WO2000066612A1 - Androgen glycosides and androgenic activity thereof - Google Patents

Androgen glycosides and androgenic activity thereof Download PDF

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Publication number
WO2000066612A1
WO2000066612A1 PCT/GB2000/001700 GB0001700W WO0066612A1 WO 2000066612 A1 WO2000066612 A1 WO 2000066612A1 GB 0001700 W GB0001700 W GB 0001700W WO 0066612 A1 WO0066612 A1 WO 0066612A1
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Prior art keywords
hydrogen
glucoside
compound according
methyl
compound
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PCT/GB2000/001700
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English (en)
French (fr)
Inventor
John Antony Kanis
Michael Francis Holick
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Strakan Limited
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Filing date
Publication date
Priority to EP00927493A priority Critical patent/EP1175433B1/en
Priority to IL14628400A priority patent/IL146284A0/xx
Priority to DK00927493T priority patent/DK1175433T3/da
Priority to NZ515134A priority patent/NZ515134A/en
Application filed by Strakan Limited filed Critical Strakan Limited
Priority to MXPA01011227A priority patent/MXPA01011227A/es
Priority to DE60021720T priority patent/DE60021720T2/de
Priority to KR1020017014072A priority patent/KR20020013533A/ko
Priority to JP2000615641A priority patent/JP5005127B2/ja
Priority to AU45893/00A priority patent/AU777770C/en
Priority to CA002372720A priority patent/CA2372720C/en
Priority to BR0010708-5A priority patent/BR0010708A/pt
Priority to AT00927493T priority patent/ATE301129T1/de
Publication of WO2000066612A1 publication Critical patent/WO2000066612A1/en
Priority to IL146284A priority patent/IL146284A/en
Priority to NO20015338A priority patent/NO321296B1/no

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Classifications

    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07JSTEROIDS
    • C07J17/00Normal steroids containing carbon, hydrogen, halogen or oxygen, having an oxygen-containing hetero ring not condensed with the cyclopenta(a)hydrophenanthrene skeleton
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07JSTEROIDS
    • C07J71/00Steroids in which the cyclopenta(a)hydrophenanthrene skeleton is condensed with a heterocyclic ring
    • C07J71/0036Nitrogen-containing hetero ring
    • C07J71/0057Nitrogen and oxygen
    • C07J71/0063Nitrogen and oxygen at position 2(3)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00Drugs for genital or sexual disorders; Contraceptives
    • A61P15/10Drugs for genital or sexual disorders; Contraceptives for impotence
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00Drugs for genital or sexual disorders; Contraceptives
    • A61P15/16Masculine contraceptives
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00Drugs for skeletal disorders
    • A61P19/08Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease
    • A61P19/10Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease for osteoporosis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00Drugs for disorders of the metabolism
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/12Antivirals
    • A61P31/14Antivirals for RNA viruses
    • A61P31/18Antivirals for RNA viruses for HIV
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P5/00Drugs for disorders of the endocrine system
    • A61P5/24Drugs for disorders of the endocrine system of the sex hormones
    • A61P5/26Androgens
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07JSTEROIDS
    • C07J17/00Normal steroids containing carbon, hydrogen, halogen or oxygen, having an oxygen-containing hetero ring not condensed with the cyclopenta(a)hydrophenanthrene skeleton
    • C07J17/005Glycosides
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07JSTEROIDS
    • C07J71/00Steroids in which the cyclopenta(a)hydrophenanthrene skeleton is condensed with a heterocyclic ring
    • C07J71/0036Nitrogen-containing hetero ring
    • C07J71/0042Nitrogen only
    • C07J71/0047Nitrogen only at position 2(3)

Definitions

  • the present invention relates to androgen derivatives and their use in therapy.
  • Testosterone an anabolic androgenic C19 steroid with a hydroxy group in position 17, is the principal male sex hormone. It is either synthesised from cholesterol and secreted by the Leydig cells in the testes or formed in the adrenal cortex [Ganong. Chapter 23 in Review of Medical Physiology, (1 79), pp. 336-339]. Testosterone is found in androgen-dependent target tissues, such as the testes, kidneys, skin, liver and prostate, where it is converted to 5 ⁇ -dihydrotestosterone (DHT) by 5 ⁇ -reductase. DHT is required for male sexual differentiation. Testosterone is also found in the brain where it is converted to oestradiol by aromatase.
  • DHT 5 ⁇ -dihydrotestosterone
  • Testosterone is also found in skeletal muscle. However, testosterone is not converted to DHT in skeletal muscle tissue, due to low 5 ⁇ -reductase activity (Handelsman, supra). According to Catlin. anabolic androgenic steroids, such as testosterone, increase the width and cross-sectional area of muscle fibres by increasing the myo filament and myofibre number [Catlin. "Anabolic Steroids.” in Endocrinology - Volume 3, Ed's DeGroot et al (1995), pp. 2362-2376]. In hypogonadal men.
  • Testosterone and related synthetic androgens are often used in androgen replacement therapy to obtain pharmacological androgenic effects to treat conditions such as hypogonadism.
  • Hypogonadism may be caused by a testosterone deficiency, resulting in manifestations of androgen deficiency, such as ambiguous genitalia. sexual dysfunction, osteoporosis, flushing, delayed puberty, microphallus, anaemia, incidental biochemical diagnosis or excessive fatigability [Handelsman. "Testosterone and Other Androgens: Physiology, Pharmacology, and Therapeutic Use.” in Endocrinology - Volume 3. Ed's DeGroot et al (1995), pp. 2351-2361].
  • testosterone compounds In hypogonadism treatment, androgen replacement therapy often consists of administering testosterone compounds to an individual to maintain testosterone levels for a prolonged period. Testosterone is ineffective, when orally administered, due to poor intestinal absorption and rapid hepatic metabolism [Daggett et al, Hormone Res. 9:121-129 (1978)]. Therefore, the effects of testosterone must be obtained by alternative means including administering sublingual methyl testosterone, injecting testosterone or testosterone esters, implanting testosterone, administering oral testosterone derivatives, e.g., fluoxymesterone. or applying testosterone by transdermal means [Bals-Pratsch et al. Acta Endocrinologica (Copenh), 775:7-13 (1988)]. The latter method requires large patches which can be irritating or uncomfortable when applied to the scrotum. In addition, patch application can be inconvenient and is only effective when detailed instructions are followed.
  • Oral testosterone derivatives include 17 ⁇ -esters, 7 ⁇ -methyl, 17 ⁇ -alkyl or methyl, 19-normethyl and D-homoandrogens [Handelsman, "Testosterone and Other Androgens: Physiology, Pharmacology, and Therapeutic Use," in Endocrinology - Volume 3, Ed's DeGroot et al. (1995), pp. 2351-2361].
  • Other known testosterone derivatives include testosterone substituted at the Cl position with methyl, e.g., methenolone and mesterolone. However, these compounds have reduced oral potency.
  • Compounds with substitutions in, and additions to, the A ring e.g., oxandrolone and stanozolol, are also known (Catlin. supra).
  • Vojtiskova et al disclose a study on the biological activity of testosterone- 17- glucoside in mice [Vojtiskova et al. Int. J. Immunopharmac. 4: 469-474 (1982)]. This glucoside showed very little activity in vivo, and certainly less than testosterone administered by the same route.
  • R 8 is hydrogen; CM alkyl; C7- 1 0 aralkyl; phenyl; phenyl substituted by chloro, fluoro, bromo. iodo.
  • the compounds of the invention are precursors for the free androgen.
  • Testosterone- 17 ⁇ -glycoside is absorbed through the intestine and enters the portal circulation. Then, it is deposited into the systemic circulation as unmetabolised testosterone glycosides. The ⁇ -glycosidases in the body remove the ⁇ -glycoside to release free testosterone resulting in a biological effect on the target tissues.
  • the invention also provides pharmaceutical compositions comprising a compound of the present invention and a pharmaceutically acceptable carrier therefor.
  • any form of glycosylation may be employed, provided that it is substantially non-toxic to the patient.
  • suitable glycosidic moieties are known and preferred glycosidic moieties include the glucosides and orthoesters thereof, examples of which are given below.
  • R ] is methyl and B is a carbonyl group
  • Rj, R 3 , R 4 and R 6 are hydrogen, R 2 and R 5 are methyl
  • A is CHR ⁇ 3 wherein R ⁇ 3 is methyl and B is a carbonyl group
  • R 3 , R 4 . and R 6 are hydrogen, R 2 and R 5 are methyl, there is a carbonyl at the 17-position of the steroid ring
  • A is CHR ⁇ 3 wherein R ⁇ 3 is hydrogen.
  • B is CHOH and there is a double bond between positions 5 and 6 of the steroid ring; or R.
  • R ⁇ . R 3 , R_ t , and R 6 are hydrogen, R 2 and R5 are methyl.
  • A is CHR ⁇ wherein Rn is hydrogen and B is a carbonyl group.
  • Preferred compounds have a double bond between positions 4 and 5 or positions 5 and 6 of the steroid ring and single bonds in all other steroid ring positions.
  • Preferred compounds include, but are not limited to. testosterone- 17 ⁇ -glucoside. 4- androstenediol-17 ⁇ -glucoside, 5 ⁇ -dihydrotestosterone-17 ⁇ -glucoside, methyltestosterone-17 ⁇ - glucoside, ethylestrenol-17 ⁇ -glucoside, fluoxymesterone-17 ⁇ -glucoside, stanozolol-17 ⁇ - glucoside, nandrolone- 17 ⁇ -glucoside, methandriol-17 ⁇ -glucoside. methyltrienolone-17 ⁇ - glucoside, dimethyl- 19-nortestosterone- 17 ⁇ -glucoside.
  • glycosidic units are meant glycopyranosyl or glycofuranosyl, as well as their amino sugar derivatives.
  • the residues may be homopolymers. random or alternating, or block copolymers thereof.
  • the acyl groups are acetyl or propionyl.
  • the compounds useful in the practice of the invention contain at least one glycoside or orthoester glycoside residue, preferably at position 3 or 17.
  • the glycoside or orthoester glycoside is linked through the 1 -carbon to the 17-position on testosterone and stanolone based molecules, and to the 3-position of prasterone based molecules.
  • the preferred amino derivatives are N-acetyl-D-galactosamine, N-acetyl-D-glucosamine, N-acetyl-D-mannosamine. N-acetylneuraminic acid, D- glucosamine. lyxosylamine. D-galactosamine. and the like.
  • the individual glycosidic rings may be bonded by 1-1. 1-2, 1-3, 1-4, 1-5 or 1-6 bonds, most preferably 1-2, 1-4 and 1-6.
  • the linkages between individual glycosidic rings may be ⁇ or ⁇ .
  • the water soluble glycosidic derivatives of the aforementioned compounds may be obtained according to the general methods disclosed by Holick in US-A- 4,410,515, the contents of which are fully incorporated by reference herein.
  • the glycosyl orthoester compounds may be obtained according to US-A-4,521,410, the contents of which are fully incorporated by reference herein.
  • Preferred testosterone glycosyl orthoesters are testosterone- 17 ⁇ -( ⁇ 1 -D-glucopyranosyl- 1 ' ,2 ' -orthoacetate) and testosterone- 17- ⁇ - 1 -glucopyranosyl- 1 ' ,2 ' - orthoacetate.
  • the compounds of the invention may be administered in any appropriate pharmaceutically acceptable carrier for oral administration since the testosterone glycosides and derivatives thereof are biologically active upon oral administration, which is the preferred route.
  • the compounds of the invention may also be administered in any appropriate pharmaceutical carrier for parenteral, intramuscular or topical administration. They can be administered by any means that treat androgen deficiency and hypogonadism and related conditions such as osteoporosis, sexual dysfunction and weight loss, treat or prevent decreased muscle mass or increase muscle mass, especially in elderly humans or patients suffering from muscle debilitation, AIDS or any debilitating disease.
  • the compounds of the present invention can be administered by any means whereby the compounds function as male contraceptives. The dosage administered will depend on the age.
  • An exemplary systemic daily dosage is about 0.001 to about 100.0 mg/kg of body weight. Normally, from about 0.01 to about 10.0 mg/kg of body weight of the glycoside or orthoester glycoside. in one or more dosages per day. is effective to obtain the desired results.
  • One of ordinary skill in the art can determine the optimal dosages and concentrations of other active testosterone compounds and orthoester glycoside compounds with only routine experimentation.
  • the invention also relates to pharmaceutical combinations comprising a compound of the invention together with a progestational compound such as progesterone, wherein each compound is present in an amount effective to induce contraception in a male animal.
  • a progestational compound such as progesterone
  • Such pharmaceutical compositions may also comprise a pharmaceutically acceptable carrier as described herein.
  • the compounds administered are preferably substantially pure, by which is meant the compounds are created by chemical synthesis and/or are substantially free of chemicals which may accompany the compounds in the natural state, as evidenced by thin layer chromatography (TLC) or high performance liquid chromatography (HPLC) (see Example 3).
  • TLC thin layer chromatography
  • HPLC high performance liquid chromatography
  • some compounds of the present invention may exist as keto/enol isomers.
  • some of the compounds may exist as stereoisomers including optical isomers.
  • the invention includes all stereoisomers and both the racemic mixtures of such stereoisomers as well as the individual enantiomers that may be separated according to methods that are well known to those of ordinary skill in the art.
  • the synthetic sequence starts from testosterone which is commercially available from Sigma Chemical Co., St. Louis, MO (T-1500). 4-Androsten-17- ⁇ -ol-3-one is the IUPAC name for testosterone (CAS # 58-22-0). Acetobromo- ⁇ -D-glucose; the bromo sugar used in the conjugation is commercially available through Sigma Chemical Co. (A- 1750). The IUPAC name for acetobromo- ⁇ -D-glucose is 2,3,4.6-tetra-O-acetyl- ⁇ -D-glucopuranosyl bromide (CAS # 572-09-8). Cadmium salts were obtained from Aldrich Chemical Co. Inc., Milwaukee, WI, and used without further purification.
  • Silver fluoride and silver nitrate were purchased from Aldrich Chemical Co., Inc., and used without further purification. Hydrated sodium metasilicate, valerolactone and maleic anhydride were also purchased from Aldrich and used without further purification for the synthesis of silver silicate and silver salts of carboxylic acids. Silver silicate for the conjugation of acetobromo- ⁇ -D-glucose was prepared from silver fluoride and sodium metasilicate. Silver nitrate was used in the preparation of silver carboxylates either by the exchange of sodium anion of the carboxylate or the lanthanide salts preferably uranium carboxylates for silver anion. The silver salts were prepared freshly and dried before use.
  • Testosterone (2.3 g; 8 mmol) and acetobromo- ⁇ -D-glucose (3.94 g; 9.6 mmol) were added to a suspension of cadmium carbonate (2.06 g) in xylene (100 ml). The suspension was heated to reflux and stirred under an inert atmosphere for about 5 hours during which time the reaction was essentially complete. The progress of the reaction was monitored by reverse- phase TLC plates. The reaction gave a blue tinge to the cadmium surface.
  • reaction mixture was evaporated to remove xylenes under reduced pressure and chromatographed on silica gel and eluted with ethyl acetate and hexane resulting in the titled tetra-acetate as a crystalline solid (1.1 g, from diethylether).
  • Testosterone (1 g) was reclaimed and used in subsequent reactions without any purification.
  • NMR spectrum of tetra-acetate of testosterone- ⁇ -glucoside ⁇ 0.9 (singlet, 3H, 18 angular methyl); ⁇ 1.1 (singlet, 3H, angular methyl); four overlapping singlets centred at ⁇ 2.0 (acetate methyl groups); multiplet ⁇ 2.5-0.9 (20 H; CH 2 and CH protons); ⁇ 5.7 (singlet; 1H, enone); ⁇ 5.25 to 4.9 (three overlapping triplets 3H; coupling constant 10 hertz); ⁇ 4.5 (1H; doublet, coupling constant 10.2 hertz; signifying a beta glucosidic linkage); ⁇ 3.2-4.25 (4H; 3 protons from the sugar residue and 1H from 17 position).
  • Mass spectrum sodium ion bombardment gave a molecular ion at 473.27. i.e.. corresponding to molecular weight of 450.27, which agrees with the structure.
  • NMR spectrum of stanolone glucoside In deuterated dimethyl sulphoxide. ⁇ 0.7 (singlet, 3H, CH 3 ), ⁇ 0.9 (singlet, 3H, CH 3 ), ⁇ 4.1 (doublet, anomeric coupling 8 Hz, 1H, ⁇ -linkage), ⁇ 0.75 to 2.5 (multiplets, aliphatic H, 22H), ⁇ 2.8 to 4.7 (multiplets, sugar-H and C17-H, 7H).
  • NMR spectrum of prasterone glucoside tetraacetate ⁇ 4.52 (doublet, 7.5 Hz. anomeric-H, ⁇ -linkage), ⁇ 5.4-3.4 (multiplets. sugar-H, and C3-H. and C6-vinylic-H. 9H), and ⁇ 0.8 and 1.0 (two singlets, CH 3 , 6H), ⁇ 2.0 to 2.1 (four overlapping singlets, acetates, 12H) and ⁇ 1.0 to 2.5 (multiplets. aliphatic-H. 19H).
  • NMR spectrum of prasterone glucoside ( 6 -DMSO) ⁇ 0.8 and 0.95 (two singlets, CH 3 , 6H), ⁇ 1.0 to 2.4 (multiplets, aliphatic-H. 19H), ⁇ 2.7 to 4.3 (multiplets, 8H. sugar-H and C3-H. and anomeric-H is a doublet, 8 Hz. at ⁇ 4.2) and ⁇ 5.3 (broad singlet. vinylic-H, 1H).
  • Testosterone-17- ⁇ -l '- ⁇ '-D-glucopyranose Testosterone glucoside
  • Testosterone (1.15g; 4 mmol) and acetobromo- ⁇ -D-glucose (1.97g; 4.8 mmol) were added to a suspension of silver silicate (4g; excess) in dichloromethane (50mL).
  • the reaction mixture was stirred for a period of 5 hours at room temperature and during this period all the testosterone was consumed.
  • the product was used as such in the deacetylation as in Example 3.
  • the product from the deacetylation was recrystallised from ethyl acetate to afford 900 mg of the desired beta-glucosylated testosterone.
  • the spectral characteristics of the compounds isolated in these experiments were identical to the compounds described in Examples 2 and 3.
  • Rats were shipped to the Laboratory Animal Science Center at the Boston University School of Medicine, randomised, coded, weighed, and housed individually in cages for 24 hours with food and water ad libitum.
  • Gi M intramuscularly injected testosterone-glucoside
  • Go orally administered testosterone-glucoside
  • Serum samples were thawed in an ice bath and 50 ⁇ l aliquots were transferred to 12 x 75 mm borosilicate test tubes in triplicate.
PCT/GB2000/001700 1999-05-04 2000-05-04 Androgen glycosides and androgenic activity thereof WO2000066612A1 (en)

Priority Applications (14)

Application Number Priority Date Filing Date Title
DE60021720T DE60021720T2 (de) 1999-05-04 2000-05-04 Androgen glykoside und die androgenische aktivität davon
DK00927493T DK1175433T3 (da) 1999-05-04 2000-05-04 Androgenglycosider og androgen aktivitet deraf
NZ515134A NZ515134A (en) 1999-05-04 2000-05-04 Androgen glycosides and androgenic activity thereof
JP2000615641A JP5005127B2 (ja) 1999-05-04 2000-05-04 アンドロゲングリコシド及びそのアンドロゲン作用活性
MXPA01011227A MXPA01011227A (es) 1999-05-04 2000-05-04 Glicosidas androgenas y su actividad androgenica.
IL14628400A IL146284A0 (en) 1999-05-04 2000-05-04 Androgen glycosides and pharmaceutical compositions containing the same
KR1020017014072A KR20020013533A (ko) 1999-05-04 2000-05-04 안드로겐 글리코사이드와 그것의 안드로겐 활성
EP00927493A EP1175433B1 (en) 1999-05-04 2000-05-04 Androgen glycosides and androgenic activity thereof
AU45893/00A AU777770C (en) 1999-05-04 2000-05-04 Androgen glycosides and androgenic activity thereof
CA002372720A CA2372720C (en) 1999-05-04 2000-05-04 Androgen glycosides and androgenic activity thereof
BR0010708-5A BR0010708A (pt) 1999-05-04 2000-05-04 Glicosìdeos androgênicos e atividade androgênica dos mesmos
AT00927493T ATE301129T1 (de) 1999-05-04 2000-05-04 Androgen glykoside und die androgenische aktivität davon
IL146284A IL146284A (en) 1999-05-04 2001-11-01 Androgen glycosides and pharmaceutical preparations containing them
NO20015338A NO321296B1 (no) 1999-05-04 2001-11-01 Androgenglukosid forbindelser samt anvendelser derav

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US13250099P 1999-05-04 1999-05-04
US19529400P 2000-04-07 2000-04-07
US60/195,294 2000-04-07
US60/132,500 2000-04-07

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JP (1) JP5005127B2 (US06630453-20031007-C00016.png)
KR (1) KR20020013533A (US06630453-20031007-C00016.png)
CN (1) CN1250563C (US06630453-20031007-C00016.png)
AT (1) ATE301129T1 (US06630453-20031007-C00016.png)
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NO (1) NO321296B1 (US06630453-20031007-C00016.png)
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WO2003026649A1 (en) * 2001-09-27 2003-04-03 Applied Research Systems Ars Holding N.V. Methods of increasing endogenous testosterone levels
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US10966916B2 (en) 2014-11-10 2021-04-06 The Procter And Gamble Company Personal care compositions
US10987290B2 (en) 2017-10-20 2021-04-27 The Procter And Gamble Company Aerosol foam skin cleanser
US11207248B2 (en) 2014-11-10 2021-12-28 The Procter And Gamble Company Personal care compositions with two benefit phases
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US20050107310A1 (en) * 2002-03-19 2005-05-19 Holick Michael F. Carboxylic acid glycuronides, glycosamides and glycosides of quinolones, penicillins, analogs, and uses thereof
WO2003086475A1 (en) * 2002-04-12 2003-10-23 A & D Bioscience, Inc. Conjugates comprising cancer cell specific ligands, a sugar and diagnostic agents, and uses thereof
WO2003094842A2 (en) * 2002-05-07 2003-11-20 A & D Bioscience, Inc. Conjugates comprising central nervous system active drug
US20050215487A1 (en) * 2002-06-27 2005-09-29 Holick Michael F Conjugates comprising an nsaid and a sugar and uses thereof
US20070225354A1 (en) * 2006-03-21 2007-09-27 Eric Marchewitz Use of dihydrolipoamide for enhancing physical performance
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