WO2001068576A1 - Dermatological compounds - Google Patents

Dermatological compounds Download PDF

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Publication number
WO2001068576A1
WO2001068576A1 PCT/US2000/006373 US0006373W WO0168576A1 WO 2001068576 A1 WO2001068576 A1 WO 2001068576A1 US 0006373 W US0006373 W US 0006373W WO 0168576 A1 WO0168576 A1 WO 0168576A1
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dimethyl
norbornane
substituted
disease
compound
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PCT/US2000/006373
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French (fr)
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Wu Yun Ren
David A. Brown
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Applied Genetics Incorporated Dermatics
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Priority to AU2000238755A priority Critical patent/AU2000238755A1/en
Priority to PCT/US2000/006373 priority patent/WO2001068576A1/en
Priority to EP00917846A priority patent/EP1261572A4/en
Publication of WO2001068576A1 publication Critical patent/WO2001068576A1/en

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    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07CACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C31/00Saturated compounds having hydroxy or O-metal groups bound to acyclic carbon atoms
    • C07C31/27Polyhydroxylic alcohols containing saturated rings
    • C07C31/278Polycyclic with condensed rings
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07CACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C35/00Compounds having at least one hydroxy or O-metal group bound to a carbon atom of a ring other than a six-membered aromatic ring
    • C07C35/22Compounds having at least one hydroxy or O-metal group bound to a carbon atom of a ring other than a six-membered aromatic ring polycyclic, at least one hydroxy group bound to a condensed ring system
    • C07C35/23Compounds having at least one hydroxy or O-metal group bound to a carbon atom of a ring other than a six-membered aromatic ring polycyclic, at least one hydroxy group bound to a condensed ring system with hydroxy on a condensed ring system having two rings
    • C07C35/28Compounds having at least one hydroxy or O-metal group bound to a carbon atom of a ring other than a six-membered aromatic ring polycyclic, at least one hydroxy group bound to a condensed ring system with hydroxy on a condensed ring system having two rings the condensed ring system containing seven carbon atoms
    • C07C35/29Compounds having at least one hydroxy or O-metal group bound to a carbon atom of a ring other than a six-membered aromatic ring polycyclic, at least one hydroxy group bound to a condensed ring system with hydroxy on a condensed ring system having two rings the condensed ring system containing seven carbon atoms being a (2.2.1) system
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07CACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C2602/00Systems containing two condensed rings
    • C07C2602/36Systems containing two condensed rings the rings having more than two atoms in common
    • C07C2602/42Systems containing two condensed rings the rings having more than two atoms in common the bicyclo ring system containing seven carbon atoms

Definitions

  • the present invention relates to novel monocyclic and bicyclic monoterpene diols that stimulate melanogenesis in mammalian skin, hair, wool or fur, and, are useful for treating or preventing various skin and proliferative disorders, neurodegenerative diseases, and diseases regulated by the nitric oxide/cyclic GMP/protein kinase G pathway.
  • U.S. Patent 5,352,440 is directed to increasing melanin synthesis in melanocytes and increasing pigmentation by administration of certain diacylglycerol compounds .
  • U.S. Patent 5,532,001 is directed to increasing pigmentation in mammalian skin via administration of certain DNA fragments.
  • U.S. Patent 5,554,359 is directed to increasing levels of melanin in melanocytes by administration of lysosomotropic agents.
  • the present invention is directed to compounds having the structure :
  • A is a substituted or unsubstituted cyclic terpene
  • R 1# R 2 , R 8 and R 9 are all -OH;
  • R 3 , R 4 , R 5 , R 6 , R 7 an ⁇ R 10 are each independently hydrogen, or a linear or branched, cyclic, bicyclic or polycyclic group containing from one atom to fifty atoms, at least one of which is carbon, nitrogen, oxygen, or sulfur.
  • Another aspect of the present invention concerns stimulation of melanogenesis in mammalian skin, hair, wool or fur, by administering to a locus in need of such stimulation an effective amount of one or more of the compounds described above .
  • Another aspect of the present invention concerns treatment of proliferative, tumorous or cancerous disorders in mammals, including but not limited to such conditions of a dermatological nature, by administering to a mammal in need of such treatment an effective amount of one or more of the compounds described above .
  • a further aspect of the present invention concerns treatment of neurodegenerative disorders or nerve damage in mammals by administering to a mammal in need of such treatment an effective amount of one or more of the compounds described above.
  • Another aspect of the present invention concerns treatment of diseases regulated by the nitric oxide/cyclic GMP/protein kinase G pathway in mammals by administering to a mammal in need of such treatment an effective amount of one or more of the compounds described above.
  • Figure 1 is a photograph of treated human skin as described in Example 7.
  • the compounds of the present invention have the structures described above.
  • the A cyclic terpene portion is monocyclic or bicyclic, more preferably bicyclic.
  • A is a substituted or unsubstituted moiety having the skeleton of (+) or (- ) -camphenes; ( +) or (-) -camphor; (-) -yff-pinenes and 2- or 3-carenes; (-)-myrtenol or (-) -myrtanol ; or (-)-verbenol or (-) -verbenone and their derivatives, some of which are shown below.
  • R 3 , R 4 , R 5 , R 6 , R 7 and R 10 are each independently hydrogen, or a linear or branched, cyclic, bicyclic or polycyclic group containing from one atom to fifty atoms, at least one of which is carbon, nitrogen, oxygen, or sulfur.
  • R groups include linear or branched alkyl, particularly alkyl, linear or branched alkenyl, linear or branched alkynyl, cycloalkyl, aryl, aralkyl, polynuclear groups such as tetralin, decalin or pyrene, and heterocyclic groups containing nitrogen, sulfur and/or oxygen, such as pyrrole, furan, thiophene, imidazole, oxazole, thiazole, pyrazole, 3- pyrroline, pyridine, pyrimidine, purine, quinoline, isoquinoline or carbazole.
  • any of the foregoing groups may be optionally substituted with groups such as halogens, amino, nitro, hydroxyl or sulfhydryl.
  • groups such as halogens, amino, nitro, hydroxyl or sulfhydryl.
  • non-cyclic terpene backbone portion of the present compounds they preferably have one of the structures shown immediately below:
  • R is hydrogen or methyl
  • Particularly preferred compounds include (-)-2,2- dimethyl-3-hydroxy-3-hydroxymethyl-norbornane; (+) -2,2- dimethyl-3-hydroxy-3-hydroxymethyl-norbornane; (-) -2,2- dimethyl-3- (2 , 3-dihydroxy-propan-3-yl) -norbornane; and (+) -2 , 2-dimethyl-3- (2 , 3-dihydroxy-propan-3-yl) - norbornane .
  • the present invention is based on the unique observation that the present compounds effectively and efficiently induce melanogenesis in mammalian cells, which has several consequences.
  • increasing melanogenesis leads to increasing the melanin content of melanocytes, and hence results in increased pigmentation or darkened color of the skin, hair, wool or fur.
  • hypopigmentation disorders such as albinism, vitiligo, etc.
  • increasing the pigmentation of skin according to the present invention will protect such skin from subsequent UV light damage, sunburn, photoaging and development of skin cancers.
  • the present invention may be used to treat hyperproliferative disorders such as actinic keratosis, basal cell carcinoma, squamous cell carcinoma, fibrous histiocytoma, dermatofibrosarcoma protuberans, hemangioma, nevus flammeus, xanothoma, Kaposi ' s sarcoma, mastocytosis, mycosis fungoides, lentigo, nevocellular nevus, lentigo maligna, malignant melanoma, and metastatic carcinoma.
  • hyperproliferative disorders such as actinic keratosis, basal cell carcinoma, squamous cell carcinoma, fibrous histiocytoma, dermatofibrosarcoma protuberans, hemangioma, nevus flammeus, xanothoma, Kaposi ' s sarcoma, mastocytosis, mycosis fungoides, lentigo,
  • the present methods and compositions are also useful in the treatment of diseases characterized by inflammation and disturbance of keratinization, including psoriasis vulgaris, psoriasis eosinophilia, acne vulgaris, acne conglobata, acne fulminans, osteoma cutis, nodulocystic acne, cystic acne and benign and premalignant dermatoses .
  • the compounds also effectively and efficiently increase differentiation of neuronal cells, including increased neuronal dendricity and neuronal tyrosine hydroxylase activity, which has several consequences.
  • increasing dendricity leads to increased neuronal communication, thereby increasing neuronal function and performance.
  • the present invention is useful for treating diseases or disorders marked by reduction of neuronal dendricity and function, including but not limited to Parkinson's disease, amyotrophic lateral sclerosis, Alzheimer's disease, or any other neurodegenerative disease, or physical or toxic damage to brain, spinal or peripheral nerve cells.
  • the present invention is useful for restoring or optimizing neuronal communication, function or performance.
  • the present invention is particularly useful for treating Parkinson's disease which is specifically marked by depletion of dopamine synthesis.
  • the present invention is useful for treating neuronal proliferative, tumorous, or cancerous disorders, or said disorders in any other cell type that might be similarly affected.
  • the present invention is useful for treating additional neurodegenerative disorders or neuropathies including but not limited to diffuse cerebral cortical atrophy, Lewy- body dementia, Pick disease, mesolimbocortical dementia, thalamic degeneration, Huntington chorea, cortical- striatal-spinal degeneration, cortical-basal ganglionic degeneration, cerebrocerebellar degeneration, familial dementia with spastic paraparesis, polyglucosan body disease, Shy-Drager syndrome, olivopontocerebellar atrophy, progressive supranuclear palsy, dystonia musculorum deformans, Hallervorden-Spatz disease, Meige syndrome, familial tremors, Gilles de la Tourette syndrome, acanthocytic chorea, Friedreich ataxia, Holmes familial cortical cerebellar atrophy, Gerstmann
  • the compounds of this invention appear to act by direct stimulation of nitric, oxide synthase (NOS) activity, thus generating NO de novo.
  • NOS nitric, oxide synthase
  • the compounds of the present invention will provide a preferred alternative method of treatment for conditions presently treated by NO donors.
  • heart disease including stable angina pectoris, unstable angina, myocardial infarction, and myocardial failure associated with myocardial ischemia, atherosclerosis, vascular hypertrophy, and thrombosis (Cooe and Dzau, 1997, A ⁇ u. .Rev. Med. 48:489-509; Thadani, 1997, Cardiovasc . Drugs 10:735);
  • NO/cGMP/PKG pathway mediates melanogenesis induced by ultraviolet light (Romero- Graillet, et al . , 1996, J “ . Biol . Chem. 271:28052-28056; Romero-Graillet, et al . , 1997, J “ . Clin . Invest . 99:635- 642) and aliphatic and alicyclic diols (United States patent application S.N. 08/933,143, entitled “Dermatalogical Compositions and Methods” filed September 18, 1997) .
  • the present invention contemplates the use of one or more of the above-mentioned compounds as an active ingredient for various uses.
  • the active ingredient (s) is combined with an acceptable carrier to form a topical formulation which may be placed on the skin for dermatological uses.
  • Topical formulations may include ointments, lotions, pastes, creams, gels, drops, suppositories, sprays, liquids, shampoos, powders and transdermal patches. Thickeners, diluents, emulsifiers, dispersing aids or binders may be used as needed.
  • one function of the carrier is to enhance skin penetration of the active ingredient (s) , and should be capable of delivering the active ingredient (s) to melanocytes under in vivo conditions.
  • Suitable carriers are well known to one of ordinary skill, and include liposomes, ethanol, dimethylsulfoxide (DMSO) , petroleum jelly (petrolatum), mineral oil (liquid petrolatum) , water, dimethylformamide, dekaoxyethylene-oleylether, oleic acid, 2-pyrrolidone and Azone ® brand penetration enhancer (Upjohn) .
  • a particularly preferred composition includes an active ingredient (s) as described above, with one of 2-pyrrolidone, oleic acid and/or Azone ® as penetration enhancer, solubilized in a base of water, ethanol, propanol and/or propylene glycol (the latter component having properties of a carrier, penetration enhancer and an active ingredient as described herein) .
  • the compositions of the present invention may also include other active ingredients, as well as inert or inactive ingredients.
  • compositions include an active ingredient (s) in conjunction with one or more melanogenesis-enhancing agents such as -hydroxy acids, salts and derivatives thereof; ⁇ -keto acids, salts and derivatives thereof; ⁇ -hydroxy acids, salts and derivatives thereof; retinoids, salts and derivatives thereof; Vitamin A and related compounds; acids; phenol; and methoxypropyl-gluconamide, as more fully described in co-pending application Serial No. filed April
  • the dose regimen will depend on a number of factors which may readily be determined, such as severity and responsiveness of the condition to be treated, but will normally be one or more doses per day, with a course of treatment lasting from several days to several months, or until a cure is effected or a diminution of disease state is achieved, or a cosmetically desired degree of melanogenesis (tanning) is achieved, depending on the application.
  • dose regimen will depend on a number of factors which may readily be determined, such as severity and responsiveness of the condition to be treated, but will normally be one or more doses per day, with a course of treatment lasting from several days to several months, or until a cure is effected or a diminution of disease state is achieved, or a cosmetically desired degree of melanogenesis (tanning) is achieved, depending on the application.
  • One of ordinary skill may readily determine optimum dosages, dosing methodologies and repetition rates.
  • topical formulations such as creams, lotions, solutions, etc.
  • a concentration of active ingredient of from about 0.01% to about 50%, preferably from about 0.1% to about 10%.
  • unit dosage form compositions according to the present invention will contain from about 0.01 mg to about 100 mg of active ingredient, preferably about 0.1 mg to about 10 mg of active ingredient.
  • compositions of the present invention also contemplate the use of one or more of the above-mentioned compounds as an active ingredient to stimulate neuronal differentiation, dendricity, and/or tyrosine hydroxylase activity (with resultant increased dopamine synthesis) and/or to treat disease conditions related to the NO/cGMP/PKG pathway.
  • the active ingredient (s) is given orally, intravenously, or transdermally in an acceptable formulation.
  • a particularly preferred carrier for some formulations is 1, 2-propylene glycol since it is an excellent solvent for certain compounds in this invention. Additionally, 1, 2-propylene glycol as carrier has itself, as described in this invention, similar but lesser activity than the preferred active ingredient (s) .
  • compositions of the present invention may also include other active ingredients, as well as inert or inactive ingredients.
  • the dose regimen will depend on a number of factors which may readily be determined, such as severity and responsiveness of the condition to be treated, but will normally be one or more doses per day, with a course of treatment lasting from several days to several months, or until a cure is effected or a diminution of disease state is achieved.
  • One of ordinary skill may readily determine optimum dosages, dosing methodologies and repetition rates.
  • unit dosage form compositions according to the present invention will contain from about 0.01 mg to about 100 mg of active ingredient, preferably about 0.1 mg to about 10 mg of active ingredient.
  • Topical formulations (such as creams, lotions, solutions, etc.) may have a concentration of active ingredient of from about 0.01% to about 50%, preferably from about 0.1% to about 10%.
  • Another aspect of the present invention is based on the observation that the subject compounds which stimulate melanin production act via the Nitric Oxide/cyclic Guanosine Monophosphate/Protein Kinase G ("NO/cGMP/PKG”) pathway.
  • NO/cGMP/PKG Nitric Oxide/cyclic Guanosine Monophosphate/Protein Kinase G
  • the present invention includes not only the compounds described above, but any compound which acts via the NO/cGMP/PKG pathway to stimulate melanin synthesis by increasing cellular production of NO, cGMP or PKG.
  • agents which decrease cellular production of NO, cGMP or PKG will decrease or suppress melanin production and pigmentation in mammalian skin, hair, fur or wool, and the present invention is also directed to those compositions and methods.
  • Such is useful in, for example, the lightening of skin, hair, wool or fur for cosmetic purposes, or the treatment of hyperpigmentation or uneven pigmentation disorders such as vitiligo, dermal melanocytosis, Franceschetti-Jadassohn Syndrome, etc.
  • the formulation and dosing would be as described above with respect to pigmentation applications .
  • Discovery of the pathway through which the present compounds act also leads to methods for screening compounds for melanogenic activity and potency, or for their ability to reduce or suppress melanogenesis, based on measurement of generation of nitric oxide (NO) or measurement of nitric oxide synthesis (NOS) activity.
  • Methods for measurement of NO or NOS include but are not limited to the following well known methods.
  • Measurement of NO is usually based on the fact that NO rapidly decomposes to nitrate and nitrite in aqueous solution.
  • Nitrate reductase is added to culture media or cell extracts to ensure complete conversion of nitrate to nitrite.
  • Griess reagents sulfanilamide and N- [1- naphthyl] -ethylenediamine are then added to convert nitrite into a deep purple azo compound that absorbs maximally at 540 nm (Schmidt, et al . , 1995, Biochemica
  • Reactions are typically carried out in a 96-well format with absorbances read on a microtiter plate reader.
  • DAN reagent (2,3- diaminonaphthalene) is added followed by NaOH which converts nitrite into the fluorescent compound 1 (H) - naphthotriazole .
  • H fluorescent compound 1
  • NOS activity is measured by adding [ 3 H] -arginine to intact tissues or protein extracts, and measuring release of 3 H resulting from the conversion of arginine to citrulline during the enzymatic formation of NO by NOS (Baudouin and Tachon, 1996, J. Invest . Derma tol . 106:428-
  • cGMP may be measured by commercially available immunoassay (see Romero-Graillet, et al . , 1996, J. Biol . Chem. 271:28052-
  • PKG may be measured by cyclic GMP dependent kination of a primary histone target (see Hidaka, et al . , Biochemistry 1984, 23, 5036-5041)
  • Compounds according to the present invention may be synthesized in a number of ways known to one of ordinary skill. For example, a series of novel monocyclic and bicyclic monoterpenoid 1,2-diol derivatives (la,b-6a,b below) may be synthesized from (+) or (-) -camphenes , (+) or (-) -camphor, ( - ) - ⁇ -pinenes, 2- or 3-carenes, (-)- myrtenol, (-)-verbenol and their derivatives.
  • the one step syntheses of (+) - and (-)-lb and 3b are accomplished by cis-hydroxylation of (+) and (-)-camphene and (-)- ⁇ -pinene with osmium tetroxide and hydrogen peroxide or N-methylmorpholine N-oxide in t-butanol.
  • the same technology may be applied to (+) and (-) -camphor and (-) -verbenone; in that case a Wittig reaction is used to convert the ketone to the corresponding olefin, and then the above described cis-hydroxylation is done to give 2b and 4b.
  • (+) or (-) la to 6a are achieved in four-steps from (+) or (-)-camphene and (-)- ⁇ -pinene and corresponding olefins of (+) or (-) -camphor, (-)- verbenone or 2- or 3-carene prepared as described above.
  • (+) or (-)-V (10 g, 0.06 mole for (+) -V or 13 gm, 0.08 mole for (-)-V) in 150 ml of tert-butyl alcohol were added 30% hydrogen peroxide in water (8 ml for (+) -V and 9.1 ml for (-)-V) and 125 mg of osmium tetroxide as catalyst.
  • This mixture was stirred and maintained at 0°C in a ice bath for 4 hours, and then at room temperature for 20 hrs.
  • Cloudman S91 mouse melanoma cells were obtained from ATCC and cultured in MEM (BioWhittaker) with 10% calf serum (BioWhittaker or HyClone) .
  • Media was changed to MEM with 2% calf serum concomitant with addition of treatments.
  • Treatments were dissolved in ethanol as 0.5M solutions which was added in appropriate volumes directly to cell culture media (Brown, et al . , 1998, J. Invest . Dermatol . 110:48-437).
  • the compounds of this invention result both in induction of cell cycle arrest and differentiation of S91 mouse melanoma cells, indicating that they have potential use as chemotherapeutic differentiation agents. It can be seen in Table 1, that following a 6 day treatment period, the compounds of this invention result in a reduction of cell numbers below that of untreated controls.
  • the compounds of this invention are considered to be cytostatic (induce cell cycle arrest) rather than cytotoxic since: (i) they did not result in a reduction of cell number below the number originally plated (0.05 X 10 6 viable cells/treatment), (ii) reductions of cell number relative to controls were accompanied by induction of the multipolar phenotype and induction of tyrosinase, both well-known markers of differentiation, and, (iii) there was no apparent detachment of cells from dishes as indicated by a lack of cells floating in the media. In contrast, 3-ethyl-2- aldehyde-pinane resulted in detachment of cells from dishes with little induction of markers of differentiation (Table 1) .
  • novel monoterpene diols of this invention will have a similar activity in neuronal cells. Furthermore, it is contemplated that the novel monoterpene diols of this invention will have the potential to treat diseases remedied by stimulation of the nitric oxide/cyclic GMP/protein kinase G as described for monoterpene diols in PCT/US98/05346.
  • Each formulation contained 50% ⁇ -hydroxy acid (AHA) face cream (CVS generic containing 8% AHA; therefore final concentration of AHA in formulation was 4%) , 35% isopropyl alcohol (Fisher) , the indicated amounts of each compound (Table 2) , and deionized water as required to bring the volume up to 100%.
  • the vehicle control solution contained 50% AHA face cream, 35% isopropyl alcohol, and 15% deionized water. Ten ul of each formulation was applied twice per day for 10 days, followed by application of 10 ul once per day for the remainder of the application period.
  • the treatment spots were along the anterior forearm which correspond to the region of the forearm closest to the body when at rest.
  • the Vehicle control was closest the elbow and VI- was closest the wrist, with the other treatment spots along the arm in the order given in Table 2.
  • the treated individual was Caucasian with an untanned (pale) forearm prior to treatment.
  • results show that 11+ and VI- were 5- and 10-fold more potent, respectively, than (2R, 3S) - (-) -PD with regards to induction of tanning when applied to human skin (compare 14 day 0. IM treatment results in Table 2) .
  • results for induction of melanogenesis in human skin by these compounds parallel those for induction of melanogenesis in cell culture (Table 1) .
  • (IR) -2 , 3 -c/e-BD which was only about 2-fold more potent than (2R, 3S) - ( - ) -PD in cell culture (see Table 20 in PCT/US98/05346) , was 5-fold more potent when applied to human skin (compare 14 day 0. IM treatment results in Table 2) .
  • VI- The family of compounds embodied by this invention and related inventions are thought to exert their effects via the nitric oxide signal transduction pathway (discussed above) . Therefore, it is contemplated that the relatively high potency of VI- may be related, in part, to its structural similarity to tetrahydrobiopterin with regards to a protruding propanediol substituent group.

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Abstract

The present invention relates to novel monocyclic and bicyclic monoterpene diols that stimulate melanogenesis in mammalian skin, hair, wool or fur, and, are useful for treating or preventing various skin and proliferative disorders, neurodegenerative diseases, and diseases regulated by the nitric oxide/cyclic GMP/protein kinase G pathway.

Description

PA- 0104
TITLE OF THE INVENTION DERMATOLOGICAL COMPOUNDS
CROSS REFERENCE TO RELATED APPLICATIONS This application is a continuation of PCT/US98/05346 filed March 18, 1998, which is a continuation-in-part of PCT/US97/16642 filed September 18, 1997, which is a continuation-in-part of application Serial No. 60/026,577 filed September 18, 1996, of application Serial No. 60/035,947 filed January 21, 1997, of application Serial No. 60/036,863 filed February 4, 1997, and of application Serial No. 60/048,597 filed June 4, 1997.
STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT
Not applicable
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates to novel monocyclic and bicyclic monoterpene diols that stimulate melanogenesis in mammalian skin, hair, wool or fur, and, are useful for treating or preventing various skin and proliferative disorders, neurodegenerative diseases, and diseases regulated by the nitric oxide/cyclic GMP/protein kinase G pathway.
2. Description of Related Art
U.S. Patent 5,352,440 is directed to increasing melanin synthesis in melanocytes and increasing pigmentation by administration of certain diacylglycerol compounds . U.S. Patent 5,532,001 is directed to increasing pigmentation in mammalian skin via administration of certain DNA fragments.
U.S. Patent 5,554,359 is directed to increasing levels of melanin in melanocytes by administration of lysosomotropic agents.
SUMMARY OF THE INVENTION In one aspect, the present invention is directed to compounds having the structure :
Figure imgf000003_0001
wherein
A is a substituted or unsubstituted cyclic terpene;
R1# R2, R8 and R9 are all -OH; and
R 3, R 4, R 5, R 6, R 7 an< R 10 are each independently hydrogen, or a linear or branched, cyclic, bicyclic or polycyclic group containing from one atom to fifty atoms, at least one of which is carbon, nitrogen, oxygen, or sulfur.
Another aspect of the present invention concerns stimulation of melanogenesis in mammalian skin, hair, wool or fur, by administering to a locus in need of such stimulation an effective amount of one or more of the compounds described above .
Another aspect of the present invention concerns treatment of proliferative, tumorous or cancerous disorders in mammals, including but not limited to such conditions of a dermatological nature, by administering to a mammal in need of such treatment an effective amount of one or more of the compounds described above . A further aspect of the present invention concerns treatment of neurodegenerative disorders or nerve damage in mammals by administering to a mammal in need of such treatment an effective amount of one or more of the compounds described above.
Another aspect of the present invention concerns treatment of diseases regulated by the nitric oxide/cyclic GMP/protein kinase G pathway in mammals by administering to a mammal in need of such treatment an effective amount of one or more of the compounds described above.
BRIEF DESCRIPTION OF THE DRAWINGS Figure 1 is a photograph of treated human skin as described in Example 7.
DETAILED DESCRIPTION OF THE INVENTION The compounds of the present invention have the structures described above. Preferably, the A cyclic terpene portion is monocyclic or bicyclic, more preferably bicyclic. Most preferably, A is a substituted or unsubstituted moiety having the skeleton of (+) or (- ) -camphenes; ( +) or (-) -camphor; (-) -yff-pinenes and 2- or 3-carenes; (-)-myrtenol or (-) -myrtanol ; or (-)-verbenol or (-) -verbenone and their derivatives, some of which are shown below.
Figure imgf000005_0001
(+) and (-)-Camphene (+) and (-) Camphor 3-carene
Figure imgf000005_0002
(-)-β-pinene (-)-myrtanol
Figure imgf000005_0003
(-)-Verbenone 2-carene
As mentioned above, R3, R4, R5, R6, R7 and R10 are each independently hydrogen, or a linear or branched, cyclic, bicyclic or polycyclic group containing from one atom to fifty atoms, at least one of which is carbon, nitrogen, oxygen, or sulfur. Those R groups include linear or branched alkyl, particularly
Figure imgf000005_0004
alkyl, linear or branched alkenyl, linear or branched alkynyl, cycloalkyl, aryl, aralkyl, polynuclear groups such as tetralin, decalin or pyrene, and heterocyclic groups containing nitrogen, sulfur and/or oxygen, such as pyrrole, furan, thiophene, imidazole, oxazole, thiazole, pyrazole, 3- pyrroline, pyridine, pyrimidine, purine, quinoline, isoquinoline or carbazole. Any of the foregoing groups may be optionally substituted with groups such as halogens, amino, nitro, hydroxyl or sulfhydryl. Regarding the non-cyclic terpene backbone portion of the present compounds, they preferably have one of the structures shown immediately below:
Figure imgf000006_0001
wherein R is hydrogen or methyl .
Particularly preferred compounds include (-)-2,2- dimethyl-3-hydroxy-3-hydroxymethyl-norbornane; (+) -2,2- dimethyl-3-hydroxy-3-hydroxymethyl-norbornane; (-) -2,2- dimethyl-3- (2 , 3-dihydroxy-propan-3-yl) -norbornane; and (+) -2 , 2-dimethyl-3- (2 , 3-dihydroxy-propan-3-yl) - norbornane .
The present invention is based on the unique observation that the present compounds effectively and efficiently induce melanogenesis in mammalian cells, which has several consequences. First, increasing melanogenesis leads to increasing the melanin content of melanocytes, and hence results in increased pigmentation or darkened color of the skin, hair, wool or fur. Thus, the present invention is useful in the treatment of hypopigmentation disorders, such as albinism, vitiligo, etc. It is also believed that increasing the pigmentation of skin according to the present invention will protect such skin from subsequent UV light damage, sunburn, photoaging and development of skin cancers. Finally, since the methods and compositions described herein induce differentiation of a melanoma cell line, the present invention may be used to treat hyperproliferative disorders such as actinic keratosis, basal cell carcinoma, squamous cell carcinoma, fibrous histiocytoma, dermatofibrosarcoma protuberans, hemangioma, nevus flammeus, xanothoma, Kaposi ' s sarcoma, mastocytosis, mycosis fungoides, lentigo, nevocellular nevus, lentigo maligna, malignant melanoma, and metastatic carcinoma. The present methods and compositions are also useful in the treatment of diseases characterized by inflammation and disturbance of keratinization, including psoriasis vulgaris, psoriasis eosinophilia, acne vulgaris, acne conglobata, acne fulminans, osteoma cutis, nodulocystic acne, cystic acne and benign and premalignant dermatoses .
The compounds also effectively and efficiently increase differentiation of neuronal cells, including increased neuronal dendricity and neuronal tyrosine hydroxylase activity, which has several consequences. First, increasing dendricity leads to increased neuronal communication, thereby increasing neuronal function and performance. Thus, the present invention is useful for treating diseases or disorders marked by reduction of neuronal dendricity and function, including but not limited to Parkinson's disease, amyotrophic lateral sclerosis, Alzheimer's disease, or any other neurodegenerative disease, or physical or toxic damage to brain, spinal or peripheral nerve cells. Further, the present invention is useful for restoring or optimizing neuronal communication, function or performance.
Second, increasing tyrosine hydroxylase activity directly increases dopamine synthesis. Thus, the present invention is particularly useful for treating Parkinson's disease which is specifically marked by depletion of dopamine synthesis.
Third, induction of neuronal differentiation reverses neuronal proliferative disorders. Thus, the present invention is useful for treating neuronal proliferative, tumorous, or cancerous disorders, or said disorders in any other cell type that might be similarly affected.
Finally, since the methods and compositions described herein induce differentiation, dendricity and tyrosine hydroxylase in a neuronal cell model, the present invention is useful for treating additional neurodegenerative disorders or neuropathies including but not limited to diffuse cerebral cortical atrophy, Lewy- body dementia, Pick disease, mesolimbocortical dementia, thalamic degeneration, Huntington chorea, cortical- striatal-spinal degeneration, cortical-basal ganglionic degeneration, cerebrocerebellar degeneration, familial dementia with spastic paraparesis, polyglucosan body disease, Shy-Drager syndrome, olivopontocerebellar atrophy, progressive supranuclear palsy, dystonia musculorum deformans, Hallervorden-Spatz disease, Meige syndrome, familial tremors, Gilles de la Tourette syndrome, acanthocytic chorea, Friedreich ataxia, Holmes familial cortical cerebellar atrophy, Gerstmann- Straussler-Scheinker disease, progressive spinal muscular atrophy, progressive balbar palsy, primary lateral sclerosis, hereditary muscular atrophy, spastic paraplegia, peroneal muscular atrophy, hypertrophic interstitial polyneuropathy, heredopathia atactica polyneuritiformis, optic neuropathy, and ophthalmoplegia.
It has also been discovered that the present class of compounds stimulate cellular nitric oxide synthesis and have their action blocked by scavengers of nitric oxide (NO) , and by inhibitors of cyclic guanosine monophosphate (cGMP) or inhibitors of cGMP-activated protein kinase (PKG) . This indicates that these compounds act via the NO/cGMP/PKG signal transduction pathway. Unlike previous compounds like nitroglycerin and isosorbide dinitrate that stimulate this pathway by releasing NO upon reaction with intracellular sulfhydryl groups (Smith and Reynard, 1992, Pharmacology, W. B. Saunders Co., Philadelphia, PA, pp. 626-31), the compounds of this invention appear to act by direct stimulation of nitric, oxide synthase (NOS) activity, thus generating NO de novo. Whereas depletion of intracellular sulfhydryl groups rapidly leads to tolerance and ineffectiveness of nitroglycerin and related compounds (Smith and Reynard, 1992) , tolerance will not be acquired to the compounds of the present invention since they do not require the presence of sulfhydryl groups for generation. Thus, it is contemplated that the compounds of the present invention will provide a preferred alternative method of treatment for conditions presently treated by NO donors.
Both clinical application and research studies have demonstrated that stimulation of the NO/cGMP/PKG pathway is useful for treatment of :
(i) heart disease including stable angina pectoris, unstable angina, myocardial infarction, and myocardial failure associated with myocardial ischemia, atherosclerosis, vascular hypertrophy, and thrombosis (Cooe and Dzau, 1997, Aππu. .Rev. Med. 48:489-509; Thadani, 1997, Cardiovasc . Drugs 10:735);
(ii) hypertension (Cooe and Dzau, 1997) ;
(iii) stroke (Samdani, et al . , 1997, Stroke 28:1283-
1288) ;
(iv) primary pulmonary hypertension, chronic obstructive pulmonary disease, and adult respiratory distress syndrome (Adnot and Raffestin, 1996, Thorax 51:762-764; Marriott and Higenbottam, 1997, Schweiz Med. Wochenschr. 127:709-714);
(v) microvascular functional abnormalities in diabetes that link insulin-resistance to hypertension, thrombosis and atherosclerosis (Tooke, et al . , 1996, Diabetes Res . Clin . Pract . 31Suppl :S127-S132 ; Baron, 1996, J". Investig. Med. 44:406-412);
(vi) hemostatic irregularities of glomerular vascular and tubular function with consequences for development of hypertension (Kone and Baylis, 1997, Am . J. Physiol . 10:F561-578; Am. J. Hypertens . 10:129-140);
(vii) microvascular irregularities in the liver with consequences for biliary transport and tissue regeneration (Suematsu, et al . , 1996, Cardiovasc . Res .
32:679-686) ;
(viii) disorders of bladder function and reflex relaxation for micturition (Andersson, 1996, Curr. Opin . Obstet . Gynecol . 8:361-365); (ix) disorders of neurotransmitter release, neuron morphogenesis, synaptic plasticity, and neuroendrocrine regulation (Dawson and Dawson, 1996, Neurochem . Int .
29:97-110; Brann, et al . , 1997, Neuroendocrinology 65:385-395) ;
(x) regional pain including migraine headaches (Mashimo, et al . , 1997, J. Clin . Pharmacol . 37:330-335; Packard and Ham, 1997, Headache 37:142-152);
(xi) gastrointestinal protection from non-steroidal anti-inflammatory drugs (Rishi, et al . , 1996, Indian J. Physiol . Pharmacol . 40:377-379);
(xii) benign anal disease (Gorfine, 1995, Dis . Colon Rectum 38:453-456) ;
(xiii) impotence (Andersson and Stief, 1997, World J. Urol . 15:14-20) ;
(xiv) regulation of tissue free radical injury (Rubbo, et al . , 1996, Chem . Res . Toxicol . 9:809-820); and
(xv) inhibition of tumor growth, tumor apoptosis, angiogenesis, and metastasis (Pipili-Synetos, et al . , 1995, Br. J. Pharmacol . 116:1829-1834; Xie, et al . , 1996, J. Leukoc . Biol . 59:797-803); and
(xvi) stimulation of wound healing including cuts, tendon injury and thermal injury (Schaffer, et al . , 1996, J". Surg. Res . 63:237-240; Murrell, et al . , 1997, Inflamm. Res . 46:19-27; Carter, et al . , 1994, Biochem . J. 304 (Pt 1) :201-04) .
In addition, the NO/cGMP/PKG pathway mediates melanogenesis induced by ultraviolet light (Romero- Graillet, et al . , 1996, J". Biol . Chem. 271:28052-28056; Romero-Graillet, et al . , 1997, J". Clin . Invest . 99:635- 642) and aliphatic and alicyclic diols (United States patent application S.N. 08/933,143, entitled "Dermatalogical Compositions and Methods" filed September 18, 1997) .
The present invention contemplates the use of one or more of the above-mentioned compounds as an active ingredient for various uses. In a preferred embodiment, the active ingredient (s) is combined with an acceptable carrier to form a topical formulation which may be placed on the skin for dermatological uses. Topical formulations may include ointments, lotions, pastes, creams, gels, drops, suppositories, sprays, liquids, shampoos, powders and transdermal patches. Thickeners, diluents, emulsifiers, dispersing aids or binders may be used as needed. Preferably, one function of the carrier is to enhance skin penetration of the active ingredient (s) , and should be capable of delivering the active ingredient (s) to melanocytes under in vivo conditions. Suitable carriers are well known to one of ordinary skill, and include liposomes, ethanol, dimethylsulfoxide (DMSO) , petroleum jelly (petrolatum), mineral oil (liquid petrolatum) , water, dimethylformamide, dekaoxyethylene-oleylether, oleic acid, 2-pyrrolidone and Azone® brand penetration enhancer (Upjohn) . A particularly preferred composition includes an active ingredient (s) as described above, with one of 2-pyrrolidone, oleic acid and/or Azone® as penetration enhancer, solubilized in a base of water, ethanol, propanol and/or propylene glycol (the latter component having properties of a carrier, penetration enhancer and an active ingredient as described herein) . Depending on the specific application, the compositions of the present invention may also include other active ingredients, as well as inert or inactive ingredients.
Particularly preferred formulations include an active ingredient (s) in conjunction with one or more melanogenesis-enhancing agents such as -hydroxy acids, salts and derivatives thereof; α-keto acids, salts and derivatives thereof; β-hydroxy acids, salts and derivatives thereof; retinoids, salts and derivatives thereof; Vitamin A and related compounds; acids; phenol; and methoxypropyl-gluconamide, as more fully described in co-pending application Serial No. filed April
6, 1998 entitled "Dermatological Formulations and Methods", the contents of which are incorporated herein by reference. The dose regimen will depend on a number of factors which may readily be determined, such as severity and responsiveness of the condition to be treated, but will normally be one or more doses per day, with a course of treatment lasting from several days to several months, or until a cure is effected or a diminution of disease state is achieved, or a cosmetically desired degree of melanogenesis (tanning) is achieved, depending on the application. One of ordinary skill may readily determine optimum dosages, dosing methodologies and repetition rates. In general, it is contemplated that topical formulations (such as creams, lotions, solutions, etc.) will have a concentration of active ingredient of from about 0.01% to about 50%, preferably from about 0.1% to about 10%. In general, it is contemplated that unit dosage form compositions according to the present invention will contain from about 0.01 mg to about 100 mg of active ingredient, preferably about 0.1 mg to about 10 mg of active ingredient.
The methods and compositions of the present invention also contemplate the use of one or more of the above-mentioned compounds as an active ingredient to stimulate neuronal differentiation, dendricity, and/or tyrosine hydroxylase activity (with resultant increased dopamine synthesis) and/or to treat disease conditions related to the NO/cGMP/PKG pathway. In a preferred embodiment, the active ingredient (s) is given orally, intravenously, or transdermally in an acceptable formulation. A particularly preferred carrier for some formulations is 1, 2-propylene glycol since it is an excellent solvent for certain compounds in this invention. Additionally, 1, 2-propylene glycol as carrier has itself, as described in this invention, similar but lesser activity than the preferred active ingredient (s) . Depending on the specific application, the compositions of the present invention may also include other active ingredients, as well as inert or inactive ingredients. The dose regimen will depend on a number of factors which may readily be determined, such as severity and responsiveness of the condition to be treated, but will normally be one or more doses per day, with a course of treatment lasting from several days to several months, or until a cure is effected or a diminution of disease state is achieved. One of ordinary skill may readily determine optimum dosages, dosing methodologies and repetition rates. In general, it is contemplated that unit dosage form compositions according to the present invention will contain from about 0.01 mg to about 100 mg of active ingredient, preferably about 0.1 mg to about 10 mg of active ingredient. Topical formulations (such as creams, lotions, solutions, etc.) may have a concentration of active ingredient of from about 0.01% to about 50%, preferably from about 0.1% to about 10%.
Another aspect of the present invention is based on the observation that the subject compounds which stimulate melanin production act via the Nitric Oxide/cyclic Guanosine Monophosphate/Protein Kinase G ("NO/cGMP/PKG") pathway. Thus, the present invention includes not only the compounds described above, but any compound which acts via the NO/cGMP/PKG pathway to stimulate melanin synthesis by increasing cellular production of NO, cGMP or PKG. Conversely, agents which decrease cellular production of NO, cGMP or PKG will decrease or suppress melanin production and pigmentation in mammalian skin, hair, fur or wool, and the present invention is also directed to those compositions and methods. Such is useful in, for example, the lightening of skin, hair, wool or fur for cosmetic purposes, or the treatment of hyperpigmentation or uneven pigmentation disorders such as vitiligo, dermal melanocytosis, Franceschetti-Jadassohn Syndrome, etc. For such depigmentation applications, the formulation and dosing would be as described above with respect to pigmentation applications . Discovery of the pathway through which the present compounds act also leads to methods for screening compounds for melanogenic activity and potency, or for their ability to reduce or suppress melanogenesis, based on measurement of generation of nitric oxide (NO) or measurement of nitric oxide synthesis (NOS) activity. Methods for measurement of NO or NOS include but are not limited to the following well known methods. Measurement of NO is usually based on the fact that NO rapidly decomposes to nitrate and nitrite in aqueous solution. Nitrate reductase is added to culture media or cell extracts to ensure complete conversion of nitrate to nitrite. Griess reagents (sulfanilamide and N- [1- naphthyl] -ethylenediamine) are then added to convert nitrite into a deep purple azo compound that absorbs maximally at 540 nm (Schmidt, et al . , 1995, Biochemica
2:22) . Reactions are typically carried out in a 96-well format with absorbances read on a microtiter plate reader. Alternatively, following conversion of nitrate to nitrite as described above, DAN reagent (2,3- diaminonaphthalene) is added followed by NaOH which converts nitrite into the fluorescent compound 1 (H) - naphthotriazole . This is measured fluorimetrically w th excitation at 365 nm and emission at 450 nm, typically in a 96-well format (Miles, et al . , 1995, Methods 7:40).
NOS activity is measured by adding [3H] -arginine to intact tissues or protein extracts, and measuring release of 3H resulting from the conversion of arginine to citrulline during the enzymatic formation of NO by NOS (Baudouin and Tachon, 1996, J. Invest . Derma tol . 106:428-
431) . Alternatively, the production of cGMP or activity of PKG can be used as a screening tool . cGMP may be measured by commercially available immunoassay (see Romero-Graillet, et al . , 1996, J. Biol . Chem. 271:28052-
28056) . PKG may be measured by cyclic GMP dependent kination of a primary histone target (see Hidaka, et al . , Biochemistry 1984, 23, 5036-5041) Compounds according to the present invention may be synthesized in a number of ways known to one of ordinary skill. For example, a series of novel monocyclic and bicyclic monoterpenoid 1,2-diol derivatives (la,b-6a,b below) may be synthesized from (+) or (-) -camphenes , (+) or (-) -camphor, ( - ) -β-pinenes, 2- or 3-carenes, (-)- myrtenol, (-)-verbenol and their derivatives.
Figure imgf000015_0001
la lb
Figure imgf000015_0002
2a 2b
Figure imgf000015_0003
3a 3b
Figure imgf000015_0004
Figure imgf000016_0001
The syntheses of the structures described above are initiated using chirally pure naturally occurring bicyclic (+) or (-) -camphenes, (+) or (-) -camphor, (-)-β- pinenes, 2 or 3-carenes, (-) -myrtenol , or (-)-verbenol as core chiral units. An enantiomerically controlled construction method is used to synthesize novel compounds that are exemplified herein by (+) and ( - ) -2 , 2-dimethyl- 3-hydroxy-3-hydroxy-methyl-norbornane, and, (+) and (-)- 2 , 2 -dimethyl-3 - (2 , 3-dihydroxy-propan-3-yl) -norbornane .
The one step syntheses of (+) - and (-)-lb and 3b are accomplished by cis-hydroxylation of (+) and (-)-camphene and (-)-β-pinene with osmium tetroxide and hydrogen peroxide or N-methylmorpholine N-oxide in t-butanol. The same technology may be applied to (+) and (-) -camphor and (-) -verbenone; in that case a Wittig reaction is used to convert the ketone to the corresponding olefin, and then the above described cis-hydroxylation is done to give 2b and 4b. For 2- and 3-carenes a hydroboration is done to generate alcohols, which are then oxidized to the corresponding ketones . The Wittig reaction is then used to convert the ketones to olefins, which give 5b and 6b following cis-hydroxylation as described above. The synthesis of (+) or (-) la to 6a are achieved in four-steps from (+) or (-)-camphene and (-)-β-pinene and corresponding olefins of (+) or (-) -camphor, (-)- verbenone or 2- or 3-carene prepared as described above. Hydroboration of olefinic la to 6a or (-) -myrtenol gives the corresponding 3-exo alcohols, which are then oxidized with pyridinium dichromate to their respective aldehydes. Treatment of the aldehydes with
(ethyl) triphenylphosphonium halide or respective corresponding (alkyl) triphenylphosphonium halide affords corresponding (2-propen-3-yl) -monoterpenes . Cis- hydroxylation of these (2 -propen-3 -yl) -monoterpenes furnishes the synthesis of la-6a.
The following examples are illustrative of the processes and products of the present invention, but are not to be construed as limiting. The examples which follow make reference to structures I -VI; those structures are depicted immediately below.
Figure imgf000018_0001
Figure imgf000018_0002
Figure imgf000018_0003
V
VI
Example 1
Synthesis of (+) and ( - ) -2 , 2-dimethyl-3-hydroxy-3- hydroxymethyl-norbornanes (II)
To an ice cooled mixture of (+) or (-)-camphene I (20 g, 0.15 mole) in 200 ml of tert-butyl alcohol were added 30% hydrogen peroxide in water (17 ml, 0.15 mole) and 125 mg of osmium tetroxide as catalyst. The mixture was stirred and temperature maintained at 0°C in a ice bath for 4 hours and then at room temperature for 20 hrs. A slurry of 5 g of magnesium silicate, 500 mg of sodium hydrogen sulfite, and 20 ml of water was added, and the magnisol was filtered. The filtrate was concentrated and the residue was added to methylene chloride. The methylene chloride solution was washed with brine twice, dried over MgS04 and evaporated to dryness. Column chromatography of the crude mixture over a silica gel column eluted with 50:1 CH2Cl2:CH3OH gave pure II (1.8 g from (-)-camphene and 1 g from (+) -camphene) as crystalline solid. The NOE difference spectrum of II showed a NOE signal increase of methylene side chain protons (3.64 ppm) upon irradiation of H-7 proton (1.62 ppm) . This evidence strongly suggests 3- hydroxymethylation of (+) or (-)-II at the exo-position.
Example 2 Synthesis of (+) and ( - ) -2 , 2 -dimethyl -3 -hvdroxymethyl- norbornanes (III)
A reaction mixture of (+) or (-) -camphene I (70 g, 0.5 mole) in 500 ml of 2-methoxyethyl ether was stirred at room temperature and under a blanket of slight positive atmospheric nitrogen pressure. To this was added dropwise a IM B2H6-THF complex (167 ml) over a period of 15 minutes. The reaction mixture was heated at 80°C (oil bath temperature) overnight, and then cooled to ice bath temperature. A 800 ml 4N NaOH solution was added dropwise followed by 70 ml of 30% H202. The reaction mixture was then extracted with diethyl ether twice (500 ml each) , dried over Na2S04 and the low boiling point solvents were evaporated. The high boiling point 2-methoxyethyl ether was removed by high vacuum distillation and the crystalline solid residue of III was collected (63 g for (+) -I and 67 g for (-)-I). The 1H nmr spectrum showed two proton multiple peaks at 3.5 ppm for methylene protons of side chain (the NOE difference spectrum of III showed that the increase of the NOE signal of methylene side chain protons (3.5 ppm) upon irradiation of H-7 proton (1.56 PPM) . This evidence suggests that 3-hydroxymethyl group was at the exo- position of the norbornane ring. Example 3 Synthesis of (+) and ( - ) -2 , 2-dimethyl-3-formylmethyl- norbornanes (IV)
To a stirred reaction mixture of (+) or (-)-2,2- dimethyl-3 -hydroxymethyl-norboranes III (20 g, 0.13 mole) in 800 ml of dichloromethane was added 58.6 g (0.15 mole) of pyridium dichromate. The reaction mixture was stirred at room temperature for 36 hours. The dark slurry reaction mixture was purified by passing through a short silica gel column eluted with dichloromethane. The collected fractions were concentrated under vacuum to give IV in quantitative yield which was used without further purification.
Example 4 Synthesis of (+) and (-) -2.2-dimethyl-3- (2-propen-3-yl) - norbornanes (V)
Sodium hydride (3.35 g, 0.14 mole) was added to DMSO under nitrogen and the resulting suspension was heated at 80°C until the solution was clear and the evolution of hydrogen ceased. The resulting solution of methylsulfinyl carbanion was cooled in a ice bath, and (ethyl) triphenyl-phosphonium iodide (58.6 g, 0.14 mole) was added to give a deep orange color mixture . The ice bath was removed and the reaction mixture was stirred at least 10 minutes at room temperature before the aldehyde
IV (20 g, 0.12 mole) in 20 ml DMSO was added. The reaction mixture was kept at room temperature overnight, and then was poured into 400 ml of water. The aqueous phase was extracted three times with 500- , 300- and 150- ml portions of n-hexanes. The combined n-hexane layer was dried over MgS04 and evaporated to dryness . The residue was distilled in vacuo to give V (14.5 g for (+) -
V and 16 g for (-)-V) . The 1H nmr spectrum showed two olefinic protons as a multiplet at 5.5 ppm and one methyl group as a multiplet at 1.6 ppm. The broadband proton decoupling spectrum of V showed twelve peaks with two peaks at 125 and 130 ppm specific for olefinic carbons. Example 5 Synthesis of (+) and ( - ) -2 , 2-dimethyl-3- (2 , 3 -dihvdroxy- propan-3 -yl) -norbornanes (VI)
To an ice cooled mixture of (+) or (-)-V (10 g, 0.06 mole for (+) -V or 13 gm, 0.08 mole for (-)-V) in 150 ml of tert-butyl alcohol were added 30% hydrogen peroxide in water (8 ml for (+) -V and 9.1 ml for (-)-V) and 125 mg of osmium tetroxide as catalyst. This mixture was stirred and maintained at 0°C in a ice bath for 4 hours, and then at room temperature for 20 hrs. A slurry of 5 g of magnesium silicate, 500 mg of sodium hydrogen sulfite, and 20 ml of water was added, and the magnisol was filtered. The filtrate was concentrated and the residue was added to methylene chloride . The methylene chloride solution was washed with brine twice, dried over MgS04 and evaporated to dryness. Column chromatography of the crude mixture over silica gel eluted with 50:1 CH2C12:CH30H gave pure VI (1.82 g from (-)-V and 2 g from (+) -V) as an oily liquid.
Example 6 Induction of melanogenesis in S91 mouse melanoma cells by (+) and ( - ) -2 , 2-dimethyl-3-hydroxy-3 -hydroxymethyl- norbornanes (II), (+) and ( - ) -2 , 2-dimethyl-3- hydroxymethylnorbornanes (III), and, (+) and (-)-2,2- dimethyl-3- (2 , 3-dihydroxy-propan-3-yl) -norbornanes (VI)
Cloudman S91 mouse melanoma cells were obtained from ATCC and cultured in MEM (BioWhittaker) with 10% calf serum (BioWhittaker or HyClone) . Cells were plated at 0.1 X106 cells/well (~50% plating efficiency = 0.05 X 106 viable cells/well) in 6-well plates the day before treatments, in media containing 10% calf serum. Media was changed to MEM with 2% calf serum concomitant with addition of treatments. Treatments were dissolved in ethanol as 0.5M solutions which was added in appropriate volumes directly to cell culture media (Brown, et al . , 1998, J. Invest . Dermatol . 110:48-437). Six days later, cells were examined microscopically, and the percentage of differentiated (multipolar) cells was estimated by counting random fields. Cells were then trypsinized, counted, pelleted and analyzed for tyrosinase activity. Cellular pellets were solubilized by sonicating for 5 seconds in 600 ul 50 mM phosphate buffer pH 6.8 containing 0.5% Triton-XlOO, followed by vortexing, incubation on ice for 30 min, and then revortexing. From this, 200 ul aliquots were combined with 200 ul of reaction mixture containing either 75 uM tyrosine, 75 uM L-Dopa, and 2 uCi L- [3 , 5-3H] Tyrosine in 50 mM NaP04 pH 6.8 (L-Dopa +) , or, 75 uM tyrosine, and 2 uCi L- [3, 5-3H] Tyrosine in 50 mM NaP04 pH 6.8 (L-Dopa -), and then incubated 1 hr at 37°C. Reactions were stopped by addition of 400 ul 10% activated charcoal in 0. IN HCl and incubation on ice for 15 min. This mixture was centrifuged at 17,300 X g for 5 min, and 400 ul supernatant was then filtered through a 0.22 uM GV Durapore centrifugal filter unit (Millipore) by centrifuging at 17,300 X g for 5 min. Filtrate was added to 4 ml Fisher Plus scintillation fluid and counted on a Hewlett Packard 2000A scintillation counter. Tyrosinase activity was calculated as dpm/hr/103 cells. Each sample was analyzed with and without L-Dopa, a necessary cofactor for tyrosinase; all reported tyrosinase values are exclusive of counts that occurred in buffer blanks and L-dopa negative aliquots (Brown, et al . , 1998, J". Invest . Dermatol . 110:48-437)
Table 1 Cells %Multi- Tyrosinase Tyrosinase (X106) Polar dpm/hr/103 Induction
Control 0, .674 5% 373 1.0X
100 uM I 0. .752 10% 804 2.2X
500 uM I 0. .359 50% 2070 5.5X
1000 uM I 0, .193 75% 4129 11. IX
2500 uM I 0, .079 100% 11295 30.3X 50 uM II- 0.433 20% 1091 2.9X
100 uM II- 0.339 35% 1524 4. IX
500 uM II- 0.279 50% 1880 5. OX
1000 uM II- 0.154 75% 2735 7.3X
50 uM 11+ 0.334 50% 1255 3.4X
100 uM 11+ 0.118 75% 3724 10. OX
500 uM 11+ 0.076 100% 7922 21.3X
1000 uM 11+ 0.049 100% 5767 15.5X
100 uM III- 0.694 25% 825 2.2X
500 uM III- 0.185 100% 1680 4.5X
1000 uM III- 0.153 100% 3070 8.2X
2500 uM III- 0.098 100% 4284 11.5X
50 uM III+ 0.634 10% 699 1.9X
100 uM III+ 0.357 35% 1626 4.4X
500 uM III+ 0.306 75% 2432 6.5X
1000 uM III+ • 0.142 100% 3461 9.3X
50 uM VI- 0.216 75% 1429 3.8X
100 uM VI- 0.189 75% 3001 8. OX
250 uM VI- 0.186 100% 5396 14.5X
50 uM VI+ 0.667 25% 1285 3.4X
100 uM VI+ 0.394 50% 1444 3.9X
500 uM VI+ 0.108 100% 4200 11.3X
1000 uM VI+ 0.044 100% 7630 20.5X
50 uM VII 0.434 25% 593 1.6X
100 uM VII 0.485 25% 516 1.4X
250 uM VII nonadherent
I: (1R,2R,3S, 5R) - (-) -pinanediol
II- : (-) -2, 2-dimethyl-3-hydroxy-3-hydroxymethyl- norbornane 11+ : (+) -2 , 2-dimethyl-3-hydroxy-3-hydroxymethyl- norbornane
III-: (-) -2 , 2-dimethyl-3 -hydroxymethyl-norbornane
III+ : (+) -2 , 2 -dimethyl-3 -hydroxymethyl-norbornane
VI- : (-) -2, 2-dimethyl-3- (2, 3-dihydroxy-propan-3-yl) - norbornane
VI+ : (+) -2 , 2 -dimethyl-3- (2 , 3-dihydroxy-propan-3-yl) - norbornane
VII: 3 -ethyl-2-aldehyde-pinane
Treatment of S91 cells showed that the compounds of this invention induce significant melanogenic activity, and are more potent than one of the most active compounds [ (IR, 2R, 3S, 5R) - ( - ) -pinanediol] described in co-pending application PCT/US98/05346. For example, only 100 uM 11+ was required to induce a 10-fold increase of tyrosinase activity in S91 cells, whereas 1000 uM (IR, 2R, 3S, 5R) - ( - ) - pinanediol was required for this same level of induction (Table 1) . VI- was nearly as active as II+, inducing an
8-fold increase of tyrosinase at 100 uM (Table 1) .
Melanogenic activity of this class of compounds is dependent on enantiomeric configuration, as demonstrated by the fact that II- and VI+ were much less potent than 11+ and VI- (Table 1) . The alcohol enantiomers (III- and III+) induced much less melanogenic than the most potent diols (11+ and VI-), substantiating our previous finding that alcohols are usually less potent inducers of melanogenesis than diols (Brown, et al . , J. Invest . Dermatol . 110:428-437, and PCT/US98/05346) .
The compounds of this invention result both in induction of cell cycle arrest and differentiation of S91 mouse melanoma cells, indicating that they have potential use as chemotherapeutic differentiation agents. It can be seen in Table 1, that following a 6 day treatment period, the compounds of this invention result in a reduction of cell numbers below that of untreated controls. However, the compounds of this invention are considered to be cytostatic (induce cell cycle arrest) rather than cytotoxic since: (i) they did not result in a reduction of cell number below the number originally plated (0.05 X 106 viable cells/treatment), (ii) reductions of cell number relative to controls were accompanied by induction of the multipolar phenotype and induction of tyrosinase, both well-known markers of differentiation, and, (iii) there was no apparent detachment of cells from dishes as indicated by a lack of cells floating in the media. In contrast, 3-ethyl-2- aldehyde-pinane resulted in detachment of cells from dishes with little induction of markers of differentiation (Table 1) .
Previously, we have found that monoterpene diols result in induction of melanogenesis in S91 mouse melanoma cells by stimulating the nitric oxide/cyclic GMP/protein kinase G signal transduction pathway (PCT/US98/05346) . Thus, it is contemplated that the novel monoterpene diols of the present invention, will also induce melanogenesis by this same pathway. Since monoterpene diols that induced melanogenesis by the nitric oxide/cyclic GMP/protein kinase G pathway, also induced differentiation of neuronal cells (PCT/US98/05346) , it is contemplated that the novel monoterpene diols of this invention will have a similar activity in neuronal cells. Furthermore, it is contemplated that the novel monoterpene diols of this invention will have the potential to treat diseases remedied by stimulation of the nitric oxide/cyclic GMP/protein kinase G as described for monoterpene diols in PCT/US98/05346. Thus, all of the uses described for monoterpene diols in PCT/US98/05346 are contemplated to apply to the compounds of the present invention. Example 7 Induction of tanning in human skin by (+) -2 , 2-dimethyl-3 - hvdroxy-3 -hydroxymethyl-norbornanes (11+) , and, (-)-2,2- dimethyl-3- (2 , 3-dihvdroxy-propan-3-yl) -norbornanes (VI-) Compounds of the present invention were formulated for application to human skin using compositions described in PCT/US98/05346 and co-pending application Serial No. filed April 6, 1998 entitled
"Dermatological Formulations and Methods", the contents of both of which are incorporated herein by reference. Each formulation contained 50% α-hydroxy acid (AHA) face cream (CVS generic containing 8% AHA; therefore final concentration of AHA in formulation was 4%) , 35% isopropyl alcohol (Fisher) , the indicated amounts of each compound (Table 2) , and deionized water as required to bring the volume up to 100%. The vehicle control solution contained 50% AHA face cream, 35% isopropyl alcohol, and 15% deionized water. Ten ul of each formulation was applied twice per day for 10 days, followed by application of 10 ul once per day for the remainder of the application period. The treatment spots were along the anterior forearm which correspond to the region of the forearm closest to the body when at rest. The Vehicle control was closest the elbow and VI- was closest the wrist, with the other treatment spots along the arm in the order given in Table 2. The treated individual was Caucasian with an untanned (pale) forearm prior to treatment.
The degree of pigmentation was estimated each day prior to the first treatment, using a subjective rating system as follows: 0 = no change from background; +0.25 = slight darkening, indistinct; 0.5 = slight darkening; +1 = slight-moderate darkening; +2 = moderate, even darkening; +3 = substantial, even darkening; +4 = profound, even darkening (from Brown, et al . , 1998, J. Invest. Dermatol . 110:428-437). The following results were obtained: Table 2
Pigmentation Ratings
Treatment Day 2 4
Vehicle
0.1M (2R,3S) - (-) -PD1 0 0 0.25 0.25
0.25M (2R,3S) - (-) -PD 0 0 0.25 0.75
1.0M (2R,3S) - (-) -PD 0 0 0.5 0.75
0.1M (IR) -2, 3-c/e-BD2 0 0 0.25 0.75
0.1M II+3 0 0.25 0.5 0.5
0.1M VI-4 0 0 0.5 0.5
1(2R,3S) - (-) -PD: (IR, 2R, 3S, 5R) -(-) -pinanediol (AGID 1090 in
2 (IR) -2, 3-c/e-BD: (IR) -2 , 3 -cis/exo-bornanediol (AGID 1107 i
3II+: (+) -2 , 2 -dimethyl- 3 -hydroxyl- 3 -hydroxymethyl -norbornan
4VI-: (-) -2 , 2-dimethyl-3- (2, 3-dihydroxyl-propan-3-yl) -norbo
See also Figure 1, which is a photograph of the subject skin taken on day 14.
Results show that 11+ and VI- were 5- and 10-fold more potent, respectively, than (2R, 3S) - (-) -PD with regards to induction of tanning when applied to human skin (compare 14 day 0. IM treatment results in Table 2) . Thus, results for induction of melanogenesis in human skin by these compounds (Table 2) parallel those for induction of melanogenesis in cell culture (Table 1) . However, (IR) -2 , 3 -c/e-BD which was only about 2-fold more potent than (2R, 3S) - ( - ) -PD in cell culture (see Table 20 in PCT/US98/05346) , was 5-fold more potent when applied to human skin (compare 14 day 0. IM treatment results in Table 2) . Some of these differences may be related to the ability of individual compounds to penetrate human skin, a property that is relatively unimportant in cell culture tests. In this regard, it is interesting to note that even though 1+ and VI- exhibit nearly identical melanogenic potency in cell culture (Table 1), by day 14, VI- has resulted in approximately twice as much skin pigmentation as 11+ (Table 2) . However, unlike pure 11+ which is a crystalline substance, pure VI- is a liquid; this is a property that is known to highly favor skin penetration (Barry, B. W. 1983. Dermatological Formulations: Percutaneous Absorption, Marcel Dekker, Inc., New York, p. 480) . Thus, the ability of compounds to induce tanning in human skin is likely to depend not only on their intrinsic melanogenic activity, but also on their ability to penetrate skin. Given these findings, VI- [ (-) -2, 2-dimethyl-3- (2 , 3-dihydroxy-propan-3-yl) - norbornane] is a preferred compound for incorporation into cosmeceutical tanning formulations.
Part of the rationale for the design of VI- [(-)-
2 , 2-dimethyl-3 - (2 , 3-dihydroxy-propan-3-yl) -norbornane] was to produce a structural analog of tetrahydrobiopterin that presented a protruding propanediol side chain similar to tetrahydrobiopterin. Additionally, the seminal discovery in this series of inventions was that 1, 2-propanediol (propylene glycol) induces melanogenesis, and most additional compounds of these inventions contain propylene glycol embodied within their structures. Tetrahydrobiopterin is a necessary co- factor for induction of nitric oxide synthase and resultant nitric oxide synthesis. The family of compounds embodied by this invention and related inventions are thought to exert their effects via the nitric oxide signal transduction pathway (discussed above) . Therefore, it is contemplated that the relatively high potency of VI- may be related, in part, to its structural similarity to tetrahydrobiopterin with regards to a protruding propanediol substituent group.

Claims

1. A compound having the structure
Figure imgf000030_0001
wherein
A is a substituted or unsubstituted cyclic terpene; R_ , R2, R8 and R9 are all -OH; and R3, R4, R5, Rs, R? an<^ Rιo are each independently hydrogen, or a linear or branched, cyclic, bicyclic or polycyclic group containing from one atom to fifty atoms, at least one of which is carbon, nitrogen, oxygen, or sulfur.
2. A compound according to claim 1, wherein A is a substituted or unsubstituted bicyclic terpene.
3. A compound according to claim 1, wherein R4, R5, Rβ and R10 are each hydrogen; and R3 and R7 are each hydrogen or methyl .
4. A compound according to claim 1, wherein A is a substituted or unsubstituted moiety having the skeleton of (+) or (-) -camphenes; (+) or (-) -camphor; ( - ) -β- pinenes and 2- or 3-carenes; (-) -myrtenol; or (-)- verbenol and their derivatives.
5. A compound according to claim 1, wherein the compound is selected from the group consisting of (-)-
2 , 2-dimethyl-3 -hydroxy-3 -hydroxymethyl-norbornane; (+) - 2 , 2dimethyl-3-hydroxy-3-hydroxymethyl-norbornane; (-) - 2 , 2-dimethyl-3 - (2 , 3-dihydroxy-propan-3-yl) -norbornane; and (+) -2, 2-dimethyl-3 - (2 , 3-dihydroxy-propan-3-yl) - norbornane .
6. A method for the stimulation of melanogenesis in mammalian skin, hair, wool or fur, which comprises administering to a locus in need of such stimulation an effective amount of at least one compound having the structure :
Figure imgf000031_0001
wherein
A is a substituted or unsubstituted cyclic terpene; Rι; R2, R8 and R9 are all -OH; and R3, R4, R5, Rε, R7 an<^ Rιo are each independently hydrogen, or a linear or branched, cyclic, bicyclic or polycyclic group containing from one atom to fifty atoms, at least one of which is carbon, nitrogen, oxygen, or sulfur.
7. A method according to claim 6, wherein A is a substituted or unsubstituted bicyclic terpene.
8. A method according to claim 6, wherein R4, R5, R6 and R10 are each hydrogen; and R3 and R7 are each hydrogen or methyl .
9. A method according to claim 6, wherein A is a substituted or unsubstituted moiety having the skeleton of (+) or (-) -camphenes; (+) or (-) -camphor; ( - ) -β- pinenes and 2- or 3-carenes; (-) -myrtenol ; or (-)- verbenol and their derivatives.
10. A method according to claim 6, wherein the compound is selected from the group consisting of (-)- 2,2-dimethyl-3 -hydroxy-3 -hydroxymethyl-norbornane ; (+) - 2 , 2-dimethyl-3-hydroxy-3-hydroxymethyl-norbornane; (-) - 2 , 2-dimethyl-3- (2,3 -dihydroxy-propan-3-yl) -norbornane; and (+) -2 , 2 -dimethyl-3 - (2, 3-dihydroxy-propan-3-yl) - norbornane .
11. A method for the treatment of proliferative, tumorous or cancerous disorders in mammals, which comprises administering to a mammal in need of such treatment an effective amount of at least one compound having the structure :
Figure imgf000032_0001
wherein
A is a substituted or unsubstituted cyclic terpene; R1, R2, R8 and R9 are all -OH; and R3, R4, R5, R6, R7 an< Rio are each independently hydrogen, or a linear or branched, cyclic, bicyclic or polycyclic group containing from one atom to fifty atoms, at least one of which is carbon, nitrogen, oxygen, or sulfur.
12. A method according to claim 11, wherein A is a substituted or unsubstituted bicyclic terpene.
13. A method according to claim 11, wherein R4, R5, R6 and R10 are each hydrogen; and R3 and R7 are each hydrogen or methyl .
14. A method according to claim 11, wherein A is a substituted or unsubstituted moiety having the skeleton of (+) or (-) -camphenes; (+) or (-) -camphor; (-) -β- pinenes and 2- or 3-carenes; (-) -myrtenol; or (-)- verbenol and their derivatives.
15. A method according to claim 11, wherein the compound is selected from the group consisting of (-)-
2 , 2-dimethyl-3-hydroxy-3 -hydroxymethyl-norbornane; (+) - 2 , 2-dimethyl-3-hydroxy-3 -hydroxymethyl-norbornane; (-) - 2 , 2 -dimethyl-3 - (2 , 3-dihydroxy-propan-3-yl) -norbornane; and (+) -2, 2-dimethyl-3- (2 , 3 -dihydroxy-propan-3-yl) - norbornane .
16. The composition of claim 11, wherein the disorder is selected from the group consisting of actinic keratosis, basal cell carcinoma, squamous cell carcinoma, fibrous histiocytoma, dermatofibrosarcoma protuberans, hemangioma, nevus flammeus, xanothoma, Kaposi's sarcoma, mastocytosis, mycosis fungoides, lentigo, nevocellular nevus, lentigo maligna, malignant melanoma, metastatic carcinoma, psoriasis vulgaris, psoriasis eosinophilia, acne vulgaris, acne conglobata, acne fulminans, osteoma cutis, nodulocystic acne, and cystic acne.
17. A method for the treatment of neurodegenerative disorders or nerve damage in mammals, which comprises administering to a mammal in need of such treatment an effective amount of at least one compound having the structure :
Figure imgf000033_0001
wherein
A is a substituted or unsubstituted cyclic terpene; Rι r R2, R8 and R9 are all -OH; and R3j R4j R5_ R6 R7 and R10 are each independently hydrogen, or a linear or branched, cyclic, bicyclic or polycyclic group containing from one atom to fifty atoms, at least one of which is carbon, nitrogen, oxygen, or sulfur.
18. A method according to claim 17, wherein A is a substituted or unsubstituted bicyclic terpene.
19. A method according to claim 17, wherein R4, R5, R6 and R10 are each hydrogen; and R3 and R7 are each hydrogen or methyl .
20. A method according to claim 17, wherein A is a substituted or unsubstituted moiety having the skeleton of (+) or (-) -camphenes ; (+) or (-) -camphor; ( - ) -β- pinenes and 2- or 3-carenes; (-) -myrtenol ; or (-)- verbenol and their derivatives.
21. A method according to claim 17, wherein the compound is selected from the group consisting of (-)- 2 , 2-dimethyl-3 -hydroxy-3-hydroxymethyl-norbornane ; (+) - 2 , 2-dimethyl-3-hydroxy-3 -hydroxymethyl-norbornane; (-) - 2 , 2-dimethyl-3- (2 , 3-dihydroxy-propan-3-yl) -norbornane; and (+) -2, 2 -dimethyl-3- (2, 3 -dihydroxy-propan-3-yl) - norbornane .
22. A method according to claim 17, wherein the treatment reverses neuronal damage .
23. A method according to claim 17, wherein the treatment alleviates a neurodegenerative disease.
24. A method according to claim 23, wherein the disease is selected from the group consisting of Parkinson's disease, amyotrophic lateral sclerosis, Alzheimer's disease, diffuse cerebral cortical atrophy, Lewy-body dementia, Pick disease, mesolimbocortical dementia, thalamic degeneration, Huntington chorea, cortical-striatal-spinal degeneration, cortical-basal ganglionic degeneration, cerebrocerebellar degeneration, familial dementia with spastic paraparesis, polyglucosan body disease, Shy-Drager syndrome, olivopontocerebellar atrophy, progressive supranuclear palsy, dystonia musculorum deformans, Hallervorden-Spatz disease, Meige syndrome, familial tremors, Gilles de la Tourette syndrome, acanthocytic chorea, Friedreich ataxia, Holmes familial cortical cerebellar atrophy, Gerstmann- Straussler-Scheinker disease, progressive spinal muscular atrophy, progressive balbar palsy, primary lateral sclerosis, hereditary muscular atrophy, spastic paraplegia, peroneal muscular atrophy, hypertrophic interstitial polyneuropathy, heredopathia atactica polyneuritiformis, optic neuropathy, and ophthalmoplegia.
25. A method of treating a disease regulated by the nitric oxide/cyclic GMP/protein kinase G pathway in mammals which comprises administering to a mammal in need of such treatment an effective amount of at least one compound having the structure:
Figure imgf000035_0001
wherein
A is a substituted or unsubstituted cyclic terpene; R1# R2, R8 and R9 are all -OH; and R3; R4/ R5 R6 R7 and R10 are each independently hydrogen, or a linear or branched, cyclic, bicyclic or polycyclic group containing from one atom to fifty atoms, at least one of which is carbon, nitrogen, oxygen, or sulfur.
26. A method according to claim 25, wherein A is a substituted or unsubstituted bicyclic terpene.
27. A method according to claim 25, wherein R4, R5, Rs and R10 are each hydrogen; and R3 and R7 are each hydrogen or methyl .
28. A method according to claim 25, wherein A is a substituted or unsubstituted moiety having the skeleton of ( +) or (-) -camphenes; ( + ) or (-) -camphor; (-)-?- pinenes and 2- or 3-carenes; (-) -myrtenol ; or (-)- verbenol and their derivatives.
29. A method according to claim 25, wherein the compound is selected from the group consisting of (-)- 2 , 2-dimethyl-3-hydroxy-3-hydroxymethyl-norbornane; (+) - 2 , 2-dimethyl-3-hydroxy-3 -hydroxymethyl -norbornane; (-) - 2, 2-dimethyl-3- (2 , 3-dihydroxy-propan-3-yl) -norbornane; and ( + ) -2 , 2 -dimethyl-3 - (2 , 3-dihydroxy-propan-3-yl) - norbornane .
30. The method of claim 25, wherein the treated disease is selected from the group consisting of heart disease, hypertension, stroke, chronic obstructive pulmonary disease, adult respiratory distress syndrome, microvascular functional abnormalities in diabetes, hemostatic irregularities of glomerular vascular and tubular function, microvascular irregularities in the liver, disorders of bladder function and reflex relaxation for micturition, disorders of neurotransmitter release, neuron morphogenesis, synaptic plasticity, and neuroendrocrine regulation, migraine headaches, benign anal disease, and impotence.
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