HPLC之峰面積平均值對標準溶液之濃度繪圖來獲得標準曲線(其中基於如藉由元素分析所測定之固體之總水含量來對標準之重量進行適當校正)。自來自HPLC結果之水性試樣之峰面積及標準曲線之斜率及截距來計算各試樣的濃度。自試樣濃度與試樣稀釋因子之
乘積來衍生下表3中所列示之溶解度值。
圖1係化合物23之兩個對稱獨立性分子之熱橢圓體繪圖。
Claims (20)
- 一種式(I)化合物,
- 如請求項1之化合物,其中X係-PO(O-M+)O-R1;M+係選 自由以下組成之群:Li+、Na+、K+、N-甲基-D-葡萄糖胺及N(R9)4 +。
- 如請求項1或2之化合物,其中R1係(C1-C20)-烷基、(C2-C20)-烯基或-O(CH2CH2O)nCH3,其中n為整數1、2或3;嗎啉基乙基、4-乙基四氫-2H-吡喃基、六氫吡啶基乙基、六氫吡嗪基乙基或吡咯啶基乙基。
- 如請求項3之化合物,其中R1係嗎啉基乙基、4-乙基四氫-2H-吡喃基、六氫吡啶基乙基、六氫吡嗪基乙基或吡咯啶基乙基。
- 如請求項3之化合物,其中R1係(C1-C20)-烷基。
- 如請求項3之化合物,其中R1係-O(CH2CH2O)nCH3,其中n為整數1、2或3。
- 如請求項1之化合物,其中該化合物係(R)-2-(5-(2-(3-乙基脲基)-6-氟-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基2-(2-甲氧基乙氧基)乙基磷酸氫酯。
- 如請求項1之化合物,其中該化合物係(R)-2-(5-(2-(3-乙基脲基)-6-氟-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基2-(2-甲氧基乙氧基)乙基磷酸銨。
- 如請求項1之化合物,其中該化合物係(R)-2-(5-(2-(3-乙基脲基)-6-氟-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基十六烷基磷酸氫酯。
- 如請求項1之化合物,其中該化合物係(R)-2-(5-(2-(3-乙基脲基)-6-氟-7-(四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基十六烷基磷酸銨。
- 如請求項1之化合物,其中該化合物係2-(5-(2-(3-乙基脲基)-6-氟-7-((R)-四氫呋喃-2-基)-1H-苯并[d]咪唑-5-基)嘧啶-2-基)丙-2-基2-嗎啉基乙基磷酸氫酯。
- 一種醫藥組合物,其包括如請求項1至11中任一項之化合物或其醫藥上可接受之鹽及醫藥上可接受之載劑、佐劑或媒劑。
- 如請求項12之醫藥組合物,其進一步包括選自以下之第二治療劑:抗生素、抗炎劑、基質金屬蛋白酶抑制劑、脂氧合酶抑制劑、細胞因子拮抗劑、免疫阻抑劑、抗癌劑、抗病毒劑、細胞因子、生長因子、免疫調節劑、前列腺素或抗血管過度增殖化合物。
- 如請求項12之醫藥組合物,其進一步包括增加細菌生物體對抗生素敏感性之藥劑。
- 一種降低或抑制生物試樣中以下細菌數量之方法:肺炎鏈球菌(Streptococcus pneumoniae)、表皮葡萄球菌(Staphylococcus epidermidis)、糞腸球菌(Enterococcus faecalis)、屎腸球菌(Enterococcus faecium)、金黃色葡萄球菌(Staphylococcus aureus)、困難梭菌(Clostridium difficile)、黏膜炎莫拉菌(Moraxella catarrhalis)、淋病奈瑟球菌(Neisseria gonorrhoeae)、腦膜炎奈瑟球菌(Neisseria meningitidis)、結核分枝桿菌(Mycobacterium tuberculosis)、禽型複合分枝桿菌(Mycobacterium avium complex)、膿腫分枝桿菌(Mycobacterium abscessus)、堪薩斯分枝桿菌(Mycobacterium kansasii)、潰瘍分枝桿菌 (Mycobacterium ulcerans)、肺炎披衣菌(Chlamydophila pneumoniae)、沙眼披衣菌(Chlamydia trachomatis)、流感嗜血桿菌(Haemophilus influenzae)、釀膿鏈球菌(Streptococcus pyogenes)或β-溶血性鏈球菌(β-haemolytic streptococci),其包括使該生物試樣與如請求項1之化合物或其醫藥上可接受之鹽接觸。
- 一種如請求項1之化合物或其醫藥上可接受之鹽之用途,其用以製造用於控制、治療或減小患者之院內或非院內細菌感染之發展、嚴重性或效應之藥劑。
- 如請求項16之用途,其中該細菌感染之特徵在於存在以下一或多者:肺炎鏈球菌、表皮葡萄球菌、糞腸球菌、屎腸球菌、金黃色葡萄球菌、困難梭菌、黏膜炎莫拉菌、淋病奈瑟球菌、腦膜炎奈瑟球菌、結核分枝桿菌、禽型複合分枝桿菌、膿腫分枝桿菌、堪薩斯分枝桿菌、潰瘍分枝桿菌、肺炎披衣菌、沙眼披衣菌、流感嗜血桿菌、釀膿鏈球菌或β-溶血性鏈球菌。
- 如請求項17之用途,其中該細菌感染係選自下列之一或多者:上呼吸道感染、下呼吸道感染、耳感染、胸膜肺及支氣管感染、複雜性泌尿道感染、非複雜性泌尿道感染、腹內感染、心血管感染、血流感染、敗血病、菌血症、CNS感染、皮膚及軟組織感染、GI感染、骨及關節感染、生殖器感染、眼感染、或肉芽腫感染、非複雜性皮膚及皮膚結構感染、複雜性皮膚及皮膚結構感染(cSSSI)、導管感染、咽炎、竇炎、外耳炎、中耳炎、支 氣管炎、膿胸、肺炎、社區獲得性肺炎(CAP)、醫院獲得性肺炎、醫院細菌肺炎、糖尿病足感染、萬古黴素(vancomycin)抗性腸球菌感染、膀胱炎及腎盂腎炎、腎結石、前列腺炎、腹膜炎及其他腹內感染、透析相關腹膜炎、內臟膿腫、心內膜炎、心肌炎、心包炎、輸血相關敗血病、腦膜炎、腦炎、腦膿腫、骨髓炎、關節炎、生殖器潰瘍、尿道炎、陰道炎、子宮頸炎、齒齦炎、結膜炎、角膜炎、眼內炎、囊性纖維化患者之感染,或發熱性嗜中性白血球過低患者之感染。
- 如請求項18之用途,其中該細菌感染係選自下列之一或多者:社區獲得性肺炎(CAP)、醫院獲得性肺炎、醫院細菌肺炎、菌血症、糖尿病足感染、導管感染、非複雜性皮膚及皮膚結構感染、複雜性皮膚及皮膚結構感染(cSSSI)、萬古黴素抗性腸球菌感染或骨髓炎。
- 如請求項16之用途,其中該藥劑係與以下組合使用:抗生素、抗炎劑、基質金屬蛋白酶抑制劑、脂氧合酶抑制劑、細胞因子拮抗劑、免疫阻抑劑、抗癌劑、抗病毒劑、細胞因子、生長因子、免疫調節劑、前列腺素或抗血管過度增殖化合物,作為與該藥劑一起之多元劑型之一部分,或作為各別劑型。
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JP5977344B2 (ja) | 2011-06-20 | 2016-08-24 | バーテックス ファーマシューティカルズ インコーポレイテッドVertex Pharmaceuticals Incorporated | ジャイレースおよびトポイソメラーゼ阻害剤のリン酸エステル |
EP2828257B1 (en) | 2012-03-22 | 2017-07-26 | Biota Europe Ltd | Antibacterial compounds |
WO2014014845A1 (en) * | 2012-07-18 | 2014-01-23 | Vertex Pharmaceuticals Incorporated | Combination therapy comprising|1 -ethyl-3-[5-[2-{1 -hydroxy-1 -methyl-ethyl}pyrimidin-5-yl]-7-(tetra hydrofuran-2-|yl}-1 h-benzimidazol-2-yl]urea and derivatives thereof to treat mycobacterium|diseases |
AR093226A1 (es) * | 2012-07-18 | 2015-05-27 | Vertex Pharma | Formas solidas de dihidrogeno fosfato de (r)-2-(5-(2-(3-etilureido)-6-fluoro-7-(tetrahidrofuran-2-il)-1h-benzo[d]imidazol-5-il)pirimidin-2-il)propan-2-ilo y sus sales |
-
2012
- 2012-06-20 JP JP2014517110A patent/JP5977344B2/ja active Active
- 2012-06-20 CN CN201280036458.1A patent/CN103702994B/zh active Active
- 2012-06-20 KR KR1020147001427A patent/KR101941420B1/ko active IP Right Grant
- 2012-06-20 EP EP12731853.3A patent/EP2721026B1/en active Active
- 2012-06-20 TW TW101122096A patent/TWI554515B/zh active
- 2012-06-20 ES ES12731853.3T patent/ES2576298T3/es active Active
- 2012-06-20 WO PCT/US2012/043266 patent/WO2012177707A1/en active Application Filing
- 2012-06-20 US US13/527,832 patent/US9125922B2/en active Active
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2014
- 2014-07-30 HK HK14107773.2A patent/HK1194365A1/zh unknown
Also Published As
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US9125922B2 (en) | 2015-09-08 |
KR20140041768A (ko) | 2014-04-04 |
ES2576298T3 (es) | 2016-07-06 |
EP2721026B1 (en) | 2016-03-02 |
TWI554515B (zh) | 2016-10-21 |
JP5977344B2 (ja) | 2016-08-24 |
JP2014520152A (ja) | 2014-08-21 |
CN103702994A (zh) | 2014-04-02 |
KR101941420B1 (ko) | 2019-01-23 |
WO2012177707A1 (en) | 2012-12-27 |
EP2721026A1 (en) | 2014-04-23 |
US20130157979A1 (en) | 2013-06-20 |
CN103702994B (zh) | 2016-03-23 |
HK1194365A1 (zh) | 2014-10-17 |
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