TWI705815B - 用於治療補體相關疾病之組合物及治療方法 - Google Patents
用於治療補體相關疾病之組合物及治療方法 Download PDFInfo
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- TWI705815B TWI705815B TW105107682A TW105107682A TWI705815B TW I705815 B TWI705815 B TW I705815B TW 105107682 A TW105107682 A TW 105107682A TW 105107682 A TW105107682 A TW 105107682A TW I705815 B TWI705815 B TW I705815B
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- complement
- dimethoxy
- dihydroquinazolin
- compound
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Abstract
本發明包括調節哺乳動物中之補體級聯反應的方法以及治療及/或預防與補體途徑相關之疾病及病症的方法,該等方法藉由投與諸如2-(4-(2-羥基乙氧基)-3,5-二甲基苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮之式I或式II化合物或其醫藥學上可接受之鹽來達成。
Description
本申請案主張2015年3月13日申請之美國臨時專利申請案第62/132,572號及2015年12月8日申請之美國臨時專利申請案第62/264,768號之優先權,該等專利申請案特此以全文引用之方式併入。
本發明係關於藉由向有需要之個體投與式I或式II化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物來治療或預防補體相關疾病或病症的方法。揭示用於調節補體系統以治療或預防與補體系統活性異常相關之疾病或病症的治療策略。
式I化合物及彼等化合物之製備方法先前已描述於以引用之方式併入本文中之美國專利8,053,440中。式I化合物包括:
及其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物,其中:R1及R3各獨立地選自烷氧基、烷基、胺基、鹵素及氫;
R2選自烷氧基、烷基、烯基、炔基、醯胺、胺基、鹵素及氫;R5及R7各獨立地選自烷基、烷氧基、胺基、鹵素及氫;R6選自胺基、醯胺、烷基、氫、羥基、哌嗪基及烷氧基;且W為CH或N。
在一些實施例中,當R6選自烷氧基時,其視情況經一或多個選自以下之基團取代:醯胺、胺、芳基、苯甲氧基、胺基甲酸酯、羧基、雜環基、羥基、甲氧基及磺醯胺。
式II化合物及彼等化合物之製備方法先前已描述於以引用之方式併入本文中之美國專利第8,569,288號及PCT公開案第WO2010/049466號中。式II化合物包括:
及其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物,其中:RA及RB獨立地選自氫、甲基、-(CH2)nRF、-(CH2)nORF及-CH2C(O)ORG;RC選自氫、對位鹵素及連接至苯基環之鄰位及間位或連接至間位及對位的-OCH2O-或-OCH2CH2O-;RD及RE獨立地選自氫及甲基;RF選自甲基、乙基及-CH2CH2OCH3;RG選自甲基、乙基、正丙基、異丙基、正丁基及第三丁基;且
n選自1、2、3及4。
人類免疫系統之主要功能為宿主防禦。此系統將包括組織、細胞及分子之本地產生之實體與稱為病原體之外來實體區別開,且將此等潛在有害分子及細胞自身體內消除。另外,免疫系統具有識別並移除源自宿主組織之異常細胞的能力。由免疫系統識別為外來實體之分子稱為抗原。免疫系統由兩種反應組成,先天性反應及適應性反應。若干分子組分(諸如補體蛋白、細胞因子及急性期蛋白)在先天性與適應性免疫反應兩者中起作用。
適應性免疫稱為抗原特異性免疫反應。其經由一系列產生抗體或細胞介導反應之識別及加工事件來起作用。兩種主要類別之淋巴細胞(白血球)(T細胞及B細胞)參與適應性免疫。此等淋巴細胞上之大量抗原特異性受體對外來抗原之識別使得能夠特異性鑑別並消除病原體。此過程可耗時若干天或若干週來開展,但適應性免疫反應使用免疫記憶以在後續暴露於特異性抗原後引起更強、更快的反應。
相比之下,先天免疫係指在識別為外來之實體引入身體之後即刻激活的非特異性免疫反應。先天免疫反應為不可適應的且在個體之壽命過程中不變。先天免疫反應之組分(包括單核細胞、嗜中性粒細胞、嗜酸性粒細胞、嗜鹼性粒細胞及自然殺傷細胞)在血液中循環且容易地活化並定位於免疫突破位點。
補體系統含有當放在一起時為先天免疫反應之主要部分的嚴格調控之蛋白質的網路。補體系統表示先天免疫反應之主要效應機理中之一者,且包含超過30種血液可溶性或膜相關性蛋白質。血漿中此等蛋白質之濃度總計超過3g/公升。Walport(2001)「Complement First of two parts.」N Engl J Med 344(14):1058-1066。
大多數補體蛋白以前蛋白形式循環且補體系統保持非活性直至被觸發。補體蛋白系列在藉由識別病原體之表面上的抗原-抗體複合物或
簡單地抗原來觸發之蛋白水解級聯反應中之一個層級加以組織。抗體為在適應性免疫反應中由B細胞產生以使得能夠更快識別已知抗原之血清蛋白。因此,若再引入同樣的抗原,則循環抗體可容易地用於結合抗原且產生隨後由T細胞或補體系統識別之抗原-抗體複合物。
補體系統之激活涉及酶原蛋白(非活性酶解蛋白),其隨後由一系列蛋白酶裂解並激活。補體激活已知經由三種主要途徑發生:經典、替代及凝集素。雖然多種因素可起始補體激活,但三種主要途徑均聚焦於血液中最豐富的補體蛋白C3的裂解。Dunkelberger及Song(2010)「Complement and its role in innate and adaptive immune responses」Cell Res 20(1):34-50。
經典途徑之起始係經由由呈與C1r及C1s之複合物(C1複合物)形式之補體蛋白C1q識別外來細胞表面上之抗原-抗體(免疫)複合物而觸發。Sarma及Ward(2011)「The complement system」Cell Tissue Res 343(1):227-235。C1複合物與免疫複合物之相互作用引起兩種C1相關蛋白酶(C1r及C1s)之自動催化激活。C1複合物之其他激活刺激物包括來自外來細胞之脂多醣、聚陰離子、RNA及DNA。激活之C1s將C2及C4裂解成更大(C4b及C2a)及更小(C4a及C2b)片段。Dunkelberger及Song(2010)。C4b及C2a片段隨後結合於外來細胞之由免疫系統攻擊之細胞膜。所得C4bC2a複合物充當C3轉化酶。經由包括C3、C5之補體蛋白的依序裂解及新因子之招募,在細胞膜上發生蛋白水解補體級聯反應之放大,直至形成含有C5b、C6、C7及C8之細胞表面複合物。多個C9蛋白質再累積至C5b至C8複合物上產生膜攻擊複合物(MAC),此導致形成跨越外來細胞之膜的孔隙,從而引起細胞溶解。
與經典途徑相比,凝集素誘導之補體途徑以類似但非免疫複合物依賴性方式起作用。Dunkelberger及Song(2010)。其激活經由甘露糖結合凝集素(MBL)或纖維膠凝蛋白(ficolin)結合於外來細胞表面上之碳
水化合物而發生。Sarma及Ward(2011)。MBL為急性期血清蛋白且以與MBL相關蛋白酶(MASP)-1、-2及-3之複合物形式循環於血清中。Dunkelberger及Song(2010)。MBL結合於外來細胞之表面激活MASP1及MASP2,其隨後觸發C2及C4之裂解,從而引起C4b及C2a片段之產生及C3轉化酶C4bC2a之形成。MASP1及MASP2在結構上類似且以類似於經典補體途徑中之C1蛋白酶的方式起作用。凝集素誘導之途徑然後以類似於經典途徑之方式放大。招募並激活剩餘補體蛋白(C3至C9),從而引起溶解外來細胞之MAC的組裝。
替代途徑(AP)不需要觸發抗原-抗體複合物。除在經典及凝集素誘導之途徑中容易地起作用之補體蛋白(C3至C9)之外,稱為因子(因子B、因子D、因子H、因子I)之循環血清蛋白亦在AP之激活及調控中起作用。
AP在C3低水準自發轉化為活性蛋白酶C3b之情況下起始。Sarma及Ward(2011)。招募循環因子B且藉由循環因子D裂解以產生活性蛋白酶C3轉化酶。此酶裂解C3以形成C3b(AP特異性C3轉化酶),其因血漿備解素(一種由激活之嗜中性粒細胞釋放之蛋白質)之存在而穩定。C3b以類似於經典及凝集素誘導之C3轉化酶C4bC2a之方式起作用。Dunkelberger及Song(2010)。替代途徑然後以類似於經典途徑之方式放大,招募其他補體蛋白(C6、C7、C8及C9),從而引起膜攻擊複合物之形成及細胞溶解。在不存在抗體目標反應之情況下,恆定低水準C3b形成確保C3b可結合於侵入之細胞,從而觸發細胞溶解。因子H及因子I經由其使C3b失活之能力充當替代途徑之調控劑。血漿備解素之招募在C3b為膜結合時保護C3b,且因此替代途徑僅在外來細胞之表面上具活性且在血漿中不持續具活性。
由嗜中性粒細胞及巨噬細胞釋放之其他蛋白酶(包括激肽釋放酶、纖溶酶及因子XIIa)產生補體激活產物。舉例而言,激肽釋放酶可
替代AP中之因子D及裂解因子B。DiScipio(1982)「The activation of the alternative pathway C3 convertase by human plasma kallikrein」Immunology 45(3):587-595。此等途徑稱為非C3依賴性途徑。
補體與凝血系統均為蛋白水解級聯反應。此等級聯反應之元素具有多個在結構上共同的特徵。Markiewski等人(2007)「Complement and coagulation:strangers or partners in crime?」Trends Immunol 28(4):184-192。補體系統之激活係由與炎症相同之刺激誘導,且一般而言,此等反應與血液凝固增加有關。Esmon(2004)「The impact of the inflammatory response on coagulation」Thromb Res 114(5-6):321-327。脈管系統損傷引起凝血激活且與感染危險增加有關,且因此觸發後續發炎反應。Keel及Trentz(2005)「Pathophysiology of polytrauma」Injury 36(6):691-709。因此,補體與凝血級聯反應之激活係並行觸發。Markiewski等人(2007)。包括C5a及MASP之補體蛋白已知放大凝血級聯反應且分別抑製經由誘導之組織因子及纖溶酶原活化抑制劑1之表現進行的纖維蛋白溶解(血凝塊之主要蛋白組分聚合纖維蛋白之斷裂)及由凝血酶原形成凝血酶(藉由促進纖維蛋白原轉化為纖維蛋白而起作用之凝血酶原的活性形式)。Ricklin等人(2010)「Complement:a key system for immune surveillance and homeostasis」Nat Immunol 11(9):785-797。
補體蛋白C3及C5為蛋白水解裂解成a-片段及b-片段之大蛋白質。Ogata等人(1989)「Sequence of the gene for murine complement component C4」J Biol Chem 264(28):16565-16572。存在若干起作用調控補體活性之機制。血漿羧肽酶裂解C3a與C5a,從而顯著降低其生物活性,蛋白酶因子I及H在C3b及C4b之裂解中起作用,且C1抑制劑使C1受體及MASP2失活。Sarma及Ward(2011)。
補體在起始免疫反應方面之活性使其成為免疫逃避之目標及許多
疾病狀態之貢獻者。Ricklin及Lambris(2007)「Complement-targeted therapeutics」Nat Biotechnol 25(11):1265-1275。過度補體活性與若干炎性、自體免疫、神經退行性及感染性疾病有關。Ricklin及Lambris(2007)。此類疾病之病變中涉及補體可為不適當起始補體級聯反應或缺乏各種途徑之特定因子或調控劑的結果。Ricklin及Lambris(2007)。
近年來年齡相關性黃斑變性(AMD)已顯現為與補體系統密切相關,因為在視網膜下脂蛋白沈積中鑑別到補體沈積。Anderson等人(2010)「The pivotal role of the complement system in aging and age-related macular degeneration:hypothesis re-visited」Prog Retin Eye Res 29(2):95-112。全基因組關聯研究(GWAS)表明因子H基因之多形性為AMD之主要危險因素。Klein等人(2005)「Complement factor H polymorphism in age-related macular degeneration」Science 308(5720):385-389。基因決定之因子H蛋白質功能障礙可導致替代補體途徑之不受控制的激活及/或調控。Gehrs等人(2010)「Complement,age-related macular degeneration and a vision of the future」Arch Ophthalmol 128(3):349-358。此外,已識別C3及因子B基因之基因變異體,其產物在視網膜下組織內替代補體途徑之激活及調控中起作用。Gehrs等人(2010)。AMD之確切發病機理尚未完全瞭解,然而,組織損傷之循環、細胞碎屑之累積、補體及炎症之慢性激活似乎為疾病狀態之主要貢獻者。Anderson等人(2010)。遺傳性血管性水腫(HAE)係由功能性C1酯酶抑制劑(C1INH,一種防止補體系統自發激活之補體蛋白)之缺乏引起的。功能性C1INH之缺乏引起緩激肽過量產生及無秩序之C4及C2裂解,此引起補體系統之自動活化。已顯示重組人類C1INH有效改良重複HAE發作之症狀(Li等人2015)。
過敏性氣喘為與補體激活有關之慢性發炎性疾病。Zhang及Kohl(2010)「A complex role for complement in allergic asthma」Expert Rev Clin Immunol 6(2):269-277。在該疾病狀態之動物模型中,經由靶向C3及C5之Crry基因(一種已知的小鼠膜補體抑制劑)抑制補體激活降低過敏性氣喘表型。Walters等人(2002)「Complement factor 3 mediates particulate matter-induced airway hyperresponsiveness」Am J Respir Cell Mol Biol 27(4):413-418;Peng等人(2005)「Role of C5 in the development of airway inflammation,airway hyperresponsiveness,and ongoing airway response」J Clin Invest 115(6):1590-1600。證據表明補體激活與過敏性氣喘之發病機理之間密切相關。
有強有力的證據表明經典與替代補體途徑均在類風濕性關節炎(RA)期間以及RA動物模型中病理激活。Okroj等人(2007)「Rheumatoid arthritis and the complement system」Ann Med 39(7):517-530。在DBA/1J(淺棕褐色非野鼠色)小鼠(RA小鼠模型)中,C3、C5或因子B之基因失活顯示小鼠對膠原蛋白誘導之關節炎產生抗性。Wang等人(2000)「A role for complement in antibody-mediated inflammation:C5-deficient DBA/1 mice are resistant to collagen-induced arthritis」J Immunol 164(8):4340-4347。此外,C3敲出小鼠以及因子B敲出小鼠關節炎(小鼠中之膠原蛋白誘導之關節炎)之產生具高度抗性。Hietala等人(2002)「Complement deficiency ameliorates collagen-induced arthritis in mice」J Immunol 169(1):454-459。證據表明補體激活與RA之發病機理之間密切相關。
包括因子H、C3、因子B及因子I之替代途徑組分的缺乏及多形性可引起過度補體激活之誘導,從而導致兩種嚴重腎臟疾病。Noris及Remuzzi(2009)「Atypical hemolytic-uremic syndrome」N Engl J Med 361(17):1676-1687。非典型性溶血性尿毒症症候群(aHUS)與膜增生性腎小球性腎炎均由補體系統不能中和或穩定C3轉化酶而引起。Ricklin等人(2010)。該兩種疾病可導致溶血性貧血、血小板減少及急性腎衰
竭。Sarma及Ward(2011)。
IgA腎病(IgAN)之特徵在於聚合IgA1及C3之腎小球系膜累積加可變IgG及/或IgM共沈積。先前研究已表明補體蛋白對動物模型及人類疾病中IgAN之開始及進展而言為重要的。Suzuki等人(2014)「Development of animal models of human IgA nephropathy」Drug Discov Today Dis Models 11:5-11。因此,調節補體級聯反應及其組分可預防或治療IgAN。
有證據表明補體因子H相關蛋白5(CFHR5)防止補體調控異常。CFHR5腎病為一種具有常染色體顯性遺傳之C3腎小球病類型且與單一基因異常有關,從而引起CFHR5基因之內部複製。與野生型蛋白質相比,突變體CFHR5蛋白質更不有效地結合於膜相關C3b,從而引起補體系統之調控異常。Skerka等人(2013)「Complement factor H related proteins(CFHRs)」Mol Immunol 56:170-180。
補體因子H相關蛋白3(CFHR3)亦具有補體調控活性,因為其抑制C3-轉化酶。在先前研究中,雜合CFHR3-1基因顯示引起家族性C3腎小球病。作者指出此基因突變增加CFHR5與CFHR3之表現且妨礙補體加工,從而導致C3累積。Malik等人(2012)「A hybrid CFHR3-1 gene causes familial C3 glomerulopathy」J Am Soc Nephrol 23(7):1155-1160。
C3腎小球性腎炎(C3GN)為替代及未端補體途徑異常調節之主要實例。以在不存在局部免疫球蛋白沈積之情況下的C3沈積為特徵之C3GN係由替代途徑抑制劑以及導致替代途徑蛋白質激活阻斷之自身抗體的引起疾病之突變引起。Heeringa及Cohen(2012)「Kidney diseases caused by complement dysregulation:acquired,inherited,and still more to come」Clin Dev Immunol 1-6。
抑制性膜攻擊複合物蛋白質CD59及補體衰減加速因子DAF在MAC之抑制中為重要的且分別藉由分解C3及C5轉化酶來起作用。
Sarma及Ward(2011)。此等調控劑為經由糖磷脂醯肌醇(GPI)錨定膜結合的。引起含GPI蛋白質之表現降低的基因突變導致陣發性夜間血紅蛋白尿(PNH),其引起補體介導之紅血細胞溶解。Liebman及Feinstein(2003)「Thrombosis in patients with paroxysmal noctural hemoglobinuria is associated with markedly elevated plasma levels of leukocyte-derived tissue factor」Thromb Res 111(4-5):235-238。歸因於不能抑制MAC及PNH之臨床表現,在過度補體激活之間存在直接聯繫。
補體調控蛋白CD59藉由防止C9聚合及形成補體膜攻擊複合物而在補體級聯反應中起重要作用。因此,CD59缺乏可引起補體敏感性增加及補體系統調控異常。使用補體溶解敏感性(CLS)測試之先前研究發現遺傳性完全缺乏CD59之患者的紅血球比正常紅血球對補體之敏感性高約8倍,證實CD59缺乏與補體介導之溶血之間的聯繫。Shuchishima等人(1999)「Complement sensitivity of erythrocytes in a patient with inherited complete deficiency of CD59 or with the Inab phenotype」Brit J Haematol 104:303-306。因此,調節補體級聯反應及其組分可改善CD59缺乏之個體所具有的一或多種症狀。
已顯示阿茨海默氏病(Alzheimer’s disease,AD)與持續補體激活有關,因為C1q及C3將澱粉樣蛋白纖絲識別為外來實體且誘導連續補體激活。Ricklin等人(2010)。向兩個AD小鼠模型投與C5aR(C5a之細胞表面受體)拮抗劑使得澱粉樣蛋白沈積減少、產生AD病理標誌並且引起記憶性能改良。Fonseca等人(2009)「Treatment with a C5aR antagonist decreases pathology and enhances behavioral performance in murine models of Alzheimer's disease」J Immunol 183(2):1375-1383。證據表明補體激活與AD之發病機理之間密切相關。
在缺血性事件之後血流恢復至損傷組織可誘導稱為缺血再灌注損傷之發炎反應。Yellon及Hausenloy(2007)「Myocardial reperfusion
injury」N Engl J Med 357(11):1121-1135。證據表明補體介導之組織損傷可作為此發炎反應之結果而發生。Diepenhorst等人(2009)「Complement-mediated ischemia-reperfusion injury:lessons learned from animal and clinical studies」Ann Surg 249(6):889-899。在大鼠與小鼠模型兩者中經由Crry基因、抗C5抗體及因子B拮抗劑抑制補體已顯示具組織保護性。Diepenhorst等人(2009)。此外,在各種器官之各種缺血再灌注模型中,已顯示在小鼠中C3及C4之基因失活引起針對局部及遠距離損傷之保護作用。Diepenhorst等人(2009)。證據表明補體激活在缺血再灌注損傷中之作用。
先前已闡明血清C3含量與心肌梗塞危險之間的關聯。在對先前未忍受缺血性事件(包括心肌梗塞、心絞痛、中風、暫時性缺血性發作或間歇性跛行)之個體的4年追蹤研究期間,發現C3含量獨立地與缺血性事件之發生相關。Muscari等人(1995)「Association of serum C3 levels with the risk of myocardial infarction.」Am J Med 98(4):357-364。因此,補體C3為將來缺血性事件之預測因子。此外,已顯示在先前已忍受缺血性事件之嚴重造影評估動脈粥樣硬化患者中補體C3及C4含量更高。Muscari等人(1988)「Association of serum IgA and C4 with severe atherosclerosis」Atherosclerosis 74(1-2):179-186。動脈粥樣化發展可與補體系統之慢性激活有關,因為在人類動脈粥樣硬化的病變中補體激活之發生已有充分記載。Seifert及Kazatchkine(1988)「The complement system in atherosclerosis」Atherosclerosis 73(2-3):91-104。因此,補體系統可在冠狀動脈粥樣硬化及/或血栓形成中起作用。
因此,已多次嘗試抑制或調節補體級聯反應及其組分,其鹹信與此等各種疾病及病狀之發病機理有關。此項技術中,已使用各種治療調配物來抑制補體系統,但此類醫學增加對感染之敏感性。
已顯示抗C5抗體有效治療若干疾病及病症。舉例而言,已顯示抗
C5抗體減輕PNH之臨床症狀,包括輸血、疲勞及腹痛。Ricklin及Lambris(2007)。已針對包括以下之其他疾病對抗C5抗體進行臨床前及臨床測試:銀屑病、類風濕性關節炎、SLE及移植排斥。Ricklin及Lambris(2007)。
冷凝集素病(CAD)涉及免疫球蛋白M(IgM)介導之血細胞凝集及穩健補體激活。一項研究在用補體抑制劑依庫珠單抗(一種人類化抗C5單克隆抗體,其阻斷C5b-9形成,其為補體級聯反應中之未端事件)治療CAD患者時顯示長期功效。Roth等人(2009)「Long-term efficacy of the complement inhibitor eculizumab in cold agglutinin disease」Blood 113(16):3885-3886。
已顯示坎普他汀(Compstatin,一種C3裂解之小分子抑制劑)在活體內與活體外有效防止補體激活及相關炎性反應。Holland等人(2004)「Synthetic small-molecule complement inhibitors」Curr Opin Investig Drugs 5(11):1164-1173。舉例而言,在疾病之紅血球溶解動物模型中,坎普他汀使溶血降低50%,且在豬至人類腎臟灌注疾病動物模型中延長移植物存活。Fiane等人(1999)「Compstatin,a peptide inhibitor of C3,prolongs survival of ex vivo perfused pig xenografts」Xenotransplantation 6(1):52-65。
補體靶向治療劑之其他潛在靶標包括蛋白酶抑制劑、小分子補體調控劑、治療性抗體及補體蛋白抑制劑。Ricklin及Lambris(2013)「Progress and Trends in Complement Therapeutics」Adv Exp Med Biol 735:1-22。
鑑於各種炎性、免疫及退行性疾病中很大程度地涉及補體,潛在的大量調節靶標及允許多點干預之級聯組織,補體為有吸引力的治療干預靶標。Ricklin及Lambris(2013)。當前治療僅批准用於孤立的適應症,包括PNH、aHUS及遺傳性血管性水腫,且因此在更流行之疾病狀
態中補體靶向治療存在潛能。Ricklin及Lambris(2013)。
US 8,053,440中所揭示之化合物已顯示具有增加脫輔基脂蛋白A-I(ApoA-I)之表現的能力且可用作心血管疾病及膽固醇或脂質相關病症之治療劑。該等化合物中有許多已描述為具有IL-6及VCAM-1抑制活性且可用於治療或預防炎性及自體免疫疾病及癌症。參見WO2010/123975。
令人驚訝地,式I及式II化合物亦具有調節補體相關疾病之能力。因此,本發明之一個態樣提供藉由投與一或多種式I或式II化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物來調節哺乳動物中之補體級聯反應的方法。本發明亦提供藉由投與一或多種式I或式II化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物來治療或預防補體相關疾病的方法。
在一些實施例中,補體相關疾病選自動脈粥樣硬化、膜性腎小球腎炎、氣喘、器官移植排斥、血栓形成、深靜脈血栓形成、瀰散性靜脈血栓栓塞、瀰漫性血管內凝血及慢性阻塞性肺病(COPD)。在某些實施例中,補體相關疾病選自陣發性夜間血紅蛋白尿、非典型性溶血性尿毒症症候群、肌萎縮性側索硬化、黃斑變性、狼瘡性腎炎、重症肌無力、視神經脊髓炎、抗磷脂症候群、災難性抗磷脂症候群、緻密物沈積病(II型膜增生性腎小球性腎炎)、產志賀樣毒素(Shiga-like toxin)大腸桿菌溶血性尿毒症症候群以及腹部及胸部主動脈瘤,且可藉由投與一或多種式I或式II化合物來進行治療或預防。在其他實施例中,補體相關疾病選自家族性CD59缺乏、冷凝集素病、家族性C3腎小球病、C3腎小球性腎炎、補體因子H相關蛋白5腎病、IgA腎病及遺傳性血管性水腫(HAE)。
圖1證實在同時用在炎症期間誘導補體表現之細胞因子處理之
Huh-7細胞中,RVX000222降低補體組分3、4及5在mRNA層面之表現。mRNA含量係藉由TaqMan實時PCR來確定且正規化至親環素mRNA之含量。數據為一式三份之樣品的平均值。
圖2證實在同時用在炎症期間誘導補體表現之細胞因子處理之HepG2細胞中,RVX000222降低補體組分3、4及5在mRNA層面之表現。mRNA含量係藉由TaqMan實時PCR來確定且正規化至親環素mRNA之含量。數據為一式三份之樣品的平均值。
圖3在用在炎症期間誘導補體表現之細胞因子預處理之Huh-7細胞中,RVX000222降低補體組分3、4及5在mRNA層面之表現。mRNA含量係藉由TaqMan實時PCR來確定且正規化至親環素mRNA之含量。數據為一式三份之樣品的平均值。
圖4在用在炎症期間誘導補體表現之細胞因子預處理之HepG2細胞中,RVX000222降低補體組分3、4及5在mRNA層面之表現。mRNA含量係藉由TaqMan實時PCR來確定且正規化至親環素mRNA之含量。數據為一式三份之樣品的平均值。
圖5證實30uM RVX000222降低同時用白介素6(IL-6)處理之Huh-7細胞的C3、C4及C5蛋白之分泌。IL-6在炎症期間誘導補體表現。蛋白質含量係藉由ELISA定量。數據為一式兩份之樣品的平均值。
圖6:證實30uM RVX000222降低同時用白介素6(IL-6)處理之原代人類肝細胞中C3、C4、C5及C9蛋白之分泌。IL-6在炎症期間誘導補體表現。蛋白質含量係藉由ELISA定量。數據為一式兩份之樣品的平均值。
圖7A:如藉由AH50分析所量測,RVX000222降低臨床樣品中之補體活性。圖7B:如藉由CH50分析所量測,RVX000222降低臨床樣品中之補體活性。
在某些實施例中,用於調節有需要之個體之補體系統的方法包括投與治療有效量之至少一種如本文所描述之式I或式II化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
在某些實施例中,用於治療有需要之個體之補體相關疾病或病症的方法包括投與治療有效量之至少一種如本文所描述之式I或式II化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
定義
除非使用的上下文另有指示,否則如本說明書中所用,以下字語、片語及符號通常旨在具有如下文所闡述之含義。在通篇中以下縮寫及術語具有所指示之含義:術語「式I化合物」係指具有以下一般結構之化合物:
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物,其中:R1及R3各獨立地選自烷氧基、烷基、胺基、鹵素及氫;R2選自烷氧基、烷基、烯基、炔基、醯胺、胺基、鹵素及氫;R5及R7各獨立地選自烷基、烷氧基、胺基、鹵素及氫;R6選自胺基、醯胺、烷基、氫、羥基、哌嗪基及烷氧基,其中該烷氧基視情況經一或多個選自以下之基團取代:醯胺、胺、芳基、苯甲氧基、胺基甲酸酯、羧基、雜環基、羥基、甲氧基及磺醯胺;且
W為CH或N。
在一些實施例中,在式I化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物中W為CH,且R1、R2、R3、R5、R6及R7如段落[0051]中所定義。
在一些實施例中,在式I化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物中,R6選自視情況經一或多個選自以下之基團取代的烷氧基:醯胺、胺、芳基、苯甲氧基、胺基甲酸酯、羧基、雜環基、羥基、甲氧基及磺醯胺,且R1、R2、R3、R5、R7及W如段落[0051]-[0052]中任一者所定義。
在一些實施例中,在式I化合物或其立體異構體、互變異構體、醫
藥學上可接受之鹽或水合物中,R6選自氫、甲氧基、及
,其中
n為1、2或3;R8選自氫或經一或多個選自以下之基團取代的C1-C6烷基:甲基、苯基及吡啶基;R9及R10獨立地選自未經取代之C1-C6烷基,其中R9及R10可與N連接在一起以形成3至12員環;且R1、R2、R3、R5、R7及W如段落[0051]-[0052]中任一者所定義。
在一些實施例中,在式I化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物中,R6選自2-(羥基)乙氧基、2-(吡咯啶-1-基)乙氧基、4-異丙基哌嗪-1-基及2-(異丙胺基)乙氧基,且R1、R2、R3、R5、R7及W如段落[0051]-[0052]中任一者所定義。
在一些實施例中,在式I化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物中,R6為2-(羥基)乙氧基,且R1、R2、R3、R5、R7及W如段落[0051]-[0052]中任一者所定義。
在一些實施例中,在式I化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物中,R1及R3均為甲氧基,R2、R5、R6、R7、R8、R9、R10及W如段落[0051]-[0056]中任一者所定義。
在一些實施例中,式I化合物選自:2-(4-(2-羥基乙氧基)-3,5-二甲基苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮;2-{3,5-二甲基-4-[2-(吡咯啶-1-基)乙氧基]苯基}-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮;2-(3,5-二甲基-4-{2-[(丙-2-基)胺基]乙氧基}苯基)-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮;5,7-二甲氧基-2-{4-[4-(丙-2-基)哌嗪-1-基]苯基}-3,4-二氫喹唑啉-4-酮;5,7-二甲氧基-2-{3-甲氧基-5-[2-(吡咯啶-1-基)乙氧基]苯基}-3,4-二氫喹唑啉-4-酮;2-{3,5-二甲基-4-[2-(吡咯啶-1-基)乙氧基]苯基}-5,7-二甲氧基-3H,4H-吡啶并[2,3-d]嘧啶-4-酮;2-{4-[2-(3,3-二氟吡咯啶-1-基)乙氧基]-3,5-二甲基苯基}-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮;N-{2-[4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基]乙基}-2-甲基丙醯胺;5,7-二甲氧基-2-[4-(哌嗪-1-基)苯基]-3,4-二氫喹唑啉-4-酮;2-(4-羥基-3,5-二甲基苯基)-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮;N-{2-[4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基]乙基}乙醯胺;N-{2-[4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基]乙基}胺基甲酸甲酯;
2-[4-(2,3-二羥基丙氧基)-3,5-二甲基苯基]-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮;N-(2-(4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基)乙基)-4-甲基苯甲醯胺;甲基胺基甲酸2-(4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基-苯氧基)乙酯;丙基胺基甲酸2-(4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基-苯氧基)乙酯;N-(2-(4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基)乙基)甲烷磺醯胺(RVX002093);4-氯-N-(2-(4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基)乙基)苯磺醯胺;N-(2-(4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基)乙基)-4-甲氧基苯磺醯胺;2-(4-(2-胺基乙氧基)-3,5-二甲基苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮;N1-(2-(4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基)乙基)-N2-甲基鄰苯二醯胺;2-(4-(2-羥基乙氧基)-3-甲基苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮;2-(4-(苯甲氧基)-3,5-二甲基苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮;6-溴-2-(4-(2-羥基乙氧基)-3,5-二甲基苯基)喹唑啉-4(3H)-酮;6-溴-2-(4-羥基-3,5-二甲基苯基)喹唑啉-4(3H)-酮;2-(4-(2-羥基乙氧基)-3,5-二甲基苯基)-6-甲氧基喹唑啉-4(3H)-酮;5,7-二氯-2-(4-(2-羥基乙氧基)-3,5-二甲基苯基)喹唑啉-4(3H)-酮;5,7-二甲氧基-2-(4-(2-甲氧基乙氧基)-3,5-二甲基苯基)喹唑啉-4(3H)-酮;
N-(2-(4-(2-羥基乙氧基)-3,5-二甲基苯基)-4-側氧基-3,4-二氫喹唑啉-6-基)乙醯胺;2-(4-(2-羥基乙氧基)-3,5-二甲基苯基)-5,7-二甲氧基吡啶并[2,3-d]嘧啶-4(3H)-酮;5,7-二甲氧基-2-(4-甲氧基-3-(嗎啉基甲基)苯基)喹唑啉-4(3H)-酮;2-(4-((4-乙基哌嗪-1-基)甲基)苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮;5,7-二甲氧基-2-(4-(嗎啉基甲基)苯基)喹唑啉-4(3H)-酮;N-(4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)苯基)-2-羥基乙醯胺;2-(4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基)乙酸;N-(4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯基)-2-羥基乙醯胺;5,7-二甲氧基-2-(4-((4-甲基哌嗪-1-基)甲基)苯基)喹唑啉-4(3H)-酮;2-(4-(2-羥基乙氧基)-3,5-二甲基苯基)-6,7-二甲氧基喹唑啉-4(3H)-酮;2-(4-(2-羥基乙氧基)-3-甲基苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮;2-(3-氯-4-(2-羥基乙氧基)苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮;2-(4-(6,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基)乙醯胺;N-(2-(4-羥基-3,5-二甲基苯基)-4-側氧基-3,4-二氫喹唑啉-6-基)乙醯胺;2-(4-(雙(2-羥乙基)胺基)苯基)-6,7-二甲氧基喹唑啉-4(3H)-酮;2-(4-(雙(2-羥乙基)胺基)苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮;
5,7-二甲氧基-2-(4-(4-甲基哌嗪-1-基)苯基)喹唑啉-4(3H)-酮(RVX000255);2-(4-(2-羥基乙氧基)-3,5-二甲基苯基)喹唑啉-4(3H)-酮;2-(3,5-二甲基-4-(2-嗎啉基乙氧基)苯基)喹唑啉-4(3H)-酮;2-(3,5-二甲基-4-(2-嗎啉基乙氧基)苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮;及其立體異構體、互變異構體、醫藥學上可接受之鹽及水合物。
在一些實施例中,式I化合物為2-(4-(2-羥基乙氧基)-3,5-二甲基苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮(RVX000222)(亦稱為RVX-208)
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
在某些實施例中,式I化合物為2-{3,5-二甲基-4-[2-(吡咯啶-1-基)乙氧基]苯基}-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
在其他實施例中,式I化合物為2-(3,5-二甲基-4-{2-[(丙-2-基)胺基]乙氧基}苯基)-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
在其他實施例中,式I化合物為5,7-二甲氧基-2-{4-[4-(丙-2-基)哌嗪-1-基]苯基}-3,4-二氫喹唑啉-4-酮
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
在一些實施例中,式I化合物為5,7-二甲氧基-2-{3-甲氧基-5-[2-(吡咯啶-1-基)乙氧基]苯基}-3,4-二氫喹唑啉-4-酮
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
在一些實施例中,式I化合物為2-{3,5-二甲基-4-[2-(吡咯啶-1-基)乙氧基]苯基}-5,7-二甲氧基-3H,4H-吡啶并[2,3-d]嘧啶-4-酮
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
在一些實施例中,化合物為2-{2-[(二甲胺基)甲基]-1H-吲哚-5-
基}-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
在一些實施例中,式I化合物為2-{4-[2-(3,3-二氟吡咯啶-1-基)乙氧基]-3,5-二甲基苯基}-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
在一些實施例中,式I化合物為N-{2-[4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基]乙基}-2-甲基丙醯胺
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
在一些實施例中,式I化合物為5,7-二甲氧基-2-[4-(哌嗪-1-基)苯基]-3,4-二氫喹唑啉-4-酮
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
在一些實施例中,式I化合物為2-(4-羥基-3,5-二甲基苯基)-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
在一些實施例中,式I化合物為N-{2-[4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基]乙基}乙醯胺
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
在一些實施例中,式I化合物為N-{2-[4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基]乙基}胺基甲酸甲酯
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
在一些實施例中,式I化合物為2-[4-(2,3-二羥基丙氧基)-3,5-二甲基苯基]-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物,其中:RA及RB獨立地選自氫、甲基、-(CH2)nRF、-(CH2)nORF及-CH2C(O)ORG;RC選自氫、對位鹵素及連接至苯基環之鄰位及間位或連接至間位及對位的-OCH2O-或-OCH2CH2O-;RD及RE獨立地選自氫及甲基;RF選自甲基、乙基及-CH2CH2OCH3;RG選自甲基、乙基、正丙基、異丙基、正丁基及第三丁基;且n選自1、2、3及4。
在一些實施例中,RC為對位Cl。
在一些實施例中,式II化合物選自:6,6-二甲基-4-苯基-9-甲基-6H-噻吩并[3,2-f]-s-三唑并[4,3-a][1,4]二氮呯;4-(3’,4’-亞甲基二氧基苯基)-9-甲基-6H-噻吩并[3,2-f]-s-三唑并[4,3-a][1,4]二氮呯;9-甲基-4-苯基-6H-噻吩并[3,2-f]-s-三唑并[4,3-a][1,4]二氮呯;(S)-2-(4-(4-氯苯基)-2,3,9-三甲基-6H-噻吩并[3,2-f][1,2,4]三唑并[4,3-a][1,4]二氮呯-6-基)乙酸第三丁酯(JQ1);及其立體異構體、互變異構體、醫藥學上可接受之鹽及水合物。
在一些實施例中,式I或式II化合物呈溶劑合物形式。在一些實施例中,式I或式II化合物呈水合物形式。在一些實施例中,式I或式II化合物呈螯合物形式。在一些實施例中,式I或式II化合物呈醫藥學上可接受之鹽形式。在一些實施例中,式I或式II化合物呈結晶形式。在一些實施例中,式I或式II化合物為多晶型物或假多晶型物。在一些實施例中,式I或式II化合物呈非溶劑合多晶型物(諸如無水物)形式。在一些實施例中,式I或式II化合物呈構象多晶型物形式。在一些實施例中,式I或式II化合物為無定形的。在一些實施例中,式I或式II化合物呈非共價複合物形式。在一些實施例中,式I或式II化合物呈鹽之溶劑合物形式。在一些實施例中,式I或式II化合物呈鹽之螯合物形式。在一些實施例中,式I或式II化合物呈半水合物形式。在一些實施例中,式I或式II化合物呈單水合物形式。
在一些實施例中,向患者投與「前藥」以例如在前藥代謝加工後變成式I或式II化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。前藥之實例包括在式I或式II化合物中之諸如羧酸基團之官能基的衍生物。羧酸基團之示例性前藥包括但不限於羧酸酯,諸
如烷基酯、羥烷基酯、芳基烷基酯及芳基氧基烷基酯。
「溶劑合物」係藉由溶劑與化合物之相互作用而形成,且式I或式II化合物可呈溶劑合物形式。類似地,式I或式II化合物之「鹽」可呈鹽之溶劑合物形式。適合之溶劑合物為藥學上可接受的溶劑合物,諸如水合物,包括單水合物及半水合物。
「螯合物」係藉由化合物在兩個(或更多個)點與金屬離子配位而形成。式I或式II化合物可呈螯合物形式。類似地,式I或式II化合物之鹽可呈螯合物形式。
「非共價複合物」可藉由式I或式II化合物與另一分子之相互作用而形成,其中化合物與分子之間不形成共價鍵。舉例而言,複合可經由凡得瓦相互作用(van der Waals interaction)及靜電相互作用(亦稱為離子鍵合)而發生。
不介於兩個字母或符號之間的短劃線(「-」)用於指示取代基之連接點。舉例而言,-CONH2係經由碳原子連接。
「視情況存在」或「視情況」意謂隨後描述之事件或情形可能存在或可能不存在,且該描述包括該事件或情形存在及情況不存在之情況下的情況。舉例而言,「視情況經取代之芳基」涵蓋如以下所定義之「芳基」及「經取代之芳基」。熟習此項技術者應瞭解,關於含有一或多個取代基之任何基團,此類基團不旨在引入空間上不切實際、合成不可行及/或固有地不穩定的任何取代或取代模式。
如本文所用之術語「醯基」術語係指附接於烷基、烯基、炔基、環烷基、雜環基、芳基或雜芳基之羰基。示例性醯基包括但不限於乙醯基、甲醯基、丙醯基、苯甲醯基及類似基團。
如本文所用之術語「醛」或「甲醯基」係指-CHO。
如本文所用之術語「烯基」係指具有至少一個碳-碳雙鍵之不飽和直鏈或分支鏈烴,諸如具有2-22、2-8或2-6個碳原子之直鏈或分支鏈基
團,本文中分別稱為(C2-C22)烯基、(C2-C8)烯基及(C2-C6)烯基。示例性烯基包括但不限於乙烯基、烯丙基、丁烯基、戊烯基、己烯基、丁二烯基、戊二烯基、己二烯基、2-乙基己烯基、2-丙基-2-丁烯基及4-(2-甲基-3-伸丁基)-戊烯基。
如本文所用之術語「烷氧基」係指附接於氧之烷基(-O-烷基-)。「烷氧基」基團亦包括附接於氧之烯基(「烯氧基」)或附接於氧之炔基(「炔氧基」)基團。示例性烷氧基包括但不限於具有1-22、1-8或1-6個碳原子之烷基、烯基或炔基情況下的基團,在本文中分別稱為(C1-C22)烷氧基、(C1-C8)烷氧基及(C1-C6)烷氧基。示例性烷氧基包括但不限於甲氧基及乙氧基。
如本文所用之術語「烷基」係指飽和直鏈或分支鏈烴,諸如具有1-22、1-8或1-6個碳原子之直鏈或分支鏈基團,本文中分別稱為(C1-C22)烷基、(C1-C8)烷基及(C1-C6)烷基。示例性烷基包括但不限於甲基、乙基、丙基、異丙基、2-甲基-1-丙基、2-甲基-2-丙基、2-甲基-1-丁基、3-甲基-1-丁基、2-甲基-3-丁基、2,2-二甲基-1-丙基、2-甲基-1-戊基、3-甲基-1-戊基、4-甲基-1-戊基、2-甲基-2-戊基、3-甲基-2-戊基、4-甲基-2-戊基、2,2-二甲基-1-丁基、3,3-二甲基-1-丁基、2-乙基-1-丁基、丁基、異丁基、第三丁基、戊基、異戊基、新戊基、己基、庚基及辛基。
如本文所用之術語「炔基」係指具有至少一個碳-碳三鍵之不飽和直鏈或分支鏈烴,諸如具有2-22、2-8或2-6個碳原子之直鏈或分支鏈基團,本文中分別稱為(C2-C22)炔基、(C2-C8)炔基及(C2-C6)炔基。示例性炔基包括但不限於乙炔基、丙炔基、丁炔基、戊炔基、己炔基、甲基丙炔基、4-甲基-1-丁炔基、4-丙基-2-戊炔基及4-丁基-2-己炔基。
如本文所用之術語「醯胺」係指結構-NRaC(O)(Rb)-或-C(O)NRbRc,其中Ra、Rb及Rc各獨立地選自烷基、烯基、炔基、芳基、
芳基烷基、環烷基、鹵烷基、雜芳基、雜環基及氫。醯胺可經由碳、氮、Rb或Rc附接於另一基團。醯胺亦可為環狀的,例如Rb及Rc可連接以形成3員至12員環,諸如3員至10員環或5員或6員環。術語「醯胺」涵蓋諸如以下基團:磺醯胺、脲、脲基、胺基甲酸酯、胺基甲酸及其環狀型式。術語「醯胺」亦涵蓋附接於羧基之醯胺基(例如-醯胺-COOH或鹽,諸如-醯胺-COONa)、附接於羧基之胺基(例如-胺基-COOH或鹽,諸如-胺基-COONa)。
如本文所用之術語「胺」或「胺基」係指結構-NRdRe或-N(Rd)Re-,其中Rd及Re獨立地選自烷基、烯基、炔基、芳基、芳基烷基、胺基甲酸酯、環烷基、鹵烷基、雜芳基、雜環基及氫。胺基可經由氮附接於母體分子基團。胺基亦可環狀,例如任何兩個Rd及Re可連接在一起或與N連接以形成3員至12員環(例如嗎啉基或哌啶基)。術語胺基亦包括任何胺基之對應季銨鹽。示例性胺基包括烷基胺基,其中Rd或Re中之至少一者為烷基。
如本文所用之術語「芳基」係指單碳環、雙碳環或其他多碳環芳族環系統。芳基可視情況稠合至一或多個選自以下之環:芳基、環烷基及雜環基。本發明之芳基可經選自以下之基團取代:烷氧基、芳氧基、烷基、烯基、炔基、醯胺、胺基、芳基、芳基烷基、胺基甲酸酯、羧基、氰基、環烷基、酯、醚、甲醯基、鹵素、鹵烷基、雜芳基、雜環基、羥基、酮、硝基、磷酸酯、硫化物、亞磺醯基、磺醯基、磺酸、磺醯胺及硫酮。示例性芳基包括但不限於苯基、甲苯基、蒽基、芴基、茚基、薁基及萘基,以及苯并稠合碳環部分,諸如5,6,7,8-四氫萘基。示例性芳基亦包括但不限於環包含6個碳原子之單環芳族環系統,本文中稱為「(C6)芳基」。
如本文所用之術語「芳基烷基」係指具有至少一個芳基取代基之烷基(例如-芳基-烷基-)。示例性芳基烷基包括但不限於具有環包含6個
碳原子之單環芳族環系統的芳基烷基,本文中稱為「(C6)芳基烷基」。
如本文所用之術語「芳氧基」係指附接於氧原子之芳基。示例性芳氧基包括但不限於具有環包含6個碳原子之單環芳族環系統的芳氧基,本文中稱為「(C6)芳氧基」。
如本文所用之術語「芳硫基」係指附接於硫原子之芳基。示例性芳硫基包括但不限於具有環包含6個碳原子之單環芳族環系統的芳硫基,本文中稱為「(C6)芳硫基」。
如本文所用之術語「芳基磺醯基」係指附接於磺醯基之芳基,例如-S(O)2-芳基-。示例性芳基磺醯基包括但不限於具有環包含6個碳原子之單環芳族環系統的芳基磺醯基,本文中稱為「(C6)芳基磺醯基」。
如本文所用之術語「苯甲基」係指基團-CH2-苯基。
如本文所用之術語「雙環芳基」係指稠合至另一芳族或非芳族碳環或雜環之芳基。示例性雙環芳基包括但不限於萘基或其部分還原之形式,諸如二氫萘基、四氫萘基或六氫萘基。
如本文所用之術語「雙環雜芳基」係指稠合至另一芳族或非芳族碳環或雜環之雜芳基。示例性雙環雜芳基包括但不限於5,6-稠合系統或6,6-稠合系統,其中一個或兩個環含有雜原子。術語「雙環雜芳基」亦涵蓋還原或部分還原形式之稠合芳族系統,其中一個或兩個環含有環雜原子。環系統可含有最多三個獨立地選自以下之雜原子:氧、氮及硫。雙環系統可視情況經一或多個選自以下之基團取代:烷氧基、芳氧基、烷基、烯基、炔基、醯胺、胺基、芳基、芳基烷基、胺基甲酸酯、羧基、氰基、環烷基、酯、醚、甲醯基、鹵素、鹵烷基、雜芳基、雜環基、羥基、酮、硝基、磷酸酯、硫化物、亞磺醯基、磺醯基、磺酸、磺醯胺及硫酮。示例性雙環雜芳基包括但不限於喹唑啉基、苯并噻吩基、苯并噁唑基、苯并咪唑基、苯并噻唑基、苯并呋喃基、吲哚基、喹啉基、異喹啉基、酞嗪基、苯并三唑基、苯并吡啶基及苯并
呋喃基。
如本文所用之術語「胺基甲酸酯」係指形式-RgOC(O)N(Rh)-、-RgOC(O)N(Rh)Ri-或-OC(O)NRhRi,其中Rg、Rh及Ri各獨立地選自烷基、烯基、炔基、芳基、芳基烷基、環烷基、鹵烷基、雜芳基、雜環基及氫。示例性胺基甲酸酯包括但不限於芳基胺基甲酸酯或雜芳基胺基甲酸酯(例如其中Rg、Rh及Ri中之至少一者獨立地選自芳基或雜芳基,諸如吡啶、嗒嗪、嘧啶及吡嗪)。
如本文所用之術語「羰基」係指-C(O)-。
如本文所用之術語「羧基」係指-COOH或其對應甲酸鹽(例如-COONa)。術語羧基亦包括「羧基羰基」,例如附接於羰基之羧基,例如-C(O)-COOH或鹽,諸如-C(O)-COONa。
如本文所用之術語「氰基」係指-CN。
如本文所用之術語「環烷氧基」係指附接於氧之環烷基。
如本文所用之術語「環烷基」係指衍生自環烷之具有3-12個碳或3-8個碳之飽和或不飽和環狀、雙環或橋接雙環烴基,本文中稱為「(C3-C8)環烷基」。示例性環烷基包括但不限於環己烷、環己烯、環戊烷及環戊烯。環烷基可經以下基團取代:烷氧基、芳氧基、烷基、烯基、炔基、醯胺、胺基、芳基、芳基烷基、胺基甲酸酯、羧基、氰基、環烷基、酯、醚、甲醯基、鹵素、鹵烷基、雜芳基、雜環基、羥基、酮、硝基、磷酸酯、硫化物、亞磺醯基、磺醯基、磺酸、磺醯胺及硫酮。環烷基可稠合至其他環烷基飽和或不飽和芳基或雜環基。
如本文所用之術語「二羧酸」係指含有至少兩個羧酸基團之基團,諸如飽和及不飽和烴二羧酸及其鹽。示例性二羧酸包括烷基二羧酸。二羧酸可經以下基團取代:烷氧基、芳氧基、烷基、烯基、炔基、醯胺、胺基、芳基、芳基烷基、胺基甲酸酯、羧基、氰基、環烷基、酯、醚、甲醯基、鹵素、鹵烷基、雜芳基、雜環基、氫、羥基、酮、硝基、
磷酸酯、硫化物、亞磺醯基、磺醯基、磺酸、磺醯胺及硫酮。二羧酸包括但不限於丁二酸、戊二酸、己二酸、辛二酸、癸二酸、壬二酸、順丁烯二酸、鄰苯二甲酸、天冬胺酸、麩胺酸、丙二酸、反丁烯二酸、(+)/(-)-蘋果酸、(+)/(-)酒石酸、間苯二甲酸及對苯二甲酸。二羧酸進一步包括其羧酸衍生物,諸如酸酐、醯亞胺、醯肼(例如丁二酸酐及丁二醯亞胺)。
術語「酯」係指結構-C(O)O-、-C(O)O-Rj-、-RkC(O)O-Rj-或-RkC(O)O-,其中O不結合於氫,且Rj及Rk可獨立地選自烷氧基、芳氧基、烷基、烯基、炔基、醯胺、胺基、芳基、芳基烷基、環烷基、醚、鹵烷基、雜芳基及雜環基。Rk可為氫,但Rj不可為氫。酯可為環狀,例如碳原子與Rj、氧原子與Rk或Rj與Rk可連接以形成3員至12員環。示例性酯包括但不限於Rj或Rk中之至少一者為烷基的烷基酯,諸如-O-C(O)-烷基、-C(O)-O-烷基-及-烷基-C(O)-O-烷基-。示例性酯亦包括芳基或雜芳基酯,例如其中Rj或Rk中之至少一者為雜芳基,諸如吡啶、嗒嗪、嘧啶及吡嗪,諸如菸鹼酸酯。示例性酯亦包括具有結構-RkC(O)O-之逆酯,其中氧結合於母體分子。示例性逆酯包括丁二酸酯、D-精胺酸酯、L-精胺酸酯、L-離胺酸酯及D-離胺酸酯。酯亦包括羧酸酸酐及酸鹵化物。
術語「醚」係指結構-Rl-O-Rm-,其中Rl及Rm可獨立地為烷基、烯基、炔基、芳基、環烷基、雜環基及醚。醚可經由Rl或Rm附接於母體分子基團。示例性醚包括但不限於烷氧基烷基及烷氧基芳基。醚亦包括聚醚,例如其中Rl及Rm中之一者或兩者為醚。
如本文所用之術語「鹵基」或「鹵素」或「Hal」係指F、Cl、Br或I。
如本文所用之術語「鹵烷基」係指經一或多個鹵素原子取代之烷基。「鹵烷基」亦涵蓋經一或多個鹵素原子取代之烯基或炔基。
如本文所用之術語「雜芳基」係指單環、雙環或其他多環芳族環系統,其含有一或多個雜原子,例如1-3個雜原子,諸如氮、氧及硫。雜芳基可經包括以下之一或多個取代基取代:烷氧基、芳氧基、烷基、烯基、炔基、醯胺、胺基、芳基、芳基烷基、胺基甲酸酯、羧基、氰基、環烷基、酯、醚、甲醯基、鹵素、鹵烷基、雜芳基、雜環基、羥基、酮、硝基、磷酸酯、硫化物、亞磺醯基、磺醯基、磺酸、磺醯胺及硫酮。雜芳基亦可稠合至非芳族環。雜芳基之說明性實例包括但不限於吡啶基、嗒嗪基、嘧啶基(pyrimidyl)、吡嗪基(pyrazyl)、三嗪基、吡咯基、吡唑基、咪唑基、(1,2,3)-三唑基及(1,2,4)-三唑基、吡嗪基(pyrazinyl)、嘧啶基(pyrimidilyl)、四唑基、呋喃基、噻吩基、異噁唑基、噻唑基、呋喃基、苯基、異噁唑基及噁唑基。示例性雜芳基包括但不限於單環芳族環,其中環包含2-5個碳原子及1-3個雜原子,本文中稱為「(C2-C5)雜芳基」。
如本文所用之術語「雜環」、「雜環基」或「雜環」係指含有一個、兩個或三個獨立地選自氮、氧及硫之雜原子的飽和或不飽和3員、4員、5員、6員或7員環。雜環可為芳族(雜芳基)或非芳族雜環。雜環可經包括以下之一或多個取代基取代:烷氧基、芳氧基、烷基、烯基、炔基、醯胺、胺基、芳基、芳基烷基、胺基甲酸酯、羧基、氰基、環烷基、酯、醚、甲醯基、鹵素、鹵烷基、雜芳基、雜環基、羥基、酮、硝基、磷酸酯、硫化物、亞磺醯基、磺醯基、磺酸、磺醯胺及硫酮。雜環亦包括雙環、三環及四環基團,其中以上雜環中之任一者稠合至一個或兩個獨立地選自以下之環:芳基、環烷基及雜環。示例性雜環包括吖啶基、苯并咪唑基、苯并呋喃基、苯并噻唑基、苯并噻吩基、苯并噁唑基、生物素基、噌啉基、二氫呋喃基、二氫吲哚基、二氫哌喃基、二氫噻吩基、二噻唑基、呋喃基、高哌啶基、咪唑啶基、咪唑啉基、咪唑基、吲哚基、異喹啉基、異噻唑啶基、異噻唑基、異噁唑啶基、
異噁唑基、嗎啉基、噁二唑基、噁唑啶基、噁唑基、哌嗪基、哌啶基、哌喃基、吡唑啶基、吡嗪基、吡唑基、吡唑啉基、嗒嗪基、吡啶基、嘧啶基(pyrimidinyl)、嘧啶基(pyrimidyl)、吡咯啶基、吡咯啶-2-酮基、吡咯啉基、吡咯基、喹啉基、喹噁啉基(quinoxaloyl)、四氫呋喃基、四氫異喹啉基、四氫哌喃基、四氫喹啉基、四唑基、噻二唑基、噻唑啶基、噻唑基、噻吩基、硫代嗎啉基、硫代哌喃基及三唑基。
如本文所用之術語「羥基(hydroxy/hydroxyl)」係指-OH。
如本文所用之術語「羥烷基」係指附接於烷基之羥基。
如本文所用之術語「羥基芳基」係指附接於芳基之羥基。
如本文所用之術語「酮」係指結構-C(O)-Rn(諸如乙醯基、-C(O)CH3或-Rn-C(O)-Ro-。酮可經由Rn或Ro附接於另一基團。Rn或Ro可為烷基、烯基、炔基、環烷基、雜環基或芳基,或Rn或Ro可連接以形成3員至12員環。
如本文所用之術語「單酯」係指羧酸中之一者官能化為酯而另一羧酸為游離羧酸或羧酸之鹽的二羧酸類似物。單酯之實例包括但不限於丁二酸、戊二酸、己二酸、辛二酸、癸二酸、壬二酸、草酸及順丁烯二酸之單酯。
如本文所用之術語「硝基」係指-NO2。
如本文所用之術語「全氟烷氧基」係指所有氫原子均已由氟原子置換之烷氧基。
如本文所用之術語「全氟烷基」係指所有氫原子均已由氟原子置換之烷基。示例性全氟烷基包括但不限於C1-C5全氟烷基,諸如三氟甲基。
如本文所用之術語「全氟環烷基」係指所有氫原子均已由氟原子置換之環烷基。
如本文所用之術語「苯基」係指6員碳環芳族環。苯基亦可稠合至
環己烷或環戊烷環。苯基可經包括以下之一或多個取代基取代:烷氧基、芳氧基、烷基、烯基、炔基、醯胺、胺基、芳基、芳基烷基、胺基甲酸酯、羧基、氰基、環烷基、酯、醚、甲醯基、鹵素、鹵烷基、雜芳基、雜環基、羥基、酮、硝基、磷酸酯、硫化物、亞磺醯基、磺醯基、磺酸、磺醯胺及硫酮。
如本文所用之術語「磷酸酯」係指結構-OP(O)O2-、-RxOP(O)O2-、-OP(O)O2Ry-或-RxOP(O)O2Ry-,其中Rx及Ry可獨立地為烷基、烯基、炔基、芳基、環烷基、雜環基及氫。
如本文所用之術語「硫化物」係指結構-RzS-,其中Rz可為烷基、烯基、炔基、芳基、芳基烷基、環烷基、鹵烷基、雜芳基、雜環基。硫化物可為環狀,從而形成3員至12員環。術語「烷基硫化物」如本文所用係指附接於硫原子之烷基。
如本文所用之術語「亞磺醯基」係指結構-S(O)O-、-RpS(O)O-、-RpS(O)ORq-或-S(O)ORq-,其中Rp及Rq可為烷基、烯基、芳基、芳基烷基、環烷基、鹵烷基、雜芳基、雜環基、羥基。示例性亞磺醯基包括但不限於烷基亞磺醯基,其中Rp或Rq中之至少一者為烷基、烯基或炔基。
如本文所用之術語「磺醯胺」係指結構-(Rr)-N-S(O)2-Rs-或-Rt(Rr)-N-S(O)2-Rs,其中Rt、Rr及Rs可為例如氫、烷基、烯基、炔基、芳基、環烷基及雜環基。示例性磺醯胺包括烷基磺醯胺(例如其中Rs為烷基)、芳基磺醯胺(例如其中Rs為芳基)、環烷基磺醯胺(例如其中Rs為環烷基)及雜環基磺醯胺(例如其中Rs為雜環基)。
如本文所用之術語「磺酸酯」係指-OSO3-。磺酸酯包括鹽,諸如-OSO3Na、-OSO3K及酸-OSO3H。
術語「磺酸」係指-SO3H-及其對應鹽(例如-SO3K-及-SO3Na-)。
如本文所用之術語「磺醯基」係指結構RuSO2-,其中Ru可為烷基、
烯基、炔基、芳基、環烷基及雜環基(例如烷基磺醯基)。如本文所用之術語「烷基磺醯基」係指附接於磺醯基之烷基。「烷基磺醯基」基團可視情況含有烯基或炔基。
術語「硫酮」係指結構-Rv-C(S)-Rw-。酮可經由Rv或Rw附接於另一基團。Rv或Rw可為烷基、烯基、炔基、環烷基、雜環基或芳基,或Rv或Rw可連接以形成3員至12員環。
「烷基」基團可經至少一個選自以下之基團取代或由其間隔或以其分支:烷氧基、芳氧基、烷基、烯基、炔基、醯胺、胺基、芳基、芳基烷基、胺基甲酸酯、羧基、氰基、環烷基、酯、醚、甲醯基、鹵素、鹵烷基、酮、雜芳基、雜環基、羥基、硝基、磷酸酯、硫化物、亞磺醯基、磺醯基、磺酸、磺醯胺、硫酮、脲基及N。取代基可分支以形成經取代或未經取代之雜環或環烷基。
「烯基」、「炔基」、「烷氧基」、「胺基」及「醯胺」基團可經至少一個選自以下之基團取代或由其間隔或以其分支:烷氧基、芳氧基、烷基、烯基、炔基、醯胺、胺基、芳基、芳基烷基、胺基甲酸酯、羰基、羧基、氰基、環烷基、酯、醚、甲醯基、鹵素、鹵烷基、雜芳基、雜環基、羥基、酮、硝基、磷酸酯、硫化物、亞磺醯基、磺醯基、磺酸、磺醯胺、硫酮、脲基及N。取代基可分支以形成經取代或未經取代之雜環或環烷基。
如本文所用,「適合之取代基」係指不廢棄式I或式II化合物之合成或醫藥功效的基團。適合之取代基的實例包括但不限於:C1-22、C1-8及C1-6烷基、烯基或炔基;C1-6芳基、C2-5雜芳基;C3-7環烷基;C1-22、C1-8及C1-6烷氧基;C6芳基氧基;-CN;-OH;側氧基;鹵基;羧基;胺基,諸如-NH(C1-22、C1-8或C1-6烷基)、-N(C1-22、C1-8及C1-6烷基)2、-NH((C6)芳基)或-N((C6)芳基)2;甲醯基;酮,諸如-CO(C1-22、C1-8及C1-6烷基)、-CO((C6芳基);酯,諸如-CO2(C1-22、C1-8及C1-6烷基)及-CO2(C6芳基)。
熟習此項技術者可基於本發明化合物之穩定性及藥理學及合成活性容易地選擇適合之取代基。
如本文所用之術語「醫藥學上可接受之載劑」係指與醫藥投與相容之任何及所有溶劑、分散介質、包衣劑、等張劑及吸收延遲劑及類似物。此類介質及試劑用於醫藥活性物質之用途為此項技術中熟知的。組合物亦可含有提供附加、額外或增強治療功能之其他活性化合物。
如本文所用之術語「醫藥學上可接受」係指組合物包含與一或多種醫藥學上可接受之載劑一起調配之至少一種如本文所揭示之化合物。
如本文所用之術語「醫藥學上可接受之前藥」表示本發明化合物之前藥,其在充分醫學判斷範圍內適合用於與人類及低等動物之組織接觸而不會有過度毒性、刺激、變態反應;與合理益處/危險比相稱;對其預期用途而言有效,以及式I或式II化合物之兩性離子形式(在可能的情況下)。論述提供於Higuchi等人,「Prodrugs as Novel Delivery Systems,」ACS Symposium Series,第14卷;及Roche,E.B.編Bioreversible Carriers in Drug Design,American Pharmaceutical Association and Pergamon Press,1987中,該兩者均以引用之方式併入本文中。
術語「醫藥學上可接受之鹽」係指可存在於用於本發明組合物中之化合物中的酸性或鹼性基團之鹽。包括本發明組合物中之本質上為鹼性之化合物能夠與各種無機及有機酸形成多種鹽。可用於製備此類鹼性化合物之醫藥學上可接受之酸加成鹽的酸為形成無毒酸加成鹽,亦即含有藥理學可接受之陰離子的包括但不限於以下之鹽的彼等:硫酸鹽、檸檬酸鹽、蘋果酸鹽(matate)、乙酸鹽、草酸鹽、氯化物、溴化物、碘化物、硝酸鹽、硫酸鹽、硫酸氫鹽、磷酸鹽、酸式磷酸鹽、異
菸鹼酸鹽、乙酸鹽、乳酸鹽、水楊酸鹽、檸檬酸鹽、酒石酸鹽、油酸鹽、丹寧酸鹽、泛酸鹽、酒石酸氫鹽、抗壞血酸鹽、丁二酸鹽、順丁烯二酸鹽、龍膽酸鹽(gentisinate)、反丁烯二酸鹽、葡糖酸鹽、葡糖醛酸鹽(glucaronate)、糖酸鹽、甲酸鹽、苯甲酸鹽、麩胺酸鹽、甲烷磺酸鹽、乙烷磺酸鹽、苯磺酸鹽、對甲苯磺酸鹽及雙羥萘酸鹽(亦即1,1'-亞甲基-雙(2-羥基-3-萘甲酸鹽))。包括胺基部分之包括於本發明組合物中之化合物可與除上文所提及之酸以外的各種胺基酸形成醫藥學上可接受之鹽。本質上為酸性的包括於本發明組合物中之化合物能夠與各種藥理學可接受之陽離子形成鹼式鹽。此類鹽之實例包括鹼金屬或鹼土金屬鹽,且尤其鈣鹽、鎂鹽、鈉鹽、鋰鹽、鋅鹽、鉀鹽及鐵鹽。
此外,若所獲得之本文所描述之化合物呈酸加成鹽形式,則可藉由鹼化酸性鹽之溶液來獲得游離鹼。反之,若產物為游離鹼,則可根據用於自鹼性化合物製備酸加成鹽之習知程序,藉由將游離鹼溶解於適合之有機溶劑中且用酸處理溶液來產生加成鹽,尤其醫藥學上可接受之加成鹽。熟習此項技術者將識別可用於製備醫藥學上可接受之無毒加成鹽之各種合成方法。
式I及式II化合物可含有一或多個對掌性中心及/或雙鍵,且因此以立體異構體(諸如幾何異構體)、對映異構體或非對映異構體形式存在。術語「立體異構體」在本文中使用時由所有幾何異構體、對映異構體或非對映異構體組成。此等化合物可視圍繞立體碳原子之取代基的組態而定藉由符號「R」或「S」加以命名。本發明涵蓋此等化合物之各種立體異構體及其混合物。立體異構體包括對映異構體及非對映異構體。對映異構體或非對映異構體之混合物可在命名中指明為「(±)」,但熟練技工將認識到結構可表示隱含對掌性中心。
用於本發明方法中之化合物的個別立體異構體可自含有不對稱或立體中心之可商購獲得之起始物質,或藉由製備外消旋混合物繼之以
一般熟習此項技術者熟知之解析方法來合成製備。此等解析方法藉由以下來例示(1)將對映異構體之混合物附接至對掌性助劑,藉由再結晶或層析法分離所得非對映異構體混合物,且自助劑釋放光學純產物,(2)使用光學活性解析劑形成鹽,或(3)在對掌性層析柱上直接分離光學對映異構體之混合物。立體異構化混合物亦可藉由諸如以下熟知方法解析成其組分立體異構體:對掌性相氣相層析法、對掌性相高效液相層析法、使化合物結晶為對掌性鹽複合物或使化合物在對掌性溶劑中結晶。立體異構體亦可藉由熟知不對稱合成方法獲自立體異構純中間物、試劑及催化劑。
幾何異構體亦可存在式I及式II化合物於。本發明涵蓋由取代基圍繞碳-碳雙鍵排列或取代基圍繞碳環排列而產生之各種幾何異構體及其混合物。圍繞碳-碳雙鍵之取代基命名為呈「Z」或「E」組態,其中術語「Z」及「E」係根據IUPAC標準使用。除非另作說明,否則展示雙鍵之結構涵蓋E與Z異構體兩者。
或者,圍繞碳-碳雙鍵之取代基可稱為「順」或「反」,其中「順」表示取代基位於雙鍵之相同側,而「反」表示取代基位於雙鍵之相對側。取代基圍繞碳環排列命名為「順」或「反」。術語「順」表示取代基位於環平面之相同側,而術語「反」表示取代基位於環平面之相對側。取代基佈置於環平面之相同側及相對側之化合物的混合物命名為「順/反」。
本文所揭示之式I及式II化合物可以互變異構體形式存在且兩種互變異構體形式旨在由本發明範疇涵蓋,儘管僅展示一種互變結構。舉例而言,以下對化合物A之任何主張應理解為包括互變結構B,且反之亦然,以及其混合物。
如本文所用,「補體相關疾病」、「補體相關病症」及「補體相關病狀」係指由補體級聯反應及其相關系統之組分中之一者或多者的異常活性介導的疾病、病症及病狀。補體相關疾病包括但不限於動脈粥樣硬化、膜性腎小球腎炎、氣喘、器官移植排斥、血栓形成、深靜脈血栓形成、瀰散性靜脈血栓栓塞、瀰漫性血管內凝血及慢性阻塞性肺病(COPD)。其他示例性補體相關疾病包括但不限於陣發性夜間血紅蛋白尿、非典型性溶血性尿毒症症候群、肌萎縮性側索硬化、黃斑變性、狼瘡性腎炎、重症肌無力、視神經脊髓炎、抗磷脂症候群、災難性抗磷脂症候群、緻密物沈積病(II型膜增生性腎小球性腎炎)、產志賀樣毒素大腸桿菌溶血性尿毒症症候群以及腹部及胸部主動脈瘤。其他示例性補體相關疾病包括但不限於家族性CD59缺乏、冷凝集素病、家族性C3腎小球病、C3腎小球性腎炎、補體因子H相關蛋白5腎病、IgA腎病及遺傳性血管性水腫(HAE)。
「個體」係指已為或將為治療、觀測或實驗之目標的動物,諸如哺乳動物。本文所描述之方法可適用用於人類治療及獸醫學應用。在一個實施例中,個體為人類。
如本文所用,「治療(treatment/treating)」係指改善疾病或病症或其至少一種可辨別之症狀。在另一實施例中,「治療(treatment/treating)」係指改善至少一種可量測、患者未必可辨別之物理參數。在另一實施例中,「治療(treatment/treating)」係指物理地例如穩定可辨別之症狀、生理學地例如穩定化物理參數或在兩種情況下減少疾病或病症之進展。在另一實施例中,「治療(treatment/treating)」係指延遲疾病或病症
發作。舉例而言,治療膽固醇病症可包括降低血液膽固醇含量。
如本文所用,「預防(prevention/preventing)」係指降低獲得給定疾病或病症或給定疾病或病症之症狀的危險。
如本文所用,「調節(modulate/modulation/modulating)」係指下調補體級聯反應之組分的表現,從而使得補體途徑之活性降低。
醫藥組合物
在某些實施例中,式I或式II化合物(或其互變異構體、立體異構體、醫藥學上可接受之鹽或水合物)係調配成用於經口投與。適合用於經口投與之調配物可存在於離散單元中,諸如膠囊、扁囊劑、糖錠、錠劑或貼片,其各自含有預定量之呈粉末或顆粒形式;呈於水性或非水性液體中之溶液或懸浮液形式;或呈水包油或油包水乳劑形式之本發明化合物。此類調配物可藉由任何適合之製藥方法製備,該任何適合之製藥方法包括使作為活性化合物之至少一種本發明化合物與載劑或賦形劑(其可構成一或多種輔助成分)相關聯之步驟。載劑必須在與調配物之其他成分相容的意義上為可接受的且不能對受體有害。載劑可為固體或液體或兩者,且可與作為活性化合物之本文所描述之化合物一起調配成單位劑量調配物,例如錠劑,其可含有約0.05重量%至約95重量%之至少一種活性化合物。亦可存在其他藥理學活性物質,包括其他化合物。本發明之調配物可藉由基本上由將組分混合組成之熟知製藥技術中之任一者來製備。
對於固體組合物,習知無毒固體載劑包括例如醫藥級之甘露糖醇、乳糖、澱粉、硬脂酸鎂、糖精鈉、滑石、纖維素、葡萄糖、蔗糖、碳酸鎂及類似物。液體藥理學可投與組合物可例如藉由以下方式來製備,例如將至少一種如本文所描述之本發明活性化合物及視情況存在之醫藥佐劑溶解或分散於諸如水、生理鹽水、右旋糖水溶液、甘油、乙醇及類似物之賦形劑中,由此形成溶液、軟膏或懸浮液。一般而言,
適合之調配物可藉由將至少一種本發明之活性化合物與液體或精細粉碎之固體載劑或兩者均勻且緊密摻合,且然後(必要時)使產物成型來製備。舉例而言,錠劑可藉由將可視情況與一或多種輔助成分組合之至少一種本發明化合物之粉末或顆粒壓製或模製來製備。
壓製錠劑可藉由在適合之機器中將可視情況與黏合劑、潤滑劑、惰性稀釋劑及/或表面活性劑/分散劑混合之呈自由流動形式(諸如粉末或顆粒)之至少一種本發明化合物壓製來製備。模製片劑可經由在適合之機器中模製來製備,其中粉末形式之至少一種本發明化合物用惰性液體稀釋劑潤濕。
適合用於頰內(舌下)投與之調配物包括糖錠,其包含含於調味基質(通常為蔗糖及阿拉伯膠或黃蓍膠)中之至少一種本發明化合物;及軟錠劑,其包含含於惰性基質(諸如明膠及甘油或蔗糖及阿拉伯膠)中之至少一種化合物。
投與之活性化合物的量可視正在治療之個體、個體之重量、投與方式及處方醫師之判斷而定。舉例而言,給藥時程可涉及以約1-100mg或100-300mg式I或式II化合物(或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物)之劑量每天一次或每天兩次投與囊封化合物。
在另一實施例中,可使用間歇投與(諸如按每月或每年)一定劑量之囊封化合物。囊封促進到達作用位點且允許同時投與活性成分,從而理論上產生協同效應。根據標準給藥方案,醫師將容易地確定最佳劑量且將能夠容易地修改投與以實現此類劑量。
本文所揭示之化合物或組合物之治療有效量可根據化合物之療效來量測。然而,劑量可視患者之需要、正在治療之病狀的嚴重程度及所使用之化合物而不同。在一個實施例中,所揭示化合物之治療有效量足以形成最大血漿濃度。如例如根據動物試驗所確定之初步劑量及人類投與之劑量的按比例變化係根據此項技術接受之作法來進行。
毒性及治療功效可在細胞培養物或實驗動物中藉由例如用於確定LD50(群體50%致死之劑量)且ED50(在群體50%中治療有效之劑量)之標準醫藥程序來確定。毒性與治療作用之間的劑量比率為治療指數且其可以比率LD50/ED50表示。展現大治療指數之組合物為優選的。
獲自細胞培養物分析或動物研究之數據可用於調配一系列用於人類之劑量。在動物模型中實現之治療有效劑量可使用此項技術中已知之換算因數轉化為用於另一動物,包括人類(參見例如Freireich等人,Cancer Chemother.Reports 50(4):219-244(1966)及表1之相等表面積劑量因數)。
此類化合物之劑量較佳位於包括在極小或沒有毒性情況下之ED50的循環濃度的範圍內。視所使用之劑型及所使用之投藥途徑而定,劑量可在此範圍內變化。一般而言,治療有效量可隨個體之年齡、病狀及性別,以及個體之醫學病狀的嚴重程度而變化。劑量可由醫師確定且根據需要進行調節,以適合所觀測到之治療效果。
治療方法
本發明提供用於調節有需要之患者之補體系統的方法。在一些實施例中,該方法包括藉由向個體(例如哺乳動物,諸如人類)投與治療有效量之至少一種本發明化合物(亦即式I或式II化合物)或其互變異構體、立體異構體、醫藥學上可接受之鹽或水合物來治療或預防補體相
關疾病或病症。在某些實施例中,本發明之方法包括投與醫藥學上可接受之組合物,其包含一或多種式I或式II化合物及醫藥學上可接受之載劑。
本發明進一步提供一種用於治療或預防補體相關疾病或病症之方法,該方法涉及藉由投與治療有效量之至少一種式I或式II化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物調節一或多種選自以下之基因:例如甘露糖結合凝集素(蛋白質C)2、補體組分9、補體組分6、補體組分8 α多肽、補體組分4B、補體組分4A、凝血因子IX、凝血因子VII、補體組分4結合蛋白-β、補體組分5、蛋白質C、凝血因子XI、激肽釋放酶B(血漿)、組織因子通道抑制劑、補體組分8 γ多肽、補體組分1-s亞組分、補體組分8-β多肽、凝血因子XII、凝血因子II、凝血因子XIII B多肽、serpin肽酶抑制劑進化枝E、補體組分2、α-2-巨球蛋白、補體因子H、補體因子I、補體因子B、補體組分1 R亞組分、甘露聚糖結合凝集素絲胺酸肽酶1、蛋白質S、凝血因子V、補體組分5a受體1、補體組分4結合蛋白α、serpin肽酶抑制劑進化枝C成員1、補體組分3、甘露聚糖結合凝集素絲胺酸肽酶2、凝血因子X、凝血因子VIII、serpin肽酶抑制劑進化枝D成員1、serpin肽酶抑制劑進化枝F成員2、纖溶酶原、緩激肽受體B2、緩激肽受體B1、serpin肽酶抑制劑進化枝A成員5、凝血因子III、serpin肽酶抑制劑進化枝G(C1抑制劑)成員1、羧肽酶B2(血漿)、纖維蛋白原β鏈、激肽原1、補體組分(3b/4b)受體1、組織型纖溶酶原激活劑、補體組分(3d/愛潑斯坦巴爾病毒(epstein barr virus))受體2、凝血酶調節素、CD55分子、補體衰減加速因子、補體組分1 Q亞組分A鏈或補體組分7、尿激酶型纖溶酶原激活劑、補體因子D、補體組分1 Q亞組分C鏈、CD46分子補體調控蛋白、纖維蛋白原γ鏈、溫韋伯氏因子(von willebrand factor)、CD59分子補體調控劑、尿激酶型纖溶酶原激活劑受體、serpin肽酶抑制劑進化枝A成員1、凝血
因子XIII A1多肽、補體組分3a受體1、纖維蛋白原α鏈、補體組分1 Q亞組分B鏈及/或凝血因子II(凝血酶)受體。
另一實施例包含一種用於治療或預防補體相關疾病或病症之方法,其涉及調節一或多種選自以下之基因:甘露糖結合凝集素(蛋白質C)2、補體組分3、補體組分5、補體因子D、補體因子H及/或補體組分9。
在一個實施例中,該方法包括向個體(諸如人類)投與至少一種式I或式II化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物作為針對諸如以下補體相關疾病及病症之預防措施:動脈粥樣硬化、膜性腎小球腎炎、氣喘、器官移植排斥、血栓形成、深靜脈血栓形成、瀰散性靜脈血栓栓塞、瀰漫性血管內凝血及慢性阻塞性肺病(COPD)。
在另一實施例中,該方法包括向個體(諸如人類)投與至少一種式I或式II化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物作為針對諸如以下補體相關疾病及病症之預防措施:陣發性夜間血紅蛋白尿、非典型性溶血性尿毒症症候群、肌萎縮性側索硬化、黃斑變性、狼瘡性腎炎、重症肌無力、視神經脊髓炎、抗磷脂症候群、災難性抗磷脂症候群、緻密物沈積病(II型膜增生性腎小球性腎炎)、產志賀樣毒素大腸桿菌溶血性尿毒症症候群以及腹部及胸部主動脈瘤。
在另一實施例中,該方法包括向個體(諸如人類)投與至少一種式I或式II化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物作為針對諸如以下補體相關疾病及病症之預防措施:家族性CD59缺乏、冷凝集素病、家族性C3腎小球病、C3腎小球性腎炎、補體因子H相關蛋白5腎病、IgA腎病及遺傳性血管性水腫(HAE)。
在一個實施例中,至少一種式I或式II化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物係作為預防措施向個體(諸如
人類)投與,該個體對諸如以下補體相關疾病及病症具有遺傳易感性:動脈粥樣硬化、膜性腎小球腎炎、氣喘、器官移植排斥、血栓形成、深靜脈血栓形成、瀰散性靜脈血栓栓塞、瀰漫性血管內凝血及慢性阻塞性肺病(COPD)。
在另一實施例中,至少一種式I或式II化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物係作為預防措施向個體(諸如人類)投與,該個體對諸如以下補體相關疾病及病症具有遺傳易感性:陣發性夜間血紅蛋白尿、非典型性溶血性尿毒症症候群、肌萎縮性側索硬化、黃斑變性、狼瘡性腎炎、重症肌無力、視神經脊髓炎、抗磷脂症候群、災難性抗磷脂症候群、緻密物沈積病(II型膜增生性腎小球性腎炎)、產志賀樣毒素大腸桿菌溶血性尿毒症症候群以及腹部及胸部主動脈瘤。
在另一實施例中,至少一種式I或式II化合物或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物係作為預防措施向個體(諸如人類)投與,該個體對諸如以下補體相關疾病及病症具有遺傳易感性:家族性CD59缺乏、冷凝集素病、家族性C3腎小球病、C3腎小球性腎炎、補體因子H相關蛋白5腎病、IgA腎病及遺傳性血管性水腫(HAE)。
在另一實施例中,式I或式II化合物可用於預防一種補體相關疾病或病症,同時又治療另一種疾病。
實例
實例1:基因表現變化
在此實例中,定量培養細胞物之mRNA含量。該分析可用於確定化合物對調控mRNA含量之影響,包括本發明中之彼等化合物。補體基因以高內源性水準表現,但其表現亦可受炎症病狀中之各種細胞因子刺激。此實例中之實驗將基礎及炎性補體基因表現作為目標。化合物介導之基因表現變化及所得mRNA含量呈現於以下表2、3及4以及圖
1、2、3及4中。
Huh-7及HepG2細胞係肝臟衍生之細胞株且為關於肝臟中可發生什麼之模型。將Huh-7細胞(JCRB Cell Bank)引入96孔板(約2.5x105個/孔)中含有10%(v/v)FBS、100U/mL青黴素、100ug/mL鏈黴素及5ug/mL plasmocin(所有試劑均來自Gibco,除了前者,其獲自Invivogen)之100μL DMEM中。在24h之後,將Huh-7細胞在用於塗鋪且補充有0.1% DMSO之相同培養基調配物中用化合物處理,持續表2、3及4中所示之量的時間。對於選擇實驗,在塗鋪後24h,將細胞同時用細胞因子與所關注化合物處理,持續48h之總處理時間。或者,在塗鋪之後24h,將細胞用細胞因子預處理24h,然後添加所關注化合物,持續48h。將HepG2細胞(ATCC)在96孔板(約2.5x105個/孔)中在含有10% FBS、1X非必需胺基酸、1mM丙酮酸鈉、2mM L-麩醯胺、100U/mL青黴素、100ug/mL鏈黴素及5ug/mL plasmocin之MEM中培養。對於用化合物或細胞因子治療,血清量降至0.5%。用化合物及細胞因子處理HepG2細胞之計時如關於Huh-7細胞所描述。將原代人類肝細胞(CellzDirect/Life Technologies)以70000個細胞/孔塗鋪於膠原蛋白塗佈之96孔板中,然後如供應商所建議用MatrigelTM覆蓋。在所建議之補充有0.1% DMSO及10% FBS(v/v)之培養基中在所指示之時間點用所關注之化合物及/或細胞因子處理細胞。藉由mRNA捕捉器PLUS套組(Life Technologies)收穫細胞,隨後使用RNA UltraSense One-Step qRT-PCR系統進行實時PCR。所關注之mRNA的含量係藉由TaqMan實時PCR相對於在相同樣品中之內源性對照親環素A進行量測。使用ViiA-7實時PCR系統(Applied Biosystems)獲得數據。
補體級聯反應之組分的表現下調將引起途徑之活性降低且因此將構成陽性結果。表2及3列舉使得所指示mRNA含量降低50%之化合物濃度,以及用化合物處理之持續時間。表4列舉用化合物處理長達72小時
之原代人類肝細胞中所量測之所指示mRNA的最大降低。圖1、2、3及4顯示化合物對細胞因子誘導之(亦即炎性)補體基因在Huh-7細胞及HepG2細胞中之表現的影響。
除表2及4中所示之基因以外,經由實時PCR在諸如但不限於Huh-7、HepG2及/或原代人類肝細胞之所培養細胞中分析補體及凝血級聯反應之其他成員。
實例2:使用小鼠模型之活體內研究。
在此實例中,藉由將人類肝細胞移植至尿激酶型纖溶酶原激活劑+/+/嚴重聯合免疫缺陷轉基因小鼠中來產生具有人類化肝臟之嵌合小鼠。人類肝細胞置換可達到80-90%。此小鼠模型可用於測定化合物(包括本發明中之彼等化合物)對在活體內調控人類肝細胞中之mRNA含
量的影響。將小鼠藉由口服灌胃用RVX000222或媒劑以150mg/kg(1天2次)處理3天。收穫肝臟且藉由實時PCR使用人類特異性TaqMan引物探針及作為內源性對照之親環素A測定RNA含量。表5列舉所指示mRNA之含量的降低。*p<0.05、**p<0.01係使用2尾史都登氏(student’s)t試驗相較於媒劑處理之動物而得到。
實例3:全血中之微陣列分析
在此實例中,藉由微陣列分析離體處理之人類全血的RNA。該方法可用於測定化合物(包括本發明中之彼等)對RNA含量之影響(表6)。
在獲得知情同意之後,將來自三個健康志願者之全血收集至BD Vacutainer肝素鈉管中,且將樣品顛倒10次。將血液樣品(1mL)與含有2mM麩醯胺、100U/mL青黴素、100ug/mL鏈黴素、20% FBS及所關注化合物或媒劑(0.1% DMSO)之1mL RPMI組合,隨後在37℃下孵育24h。將所處理之樣品轉移至PAXgene RNA管(PreAnalytix/Qiagen)中,顛倒5次並冷凍。用PAXgene RNA套組根據製造商之說明書分離RNA。使用Affymetrix Human U133 Plus 2.4陣列藉由Asuragen(Austin,TX)進行微陣列分析。表6中所示為3個獨立樣品之平均值(p<0.01)。補體級聯反應之組分的表現下調將引起途徑之活性降低且因此將構成陽性結果。負調控劑對途徑之上調或正調控劑之下調亦將引起途徑之活性降低且因此將構成陽性結果。
實例4:所分泌之補體蛋白之量測
在此實例中,在所關注化合物存在下在培養物由細胞生長引起之蛋白質分泌係藉由酶聯免疫吸附分析(ELISA)進行分析。在一些情況下,將所培養之細胞用細胞因子及所關注化合物處理以模擬炎性狀態。該方法可用於測定化合物(包括本發明中之彼等)對在基礎及細胞因子刺激(亦即炎性)條件下在培養物中由細胞生長引起之特異性蛋白之分泌的影響(表7、圖5及6)。
將Huh-7細胞(JCRB Cell Bank)以200000個細胞/孔引入24孔板中補充有10%(v/v)FBS、100U/mL青黴素、100ug/mL鏈黴素及5ug/mL plasmocin(所有試劑均來自Gibco,除了前者,其來自Invivogen)之500μL DMEM中。在24h之後,將細胞在含有0.1% DMSO之DMEM加10% FBS中用所關注化合物及/或細胞因子處理72h之總處理時間。在實驗之最後24h引入含有化合物及/或細胞因子之新鮮培養基。在收穫時,收集培養基,藉由簡單離心移除碎片,且按照製造商之方案對所指示蛋白質進行ELISA分析。為校正細胞數目之差異,將所獲得之補體蛋白的值正規化為轉鐵蛋白之值。在含有10% FBS、1X非必需胺基酸、1mM丙酮酸鈉、2mM L-麩醯胺、100U/mL青黴素、100ug/mL鏈黴素及5ug/mL plasmocin之MEM中培養HepG2細胞(ATCC)。當化合物存在時血清量降至0.5%。處理組合及計時如上文關於Huh-7細胞所描述。將原代人類肝細胞(CellzDirect/Life Technologies)以70000個細胞/孔塗鋪於膠原蛋白塗佈之96孔板中,然後如供應商所建議用MatrigelTM覆蓋。將
細胞在所建議之補充有10% FBS及0.1% DMSO(v/v)的培養基中在存在或不存在所指示細胞因子之情況下用所關注化合物處理總共72h。收集培養基用於量測所分泌之蛋白質。
用於偵測補體C3、C4、C5及C9之ELISA套組係獲自AssayPro(St.Charles,MO),而用於轉鐵蛋白偵測之ELISA試劑係來自Bethyl Laboratories(Montgomery,TX)。數據係在Thermo Scientific Multiskan GO設備上收集。補體級聯反應之組分的表現下調將引起途徑之活性降低且因此將構成陽性結果。表7:圖5及6列舉在用RVX000222(與DMSO相比)處理之細胞培養基中偵測到之C3、C4、C5及C9蛋白的量。
評估使用ELISA方法對來自所培養細胞之其他所分泌蛋白質之定量。此包括但不限於補體C6、C8、MBL2或因子H。
實例5:多分析物型態分析(Multi-Analyte Profiling)
在此實例中,藉由多分析物型態分析(MAP)技術分析來自用安慰劑或RVX000222處理之人類個體之血漿樣品。該方法可用於測定化合物(包括本發明中之彼等)對血漿中之各種分析物之含量的影響(表8)。
將在基線及終止時間點(26週)收集自二十個經RVX000222處理之個體及十個經安慰劑處理之個體的血漿(來自先前完成之ASSURE臨床試驗;NCT01067820)送去進行MAP分析。使用基於微球之免疫多路測定技術,分析各樣品且定量107種不同血漿蛋白之含量。各蛋白質分析物之值的變化係相較於基線量測來計算且報導統計顯著性(p<0.05)及
趨勢(0.01>p>0.05)值。補體級聯反應之組分的表現下調將引起途徑之活性降低且因此將構成陽性結果。表8概述在用RVX000222處理26週之情況下所觀測到血漿分析物之變化。
實例6:使用LC-MRM/MS之蛋白質定量
在此實例中,藉由1D LC-MRM/MS技術分析來自用安慰劑或RVX000222處理之人類個體之血漿樣品。該方法可用於測定化合物(包括本發明中之彼等)對血漿中所發現之各種分析物之含量的影響。
將在基線及終止時間點(26週)收集自74個經RVX000222處理之個體及17個經安慰劑處理之個體的血漿(來自先前完成之ASSURE臨床試驗;NCT01067820)送去進行絕對蛋白質定量。使用質譜法(包括多反應監測(MRM)質譜法(MRM-MS))分析各樣品中43種不同血漿蛋白之存在及量。各蛋白質分析物之值的變化係相較於基線量測來計算且報導統計顯著性(p<0.05)及趨勢(0.10>p>0.05)值(表9)。補體級聯反應之組分的表現下調將引起途徑之活性降低且因此將構成陽性結果。
注意:肽之結果係以最高濃度顯示;斜體字指示中值
實例7:補體活性分析
在此實例中,藉由總溶血補體(CH50)分析及補體替代途徑(AH50)分析來分析來自用安慰劑或RVX000222處理之人類個體之血清樣品。該方法可用於測定化合物(包括本發明中之彼等)對臨床樣品中經典及替代補體系統之活性的影響。
將在基線及終止時間點(26週)收集自經RVX000222處理之個體及經安慰劑處理之個體的血清(來自先前完成之ASSURE臨床試驗;NCT01067820)在AH50及CH50分析中進行分析。使用CH50篩檢分析來偵測藉由特異性抗體敏化之羊紅血球之溶血,量測來自經處理及未經處理之個體的血清樣品中補體系統之溶血活性。同樣地,使用僅激活替代途徑(AH50)之特定條件,量測補體反應之活性。在基線處及終點量測補體激活之程度以確定在藥物處理之後補體系統之功能是否存在
任何變化(圖7)。補體系統功能降低構成陽性結果。
實例8:使用SOMAScan
TM
之臨床樣品中之蛋白質定量。
在此實例中,藉由SOMAscanTM分析(SomaLogic)來分析來自用安慰劑或RVX000222處理之人類個體之血漿樣品。該方法可用於測定化合物(包括本發明中之彼等)對臨床樣品中蛋白質(包括補體組分)之豐度的影響。
將在基線及終止時間點(26週)收集自47個經RVX000222處理之個體的血漿(來自先前完成之ASSURE臨床試驗;NCT01067820)送去分析。使用SOMAscanTM技術,分析各樣品中1,310種不同蛋白質之相對存在及量。各蛋白質分析物之值的變化係相較於基線量測來計算且報導統計顯著性(p<0.05)值(表10)。補體級聯反應之組分的表現下調將引起途徑之活性降低且因此將構成陽性結果。
本文中所提及之所有參考文獻係以全文引用的方式併入本文中。經由考慮本說明書及實踐本文所揭示之本發明,本發明之其他實施例對熟習此項技術者而言將顯而易見。
Claims (14)
- 如請求項1之用途,其中W為CH;以及R6選自經一或多個選自以下之基團取代的C1-C6烷氧基:丙-2-基胺基、吡咯啶基、甲烷磺醯胺、2-甲基丙醯胺、乙醯胺、胺基甲酸乙酯及羥基。
- 如請求項1之用途,其中R6選自2-(羥基)乙氧基、2-(吡咯啶-1-基) 乙氧基、4-異丙基哌嗪-1-基及2-(異丙胺基)乙氧基。
- 如請求項1之用途,其中R6為2-(羥基)乙氧基;且R1及R3為甲氧基。
- 如請求項1之用途,其中該式I化合物選自:2-(4-(2-羥基乙氧基)-3,5-二甲基苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮;2-{3,5-二甲基-4-[2-(吡咯啶-1-基)乙氧基]苯基}-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮;2-(3,5-二甲基-4-{2-[(丙-2-基)胺基]乙氧基}苯基)-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮;5,7-二甲氧基-2-{4-[4-(丙-2-基)哌嗪-1-基]苯基}-3,4-二氫喹唑啉-4-酮;5,7-二甲氧基-2-{3-甲氧基-5-[2-(吡咯啶-1-基)乙氧基]苯基}-3,4-二氫喹唑啉-4-酮;2-{3,5-二甲基-4-[2-(吡咯啶-1-基)乙氧基]苯基}-5,7-二甲氧基-3H,4H-吡啶并[2,3-d]嘧啶-4-酮;2-{4-[2-(3,3-二氟吡咯啶-1-基)乙氧基]-3,5-二甲基苯基}-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮;N-{2-[4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基]乙基}-2-甲基丙醯胺;5,7-二甲氧基-2-[4-(哌嗪-1-基)苯基]-3,4-二氫喹唑啉-4-酮;2-(4-羥基-3,5-二甲基苯基)-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮;N-{2-[4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基]乙基}乙醯胺;N-{2-[4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基]乙基}胺基甲酸甲酯;2-[4-(2,3-二羥基丙氧基)-3,5-二甲基苯基]-5,7-二甲氧基-3,4-二 氫喹唑啉-4-酮;甲基胺基甲酸2-(4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基-苯氧基)乙酯;丙基胺基甲酸2-(4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基-苯氧基)乙酯;N-(2-(4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基)乙基)甲烷磺醯胺;2-(4-(2-羥基乙氧基)-3-甲基苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮;2-(4-(2-羥基乙氧基)-3,5-二甲基苯基)-5,7-二甲氧基吡啶并[2,3-d]嘧啶-4(3H)-酮;2-(4-(2-羥基乙氧基)-3,5-二甲基苯基)-6,7-二甲氧基喹唑啉-4(3H)-酮;2-(4-(2-羥基乙氧基)-3-甲氧基苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮;及其立體異構體、互變異構體、醫藥學上可接受之鹽及水合物。
- 如請求項1之用途,其中該式I化合物為[2-(4-(2-羥基乙氧基)-3,5-二甲基苯基)-5,7-二甲氧基喹唑啉-4(3H)-酮]或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
- 如請求項1之用途,其中該式I化合物為2-{3,5-二甲基-4-[2-(吡咯啶-1-基)乙氧基]苯基}-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
- 如請求項1之用途,其中該式I化合物為2-(3,5-二甲基-4-{2-[(丙-2-基)胺基]乙氧基}苯基)-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
- 如請求項1之用途,其中該式I化合物為5,7-二甲氧基-2-{4-[4-(丙 -2-基)哌嗪-1-基]苯基}-3,4-二氫喹唑啉-4-酮或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物。
- 一種2-{2-[(二甲胺基)甲基]-1H-吲哚-5-基}-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮或其立體異構體、互變異構體、醫藥學上可接受之鹽或水合物用於製造藥劑之用途,其中該藥劑係用於藉由調節有需要各體之補體系統來治療選自下列之補體相關疾病或病症:陣發性夜間血紅蛋白尿、家族性CD59缺乏、冷凝集素病及遺傳性血管性水腫。
- 如請求項1至10中任一項之用途,其中該補體相關疾病或病症為陣發性夜間血紅蛋白尿。
- 如請求項1至10中任一項之用途,其中該補體相關疾病或病症選自家族性CD59缺乏、冷凝集素病及遺傳性血管性水腫(HAE)。
- 一種化合物,其選自:2-{4-[2-(3,3-二氟吡咯啶-1-基)乙氧基]-3,5-二甲基苯基}-5,7-二甲氧基-3,4-二氫喹唑啉-4-酮;N-{2-[4-(5,7-二甲氧基-4-側氧基-3,4-二氫喹唑啉-2-基)-2,6-二甲基苯氧基]乙基}胺基甲酸甲酯;及其立體異構體、互變異構體、醫藥學上可接受之鹽及水合物。
- 一種醫藥組合物,其包含如請求項13之化合物以及醫藥學上可接受之載劑。
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KR102662814B1 (ko) | 2024-05-03 |
CN107530356A (zh) | 2018-01-02 |
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JO3789B1 (ar) | 2021-01-31 |
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US10772894B2 (en) | 2020-09-15 |
EP3268007A4 (en) | 2018-11-07 |
TW201639574A (zh) | 2016-11-16 |
US20190091235A1 (en) | 2019-03-28 |
US20160263126A1 (en) | 2016-09-15 |
US10111885B2 (en) | 2018-10-30 |
JP6903585B2 (ja) | 2021-07-14 |
CN114984016A (zh) | 2022-09-02 |
CA2977308A1 (en) | 2016-09-22 |
KR20170123696A (ko) | 2017-11-08 |
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