WO1998031380A1 - Derives et analogues de phalloide destines a traiter l'insuffisance cardiaque globale - Google Patents

Derives et analogues de phalloide destines a traiter l'insuffisance cardiaque globale Download PDF

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Publication number
WO1998031380A1
WO1998031380A1 PCT/US1998/000952 US9800952W WO9831380A1 WO 1998031380 A1 WO1998031380 A1 WO 1998031380A1 US 9800952 W US9800952 W US 9800952W WO 9831380 A1 WO9831380 A1 WO 9831380A1
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alkyl
absent
bond
phalloidin
halo
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PCT/US1998/000952
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English (en)
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Anna E. Boukatina
Kenneth B. Campbell
Lawrence L. Kunz
Sudhakar Kasina
Louis J. Theodore
Alan R. Fritzberg
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Washington State University Research Foundation
Neorx Corporation
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Priority to AU60300/98A priority Critical patent/AU6030098A/en
Publication of WO1998031380A1 publication Critical patent/WO1998031380A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/04—Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
    • A61K38/12—Cyclic peptides, e.g. bacitracins; Polymyxins; Gramicidins S, C; Tyrocidins A, B or C
    • 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

Definitions

  • CHF Congestive heart failure
  • systolic CHF the heart muscle has lost some of its normal contractile strength.
  • the heart muscle in a heart from a patient with systolic CHF produces less than normal contractile force or, if allowed to shorten against a load during contraction, shortens less rapidly and to a lesser extent.
  • Such impairment of heart muscle function results in an inability of the heart to deliver a normal stroke volume when the heart is filled to a normal end-diastolic volume.
  • An adequate stroke volume to sustain a cardiac output can be delivered by hearts of CHF patients only when the heart has been filled to greater than normal end-diastolic volumes. At best, this is a life commensurate with reduced activity and exertional effort.
  • CHF CHF vascular disease 2019
  • Pharmacologic therapy is primarily directed at relieving CHF symptoms (diuretics, vasodilators, cardiac inotropic agents) and impeding or reversing structural changes in the heart and vascular system that exacerbate these symptoms (ACE inhibitors, angiotensin blocking agents).
  • cardiac inotropic agents for therapeutic uses fall into one of three categories: digitalis glycosides; ⁇ -agonists; and phosphodiesterase (PDE) III inhibitors. All of these agents enhance cardiac muscle contraction by making more intracellular Ca 2+ available to cardiac myofilaments during muscle activation.
  • increased intracellular Ca 2+ has three undesirable effects: 1) it increases cellular electrical excitability and thus, increases the potential of arrhythmia induction or subsequent fibrillation; 2) it increases the energy costs of contraction by increasing the energy needed to handle the extra Ca 2+ during a contraction cycle, thereby increasing cardiac load; and 3) it adds an extra Ca 2+ load to debilitated heart muscle cells that already have difficulty maintaining intracellular Ca 2+ homeostasis which can result in cell death.
  • intracellular Ca 2+ that results from treatment with one of the currently used cardiac inotropes often exacerbates the condition of patients with CHF. This is because functionally impaired heart muscle cells in patients with CHF barely maintain appropriate excitable rhythm, a balance of their energy needs with their energy supply, or intracellular Ca 2+ levels low enough to prevent the cascade of events that lead to cell death resulting from an increase in intracellular Ca 2+ . For example, lethal cardiac arrhythmias often develop, as well as expanded areas of necrosis in border zones surrounding ischemic regions which lead to further loss of cardiac function.
  • Ca 2+ -sensitizing cardiac inotropes A new class of cardiac inotropic drugs, termed Ca 2+ -sensitizing cardiac inotropes, has been described. These agents enhance force development by cardiac myofilaments in the presence of fixed amounts of Ca 2+ , i.e., without an increase in intracellular Ca 2+ concentrations (Lee and Allen, Modulation of Calcium Sensitivity, Oxford Univ. Press, Inc, 1993).
  • Some Ca 2+ -sensitizers e.g., levosimedan, increase the Ca 2+ binding affinity of troponin C (TnC; Pollesello et al., J. Biol.
  • Ca 2+ sensitizing compounds are their specificity of action.
  • Ca 2+ sensitizers e.g., sumazol, pimobendan, levosimendan and MCI 154
  • PDE III inhibitors e.g., sumazol, pimobendan, levosimendan and MCI 154
  • EMD 53998 which was found to consist of a racemic mixture in which the (-) enantiomer was a PDE III inhibitor while the (+) enantiomer, EMD 57033, was primarily a Ca 2+ sensitizer (Gambassi et al., Am. J. Physiol, 264:H728-738, 1993; White et al., Circ. Res., 73:61-70, 1993; Solaro et al., Circ. Res., 73:981-990, 1993).
  • the invention provides a method to treat a mammal having, or prevent a mammal at risk of, a condition characterized by reduced heart muscle contractile strength.
  • the method comprises the administration of an amount of at least one therapeutic agent effective to increase the contractile force of the heart in said mammal.
  • the agent binds to cardiac actin more strongly than to skeletal actin.
  • the agent is a non-toxic phalloidin derivative or analog, e.g., a compound of formula (I)-(IN) (see below).
  • Conditions characterized by reduced heart muscle contractile strength include, but are not limited to, CHF, ischemic myocardial infarction, hypertension, myocarditis, epicarditis, endocarditis, pulmonary edema, heart failure secondary to ischemic heart disease, valavular heart disease, hypodynamic heart such as occurs in cardiogenic shock, cardiac arhythmia, atrial or ventricle arrhythmias, other cardiomyopathies or acute heart conditions, e.g., septic shock leading to cardiogenic shock or post-myocardial infarction.
  • cardiomyopathies includes, but is not limited to, dilated cardiomyopathy, hypertrophic cardiomyopathy, and restrictive cardiomyopathy, as well as cardiomyopathies of known origin, e.g., from infection by viruses, bacteria or fungi, metabolic disorders, general system diseases, hereditary muscle and neurological disorders and the like.
  • the term “mammals” includes human patients, domestic animals and other animals.
  • the invention also provides a method to prevent or treat systolic congestive heart failure (CHF) in a mammal, e.g., a human.
  • CHF congestive heart failure
  • the method comprises the administration to a mammal of an amount of at least one non-toxic phalloidin analog or derivative effective to reduce or inhibit at least one of the symptoms associated with systolic CHF, e.g., a decrease in discharge of blood from the heart, a decrease in contractile force of the heart, and/or an increase in the structural remodeling and enlargement of the heart.
  • phalloidin derivatives have described as being useful to treat interleukin-2 mediated edema (Shepro et al., U.S. Patent No.
  • interleukin-2 mediated edema is an inflammatory edema related to increased endothelial permeability which results in an exudate having proteins, e.g., plasma proteins, and polymorphonuclear leukocytes.
  • proteins e.g., plasma proteins
  • non-inflammatory edema which is associated with CHF is protein poor, and is a clinically distinct pathology.
  • the administration of a phalloidin analog or derivative of the invention enhances contractile vigor of the heart muscle without increasing intracellular Ca 2+ levels, i.e., it is a Ca 2+ -sensitizing agent.
  • Preferred phalloidin analogs or derivatives are ones that are specific in their Ca 2+ -sensitizing action, i.e., they have high affinity for cardiac actin relative to skeletal actin. Also preferably, the administration of a phalloidin analog or derivative of the invention enhances contractile vigor of the muscle fibers without increasing oxygen consumption by the heart. In addition, phalloidin analogs or derivatives of the invention that do not increase arrhythmia induction and/or cardiac load are particularly useful for prolonged or chronic use.
  • non-toxic with respect to a phalloidin analog or derivative means that the administration of the phalloidin analog or derivative does not result in detrimental consequences to an organism, e.g., liver toxicity, that outweigh the therapeutic benefit provided by the administration.
  • the toxicity of a phalloidin analog or derivative can be measured by methods well known to the art, e.g., by determining the LD 50 in laboratory animals (mice, rats, guinea pigs, rabbits, hamsters, etc.), for example, as described by Theodor Wieland, "Peptides of poisonous Amanita mushrooms” Springer- Verlag, Berlin, 1986, p. 45.
  • Toxic phalloidin analogs and derivatives have a very high affinity for F-actin, irreversibly bind to actin, or have an LD 50 which is similar to, or up to 15 times greater than, the LD 50 of phalloidin. High affinity for actin leads to strong stabilization of the actin filament.
  • the ability of some phalloidin derivatives to modify skeletal muscle tension was found to be qualitatively correlated with their ability to structurally stabilize F-actin.
  • dethiophalloidin a derivative of phalloidin that is a poor F-actin stabilizer in skeletal muscle was found to enhance cardiac muscle contraction (Example 2).
  • phalloidin analogs or derivatives bind to actin more weakly than does phalloidin.
  • the phalloidin analogs or derivatives of the invention have at least about 1%, preferably at least about 10% or 50%, and more preferably at least about 100%, or greater than 200%, of the biological activity of dethiophalloidin, e.g., the ability to enhance cardiac muscle contraction.
  • the biological activity of a phalloidin analog or derivative on muscle, skeletal or cardiac is determined by methods well known to the art. See, for example, Examples 1-2 hereinbelow, Bukatina et al., J. Mol. Cell. Cardiol, 27:1311-1315, 1995; Bukatina and Fuchs, J. Muscl. Res.
  • an analog or derivative may be characterized by in vitro assays, such as the contractile force of cardiac muscle under normal or stress conditions, relaxation times in an explanted heart, or actin binding, or by in vivo assays such as left ventricle ejection fraction, oxygen consumption or exercise tolerance in a mammal, in the presence or absence of the analog or derivative.
  • a preferred phalloidin analog or derivative is a compound of formula ⁇ :
  • each of R 1 and R° is H, OH, (C,-C 4 )alkyl, O(C,-C 4 )alkyl, halo, halo(C r
  • each of R 11 and R 12 is H, (C r C 22 )alkyl, benzyl, phenyl, C(O)(C,-C 22 )alkyl, a peptide or protein, or a residue of a sugar;
  • R is H, (C,-C 5 )alkyl, (C,-C 5 )alkanoyl, benzyl, or CH 2 C(O)N(R n )(R 12 );
  • R 2 is H or (C,-C 4 )alkyl;
  • R 3 is H, (C,-C 4 )alkyl, CO 2 H, CH 2 OH or benzyl;
  • R 4 is H, OH, halo, acetoxy or OTs (tosyloxy) (preferrably, R 4 is cis to the carboxy substituent at the 2-position of the pyrrolidine ring);
  • R 5 is H, OH, acetoxy, halo or OTs
  • each of R 6 and R 7 is absent or is H, (C,-C 4 )alkyl, acetyl, or phenyl when the C N bond is absent;
  • R 10 is H, (C,-C 4 )alkyl, CO 2 H, CO 2 (C,-C 4 )alkyl, or C(O)N(R' ! )(R 12 );
  • Y is H, (C r C 4 )alkyl, optionally substituted by N(R' ')(R 12 ), acetoxy, acetyl, 2-methyl-l,3-dithiolan-2-yl optionally 4-substituted with CH 2 N(R n )(R 12 ) or CO 2 R n ; or is C(R 13 )(R 14 )(OH) wherein R 13 is H, (C,-C 4 )alkyl, CO 2 H or CH 2 OQ wherein Q is H, acetyl, or Ts (tosyl) and R 14 is (C,-C 4 )alkyl, halo(C r C 4 )alkyl, haloacetyl, CO 2 H, CH 2 OQ wherein Q is as defined above, or is C(O)(C 12 -C 22 )alkyl, a peptide or protein, a residue of a sugar (e.g.
  • R 6 is -CH 2 -O- and R 6 is absent or is OR" when the C N bond is absent; or a pharmaceutically acceptable salt thereof; with the proviso that the compound of formula (I) is not phalloidin.
  • R, R°, R 1 and R 2 are H, X is S, Z is CH 2 , R 3 is CH 3 , R 4 and R 5 are OH, R 6 , R 7 and R 8 are absent, Y is C(CH 3 )(OH)(CH 2 OH), then R 10 is not CH 3 .
  • a preferred compound of formula (I) is dethiophalloidin and analogs and derivatives thereof.
  • Another preferred compound of formula (I) is secophalloidin and analogs and derivatives thereof.
  • a "derivative" of a therapeutic agent of the invention includes modifications that do not substantially effect the biological activity of the therapeutic agent.
  • substantially effect is meant that the activity is quantitatively different but qualitatively the same.
  • a, or other modifications which may improve the derivative of phalloidin may comprise for example, bound peptides, polypeptides, phospholipids, steroidal moieties, fatty acid moieties, covalently linked carbohydrates solubility, absorption or biological half life of the derivative.
  • the modifications may also decrease the toxicity of the analog or derivative, or eliminate or attenuate any undesirable side effect of the analog or derivative.
  • Another preferred phalloidin analog or derivative is a compound of formula (II):
  • each of R 1 and R° is H, OH, CH 3 O, halo, CN, NO 2 , CF 3 , CO 2 H, CO 2 (C r C 4 )alkyl or N(R ⁇ )(R 12 ) wherein each of R 11 and R 12 is H, (C,-C 4 )alkyl, benzyl, phenyl, C(O)(C,-C 22 )alkyl, a peptide or protein, or a residue of a sugar;
  • R is H, CH 3 , formyl, or acetyl;
  • R 2 is H or CH 3 ;
  • R 3 is CH 3 , iso-propyl, or iso-butyl
  • R 4 is H or OH
  • R 5 is H or OH:
  • R 6 is absent or together with R 10 is a covalent bond
  • R 7 is absent or is COCH 3 or R 1 * when the C N bond is absent ;
  • X is H, S, O, Se or S(O) 1-2 ;
  • Z is C(O) or -CH 2 -, or H or (C r C 4 )alkyl when the X Z bond is absent;
  • R 8 is absent or is H or (C r C 4 )alkyl when the X Z bond is absent;
  • R 10 is H, a peptide or protein, a monosaccharide, C(O)(C 12 -C 22 )alkyl, or haloacetyl;
  • R 13 is H, a peptide or protein, a monosaccharide, C(O)(C 12 -C 22 )alkyl, or haloacetyl; or a pharmaceutically acceptable salt thereof; with the proviso that the compound of formula (II) is not phalloidin.
  • a preferred compound of formula (II) is dethiophalloidin and analogs and derivatives thereof.
  • Another preferred phalloidin analog is a compound of formula (III):
  • R is -(C(OR 4 )(CH 3 )(CH 2 OR 5 ) or haloacetyl, wherein R 4 is H or together with Z is a covalent bond
  • R 5 is H, a peptide or protein, a sugar residue or C(O)R' wherein R' is (C ]2 -C 22 )alkyl, optionally comprising 1-3 double bonds
  • Z is absent or together with R 4 is a covalent bond
  • Y is absent or is H when the C — N bond is absent, and X is - H H-, SO, O, or Se
  • R 3 is H or an acetyl, or a pharmaceutically acceptable salt thereof.
  • R a , R b , and R g are individually any naturally or unnaturally occurring alpha amino acid, or lysine coupled through its ⁇ -amino group to a steroidal or fatty acid moiety; (2) x is 0, 1 or 2;
  • each of R 1 and R° is H, OH, (C,-C 4 )alkyl, O(C r C 4 )alkyl, halo, halo(C r
  • R 11 and R 12 is H, (C,-C 4 )alkyl, benzyl, phenyl, C(O)(C,-C 22 )alkyl, a peptide or protein, or a residue of a sugar; (4) the bond represented by is present or absent; (5) R is H, (C r C 5 )alkyl, (C,-C 5 )alkanoyl, benzyl, or CH 2 C(O)N(R' ')(R 12 );
  • R 2 is H or (C,-C 4 )alkyl
  • R 3 is H, (C,-C 4 )alkyl, CO 2 H, CH 2 OH or benzyl;
  • R 4 is H, OH, halo, acetoxy or OTs (tosyloxy);
  • X is H, O, S, Se, or S(O),_ 2 ;
  • R 8 is absent or is H or (C r C 4 )alkyl when the X Z bond is absent;
  • Z is C(O) or -CH 2 -, or is H or (C,-C 4 )alkyl when the X Z bond is absent.
  • R a and R b are individually valine, leucine, isoleucine, alanine, serine, methionine, phenylalanine, norleucine, glycine or lysine.
  • R ⁇ is valine, leucine, isoleucine, serine, methionine, phenylalanine, norleucine, glycine or lysine.
  • the invention also provides a method to enhance cardiac muscle contraction in a mammal, comprising the administration of an amount of at least one non-toxic phalloidin derivative or analog effective to enhance cardiac muscle contraction in said mammal.
  • the phalloidin analog or derivative which is administered is a compound of formula (I), a compound of formula (II), a compound of formula (III), or a compound of formula (IN), or a combination thereof.
  • the invention also provides novel phalloidin analogs or derivatives of formula (I), (II), (III), or (IN), as well as salts thereof, and derivatives thereof that comprise bound peptides, polypeptides, phospholipids, steroidal moieties, fatty acid moieties, or covalently linked carbohydrates.
  • Some phalloidin analogs or derivatives may be useful as intermediates for preparing other phalloidin analogs or derivatives.
  • the invention also provides intermediates (e.g. compounds of formula (I), (II), (III), or (IN)) that are useful for preparing other phalloidin analogs or derivatives.
  • Figure 1 depicts the dose-dependent effects of dethiophalloidin (DTPH) on cardiac muscle force. The lowest trace indicates pCa values. Single arrows indicate solution changes. Double arrows indicate transfer of the preparation to a new well.
  • DTPH dethiophalloidin
  • Figure 2 depicts the response of DTPH at different pCa.
  • Figure 3 depicts the absence of effect of DTPH on passive, relaxed cardiac muscle.
  • Figure 4 depicts the absence of effect of DTPH on rigor force cardiac muscle.
  • Figure 5 depicts a representative trace of the force of the effect of DTPH on cardiac muscle.
  • Figure 6 depicts a graph of force versus pCa. A) Absolute force versus pCa. B) Relative force versus pCa. Points indicate mean ⁇ SE.
  • Figure 7 depicts a graph of force versus pCa.
  • Figure 8 depicts the prevention of the DTPH-induced cardiac muscle force enhancement by pretreatment with phalloidin (PH) (80 ⁇ M).
  • Figure 9 depicts the effect of PH administration (40 ⁇ M) on muscle force elevated by DTPH.
  • Figure 10 depicts the effect of (S)-phalloidin-sulfoxide A on muscle isometric force at full activation (A) and at partial activation (B).
  • Figure 11 depicts the dose-dependent effect of secophalloidin at maximal calcium activation.
  • Figure 12 depicts the relationship between the action of secophalloidin (80 ⁇ M) and phalloidin (80 ⁇ M).
  • pCa was 5.89, which corresponds to about half maximal activation (see Figure 6B).
  • (S)- phalloidin-sulfoxide A was added at 40 ⁇ M.
  • Figure 13 depicts exemplary and preferred amino acid substitutions. Detailed Description of the Invention
  • the present invention provides a method to prevent or treat congestive heart failure in a mammal which employs a phalloidin-based cardiac inotrope having specificity for cardiac muscle.
  • Phalloidin an agent which modulates the contractile process, i.e., the interaction of actin filaments with myosin in muscle, by binding to actin, is one of several toxic compounds produced by the mushroom Amanita phalloides (Weiland, T., Peptides of Poisonous Amanita Mushrooms. New York, Springer, 1986). In binding tightly to F-actin, phalloidin stabilizes the F-actin filament and inhibits filament depolymerization.
  • Phalloidin is highly toxic to cells, such as liver cells, where rapid actin depolymerization and polymerization is required for cellular function.
  • phalloidin does not disrupt cellular function but instead modulates the contractile process (Bukatina and Morozov, Biophysics, 24:527-531 (1979); Son'kin et al., Biophysics, 28:892-899 (1983); Bukatina et al., Histochemistry, 81 :301-304(1984); Alievskaya et al., Biophysics, 32:105-109 (1987); Boels and Pf ⁇ tzer, J. Muscle Res., Cell Motil, 13:71-80 (1992); Bukatina and Fuchs, J.
  • cardiac muscle response to phalloidin differs from that of other muscles, both with respect to the shape of the response and the time scale with which it evolves.
  • cardiac muscle response to phalloidin differs from that of other muscles, both with respect to the shape of the response and the time scale with which it evolves.
  • the main effect of phalloidin is a decrease in tension.
  • the initial decrease is followed by an increase in tension.
  • cardiac muscle responds uniquely with only an increase in tension.
  • the phalloidin- induced force changes develop over tens of minutes in skeletal and smooth muscle, the response in cardiac is completed more quickly, i.e., in two to three minutes.
  • phalloidin The observed muscle-type specific differences in response to phalloidin are believed to be due to the differences in thin filament composition. Both skeletal and smooth muscle thin filaments contain proteins located along the entire filament length (nebulin and caldesmon, respectively) that are not expressed in cardiac muscle (Small et al., Eur. J. Biochem., 208:559-572 (1992)). Moreover, there is evidence that phalloidin binds very slowly in skeletal muscle but binds much more quickly in cardiac muscle (Ao and Lehrer, Biophys. J., 66:A194, 1994).
  • phalloidin and nebulin bind to the same site on the actin filament, and the binding of phalloidin causes unzipping of nebulin from the actin filament. This slow process is believed to be the rate limiting step in phalloidin binding in skeletal muscle.
  • derivatives and analogs of phalloidin were analyzed for their ability to enhance cardiac muscle contraction.
  • Agents useful in the practice of the methods of the invention include agents that increase heart muscle contractility, e.g., phalloidin analogs and derivatives, preferably by reversibly binding to cardiac actin.
  • the agents of the invention are substantially free of natural contaminants which associate with the agent either in vivo (in a prokaryotic or eukaryotic) host, or in vitro (as a result of a chemical synthesis).
  • An agent is said to be "substantially free of natural contaminants” if it has been substantially purified from materials with which it is normally and naturally found before such purification.
  • preparations containing the agents of the invention may include quantities of contaminants which do not interfere with the desired therapeutic effect of the agent upon administration thereof and do not harm the animal as the result of the administration.
  • a preferred therapeutic agent is an analog or derivative of phalloidin.
  • Phalloidin analogs and derivatives falling within the scope of the invention include pharmaceutically useful, or "non-toxic,” acyclic and cyclic phalloidin analogs or derivatives which enhance cardiac muscle contraction by increasing the sensitivity, i.e., response, of cardiac muscle to Ca 2+ .
  • These phalloidin analogs and derivatives include all phalloidin analogs and derivatives that bind to thin filament actin of normal rabbit skeletal muscle more weakly than phalloidin.
  • Phalloidin analogs and derivatives of the invention include, but are not limited to dethiophalloidin, secophalloidin, N-acetyl-secophalloidin, and the phalloidin analogs and derivatives described in Weiland (see Tables 16 and 18 in Peptides of the Amanita Mushrooms, Springer Nerlag, 1986, both of which Tables are specifically incorporated by reference herein) and Shepro et al. (U.S. Patent No. 5,278,143, Table 1 of which is specifically incorporated by reference herein), the disclosures of which are incorporated by reference herein.
  • amino acid analogs of phalloidin which have at least one amino acid substitution, deletion or addition relative to phalloidin.
  • Amino acid substitutions include substitutions which utilize the D rather than L form, as well as other well known amino acid analogs.
  • analogs include phosphoserine, phosphothreonine, phosphotyrosine, hydroxyproline, garnma-carboxyglutamate; hippuric acid, octahydroindole-2- carboxylic acid, statine, l,2,3,4,-tetrahydroisoquinoline-3-carboxylic acid, penicillamine, ornithine, citruline, ⁇ -methyl-alanine, para-benzoyl-phenylalanine, phenylglycine, propargylglycine, sarcosine, and tert-butylglycine.
  • One or more of the residues of the analog can be altered, so long as the analog is biologically active.
  • the analog has at least about 10% of the biological activity of the corresponding non-toxic phalloidin.
  • Conservative amino acid substitutions are preferred—that is, for example, aspartic-glutamic as acidic amino acids; lysine/arginine/histidine as basic amino acids; leucine/isoleucine, methionine/valine, alanine/valine as hydrophobic amino acids; serine/glycine/alanine/threonine as hydrophilic amino acids.
  • Conservative substitutions are shown in Figure 13 under the heading of exemplary substitutions. More preferred substitutions are under the heading of preferred substitutions. After the substitutions are introduced, the amino acid analogs are screened for biological activity.
  • Amino acid substitutions falling within the scope of the invention are, in general, accomplished by selecting substitutions that do not differ significantly in their effect on maintaining (a) the structure of the generally cyclic nature of the phalloidins, (b) the charge or hydrophobicity of the molecule at the target site, or (c) the bulk of the side chain.
  • Naturally occurring residues are divided into groups based on common side-chain properties:
  • hydrophobic norleucine, met, ala, val, leu, ile
  • neutral hydrophilic cys, ser, thr
  • the substitution increases the hydrophobicity of the analog so as to increase its bioavailability.
  • phalloidin analogs with non- conservative substitutions.
  • Non-conservative substitutions entail exchanging a member of one of the classes described above for another.
  • preferred amino acid analogs of phalloidin include a compound of formula (IN):
  • R a , R b , and R g are individually any naturally or unnaturally occurring alpha amino acid, or lysine coupled through its ⁇ -amino group to a steroidal or fatty acid moiety; (2) x is 0, 1 or 2;
  • each of R 1 and R° is H, OH, (C,-C 4 )alkyl, O(C r C 4 )alkyl, halo, halo(C r C 4 )alkyl, C ⁇ , ⁇ O 2 , CF 3 , CO 2 H, CO 2 (C r C 4 )alkyl or N(R")(R 12 ) wherein each of R 11 and R 12 is H, (C r C 4 )alkyl, benzyl, phenyl, C(O)(C,-C 22 )alkyl, a peptide or protein, or a residue of a sugar; (4) the bond represented by is present or absent;
  • R is H, (C,-C 5 )alkyl, (C,-C 5 )alkanoyl, benzyl, or CH 2 C(O)N(R> >)(R 12 );
  • R 2 is H or (C,-C 4 )alkyl
  • R 3 is H, (C,-C 4 )alkyl, CO 2 H, CH 2 OH or benzyl;
  • R 4 is H, OH, halo, acetoxy or OTs (tosyloxy);
  • X is H, O, S, Se, or S(O),. 2 ;
  • R 8 is absent, or is H or (C r C 4 )alkyl when the X Z bond is absent;
  • (I I) Z is C(O) or -CH 2 -, or is H or (C,-C 4 )alkyl when the X Z bond is absent.
  • R a and R b are individually valine, leucine, isoleucine, alanine, serine, methionine, phenylalanine, norleucine, glycine or lysine.
  • R g is valine, leucine, isoleucine, serine, methionine, phenylalanine, norleucine, glycine or lysine.
  • Another preferred phalloidin analog or derivative is a compound of formula (I):
  • each of R 1 and R° is H, OH, (C r C 4 )alkyl, O(C,-C 4 )alkyl, halo, halo(C r C 4 )alkyl, CN, NO 2 , CF 3 , CO 2 H, CO 2 (C r C 4 )alkyl or N(R U )(R 12 ) wherein each of R 11 and R 12 is H, (C r C 4 )alkyl, benzyl or phenyl
  • R is H, (C,-C 5 )alkyl, acetyl, benzyl, or CH 2 C(O)N(R n )(R 12 );
  • R 2 is H or (C,-C 4 )alkyl;
  • R 3 is H, (C,-C 4 )alkyl, CO 2 H, CH 2 OH or benzyl (R 3 is preferrably H, (C,-
  • R 4 is H, OH, halo, acetoxy or OTs (tosyloxy); (7) R 5 is H, OH, acetoxy, halo or OTs; (8) each of R 6 and R 7 is absent or is H, (C,-C 4 )alkyl, acetyl, or phenyl when the
  • R 10 is H, (C,-C 4 )alkyl, CO 2 H or C(O)N(R n )(R 12 ) (R 10 is preferrably H, (C,- C 4 )alkyl, or C(O)N(R n )(R 12 ));
  • X is H, O, S, Se, or S(O),. 2 ;
  • R 8 is absent, or is H or (C r C 4 )alkyl when the X Z bond is absent;
  • Z is C(O) or -CH 2 -, or is H or (C , -C 4 )alkyl when the X Z bond is absent;
  • Y is H, (C r C 4 )alkyl, optionally substituted by N(R n )(R 12 ), acetoxy, acetyl, 2-methyl- 1 ,3-dithiolan-2-yl optionally 4-substituted with CH 2 N(R' ')(R 12 ) or
  • R 6 is absent, or is OR 11
  • Q is H, acetyl, Ts, C(O)(C 12 -C 22 )alkyl optionally comprising 1-3 double bonds, a peptide or protein, a residue of a sugar, haloacetyl, or when the C N bond is absent, in combination with R 6 is -CH 2 -O- and R 6 is absent, or R 6 is OR 11 ); or a pharmaceutically acceptable salt thereof; with the proviso that the compound of formula (I) is not phalloidin.
  • Y is a peptide or protein
  • the peptide or protein is a fragment of an antibody, or an antibody, which binds to a molecule which is specific to the heart, e.g., cardiac muscle.
  • Y is haloacetyl
  • a peptide or protein molecule can be readily added at this position, by methods well known to the art.
  • a compound of formula (I) includes wherein:
  • each of R° and R 1 is H, (C 2 -C 4 )alkyl, O(C 2 -C 4 )alkyl, halo(C,-C 4 )alkyl, CO 2 (C 3 -C 4 )alkyl or N(R n )(R 12 ) wherein each of R 11 and R 12 is (C 3 -C 4 )alkyl, benzyl or phenyl;
  • R is H, (C 2 -C 5 )alkyl, benzyl, or CH 2 C(O)N(R 1 (R 12 );
  • R 2 is H or (C 2 -C 4 )alkyl
  • R 3 is H, (C,-C 4 )alkyl or benzyl; (6) R 4 is H, OH, halo, acetoxy or OTs (tosyloxy);
  • R 5 is H, OH, acetoxy, halo or OTs
  • each of Re and R 7 is absent or is H, (C,-C 4 )alkyl, COCH 3 , or phenyl when the C N bond is absent;
  • R 10 is H, (C r C 4 )alkyl or C(O)N(R' ')(R 12 );
  • X is H, S, or S(O),. 2 ;
  • R 8 is absent, or is H or (C r C 4 )alkyl when the X Z bond is absent;
  • Z is -CH 2 - or is H or (C,-C 4 )alkyl when the X Z bond is absent;
  • x is 0, 1 or 2;
  • Y is H, (C r C 4 )alkyl, optionally substituted by N(R U )(R 12 ), acetoxy, acetyl, 2-methyl-l,3-dithiolan-2-yl optionally 4-substituted with CH 2 N(R ⁇ )(R 12 ) or CO 2 R n ; or is C(R I3 )(R 14 )(OH) wherein R 13 is H, (C,-C 4 )alkyl or CH 2 OQ wherein Q is H, Ac or Ts (tosyl) and R 14 is halo(C r C 4 )alkyl, CO 2 H or CH 2 OQ wherein Q is as defined above, or when the C N bond is absent in combination with R 6 is -CH 2 -O- and R 6 is absent or R 6 is OR 11 ; or a pharmaceutically acceptable salt thereof, with the proviso that the compound of formula (I) is not phal
  • Another preferred phalloidin analog or derivative is a compound of formula (II):
  • each of R 1 and R° is H, OH, CH 3 O, halo, CN, NO 2 , CF 3 , CO 2 H, CO 2 (C r C 4 )alkyl or N(R ⁇ )(R 12 ) wherein each of R 11 and R 12 is H, (C,-C 4 )alkyl, benzyl, phenyl, C(O)(C ! -C 22 )alkyl, a peptide or protein, or a residue of a sugar;
  • R is H, CH 3 , formyl, or acetyl
  • R 2 is H or CH 3 ;
  • R 3 is CH 3 , iso-propyl, or iso-butyl; (6) R 4 is H or OH;
  • R 5 is H or OH:
  • R 6 is absent or together with R 10 is a covalent bond
  • R 7 is absent or is COCH 3 or R n when the C N bond is absent;
  • X is H, S, O, Se or S(O),. 2 ;
  • Z is C(O) or -CH 2 -, or H or (C,-C 4 )alkyl when the X Z bond is absent;
  • R 8 is absent, or is H or (C,-C 4 )alkyl when the X Z bond is absent;
  • R 10 is H, a peptide or protein, a monosaccharide, C(O)(C 12 -C 22 )alkyl, or haloacetyl;
  • R 13 is H; or a pharmaceutically acceptable salt thereof; with the proviso that the compound of formula (II) is not phalloidin.
  • R 10 or R 13 is a peptide or protein, it is preferred that the peptide or protein is a fragment of an antibody, or an antibody, which binds to a molecule which is specific to the heart, e.g., cardiac muscle.
  • phalloidin analogs include a compound of formula (III):
  • R is -(C(OR 4 )(CH 3 )(CH 2 OR 5 ), or haloacetyl wherein R 4 is H or together with Z is a covalent bond
  • R 5 is H, a peptide or protein, a sugar residue or C(O)R' wherein R' is (C 12 -C 22 )alkyl, optionally comprising 1-3 double bonds, Z is absent or together with R 4 is a covalent bond
  • Y is absent, or is H when the C — N bond is absent, and X is -H H-, SO, O, Se
  • R 3 is H or an acetyl, or a pharmaceutically acceptable salt thereof.
  • R 5 is a peptide or protein
  • it is preferred that the peptide or protein is a fragment of an antibody, or an antibody, which binds to a molecule which is specific to the heart.
  • the therapeutic agents of the invention bind cardiac actin more strongly than skeletal actin, improve cardiac contractility over a wide range of Ca 2+ concentrations, relax smooth muscle, normalize smooth muscle function or any combination thereof.
  • Preferred therapeutic agents of the invention lower intracellular Ca 2+ levels. It is also preferred that the therapeutic agents of the invention do not increase MvO2, i.e., the consumption of oxygen by the heart.
  • Preferred therapeutic agents have a LD 50 which is less than the LD 50 of phalloidin.
  • the LD 50 of phalloidin is species specific (see, Faulstich, In: Chemistry of Peptides and Proteins, Noelter et al (eds.), Walter de Gruyter, Berlin, Germany (1982), pp. 279-288).
  • phalloidin analogs or derivatives can be prepared by methods well known to the art, including derivatizing or otherwise modifying phalloidin (available from Sigma Chemical Co., St. Louis, MO). For example, see Weiland et al. (Derivate. Liebigs Ann. Chem., 577:215-233, 1952); Weiland (Peptides of the Amanita Mushrooms, Springer Nerlag, 1986); Kobayashi et al. (Eur. J. Chem., 232: 726-736, 1995); Wulf et al. (Proc. Natl. Acad. Sci.
  • the bicyclic ring system can be converted to a monocyclic ring system by two types of reaction: by cleavage of a peptide bond and by removal of the sulfur bridge.
  • Functional groups subjected to modification include the hydroxyl groups in side chains 2, 4, and 7, the carboxyl group in side chain-2 of the acidic phalloidins and the indole NH of the tryptathionine moiety.
  • the side chain No. 7 of ⁇ , ⁇ -dihydroxyleucine of phalloidin, with its glycol unit, is subject to oxidation by periodate.
  • the sulfur atom of the tryptathionine residue can undergo oxidation by peroxyacetic acid and intramolecular alkylation.
  • the phalloidins possess primary and secondary OH-groups that differ in their reactivity, and a tertiary group that is virtually non-reactive, except in lactone formation. In phalloidin (and in phallacidin), the most reactive is the ⁇ -hydroxyl group of side chain-7. It has been selectively acetylated (Faulstich and Wieland, Eur. J. Biochem. 22:70-86, 1971) and tosylated (Wieland and Rehbinder, Liebigs Ann. Chem, 670:149-157, 1963). The monoacyl products can be toxic, providing evidence that side chain-7 is not involved in binding of the molecule to F-actin.
  • the OH-group of the D-threonine residue can be acetylated.
  • the latter OH participates in binding to the target protein, for its absence leads to lack of toxicity.
  • the second tosyl residue may have the essential hydroxyl of ⁇ /7ohydroxy proline.
  • the triacylated derivatives and also the tribromo derivative, obtained from a tritosyl compound by a Finkelstein reaction (KBr in acetone), are non-toxic.
  • Alkylation at the indole-N can be achieved by reaction of the sodium compound with the corresponding alkyl iodides (Faulstich and Wieland, supra, 1971) to obtain the N-methyl, N-ethyl, N- «-propyl, N-n-pentyl, N-tert-butyl, and carbamidomethyl compounds.
  • the N-methyl derivative cannot be distinguished chromatographically from the parent phalloidin, since the R F values of the N-methyl derivative were nearly identical in all solvents.
  • the carboxyl group of the acidic phalloidins in side chain No. 2 is not essential for binding to F-actin, since it can be replaced by methyl, as in the neutral phalloidins, or may be esterified by diazoalkanes.
  • a 2-aminoethylamide of phallacidin was prepared that, on reaction with 4-chloro-7- nitro-benz-2-oxa-l,3-diazole, yields a fluorescent derivative of phallacidin, NPD- PHC, that still binds to F-actin (Barak et al., Proc. Natl. Acad. Sci. USA, 77:980- 9841980; Barak and Yocum, Anal. Biochem., 110:31-38, 1981; U.S. Patent No. 4,387,088).
  • a non-toxic conjugate of phallacidin with bovine serum albumin has been described by Wieland and Buku, FEBSLett., 4:341-342, 1969.
  • the side chain No. 7 of phalloidins can be modified by a variety of chemical reactions of monotosyl phalloidin.
  • the O-tosyl group of ⁇ 7 O-tosyl phalloidin (Wieland and Rehbinder, supra, 1963) can be displaced by various nucleophiles, such as ammonia, methylamine, aniline, aminofluorescein and hydrogen sulfide (HS ), to yield the corresponding ⁇ -substituted phalloin derivatives (Wieland et al., Liebigs Ann. Chem., 1983:1533-1540, 1983).
  • ⁇ -Aminophalloin can be used to introduce various acyl residues into the phalloidin skeleton, without destroying its binding property to F-actin.
  • reaction of aminophalloin with, e.g., iodoacetyl chloride afforded a iodoacetylamino-phalloin.
  • a photolabile radioactive affinity label can be introduced by acylating with the conjugate of [ 3 H]- containing ⁇ -alanine with the photolabile carbene-generating 4-(l-azi-2,2,2- trifluoroethyl)-benzoic acid of Nassal (Liebigs Ann. Chem., 1983:1510-1523, 1983).
  • Fluorescent probes FLPHD (Wieland et al., Liebigs Ann. Chem., 1980:416-424, 1980) and RHPHN (Wieland et al., supra, 1983), respectively, were successfully applied for the visualization of F-actin in a variety of cells, ⁇ - Aminophalloin is only weakly toxic, as it is also the N-methyl compound.
  • ⁇ - Aminophalloin is only weakly toxic, as it is also the N-methyl compound.
  • an epoxide is formed that could be obtained as a pure substance (Wieland and Rehbinder, supra, 1963).
  • ketophalloidin By reduction with NaBH 4 , the carbonyl group of ketophalloidin was converted to a secondary alcohol (Wieland and Rehbinder, supra, 1963); demethylphallom ( ⁇ -amino- ⁇ -hydroxyvaleric acid-7-phalloidin) can be obtained in a radioactively labeled form by using [ 3 H]-Na boranate (Puchinger and Wieland, Liebigs Ann. Chem., 725:238-240, 1969).
  • ketophalloidin forms a dithiolane derivative.
  • This reaction can be used for the introduction of [ 32 S], and for the attachment of an amino-containing side chain using l-amino-2,3-dimercaptopropane (Wieland et al., supra, 1980).
  • the amino group of the side chain of dithiolane can be used for the introduction of an iodoacetyl residue and serve as a link to fluorescent moieties by reaction with fluorescein- or rhodamine-isothiocyanate (Faulstich et al, Exp. Cell Res., 144:73-82, 1983).
  • the dithiolane is desulfurized hydrogenolytically without cleaving the tryptathionine bridge, by careful treatment with Raney nickel, thus yielding norphalloin (norvaline-7-phalloidin) (Wieland and Jeck, Liebigs Ann. Chem., 713:196-200, 1968).
  • norphalloin norvaline-7-phalloidin
  • the first total synthesis of a bioactive phalloidin was carried out with norvaline (Fahrenholz et al., Liebigs Ann. Chem., 743:83-94, 1971).
  • Sulfoxides and Sulfone In contrast to the amatoxins, which are (R)- sulfoxides, S-oxygenated phalloidins have never been found in nature.
  • phalloidin By oxidation with peroxy acids, phalloidin yielded two diastereoisomeric sulfoxides (R- and S-) and a sulfone, which were separated by chromatography (Faulstich et al., Liebigs Ann. Chem., 713:186-195, 1968).
  • One sulfoxide (B) formed in lesser amount than the other (A).
  • the sulfone of phalloidin can be generated by further oxidation of the sulfoxides.
  • the affinities to F-actin of the respective compounds are, in percent of that of phalloidin, as follows: 10(B):l(A):40(sulfone).
  • the cyclization reaction may take place at any position using the acyclic precursor where an amino group and an activated carboxyl group are available for reaction.
  • an amino reactive group is reversibly protected.
  • the amino protective group is then removed and proteinated.
  • the deproteination of the reactive amino group in highly dilute basic solution, in the presence of an activated carboxyl group leads to cyclization.
  • the addition of base in dilute solution, or the addition of a dehydrating agent, with the amino group in proteinated form, in the presence of an activated carboxyl group leads to cyclization.
  • the phalloidin analogs or derivatives may be purified by fractionation on immunoaffmity or ion-exchange columns; ethanol precipitation; reverse phase HPLC; chromatography on silica or on an anion-exchange resin such as DEAE; chromatofocusing; SDS-PAGE; ammonium sulfate precipitation; gel filtration using, for example, Sephadex G-75; or ligand affinity chromatography, and the like.
  • derivatives and chemically derived variants of the purified phalloidin analog or derivative e.g., a compound of formula (I) can be readily prepared.
  • amides of phalloidin analogs of the present invention may also be prepared by techniques well known in the art for converting a carboxylic acid group or precursor, to an amide.
  • a preferred method for amide formation at the C-terminal carboxyl group is to cleave the phalloidin analog from a solid support with an appropriate amine, or to cleave in the presence of an alcohol, yielding an ester, followed by aminolysis with the desired amine.
  • Salts of carboxyl groups of the phalloidin analog may be prepared in the usual manner by contacting the analog with one or more equivalents of a desired base such as, for example, a metallic hydroxide base, e.g., sodium hydroxide; a metal carbonate or bicarbonate base such as, for example, sodium carbonate or sodium bicarbonate; or an amine base such as, for example, triethylamine, triethanolamine, and the like.
  • a desired base such as, for example, a metallic hydroxide base, e.g., sodium hydroxide
  • a metal carbonate or bicarbonate base such as, for example, sodium carbonate or sodium bicarbonate
  • an amine base such as, for example, triethylamine, triethanolamine, and the like.
  • N-acyl derivatives of an amino group of the present phalloidin analogs or derivatives may be prepared by utilizing an N-acyl protected amino acid for the final condensation, or by acylating a protected or unprotected
  • O- acyl derivatives may be prepared, for example, by acylation of a free hydroxy peptide or peptide resin. Either acylation may be carried out using standard acylating reagents such as acyl halides, anhydrides, acyl imidazoles, and the like. Both N- and O-acylation may be carried out together, if desired.
  • the amino acids of the phalloidin analogs can be modified by substituting one or two conservative amino acid substitutions for the positions specified, including substitutions which utilize the D rather than L form.
  • amino acid substitutions are preferred—that is, for example, hydroxyproline-aspartic-glutamic as acidic amino acids; lysine/arginine/histidine as basic amino acids; leucine/isoleucine, methionine/valine, alanine/valine as hydrophobic amino acids; serine/glycine/alanine/threonine as hydrophilic amino acids.
  • Acid addition salts of the phalloidin analogs may be prepared by contacting the analog with one or more equivalents of the desired inorganic or organic acid, such as, for example, hydrochloric acid.
  • Esters of carboxyl groups of the analogs may also be prepared by any of the usual methods known in the art.
  • Administration of a therapeutic agent of the invention in accordance with the present invention may be continuous or intermittent, depending, for example, upon the recipient's physiological condition, whether the purpose of the administration is therapeutic or prophylactic, and other factors known to skilled practitioners.
  • the administration of the agents of the invention may be essentially continuous over a preselected period of time or may be in a series of spaced doses. Both local and systemic administration is contemplated.
  • One or more suitable unit dosage forms comprising the agents of the invention can be administered by a variety of routes including oral, or parenteral, including by rectal, transdermal, subcutaneous, intravenous, intramuscular, intraperitoneal, intrathoracic, intrapulmonary and intranasal routes.
  • the formulations may, where appropriate, be conveniently presented in discrete unit dosage forms and may be prepared by any of the methods well known to pharmacy. Such methods may include the step of bringing into association the therapeutic agent with liquid carriers, solid matrices, semi-solid carriers, finely divided solid carriers or combinations thereof, and then, if necessary, introducing or shaping the product into the desired delivery system.
  • the agent of the invention When the agent of the invention is prepared for oral administration, it is preferably combined with a pharmaceutically acceptable carrier, diluent or excipient to form a pharmaceutical formulation, or unit dosage form.
  • a pharmaceutically acceptable carrier, diluent or excipient to form a pharmaceutical formulation, or unit dosage form.
  • the total active ingredients in such formulations comprise from 0.1 to 99.9%) by weight of the formulation.
  • pharmaceutically acceptable it is meant the carrier, diluent, excipient, and/or salt must be compatible with the other ingredients of the formulation, and not deleterious to the recipient thereof.
  • the active ingredient for oral administration may be present as a powder or as granules; as a solution, a suspension or an emulsion; or in achievable base such as a synthetic resin for ingestion of the active ingredients from a chewing gum.
  • the active ingredient may also be presented as a bolus, electuary or paste.
  • compositions containing the agents of the invention can be prepared by procedures known in the art using well known and readily available ingredients.
  • the agent can be formulated with common excipients, diluents, or carriers, and formed into tablets, capsules, suspensions, powders, and the like.
  • excipients, diluents, and carriers that are suitable for such formulations include the following fillers and extenders such as starch, sugars, mannitol, and silicic derivatives; binding agents such as carboxymethyl cellulose, HPMC, and other cellulose derivatives, alginates, gelatin, and polyvinyl-pyrrolidone; moisturizing agents such as glycerol; disintegrating agents such as calcium carbonate and sodium bicarbonate; agents for retarding dissolution such as paraffin; resorption accelerators such as quaternary ammonium compounds; surface active agents such as cetyl alcohol, glycerol monostearate; adsorptive carriers such as kaolin and bentonite; and lubricants such as talc, calcium and magnesium stearate, and solid polyethyl glycols.
  • fillers and extenders such as starch, sugars, mannitol, and silicic derivatives
  • binding agents such as carboxymethyl cellulose, HPMC, and other cellulose
  • tablets or caplets containing the agents of the invention can include buffering agents such as calcium carbonate, magnesium oxide and magnesium carbonate.
  • Caplets and tablets can also include inactive ingredients such as cellulose, pregelatinized starch, silicon dioxide, hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, starch, talc, titanium dioxide, benzoic acid, citric acid, corn starch, mineral oil, polypropylene glycol, sodium phosphate, and zinc stearate, and the like.
  • Hard or soft gelatin capsules containing the agents of the invention can contain inactive ingredients such as gelatin, microcrystalline cellulose, sodium lauryl sulfate, starch, talc, and titanium dioxide, and the like, as well as liquid vehicles such as polyethylene glycols (PEGs) and vegetable oil.
  • the enteric coated caplets or tablets of the agents of the invention are designed to resist disintegration in the stomach and dissolve in the more neutral to alkaline environment of the duodenum. Coatings may also reduce the immunogenicity of the agents.
  • Particularly useful coatings include phospholipids, including liposomal encapsulation and coatings of bound polyethylene glycol and/or polyethylene glycol derivatives.
  • the agents of the invention can also be formulated as elixirs or solutions for convenient oral administration or as solutions appropriate for parenteral administration, for instance by intramuscular, subcutaneous or intravenous routes.
  • the pharmaceutical formulations of the therapeutic agents of the invention can also take the form of an aqueous or anhydrous solution or dispersion, or alternatively the form of an emulsion or suspension.
  • the therapeutic agent may be formulated for parenteral administration (e.g., by injection, for example, bolus injection or continuous infusion) and may be presented in unit dose form in ampules, pre-filled syringes, small volume infusion containers or in multi-dose containers with an added preservative.
  • the active ingredients may take such forms as suspensions, solutions, dispersions or emulsions in oily or aqueous vehicles, and may contain formulatory agents such as suspending, stabilizing and/or dispersing agents.
  • the agents of the invention may be in powder form, obtained by aseptic isolation of sterile solid or by lyophilization from solution, for constitution with a suitable vehicle, e.g., sterile, pyrogen-free water, before use.
  • formulations can contain pharmaceutically acceptable vehicles and adjuvants which are well known in the prior art. It is possible, for example, to prepare solutions using one or more organic solvent(s) that is/are acceptable from the physiological standpoint, chosen, in addition to water, from solvents such as acetone, ethanol, isopropyl alcohol, glycol ethers such as the products sold under the name "Dowanol”, polyglycols and polyethylene glycols, C r C 4 alkyl esters of short- chain acids, preferably ethyl or isopropyl lactate, fatty acid triglycerides such as the products marketed under the name "Miglyol", isopropyl myristate, animal, mineral and vegetable oils and polysiloxanes.
  • organic solvent(s) that is/are acceptable from the physiological standpoint, chosen, in addition to water, from solvents such as acetone, ethanol, isopropyl alcohol, glycol ethers such as the products sold under the name "Dowanol”, polyg
  • compositions according to the invention can also contain thickening agents such as cellulose and/or cellulose derivatives. They can also contain gums such as xanthan, guar or carbo gum or gum arabic, or alternatively polyethylene glycols, bentones and montmorillonites, and the like.
  • an adjuvant chosen from antioxidants, surfactants, other preservatives, film-forming, keratolytic or comedolytic agents, perfumes and colorings.
  • other active ingredients may be added, whether for the conditions described or some other condition.
  • t-butylhydroquinone t-butylhydroquinone
  • butylated hydroxyanisole butylated hydroxytoluene and ⁇ -tocopherol and its derivatives
  • the galenical forms chiefly conditioned for topical application take the form of creams, milks, gels, dispersion or microemulsions, lotions thickened to a greater or lesser extent, impregnated pads, ointments or sticks, or alternatively the form of aerosol formulations in spray or foam form or alternatively in the form of a cake of soap.
  • the agents of the invention are well suited to formulation as sustained release dosage forms and the like.
  • the formulations can be so constituted that they release the active ingredient only or preferably in a particular part of the intestinal tract, possibly over a period of time.
  • the coatings, envelopes, and protective matrices may be made, for example, from polymeric substances, such as polylactide-glycolates, liposomes, microemulsions, microparticles, nanoparticles, or waxes.
  • the therapeutic agents of the invention can be delivered via patches for transdermal administration. See U.S. Patent No. 5,560,922 for examples of patches suitable for transdermal delivery of a therapeutic agent.
  • Patches for transdermal delivery can comprise a backing layer and a polymer matrix which has dispersed or dissolved therein a therapeutic agent, along with one or more skin permeation enhancers.
  • the backing layer can be made of any suitable material which is impermeable to the therapeutic agent.
  • the backing layer serves as a protective cover for the matrix layer and provides also a support function.
  • the backing can be formed so that it is essentially the same size layer as the polymer matrix or it can be of larger dimension so that it can extend beyond the side of the polymer matrix or overlay the side or sides of the polymer matrix and then can extend outwardly in a manner that the surface of the extension of the backing layer can be the base for an adhesive means.
  • the polymer matrix can contain, or be formulated of, an adhesive polymer, such as polyacrylate or acrylate/vinyl acetate copolymer.
  • an adhesive polymer such as polyacrylate or acrylate/vinyl acetate copolymer.
  • Examples of materials suitable for making the backing layer are films of high and low density polyethylene, polypropylene, polyurethane, polyvinylchloride, polyesters such as poly(ethylene phthalate), metal foils, metal foil laminates of such suitable polymer films, and the like.
  • the materials used for the backing layer are laminates of such polymer films with a metal foil such as aluminum foil. In such laminates, a polymer film of the laminate will usually be in contact with the adhesive polymer matrix.
  • the backing layer can be any appropriate thickness which will provide the desired protective and support functions.
  • a suitable thickness will be from about 10 to about 200 microns.
  • those polymers used to form the biologically acceptable adhesive polymer layer are those capable of forming shaped bodies, thin walls or coatings through which therapeutic agents can pass at a controlled rate. Suitable polymers are biologically and pharmaceutically compatible, nonallergenic and insoluble in and compatible with body fluids or tissues with which the device is contacted. The use of soluble polymers is to be avoided since dissolution or erosion of the matrix by skin moisture would affect the release rate of the therapeutic agents as well as the capability of the dosage unit to remain in place for convenience of removal.
  • Exemplary materials for fabricating the adhesive polymer layer include polyethylene, polypropylene, polyurethane, ethylene/propylene copolymers, ethylene/ethylacrylate copolymers, ethylene/vinyl acetate copolymers, silicone elastomers, especially the medical-grade polydimethylsiloxanes, neoprene rubber, polyisobutylene, polyacrylates, chlorinated polyethylene, polyvinyl chloride, vinyl chloride-vinyl acetate copolymer, crosslinked polymethacrylate polymers (hydro- gel), polyvinylidene chloride, poly(ethylene terephthalate), butyl rubber, epichlorohydrin rubbers, ethylenvinyl alcohol copolymers, ethylene- vinyloxyethanol copolymers; silicone copolymers, for example, polysiloxane- polycarbonate copolymers, polysiloxanepolyethylene oxide copolymers, polysiloxane-pol
  • a biologically acceptable adhesive polymer matrix should be selected from polymers with glass transition temperatures below room temperature.
  • the polymer may, but need not necessarily, have a degree of crystal- linity at room temperature.
  • Cross-linking monomeric units or sites can be incorporated into such polymers.
  • cross-linking monomers can be incorporated into polyacrylate polymers, which provide sites for cross-linking the matrix after dispersing the therapeutic agent into the polymer.
  • Known cross-linking monomers for polyacrylate polymers include polymethacrylic esters of polyols such as butylene diacrylate and dimethacrylate, trimethylol propane trimethacrylate and the like.
  • Other monomers which provide such sites include allyl acrylate, allyl methacrylate, diallyl maleate and the like.
  • a plasticizer and or humectant is dispersed within the adhesive polymer matrix.
  • Water-soluble polyols are generally suitable for this purpose. Incorporation of a humectant in the formulation allows the dosage unit to absorb moisture on the surface of skin which in turn helps to reduce skin irritation and to prevent the adhesive polymer layer of the delivery system from failing.
  • transdermal drug delivery system In order to increase the rate of permeation of a therapeutic agent, a transdermal drug delivery system must be able in particular to increase the permeability of the outermost layer of skin, the stratum corneum, which provides the most resistance to the penetration of molecules.
  • the fabrication of patches for transdermal delivery of therapeutic agents is well known to the art. Suitable transdermal delivery systems are also disclosed, for example, in U.S. Patent No. 4,788,603, U.S. Patent No. 4,931,279, U.S. Patent No. 4,668,506, and U.S. Patent No. 4,713,224.
  • the local delivery of the therapeutic agents of the invention can also be by a variety of techniques which administer the agent at or near the site of disease.
  • site-specific or targeted local delivery techniques are not intended to be limiting but to be illustrative of the techniques available.
  • local delivery catheters such as an infusion or indwelling catheter, e.g., a needle infusion catheter, shunts and stents or other implantable devices, site specific carriers, direct injection, or direct applications.
  • the therapeutic agents may be formulated as is known in the art for direct application to a target area.
  • Conventional forms for this purpose include wound dressings, coated bandages or other polymer coverings, ointments, creams, lotions, pastes, jellies, sprays, and aerosols.
  • Ointments and creams may, for example, be formulated with an aqueous or oily base with the addition of suitable thickening and/or gelling agents.
  • Lotions may be formulated with an aqueous or oily base and will in general also contain one or more emulsifying agents, stabilizing agents, dispersing agents, suspending agents, thickening agents, or coloring agents.
  • the active ingredients can also be delivered via iontophoresis, e.g., as disclosed in U.S. Patent Nos. 4,140,122; 4,383,529; or 4,051 ,842.
  • the percent by weight of a therapeutic agent of the invention present in a topical formulation will depend on various factors, but generally will be from 0.01% to 95% of the total weight of the formulation, and typically 0.1-25% by weight.
  • the agents of the invention may also be formulated so as to be suitable for administration by inhalation or insufflation or for nasal, intraocular or other topical (including buccal and sub-lingual) administration.
  • the therapeutic agents of the invention are conveniently delivered from an insufflator, nebulizer or a pressurized pack or other convenient means of delivering an aerosol spray.
  • Pressurized packs may comprise a suitable propellant such as dichlorodifluoromethane, trichlorofluorornefhane, dichlorotetrafluoroethane, carbon dioxide or other suitable gas.
  • the dosage unit may be determined by providing a valve to deliver a metered amount.
  • the composition may take the form of a dry powder, for example, a powder mix of the therapeutic agent and a suitable powder base such as lactose or starch.
  • the powder composition may be presented in unit dosage form in, for example, capsules or cartridges, or, e.g., gelatine or blister packs from which the powder may be administered with the aid of an inhalator, insufflator or a metered-dose inhaler.
  • the therapeutic agent may be administered via nose drops, a liquid spray, such as via a plastic bottle atomizer or metered-dose inhaler.
  • Typical of atomizers are the Mistometer (Wintrop) and the Medihaler (Riker).
  • Drops such as eye drops or nose drops, may be formulated with an aqueous or non-aqueous base also comprising one or more dispersing agents, solubilizing agents or suspending agents.
  • Liquid sprays are conveniently delivered from pressurized packs. Drops can be delivered via a simple eye dropper-capped bottle, or via a plastic bottle adapted to deliver liquid contents dropwise, via a specially shaped closure.
  • the therapeutic agent may further be formulated for topical administration in the mouth or throat.
  • the active ingredients may be formulated as a lozenge further comprising a flavored base, usually sucrose and acacia or tragacanth; pastilles comprising the composition in an inert base such as gelatin and glycerin or sucrose and acacia; and mouthwashes comprising the composition of the present invention in a suitable liquid carrier.
  • the formulations and compositions described herein may also contain other active ingredients such as antimicrobial agents, or preservatives.
  • the agents of the invention may also be used in combination with other therapeutic agents, for example, other cardiac inotropes, anti-inflammatory agents, diuretics, vasodilators, anti-arrythmics, anti-coagulants, Ca 2+ channel blockers, ⁇ - blockers, ACE inhibitors, and the like.
  • other therapeutic agents for example, other cardiac inotropes, anti-inflammatory agents, diuretics, vasodilators, anti-arrythmics, anti-coagulants, Ca 2+ channel blockers, ⁇ - blockers, ACE inhibitors, and the like.
  • the administration of a combination of a phalloidin analog or derivative with other agents e.g., other cardiac inotropes, may have a synergistic effect.
  • the examples of the local delivery of the agents of the invention are not intended to be limiting but to be illustrative of the techniques available.
  • Examples include local delivery catheters, such as an infusion or indwelling catheter, e.g., a needle infusion catheter, or other implantable devices.
  • Catheters which may be useful in the practice of the invention include catheters such as those disclosed in Just et al. (U.S. Patent No. 5,232,444), Abusio et al. (U.S. Patent No. 5,213,576), Shapland et al. (U.S. Patent No. 5,282,785), Racchini et al. (U.S. Patent No. 5,458,568) and Shaffer et al. (U.S. Patent No. 5,049,132), the disclosures of which are incorporated by reference herein.
  • Local delivery by an implant describes the surgical placement of a matrix that contains the agents of the invention.
  • the implanted matrix releases the analog or derivative by diffusion, chemical reaction, or solvent activators. Lange, Science. 249, 1527 (1990).
  • Local delivery by site specific carriers describes attaching the agents of the invention to a carrier which will direct the therapeutic agent to the target site, e.g., to a vessel of the heart.
  • a carrier such as a protein ligand, e.g., a monoclonal antibody or antibody fragment. Lange, Science. 242,1527 (1990). See, for example, WO 94/16706 for methods useful to link or couple, preferably covalently link or couple, peptide or protein ligands to other macromolecules.
  • Phalloidin analogs or derivatives are preferably intravenously administered at doses of about 0.01-100.0 ⁇ M/L blood, more preferably at doses of about 0.01-50.0 ⁇ M/L blood, and even more preferably at doses of about 0.1-10.0 ⁇ M/L blood, although other dosages may provide beneficial results.
  • the phalloidin analogs or derivatives can be administered at about 0.01-100 mg/kg/day, preferably at about 0.01-50 mg/kg/day, and more preferably at about 0.1-10 mg/kg/day, although other dosages may provide beneficial results.
  • a compound of formula (I) is preferably administered at about 2-20, more preferably 1.5-15, and even more preferably 1 - 10 ⁇ g of analog or derivative per gram of topical carrier.
  • the invention provides a method of treating a mammal having, or preventing, a disease characterized by reduced or decreased heart muscle contractility, e.g., congestive heart failure, ischemic myocardial infarction, hypertension, myocarditis, epicarditis, endocarditis, pulmonary edema, atrial or ventricle arrhythmias, and other conditions classified as cardiomyopathies, or acute heart failure related to septic shock.
  • a disease characterized by reduced or decreased heart muscle contractility
  • ischemic myocardial infarction hypertension
  • myocarditis epicarditis
  • endocarditis pulmonary edema
  • atrial or ventricle arrhythmias e.g., pulmonary edema
  • atrial or ventricle arrhythmias e.g., pulmonary edema
  • atrial or ventricle arrhythmias e.g., pulmonary edema
  • the compound of formula (I) useful in the practice of the invention is administered continually over a preselected period of time or administered in a series of spaced doses, i.e., intermittently, for a period of time as a preventative measure.
  • therapeutically/prophylactically effective dosages of these analogs and derivatives and compositions will be dependent on several factors. Those skilled practitioners trained to deliver drugs at therapeutically or prophylactically effective dosages (e.g., by monitoring drug levels and observing clinical effects in patients) will determine the optimal dosage for an individual patient based on experience and professional judgment.
  • Cardiac Muscle Preparation Cardiac Muscle Preparation Cardiac muscle bundles were dissected from the left ventricular free- wall of fresh bovine heart obtained from the local abbatoir (Washington State University Quality Meat Laboratory). Dissection was performed in a 4°C cold room to produce oriented muscle bundles about 1 to 2 cm in length and 1 mm in diameter.
  • Muscle bundles were tied to a plastic frame and incubated for 6 hours in a skinning solution (80 mM KC1, 5 mM MgCl 2 , 20 mM MOPS (pH 7.0), 5 mM EGTA, 2 mM DTT, 1% Triton XI 00) and then further incubated in storage solution (80 mM KC1, 1 mM MgCl 2 , 20 mM phosphate buffer (pH 7.0), 2.5 mM DTT, 50% glycerol) with continuous agitation for 24 hours at 4°C. Thereafter, muscle bundles were stored in storage solution at -20 °C.
  • a skinning solution 80 mM KC1, 5 mM MgCl 2 , 20 mM MOPS (pH 7.0), 5 mM EGTA, 2 mM DTT, 1% Triton XI 00
  • storage solution 80 mM KC1, 1 mM MgCl 2 ,
  • a video image of the muscle fiber was displayed on a TN monitor using a video camera through a X40 objective lens. Total magnification from fiber to TV monitor was approximately 10 4 .
  • the system was calibrated with a stage micrometer. Length of muscle sarcomeres was determined in rigor solution by measuring the length of a row of 10 sarcomeres on the TV monitor. The average sarcomere length value was based on 5 measurements made along a 2 mm length of the fiber. Fibers used in these experiments had sarcomere lengths in the range of 2.1 - 2.3 ⁇ m.
  • pCa values were calculated with constants given by Fabiato and Fabiato (J. Physiol, 75:463-505, 1979) with the exception that the absolute CaEGTA stability constant was taken to be 7.9 x 10'° M ⁇ ' (as described by Bukatina et al., J. Mus. Res. & Cell Motil, 17:365-371, 1996).
  • the first episode of activation was one of a brief period (approximately 1 minute) of maximal activation (pCa 4.5). This allowed evaluation of the contractile viability of the preparation.
  • This maximal activation episode was terminated by quickly changing the bathing solution to relaxing solution. Quick solution changes were achieved by draining the well through a special port connected to a vacuum line and quickly refilling the cell with a new solution. During the entire period of activation and relaxation, solutions were intensively agitated with a vibrating stainless steel wire to ensure uniform distribution of substances within the bathing solution and minimize diffusion gradients.
  • phalloidin analogs or derivatives were applied as dried preparations to muscle preparations when the muscle preparations were developing force during Ca 2+ activation.
  • the phalloidin analogs or derivatives were added as dried preparations to the relaxing solution several minutes before step-wise Ca 2+ activation.
  • phalloidin derivatives were prepared as follows: dethiophalloidin (37.5, 20, 7.5, 3.75 mM), phalloidin sulfoxide-A (10 mM) and phalloidin (20 and 10 mM) in ethyl alcohol, and secophalloidin (10 mM) in water. These stock solutions were stored in a freezer at -20 °C. At the time they were to be administered to muscle preparations, 0.4 ⁇ l (or 0.8 ⁇ l) of a stock solution was dried on the end of thin narrow sheet of parafilm in the air. To add into solution, the parafilm sheet was lowered into the solution in the cell just near the vibrating wire for several seconds. This procedure can cause transient changes in tension, which is a mechanical artifact, as seen in the experimental data described below.
  • Example 2 Micromolar Concentrations of Dethiophalloidin Are Effective in Enhancing Cardiac Muscle Contraction at All Levels of Ca 2+ - Activation Following an initial maximal activation episode (pCa 4.5) and relaxation, a muscle preparation was partially activated with pCa 6.20 and then dethiophalloidin was added in several steps to achieve 15, 30, 60, and 90 ⁇ M concentrations (Figure 1), which led to a marked increase in tension. The major increase in tension (80%) was reached with 15 ⁇ M dethiophalloidin. At a dethiophalloidin concentration of 90 ⁇ M, saturation had clearly been reached (Figure 1).
  • dethiophalloidin To work at a saturating concentration of dethiophalloidin, 80 ⁇ M dethiophalloidin was employed for the remaining experiments. The amount of force enhancement by dethiophalloidin varied with the level of Ca 2+ -activation. When 80 ⁇ M of dethiophalloidin was added to maximal Ca 2+ -activated fibers (1st activation episode in Figure 2), the increase in force was approximately 15%. This contrasts with force enhancement during partial activation at pCa 6.20 (second activation episode in Figure 2) where the increase in force with dethiphalloidin addition was 180%. However, dethiophalloidin does not enhance or cause force development in cardiac muscle fibers when pCa ⁇ 8.0.
  • Dethiophalloidin also increases Ca 2+ -sensitivity and maximum Ca 2+ - activated force in cardiac muscle fibers. Recordation of force obtained in several sequential activation episodes are shown in Figure 5. This data shows that the muscle preparation was sufficiently stable to be repeatedly activated and relaxed. If force is plotted versus pCa ( Figures 6 and 7) during sequential activation, a force- pCa curve results. Figures 6 and 7 represent data from fibers derived two different animals. The graphs in panel A of Figures 6 and 7 show that dethiophalloidin increased maximum Ca 2+ -activated force by 10% and shifted the force-pCa curve to the left, i.e., greater force is achieved for the same level of activating Ca 2+ .
  • This shift reflects an increase in Ca 2+ -sensitivity.
  • the graphs in panel B of Figures 6 and 7 show force-pCa curves which were normalized to their maximum value so that the increase in Ca 2+ -sensitivity with dethiophalloidin can be easily quantified. From panel B, the Ca 2+ -sensitivity increase can be calculated as the length of the segment between two curves at the level of half maximal activation. There were 0.33 pCa units of increase at half-maximal activation with dethiophalloidin treatment in both fibers.
  • a measure of the strength of enhanced activation by dethiophalloidin can be obtained by comparing the pCa units of left shift with the pCa units required to change activation from 25 to 75% of maximal activation under control (untreated) conditions.
  • a strong Ca 2+ sensitizing effect would be one in which the left shift is as large as the change in pCa required to go from 25 to 75% of maximal activation.
  • 0.33 pCa units of left shift compares with 0.3 pCa units to change activation from 25 to 75% of maximal.
  • dethiophalloidin is a strong Ca 2+ -sensitizer with sensitizing effects that are as large as may be tolerated so as to avoid excessive activation at low pCa.
  • Example 3 Relationship Between Actions of Phalloidin and Dethiophalloidin
  • the first protocol was to examine the influence of pre-treatment of the muscle preparation with phalloidin on the response to dethiophalloidin. Given that phalloidin binds extremely firmly to actin, pre-treatment with phalloidin would result in all phalloidin-binding sites being irreversibly occupied by phalloidin. If dethiophalloidin exerts its contraction enhancing effects after binding to the phalloidin binding site, then pretreatment with phalloidin would suppress the dethiophalloidin effects.
  • the results of a phalloidin pretreatment experiment are shown in Figure 8.
  • the muscle fiber is maximally activated (first activation episode), relaxed and, then maximally activated again when it is treated with phalloidin (second activation episode).
  • Phalloidin caused a small increase in maximally activated force in agreement with earlier observations (Bukatina et al., J. Mol Cell. Cardiol, 27:1311-1315 (1995)).
  • the fiber is partially activated (pCa 6.2) and treated with dethiophalloidin (third activation episode). There was no force enhancement with dethiophalloidin treatment.

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Abstract

L'invention concerne un procédé destiné à traiter l'insuffisance cardiaque globale à l'aide d'un analogue ou d'un dérivé de phalloïdine. L'invention concerne également un procédé destiné à traiter d'autres cardiopathies, liées à une baisse de la capacité de contraction du myocarde. L'invention concerne enfin de nouveaux analogues ou de nouveaux dérivés de phalloïdine, des compositions pharmaceutiques renfermant des analogues ou des dérivés de phalloïdine, ainsi que des intermédiaires utiles à la préparation d'analogues ou de dérivés de phalloïdine.
PCT/US1998/000952 1997-01-16 1998-01-16 Derives et analogues de phalloide destines a traiter l'insuffisance cardiaque globale WO1998031380A1 (fr)

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WO2001055365A1 (fr) * 2000-01-27 2001-08-02 Toyo Kohan Co., Ltd. Support destine a fixer des nucleotides et procede de production correspondant
CN111273041A (zh) * 2020-04-13 2020-06-12 北京维德维康生物技术有限公司 一种检测鬼笔环肽的酶联免疫试剂盒及其制备和应用

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2001055365A1 (fr) * 2000-01-27 2001-08-02 Toyo Kohan Co., Ltd. Support destine a fixer des nucleotides et procede de production correspondant
CN111273041A (zh) * 2020-04-13 2020-06-12 北京维德维康生物技术有限公司 一种检测鬼笔环肽的酶联免疫试剂盒及其制备和应用
CN111273041B (zh) * 2020-04-13 2023-09-19 北京维德维康生物技术有限公司 一种检测鬼笔环肽的酶联免疫试剂盒及其制备和应用

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