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  • C07H19/02—Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof sharing nitrogen
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  • A61K31/7052—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
  • A61K31/706—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
  • A61K31/7064—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
• • 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
  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/7042—Compounds having saccharide radicals and heterocyclic rings
  • A61K31/7052—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
  • A61K31/706—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
  • A61K31/7064—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
  • A61K31/7076—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines containing purines, e.g. adenosine, adenylic acid
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  • C07D487/00—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, not provided for by groups C07D451/00 - C07D477/00
  • C07D487/02—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, not provided for by groups C07D451/00 - C07D477/00 in which the condensed system contains two hetero rings
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  • C07H19/02—Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof sharing nitrogen
  • C07H19/04—Heterocyclic radicals containing only nitrogen atoms as ring hetero atom
  • C07H19/052—Imidazole radicals
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  • C07H19/00—Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof
  • C07H19/02—Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof sharing nitrogen
  • C07H19/04—Heterocyclic radicals containing only nitrogen atoms as ring hetero atom
  • C07H19/06—Pyrimidine radicals
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  • C07H19/02—Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof sharing nitrogen
  • C07H19/04—Heterocyclic radicals containing only nitrogen atoms as ring hetero atom
  • C07H19/14—Pyrrolo-pyrimidine radicals
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  • C07H19/02—Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof sharing nitrogen
  • C07H19/04—Heterocyclic radicals containing only nitrogen atoms as ring hetero atom
  • C07H19/16—Purine radicals

Definitions

• This invention relates to adenosine kinase inhibitors and to nucleoside analogs, specifically to orally active, substituted 5-aryl pyrroio[2,3-d]pyrimidine and 3- aryl pyrazolo[3,4-d] pyrimidine nucleoside analogs having activity as adenosine kinase inhibitors.
• the invention also relates to the preparation and use of these and other adenosine kinase inhibitors in the treatment of cardiovascular and cerebrovascular diseases, inflammation and other diseases which can be regulated by increasing the local concentration of adenosine.
• Adenosine is an endogenously produced molecule that plays a major role in a variety of important cellular processes. It is a vasodilator, can inhibit immune function, enhance activation of mast cells (associated with allergic reactions), inhibit neutrophil oxygen free-radical production, is antiarrhythmic, and is an inhibitory neurotransmitter. Adenosine is phosphorylated to adenosine triphosphate (ATP) which is used by ail cells to store energy for use in future energy-utilizing metabolic reactions or mechanical work (e.g. muscle contraction).
• ATP adenosine triphosphate
• Extracellular adenosine frequently prouced by breakdown of intracellular ATP pools, evokes a variety of pharmacological responses through activation of extracellular adenosine receptors located on the surface of nearly all cells.
• adenosine produces a variety of cardiovascular related effects including vasodilation, inhibition of platelet aggregation, and negative inotropic, chronotropic and domotropic effects on the heart.
• Adenosine also has effects within the central nervous system (CNS) including inhibition of neurotransmitter release from presynaptic neurons and inhibition of post-synaptic neuron firing in brain and the spinal cord and at sites of inflammation, such as inhibition of neutrophil adhesion to endothelial cells and inhibition of neutrophil oxygen free-radical production.
• CNS central nervous system
• Compounds that increase extracellular adenosine can be beneficial to living organisms, particularly under certain conditions.
• compounds that increase adenosine levels have been associated with the treatment of ischemic conditions such as stroke, as well as other conditions benefitted by enhanced adenosine levels, such as inflammation, arthritis, seizures, epilepsy and other neurological conditions.
• the compounds are also useful for treating pain, as muscle relaxants, and for inducing sleep.
• Adenosine kinase is a cytostolic enzyme which catalyzes the phosphorylation of adenosine to AMP. Inhibition of adenosine kinase can potentially reduce the ability of the cell to utilize adenosine, leading to increased adenosine outside of the cell where it is pharmacologically active.
• the regulation of adenosine concentration is complex and involves other adenosine-metabolizing enzymes each with different kinetic properties and mechanisms of regulation.
• Adenosine can also be deaminated to inosine by adenosine deaminase (ADA) and condensed with L- homocysteine to S-adenosylhomocysteine (SAH) by SAH hydrolase.
• ADA adenosine deaminase
• SAH S-adenosylhomocysteine
• SUBS ⁇ nfTE SHEET (RULE 26) of these enzymes in modulating adenosine concentration is dependent on the prevailing physiological conditions, is tissue specific and is not well understood.
• nucleosides including pyrrolo[2,3-d]pyrimidine and pyrazolo[3,4-d]pyrimidine analogs have been evaluated for inhibition of adenosine kinase but were reported to have K-'s of greater than 800 nM. Caidwell and Henderson, Cancer Chemother. Rep.. 2:237-46 (1971); Miller et al.. J. Biol. Chem.. 254:2346-52 (1979). A few compounds have been reported as potent inhibitors of adenosine kinase with K-'s of less than 100 nM.
• adenosine release has been measured in neuroblastoma cells in culture and compared with that of a variant deficient in adenosine kinase (AK " ).
• the AK " cells used in this study were said to release adenosine at an accelerated rate; the concentration of adenosine in the growth medium was reported to be elevated compared to the normal cells. Green, J, Supramol. Structure. 13:175-182 (1980).
• adenosine uptake was reportedly inhibited by the adenosine kinase inhibitors, 5-iodotubercidin and 5'-deoxy-5-iodotubercidin. Davis et al., Biochem. Pharmacol.. 33:347-55 (1984). However, inhibition of uptake and intracellular trapping via phosphorylation does not necessarily result in increased extracellular adenosine, since the adenosine could enter other metabolic pathways or the percentage of adenosine being phosphorylated could be insignificant compared to the total adenosine removed.
• adenosine kinase inhibitors with a useful half-life, i.e. compounds which can be exploited to beneficially influence or control endogenous adenosine kinase activity, and therefore, extracellular adenosine levels.
• the compounds of the invention are suitable adenosine kinase inhibitors having these characteristics.
• the invention is directed to novel pyrrolo[2,3-d] pyrimidine and pyrazolo[3,4-d] pyrimidine nucleoside analogs.
• Preferred compounds are 4-amino py ⁇ olo[2,3-d] pyrimidine analogs that have an aryl substitutent at either or both the 4- amino group or the 5-position.
• 4-amino pyrazolo[3,4-d] pyrimidine analogs that have any aryl substituent at either or both the 4-amino group or the 3- position.
• the diaryl compounds having an aryl group at both positions, particularly those where at least one aryl group is a substituted phenyl.
• these compounds are highly selective adenosine kinase inhibitors with with oral bioavailability and oral efficacy significantly higher than other known known adenosine kinase inhibitors.
• the compounds are also nontoxic, particularly in connection with liver function.
• the invention concerns the compounds themselves, the preparation of these compounds, and their in vitro and vivo adenosine kinase inhibition activity of these compounds.
• Another aspect of the invention is directed to the clinical use of the compounds to increase adenosine concentrations in biological systems.
• in vivo inhibition of adenosine kinase prevents phosphorylation of adenosine resulting in higher local concentrations of endogenous adenosine.
• the compounds of the invention possess advantages for pharmaceutical use such as enhanced pharmacological selectivity, efficacy, bioavailability, ease of manufacture and compound stability.
• the compounds of the invention may be used clinically to treat medical conditions where an increased localized adenosine concentration is beneficial. Accordingly, the invention is directed to the treatment of ischemic conditions such as stroke, as well as other conditions benefitted by enhanced adenosine levels, such as inflammation, arthritis, seizures, epilepsy and other neurological conditions. The compounds are also useful for treating pain, as muscle relaxants, and for inducing sleep. The invention is also directed to prodrugs and pharmaceutically acceptable salts of the compounds described, and to pharmaceutical compositions suitable for different routes of drug administration and which comprise a therapeutically effective amount of a described compound admixed with a pharmacologically acceptable carrier. Definitions
• aryl refers to aromatic groups, which have at least one ring having a conjugated pi electron system, including for example carbocyclic aryl, heterocyclic aryl and biaryl groups, all of which may be optionally substituted.
• Carbocyclic aryl groups are groups wherein all the ring atoms on the aromatic ring are carbon atoms, such as phenyl.
• phenyl groups being preferably phenyl or phenyl substituted by one to three substituents, preferably lower alkyl, hydroxy, lower alkoxy, lower alkanoyloxy, halogen, cyano, perhalo lower alkyl, lower acylamino, lower alkoxycarbonyl, amino, alkylamino, carboxamido, and sulfonamido.
• Heterocyclic aryl groups are groups having from 1 to 3 heteroatoms as ring atoms in the aromatic ring and the remainder of the ring atoms carbon atoms. Suitable heteroatoms include oxygen, sulfur, and nitrogen. Heterocyclic aryl groups include furanyl, thienyl, pyridyl, pyrrolyl, pyrimidyl, pyrazinyl, imidazolyl, and the like, all optionally substituted. Also included are phenyl rings fused with a five or six membered heterocycle containing one or more heteroatoms such as oxygen, sulfur, and nitrogen.
• Optionally substituted furanyl represents 2- or 3-furanyl or 2- or 3-furanyl preferably substituted by lower alkyl or halogen.
• Optionally substituted pyridyl represents 2-, 3- or 4-pyridyl or 2-, 3- or 4-pyridyl preferably substituted by lower alkyl or halogen.
• Optionally substituted thienyl represents 2- or 3-thienyl, or 2- or 3-thienyl preferably substituted by lower alkyl or halogen.
• biaryl represents phenyl substituted by carbocyclic aryl or heterocyclic aryl as defined herein, ortho, meta or para to the point of attachment of the phenyl ring, advantageously para; biaryl is also represented as -C 6 H 4 -Ar where Ar is aryl.
• aralkyl refers to an alkyl group substituted with an aryl group. Suitable aralkyl groups include benzyl, picolyl, and may be optionally substituted.
• lower referred to herein in connection with organic radicals or compounds respectively defines such with up to and including 7, preferably up to and including 4 and advantageously one or two carbon atoms. Such groups may be straight chain or branched.
• alkyl amino refers to the groups -NRR' wherein respectively, (a) R is alkyl and R' is hydrogen, aryl or alkyl; (b) R is aryl and R' is hydrogen or aryl, and (c) R is aralkyl and R' is hydrogen or aralkyl.
• acylamino refers to RC(0)NR'-.
• carbonyl refers to -C(O)-.
• carboxylate refers to -CONR 2 wherein each R is independently hydrogen, lower alkyl or lower aryl.
• alkyl refers to saturated aliphatic groups including straight-chain, branched chain and cyclic groups, optionally containing one or more heteroatoms.
• alkenyl refers to unsaturated alkyl groups which contain at least one carbon-carbon double bond and includes straight-chain, branched or cyclic groups optionally containing one or more heteroatoms.
• alkynyl refers to unsaturated alkyl groups which contain at least one carbon-carbon triple bond and includes straight-chain, branched or cyclic groups, optionally containing one or more heteroatoms.
• mercapto refers to SH or a tautomeric form thereof.
• alkylene refers to a divalent straight chain or branched chain saturated aliphatic radical.
• sulfonamido means -S0 2 NHR where R is hydrogen or lower alkyl.
• N-sulfonyl amine means -NHS0 2 R where R is fluoro, lower perfluoroalkyl or lower alkyl.
• N-acylated sulfonamide refers to the group -S0 2 NHCOR where R is lower alkyl or lower perfluoroalkyl.
• aminoguanidino refers to the group -NR 1 C(NR 2 )NR 3 R 4 where R 1f R 2 , R 3 and R 4 are independently hydrogen, alkyl or aryl groups.
• aminoguanidino refers to the group -NR 1 NR 2 C(NR 3 )NR 4 5 where R v R 2 , R 3 , R 4 and Rs are independently hydrogen, alkyl or aryl groups.
• ureido refers to the group -NR 1 C(0)NR 2 R 3 where R,, R 2 and R 3 are independently hydrogen, alkyl or aryl groups.
• carboxylic acid refers to the group -COOH.
• acylguanidino refers to the group -CONR C(NR 2 )NR 3 R 4 where
• R,, R 2 , R 3 and R 4 are independently hydrogen, alkyl or aryl groups.
• basic nitrogen generally refers to the nitrogen atom of an alkyl amine and implies a compound whose conjugated acid in aqueous solution has a pKa in the range of 9 to 11.
• prodrug refers to any compound that, when administered to a biological system generates the "drug” substance either as a result of spontaneous chemical reaction or by enzyme catalyzed or metabolic reaction.
• prodrugs such as acyl esters, carbonates, and urethanes, included herein as examples. The groups illustrated are exemplary, not exhaustive and one skilled in the art could prepare other known varieties of prodrugs. Such prodrugs of the compounds of the invention, fall within the scope of the invention.
• pharmaceutically acceptable salt includes salts of compounds described herein derived from the combination of a compound of this invention and an organic or inorganic acid.
• the compounds of the present invention are useful in both free base and salt form. In practice the use of salt form amounts to use of base form; both forms are within the scope of the present invention.
• treatment includes prophylatic or therapeutic administration of compounds of the invention, for the cure or amelioration of disease or symptoms associated with disease, and includes any benefit obtained or derived from the administration of the described compounds.
• the invention relates to adenosine kinase inhibitors of the general Formula I.
• A, and A j are each independently hydrogen, acyl, or taken together form a cyclic carbonate;
• B is CH 3 alkenyl, or (CH 2 ) n -B ⁇ where n is from 1 to 4 and B' is hydrogen, hydroxy, alkyl, alkoxy, amino, azido, or halogen;
• D is halogen, aryl, aralkyl, alkyl, alkenyl, alkynyl, optionally containing one or more heteroatoms such as N and/or 0, haloalkyl, cyano, or carboxamido;
• Y is carbon or nitrogen;
• E is nothing when Y is nitrogen, and is hydrogen, halogen or alkyl when Y is carbon;
• G is hydrogen or halogen; p is from 0 to 3, preferably 0; and X is a five or six member aryl ring, optionally substituted at any one or more positions by hydroxy, alkoxy, perhalo lower alkyl, sulfonamide, halogen, cyano, carboxamido, acylamino, NRR', or SR where R and R' are independently hydrogen or lower alkyl.
• These compounds are potent adenosine kinase inhibitors, are superior in oral availability, and are suitably non-toxic.
• X is a six member ring (phenyl), the most preferred substitution is at the para position, and the most preferred substituent is halogen (e.g., fluorine).
• substitution of the ring structure as described, particularly at the para position of the phenylamino group i.e. 4N-4-substituted phenylamino
• blocks certain oxidation or glucoronidation sites which in turn increases the half-life of the compound by reducing the rate of in vivo elimination after oral administration. The result is a more effective and longer-lasting compound when administered orally.
• A, and A 2 are hydrogen; and B is
• CH 2 OH or most preferably is CH
• D is preferably aryl, and most preferably is phenyl or substituted phenyl.
• E is nothing when Y is nitrogen, and is preferably hydrogen when
• Y is carbon.
• G is also preferably hydrogen.
• preferred compounds can be represented by Formula 2:
• B is CH 2 OH, or most preferably CH 3 ;
• D is as defined in Formula I, or preferably is aryl, phenyl, or substituted phenyl;
• E is halogen, alkyl, or most preferably hydrogen
• Y is carbon or nitrogen, preferably carbon; and J and J 1 are independently halogen, preferably fluorine. in another embodiment, preferred compounds are those of Formula 3
• J and J 1 are each independently halogen or cyano, preferably fluorine.
• Prodrugs of the compounds of the present invention are included in the scope of this application. Such prodrugs may be prepared by esterification of the hydroxyl groups on the sugar moiety. Specially preferred will be the ester derivatives that improve water solubility or oral bioavailability. Further, the compounds of the present invention contain asymmetric carbon atoms and hence can exist as stereoisomers, both enantiomers and diastereomers. The individual preferred stereoisomers and mixtures thereof are considered to fall within the scope of the present invention. The compounds described
• SUBSTITUTE SHEET by Formula 1 may contain a 5-modified 1 - ⁇ -D-ribofuranosyl group and that isomer comprises a particularly preferred diastereomeric and enantiomeric form for compounds of the present invention.
• the corresponding lyxofuranosyl form of these compounds are within the scope of the invention.
• additional asymmetric carbons may be present in compounds of the present invention, being present in moieties A.,, A ⁇ or B, or in the substituted heterocyclic pyrrolo[2,3-d] pyrimidine or pyrazolo[3,4-d] pyrimidine ring. In this event, both of the resulting diastereomers are considered to fall within the scope of the present invention.
• the compounds of the invention can be made by several reaction schemes, and for convenience can be grouped as pyrrolo or pyrazolo pyrimidines. Exemplary synthetic routes are given below.
• Desired 5-substituted-5-deoxy ribose analogs are prepared by tosylation of a suitably protected ribose, displacing the tosylate with an appropriate nucieophile, such as hydride or azide, and subsequent manipulation of the protecting groups. Snyder, J.; Serianni, A; Carbohydrate Research. 163:169 (1987).
• the sugar, 1-alpha- chloro-5-deoxy-2,3-isopropylidene-D-ribofuranose (7) used in this process is made by reacting the corresponding sugar (8) with Vilsmeier reagent (DMF and oxalylchloride) at 0°C.
• This compound was made by a route similar to Example 2B. Here, the 4- fluoroaniline was replaced with 4-chloroaniline. m.p. 233-236 °C.
• This compound was made by a route similar to Example 2B. Here, the 4 -fluroaniline aniline was replaced with aniline, m.p. 210-215 °C.
• This compound was made by a procedure similar to the one described for 4-N-(4-fluorophenyl)amino-5-phenylpyrrolo[2,3-d]pyrimidine except that 4-fiuoroaniline was replaced with 4-iodoaniline. m.p. 239-240 °C.
• This iodo compound is treated with an aryl boronic acid in the presence of a palladium catalyst to generate the targeted 4-(N- substituted)amino-5-aryl-7-(1- ⁇ -D-5-deoxyribofuranosyl)pyrrolo[2,3-d]pyrimidine, which is purified by chromatography and/or recrystallization from a suitable solvent.
• a halogenated nucleoside or the corresponding base was heated with an arylboronic acid and a palladium-phosphine catalyst such as palladium tetrakis(triphenylphosphine) to prepare the analogous arylated compound by displacement of halogen.
• Phenylation of 4-N-(4-fluorophenyl)amino-5-iodo-7-(5-deoxy-2,3- isopropylidene-1- ⁇ -D-ribofuranosyl)pyrrolo[2,3-d]pyrimidine can be achieved according to the following protocol.
• the reaction mixture was filtered and the residue was washed with ethanol(1x10 mL).
• the filtrate was concentrated under reduced pressure and the residue was chromatographed on Si0 2 using 3:1 hexane:ethyl acetate as eluting solvent. Appropriate fractions were combined and evaporated to obtain the desired product as a glassy material. Yield 450 mg.
• the 5 product was dissolved in 70%) TFA (20 mL) and stirred at room temperature for 1.5 hours. Volatiles were evaporated and the residue was coevaporated with water(3x20 mL) and once with ethanol (1x10 mL). The residue was suspended in water (10 mL) and treated with NaHC0 3 solution(3 mL). The precipitate was collected by filtration, washed with water and dried, and the product was crystallized from boiling ethanol.
• Triethylphosphonoacetate (0.45 mL) was added to a suspension of sodium hydride (60% in oil, 230 mg) in ether (5 mL) at 0 °C. After stirring at 0 °C for one hour, a solution of 4-N-(4-fluorophenyl)amino-5-(4-formylphenyl)-7-(5-deoxy-2,3-0- isopropylidene- ⁇ -D-hbofuranosyl)pyrrolo[2,3-d]pyrimidine * (523 mg) in ether (5 mL) was added. The reaction mixture was stirred one hour at room temperature, quenched with saturated ammonium chloride and diluted with ethyl acetate.
• #180 4-N-(4-Fluorophenyl)amino-5--(3,4-dimethoxyphenyl)-7-(5-deoxy-1 - ⁇ -D- ribofuranosyl)pyrrolo(2,3-d)pyrimidine.
• #181 4-N-(4-Fluorophenyl)amino-5-(3,4-diethoxyphenyl)-7-(5-deoxy-1 - ⁇ -D- ribofuranosyl)pyrrolo(2,3-d)pyrimidine.
• #191 4-N-(5-Benzoxazol yl )am i no-5-phenyl-7-(5-deoxy- 1 - ⁇ -D- ribofuranosyl)pyrrolo(2,3-d)pyrimidine.
• #192 4-N-(5-Benzothiazolyl )amino-5-phenyl-7-(5-deoxy-1 - ⁇ -D- ribofuranosyl)pyrrolo(2,3-d)pyrimidine.
• Pyrrolo[2,3-d]pyrimidine analogs substituted at the 5-position with an alkyl, alkenyl or alkynyl group are considered to fall within the scope of the present invention.
• These alkyl, alkenyl or alkynyl groups may contain one or more heteroatoms and may be either in the open chain or the cyclic form.
• the synthesis of 4-N-arylamino-5-substituted pyrrolo[2,3-d]pyrimidines can be achieved by application of the methods illustrated by Friesen and Sturino (J. Org. Chem.
• 5-alkynyl derivatives can be accomplished by reaction of a suitably functionalized 4-N-arylamino-5-iodo-pyrrolo[2,3-d]pyrimidine and an alkyne in the presence of a palladium catalyst as is well known in the literature (R.C. Larock, "Comprehensive Organic Transformations: A Guide to Functional Group Preparations", VCH Publishers, Inc.1989 page 302).
• the preparation of 5-dioxolane derivatives of pyrrolo[2,3-d]pyrimidines can be achieved by reaction of a suitably functionalized 4-N-arylamino-5-iodo-pyrrolo[2,3-
• SUBSmUTESHEET(I ⁇ E26) evaporated the solvent under reduced pressure.
• the residue was treated with a dilute sodium bicarbonate solution, the water was removed by evaporation, coevaporating with toluene and the white precipitate heated to reflux in ethanol for 5 min.
• the hot ethanolic suspension was filtered and the ethanol evaporated.
• the 6-halosubstituted pyrrolo[2,3-d]pyrimidine nucleosides of the invention can be prepared by halogenation of the base, as described in Example 2F (preparation of 6-bromo-5-phenyl-4-N-phenylaminopyrrolo[2,3-d]pyrimidine) followed by ribosylation and deprotection as described in Example 3. It will be apparent that other halogenated analogs can be prepared in a similar fashion.
• 6-alkyl substituted pyrrolo [2,3-d]pyrimidines generally follows the sequence outlined in Example 1 , except that the phenacyl chloride has an appropriate alkyl substitutent at the aliphatic carbon alpha to the carbonyl group.
• Prodrugs of the compounds of the present invention are included in the scope of this application. Such prodrugs may be prepared, for example, by esterification of the hydroxyl groups on the sugar moiety. The synthesis of an ester derivative with improved water solubility is described in the following example:
• Still another aspect of this invention is the preparation of 5'-modified pyrazolo[3,4-d]pyrimidine ribosides. Accordingly, a substituted pyrazolo[3,4-d] pyrimidine is ribosylated with an esterified 5-deoxy- or 5-deoxy-5-azido-ribofuranoside analog in the presence of a Lewis acid such as boron trifluoride. Browne et al., Serial
• the 5-substituted sugar is prepared by esterification of the deblocked sugar.
• Suitable esters include the acetate, benzoate, toluate, anisoate and the like.
• the substituted pyrazolo[3,4-d]pyrimidine base may be prepared by a variety of known procedures which are apparent to practitioners. Another exemplary synthetic route follows.
• One route comprises coupling an esterified ribose prepared as described above with a 3-substituted pyrazolo[3,4-d]pyrimidin-4-one.
• the pyrimidone riboside may be activated by chlorination with thionyl chloride/dimethyl- formamide or other reagents previously described and then reacted with ammonia or an amine to provide a variety of substituted 5'-modified N-4-substituted-amino-pyrazolo[3,4- djpyrimidine nucleosides.
• Another route for preparation of substituted pyrazolo[3,4-d]pyrimidine nucleosides comprises coupling the esterified ribose with various substituted 4-amino or 4-substituted aminopyrazolo[3,4-d]pyrimidines, using procedure similar to those described for the pyrrolo pyrimidines. The resulting products are then further modified or deblocked to afford the desired compounds.
• 3-phenyl-4- phenylaminopyrazolo[3,4-d]pyrimidine 5-modified ribosides are prepared from 3-phenyl- 4-phenylaminopyrazolo[3,4-d]pyrimidine and various ⁇ '-modified sugars.
• 3-halogenated pyrazolo[3,4 d]pyrimidine ribosides can be arylated using arylboronic acids and palladium catalysts as described for the pyrrolo[2,3-d]pyrimidines.
• 3-iodopyrazolo[3,4-d]pyrimidone nucleosides are prepared by nonaqueous diazotization-iodination of the 3-amino compounds using a nitrite ester such as isoamyl nitrite and methylene iodide.
• 4-chloro or 4-amino pyrazolo[3,4-d] pyrimidine may be iodinated using N-iodosuccinimide in a solvent such as DMF and the resulting 5-iodo heterocycle is coupled to the sugar to obtain the desired 4-iodinated pyrazolo[3,4-d]pyrimidine nucleoside.
• (13) Snyder, J.; Serianni, A.; Carbohydrate Research. 163:169 (1987)
• sodium azide in dry DMF at elevated temperatures provided the corresponding 5-azido ribofuranoside (14) which was subjected to removal of the protecting groups under acidic conditions and the resulting ribose was acetyiated with acetic anhydride and pyridine to provide (15).
• 5-Deoxy-1,2,3-tri-0-acetyl-D- ribofuranose (16) used in the current invention was synthesized by subjecting (13) to LAH reduction to provide methyl 5-deoxy-2,3-isopropylidene-D-ribofuranose, followed by appropriate protecting group manipulations.
• the azide function could be reduced by catalytic hydrogenation or by using other reagents such as propanethiol/acetic acid or sodium dithionite.
• #115 1-(5-deoxy-1 - ⁇ -D-ribofuranosyl )-3-phenyl-4-N-(4- ethylphenyl)aminopyrazolo[3,4-d]pyrimidine.
• #116 1-(5-deoxy-1- ⁇ -D-ribofuranosyl)-3-phenyl-4-N-(4-(2- methylphenyl)aminopyrazolo[3,4-d]pyrimidine.
• SUBST ⁇ E SHEET (RULE 26) was refluxed gently for 90 minutes, then cooled and evaporated under vacuum. The residue was treated with triethyl amine and water and extracted with methylene chloride. The organic layer was dried over sodium sulfate and evaporated. The residue was chromatographed over silica gel using a gradient of ethyl acetate and hexane as eluting system. The product thus obtained was dissolved in methanol and treated with freshly prepared sodium methoxide solution to adjust the pH to - 10. After stirring the reaction for 2 hours the pH of the solution was adjusted to 4 by adding strongly acidic resin Dowex-120 H + type. The resin was filtered off, washed with methanol and the filtrate was evaporated under reduced pressure. The residue was crystallized from appropriate solvent. The following compounds were synthesized by the procedures in
• adenosine kinase inhibitors of the present invention may be used in the treatment of a variety of clinical situations where increasing local levels of adenosine are beneficial.
• the compounds of the invention act as potent inhibitors of adenosine kinase in vitro, and the present compounds in particular are orally available.
• Adenosine has been proposed to serve as a natural anticonvulsant.
• Adenosine kinase inhibitors may be used in the treatment of patients with seizures or epilepsy or patients who might have chronic low or insufficient adenosine levels or might benefit from increased adenosine such as those suffering from autism, cerebral palsy, insomnia or other neuropsychiatric symptoms.
• Adenosine kinase inhibitors of the invention find further utility in the treatment of acute pain, including but not limited to peri-operative, post-surgical, and end-stage cancer pain.
• Compounds of the invention are also useful in controlling chronic pain, including but not limited to pain caused by arthritis, cancer, trigeminal neuralgia, multiple sclerosis, neuropathies such as those arising from diabetes and AIDS and in addition, lower back pain and phantom limb pain.
• Treatment of acute and chronic pain can be treated by administration of the compounds of the invention in a systemic or oral fashion, as illustrated by animal models detailed below.
• Adenosine has been reported to be an endogenous modulator of inflammation by virtue of its effects on stimulated neutrophil function and on macrophage, lymphocyte and platelet function.
• the compounds of this invention may therefore be used in treating conditions in which inflammatory processes are prevalent such as arthritis, reperfusion injury, and other inflammatory disorders.
• the compounds of the invention are also useful in the treatment of chronic neurodegenerative disease, such as Alzheimer's disease, Parkinson's deisease, ALS, Huntington's disease, and AIDS dimentia.
• Stroke and central nervous system (“CNS") trauma are conditions where tissue injury results from reduced blood supply to the CNS and are thus amenable to an intervention that provides increased levels of adenosine to the compromised tissue. It is reported that a significant component of the neurodegeneration resulting from stroke or CNS trauma is caused by increased excitatory amino acid release and sensitivity, which results in neurons being stimulated to death. In addition to vasodilatory properties, adenosine has been reported to inhibit release of excitatory amino acids (Burke and Nadler J. Neurochem., 1988, 51:1541 ) and responsiveness of neurons to excitation.
• the compounds of this invention, which increase adenosine levels may also be used in the treatment of conditions where release of or sensitivity to excitatory amino acids is implicated.
• Adenosine kinase activity was measured essentially as described by Yamada et al. Biochim. Biophys. Acta 660, 36-43 (1988) with a few minor modifications.
• Assay mixtures contained 50 mM TRIS-maleate buffer, pH 7.0, 0.1% BSA, 1 mM ATP
• the assay was quenched upon spotting 30 ⁇ L aliquots onto 2 cm 2 pieces of Whatman DE81 anion exchange paper.
• the paper squares were washed for 3 minutes in 6 L distilled/deionized water to remove the unreacted adenosine.
• the washed squares were rinsed in 95% ethanol and dried in an oven at 100°C for 10 minutes.
• the amount of 14 C-AMP was quantified by scintillation counting.
• the concentration of inhibitor required to inhibit 50% of the adenosine kinase activity (ICso) was determined graphically. The results for representative compounds of the invention are shown in Table 1.
• SA rats 100-150g, Simonsen
• MES maximal electroshock
• the rats were maintained on a 12/12 light/dark cycle in temperature controlled facilities with free access to food and water.
• the animals are fasted overnight, prior to the experiment.
• One to two hours prior to seizure testing the animals were injected interperitoneally (ip) or orally (per os, po) with one of various doses of test compound dissolved in DMSO or PEG 400.
• MES Maximal electroshock seizures
• HTE hind limb tonic extension
• the effective dose at which 50% of the rats were protected was calculated from a dose response curve.
• the results for exemplary compounds of the invention are in Table 1 , expressed as ED 50 values.
• the result is >5 if HTE was inhibited in fewer than 50% of the animals in the initial screen, or ⁇ 5 if HTE was inhibited in more than 50% of the animals in the initial screen. » or ⁇ signs were used to indicate that either no activity or maximal activity, respectively, were observed at the stated dose.
• Analgesic activity of representative compounds of the invention was evaluated in male SA rats (100-150g, Simonsen) using the hot plate, tail flick, and formalin paw models of pain, similar to those described in Sosnowski et al., J.
• the tail flick response is evoked by placing the tail of a rat over a focused beam of light.
• the latency or response time to flick the tail away from the incident heat source was recorded electronically by an appropriate measuring device, for example an apparatus manufactured by Ugo Basile. Longer times indicate greater tolerance to the thermally induced pain stimulus.
• the maximum exposure time is limited to avoid tissue damage (8 seconds), in the event a rat does not respond to the stimulus within a predetermined period.
• the rats were accommodated to the hand restraint of the testing to prevent spurious movements from causing false responses.
• a mark was made on the dorsal surface of each tail approximately 3-5 cm from the tip to ensure testing at the same location on the tail.
• a rat In the hot plate model, a rat is placed on a heated metal plate (typically 50 C). The endpoint of this evaluation is the time required for the rat to lick its hind paw. A predetermined cutoff time (60 seconds) is used to protect the animals from injury, in the event there is no response.
• Phase 1 of the response which is brief, lasting approximately 0 - 5 min post-injection, is followed by a more prolonged phase 2, lasting approximately 10 - 80 min post-injection.
• Phase 1 behavior is thought to be a direct effect of the irritant on nociceptors at the injection site while phase 2 behavior is thought to include a hyperalgesic component mediated by sensitization of neuronal elements within the spinal cord.
• Phase 2a Phase 2a
• Rats Male, Simonsen weighing between 100 - 200 g, are used in the present experiments.
• drugs are administered orally 90 min prior to initiation of formalin test.
• the animals in groups of 4 are placed individually in a small animal restrainer with the right hindpaw accessible through a hole in the bottom of the restrainer.
• the formalin paw assay is initiated by the injection using a 30G needle of 50 ul of a 5% formalin solution in saline into the right plantar surface of each hindpaw.
• the rat is then immediately placed in a separate plexiglass box and scoring (described below) of the animal's behavior is begun at 1.7 min after formalin injection.
• the instantaneous behavior of each animal in a group of 4 was observed and assigned a score once in each 20 second interval. This sequence is repeated over a 30 min period.
• the scoring protocol is an adaptation of the method published by Dubuisson and Dennis (Pain 4:161 -174, 1977) which assigns a score from 0 - 3 as follows:
• Scores are continuously recorded directly onto an Excel spreadsheet. For comparative examination of drug effects the data is reported two different ways: 1 ) the scores are summed for Phase 1 (1.7 - 5 min post-formalin) and for Phase 2 (10.3 - 30 min post-formalin) and the mean values of the sums are determined from 6 different animals with results expressed as % inhibition compared to vehicle control; 2) the total number of incidences specifically of licking/biting behavior is summed over Phase 2 and mean values determined from 6 different animals with results expressed as % inhibition compared to vehicle control. These data are presented in Table 2a.
• Carrageenan (Type ⁇ ) was suspended in sterile PBS at 1 % (w/v), autoclaved for 30 minutes, and stored in a refrigerator. Rats were pretreated with vehicle or AK inhibitor (10 mg/kg) by oral gavage or i.p. administration and the volume of the left hind paw was measured using a water displacement plethysmometer (Stoelting Co., Wood Dale, IL). One hour after oral treatment or 30 minutes after i.p. treatment, the rats were briefly anesthetized, and 0.1 ml of the carrageenan solution was injected subcutaneously into the planar surface of the left hind paw. The ensuing paw swelling was measured by plethysmometry after 3 hours.
• Oral bioavailability was determined by comparing the dose corrected areas under the plasma-concentration time curve (AUC) to infinity for the each tested compound, given orally and intravenously in dogs.
• AUC plasma-concentration time curve
• test compound for each compound, two female beagles were fasted overnight and received an intravenous infusion of test compound in a 10 mg/ml solution of PEG-400 via a cephalic vein.
• One dog received this solution at an infusion rate of 0.1 mL/min for 20 minutes.
• the other dog received a 0.2 mL/in infusion for 10 minutes.
• Heparinized blood was obtained from the other cephalic vein at predetermined time points during the infusion (0 [pre-dose], 5, 10, 15, and 20 minutes for the 20 min. infusion and 0, 5 and10 minutes for the 10 min. infusion). After the infusion, heparinized blood was obtained at 5, 10, 15, 30, 45 min., and 1, 1.5, 2, 4, 6, 8, and 24 hours post infusion.
• the plasma was separated within 10 minutes of blood collection and was stored frozen. The plasma concentration of compound was then determined for these IV infusions. Another two female beagles also fasted overnight, received 10 mg/kg of compound solution via a stomach tube, followed by a 6 ml rinse of the tube with PEG- 400. Blood samples were handled as for the IV experiments, with samples taken at 0 [pre-dose], 15, 30 and 45 minutes and 1 , 1.5, 2, 4, 6, 8, and 24 hours after administration. The plasma concentration of compound was determined for this oral administration.
• the samples were assayed for intact adenosine kinase inhibitor by high performance liquid chromatography (HPLC).
• HPLC high performance liquid chromatography
• An internal standard was added to each test sample and standard sample.
• Each was then extracted with 10 volumes of 1 % v/v dimethyisulfoxide in acetonitrile. After vigorous vortexing, the mixture was centrifuged and the supematant was evaporated to dryness under nitrogen at 50 C. The dried residue was reconstituted in mobile phase and the contents were analyzed for the adenosine kinase inhibitor (AKI) on HPLC.
• AKI adenosine kinase inhibitor
• HPLC HPLC was performed on a Beckman Ultrasphere C18 reverse phase column (4.6 x 150 mm) eluted isocratically at ambient temperature with a mobile phase of 60-70% methanol at a flow rate of 1.5 ml/min. The eluant was monitored by UV absorbance at 300 nm.
• Pharmacokinetic parameters were calculated from the plasma concentration vs. time data, using standard non-compartmentai methods. Giraldi et al., Pharmacokinetics. 2d ed. Marcel Dekker, NY (1983). After normalization to account for the different amounts of compound given, the oral bioavailability is calculated as the normalized oral AUC divided by the IV AUC x 100%.
• Liver enzymes serum glutamic- oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), alkaline phosphatase
• SGOT serum glutamic- oxaloacetic transaminase
• SGPT serum glutamic-pyruvic transaminase
• alkaline phosphatase alkaline phosphatase
• FORMULATIONS Compounds of the invention are administered to the affected tissue at the rate of from 0.1 to 200 nmole/min/kg, preferably from 1 to 50 nmol/min/kg. Such rates are easily maintained when soluble compounds are intravenously administered as discussed below. When other methods are used (e.g., oral administration), use of time- release preparations to control the rate of release of the active ingredient may be preferred. These compounds are administered in a dose of about 0.01 mg/kg/day to about 100 mg/kg/day, preferably from about 0.1 mg/kg/day to about 10 mg/kg/day.
• the compounds of the invention may be administered by a variety of means including orally, parenterally, by inhalation spray, topically, or rectally in formulations containing conventional non-toxic pharmaceutically acceptable carriers, adjuvants and vehicles.
• parenteral as used herein includes subcutaneous, intravenous, intramuscular, and intraarterial injections with a variety of infusion techniques.
• Intraarterial and intravenous injection as used herein includes administration through catheters. Preferred for certain indications are methods of administration which allow rapid access to the tissue or organ being treated, such as intravenous injections for the treatment of myocardial infarction. When an organ outside a body is being treated, perfusion is preferred.
• compositions containing the active ingredient may be in any form suitable for the intended method of administration.
• tablets, troches, lozenges, aqueous or oil suspensions, dispersible powders or granules, emulsions, hard or soft capsules, syrups or elixirs may be prepared.
• Compositions intended for oral use may be prepared according to any method known to the art for the manufacture of pharmaceutical compositions and such compositions may contain one or more agents including those from the group consisting of sweetening agents, flavoring agents, coloring agents and preserving agents, in order to provide a palatable preparation.
• Tablets containing the active ingredient in admixture with non-toxic pharmaceutically acceptable excipient which are suitable for manufacture of tablets are acceptable.
• excipients may be, for example, inert diluents, such as calcium carbonate, sodium carbonate, lactose, calcium phosphate or sodium phosphate; granulating and disintegrating agents, such as maize starch, or alginic acid; binding agents, such as starch, gelatin or acacia; and lubricating agents, such as magnesium stearate, stearic acid or talc. Tablets may be uncoated or may be coated by known techniques including microencapsulation to delay disintegration and adsorption in the gastrointestinal tract and thereby provide a sustained action over a longer period. For example, a time delay material such as glyceryl monostearate or glyceryl distearate alone or with a wax may be employed.
• inert diluents such as calcium carbonate, sodium carbonate, lactose, calcium phosphate or sodium phosphate
• granulating and disintegrating agents such as maize starch, or alginic acid
• Formulations for oral use may be also presented as hard gelatin capsules wherein the active ingredient is mixed with an inert solid diluent, for example calcium phosphate or kaolin, or as soft gelatin capsules wherein the active ingredient is mixed with water or an oil medium, such as peanut oil, liquid paraffin or olive oil.
• an inert solid diluent for example calcium phosphate or kaolin
• an oil medium such as peanut oil, liquid paraffin or olive oil.
• Aqueous suspensions of the invention contain the active materials in admixture with excipients suitable for the manufacture of aqueous suspensions.
• excipients include a suspending agent, such as sodium carboxymethylcellulose, methylcellulose, hydroxypropylmethylcelluose, sodium alginate, polyvinylpyrrolidone, gum tragacanth and gum acacia, and dispersing or wetting agents such as a naturally occurring phosphatide (e.g., lecithin), a condensation product of an alkylene oxide with a fatty acid (e.g., polyoxyethylene stearate), a condensation product of ethylene oxide with a long chain aliphatic alcohol (e.g., heptadeaethyleneoxycetanol), a condensation product of ethylene oxide with a partial ester derived from a fatty acid and a hexitol anhydride (e.g., polyoxyethylene sorbitan mono-oleate).
• SUBSTMiE SHEET (Ri'II 26) or more coloring agent, one or more flavoring agent and one or more sweetening agent, such as sucrose or saccharin.
• Oil suspensions may be formulated by suspending the active ingredient in a vegetable oil, such as arachis oil, olive oil, sesame oil or coconut oil, or in a mineral oil such as liquid paraffin.
• the oral suspensions may contain a thickening agent, such as beeswax, hard paraffin or cetyl alcohol.
• Sweetening agents, such as those set forth above, and flavoring agents may be added to provide a palatable oral preparation.
• These compositions may be preserved by the addition of an antioxidant such as ascorbic acid.
• Dispersible powders and granules of the invention suitable for preparation of an aqueous suspension by the addition of water provide the active ingredient in admixture with a dispersing or wetting agent, a suspending agent, and one or more preservatives. Suitable dispersing or wetting agents and suspending agents are exemplified by those disclosed above. Additional excipients, for example sweetening, flavoring and coloring agents, may also be present.
• the pharmaceutical compositions of the invention may also be in the form of oil-in-water emulsions.
• the oily phase may be a vegetable oil, such as olive oil or arachis oil, a mineral oil, such as liquid paraffin, or a mixture of these.
• Suitable emulsifying agents include naturally-occurring gums, such as gum acacia and gum tragacanth, naturally occurring phosphatides, such as soybean lecithin, esters or partial esters derived from fatty acids and hexitol anhydrides, such as sorbitan mono-oleate, and condensation products of these partial esters with ethylene oxide, such as polyoxyethylene sorbitan mono-oleate.
• the emulsion may also contain sweetening and flavoring agents.
• Syrups and elixirs may be formulated with sweetening agents, such as glycerol, sorbitol or sucrose. Such formulations may also contain a demulcent, a preservative, a flavoring or a coloring agent.
• sweetening agents such as glycerol, sorbitol or sucrose.
• Such formulations may also contain a demulcent, a preservative, a flavoring or a coloring agent.
• compositions of the invention may be in the form of a sterile injectable preparation, such as a sterile injectable aqueous or oleaginous suspension.
• a sterile injectable preparation such as a sterile injectable aqueous or oleaginous suspension.
• This suspension may be formulated according to the known art using those suitable dispersing or wetting agents and suspending agents which have been mentioned above.
• the sterile injectable preparation may also be a sterile injectable solution or suspension in a non-toxic parenteral ly-acceptable diluent or solvent such as a solution in 1 ,3-butanediol or prepared as a lyophyiized powder.
• acceptable vehicles and solvents that may be employed are water, Ringer's solution and isotonic sodium chloride solution.
• sterile fixed oils may conventionally be employed as a solvent or suspending medium.
• any bland fixed oil may be employed including synthetic mono- or diglycerides.
• fatty acids such as oleic acid may likewise be used in the preparation of injectables.
• a time-release formulation intended for oral administration to humans may contain 20 to 1000 ⁇ moles of active material compounded with an appropriate and convenient amount of carrier material which may vary from about 5 to about 95% of the total compositions. It is preferred that pharmaceutical composition be prepared which provides easily measurable amounts for administration.
• an aqueous solution intended for intravenous infusion should contain from about 0.1 to about 15 ⁇ moles of the active ingredient per milliliter of solution in order that infusion of a suitable volume at a rate of about 30 mL /hr can occur.
• formulations of the present invention suitable for oral administration may be presented as discrete units such as capsules, cachets or tablets each containing a predetermined amount of the active ingredient; as a powder or granules; as a solution or a suspension in an aqueous or non-aqueous liquid; or as an oil-in-water liquid emulsion or a water-in-oil liquid emulsion.
• the active ingredient may also be administered as a bolus, electuary or paste.
• a tablet may be made by compression or molding, optionally with one or more accessory ingredients.
• Compressed tablets may be prepared by compressing in a suitable machine the active ingredient in a free-flowing form such as a powder or granules, optionally mixed with a binder (e.g.. povidone, gelatin, hydroxypropylmethyl cellulose), lubricant, inert diluent, preservative, disintegrant (e.g.. sodium starch glycolate, cross-linked povidone, cross-linked sodium carboxymethyl cellulose) surface- active or dispersing agent.
• Molded tablets may be made by molding in a suitable machine a mixture of the powdered compound moistened with an inert liquid diluent.
• the tablets may optionally be coated or scored and may be formulated so as to provide slow or controlled release of the active ingredient therein using, for example, hydroxypropylmethyl cellulose in varying proportions to provide the desired release profile. Tablets may optionally be provided with an enteric coating, to provide release in parts of the gut other than the stomach. This is particularly advantageous with the compounds of formula (I) as such compounds are susceptible to acid hydrolysis.
• Formulations suitable for topical administration in the mouth include lozenges comprising the active ingredient in a flavored basis, usually sucrose and acacia or tragacanth; pastilles comprising the active ingredient in an inert basis such as gelatin and glycerin, or sucrose and acacia; and mouthwashes comprising the active ingredient in a suitable liquid carrier.
• Formulations for rectal administration may be presented as a suppository with a suitable base comprising for example cocoa butter or a salicylate.
• Formulations suitable for vaginal administration may be presented as pessaries, tampons, creams, gels, pastes, foams or spray formulations containing in addition to the ddPN ingredient such carriers as are known in the art to be appropriate.
• Formations suitable for parenteral administration include aqueous and non-aqueous isotonic sterile injection solutions which may contain anti-oxidants, buffers, bacteriostats and solutes which render the formation isotonic with the blood of the intended recipient; and aqueous and non-aqueous sterile suspensions which may include suspending agents and thickening agents.
• the formulations may be presented in unit-dose or multi-dose sealed containers, for example, ampoules and vials, and may be sorted in a freeze-dried (lyophilized) condition requiring only the addition of the sterile liquid carrier, for example water for injections, immediately prior to use.
• Extemporaneous injection solutions and suspensions may be prepared from sterile powders, granules and tablets of the kind previously described.
• Preferred unit dosage formulations are those containing a daily dose or unit, daily sub-dose, or an appropriate fraction thereof, of an adenosine kinase inhibitor compound. It will be understood, however, that the specific dose level for any particular patient will depend on a variety of factors including the activity of the specific compound employed; the age, body weight, general health, sex and diet of the individual being treated; the time and route of administration; the rate of excretion; other drugs which have previously been administered; and the severity of the particular disease undergoing therapy, as is well understood by those skilled in the art.
• Capsules comprising adenosine kinase inhibitors suitable for oral administration according to the methods of the present invention may be prepared as follows: (1) for a 10,000 capsule preparation: 1500 g of adenosine kinase inhibitor is blended with other ingredients (as described above) and filled into capsules which are suitable for administration depending on dose, from about 4 capsules per day (1 per 6 hours) to about 8 capsules per day (2 capsules per 6 hours), to an adult human.

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