US20170202791A1 - N,n-bis-2-mercaptoethyl isophthalamide for the treatment of neurodegenerative diseases - Google Patents

N,n-bis-2-mercaptoethyl isophthalamide for the treatment of neurodegenerative diseases Download PDF

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US20170202791A1
US20170202791A1 US15/313,877 US201515313877A US2017202791A1 US 20170202791 A1 US20170202791 A1 US 20170202791A1 US 201515313877 A US201515313877 A US 201515313877A US 2017202791 A1 US2017202791 A1 US 2017202791A1
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disease
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neurodegenerative disorder
nbmi
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Boyd Eugene HALEY
Ragnar Axel Theodor KLINGBERG
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Emeramed Ltd
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/16—Amides, e.g. hydroxamic acids
    • A61K31/165—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide
    • A61K31/166—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the carbon of a carboxamide group directly attached to the aromatic ring, e.g. procainamide, procarbazine, metoclopramide, labetalol
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/13—Amines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/16—Amides, e.g. hydroxamic acids
    • A61K31/165—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19—Carboxylic acids, e.g. valproic acid
    • A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
    • A61K31/197—Carboxylic acids, e.g. valproic acid having an amino group the amino and the carboxyl groups being attached to the same acyclic carbon chain, e.g. gamma-aminobutyric acid [GABA], beta-alanine, epsilon-aminocaproic acid or pantothenic acid
    • A61K31/198—Alpha-amino acids, e.g. alanine or edetic acid [EDTA]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/425—Thiazoles
    • A61K31/428—Thiazoles condensed with carbocyclic rings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47—Quinolines; Isoquinolines
    • A61K31/4738—Quinolines; Isoquinolines ortho- or peri-condensed with heterocyclic ring systems
    • A61K31/4745—Quinolines; Isoquinolines ortho- or peri-condensed with heterocyclic ring systems condensed with ring systems having nitrogen as a ring hetero atom, e.g. phenantrolines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
    • Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

Definitions

  • This invention relates to a new use of a known heavy metal-chelating compound.
  • Neurological disorders are disorders of the body's nervous system, resulting in mental symptoms, such as confusion, altered levels of consciousness, and/or physical symptoms, including pain, loss of sensation, paralysis, muscle weakness, poor coordination and/or seizures.
  • All neurological disorders are characterised by one or more structural, biochemical and/or electrical abnormalities in the brain, spinal cord and/or other part of the nervous system.
  • the World Health Organization has estimated that neurological disorders and their sequelae affect as many as one billion people worldwide, and has also identified health inequalities and social stigma/discrimination as major factors contributing to the associated disability and suffering.
  • NDs neurodegenerative disorders
  • Neurodegenerative processes that lead to the latter conditions involve loss of structure and/or function (including death) of neurons, and may take place in many different levels of molecular and/or systemic neuronal circuitry.
  • AD Alzheimer's disease
  • AD Alzheimer's disease
  • AD Alzheimer's disease
  • diagnosis is typically confirmed by tests that evaluate behaviour, and/or a brain scan, with examination of brain tissue being required for a definitive diagnosis.
  • the disease is thought to be associated with plaques and tangles in the brain (see, for example, Tiraboschi et al, Neurology, 62, 1984 (2004)).
  • AD presents a significant burden on society.
  • AD Alzheimer's disease
  • Parkinson's disease is a ND of the central nervous system, which affects a sufferer's movement and coordination. The disease is fairly common (affecting approximately 0.15% of the population at any one time). Although it tends to be more prevalent in older people, it can also occur in younger adults.
  • the parts of the brain that are affected by the onset of PD include principally the substantia nigra, which is a part of the brain that controls motor function, as well as the nigrostriatal pathways and the locus coeruleus.
  • the presence of the disease gives rise to reduced level of the key neurotransmitter, dopamine in these areas.
  • Reduced dopamine activity gives rise to numerous symptoms, many of them extremely unpleasant and embarrassing for the sufferer.
  • the main symptoms are an uncontrollable tremor, particularly in the limbs, which is usually worse when a limb is at rest; increased rigidity/stiffness in the limbs (“cogwheeling”); and bradykinesias (reduced/slower movements, often manifest by shuffling when walking, soft speech and swallowing difficulties).
  • cogwheeling increased rigidity/stiffness in the limbs
  • bradykinesias reduced/slower movements, often manifest by shuffling when walking, soft speech and swallowing difficulties.
  • joint and muscle pain including joint and muscle pain, dribbling, postural hypotension and dizziness, in addition to dementia, which can often occur at later stages of the disease.
  • L-dopa has its problems, however. Although initial treatment often results in alleviation of symptoms, long-term use gives rise to a notable variability in the drug's ability to control those symptoms (so-called “motor fluctuations”). Motor fluctuations may be manifest by end of dose deterioration (i.e. a sufferer noticing that the effect of his regular dose wears off prior to his scheduled time for the next dose), involuntary fidgety movements (dyskinesias) and, most disturbingly, sudden and unexpected re-appearance of symptoms, in particular stiffness.
  • Huntington's disease is a genetic ND that affects muscle coordination and leads to cognitive decline and psychiatric problems.
  • the disease is often manifest by abnormal involuntary writhing movements (chorea, hence the previous name “Huntington's chorea”).
  • Physical symptoms of HD can start at any age, but usually begin between the ages of 35 and 44.
  • the disease is caused by an autosomal dominant mutation in either of an individual's two copies of the Huntingtin gene. Expansion of a CAG triplet repeat stretch within that gene results in a different (mutant) form of the Huntingtin protein that is expressed thereby, which gradually damages cells in the brain.
  • ALS Amyotrophic lateral sclerosis
  • MND motor neuron disease
  • Lou Gehrig's disease is a ND characterised by rapidly progressive weakness due to muscular atrophy and spasticity, often resulting difficulty in speaking, swallowing and breathing.
  • Sensory nerves and the autonomic nervous system are also generally unaffected, meaning the majority of patients maintain their sense of hearing, sight, touch, smell and taste.
  • Cognitive function is often unaffected in ALS sufferers, although if often coexists in individuals who also experience dementia, degenerative muscle disease, and degenerative bone disease as part of a syndrome called “multisystem proteinopathy”.
  • ALS irritable bowel syndrome
  • Treatments for ALS can presently only to relieve symptoms and moderately improve quality of life for patients, keeping them as mobile and comfortable as possible for as long as possible.
  • Riluzole is the only treatment that has been found to improve survival, but only to a modest extent (see Ezekowitz et al, American Family Physician, 68, 2379 (2003)), and typically lengthens survival only by a matter of months. It is not capable of reversing the damage already done to motor neurons.
  • Microglial cells are a type of resident immune that present in macrophages of the CNS system, including the brain and spinal cord. Microglia thus act as the main form of active immune defence in the CNS.
  • Microglia scavenge the CNS for plaques, damaged neurons and infectious agents.
  • the brain and spinal cord are protected from the rest of the body by a series of endothelial cells (the blood-brain barrier). This barrier prevents most infections from reaching sensitive nervous tissue. Accordingly, microglial cells react quickly to decrease inflammation and destroy the infectious agents before they damage neural tissue.
  • microglia may play a significant role in the pathogenesis of NDs.
  • Chronic activation of microglia in NDs results in release of a variety of pro-inflammatory substances (e.g. interleukin-1-beta (IL-113), tumour necrosis factor alpha (TNF- ⁇ ) and interleukin-1 (IL-6)) in the brain parenchyma, which is thought to contribute in a significant way to neurodegeneration (see, for example, Kaushik et al, CNS Neurol. Disord. Drug Targets, 12, 726 (2013), Kim et al, Exp. Mol. Med., 38, 333 (2006), Wojtera et al, Folia Neuropathol., 43, 311 (2005) and Khandelwal et al, J. Neuroimmunol., 238, 1 (2011)).
  • pro-inflammatory substances e.g. interleukin-1-beta (IL-113), tumour necrosis factor alpha (TNF- ⁇ ) and interleukin-1 (
  • Down-regulation of pro-inflammatory substances such as TNF- ⁇ and IL-6 therefore represents a viable starting point for a potential treatment protocol for NDs generally.
  • AD is known to be caused by accumulation of abnormally folded beta-amyloid (A ⁇ ) in the brain of affected individuals.
  • a ⁇ abnormally folded beta-amyloid
  • This stimulates a chronic inflammatory reaction, involving microglial activation, production of inflammatory cytokines and neurodegeneration (see, for example, Mazzitelli et al, J. Neurosci., 31, 16969 (2011) and Joshi et al, Cell Death Differ., 21, 582 (2014)).
  • a ⁇ 42 is phagocytised by activated microglia and released back as a form susceptible of differential aggregation, increasing plaque formation and neuronal death.
  • N,N-bis-2-mercaptoethyl isophthalamide was first disclosed in U.S. Pat. No. 6,586,600 B2. Its use as a dietary supplement, and in the relief of oxidative stress is disclosed in US patent application 2010/0227812.
  • NBMI is known to be a powerful chelator of heavy metals, including mercury, cadmium and lead. See also Patel et al, Toxicology Mechanisms and Methods, 22, 383 (2012).
  • NBMI is surprisingly capable of inhibiting release of key anti-inflammatory markers, such as IL-6, that are known to be expressed in patients with NDs, such as AD, PD, HD and ALS (see, for example, Urrutia et al, Front Pharmacol., 10, 38 (2014)), but also, even more surprisingly, that NBMI may be capable of modifying the aggregation state of A ⁇ 42 and microglia activation, by reducing TNF- ⁇ production and increasing A ⁇ 42-488 release, so reducing neuronal death.
  • NDs such as AD, PD, HD and ALS
  • NBMI may be administered to patients to treat NDs therapeutically by ameliorating symptoms and modifying/abrogating the progression of such diseases, without giving rise to significant adverse side effects.
  • NBMI or a pharmaceutically-acceptable salt thereof or derivative thereof, packaged and presented for use in a method of treating a ND.
  • Such a method comprises administering a pharmaceutically-effective amount of NBMI, or a pharmaceutically-acceptable salt thereof, or a pharmaceutically-acceptable derivative thereof, to a patient in need of such treatment.
  • ND will be understood to include any disorder, disease or condition characterised for example by neurodegenerative processes that involve loss of structure and/or function (including death) of neurons, and/or any degenerative condition characterised by accumulation and/or aggregation of (e.g. intracellular toxic) proteins (i.e. “proteinopathies”), such as ALS (including multisystem proteinopathy), AD, PD and prion diseases, such as Creutzfeldt-Jakob disease (and other transmissible spongiform encephalopathies), as well as HD.
  • proteinopathies such as ALS (including multisystem proteinopathy), AD, PD and prion diseases, such as Creutzfeldt-Jakob disease (and other transmissible spongiform encephalopathies), as well as HD.
  • Ataxia telangiectasia autosomal dominant cerebellar ataxia
  • Batten disease including Spielmeyer-Vogt-Sjögren-Batten disease
  • Corticobasal degeneration including Corticobasal ganglionic degeneration
  • fatal familial insomnia hereditary motor and sensory neuropathy with proximal dominance, infantile Refsum disease, locomotor ataxia, Lyme disease
  • Machado-Joseph disease also known as Machado-Joseph Azorean disease, Joseph's disease, spinocerebellar ataxia type 3 (SCA3) mental retardation
  • microcephaly with pontine and cerebellar hypoplasia also known as mental retardation, X-linked, syndromic, Najm type
  • multiple system atrophy including Shy-Drager syndrome
  • neuroacanthocytosis pontocerebellar hypop
  • AD Alzheimer's disease
  • PD including Parkinsonism
  • HD including Huntington's chorea
  • ALS Lou Gehrig's disease, and all other forms of motor neuron disease, such as primary lateral sclerosis, progressive muscular atrophy, progressive bulbar palsy and pseudobulbar palsy.
  • treatment include the therapeutic, or palliative, treatment of patients in need of, a ND, or other relevant conditions mentioned herein.
  • Patients include human patients.
  • Pharmaceutically-acceptable salts of NBMI include alkaline earth, and more particularly alkali, metal salts, such as lithium, sodium, potassium, rubidium, caesium and francium salts.
  • Such salts may be formed by conventional means, for example by reaction of NBMI with one or more equivalents of an appropriate base, optionally in a solvent, or in a medium in which the salt is insoluble, followed by removal of said solvent, or said medium, using standard techniques (e.g. in vacuo, by freeze-drying or by filtration). Salts may also be prepared by exchanging a counter-ion of an active ingredient in the form of a salt with another counter-ion, for example using a suitable ion exchange resin.
  • NBMI Pharmaceutically-acceptable derivatives of NBMI include glutathione derivatives, cysteine derivatives, alphadihydrolipoic acid derivatives, cystamine derivatives, thiolphosphate derivatives, 5′-thioladenosine derivatives, L-homocysteine, co-enzyme A derivatives, 2-mercaptoethanol derivatives, dithiothreitol derivatives, iodoacetate derivatives, bromoacetate derivatives, fluoroacetate derivatives, or chloroacetate derivatives, of NMBI.
  • Such derivatives may be prepared as described in, for example, US patent application 2011/0237776.
  • a method of treating a ND in a patient by (packaging, presenting and/or) administering NBMI, or a pharmaceutically-acceptable salt or derivative thereof, at a sufficient, pharmaceutically-effective dose.
  • NBMI may be of use in the relief of symptoms of NDs, including those mentioned hereinbefore for the various conditions.
  • a method of relieving one or more symptom of a ND in a patient suffering from that ND comprises administering NBMI, or a pharmaceutically-acceptable salt or derivative thereof, to such a patient.
  • NBMI is preferably administered locally or systemically, for example orally, intravenously or intraarterially (including by intravascular or other perivascular devices/dosage forms (e.g. stents)), intramuscularly, cutaneously, subcutaneously, transmucosally (e.g. sublingually or buccally), rectally, transdermally, nasally, pulmonarily (e.g. by inhalation, tracheally or bronchially), topically, or by any other parenteral route, in the form of a pharmaceutical preparation comprising the compound in a pharmaceutically acceptable dosage form.
  • Preferred modes of delivery include oral (particularly), intravenous, cutaneous or subcutaneous, nasal, intramuscular, or intraperitoneal delivery.
  • NBMI will generally be administered in the form of one or more pharmaceutical formulations in admixture with a pharmaceutically acceptable adjuvant, diluent or carrier, which may be selected with due regard to the intended route of administration and standard pharmaceutical practice.
  • a pharmaceutically acceptable adjuvant diluent or carrier
  • Such pharmaceutically acceptable carriers may be chemically inert to the active compounds and may have no detrimental side effects or toxicity under the conditions of use.
  • Such pharmaceutically acceptable carriers may also impart an immediate, or a modified, release of NBMI.
  • Suitable pharmaceutical formulations may be commercially available or otherwise are described in the literature, for example, Remington The Science and Practice of Pharmacy, 19th ed., Mack Printing Company, Easton, Pa. (1995) and Martindale—The Complete Drug Reference (35 th Edition) and the documents referred to therein, the relevant disclosures in all of which documents are hereby incorporated by reference. Otherwise, the preparation of suitable formulations may be achieved non-inventively by the skilled person using routine techniques. Suitable pharmaceutical formulations for use with NBMI are also described in US patent application 2010/0227812.
  • NBMI/salt/derivative in the formulation will depend on the severity of the condition, and on the patient, to be treated, as well as the compound(s) which is/are employed, but may be determined non-inventively by the skilled person.
  • NBMI may be administered at varying therapeutically effective doses to a patient in need thereof.
  • the dose administered to a human should be sufficient to effect a therapeutic response over a reasonable timeframe (as described hereinbefore).
  • the selection of the exact dose and composition and the most appropriate delivery regimen will also be influenced by inter alia the pharmacological properties of the formulation, the nature and severity of the condition being treated, and the physical condition and mental acuity of the recipient, as well as the age, condition, body weight, sex and response of the patient to be treated, and the stage/severity of the disease, as well as genetic differences between patients.
  • Administration of NBMI may be continuous or intermittent (e.g. by bolus injection).
  • the dosage may also be determined by the timing and frequency of administration.
  • Suitable doses of NBMI are therefore in the range of about 0.05 and about 100.0 mg, including between about 0.1 (e.g. about 1) and about 50 (e.g. about 60) mg, for example between about 0.5 (e.g. about 1.5) and about 10 (e.g. about 40) mg of the compound per kilogram of the patient's total body weight per day.
  • the medical practitioner or other skilled person, will be able to determine routinely the actual dosage, which will be most suitable for an individual patient.
  • the above-mentioned dosages are exemplary of the average case; there can, of course, be individual instances where higher or lower dosage ranges are merited, and such are within the scope of this invention.
  • NBMI may also be combined with one or more active ingredients that are potentially useful, or have been indicated for use, in the treatment of a ND. Such patients may thus also (and/or already) be receiving therapy based upon administration of one or more of such active ingredients, by which we mean receiving a prescribed dose of one or more of those active ingredients mentioned herein, prior to, in addition to, and/or following, treatment with NBMI.
  • Such active ingredients include, for example, for AD, cholinesterase inhibitors, such as donepezil, rivastigmine, tacrine and galantamine, and NMDA receptor antagonists, such as memantine; for PD, L-dopa (and optionally dopamine decarboxylase inhibitors, such as carbidopa or benserazide (which may be given in combination with L-dopa)), dopamine agonists (including bromocriptine, pergolide, pramipexole, ropinirole, pribedil, cabergoline, apomorphine, lisuride and rotigotine), MAO-B inhibitors (such as selegline and rasagiline), or other PD drugs (such as amantadine and anticholinergics); for HD, tetrabenazine and other drugs that help to reduce chorea include neuroleptics and benzodiazepines), amantadine or remacemide; and
  • ND compound(s) Pharmaceutically-acceptable salts of other active ingredients useful in the treatment a ND that may be mentioned include acid addition salts and base addition salts. Such salts may be formed by conventional means. Such compounds and salts are referred to hereinafter together as “ND compound(s)”.
  • Suitable doses of such ND compounds are known to those skilled in the art and include those listed for the drugs in question to in the medical literature, such as Martindale—The Complete Drug Reference (35 th Edition) and the documents referred to therein, the relevant disclosures in all of which documents are hereby incorporated by reference.
  • This aspect of the invention provides for the administration of NBMI in conjunction with an ND compound, as hereinbefore defined.
  • Such combinations may thus be presented either as separate formulations, wherein at least one of those formulations comprises NBMI or salt/derivative thereof, and at least one comprises the ND compound, or may be presented (i.e. formulated) as a combined preparation (i.e. presented as a single formulation including NBMI/salt/derivative and a ND compound).
  • a pharmaceutical formulation including NBMI, or a pharmaceutically-acceptable salt or derivative thereof; one or more ND compound; and a pharmaceutically-acceptable adjuvant, diluent or carrier which formulation is hereinafter referred to as a “combined preparation”
  • a method of making a kit of parts as defined above comprises bringing component (A), as defined above, into association with a component (B), as defined above, thus rendering the two components suitable for administration in conjunction with each other.
  • components (A) and (B) of the kit of parts may be:
  • kit of parts comprising:
  • kits of parts described herein may comprise more than one formulation including an appropriate quantity/dose of NBMI/salt/derivative, and/or more than one formulation including an appropriate quantity/dose of ND compound, in order to provide for repeat dosing. If more than one formulation (comprising either active compound) is present, such formulations may be the same, or may be different in terms of the dose of either compound, chemical composition(s) and/or physical form(s).
  • NMBI/salt/derivative may also be co-administered with antioxidants or chelators, including vitamin-E, vitamin-D, cysteine, cystine, glutathione, lipoic acid glutathione (GSH), dihydrolipoic acid (DLPA), lipoic acid (LPA), N-acetylcysteine (NAC), dimercaptopropane sulfonate (DMPS), dimercaptosuccinic acid (DMSA), ethylenediaminetetraacetic acid (EDTA), and mixtures thereof.
  • antioxidants or chelators including vitamin-E, vitamin-D, cysteine, cystine, glutathione, lipoic acid glutathione (GSH), dihydrolipoic acid (DLPA), lipoic acid (LPA), N-acetylcysteine (NAC), dimercaptopropane sulfonate (DMPS), dimercaptosuccinic acid (DMSA), ethylenediaminet
  • the uses/methods described herein may have the advantage that, in the treatment of relevant NDs, they may be more convenient for the physician and/or patient than, be more efficacious than, be less toxic than, have a broader range of activity than, be more potent than, produce fewer side effects than, or that it may have other useful pharmacological properties over, similar methods (treatments) known in the prior art for use in therapy of the relevant ND.
  • FIG. 1 illustrates the effect of NBMI A ⁇ 42-induced cell death in primary neurons incubated with oligomeric A ⁇ 42 and co-cultured in with N9 cells.
  • FIG. 2A illustrates the effect of NBMI on primary microglia activation (evaluated as TNF- ⁇ release) following A ⁇ 42 administration.
  • FIG. 2B illustrates the effect of NBMI on modulated internalization of A ⁇ 42 by microglia following A ⁇ 42 administration.
  • FIG. 3 illustrates the effect of NBMI on the aggregation state of A ⁇ 42 in media and in the cell lysate cultures following its administration in primary microglia cultures.
  • Lung epithelial cells were seeded at 5 ⁇ 10 4 in 24-well plates. After pre-incubation with NBMI, the antioxidant compound, N-acetyl-L-cysteine (NAC), which was used as a positive control, or vehicle, for 3 hours the medium was removed.
  • NAC N-acetyl-L-cysteine
  • Fresh media containing various particles (as below) in different concentrations was in a total volume of 0.5 ml for an additional 24 hours. The supernatants were then separated from the cells by centrifugation.
  • IL-8, IL-6, GM-CSF and MCP-1 were measured in the cell free fluid using the DuoSet ELISA Development kit (R&D Systems, Abingdon, UK) according to manufacturer's protocol.
  • NBMI can reduce the particle-induced secretion of pro-inflammatory cytokines in both cell lines, although the reduction was only in some cases reduced to background levels.
  • IL-8 and IL-6 were achieved in supernatants of A549 cells exposed to TiO 2 P25 at 75 ⁇ g/cm 2 .
  • 50 ⁇ M NBMI reduced the secretion of IL-8 with 29% and IL-6 with 38%.
  • a ⁇ 42 stock was solubilized in DMSO at a concentration of 2 mM, vortexed and sonicated for 2 minutes to ensure complete dissolution.
  • a ⁇ 42 was diluted in 50 mM NaPi, 100 mM NaCl (pH 7.4) buffer at a concentration of 200 ⁇ M and was used within 3 hours at a final concentration of 200 nM.
  • cortical neurons Primary cultures of cortical neurons were prepared from the cerebral cortex of mice at embryonic stage 17 (E17). The cells from each cortex were seeded separately on poly-L-ornithine (Sigma) pre-coated 6-well plates at a density of 0.25 ⁇ 106 cells/cm 2 in Neurobasal media containing B27 supplement with antioxidant, 1% penstrep and 1% glutamine.
  • neurons were used in experiments. Where indicated, cells were pre-treated for 30 minutes with NBMI (10 nM) added directly to the cell culture medium.
  • N9 cells were maintained at 37° C. and 5% CO 2 in RPMI 1640 (Gibco Laboratories, USA), supplemented with 10% heat-inactivated fetal bovine serum (FBS) and 0.5% penicillin-streptomycin.
  • FBS heat-inactivated fetal bovine serum
  • TNF- ⁇ secretion from primary microglia and the BV2 cell line was valued by a specific sandwich-type enzyme-linked immunoabsorbent assay (ELISA) (Duoset, R&D system) according to the manufacturer's instructions.
  • ELISA enzyme-linked immunoabsorbent assay
  • Intracellular concentration of A ⁇ 42 was measured using a specific sandwich-type ELISA assay (human A ⁇ 42 kit, Invitrogen, KHB3441 and mouse/rat, IBL 27721; Immuno-Biological Laboratories Co., Ltd., Japan) according to the manufacturer's instructions.
  • Homogenization was performed with a cold 4 ⁇ volume of PBS supplemented with the 1 ⁇ protease inhibitor cocktail, followed by the addition of a solution 8.2 M guanidine/82 mM Tris HCl (pH 8.0) to yield a solution with a 5M final guanidine concentration.
  • N9 cells were treated with 200 nM A ⁇ 42488 (Anaspect), and A ⁇ internalization was recorded in culture for 24 hours after A ⁇ administration using a CellR microscope, with the image processed using CellR software.
  • NBMI reduced A ⁇ 42-induced cell death in primary neurons incubated with oligomeric A ⁇ 42 and co-cultured in with N9 cells (see FIG. 1 )
  • NBMI also blocked primary microglia activation (evaluated as TNF- ⁇ release) following A ⁇ 42 administration (see FIG. 2A ) and modulated internalization of A ⁇ 42 by microglia ( FIG. 2B ).
  • NBMI changed the aggregation state of A ⁇ 42, both in the media and in the cell lysate cultures following its administration in primary microglia cultures ( FIG. 3 ).

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