WO2003012051A2 - Inhibitor of dna methylation - Google Patents
Inhibitor of dna methylation Download PDFInfo
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- WO2003012051A2 WO2003012051A2 PCT/US2002/024223 US0224223W WO03012051A2 WO 2003012051 A2 WO2003012051 A2 WO 2003012051A2 US 0224223 W US0224223 W US 0224223W WO 03012051 A2 WO03012051 A2 WO 03012051A2
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- zebularine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/70—Carbohydrates; Sugars; Derivatives thereof
- A61K31/7042—Compounds having saccharide radicals and heterocyclic rings
- A61K31/7052—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
- A61K31/706—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
- A61K31/7064—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
- A61K31/7068—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines having oxo groups directly attached to the pyrimidine ring, e.g. cytidine, cytidylic acid
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- 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
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
- A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
- A61K31/513—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim having oxo groups directly attached to the heterocyclic ring, e.g. cytosine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/70—Carbohydrates; Sugars; Derivatives thereof
- A61K31/7042—Compounds having saccharide radicals and heterocyclic rings
- A61K31/7052—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
- A61K31/706—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
- A61K31/7064—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
- A61K31/7068—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines having oxo groups directly attached to the pyrimidine ring, e.g. cytidine, cytidylic acid
- A61K31/7072—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines having oxo groups directly attached to the pyrimidine ring, e.g. cytidine, cytidylic acid having two oxo groups directly attached to the pyrimidine ring, e.g. uridine, uridylic acid, thymidine, zidovudine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/70—Carbohydrates; Sugars; Derivatives thereof
- A61K31/7088—Compounds having three or more nucleosides or nucleotides
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
- A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
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- 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
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07H—SUGARS; DERIVATIVES THEREOF; NUCLEOSIDES; NUCLEOTIDES; NUCLEIC ACIDS
- C07H19/00—Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof
- C07H19/02—Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof sharing nitrogen
- C07H19/04—Heterocyclic radicals containing only nitrogen atoms as ring hetero atom
- C07H19/06—Pyrimidine radicals
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07H—SUGARS; DERIVATIVES THEREOF; NUCLEOSIDES; NUCLEOTIDES; NUCLEIC ACIDS
- C07H21/00—Compounds containing two or more mononucleotide units having separate phosphate or polyphosphate groups linked by saccharide radicals of nucleoside groups, e.g. nucleic acids
Definitions
- This disclosure relates to methods of inhibiting DNA methylation and methods of treating or ameliorating hypermethylation-related disease, using the compound Zebularine and related compounds.
- DNA methyltransferases also referred to as DNA methylases transfer methyl groups from the universal methyl donor S-adenosyl methionine to specific sites on a DNA molecule.
- DNA methyltransferases transfer methyl groups from the universal methyl donor S-adenosyl methionine to specific sites on a DNA molecule.
- Several biological functions have been attributed to the methylated bases in DNA. The most established biological function is the protection of the DNA from digestion by cognate restriction enzymes. The restriction modification phenomenon has been observed only in bacteria. Mammalian cells possess at least several methyltransferases; one of these (DNMT1) preferentially methylates cytosine residues on the DNA, which are 5' (upstream) neighbors of guanine (forming the dinucleotide CpG).
- a maternally-inherited copy of a gene is more highly methylated than the paternally-inherited copy, the paternally-inherited copy will be expressed more effectively.
- a gene when a gene is expressed in a tissue-specific manner, that gene often will be unmethylated in the tissues where it is active but highly methylated in the tissues where it is inactive.
- Zebularine is a potent inhibitor of methylation, and that it can specifically reactivate silenced tumor suppressor genes. Zebularine can be used to inhibit methylation and thereby combat certain diseases (including cancers that have been linked to hypermethylation) and activate methylation-silenced genes in plants, fungi, and animals. Substantially more stable than 5-azacytidine, Zebularine can be given orally, which is tremendously beneficial in the clinical setting.
- This disclosure provides methods of employing the hypomethylating activity of Zebularine (and derivatives, analogs, and mimetics), for instance to reduce or reverse DNA methylation, to inhibit, ameliorate, reverse, reduce or relieve methylation-linked diseases, conditions, and disorders, and to ameliorate or reduce a tumorigenic state of a tumor.
- the disclosure further provides kits for use in these methods.
- DNA and RNA oligonucleotides comprising Zebularine, 2'- deoxy-Zebularine and derivatives thereof; and pharmaceutical preparations comprising Zebularine and Zebularine derivatives.
- FIGURES Figure 1 shows the chemical structure of cytidine, and the cytidine analogs 5-azacytidine and Zebularine.
- Figure 2 is a schematic representation of the metabolism of 5-azacytidine and 5-aza- 2'deoxycytidine.
- Figure 3 is a schematic representation of the proposed metabolism of Zebularine and 2 ' deoxy-Zebularine .
- FIG. 4 shows Southern blots of DNA from N. crassa, showing the effects of 5-azacytidine (5-AC), trichostatin A (TSA) and Zebularine on DNA methylation of the am RIP and ⁇ 63 sequences.
- DNA was digested with Dpn II (D) or S ⁇ w3AI (S), fractionated by gel electrophoresis, transferred to a membrane and probed for am (Fig. 4A) or ⁇ 63 (Fig. 4B) sequences.
- Dpn II and Sau3Al both recognize the sequence GATC, but S ⁇ w3AI fails to cleave if the C residue is methylated.
- differences between S and D lanes are indicative of DNA methylation.
- the ramp symbols at the top of the figure represent increasing concentrations of drug. Drug concentrations were 12 and 24 ⁇ M 5-AC; 0.33 and 3.3 ⁇ M TSA; and 20, 39, 78, 160 and 310 ⁇ M Zebularine. The positions of selected size standards (kb) are indicated.
- FIG. 5 is a series of photographs of plate assays, showing reactivation of the silenced hph gene in Neurospora crassa by Zebularine.
- N. crassa strain N644 has a single copy of the E. coli hph gene that was silenced by cytosine methylation.
- the active hph gene confers hygromycin resistance.
- Treatments are indicated above each plate; the listed compound was applied to the paper discs in the middle of each plate.
- the "no hygromycin" plate all plates had 5 mg hygromycin B added in a 5 ml 0.7% agar overlay after 24 hours growth at 32 °C. The plates were then incubated an additional two days at the same temperature and photographed.
- Figure 6 is a series of photographs of plate assays, illustrating that the inhibitory growth effects of Zebularine on N. crassa do not depend on the dim-2 DNA methyltransferase.
- Figure 8 is a RT-PCR analysis, showing the level of pl6 mRNA produced in human T24 cells subjected to the indicated treatments. Parallel GAPDH mRNA levels are also shown; transcription of GAPDH is essentially unaffected by methylation.
- Figure 9 schematically illustrates the pl6 (Fig. 9A) and p3 (Fig. 9B) loci used for Ms-
- Figure 10 is a pair of bar graphs showing methylation status in T24 cells of pl6 promoter and exon 2 (Fig. 10A) and the corresponding level of toxicity (Fig. 10B) for the indicated treatments. Drug treatments are indicated below each bar.
- Figure 11 illustrates an analysis of the effects of long-term, continuous treatment of T24 cells with Zebularine.
- Fig. 11A is a RT-PCR analysis, showing the level of pl6 gene expression in T24 cells treated with either 50 ⁇ M or 100 ⁇ M of Zebularine for the indicated time points; two film exposure times (7 and 41 hours) are shown. As in Fig. 8, parallel GAPDH levels are shown for comparison.
- Figure 11B shows a quantitative summary of the levels of pl6 promoter and pl6 exon 2 methylation in T24 cells treated with the 100 ⁇ M Zebularine for the indicated times. The maximum demethylation observed after treatment with 100 ⁇ M Zebularine (from -96% to -47%) occurs at Day 14.
- Figure 12 shows Western blot analyses detecting levels of DNMT1 and DNMT3b3 for cells treated with Zebularine and untreated cells.
- Figure 13 is a graph of relative tumor volume vs. time for BALB/c nu/nu mice treated with Zebularine, showing suppression of tumor growth in treated groups.
- Figure 14 is a graph of body weight vs. time for BALB/c nu/nu mice treated with Zebularine, showing minimal weight loss for all treated groups.
- Figure 15 shows reactivation of pl6 gene expression in T24 cells by the indicated drugs.
- Figure 16 is a bar graph depicting the relative levels of pl6 promoter methylation for the indicated groups.
- Figure 17 shows a dose-dependent increase in Zebularine metabolites (pmoles/10 6 cells) in T24 cells after a 6 hr incubation period (10 ⁇ M, l ⁇ Ci).
- ZB, ZB-MP, ZB-DP and ZB-TP correspond, respectively, to Zebularine, 5'-mono, 5'-di- and 5'-triphosphate metabolites.
- Figure 18 shows a time course of metabolite levels in T24 cells after a 24 hr incubation period with Zebularine (ZB, 10 ⁇ M, l ⁇ Ci).
- Figure 19 is a bar graph depicting the relative incorporation of Zebularine into DNA and
- RNA in T24 cells showing that approximately 7 times the amount of Zebularine is incorporated into RNA as DNA.
- Figure 20 is a graph showing the relative inhibition of Hhal methyltransferase by oligonucleotides including either a 2'-deoxy-Zebularine or a 2'-deoxy-5-azacytidine.
- SEQ ID NO: 1 is a pl6 sense cDNA amplification primer.
- SEQ ID NO: 2 is a pl6 antisense cDNA amplification primer.
- SEQ ID NO: 3 is a GAPDH sense cDNA amplification primer.
- SEQ ID NO: 4 is a GAPDH antisense cDNA amplification primer.
- SEQ ID NO: 5 is apl ⁇ promoter/exon 1 sense primer for bisulfite-treated DNA amplification.
- SEQ ID NO: 6 is apl ⁇ promoter/exon 1 antisense primer for bisulfite-treated DNA amplification.
- SEQ ID NO: 7 is &pl ⁇ exon 2 sense primer for bisulfite-treated DNA amplification.
- SEQ ID NO: 8 is a pl6 exon 2 antisense primer for bisulfite-treated DNA amplification.
- SEQ ID NO: 9 is a P3 sense primer for bisulfite-treated DNA amplification
- SEQ ID NO: 10 is a P3 antisense primer for bisulfite-treated DNA amplification.
- SEQ ID NOs: 11, 12, and 13 are pl6 promoter/exon 1 SNuPE primers.
- SEQ ID NOs: 14, 15, and 16 are pl6 exon 2 SNuPE primers.
- SEQ ID NOs: 17, 18, and 19 are p3 SNuPE primers.
- SEQ ID NO: 20 is a Zebularine-derivatized oligonucleotide, where N re presents 2'-deoxy- Zebularine.
- 5-aza-CR also 5-azaC, 5-AC: 5-azacytidine
- FdCyd 5-fluorodeoxycytidine
- GM-CSF granulocyte macrophage colony stimulating factor
- IL-2 Interleukin 2
- TSA trichostatin A
- Alcohol refers to a chemical compound with the structure R-OH, wherein R is alkyl, especially lower alkyl (for example in methyl, ethyl or propyl alcohol).
- R is alkyl, especially lower alkyl (for example in methyl, ethyl or propyl alcohol).
- An alcohol may be either linear or branched, such as isopropyl alcohol.
- Alkyl refers to a cyclic, branched, or straight chain alkyl group containing only carbon and hydrogen, and unless otherwise mentioned contains one to twelve carbon atoms. This term is further exemplified by groups such as methyl, ethyl, n-propyl, isobutyl, t-butyl, pentyl, pivalyl, heptyl, adamantyl, and cyclopentyl. Alkyl groups can either be unsubstituted or substituted with one or more substituents, e.g.
- lower alkyl refers to a cyclic, branched or straight chain monovalent alkyl radical of one to five carbon atoms. This term is further exemplified by such radicals as methyl, ethyl, n-propyl, i-propyl, n-butyl, t-butyl, i-butyl (or 2-methylpropyl), cyclopropylmethyl, i-amyl, and n-amyl. Lower alkyl groups can also be unsubstituted or substituted, where a specific example of a substituted alkyl is 1,1 -dimethyl propyl.
- Alkoxy refers to a substituted or unsubstituted alkoxy, where an alkoxy has the structure -O-R, where R is substituted or unsubstituted alkyl. In an unsubstituted alkoxy, the R is an unsubstituted alkyl.
- substituted alkoxy refers to a group having the structure -O- R, where R is alkyl which is substituted with a non-interfering substituent.
- amino refers to a chemical functionality -NR1R2 where Rl and R2 are independently hydrogen, alkyl, or aryl groups.
- Analog, derivative or mimetic An analog is a molecule that differs in chemical structure from a parent compound, for example a homolog (differing by an increment in the chemical structure, such as a difference in the length of an alkyl chain), a molecular fragment, a structure that differs by one or more functional groups, a change in ionization. Structural analogs are often found using quantitative structure activity relationships (QSAR), with techniques such as those disclosed in Remington (The Science and Practice of Pharmacology, 19th Edition (1995), chapter 28).
- QSAR quantitative structure activity relationships
- a derivative is a substance related to a base structure, and theoretically derivable from the base structure.
- a mimetic is a biomolecule that mimics the activity of another biologically active molecule.
- Biologically active molecules can include chemical structures that mimic the biological activities of a compound, for instance Zebularine.
- Animal Living multi-cellular organisms, for instance a vertebrate (a category that includes, for example, mammals, and birds).
- the term mammal includes both human and non-human mammals.
- subject includes both human and veterinary subjects.
- Anti-proliferative activity An activity of a molecule, e.g., a compound, which reduces proliferation of at least one cell type, but which may reduce the proliferation (either in absolute terms or in rate terms) of multiple different cell types (e.g., different cell lines, different species, etc.).
- an anti-proliferative activity will be apparent against cells (either in vitro or in vivo) that exhibit a hyper-proliferative condition, such as is characteristic of certain disorders or diseases.
- an anti-proliferative activity can be an anti-tumor or anti-neoplastic activity of a compound.
- Such molecules will be useful to inhibit or prevent or reduce cellular proliferation or growth, e.g., in a tumor, such as a malignant neoplasm.
- aryl refers to a monovalent unsaturated aromatic carbocyclic group having a single ring (e.g. phenyl) or multiple condensed rings (e.g. naphthyl or anthryl), which are optionally unsubstituted or substituted with, e.g., halogen, alkyl, alkoxy, mercapto (-SH), alkylthio, trifluoromethyl, acyloxy, hydroxy, mercapto, carboxy, aryloxy, aryl, arylalkyl, heteroaryl, amino, alkylamino, dialkylamino, morpholino, piperidino, pyrrolidin-1-yl, piperazin-1-yl, or other functionality.
- Carboxyl This term refers to the radical -COOH, and substituted carboxyl refers to -COR where R is alkyl, lower alkyl or a carboxylic acid or ester.
- DNA deoxyribonucleic acid
- DNA is a long chain polymer which comprises the genetic material of most living organisms (some viruses have genes comprising ribonucleic acid (RNA)).
- the units in DNA polymers are four different nucleotides, each of which comprises one of the four bases, adenine, guanine, cytosine and thymine bound to a deoxyribose sugar to which a phosphate group is attached.
- Triplets of nucleotides (referred to as codons) code for each amino acid in a polypeptide, or for a stop signal.
- codon is also used for the corresponding (and complementary) sequences of three nucleotides in the mRNA into which the DNA sequence is transcribed.
- any reference to a DNA molecule is intended to include the reverse complement of that DNA molecule. Except where single-strandedness is required by the text herein, DNA molecules, though written to depict only a single strand, encompass both strands of a double-stranded DNA molecule.
- Halogen refers to fluoro, bromo, chloro and iodo substituents.
- Heterocycle refers to a monovalent saturated, unsaturated, or aromatic carbocyclic group having a single ring (e.g. benzyl, morpholino, pyridyl or furyl) or multiple condensed rings (e.g. naphthyl, quinolinyl, indolizinyl or benzo[b]thienyl) and having at least one heteroatom, defined as N, O, P, or S, within the ring, which can optionally be unsubstituted or substituted with, e.g.
- Hyper-proliferative disorder A disorder characterized by abnormal proliferation of cells, and gene ⁇ cally includes skin disorders such as psoriasis as well as benign and malignant tumors of all organ systems
- a pharmaceutically acceptable fluid composition comprising at least one active ingredient, e g , Zebularine or a compound with Zebularine-hke hypomethylation activity
- the active ingredient is usually dissolved or suspended in a physiologically acceptable carrier, and the composition can additionally comprise minor amounts of one or more non-toxic auxiliary substances, such as emulsifying agents, preservatives, and pH buffering agents and the like
- non-toxic auxiliary substances such as emulsifying agents, preservatives, and pH buffering agents and the like
- Methylation A chemical or biochemical process of introducing a methyl group into an organic molecule DNA methylation, the addition of a methyl group onto a nucleotide, is a postrephcative covalent modification of DNA that is catalyzed by the DNA methyltransferase enzyme (MeTase) (Koomar et al , Nucl Acids Res 22 1-10, 1994, and Bestor et al , J Mol Biol 203 971-983, 1988)
- Methylation A chemical or biochemical process of introducing a methyl group into an organic molecule DNA methylation, the addition of a methyl group onto a nucleotide, is a postrephcative covalent modification of DNA that is catalyzed by the DNA methyltransferase enzyme (MeTase) (Koomar et al , Nucl Acids Res 22 1-10, 1994, and Bestor et al , J Mol Biol 203 9
- DNA methylation can serve as a mechanism for changing the structure of DNA without altering its coding function or its sequence DNA methylation is a heritable, reversible and epigenetic change It can alter gene expression, particularly by inactivating genes, which has profound developmental and disease consequences
- Methylation of CpG islands that are associated with tumor suppressor genes can cause decreased gene expression Increased methylation of such regions often leads to reduction of normal gene expression, which may cause the selection of a population of cells having a selective growth advantage and thus are or become malignant
- hypomethylation refers to an increased or high level (above a reference level, such as wild-type or other basal level) of DNA methylation at a specific site on a nucleic acid molecule (e g , a. CpG island), or more generally in a genome or region of a genome (e g , a promoter region)
- hypomethylation refers to a decreased or low level (below a reference level, such as wild-type or other basal level) of DNA methylation at a specific site on a nucleic acid molecule (e g , & CpG island), or more generally in a genome or region of a genome (e g , a promoter region)
- hypomethylating agent refers to an agent that reduces or reverses
- Hypomethylating agents can be referred to as possessing "hypomethylating activity " By way of example, such activity is measured by determining the methylation state and/or level of a specific DNA molecule or site therein, or the general methylation state of a cell, on parallel samples that have and have not been treated with the hypomethylating agent (or putative hypomethylation agent). A reduction in methylation in the treated (versus the untreated) sample indicates that the agent has hypomethylating activity.
- the methylation level is reduced by at least 5% upon treatment with a hypomethylating agent; in other embodiments it is reduced by at least 10%, by at least 15%, by at least 20%, by at least 25%, by at least 30%, by at least 40%, or by at least 50% compared to an untreated sample.
- Particularly effective hypomethylating agents, or agents used in particularly susceptible systems will yield even greater reduction levels, for instance at least 60%, 70%, 80%, 90%, or in some examples 95% or more.
- Methylation-mediated condition/disease/disorder A biological condition, disease or disorder of a subject that is associated with, caused by, or influenced by the methylation state (e.g., the extent of methylation) of a DNA sequence, or level of methylation throughout the genome of the subject.
- methylation state e.g., the extent of methylation
- Hypermethylation-associated diseases, disorders, and conditions are characterized by exhibiting hypermethylation of one or more DNA sequences. Such diseases, disorders, and conditions therefore can be identified by examining the methylation state (or level) of nucleic acids in a subject known to or suspected of suffering therefrom; a high level of specific or general DNA methylation indicates that the disease/disorder/condition is hypermethylation-associated. It is beneficial to treat (or prevent) such diseases, disorders, and conditions with the provided Zebularine- comprising compositions.
- hypomethylation-associated diseases, disorders, and conditions are characterized by exhibiting hypomethylation of one or more DNA sequences.
- hypomethylation-associated diseases/disorders/conditions can be identified by examining the methylation state (or level) of nucleic acids in the subject known to or suspected of suffering therefrom.
- Nucleoside includes, but is not limited to, a monomer that includes a base, such as a pyrimidine, purine, or synthetic analogs thereof, linked to a carbohydrate.
- Nucleotide A nucleotide is a nucleoside plus a phosphate, and forms one monomer in a polynucleotide.
- a nucleotide sequence refers to the sequence of bases in a polynucleotide.
- Oligonucleotide is a plurality of joined nucleotides joined by native phosphodiester bonds, between about 6 and about 300 nucleotides in length.
- An oligonucleotide analog refers to moieties that function similarly to oligonucleotides but have non-naturally occurring portions.
- oligonucleotide analogs can contain non-naturally occurring portions, such as altered sugar moieties or inter-sugar linkages, such as a phosphorothioate oligodeoxynucleotide.
- Functional analogs of naturally occurring polynucleotides can bind to RNA or DNA.
- oligonucleotides that contain one or more Zebularine derivatives integrated into the molecule.
- Particular oligonucleotides and oligonucleotide analogs can include linear sequences up to about 200 nucleotides in length, for example a sequence (such as DNA or RNA) that is at least 6 bases, for example at least 8, 10, 15, 20, 25, 30, 35, 40, 45, 50, 100 or even 200 bases long, or from about 6 to about 50 bases, for example about 10-25 bases, such as 12, 15 or 20 bases.
- Parenteral Administered outside of the intestine, e.g., not via the alimentary tract.
- parenteral formulations are those that will be administered through any possible mode except ingestion. This term especially refers to injections, whether administered intravenously, intrathecally, intramuscularly, intraperitoneally, or subcutaneously, and various surface applications including intranasal, intradermal, and topical application, for instance.
- Pharmaceutical agent or drug A chemical compound or composition capable of inducing a desired therapeutic or prophylactic effect when properly administered to a subject.
- compositions and formulations suitable for pharmaceutical delivery are conventional. See, for instance, Remington's Pharmaceutical Sciences, by E. W. Martin, Mack Publishing Co., Easton, PA, 15th Edition (1975), which describes compositions and formulations suitable for pharmaceutical delivery.
- parenteral formulations usually comprise injectable fluids that include pharmaceutically and physiologically acceptable fluids such as water, physiological saline, balanced salt solutions, aqueous dextrose, glycerol or the like as a vehicle.
- pharmaceutically and physiologically acceptable fluids such as water, physiological saline, balanced salt solutions, aqueous dextrose, glycerol or the like as a vehicle.
- physiologically acceptable fluids such as water, physiological saline, balanced salt solutions, aqueous dextrose, glycerol or the like
- solid compositions e.g., powder, pill, tablet, or capsule forms
- conventional non-toxic solid carriers can include, for example, pharmaceutical grades of mannitol, lactose, starch, or magnesium stearate.
- compositions to be administered can contain minor amounts of non- toxic auxiliary substances, such as wetting or emulsifying agents, preservatives, and pH buffering agents and the like, for example sodium acetate or sorbitan monolaurate.
- Prodrug Any molecule that undergoes in vivo metabolic conversion to one or more pharmacologically active compounds.
- Tumor A neoplasm that may be either malignant or non-malignant. 'Tumors of the same tissue type" refers to primary tumors originating in a particular organ (such as breast, prostate, bladder or lung). Tumors of the same tissue type may be divided into tumor of different sub-types (a classic example being bronchogenic carcinomas (lung tumors) which can be an adenocarcinoma, small cell, squamous cell, or large cell tumor).
- This disclosure provides methods of inhibiting a DNA methyltransferase, comprising contacting the DNA methyltransferase with an amount of Zebularine (or an analog or a derivative thereof that retains hypomethylating activity) effective to inhibit the DNA methyltransferase.
- Zebularine or an analog or a derivative thereof that retains hypomethylating activity
- Such methods can be carried out in vivo or in vitro; in particular embodiments in which the method is carried out within a cell, the cell may be a bacterial cell, a protist cell, a fungal cell, a plant cell, or an animal cell, for instance. It is particularly contemplated that, in some cases, the cell is known to comprise or suspected of comprising a hypermethylated nucleic acid molecule (e.g., one that includes at least one CpG dinucleotide).
- Another embodiment provides methods of reducing, preventing or reversing DNA methylation in a cell, which methods involve administering a hypomethylating effective amount of Zebularine to the cell, thereby reducing, preventing or reversing DNA methylation in the cell (e.g., a bacterial cell, a protist cell, a fungal cell, a plant cell, or an animal cell).
- a nucleic acid in the cell is known to be or suspected of being hypermethylated.
- the cell to which Zebularine is administered is a hyper- proliferative cell (e.g., a mammalian tumor cell).
- a further embodiment is a method of treating or ameliorating a hypermethylation-related disease, condition, or disorder in a subject, which method involves administering to the subject a hypomethylating effective amount of Zebularine, or an analog or a derivative thereof that retains hypomethylating activity (e.g., in the form of a pharmaceutical composition).
- the disease is a hyper-proliferative disease, for instance a mammalian neoplasm.
- a hypomethylating effective amount of Zebularine, or an analog or a derivative thereof, such as a compound bearing a 2-pyrimidinone moiety, that retains hypomethylating activity is administered to the cell to reduce methylation of cytosine in a CpG dinucleotide in the cell, thereby ameliorating the tumorigenic state of the cell.
- one or more anti-cancer agents are also administered to the cell.
- the cell to which Zebularine is administered is a cell in a subject, such as a tumor cell.
- the active compound e.g., Zebularine
- the active compound is incorporated into an oligonucleotide.
- Also provided are methods of inhibiting methylation of a target sequence (e.g., one which includes at least one CpG dinucleotide), which methods involve contacting the sequence with a derivatized oligonucleotide complementary to at least a portion of the target sequence.
- the derivatized oligonucleotide includes at least one Zebularine residue or hypomethylating effective derivative thereof.
- target sequences include regulatory regions of tumor suppressor genes, including those tumor suppressor genes known to be or suspected of being inactivated by methylation. Examples of these methods of inhibiting methylation occur inside of a cell, for instance a bacterial cell, a protist cell, a fungal cell, a plant cell, or an animal cell.
- Another embodiment is a derivatized oligonucleotide that includes at least one Zebularine residue, or at least one hypomethylating effective derivative of Zebularine.
- Examples of such oligonucleotides have a sequence that is homologous to a sequence within a tumor suppressor gene regulatory region.
- derivatives of Zebularine wherein the derivative is substantially stable in a biological system and retains hypomethylating activity compared to Zebularine. In some specific examples, such derivatives have greater hypomethylating activity compared to Zebularine.
- kits for inhibiting a DNA methyltransferase include an amount of Zebularine (e.g. , in the form of a pharmaceutical composition) effective to inhibit the DNA methyltransferase and optionally may include instructions for using the kit for its intended purpose(s).
- kits for treating hyper-methylation mediated disease or disorder in a subject suspected of needing such inhibition for instance a subject known to or suspected of suffering from a methylation-linked disease or disorder.
- Fig. 1 also known as l- ⁇ -ribofuranosyl-l,2-dihydropyrimidin-2-one and 1- ⁇ - ribofuranosyl-2(lH)-pyrimidinone, has been attributed with cytidine deaminase inhibiting activity (see, e.g., Kim et al, J. Med. Chem. 29:1374-1380, 1986; WO 00/51639, issued to Greer, and entitled "Dramatic Simplification of a Method to Treat Neoplastic Disease by Radiation;" McCormack et al., Biochem Pharmacol. 29:830-832, 1980).
- Zebularine had antitumor activity (Driscoll et al, J. Med. Chem. 34:3280-3284, 1991) when given orally, though no mechanism has previously been determined for this activity. It has been surprisingly found that Zebularine is a potent, low toxicity inhibitor of DNA methylation (a hypomethylating agent). As described more fully below, Zebularine shows hypomethylating activity in the N. crassa in vivo system for measuring methylation (Example 1), and in mammalian cell lines such as the human bladder carcinoma cell lines T24 and normal mouse embryonic fibroblast cell line 10T1/2 (Examples 2 and 3). The compounds 5-azacytidine (5-Aza-CR; Fig.
- 5-Aza-2'-deoxycytidine 5-Aza-CdR
- 5-Aza-CR and 5-Aza-CdR are metabolized (see Fig. 2) and are ultimately incorporated into cellular DNA.
- DNA that contains 5-Aza-CdR directly inhibits DNA methyltransferases and thus DNA methylation.
- Zebularine is a modified pyrimidine ribonucleoside that can be incorporated into RNA or, following conversion to the corresponding 2'-deoxy compound, into DNA (Jeong et al, J. Med. Chem. 41:2572-2578, 1998; Betts et al, J. Mol.
- the inventors recognize in vivo effects observed for Zebularine may arise from direct inhibition of a DNA methyltransferase, or via an indirect mechanism, such as interference with RNA silencing mechanisms (see, e.g., Plasterk, Science, 296:1263-1265, 2002).
- Zebularine is a substrate for uridine kinase (UK) and human tumor cells exhibit elevated UK activity. This raises the possibility that Zebularine may operate through a biologically active, phosphorylated derivative via a mechanism selective for tumor cells. See, Weber, et al, Cancer Biochem. Biophys. 16 : 1 - 15 , 1998.
- prodrugs may include, for example and without limitation, the mono-, di-, or tri-phosphate derivatives of zebularine or its analogs and homologs; the mono-, di-, or tri-phosphate derivatives of 2'-deoxyzebularine or its analogs or homologs; or any other compounds that result in the delivery of an effective amount of 2-pyrimidinone or a derivative thereof to cells, particularly those that result in the incorporation of a 2-pyrimidinone moiety into DNA and/or RNA as an alternative base.
- prodrugs are well known in the art.
- prodrugs derivatives see, e.g., Methods in Enzymology, 42:309-396, 1985, which is incorporated herein by reference.
- Particular contemplated prodrugs include "masked" phosphates of Zebularine and 2'-deoxy Zebularine, including masked monophosphates of 2'-deoxy Zebularine, and particularly including phosphoesters, phosphoethers, and alkylated derivatives.
- alkali metals such as sodium, potassium and lithium
- alkali earth metals such as calcium, magnesium and barium
- organic bases such as amine bases, for example, dicyclohexylamine, pyridine, arginine, lysine and the like.
- Other compounds, such as the prodrugs described above may form salts with a variety of organic and inorganic acids. Solely by way of example, such salts may include those formed with hydrogen chloride, hydrogen bromide, methanesulfonic acid, toluene sulfonic acid, citric acid, tartaric acid succinic acid, acetic acid, trifluoroacetic acid, and various others of the like.
- the first enzyme believed to be involved in activating Zebularine is elevated above normal levels in many human tumors, including human ovarian, breast, rectal, and lung tumors (see Example 4). Because this enzyme may be important in the in vivo hypomethylating activity of Zebularine, its elevation in tumor tissue provides a mechanism for preferential activity of the drug in those tissues most in need of reduction of (or reversal of) DNA methylation.
- Zebularine exhibits some toxicity in both Neurospora and mammalian cells (see, Example 2 and Fig. 6). This toxicity is substantially lower than that observed with 5-Aza-CR, and appears not to be mediated by its inhibition of DNA methyltransferase (Example 1).
- Table 1 provides a summary of chemical and biological characteristics of Zebularine in comparison to the known DNA methyltransferase inhibitor 5-azacytidine.
- Hypermethylation-associated diseases, disorders, and conditions are characterized by exhibiting hypermethylation of one or more DNA sequences. Such diseases, disorders, and conditions therefore can be identified by examining the methylation state (or level) of nucleic acids in a subject known to or suspected of suffering therefrom; a high level of specific or general DNA methylation indicates that the disease/disorder/condition is hypermethylation-associated. It is beneficial to treat (or prevent) such diseases, disorders, and conditions with Zebularine, for instance a Zebularine-comprising composition such as a pharmaceutical composition.
- screening in some embodiments involves examining the methylation level of the genome of cell or tissue sample from the subject, or of a specific target sequence from such genome. In some embodiments, screening involves detecting the level of uridine-cytidine kinase in a cell or tissue. In particular embodiments, both the methylation state and level of uridine-cytidine kinase are tested prior to selecting Zebularine (or a derivative thereof) for use in a treatment. Methods for testing both uridine-cytidine kinase levels and methylation state are provided herein.
- Zebularine's activity as a hypomethylation agent is thought to be effective in any system that is subject to DNA methylation.
- Zebularine is useful in other systems.
- Zebularine presumably can be used to alter the methylation state of DNA in plants, including transformed plants that have undergone methylation- mediated gene silencing or silenced plant developmental genes (see for instance, USPN 6,011,200, entitled “Methods for Altering the Rate of Plant Development and Plants Obtained Therefrom”).
- Zebularine presumably can be used to influence these processes by altering the DNA methylation state of the system.
- hypomethylation activity of Zebularine can be used to reduce antimicrobial resistance, similarly to the system described in USPN 5,872,104 (entitled “Combinations and Methods for Reducing Antimicrobial Resistance”). Examples of such methods work by reducing the methylation-mediated binding inhibition of an antibiotic agent, for instance on an rRNA molecule, thereby increasing the susceptibility of the treated microbes to that antibiotic agent.
- Derivatives of Zebularine can be produced using well known chemical methods, for instance by substitution or addition of one or more side groups on Zebularine for other organic groups, halogens, and so forth. Some derivatives have been published previously (Barchi et al, J. Enzyme Inhib. 9: 147-162, 1995; Driscoll et al, J. Med. Chem. 34:3280-3284, 1991).
- Particular contemplated analogs and derivatives of Zebularine include variations of the pyrimidinone group and/or the ribose moiety, such as 2'-deoxy-Zebularine, 5-fluoro-analogs of Zebularine and of 2'-deoxy-Zebularine, and 4,6-difluoro analogs of Zebularine and 2'-deoxy-Zebularine.
- Additional contemplated analogs and derivatives of Zebularine include variations on the carbohydrate moiety, such as halogenated derivatives, for example 2'-deoxy-2'-fluoro-ribose derivatives.
- Particular derivatives, including prodrugs of Zebularine are represented by the structure of Formula 1.
- R groups independently are H or groups cleaved during metabolism of the compound to release Zebularine or a Zebularine derivative.
- particular R groups independently are selected from the group consisting of carboxylic acid esters, phosphoesters and ethers.
- An exemplary ester R group is pivaloyl, and exemplary ethers include those where R is an alkyl group.
- X may be selected from the group consisting of H, F, Cl, Br, alkyl, alkenyl, and alkynyl groups. In particular examples, X may be a group according to Formula 2a or 2b.
- Y may be selected from the group consisting of H, carboxylic acids, carboxylic acid esters, and the halogens.
- X is a halogen
- the compound may be prepared according to the method of McCormack et al, Biochem Pharmacol 29:830-832, 1980.
- Zebularine is an effective hypomethylating agent
- Zebularine can.be integrated into oligonucleotides and the resultant derivatized oligonucleotides used to inhibit methylation at specific targeted sites in nucleic acid molecules.
- the synthesis reactions proceed as follows: First, a dimethoxytrityl or equivalent protecting group at the 5' end of the growing oligonucleotide chain is removed by acid treatment. (The growing chain is anchored by its 3' end to a solid support such as a silicon bead.) The newly liberated 5' end of the oligonucleotide chain is coupled to the 3'-phosphoramidite derivative of the next deoxynucleoside to be added to the chain, using the coupling agent tetrazole. The coupling reaction usually proceeds at an efficiency of approximately 99%; any remaining unreacted 5' ends are capped by acetylation so as to block extension in subsequent couplings.
- the phosphite triester group produced by the coupling step is oxidized to the phosphotriester, yielding a chain that has been lengthened by one nucleotide residue. This process is repeated, adding one residue per cycle. See, for instances, U.S. Patent Nos. 4,415, 732, 4,458,066, 4,500,707, 4,973,679, and 5,132,418.
- Oligonucleotide synthesizers that employ this or similar methods are available commercially (e.g., the PolyPlex oligonucleotide synthesizer from Gene Machines, San Carlos, CA). In addition, many companies will perform such synthesis (e.g., Sigma-Genosys, TX; Operon Technologies, CA; Integrated DNA Technologies, IA; and TriLink BioTechnologies, CA).
- Derivatized or modified nucleotides and nucleotide analogs such as Zebularine and deoxy- Zebularine, can be incorporated into an oligonucleotide essentially as described above for non- modified nucleotides, once the phosphoramidite form of the nucleotide analog is produced.
- Phosphoramidites of nucleotides and nucleotide analogs can be synthesized and purified as described in Marasco et al, J. Org. Chem. 57:6363-6365, 1992; see also Hurd et al, J. Mol. Biol. 286, 389-401, 1998.
- methods for producing Zebularine-containing oligonucleotides are conventional.
- the standard oligonucleotide synthesis methodology can be modified to deal with the instability of the 2-pyrimidinone ring during synthesis; see Zhou et al, Nucleic Acids Res. 24,:2652-2659, 1996; Adams et al. Tetrahedron Lett. 35:1597- 1600, 1994; and Gildea et al, Nucleic Acids Res. 17:2261-2281, 1989.
- Oligonucleotides that have been derivatized to contain at least one zebularine residue can be used to inhibit methylation at a target nucleic acid sequence substantially homologous to the oligonucleotide.
- This disclosure specifically contemplates methods of inhibiting methylation of a target sequence, which methods involve contacting a cell containing that sequence with a Zebularine-derivatized oligonucleotide complementary to at least a portion of the target sequence.
- the target sequence contains one or more CpG dinucleotides.
- Specific examples of target sequences include regulatory regions of genes, such as tumor suppressor genes.
- Zebularine-derivatized oligonucleotides also can be used to elucidate the mechanism(s) of Zebularine's hypomethylating activity.
- Zebularine-derivatized oligonucleotides also can be used to elucidate the mechanism(s) of
- Zebularine's hypomethylating activity By comparing the inhibitory potency of an oligonucleotides containing 2'-deoxy-Zebularine with similar sequences containing other inhibitors (e.g., 5-fluoro-2'- deoxycytidine or 5-aza-2'-deoxycytidine), it will be possible to determine whether Zebularine is a weaker inhibitor of methylation due to low incorporation into DNA, or another inherent low inhibiting activity. If the level of inhibition provided by the derivatized oligonucleotides, including Zebularine, is comparable or identical to each other, it is contemplated that Zebularine's hypomethylating activity can be enhanced by administering a Zebularine pro-drug.
- other inhibitors e.g., 5-fluoro-2'- deoxycytidine or 5-aza-2'-deoxycytidine
- oligonucleotide has the following sequence: TGTCAGXGCATGG (SEQ ID NO: 20), wherein X represents 2'-deoxy-Zebularine.
- This oligonucleotide is directed to the Hhal methylase, as described in Wang et al. (J. Am. Chem. Soc. 122:12422-12434, 2000). As indicated in Sheikhnejad et al. (J. Mol. Biol. 285:2021-2034, 1999) and Marquez et al. (Antisense & Nucleic Acid Drug Dev. 9:415-421, 1999), other sequences to target mammalian enzymes can be synthesized.
- this oligonucleotide was synthesized and compared to an oligonucleotide of the same sequence having 2'-deoxy-5-azacytidine in place of the 2'-deoxy-Zebularine. Both modified oligodeoxynucleotides, as annealed duplexes with the complementary strand having 5-methylcytidine for pairing with 2'-deoxy-Zebularine and 2'- deoxy-5-azacytidine, inhibited methylation of the substrate oligonucleotide to the same extent.
- Each RE can "cut" DNA at a certain short (e.g., 4-8 nucleotide) recognition sequence. The position of such cuts can be determined based on the length of fragments produced after a digestion reaction, which fragments are detected, for instance, by gel electrophoresis, transfer to a membrane and hybridization.
- Certain REs are "methylation-sensitive" in that certain bases within the recognition sequence must be unmethylated at particular adenine and/or cytosine residues for digestion to occur.
- methylation-sensitive REs include Sau3 Al and Dpnll.
- the band pattern after digestion with a methylation-sensitive RE changes depending on the methylation pattern of the DNA.
- Techniques based on methylation-sensitive REs can be somewhat limited, because many CpG's that might be methylated are outside the recognition sequences of REs, and thus cannot be examined using these methods.
- Ms-SNuPE Methylation-sensitive Single Nucleotide Primer Extension
- unmethylated cytosines (C or T) is determined by incubating the annealed product with Taq polymerase and either (a- 32 P) dCTP or (a- 32 P) dTTP, followed by gel electrophoresis and Phosphorlmager analysis.
- High-throughput methylation assays are also useful for measuring methylation.
- one such assay is the Methy light assay (Eads et al, Cancer Res. 61:3410-3418, 2001; published international patent application PCT/USOO/13029), a high-throughput quantitative methylation assay that utilizes fluorescence-based real-time PCR (TaqMan) technology.
- the present disclosure includes a treatment for methylation-mediated disease such as a hyper-proliferative disease or disorder, in a subject.
- the method includes administering the compound Zebularine, or an analog, mimetic, or derivative thereof that has similar hypomethylation function, or a combination of such compound and one or more other pharmaceutical agents, to the subject in a pharmaceutically compatible carrier and in an amount effective to inhibit the development or progression of a methylation-mediated disease.
- the treatment can be used prophylactically in any patient in a demographic group at significant risk for such diseases, subjects can also be selected using more specific criteria, such as a definitive diagnosis of the disease/condition or identification of one or more factors that increase the likelihood of developing such disease (e.g., a genetic, environmental, or lifestyle factor).
- the vehicle in which the drug is delivered can include pharmaceutically acceptable compositions of the compounds, using methods well known to those with skill in the art. Any of the common carriers, such as sterile saline or glucose solution, can be utilized. Routes of administration include but are not limited to oral and parenteral routes, such as intrathecal, intravenous (iv), intraperitoneal (ip), rectal, topical, ophthalmic, nasal, and transdermal.
- routes of administration include but are not limited to oral and parenteral routes, such as intrathecal, intravenous (iv), intraperitoneal (ip), rectal, topical, ophthalmic, nasal, and transdermal.
- the compounds may be administered intravenously in any conventional medium for intravenous injection, such as an aqueous saline medium, or in blood plasma medium.
- the medium may also contain conventional pharmaceutical adjunct materials such as, for example, pharmaceutically acceptable salts to adjust the osmotic pressure, lipid carriers such as cyclodextrins, proteins such as serum albumin, hydrophilic agents such as methyl cellulose, detergents, buffers, preservatives and the like.
- lipid carriers such as cyclodextrins, proteins such as serum albumin
- hydrophilic agents such as methyl cellulose
- Embodiments of other pharmaceutical compositions can be prepared with conventional pharmaceutically acceptable carriers, adjuvants, and counter-ions as would be known to those of skill in the art.
- compositions in some embodiments are in the form of a unit dose in solid, semi-solid and liquid dosage forms such as tablets, pills, powders, liquid solutions, or suspensions.
- the compounds of the present disclosure can be administered at about the same dose throughout a treatment period, in an escalating dose regimen, or in a loading-dose regime (e.g., in which the loading dose is about two to five times the maintenance dose).
- the dose is varied during the course of a treatment based on the condition of the subject being treated, the severity of the disease or condition, the apparent response to the therapy, and/or other factors as judged by one of ordinary skill in the art.
- long-term treatment with the drug is contemplated, for instance in order to reduce the occurrence of remethylation of a tumor suppressor gene.
- Zebularine's role in reactivating tumor suppressor genes also makes it a good candidate for follow-up therapy after radiation or conventional chemotherapy to avoid recurrence of the tumor.
- Zebularine can reactivate a glycoprotein that prevents cell migration and/or a gene that encodes a hormone receptor. The tumor load cannot be too great for Zebularine to act properly.
- sustained intra-tumoral (or near-tumoral) release of the pharmaceutical preparation that comprises a hypomethylation effective amount of Zebularine may be beneficial.
- Slow-release formulations are known to those of ordinary skill in the art.
- polymers such as bis( ⁇ -carboxyphenoxy)propane-sebacic-acid or lecithin suspensions may be used to provide sustained intra-tumoral release.
- delivery is via an injected and/or implanted drug depot, for instance comprising multi- vesicular liposomes such as in DepoFoam
- perfusion of a tumor with a pharmaceutical composition that contains a hypomethylation effective amount of Zebularine is contemplated.
- Therapeutically effective doses of the compounds of the present disclosure can be determined by one of skill in the art.
- the low toxicity of the compound makes it possible to administer high doses, for example 100 mg/kg, although doses of 10 mg/kg, 20 mg/kg, 30 mg/kg or more are contemplated.
- An example of such a dosage range is 0.1 to 200 mg/kg body weight orally in single or divided doses.
- Another example of a dosage range is 1.0 to 100 mg/kg body weight orally in single or divided doses.
- compositions are, for example, provided in the form of a tablet containing 1.0 to 1000 mg of the active ingredient, particularly 1, 5, 10, 15, 20, 25, 50, 100, 200, 400, 500, 600, 800, and 1000 mg of the active ingredient for the symptomatic adjustment of the dosage to the subject being treated.
- the specific dose level and frequency of dosage for any particular subject may be varied and will depend upon a variety of factors, including the activity of the specific compound, the metabolic stability and length of action of that compound, the age, body weight, general health, sex, diet, mode and time of administration, rate of excretion, drug combination, and severity of the condition of the host undergoing therapy.
- the pharmaceutical compositions comprising a hypomethylation effective amount of
- Zebularine can be used in the treatment or prevention of a variety of diseases and conditions that are associated with and/or caused by hypermethylation of one or more gene sequences.
- diseases include cancers, in particular tumors that are characterized by having one or more hypermethylated sequences such as a tumor suppressor gene, particularly where the hypermethylation has resulted in the inactivation (silencing) of that gene.
- cadherin inactivation of which is often associated with breast or prostate tumors and squamous cell lung carcinoma, and the migration of tumor cells to distant nodes
- estrogen receptor inactivation of which is often associated with estrogen receptor negative breast tumors; reactivation of the receptor leads to potential by, for example, tamoxifen
- VHL inactivation of which is associated with renal cancer
- H19 a tumor suppressor gene located on l ip, the inactivation of which is implicated in many tumors
- 14-3-3 ⁇ silenced in some breast cancers
- Apaf-1 inactivated in metastatic melanomas, though it appears that the methylation inactivation related to this gene may be indirect or through a genetic region other than the Apaf-1 promoter
- p53 a tumor suppressor gene, the inactivation of which is implicated in many tumors, particularly unstable tumors.
- hypermethylation at CpG islands which are not
- GST glutathione-S-transferase
- TIMP-3 tissue inhibitor of metalloproteinase-3
- Methyldeoxycytidine when deaminated, becomes thymidine, and pairs with deoxyadenosine rather than deoxyguanidine, so that a CG base pair is converted to a TA pair, leading to mutation.
- some cancers arise from or are enhanced by mutations in genes where the mutation is thought to have been caused by methylation of a cytidine residue, followed by the subsequent conversion of the methylated deoxycytidine to a thymidine. This often occurs with the tumor suppressor p53.
- the methyltransferase causes mutational hot spots. This can result in tumor gene unstabilization, tumor metastasis, tumor progression, tumor recurrence and resistance of the tumor to therapy by cytotoxic agents.
- Subclones of the tumor containing the mutated gene(s) may be more aggressive, metastatic, and therapy resistant. It is believed that Zebularine hypomethylation activity can be used to prevent or reduce the likelihood of such mutations.
- the present disclosure also contemplates combinations of Zebularine compounds with one or more other agents useful in the treatment of hypermethylation-related disease.
- the compounds of this disclosure may be administered in combination with effective doses of other medicinal and pharmaceutical agents.
- one or more known anti-cancer drugs are included with the Zebularine.
- administration in combination with refers to both concurrent and sequential administration of the active agents.
- the compounds and/or peptides of this disclosure may be administered in combination with effective doses of radiation, anti-proliferative agents, anti-cancer agents, immunomodulators, anti-inflammatories, anti-infectives, hypomethylation agents, nucleosides and analogs thereof, and/or vaccines.
- anti-proliferative agents examples include, but are not limited to, the following: ifosamide, cisplatin, methotrexate, procarizine, etoposide, bischloroethyl nitrosourea (BCNU), vincristine, vinblastine, cyclophosphamide, gemcitabine, 5-fluorouracil, paclitaxel, or doxorubicin.
- Non-limiting examples of immuno-modulators that can be used in combination with Zebularine are AS-101 (Wyeth-Ayerst Labs.), bropirimine (Upjohn), gamma interferon (Genentech), GM-CSF (granulocyte macrophage colony stimulating factor; Genetics Institute), IL-2 (Cetus or Hoffman-LaRoche), human immune globulin (Cutter Biological), IMREG (from Imreg of New La, La.), SK&F 106528, and TNF (tumor necrosis factor; Genentech).
- Zebularine is thus free to be further processed, for example, incorporated into a nucleic acid; or Zebularine can bind to another enzyme or receptor, thereby acting, for example, as a hypomethylating agent.
- a cytidine deaminase inhibitor such as tetrahydrouridine
- Tetrahydrouridine has been shown to be safe and non toxic in mammalian cells. See, Cooper and Greer, "The Effect of Inhibition of Cytidine Deaminase by Tetrahydrouridine on the Utilization of Deoxycytidine and 5-bromodeoxycytidine for DNA
- the combination therapies are of course not limited to the lists provided in these examples, but includes any composition for the treatment of diseases or conditions associated with hypermethylation of one or more gene sequences.
- kits for use in inhibiting a DNA methyltransferase kits for use in reducing the methylation of a nucleic acid, and kits for prevention and/or treatment of a disorder, condition or diseases (e.g., a hyper- proliferative disorder, such as neoplasm, in particular a hyper-proliferative disorder that is mediated by methylation of one or more gene sequences).
- a hypomethylating effective amount of one or more of the compounds is provided in one or more containers.
- the compounds may be provided suspended in an aqueous solution or as a freeze-dried or lyophilized powder, for instance.
- the compounds will be provided in the form of a pharmaceutical composition.
- Kits can also include instructions, usually written instructions, to assist the user in treating or preventing a disorder, condition or disease (e.g., a methylation-mediated hyper-proliferative disorder) with a kinase-activity modifying compound and/or binding peptide.
- a disorder, condition or disease e.g., a methylation-mediated hyper-proliferative disorder
- Such instructions can optionally be provided on a computer readable medium.
- the container(s) in which the compound(s) are supplied can be any conventional container that is capable of holding the supplied form, for instance, microfuge tubes, ampoules, or bottles.
- the therapeutic compound may be provided in pre-measured single use amounts in individual, typically disposable, tubes, or other such containers.
- kits can be any appropriate amount, depending for instance on the market to which the product is directed. For instance, if the kit is adapted for research or clinical use, the amount of each hypomethylating compound (e.g., Zebularine) provided likely would be an amount sufficient for several treatments.
- Certain kits will also include one or more other agents useful treating or preventing a disease or condition, for instance an agent useful in inhibiting cell proliferation that is mediated by or influenced by hypermethylation of a gene sequence, e.g. in treating hyper-proliferation of a methylation-associated tumor. For example, such kits may include one or more effective doses of anti-proliferative or anti-cancer drugs.
- This example provides methods for assessing the hypomethylation/demethylation activity of Zebularine, or related compounds, in Neurospora crassa, which serves as a convenient laboratory system for DNA methylation studies.
- Fig. 4 The results of a representative experiment are shown in Fig. 4. The positions of selected size standards (kb) and the origin (ori) are indicated. A control hybridization (not shown in the figure) indicated that the digests were complete. Differences between S and D lanes are indicative of DNA methylation.
- N. crassa was used to quantitatively examine the effectiveness of Zebularine at reducing or reversing methylation (Selker, Proc. Natl. Acad. Sci. USA, 95:9430-9435, 1998).
- N crassa strain N644 has a single copy of the Escherichia coli hph gene that was silenced (repressed) by cytosine methylation resulting from the action of RIP on flanking direct repeats of the am gene (see Irelan and Selker, Genetics 146:509-523, 1997).
- the active hph gene confers hygromycin (hyg) resistance. Thus, growth of colonies on the plates that contain hygromycin indicates reactivation of the hph gene through loss of methylation.
- Plates (Fig. 5) were treated with Zebularine (0, 2.5, 5.0, 10, 20, 100, 200, and 400 nmoles, as indicated), 20 nmoles 5-azacytidine (a known global demethylating drug used as a positive control for the RIP system), or no hygromycin (a positive control to show maximal conidia growth). As shown by the conidia growth on plates treated with Zebularine, this compound is effective to reduce or reduce methylation, and thereby reactivate the hph gene.
- dim-2 strains with mutations in dim-2 lack all detectable methyltransferase activity (Kouzminova and Selker, "Dim-2 encodes a DNA-methyltransferase responsible for all known cytosine methylation in Neurospora," EMBO J. August 1, 2001).
- dim-2 strain (N613) and a wild-type control (N242) were challenged with a high concentration (400 nmoles) of Zebularine. No hygromycin was applied to these plates.
- Fig. 6 is a series of photographs of plate from a representative experiment, illustrating that the inhibitory growth effects of Zebularine do not depend on the dim-2 DNA methyltransferase. This is evident because the region of conidia toxicity around the WhatmanTM filter disks is roughly equivalent in both dim-2 and wildtype strains treated with 400 nmoles of Zebularine.
- This example provides methods that have been used to analyze the effectiveness of Zebularine for inhibiting DNA methylation in mammalian cells.
- the T24 cell line was obtained from the American Type Culture Collection (Rockville, MD) and cultured in DMEM supplemented with 10% heat-inactivated fetal calf serum and 100 U/ml penicillin-streptomycin. Cultures were grown in a humidified incubator at 37° C in an atmosphere of 5% C0 2 in air.
- Cells were plated (3 x 10 5 cells/100-mm dish) and treated 24 hours later with the indicated concentrations of compounds. The medium was either changed 24 hours or 48 hours after drug treatment.
- Myotube formation was assayed in 10T1/2 cells as previously described (Constantinides et al, Nature 267:364-366, 1977).
- RNA and RNA were isolated three days after treatment using the NucleoBond RNA/DNA Midi Kit (Clontech Laboratories, Inc., Palo Alto, CA).
- RNA -10 ⁇ g was reverse-transcribed using the following reagents: 100 units RNAsin (Promega Corp., Madison, WI), 0.1 M DTT (Life Technologies, Inc.), 1000 units of MMLV-RT (Life Technologies, Inc.), 1 mM deoxynucleotide triphosphates (Boehringer Mannheim, Germany), 75 ⁇ g/ml BSA, 1 X MMLV-RT buffer (Life Technologies, Inc.), and 0.025 ODU Random Hexamers (Amersham-Pharmacia Biotech, Piscataway, NJ).
- the reaction mixture was incubated for 10 minutes at 25° C, 45 minutes at 42° C, 3 minutes at 90° C, and chilled for 5 minutes at 4° C, during which time 1.25 ⁇ l of MMLV-RT (200 U/ ⁇ l) were added and the sample then incubated for 45 minutes at 42° C, 10 minutes at 75° C, and stored at -20° C.
- cDNA was amplified with primers specific for either pl6 or GAPDH.
- PCR reactions were performed in 25- ⁇ l volumes at 94° C for 3 minutes, 28 cycles at 94° C for 1 minute, 56° C for 30 seconds, 72° C for 40 seconds, and a final extension step at 72° C for 5 minutes (pl6 amplification), and 94° C for 1 minute, 19 cycles at 94° C for 1 minute, 58° C for 30 seconds, 72° C for 45 seconds, and a final extension step at 72° C for 2 minutes (GAPDH amplification).
- GAPDH sense 5'-CAG CCG AGC CAC ATC GCT CAG ACA-3' (SEQ ID NO: 3); and GAPDH antisense, 5'-TGA GGC TGT TGT CAT ACT TCT C-3' (SEQ ID NO: 4).
- PCR amplifications were performed with cDNA template concentration equivalent to 100 ng of RNA in 10% DMSO. All reactions were analyzed in the linear range of amplification. PCR products were resolved on 2% agarose gels and subsequently transferred to a nylon membrane (Zetaprobe; Bio-Rad, Richmond, CA) under alkaline conditions. All blots were hybridized with a ⁇ - 32 P-labeled internal oligonucleotide probe, using protocols previously described (Xiong and Laird, Nuc. Acids Res. 25:2532-2534, 1997).
- Cytidine analogs with modifications in the five (5) position of the ring are powerful inhibitors of DNA methylation that can induce the formation of striated muscles cells in the non-myogenic C3H 10T1/2 C18 line of embryonic cells (Jones and Taylor, Cell 20:85-93, 1980). The ability of Zebularine to cause 10T1/2 cells to undergo the myogenic switch was therefore tested (Fig. 7).
- the T24 bladder carcinoma-derived cell line has been shown to contain a transcriptionally silent, hypermethylated pl6 gene, which can be demethylated by 5-Aza-CdR to reactivate pl6 gene expression (Gonzalgo et al, Cancer Res. 58:1245-1252, 1998). Since 5-Aza-CdR has been shown previously to induce p 6 expression in a dose-dependent manner (Bender et al, Cancer Res. 58:95- 101, 1998), the two ribonucleoside analogs 5-Aza-CR and Zeb were examined to determine their abilities to induce pi 6 expression (Figure 8).
- Fig. 11A shows a RT-PCR analysis of pl6 gene expression, as well as GAPDH, in T24 cells treated with either 50 ⁇ M or 100 ⁇ M of Zebularine for the indicated time points (Day 5, Day 7, Day 14, Day 21, Day 27, Day 33, and Day 40). For instance for Day 5 time point, this would indicate that the T24 cells were continuously treated with either 50 or 100 ⁇ M of Zebularine for five days, and the mRNA levels of pl6 and GAPDH (internal control) were assessed.
- This example provides evidence that treatment with Zebularine is effective to reactivate tumor suppressor expression in mammalian cell lines.
- genomic DNA (- 4 ⁇ g) was digested overnight with 4 units of Ec ⁇ Rl (Boehringer Mannheim) (pi 6 promoter/exon 1 and /?76 exon 2; Fig. 9A) or with 4 units of Rsal (Boehringer Mannheim) (P3; Fig. 9B) to cut outside the region of interest.
- pi 6 promoter/exon 1 sense, 5'-GTAGGTGGGGAGGAGTTTAGTT-3' (SEQ ID NO: 5); and antisense, 5'-TCTAATAACCAACCAACCCCTCCT-3' (SEQ ID NO: 6).
- p!6 exon 2 sense, 5'-TTGATTATTTTGTTTTTTTTGGTAGGTT-3' (SEQ ID NO: 7); and antisense, 5 '-CAAATTCTCAAATCATCAATCCTCACCT-3' (SEQ ID NO: 8).
- p3 sense, 5'-GTTTATAGGTTTAGAGGTTTT-3' (SEQ ID NO: 9); and antisense, 5'-AACACATAAACCTATTTTAAACTTA-3' (SEQ ID NO: 10).
- PCR product was electrophoresed and isolated from a 2% agarose gel, using Qiaquick Gel Extraction Kit (Qiagen), and the template eluted in a final volume of 30 ⁇ L double-distilled H 2 0.
- Duplicates of 4 ⁇ l of template were then added to 6 ⁇ l of mixture consisting of IX PCR buffer, 1 ⁇ M final concentration primers, 1 ⁇ Ci of [ 32 P]dCTP or dTTP, and 1 unit 1:1 Taq/TaqStart antibody (Clontech, Palo Alto, CA).
- Single nucleotide extension involved incubation at 95° C for 1 minute, then 50° C for 2 minutes, and finally 72° C for 1 minute (pi 6 promoter/exonl and pi 6 exon
- SNuPE primers were as follows:
- 10T1/2 (250/60-mm dish) and T24 cells (100/60-mm dish) were plated in triplicate sets for a colony-formation assay. 10T1/2 cells and T24 were treated with indicated concentrations of compounds. Once cell colonies were visible (after 12-14 days), cells were fixed in 100% methanol and stained with 10% Giemsa stain. The percentage cell survival was assessed by dividing the mean colony number on the treated plates divided by the mean colony number on the untreated plates X 100.
- 10T1/2 cells were treated with the indicated cytidine analogs for 24 hours and scored for muscle cells 9-10 days later as + to +++ (with + representing minimal muscle formation and +++ representing maximal muscle formation).
- the p3 locus was assayed for percentages of methylation using Ms-SNuPE analysis.
- Cell killing was determined by the lowering of plating efficiency in similarly treated cultures containing 250 cells and stained with Giemsa stain after 14-16 days. Results are the mean values obtained for triplicate dishes in two separate experiments.
- Table 2 also shows the cytotoxicity, as measured by decrease in plating efficiency, of all three drugs on cultured 10T1/2 cells.
- a dose of 0.3 ⁇ M 5-Aza-CdR is considerably more cytotoxic than either 3 ⁇ M 5-Aza-CR or 30 ⁇ M Zebularine (74% vs. 24% vs. 17% decrease in plating deficiency, respectively, Table 2).
- pl6 promoter and exon 2 loci are frequently methylated in bladder cancer cell lines and tumors, and demethylation of pl6 promoter has been noted previously to correspond directly with pl6 expression (Gonzalez-Zulueta et al, Cancer Res. 55:4531-4537, 1995; Bender et al, Cancer Res. 58:95-101, 1998).
- p76 gene expression can be induced by all three drugs tested ( Figure 8)
- Figure 8 the effectiveness of these drugs in demethylating both pi 6 promoter and pi 6 exon 2 was further investigated by Ms-SNuPE analysis.
- Table 3 also shows the cytotoxicity, as measured by decrease in plating efficiency, of all three drugs on cultured T24 cells.
- a dose of 3 ⁇ M 5-Aza-CdR is extremely cytotoxic (75% decrease in plating efficiency).
- 5-Aza-CR showed dose-dependent cytotoxicity, with extremely minimal cytotoxic effects observed with the 3 ⁇ M dose to considerable cytotoxic effects observed with the 100 ⁇ M dose (54% decrease in plating efficiency).
- Zebularine showed dose-dependent cytotoxicity with insignificant time-dependent cytotoxicity. In other words, the increase in the time of treatment did not significantly increase the cytotoxicity for any of the Zebularine doses.
- T24 cells with Zebularine caused a significant reduction in the levels of DNMT1 and DNMT3b3.
- the mRNA for DNMT3b3 is the only 3b transcript expressed in T24 cells, and DNMT3a levels could not be assessed because no suitable antibodies against DNMT3a are available.
- protein extracts were isolated from both treated and untreated T24 cells (population 3 million cells, treated with 500 ⁇ M Zebularine for 48h), and analyzed by Western blot analysis with specific antibodies for DNMT1 and DNMT3b3 as shown in Fig. 12.
- ⁇ -actin was included as a loading control, and the molecular weights of each protein are indicated.
- FIG. 10B shows the cytotoxicity, as measured by decrease in plating efficiency, of all three drugs on cultured T24 cells.
- a dose of 3 ⁇ M 5-Aza-CdR is extremely cytotoxic (75% decrease in plating efficiency).
- 5-Aza-CR showed dose-dependent cytotoxicity, with the highest level in the 100 ⁇ M dose (54% decrease in plating efficiency).
- Zebularine showed dose- dependent cytotoxicity with slight time-dependent cytotoxicity. In other words, the increase in the time of treatment did not significantly increase the cytotoxicity for any of the Zebularine doses.
- the highest cytotoxicity is observed in T24 cells treated with 1 mM Zebularine for 48 hrs (23% decrease in plating efficiency), which is significantly lower toxicity than either 5-Aza-CR or 5-Aza-CdR.
- Example 5 Quantification of Uridine-Cytidine Kinase in Human Lung Tumors This example provides a representative method for testing tissues for uridine-cytidine kinase activity. Since uridine-cytidine kinase is thought to be the first enzyme involved in activating Zebularine, its elevation in tumor tissue provides a mechanism for preferential activity of the drug in those tissues most in need of reduction of (or reversal of) DNA methylation.
- the buffer was taken to 2 mM DTT and 0.5 mM PMSF just before extraction.
- the tissue sample was homogenized in this mixture, then sonicated for 3 five-second pulses to disrupt the cells.
- the cell extract was centrifuged at 14,000g at 4° C for 10 minutes, and the supernatant removed.
- Protein extraction was determined by the Bradford method using bovine serum albumin as the standard.
- the kinase assay reaction mixture contained 50 mM MgCl 2 , 5 mM ATP, and 85 % H 2 0. 2 mM DTT is added just before use.
- the reaction was initiated by adding 5 ⁇ l of 200 mM CP and CPK ( 1 unit ⁇ l) to 150 ⁇ l of the reaction mix and incubating for 2 minutes at 37° C. Then, 500 ⁇ M of 3 H labeled uridine was added and the sample incubated for 1 minute at 37° C before the enzyme extract was added and incubated for a period of time ranging from 0-15 minutes. Reactions were terminated by heating in a boiling H 2 0 bath for 2 minutes.
- the amount of nucleotide formed was determined by spotting 20 ⁇ l aliquots of the reaction mixture onto DE-81 2.2 cm Whatman filter discs. After air drying, the nucleoside substrate was removed by washing the discs twice for 10 minutes in 1 mM ammonium formate and twice for 5 minutes in deionized water, with gentle stirring. It is useful to have a control sample, lacking enzyme that is assayed concurrently with each determination.
- the washed paper discs were heat dried and then placed into individual scintillation vials, and eluted for 30 minutes in .IM HCl - .IMKCl and then rocked for 10 minutes in scintillation mixture; activity was determined by scintillation counting. Enzyme activity is expressed in pmoles/minute/mg protein.
- U/CK uridine/cytidine Kinase pmoles/min/mg protein; values for tumor appear over values for normal tissue 2 Ratio of activity in tumor/activity in adjacent paired normal tissue
- Example 6 In vivo effects of Zebularine.
- Example 6 describes in vivo effects of Zebularine on EJ6 tumors in BALB/c nu/nu mice. Furthermore, Example 6 demonstrates the efficacy of Zebularine against human tumor cells.
- MATERIALS AND METHODS EJ6 cells (5 x 10 5 /injection) were inoculated subcutaneously into the right and left flanks of male BALB/c nu/nu mice at 4-6 weeks of age (available from Harlan, San Diego, CA). Zebularine treatments were initiated after macroscopic (50-200 mm 3 ) tumor formation (4-6 weeks later). Zebularine (500 mg/kg or 1000 mg/kg) was administered daily via intraperitoneal injection or oral gavage feeding over a period of 18 days.
- mice received 0.45% saline administered via intraperitoneal injection or oral gavage feeding over a period of 18 days.
- Animals were sacrificed 24 hours after the last treatment. Tumors were removed, immediately fixed with neutral buffered formalin and then embedded in OCT compound for frozen sections. The frozen sections were processed and stained with hematoxylin and eosin (H&E). All histological examinations were carried out by light microscopy using a Leica DM LB microscope (Leica Microsystems, Germany).
- Example 7 Metabolism of Zebularine Zebularine metabolites were identified after incubation of human bladder cancer cells (T24) in DMEM+10% FCS medium with antibiotics. Zebularine (10 ⁇ M, 1 ⁇ Ci), specific activity 200 DPM/pmole was used in these experiments. At the end of the incubation, cells were extracted with 60% methanol and aliquots were analyzed by SAX- 10 HPLC using a methanol/water gradient as follows: 1-5 min 1% MeOH, 5-25 min gradient to 25% MeOH, 25-35 min isocratic with 25% MeOH and back to 1% MeOH after 10 min. The phosphorylated metabolites were identified by comparison with authentic synthetic standards.
- RNA and DNA were isolated by the tri-reagent method according to the manufacture's instructions.
- Levels of Zebularine and 2'-Deoxyzebularine were determined by measuring total radioactivity in purified RNA and DNA, respectively.
- the identity of Zebularine and 2'- Deoxyzebularine was accomplished by a reverse phase HPLC analysis of digested RNA and DNA and comparison against authentic standards.
- a bar graph depicts the relative incorporation of Zebularine into DNA and RNA in T24 cells, showing that approximately 7 times the amount of Zebularine is incorporated into RNA as DNA.
- This disclosure provides embodiments for using Zebularine, and derivatives thereof, to inhibit DNA methylation.
- the method further provides means of treating or ameliorating hypermethylation-related diseases, such as hypermethylation-related cancers, by administering Zebularine (or a derivative thereof) to the subject.
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US10/485,438 US8207142B2 (en) | 2001-07-31 | 2002-07-30 | Inhibitor of DNA methylation |
EP02756825.2A EP1418949B1 (en) | 2001-07-31 | 2002-07-30 | Inhibitor of dna methylation |
CA2454147A CA2454147C (en) | 2001-07-31 | 2002-07-30 | Inhibitor of dna methylation |
AU2002322805A AU2002322805B2 (en) | 2001-07-31 | 2002-07-30 | Inhibitor of DNA methylation |
JP2003517229A JP2005508885A (en) | 2001-07-31 | 2002-07-30 | Inhibitors of DNA methylation |
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US8207142B2 (en) * | 2001-07-31 | 2012-06-26 | The United States Of America As Represented By The Secretary Of The Department Of Health And Human Services | Inhibitor of DNA methylation |
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US8207142B2 (en) | 2012-06-26 |
AU2002322805A2 (en) | 2003-02-17 |
JP2010248223A (en) | 2010-11-04 |
WO2003012051A3 (en) | 2003-10-30 |
EP1418949A4 (en) | 2009-03-04 |
CA2454147A1 (en) | 2003-02-13 |
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