Classifications

• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07J—STEROIDS
  • C07J9/00—Normal steroids containing carbon, hydrogen, halogen or oxygen substituted in position 17 beta by a chain of more than two carbon atoms, e.g. cholane, cholestane, coprostane
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
  • A61K31/575—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of three or more carbon atoms, e.g. cholane, cholestane, ergosterol, sitosterol
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
  • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
  • A61K47/54—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
  • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
  • A61K47/54—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound
  • A61K47/542—Carboxylic acids, e.g. a fatty acid or an amino acid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
  • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
  • A61K47/54—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound
  • A61K47/543—Lipids, e.g. triglycerides; Polyamines, e.g. spermine or spermidine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
  • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
  • A61K47/54—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound
  • A61K47/554—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound the modifying agent being a steroid plant sterol, glycyrrhetic acid, enoxolone or bile acid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
  • A61P1/16—Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
  • A61P3/06—Antihyperlipidemics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
  • A61P3/08—Drugs for disorders of the metabolism for glucose homeostasis
  • A61P3/10—Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P7/00—Drugs for disorders of the blood or the extracellular fluid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
  • A61P9/10—Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07J—STEROIDS
  • C07J41/00—Normal steroids containing one or more nitrogen atoms not belonging to a hetero ring
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07J—STEROIDS
  • C07J41/00—Normal steroids containing one or more nitrogen atoms not belonging to a hetero ring
  • C07J41/0005—Normal steroids containing one or more nitrogen atoms not belonging to a hetero ring the nitrogen atom being directly linked to the cyclopenta(a)hydro phenanthrene skeleton
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07J—STEROIDS
  • C07J41/00—Normal steroids containing one or more nitrogen atoms not belonging to a hetero ring
  • C07J41/0033—Normal steroids containing one or more nitrogen atoms not belonging to a hetero ring not covered by C07J41/0005
  • C07J41/0055—Normal steroids containing one or more nitrogen atoms not belonging to a hetero ring not covered by C07J41/0005 the 17-beta position being substituted by an uninterrupted chain of at least three carbon atoms which may or may not be branched, e.g. cholane or cholestane derivatives, optionally cyclised, e.g. 17-beta-phenyl or 17-beta-furyl derivatives

Definitions

• the present invention relates to new uses of certain bile acid or bile salt fatty acid conjugates.
• G is a bile acid or bile salt radical, which if desired, is conjugated in position 24 with a suitable amino acid
• W stands for one or two fatty acid radicals having 18-22 carbon atoms
• X stands for a NH bond between said bile acid or bile salt radical and the fatty acid(s).
• Said BAFACS and pharmaceutical compositions comprising same can also be used in the treatment of said diseases.
• the bond has to be a solid bond that is not substantially deconjugated by intestinal and/or bacterial enzymes during the process of absorption.
• An ester bond is thus not suitable since it is easily deconjugated.
• the bond stands in particular for NH but may also stand for other suitable bonding members, e.g. S, P, 0-ether, etc.
• the bond can be in the alpha or beta configuration and can be attached in various positions of the bile acid molecule, positions 3, 6, 7, 12 and 24 being preferred.
• Hypercholesterolemia is deleterious to health. It is a causative factor in several major disease processes such as ischemic heart disease, myocardial infarction, peripheral vascular disease, possibly stroke, etc. Reduction of cholesterol concentration in blood is beneficial or preventive in some of said diseases.
• Current medical treatment of hypercholesterolemia is aimed at reducing endogenous cholesterol synthesis in the liver.
• the statins used for this purpose inhibit the enzyme HMG CoAReductase.
• HMG CoAReductase enzyme
• a major portion of body cholesterol originates from dietary cholesterol. Diet restrictions are notoriously ineffective.
• Ion exchange resins have also been used to bind bile acids (products of cholesterol catabolism) and sequester them in the intestinal lumen leading to their fecal excretion. They have some effect on blood cholesterol but also important side effects which limit their use.
• BAFACs II reduce diet induced hypercholesterolemia in several animal species even as the animals continue to consume the high cholesterol, high fat diet.
• Fatty liver is one of the most common liver diseases today. It is due to excessive accumulation of fat in the liver. It is demonstrated histologically by the presence of variable amounts of micro and/or macro vesicular fat droplets in the liver tissue. Fatty liver can be caused by drugs, chemicals, diseases, bacteria, etc. but the main cause is excessive dietary intake leading to (mainly truncal) obesity.
• BAFACs II can reduce and prevent fatty liver. This has also been demonstrated during continuation of the excessive dietary intake in several animal species.
• Diabetes mellitus is a disorder of carbohydrate (glucose) metabolism. It is schematically divided into type 1 , insulin dependent diabetes mellitus (IDDM) characterized by insulin deficiency and type 2, not insulin dependent diabetes mellitus (NIDDM) in which there is mainly insulin resistance. NIDDM is often associated with obesity and/or fatty liver. There are also other causes of hyperglycemia. Treatment of diabetes mellitus involves diet, insulin injections and/or oral hypoglycemic drugs. The aim of therapy is to normalize blood glucose levels. Diabetes, particularly poorly controlled diabetes leads to severe complications.
• BAFACs reduce and normalize blood glucose levels in animal models of IDDM and NIDDM.
• Carbohydrates 50%, Protein 21%, Fat 4% with mineral, fiber, and vitamin supplements (manufactured by Koffolk, Petach Tiqwa, Israel).
• Figs. 1A, 1 B and 1C show fasting blood glucose concentrations in rodents on different regimens with or without BAFAC (150 mg/kg/day), i.e.: Fig. 1 A for Rats (4w) Fig. 1B for Hamsters (3w) Fig. 1C for Mice (16d) and
• Fig. 2 shows the lipid/protein ratio in the liver of inbred C57J/L mice fed a high fat diet +/- BAFAC (150 mg/kg/day) for five weeks.
• mice Inbred C57J/L male mice (Jackson Lab., Maine, USA) 4-6 weeks old weighing 20-25 gm were used. They were given their regular diet supplemented with (%w/w) Butter fat 15, Cholesterol 1 , Cholic Acid 0.5, Corn Oil 2 (modified from.Khanuia et al., Proc.Natnl.Acad.Sci.USA 1995:92:7729-33) for 4-8 weeks.(Lithogenic diet #2) Half of the group were given 3 ⁇ -arachidylamido-7 ⁇ ,12 ⁇ - dihidroxy-5 ⁇ - cholan-24-oic acid at a dose of 150 mg/kg/day suspended in saline by intragastric gavage. The other half were similarly given an equal volume of saline. After 4-8 weeks the animals were anesthetized, heart blood was drawn for analysis. The liver and other organs were removed. Serum cholesterol levels were determined by autoanalyzer.
• mice C57 J/L male inbred mice (Jackson Laboratories, Maine, USA) 4-6 weeks old weighing20-25 gm. were given a lithogenic diet (No.2) for 8 weeks and then a regular diet for another 8 weeks. During the 8 weeks of the regular diet part of the animals were given 3 ⁇ -arachidylamido-7 ⁇ ,12C ( - dihidroxy-5 ⁇ - cholan-24-oic acid by intragastric gavage at a dose of 150 mg/kg/day. After a total of 16 weeks the animals were anesthetized, heart blood was drawn for analysis. Liver and other organs were removed. Serum cholesterol levels were analyzed as above. A third group of animals were given a regular diet throughout the 16 weeks and then similarly analyzed. The number of animals in each group and the results are given in the following Table 1
• the presence of fatty liver was evaluated by a pathologist unaware of the treatments, scoring coded slides in a blinded manner.
• the scoring system was as follows:
• mice C57 male inbred mice (Jackson Lab., Maine, USA) 4-6 weeks old weighing 20-25 gm were used. They were fed a" Western" diet (George et.al.Circulation 2000,102:1822-27) containing cholesterol 1.5 gm/kg and Fat 42%, Carbohydrates 43%), and Protein 15% (as % of calories). Half were given in addition 150 mg/kg/day of 3 ⁇ -arachidylamido-7 ⁇ ,l2 ⁇ -dihidroxy-5 ⁇ -cholan-24-oic acid suspended in saline by intragastric gavage. The other half were similarly given saline only. After 4 weeks the animals were anesthetized and sacrificed. Liver and other organs were removed and placed in formaline prior to histologic examination
• the hamsters and rats on the high fat diets developed fatty liver (confirmed by chemical measurement of liver fat), a high fasting blood glucose, and represented models of NIDDM.
• mice 4 weeks old (approx. 20gm) were fed a regular diet. Streptozotocin 200 mg/kg was injected i.p. on the first day of the experiment. (This induced damage to the islet cells of the pancreas and simulated IDDM). Fasting blood glucose was obtained from sacrificed animals after 16 days of the trial. There were 3 groups of 7 animals each. Controls - regular diet only. Streptozotocin (Stz) treated animals receiving saline only by gavage and streptozocin treated animals receiving 150mg/kg/day of BAFAC by gavage. The BAFAC used in all these hyperglycemia studies was a conjugate of arachidic and cholic acid (at position 3) using an amide bond (C-20 BAFAC, Aramchol).
• mice 4 weeks old and weighing approx. 20gm (Jackson Lab. Maine, USA) were used. They were fed for 5 weeks a high fat lithogenic diet consisting of: Cholesterol 1%, Cholic Acid 0.5%, lard 10%, butter 6%, palmitic acid 1.2% and corn oil 2% added (w/w) to their regular diet. In addition to the diet the animals were given daily, by gavage, either a BAFAC(150mg/Kg) suspended in saline or an equal volume of saline only.
• a high fat lithogenic diet consisting of: Cholesterol 1%, Cholic Acid 0.5%, lard 10%, butter 6%, palmitic acid 1.2% and corn oil 2% added (w/w) to their regular diet.
• a high fat lithogenic diet consisting of: Cholesterol 1%, Cholic Acid 0.5%, lard 10%, butter 6%, palmitic acid 1.2% and corn oil 2% added (w/w) to their regular diet.
• the animals
• the BAFACs were conjugates of cholic acid (at position 3) with either Palmitic Acid (C-16) or Arachidic Acid (C-20) or Behenic Acid (C-22) using an amide bond.
• the animals were anesthetized using ketamine, the liver was removed, and the animals were sacrificed by ketamine overdose.
• a 0.5gm sample of liver was homogenized in 5ml of buffered saline.
• Liver lipids were extracted from the homogenate by the Folch method using chloroform: methanol (2:1 , vol/vol). Half a ml of the homogenate were extracted in 5ml of the Folch solution. After evaporation of the solvent the lipids were weighed and reevaporated several times until constant weight was obtained. The proteins were quantified in another aliquot of the homogenate according to the method of Bradford. (Bradford M.M., Annal. Biochem. 1976,72:248)
• the lipid protein ratio (mg/mg) was calculated.
• the results for each group are given as means (+St. Dev.) The group values were:

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