WO2006091728A2 - Microtubule stabilizing compounds and methods of their use - Google Patents

Abstract

Methods for the stabilization of microtubules involved in axonal transport are disclosed. The methods employing compounds which functionally substitute for microtubule binding protein tau are useful, inter alia, in the treatment of neurodegenerative diseases or tauopathies. Microtubule stabilizing compounds are useful for the treatment of neurodegenerative diseases, as well as schizophrenia and other mental disorders that are characterized by disruption of maintain neuronal intracellular transport, neurite architecture, or neuronal migration.

Description

MICROTUBULE STABILIZING COMPOUNDS AND METHODS OF THEIR USE

FIELD OF THE INVENTION

The present invention generally relates to the stabilization of microtubules involved in axonal transport and to the maintenance of modes of intracellular transport in neurons. More specifically, the present invention relates to methods employing compounds which functionally substitute for microtubule binding protein tau in the treatment of neurodegenerative diseases. Further, it specifically relates to methods of treating neurodegenerative diseases, neuropsychiatric diseases, or mental disorders by employing compounds that stabilize microtubules or maintain neuronal intracellular transport, neurite architecture, or neuronal migration.

BACKGROUND OF THE INVENTION

Several compounds which affect microtubule assembly, disassembly, or function, for example through binding to or the stabilizing of microtubules, or through polymerization of tubulins to form microtubules, and the like, are known and include coumarin and dicoumarol (Jacobs, R. S. et al. US2002151560 Al), dictyostatin ( Curran, D. P. et al., US2004186165 Al), eleutherobin (Lindel, T. et al., J. Am. Chem. Soc. 1997, 119(37), 8744-45), sarcodictyin (Nicolaou, K. C, et al., WO9921862), epothilones (Goodin, S., et al., J. Clin Oncology, 2004, 22(10), 2015-25), FRl 82877 (Sato, B. et al., WO9632402), laulimalide and isolaulimalide (Mooberry, S. L., et al., Cancer Research, 1999, 59(3), 653-60), peloruside (Gaitanos, T. N., et al., Cancer Research, 2004, 64(15), 5063-67; and De Brabander, J. and Liao, X., US2004235939 Al), taccalonolides (Hemscheidt, T. K. and Mooberry, S. L., WO0071563), tubercidin (Mooberry, S. L., et al., Cancer Letters (Shannon, Ireland), 1995, 96(2), 261-6), taxol and its analogs (Trojanowski, J. Q. and Lee, V. US 5,580,898, 1996), discodermolide (Hung, D. T., et al., Chemistry and Biology, 1996, 3(4), 287-93; ter Haar, E., et al. Biochemistry, 1996, 55(1), 243-50; Kowalski, R. L., et al., Molec. Pharm., 1997, 52, 613-22), and its analogs (Smith, et al., US 2002-0103387 Al and PCT US02/24932), and the like, the reference each of which is hereby incorporated herein by reference, in its entirety. The majority of these studies have been directed toward cytotoxic compounds which stabilize microtubules, leading to mitotic arrest in neoplastic disease or cancer states. Certain of these studies have disclosed results that suggest different binding sites, properties, or reaction pathway dynamics as compared with taxol. _

Taxol has been disclosed as a microtubule stabilizing agent in methods directed toward subjects suspected of suffering from Alzheimer's disease (Trojanowski, J. Q. and Lee, V., US 5,580,898, 1996). In another study, taxol has been reported as having an ability to offset protein tau sequestration by stabilizing microtubules and reversing fast axonal transport deficits in tauopathy model systems (Zhang, B., et al., PNAS, January 4, 2005, 102(1), 227-31). Various other diseases and disorders linked to central degeneration of the CNS are reported to be associated with microtubule assembly, disassembly, function or a combination thereof. Recently, axonal transport has been identified as a common theme in neurodegenerative diseases, including Alzheimer's disease, frontotemporal dementias, Parkinson's disease, and polyglutamine diseases (Roy, S., et al., Acta Neuropathol. 2005, 109, 5-13). Other neurodegenerative diseases and disorders such as sporadic and familial Alzheimer's disease, including the prodromal phase of Alzheimer's disease known as mild cognitive impairment, Down's syndrome, Lewy body variant of Alzheimer's disease, as well as sporadic or hereditary neurodegenerative diseases known collectively as tauopathies (e.g. Pick's disease, corticobasal degeneration, progressive supranuclear palsy, frontotemporal dementia with Parkinsonism linked to chromosome 17 or FTDP-17), various forms of motor neuron disease (e.g. Lou Gehrig's disease or sporadic or hereditary amyotrophic lateral sclerosis), polyglutamine or or trinucleotide repeat diseases (including Huntington's disease), sporadic and familial synucleinopathies (including dementia with Lewy bodies, Parkinson's disease, multiple system atrophy, neurodegeneration with brain iron accumulation), neuronal intranuclear inclusion disease, hereditary spastic paraplegias, Charcot-Marie-Tooth disease, sporadic or hereditary prion disease, in addition to traumatic brain injury, and the like, may be associated with impaired microtubule structure, or function, or associated disruption of axonal transport.

These and other diseases, disorders, and/or conditions that may be associated with impaired microtubule structure, or function, or associated disruption of axonal transport may benefit from therapeutic interventions with compounds that stabilize microtubules thereby maintaining axonal and other forms of intraneuronal transport. By way of illustration, the offsetting of tau protein function losses that result from the sequestration of microtubule- stabilizing protein tau into filamentous inclusions through the use of microtubule stabilizing drugs may have therapeutic potential for treating neurodegenerative diseases or tauopathies. For example, familial FTDP-17 may be identified in subjects with tau gene mutations before disease onset, and as such, treatment with microtubule-stabilizing drugs may prevent disease onset in FTDP-17 subjects harboring tau gene mutations. Similarly, emerging data suggest that several other neurodegenerative diseases (motor neuron diseases, polyglutamine diseases, . . synucleinopafhties) may result in part from a disruption of axonal transport, and may benefit from microtubule stabilizing drug treatment. Other diseases that may show the same tau pathologies may benefit from treatment with microtubule stabilizing drugs to preserve axonal transport and prevent symptom onset with disease progression, such as , for example in the prodromal phase (mild cognitive impairment) of Alzheimer's disease. Neurons with impaired transport machinery resulting from traumatic brain injury, may in some instances be the consequence of induced destabilization of microtubules. Herein too, patients with this type of injury may benefit from treatment with microtubule stabilizing drugs to preserve axonal transport and prevent later the degenerative sequelae of brain injury.

Other examples of diseases, disorders, and/or conditions that benefit from therapeutic interventions with compounds that stabilize microtubules include, for example, schizophrenia and other psychiatric diseases or mental disorders. Research by Andrieaux, A., et al. (Pathol. Biol. 52:89-92, 2004), and Benitez-King, et al., (Curr. Drug Targets CNS Neurol. Disord. 3:515- 33, 2004) appear to link schizophrenia and other psychiatric diseases or mental disorders to impaired axonal transport. There also are data implicating impaired microtubule structure or function, the associated disruption of axonal transport, or any combination thereof, in schizophrenia and other mental disorders (van Woerkum, A.E., Med Hypotheses.31:7-15, 1990; Arnold, S., et al., Proc. Natl. Acad. Sci. USA, 88:10850-10854, 1991; Andrieaux, A., et al., Pathol Biol 52:89-92, 2004; Benitez-King, G., et al., Curr Drug Targets CNS Neurol Disord. 3:515-33, 2004). For example, there are reports suggesting that destabilization of microtubules may lead to impaired transport of receptors in CNS neurons thereby resulting in mental disorders (Yuen, E. Y., et al. J Biol Chem. 280:29420-7, 2005). Specifically, the destabilization of microtubules was shown to interfere with the action of the NMDA receptor (NMDAR), a target of the neurotransmitter glutamate, which plays a critical role in learning and memory.

Further, the same group showed in another study (Yuen, E. Y., et al. J Neurosci. 25:5488- 501, 2005) that the neuromodulator serotonin, which is involved in the treatment of depression and anxiety, also regulates NMDAR functions through mechanisms that are dependent on microtubules.

Genetic studies suggest a link between a novel gene (known as Disrupted-In- Schizophrenia 1 or DISCI) and mechanisms underlying schizophrenia. It is also known that the protein encoded by the DISCI gene is implicated in axonal transport. Thus, abnormalities in DISCI may contribute to the susceptibility for schizophrenia, the most prevalent psychiatric disorder, by disrupting transport systems in neurons that are located mainly in selectively . affected regions of the brains of schizophrenia patients (Morris, J.A., et al. Hum MoI Genet. 12:1591-608, 2003).

Other research has shown that STOP null mice show synaptic defects, including depleted synaptic vesicle pools, impaired synaptic plasticity, and severe neuroleptic-sensitive behavioral abnormalities that may model some of the clinical manifestations of psychiatric disorders in patients (Andrieaux, A., et al., Genes Dev. 16:2350-64, 2002). This is significant because the microtubule-associated protein STOP is involved in maintaining microtubule stability. The long- term administration of psychotropic drugs to STOP-/- mice has reportedly alleviated their behavioral impairments, thereby implicating destabilization of neuronal microtubules in abnormal synaptic function and/or plasticity, both of which are hypothesized to play roles in the onset and/or progression of schizophrenia.

Therefore, a need exists for methods utilizing microtubule stabilizing compounds for treating diseases and disorders, such as neurodegenerative diseases, disorders, and/or conditions, that may be favorably impacted by the use of compounds that act to help maintain neuronal transport systems and/or associated with microtubule formation, stabilization, or function. Applicants' invention is directed to these and other important ends.

SUMMARY OF THE INVENTION

The present invention is directed, in part, to methods for treating neurodegenerative diseases or tauopathies in a patient in need thereof, comprising administering to said patient, a composition comprising an effective amount of certain microtubule stabilizing compounds other than taxol or taxol analogs.

Certain embodiments of the present invention are directed to methods for treating neurodegenerative diseases or tauopathies other than Alzheimer's disease in a patient in need thereof, comprising administering to said patient, a composition comprising an effective amount of certain microtubule stabilizing compounds.

Certain aspects of the present invention are directed to methods of stabilizing microtubules for axonal transport in neurons in a patient in need thereof, comprising the step of administering to the patient an effective amount of one or more of these microtubule stabilizing compounds.

The present invention is also directed, in part, to methods of inducing polymerization of tubulins to microtubules for axonal transport in axonal transport-deficient-neurons in a patient in need thereof comprising the step of administering to said patient, a composition comprising an effective amount of certain microtubule stabilizing compounds. ,.

Other aspects of the present invention are directed to methods for treating a neurodegenerative or neuropsychiartric disease characterized by the disruption of neuronal intracellular transport, disruption of neurite architecture, or disruption of neuronal migration. The method comprises administering to a patient suspected of suffering from such disease, an amount of a microtubule stabilizing compound, or pharmaceutically acceptable salt or composition thereof effective to diminish the disruption or suppress the symptoms of the disease or diseases from which the patient suffers.

The present invention is also directed, in part, to methods for treating a neurodegenerative or neuropsychiatric disease characterized by the disruption of neuronal intracellular transport, neurite architecture, or neuronal migration, comprising administering to a patient suspected of suffering from said disease, an effective amount of taxol, coumarin compound, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, or a pharmaceutically acceptable salt thereof.

In certain embodiments, the invention is directed to methods for treating a neurodegenerative or neuropsychiatric disease characterized by the disruption of neuronal intracellular transport, neurite architecture, or neuronal migration, comprising: co-administering to a patient suspected of suffering from such disease, discodermolide, a discodermolide analog, or a discodermolide homolog together with taxol, a taxol analog, or a taxol homolog; said co-administration being in predetermined amounts and at times effective to relieve at least one symptom or effect of the disease.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

As employed above and throughout the disclosure, the following terms, unless otherwise indicated, shall be understood to have the following meanings.

"Side effect" refers to a consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other then the one sought to be benefited by its administration. In the case, for example, of microtubule stabilizing compounds, the term "side effect" may refer to such conditions as, for example, the excessive polymerization of microtubules. In some instances, this excessive polymerization is thought to result in reversible neuropathic symptoms that may be ameliorated by withdrawing drug or giving lower doses of drug or treating with drug at less frequent intervals. "Effective amount" refers to an amount of a compound as described herein that may be therapeutically effective to treat the symptoms of particular disease, disorder, condition, or side effect. Such diseases, disorders, conditions, and side effects include, but are not limited to, those pathological conditions associated with the administration of microtubule stabilizing compounds (for example, in connection with the treatment of neurodegenerative diseases or neuropsychiatric diseases, disorders, and/or conditions such as Alzheimer's disease, mild cognitive impairment, and schizophrenia and other neuropsychiatric diseases or mental disorders), wherein the treatment comprises, for example, inhibiting the depolymerization or destabilization of microtubules by contacting tubulins, or microtubules, or both, with compounds of the present invention that preserve the integrity of existing microtubules or promote formation of microtubules from tubulin monomers, or wherein the treatment comprises, for example, administration of one or more compounds of the present invention that act to maintain neuronal intracellular transport, neurite architecture, or neuronal migration. Thus, the term "effective amount," when used in connection with microtubule stabilizing compounds, for example, for the treatment of neurodegenerative diseases, schizophrenia, or other mental or neuropsychiatric disorder, refers to treatment of the impairment of axonal transport by maintaining the microtubule network essential for continuous axonal transport, other transport within neurons, or by otherwise maintaining neuronal intracellular transport, neurite architecture, or neuronal migration, for example, dendritic transport.

As used herein, "microtubule-binding-protein-tau-depleted neurons" refers to neurons having a level of microtubule binding tau protein less than that required to maintain the stability of microtubules wherein destabilization of microtubules or reduced induction of tubulin polymerization results, or both.

As used herein, the term "destabilization of microtubules" refers to the process whereby conditions bring about a depolymerization of microtubules and at least some of the tubulin subunits remain unpolymerized.

The term "pharmaceutically acceptable" refers to those compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem complications commensurate with a reasonable benefit/risk ratio.

When the term, "pharmaceutically acceptable salts" is used in this application, it refers to derivatives of the disclosed compounds wherein the parent compound is modified by making acid or base salts thereof. Examples of pharmaceutically acceptable salts include, but are not limited to, mineral or organic acid salts of basic residues such as amines; alkali or organic salts of acidic residues such as carboxylic acids; and the like. The pharmaceutically acceptable salts include the conventional non-toxic salts or the quaternary ammonium salts of the parent compound formed, for example, from non-toxic inorganic or organic acids. For example, such conventional non-toxic salts include those derived from inorganic acids such as hydrochloric, hydrobromic, sulfuric, sulfamic, phosphoric, nitric and the like; and the salts prepared from organic acids such as acetic, propionic, succinic, glycolic, stearic, lactic, malic, tartaric, citric, ascorbic, pamoic, maleic, hydroxymaleic, phenylacetic, glutamic, benzoic, salicylic, sulfanilic, 2- acetoxybenzoic, fumaric, toluenesulfonic, methanesulfonic, ethane disulfonic, oxalic, isethionic, and the like. These physiologically acceptable salts are prepared by methods known in the art, e.g., by dissolving the free amine bases with an excess of the acid in aqueous alcohol, or neutralizing a free carboxylic acid with an alkali metal base such as a hydroxide, or with an amine.

"Dosage unit" refers to physically discrete units suited as unitary dosages for the particular individual to be treated. Each unit may contain a predetermined quantity of active compound(s) calculated to produce the desired therapeutic effect(s) in association with the required pharmaceutical carrier. The specification for the dosage unit forms of the invention may be dictated by (a) the unique characteristics of the active compound(s) and the particular therapeutic effect(s) to be achieved, and (b) the limitations inherent in the art of compounding such active compound(s).

When "treatment" is used herein, it includes preventative (e.g., prophylactic), curative, or palliative treatment and "treating" as used herein also includes preventative, curative, and palliative treatment.

The terms "schizophrenia and other mental disorders" refer to a number of conditions or disease states wherein patients manifest positive (delusions, hallucinations, mania) and/or negative (apathy, anhedonia, social withdrawal) psychiatric signs and symptoms in the absence of other conditions (e.g. Alzheimer's disease or related neurodegenerative disorders) or circumstances (substance abuse, over medication with prescription drugs) to account for the abnormal behaviors.

As used herein, "tauopathy" refers to any of a number of conditions or disease states where there is abnormal formation of the tau protein pathologies in the brain that are typically referred to as neurofibrillary tangles, glial tangles and dystrophic neurites. For example, these tau pathologies also occur in neurodegenerative conditions in which there are lesions formed principally by other disease proteins. As a means of illustration, in prion diseases or so-called .

"mad cow" disease where the principal disease protein is the prion, there are also associated tau pathologies.

For the purposes of this invention, "synucleinopathy" refers to any neurodegenerative disease wherein there are prominent accumulations of fibrillar forms of alpha-synuclein that aggregate into inclusions typically known as Lewy bodies, Lewy neurites and glial cytoplasmic inclusions. These accumulations typically occur in familial and sporadic disorders such as Parkinson's disease, dementia with Lewy bodies, multiple system atrophy, the Lewy body variant of Alzheimer's disease, REM sleep disorder, and other conditions that have a mixed profile of inclusions including those formed by pathological alpha-synuclein filaments.

"Neurodegenerative disease" according to the invention refers to any neurodegenerative condition wherein there is tau pathology by itself or in association with other neurodegenerative CNS lesions), synucleinopathy, and other sporadic and hereditary disorder caused by central nervous system (CNS) degeneration, wherein synucleinopathy and tauopathy are as hereinabove defined. While some researchers do not consider schizophrenia to be a neurodegenerative disorder, applicants believe that schizophrenia may be the consequence of abnormal processes in brain development during the prenatal or early postnatal period, and that these abnormal brain developmental processes, whose effects or symptoms may not immediately manifest in the patient, may nonetheless be characterized by the disruption or impairment of 1) neuronal intracellular transport, 2) neurite architecture, or 3) neuronal migration.

Applicants believe that disruption of the microtubule network may factor in disease processes underlying schizophrenia, resulting in alterations of the microtubule network that may impair axonal transport and thereby impair neuronal functions. Applicants further believe that treatment of patients having the symptoms of schizophrenia with microtubule stabilizing drugs may reduce or reverse the extent of impaired axonal transport and/of impaired neuronal functions as well as ameliorate the symptoms of the of schizophrenic condition through stabilization of microtubules.

The term, "microtubule stabilizing compound" refers to any compound having the ability to bind, attach, or otherwise stabilize microtubules (protein polymers provided by polymerization of tubulins), hi some preferred embodiments, the microtubule stabilizing compound binds, attaches, or otherwise stabilizes microtubules formed from tubulins typically polymerized by microtubule binding protein tau.

Insofar as compounds and their analogs known to possess microtubule stabilizing or tubulin polymerization inducing properties are known or have been disclosed, they are also considered to be within the ambit of the invention. For example, Smith, et al, US 2002-0103387 _,

Al and PCT US02/24932, have disclosed a wide range of discodermolide analogs reported to have microtubule binding properties. By way of additional illustration, coumarin and dicoumarol (Jacobs, R. S. et al. US2002151560 Al), dictyostatin and analogs thereof ( Curran, D. P. et al., US2004186165 Al), eleutherobin (Lindel, T. et al., J. Am. Chem. Soc. 1997, 119(37), 8744-45), sarcodictyin (Nicolaou, K. C, et al., WO9921862), epothilones (Goodin, S., et al., J. Clin Oncology, 2004, 22(10), 2015-25), FR182877 (Sato, B. et al., WO9632402), laulimalide and islaulimalide (Mooberry, S. L., et al., Cancer Research, 1999, 59(3), 653-60), peloruside (Gaitanos, T. N., et al., Cancer Research, 2004, 64(15), 5063-67; and De Brabander, J. and Liao, X., US2004235939 Al), taccalonides (Hemscheidt, T. K. and Mooberry, S. L., WO0071563), and tubercidin (Mooberry, S. L., et al., Cancer Letters (Shannon, Ireland), 1995, 96(2), 261-6, have also been reported to have microtubule binding or tubulin polymerization properties, the reference of each of which is hereby incorporated herein by reference, in its entirety.

For the purposes of the invention, "axonal transport in neurons" refers to such axonal transport in neurons or in any other compartment of a neuron; for example, in dendrites. Further, the term "axonal transport", as herein defined, includes axonal and other forms of intraneuronal transport.

Further the term "axonal transport", as herein defined, includes axonal and other forms of intraneuronal transport.

As used herein, "axonal transport-deficient-neurons" refer to microtubule-depleted neurons or neurons with impaired transport machinery whose microtubule depletion or impaired transport machinery is at least in part caused by other microtubule destabilizing events or processes that disrupt transport systems in neurons, hi some preferred embodiments, the microtubule- depleted neurons are microtubule-binding-protein-tau-depleted neurons. Neurons with impaired transport machinery may be the result of, for example, traumatic brain injury induced destabilization of microtubules or pathological mechanisms similar to those underlying schizophrenia and other mental disorders or psychiatric diseases.

The term "patient" refers to animals, including mammals, preferably humans.

For the purposes of the invention, "prodrug" refers to compounds specifically designed to maximize the amount of active species that reaches the desired site of reaction, which are of themselves typically inactive or minimally active for the activity desired, but through biotransformation are converted into biologically active metabolites.

The compounds employed in the methods of the present invention may exist in prodrug form. As used herein, "prodrug" is intended to include any covalently bonded carriers which release the active parent drug, for example, as according to formulas or compounds employed in . . the methods of the present invention in vivo when such prodrug is administered to a mammalian subject. Since prodrugs are known to enhance numerous desirable qualities of pharmaceuticals (e.g., solubility, bioavailability, manufacturing, etc.) the compounds employed in the present methods may, if desired, be delivered in prodrug form. Thus, the present invention contemplates methods of delivering prodrugs. Prodrugs of the compounds employed in the present invention, for example, taxol or taxol analog, a coumarin, dicoumarol, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof; preferably dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof, may be prepared by modifying functional groups present in the compound in such a way that the modifications are cleaved, either in routine manipulation or in vivo, to the parent compound.

Accordingly, prodrugs include, for example, compounds described herein in which a hydroxy, amino, or carboxy group is bonded to any group that, when the prodrug is administered to a mammalian subject, cleaves to form a free hydroxyl, free amino, or carboxylic acid, respectively. Examples include, but are not limited to, acetate, formate and benzoate derivatives of alcohol and amine functional groups; and alkyl, carbocyclic, aryl, and alkylaryl esters such as methyl, ethyl, propyl, zso-propyl, butyl, isobutyl, .fee-butyl, fert-butyl, cyclopropyl, phenyl, benzyl, and phenethyl esters, and the like.

In certain embodiments, the neurodegenerative diseases, include Alzheimer's disease, frontotemporal dementias, Parkinson's disease, and polyglutamine. In other embodiments, the neurodegenerative diseases include disorders such as sporadic and familial Alzheimer's disease, including the prodromal phase of Alzheimer's disease known as mild cognitive impairment, Down's syndrome, Lewy body variant of Alzheimer's disease, as well as sporadic or hereditary neurodegenerative diseases known collectively as tauopathies (e.g. Pick's disease, corticobasal degeneration, progressive supranuclear palsy, frontotemporal dementia with parkinsonism linked to chromosome 17 or FTDP-17), in addition to various forms of motor neuron disease (e.g. Lou Gehrig's disease or sporadic or hereditary amyotrophic lateral sclerosis), polyglutamine or or trinucleotide repeat diseases (including Huntington's disease), sporadic and familial synucleinopathies (including dementia with Lewy bodies, Parkinson's disease, multiple system atrophy, neurodegeneration with brain iron accumulation), neuronal intranuclear inclusion disease, hereditary spastic paraplegias, Charcot-Marie-Tooth disease, sporadic or hereditary prion disease, traumatic brain injury, and the like. In some other embodiments, „ neurodegenerative diseases include motor neuron diseases, polyglutamine diseases, synucleinopathties, which may result in part from a disruption of axonal transport.

As used herein, "neuronal intracellular transport" refers to the energy dependent translocation of diverse proteins, organelles and otherbiological cargoes from one site to another within neurons and their processes (axons, dendrites).

The term "biological cargoes" herein refers to any molecules or other moieties that are associated with the proteins and organelles, including but not limited to oligopeptides, lipids, nucleic acids, mitochondria, lysosomes, synaptic vesicles, and the like.

According to the invention, "neurite architecture" refers to the complex three- dimensional array of neuronal processes (axons, dendrites) in the brain.

For the purposes of the invention, "neuronal migration" refers to the movement of neurons from one brain region to another.

The term, "DISCI" refers to a multifunctional protein or gene, Disrupted-In- Schizophrenia 1, which is associated with schizophrenia, so named because disrupted variants of it are associated with schizophrenia.

As used herein, "DISCI truncation" refers to a shortening of DISC 1, the act of which contributes to schizophrenia susceptibility by disrupting intracellular transport, neurite architecture, and /or neuronal migration. Applicants believe that these deleterious consequences of DISCI truncation are linked to underlying mechanisms of schizophrenia.

In certain embodiments, the present invention, is directed, in part, to methods for treating a neurodegenerative or neuropsychiatric disease characterized by the disruption of neuronal intracellular transport, neurite architecture, or neuronal migration, comprising administering to a patient suspected of suffering from said disease, an effective amount of a microtubule stabilizing compound, or a pharmaceutically acceptable salt thereof. hi other embodiments, the invention is directed, in part, to methods for treating a neurodegenerative or neuropsychiatric disease characterized by the disruption of neuronal intracellular transport, neurite architecture, or neuronal migration, comprising administering to a patient suspected of suffering from said disease, an effective amount of taxol, coumarin compound, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, or a pharmaceutically acceptable salt thereof. hi certain preferred embodiments of the present invention, the neurodegenerative disease includes schizophrenia and/or other mental or psychiatric disorders, even more preferably it includes familial and/or sporadic variants of these diseases, disorders, or conditions. ₁

In certain preferred embodiments, the microtubule stabilizing compound is other than taxol or a taxol analog; more preferably other than taxol, a taxol analog, or coumarin compound.

In other preferred embodiments the microtubule stabilizing compound is taxol, coumarin, dicoumarol, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof; more preferably coumarin, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, still more preferably dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof.

In other preferred embodiments, the neurodegenerative disease characterized by the disruption of neuronal intracellular transport, neurite architecture, or neuronal migration is sporadic and/or hereditary.

In certain preferred embodiments of the methods of treating a neurodegenerative or neuropsychiatric disease characterized by the disruption of neuronal intracellular transport, neurite architecture, or neuronal migration, the disruption of the neuronal intracellular transport, neurite architecture, or neuronal migration is associated with DISCI truncation. hi other embodiments, the present invention is directed to methods for treating schizophrenia or other mental or neuropsychiatric disease or disorder in a patient in need of such treatment, comprising the step of administering to said patient, a composition comprising an effective amount of a microtubule stabilizing compound in accordance with this invention. In certain preferred embodiments, the microtubule stabilizing compound administered is other than taxol or a taxol analog; more preferably other than taxol, a taxol analog, or coumarin compound.

In certain preferred embodiments, the microtubule stabilizing compound administered is taxol, coumarin, dicoumarol, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof; preferably coumarin, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, more preferably dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof.

In other preferred embodiments, the schizophrenia or other mental or neuropsychiatric disease or disorder includes all prodromal and all post onset phases thereof. By way of example, _{, ,} . this includes any prodromal or post-onset aspect of schizophrenia or other mental or neuropsychiatric disease ordisorder wherein the psychiatric manifestations of the disease may be caused by a failure of axonal transport due to disruption of microtubules or other components of the axonal transport machinery of neurons and their processes (dendrites).

In some embodiments, the present invention is directed to methods for treating neurodegenerative diseases or tauopathies in a patient in need of such treatment, comprising the step of administering to said patient, a composition comprising an effective amount of a microtubule stabilizing compound in accordance with this invention. In certain preferred embodiments, the microtubule stabilizing compound is other than taxol or a taxol analog; more preferably other than taxol, a taxol analog, or coumarin compound. In other embodiments the microtubule stabilizing compound is coumarin, dicoumarol, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof; preferably dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof. In other preferred embodiments, the neurodegenerative disease or tauopathy is sporadic or hereditary Alzheimer's disease, including all prodromal and all post onset phases of Alzheimer's disease. By way of example, this includes any prodromal or post- onset aspect of Alzheimer/s disease wherein brain degeneration or functional impairment in Alzheimer's disease may be caused by a failure of axonal transport due to disruption of microtubules as a consequence of sequestration of microtubule binding protein tau into inclusions such as neurofibrillary tangles and neuropil threads or dystrophic neurites; more preferably the neurodegenerative disease or tauopathy is a prodromal phase of Alzheimer's disease, yet more preferably, mild cognitive impairment. In certain embodiments, the neurodegenerative disease or tauopathy is Pick's disease, corticobasal degeneration, progressive supranuclear palsy, or frontotemporal dementia with parkinsonism linked to chromosome 17, that is, FTDP-17. In other embodiments, the neurodegenerative disease may have tau pathologies admixed with or in association with other pathologies formed by other disease proteins or microtubules may otherwise be unstable leading to impaired axonal transport as in the case of motor neuron disease, polyglutamine disease, or synucleinopathy, as well as traumatic brain injury. In still other embodiments, the neurodegenerative disease or tauopathy is sporadic or hereditary amyotrophic lateral sclerosis, dementia with Lewy bodies, sporadic or hereditary Down's syndrome, Lewy body variant of Alzheimer's disease, multiple system atrophy, neurodegeneration with brain iron accumulation, neuronal intranuclear inclusion disease, Parkinson's disease, hereditary spastic paraplegias, Charcot-Marie-Tooth disease, Huntington's disease, sporadic or hereditary prion disease, or tri-nucleotide repeat disease. In certain embodiments, the neurodegenerative disease or tauopathy is other than Alzheimer's disease.

In some embodiments, the neurodegenerative sporadic or hereditary tauopathy is mild cognitive impairment, Pick's disease, corticobasal degeneration, progressive supranuclear palsy, frontotemporal dementia with parkinsonism linked to chromosome 17 or FTDP- 17, motor neuron disease, polyglutamine disease, synucleinopathy, sporadic or hereditary amyotrophic lateral sclerosis, dementia with Lewy bodies, sporadic or hereditary Down's syndrome, Lewy body variant of Alzheimer's disease, multiple system atrophy, neurodegeneration with brain iron accumulation, neuronal intranuclear inclusion disease, Parkinson's disease, hereditary spastic paraplegias, Charcot-Marie-Tooth disease, Huntington's disease, sporadic or hereditary prion disease, or tri-nucleotide repeat disease. The microtubule stabilizing compound is other than taxol or a taxol analog; preferably other than taxol, a taxol analog, or coumarin compound. In certain embodiments the microtubule stabilizing compound is a coumarin, dicoumarol, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof; preferably dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof.

In certain embodiments the invention is directed to methods of stabilizing microtubules for axonal transport in neurons in a patient in need thereof, comprising the step of administering to said patient an effective amount of a microtubule stabilizing compound; preferably wherein the microtubule stabilizing compound is other than taxol or a taxol analog; preferably other than taxol, a taxol analog, or a coumarin compound. In some more preferred embodiments, the microtubule stabilizing compound is a coumarin, dicoumarol, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof; preferably dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof.

In yet other embodiments, the invention is directed to methods of inducing polymerization of tubulins to microtubules for axonal transport in axonal transport-deficient- neurons in a patient in need thereof comprising the step of administering to said patient, a composition comprising an effective amount of a microtubule stabilizing compound. In certain , - preferred embodiments, the microtubule stabilizing compound is other than taxol or a taxol analog; more preferably other than taxol, a taxol analog, or a coumarin compound. Li certain embodiments, the microtubule stabilizing compound is a coumarin, dicoumarol, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof; preferably dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof.

Paclitaxel and its analogs and homologs and discodermolide along with its analogs and homologs form two families of compounds which bind or stabilize the formation of certain microtubules within cells, leading to apoptosis. It is believed that the individual compounds, paclitaxel and discodermolide are effective tools in the treatment of certain cancers. More recently, it has been shown that discodermolide and taxol, when used in combination, exhibit synergism both their in vitro cytotoxicities and in their in vivo antitumor activity. (Matrello L. A., M^cDaid, H. M., Regl, D.L., et al., Taxol and Discodermolide Represent a Synergistic Drug Combination in human Carcinoma Cell Lines, Clin. Cancer Res.(2000) (5:1978-1987). It is now believed that when used in combination with paclitaxel or a homolog or analog at lower than cytotoxic dosing levels, discodermolide, or any of its homologs and analogs will provide synergistic efficacy in the treatment of a host of neurodegenerative diseases or disorders such as those noted in this specification.

Accordingly, in certain embodiments, the invention is directed to methods for treating a neurodegenerative disease or tauopathy in a patient in need thereof, comprising co-administering to a patient suspected of suffering from such disease, discodermolide, a discodermolide analog, or a discodermolide homolog together with taxol, a taxol analog, or a taxol homolog; said coadministration being in predetermined amounts and at times effective to relieve at least one symptom or effect of the disease. In some preferred embodiments, the neurodegenerative disease or tauopathy being treated in a patient in need thereof is other than Alzheimer's disease. In other preferred embodiments, the neurodegenerative disease or tauopathy being treated in a patient in need thereof is mild cognitive impairment.

Compounds employed in the invention may, in some embodiments, arrest or delay onset of any of the phases of Alzheimer's disease, including prodromal phase mild cognitive impairment or any phase prior to the onset of clinical symptoms of Alzheimer's disease. In other embodiments, the methods may be used to treat sporadic or hereditary neurodegenerative diseases known collectively as tauopathies, such as for example, Pick's disease, corticobasal .. degeneration, progressive supranuclear palsy, rrontotemporal dementia with parkinsonism linked to chromosome 17 or FTDP- 17, motor neuron disease, polyglutamine disease, synucleinopathy, sporadic or hereditary amyotrophic lateral sclerosis, dementia with Lewy bodies, sporadic or hereditary Down's syndrome, Lewy body variant of Alzheimer's disease, multiple system atrophy, neurodegeneration with brain iron accumulation, neuronal intranuclear inclusion disease, Parkinson's disease, hereditary spastic paraplegias, Charcot-Marie-Tooth disease, Huntington's disease, sporadic or hereditary prion disease, or tri-nucleotide repeat disease. For example, familial FTDP-17 may be identified in subjects with tau gene mutations before disease onset, and as such, treatment with microtubule-stabilizing drugs may prevent disease onset in FTDP-17 subjects harboring tau gene mutations. Similarly, emerging data suggest that several other neurodegenerative diseases (motor neuron diseases, polyglutamine diseases, synucleinopathies) may result in part from a disruption of axonal transport, and may benefit from microtubule stabilizing drug treatment. Finally, emerging data indicate the microtubules are unstable following traumatic brain injury thereby providing a rationale to treat patients with traumatic brain injury with microtubule binding drugs to prevent disruption of axonal transport and later neurodegenerative sequellae of traumatic brain injury.

For example, compounds having been reported to bind microtubules include coumarin and dicoumarol (Jacobs, R. S. et al. US2002151560 Al), dictyostatin ( Curran, D. P. et al., US2004186165 Al), eleutherobin (Lindel, T. et al., J. Am. Chem. Soc. 1997, 119(37), 8744-45), sarcodictyin (Nicolaou, K. C, et al., WO9921862), epothilones (Goodin, S., et al., J. Clin Oncology, 2004, 22(10), 2015-25), FRl 82877 (Sato, B. et al., WO9632402), laulimalide and islaulimalide (Mooberry, S. L., et al., Cancer Research, 1999, 59(3), 653-60), peloruside (Gaitanos, T. N., et al., Cancer Research, 2004, 64(15), 5063-67; and De Brabander, J. and Liao, X., US2004235939 Al), taccalonides (Hemscheidt, T. K. and Mooberry, S. L., WO0071563), and tubercidin (Mooberry, S. L., et al., Cancer Letters (Shannon, Ireland), 1995, 96(2), 261-6, the reference of each of which is hereby incorporated herein by reference, in its entirety.

Insofar as analogs of compounds known to possess microtubule stabilizing or tubulin polymerization inducing properties have been disclosed, they are also considered to be within the ambit of the invention. For example, Smith, et al., US 2002-0103387 Al and PCT US02/24932, have disclosed a wide range of discodermolide analogs reported to have microtubule binding properties. By way of additional illustration, analogs of dictyostatin ( Curran, D. P. et al., US2004186165 Al), sarcodictyin (Nicolaou, K. C, et al., WO9921862), and peloruside (De Brabander, J. and Liao, X., US2004235939 Al), have also been reported to have microtubule binding or tubulin polymerization properties. Compounds employed in the invention may, in some embodiments, arrest or delay onset of any of the phases of schizophrenia or other mental or neuropsychiatric disease or disorder including phases or any phase prior to the onset of psychiatric signs and symptoms of schizophrenia or other mental or psychiatric disorder.

In certain embodiments, the invention is directed to methods for treating a neuropsychiatric disorder in a patient in need thereof, comprising the steps of identifying a patient suffering from a neuropsychiatric disease or disorder; and administering to said patient, a composition comprising an effective amount of a microtubule stabilizing compound, or a pharmaceutically acceptable salt thereof, hi some preferred embodiments, the treatment of the disorder is initiated during its prodromal phase. Schizophrenia is among the disorders that may be treated in the methods of the invention, hi certain preferred embodiments, the mental or neuropsychiatric disorder, including more preferably schizophrenia, is sporadic or hereditary. hi other preferred embodiments where treatment of neuropsychiatric disorders is provided, the compound administered to a patient identified with a neuropsychiatric diseases or disorder is a microtubule stabilizing compound is other than taxol or a taxol analog, more preferably it is other than taxol, a taxol analog, or coumarin compound, hi certain preferred embodiments, the microtubule stabilizing compound administered is taxol, coumarin, dicoumarol, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof; preferably coumarin, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, more preferably dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof.

In other embodiments, the methods may be used to treat sporadic or hereditary forms of schizophrenia or other mental or neuropsychiatric disease or disorder that result in part from a disruption of axonal transport, which may benefit from treatment with microtubule stabilizing drugs or other compounds that act to maintain modulate or otherwise support neuronal transport systems. While not intending to be bound by any theory or theories of operation, it is contemplated that when taken together, results of recent studies by Andrieaux, A., et al. (Pathol. Biol. 52:89-92, 2004); Benitez-King, et al., (Curr. Drug Targets CNS Neurol. Disord. 3:515-33, 2004); (van Woerkum, A.E., Med Hypotheses.31:7-15, 1990; Arnold, S., et al., Proc. Natl. Acad. Sci. USA, 88:10850-10854, 1991; and Yuen, E.Y., et al. J Neurosci. 25:5488-501, 200) and other data suggest that serotonin may regulate NMDAR transport along the microtubule cytoskeleton _ in neurons, and impairments in transport and/or microtubule function may be a potential mechanism underlying schizophrenia and related mental disorders.

The present invention includes enumeration of compounds for the treatment of neuropsychiatric diseases or disorders, such as for example, schizophrenia, that may be therapeutically benefited by correcting defective microtubule formation, stabilization, or function, or by correcting other abnormalities that affect one or more additional components of the axonal transport machinery in neurons. In certain preferred embodiments, the compounds employed in treating psychiatric disorders include compounds recognized for their ability to stabilize microtubules, especially those compounds known to stabilize microtubules involved in axonal transport, m other preferred embodiments, the compounds employed in treating psychiatric disorders include compounds known to modulate and/or maintain the neuronal transport system.

In certain aspects of the invention, the invention is directed to methods for treating a neurodegenerative or neuropsychiatric disease or disorder characterized by the disruption of neuronal intracellular transport, neurite architecture, or neuronal migration, comprising: co-administering to a patient suspected of suffering from such disease, discodermolide, a discodermolide analog, or a discodermolide homolog together with taxol, a taxol analog, or a taxol homolog; said co-administration being in predetermined amounts and at times effective to relieve at least one symptom or effect of the disease.

Preferably, the neurodegenerative disease is initiated during a prodromal phase, or alternatively, is sporadic or hereditary, hi some preferred embodiments, the neuropsychiatric disease is schizophrenia. Alternatively, the disruption of the neuronal intracellular transport, neurite architecture, or neuronal migration may be associated with DISCI truncation.

Compounds described herein throughout, can be used in alternate forms. For example, many amino-containing compounds can be used as an acid addition salt. Often such salts improve isolation and handling properties of the compound. For example, depending on the reagents, reaction conditions and the like, compounds as described herein can be used, for example, as their hydrochloride or tosylate salts. Isomorphic crystalline forms, all chiral and racemic forms, N-oxide, hydrates, solvates, and acid salt hydrates, are also contemplated to be within the scope of the present invention.

Certain acidic or basic compounds of the present invention may exist as zwitterions. All forms of the compounds, including free acid, free base and zwitterions, are contemplated to be within the scope of the present invention. It is well known in the art that compounds containing both amino and carboxy groups often exist in equilibrium with their zwitterionic forms. Thus, _t . any of the compounds described herein throughout that contain, for example, both amino and carboxy groups, also include reference to their corresponding zwitterions.

The compounds are preferably combined with a pharmaceutical carrier or diluent selected on the basis of the chosen route of administration and standard pharmaceutical practice as described, for example, in Remington 's Pharmaceutical Sciences (Mack Pub. Co., Easton, PA, 1980), the disclosure of which is hereby incorporated herein by reference, in its entirety.

The compounds employed in the invention may be administered in an effective amount by any of the conventional techniques well-established in the medical field. The compounds employed in the methods of the present invention including, for example, the microtubule stabilizing compounds may be administered by any means that results in the contact of the active agents with the agents' site or site(s)of action in the body of a patient. The compounds may be administered by any conventional means available for use in conjunction with pharmaceuticals, either as individual therapeutic agents or in a combination of therapeutic agents. For example, they may be administered as the sole active agents in a pharmaceutical composition, or they can be used in combination with other therapeutically active ingredients.

Compounds employed in the present invention may be administered to a mammalian host in a variety of forms adapted to the chosen route of administration, e.g., orally or parenterally. Parenteral administration in this respect includes administration by the following routes: intravenous, intramuscular, subcutaneous, intraocular, intrasynovial, transepithelial including transdermal, ophthalmic, sublingual and buccal; topically including ophthalmic, dermal, ocular, rectal and nasal inhalation via insufflation, aerosol and rectal systemic.

The active compound may be orally administered, for example, with an inert diluent or with an assimilable edible carrier, or it may be enclosed in hard or soft shell gelatin capsules, or it may be compressed into tablets, or it may be incorporated directly with the food of the diet. For oral therapeutic administration, the active compound may be incorporated with excipient and used in the form of ingestible tablets, buccal tablets, troches, capsules, elixirs, suspensions, syrups, wafers, and the like. The amount of active compound(s) in such therapeutically useful compositions is preferably such that a suitable dosage will be obtained. Preferred compositions or preparations according to the present invention may be prepared so that an oral dosage unit form contains from about 1 to about 75% of their known antimitotic (dose used in anti-cancer therapy) dose, preferably about 2 to about 50%, more preferably about 5 to about 30%, yet more preferably about 10 to about 20%, still more preferably about 10% of the microtubule stabilizing compound's known antimitotic oral dosage unit weight of active compound. _{I U lL} .

The tablets, troches, pills, capsules and the like may also contain one or more of the following: a binder, such as gum tragacanth, acacia, corn starch or gelatin; an excipient, such as dicalcium phosphate; a disintegrating agent, such as corn starch, potato starch, alginic acid and the like; a lubricant, such as magnesium stearate; a sweetening agent such as sucrose, lactose or saccharin; or a flavoring agent, such as peppermint, oil of wintergreen or cherry flavoring. When the dosage unit form is a capsule, it may contain, in addition to materials of the above type, a liquid carrier. Various other materials may be present as coatings or to otherwise modify the physical form of the dosage unit. For instance, tablets, pills, or capsules may be coated with shellac, sugar or both. A syrup or elixir may contain the active compound, sucrose as a sweetening agent, methyl and propylparabens as preservatives, a dye and flavoring, such as cherry or orange flavor. Of course, any material used in preparing any dosage unit form is preferably pharmaceutically pure and substantially non-toxic in the amounts employed. In addition, the active compound may be incorporated into sustained-release preparations and formulations.

The active compound may also be administered parenterally or intraperitoneally. Solutions of the active compounds as free bases or pharmacologically acceptable salts can be prepared in water suitably mixed with a surfactant, such as hydroxypropylcellulose. A dispersion can also be prepared in glycerol, liquid polyethylene glycols, and mixtures thereof and in oils. Under ordinary conditions of storage and use, these preparations may contain a preservative to prevent the growth of microorganisms.

The pharmaceutical forms suitable for injectable use include, for example, sterile aqueous solutions or dispersions and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersions, hi all cases, the form is preferably sterile and fluid to provide easy syringability. It is preferably stable under the conditions of manufacture and storage and is preferably preserved against the contaminating action of microorganisms such as bacteria and fungi. The carrier may be a solvent or dispersion medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, liquid polyethylene glycol and the like), suitable mixtures thereof, and vegetable oils. The proper fluidity can be maintained, for example, by the use of a coating, such as lecithin, by the maintenance of the required particle size in the case of a dispersion, and by the use of surfactants. The prevention of the action of microorganisms may be achieved by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, sorbic acid, thimerosal and the like. In many cases, it will be preferable to include isotonic agents, for example, sugars or sodium chloride. Prolonged absoφtion of the injectable compositions may be achieved by the use of agents delaying absorption, for example, aluminum monostearate and gelatin.

Sterile injectable solutions may be prepared by incorporating the active compounds in the required amounts, in the appropriate solvent, with various of the other ingredients enumerated above, as required, followed by filtered sterilization. Generally, dispersions may be prepared by incorporating the sterilized active ingredient into a sterile vehicle which contains the basic dispersion medium and the required other ingredients from those enumerated above. In the case of sterile powders for the preparation of sterile injectable solutions, the preferred methods of preparation may include vacuum drying and the freeze drying technique that yields a powder of the active ingredient, plus any additional desired ingredient from the previously sterile-filtered solution thereof.

The therapeutic compounds employed in this invention may be administered to a patient alone or in combination with a pharmaceutically acceptable carrier. As noted above, the relative proportions of active ingredient and carrier may be determined, for example, by the solubility and chemical nature of the compounds, chosen route of administration and standard pharmaceutical practice.

The dosage of the compounds employed in the present invention that will be most suitable for treatment will vary with the form of administration, the particular compound chosen and the physiological characteristics of the particular patient under treatment. Generally, small dosages may be used initially and, if necessary, increased by small increments until the desired effect under the circumstances is reached. Generally speaking, oral administration may require higher dosages.

It may be appreciated that a number of families of compounds are effective when utilized in the methods of the invention, and that these families differ in such properties as molecular structure, molecular weight, water solubility, lipophilicity, among others. These and other properties may effect the dosages or frequency of dosing, or both, that is required by the methods of the invention to treat a particular disease or condition with a particular compound. Although the proper dosage of the microtubule stabilizing compounds of this invention will be readily ascertainable by one skilled in the art, once armed with the present disclosure, by way of general guidance, the microtubule stabilizing compounds, for example, may typically be dosed at a level in the range of about 1 to about 75% of their known antimitotic (dose used in anti-cancer therapy) dosing ranges, preferably about 2 to about 50%, more preferably about 5 to about 30%, yet more preferably about 10 to about 20%, still more preferably about 10% of the microtubule stabilizing compound's known antimitotic dosing range. For example, the range of the amount PCX/ UU 5S OO BE of taxol or an analog thereof that is effective for stabilizing microtubules in the brain cells of individuals suffering from a neurodegenerative disease, tauopathy, or schizophrenia or other mental or psychiatric disorder may be determined by one having ordinary skill in the art. It is contemplated that the daily dosage of microtubule stabilizing compound of the invention, such as for example, taxol or an analog thereof, may be in the range of from about 0.001 mg to about 10 mg per kg of body weight, preferably from about 0.01 mg to about 1 mg per kg body weight. It is also contemplated that the daily dosage of taxol or an analog thereof of the invention may be in the range of from about 0.25-0.50 mg to about 20 mg per kg of body weight. Persons of ordinary skill will be able to determine dosage forms and amounts with only routine experimentation based upon the considerations of this invention.

It will be further appreciated that the amount of the compound, or an active salt or derivative thereof, required for use in treatment will vary not only with the particular salt selected but also with the route of administration, the nature of the condition being treated and the age and condition of the patient and will be ultimately at the discretion of the attendant physician or clinician.

The desired dose may conveniently be presented in a single dose or as divided doses administered at appropriate intervals, for example, as two, three, four or more sub-doses per day. The sub-dose itself may be further divided, e.g., into a number of discrete loosely spaced administrations; such as multiple inhalations from an insufflator or by application of a plurality of drops into the eye.

The dose may also be provided by controlled release of the compound, by techniques well known to those in the art.

Pharmaceutical kits useful in, for example, the treatment of neurodegenerative disease, schizophrenia, or other mental or psychiatric disorder, which comprise a therapeutically effective amount of a microtubule stabilizing compound, in one or more sterile containers, are also within the ambit of the present invention. Sterilization of the container may be carried out using conventional sterilization methodology well known to those skilled in the art. The sterile containers of materials may comprise separate containers, or one or more multi-part containers, as exemplified by the UNTVIAL™ two-part container (available from Abbott Labs, Chicago, Illinois), as desired. Such kits may further include, if desired, one or more of various conventional pharmaceutical kit components, such as for example, one or more pharmaceutically acceptable carriers, additional vials for mixing the components, etc., as will be readily apparent to those skilled in the art. Instructions, either as inserts or as labels, indicating quantities of the u . components to be administered, guidelines for administration, and/or guidelines for mixing the components, may also be included in the kit.

The efficacy of compounds for use in the methods of the invention may be evaluated in mouse model systems by substituting the compound or compounds to be tested for the microtubule binding protein tau that becomes sequestered into inclusions of human tauopathies and transgenic (Tg) mouse models thereof (Zhang, B., et al., PNAS, January 4, 2005, 102(1), 227-31). Tg mice may be treated with a range of doses of unmodified MT binding drugs. The dosing of Tg and wild type (WT) control mice may typically include regimens for variable lengths of time via different routes of delivery before and after onset of clinically evident tauopathy. The ability of the microtubule stabilizing compounds to modify the disease phenotype is typically monitored with special attention focused on the ability of these compounds to restore fast axonal transport (FAT) in CNS axons as well as on microtubule numbers and levels of stable (detyrosinated) tubulins. The effects of these drugs on behavioral impairments may also be monitored in comparison with sham treatment of Tg mice.

Alternatively, for some embodiments, the efficacy of compounds for use in the methods of the invention may be evaluated in mouse model systems by substituting the compound or compounds to be tested for their microtubule binding as demonstrated in studies of transgenic (Tg) mouse models thereof (Zhang, B., et al., PNAS, January 4, 2005, 102(1), 227-31). Tg mice may be treated with a range of doses of unmodified MT binding drugs. The dosing of Tg and wild type (WT) control mice may typically include regimens for variable lengths of time via different routes of delivery before and after onset of clinical manifestations of psychiatric disease. The ability of the microtubule stabilizing compounds to modify the disease phenotype is typically monitored with special attention focused on the ability of these compounds to restore axonal transport in CNS neurons as well as on microtubule numbers and levels of stable (detyrosinated) tubulins. The effects of these drugs on behavioral impairments may also be monitored in comparison with sham treatment of Tg mice.

The disclosure of each patent, patent application, and publication cited or described in this document is hereby incorporated herein by reference, in its entirety.

Those skilled in the art will appreciate that numerous changes and modifications can be made to the preferred embodiments of the invention and that such changes and modifications can be made without departing from the spirit of the invention. It is, therefore, intended that the appended claims cover all such equivalent variations as fall within the true spirit and scope of the invention.

Claims

;:;n . . What is Claimed:

1. A method for treating a neurodegenerative disease or tauopathy in a patient in need thereof, comprising the step of: administering to said patient, a composition comprising: an effective amount of a microtubule stabilizing compound other than taxol or a taxol analog.

2. A method for treating a neurodegenerative disease or tauopathy other than Alzheimer's disease in a patient in need thereof, comprising the step of: administering to said patient, a composition comprising: an effective amount of a microtubule stabilizing compound.

3. The method of claim 1, wherein the microtubule stabilizing compound is other than a coumarin compound.

4. The method of claim 3, wherein the microtubule stabilizing compound is dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof.

5. The method of claim 1, wherein the neurodegenerative disease or tauopathy is sporadic or hereditary Alzheimer's disease.

6. The method of claim 5, wherein the neurodegenerative disease or tauopathy is mild cognitive impairment.

7. The method of claim 1, wherein the neurodegenerative disease or tauopathy is Pick's disease, corticobasal degeneration, progressive supranuclear palsy, or FTDP-17.

8. The method of claim 1 , wherein the neurodegenerative disease or tauopathy is motor neuron disease, polyglutamine disease, synucleinopathy, or traumatic brain injury.

9. The method of claim 1, wherein the neurodegenerative disease or tauopathy is sporadic or hereditary amyotrophic lateral sclerosis, dementia with Lewy bodies, sporadic or hereditary Down's syndrome, Lewy body variant of Alzheimer's disease, multiple system atrophy, _

PCτ/USpB/PBM-JD± _{t .} , _. , neurodegeneration with bram iron accumulation, neuronal intranuclear inclusion disease,

Parkinson's disease, hereditary spastic paraplegias, Charcot-Marie-Tooth disease, Huntington's disease, sporadic or hereditary prion disease, or tri-nucleotide repeat disease.

10. The method of claim 1, wherein the sporadic or hereditary neurodegenerative disease or tauopathy is mild cognitive impairment, Pick's disease, corticobasal degeneration, progressive supranuclear palsy, FTDP-17, motor neuron disease, polyglutamine disease, synucleinopathy, sporadic or hereditary amyotrophic lateral sclerosis, dementia with Lewy bodies, sporadic or hereditary Down's syndrome, Lewy body variant of Alzheimer's disease, multiple system atrophy, neurodegeneration with brain iron accumulation, neuronal intranuclear inclusion disease, Parkinson's disease, hereditary spastic paraplegias, Charcot-Marie-Tooth disease, Huntington's disease, sporadic or hereditary prion disease, or tri-nucleotide repeat disease, and the microtubule stabilizing compound is other than taxol or taxol analog.

11. The method of claim 10, wherein the microtubule stabilizing compound is coumarin, dicoumarol, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone,

FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof.

12. A method of stabilizing microtubules for axonal transport in neurons in a patient in need thereof, comprising the step of: administering to said patient an effective amount of a microtubule stabilizing compound.

13. The method of claim 12, wherein the microtubule stabilizing compound is other than taxol or a taxol analog.

14. The method of claim 13, wherein the microtubule stabilizing compound is other than taxol, a taxol analog, or coumarin compound.

15. The method of claim 14, wherein the microtubule stabilizing compound is dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof.

16. A method of inducing poly. meri .zati.on o,f tu„bu,li.ns to mi .crotubules for axonal transport i.n axonal transport-deficient-neurons in a patient in need thereof comprising the step of: administering to said patient, a composition comprising: an effective amount of a microtubule stabilizing compound.

17. The method of claim 16, wherein the microtubule stabilizing compound is other than taxol or a taxol analog.

18. The method of claim 16, wherein the microtubule stabilizing compound is other than taxol, a taxol analog, or coumarin compound.

19. The method of claim 18, wherein the microtubule stabilizing compound is dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof.

20. A method for treating a neurodegenerative disease or tauopathy in a patient in need thereof, comprising: co-administering to a patient suspected of suffering from such disease,

discodermolide, a discodermolide analog, or a discodermolide homolog together with taxol, a taxol analog, or a taxol homolog; said co-administration being in predetermined amounts and at times effective to relieve at least one symptom or effect of the disease.

21. The method of claim 20, wherein the neurodegenerative disease or tauopathy is other than Alzheimer's disease.

22. The method of claim 20, wherein the neurodegenerative disease or tauopathy is mild cognitive impairment.

23. A method for treating a neurodegenerative or neuropsychiatric disease characterized by the disruption of neuronal intracellular transport, neurite architecture, or neuronal migration, comprising: administering to a patient suspected of suffering from such disease, an amount of a microtubule stabilizing compound or pharmaceutically acceptable salt or composition thereof effective to dimmish the disruption, or suppress the symptoms, of the disease or diseases from which the patient suffers.

24. The method of claim 23, wherein treatment of the neurodegenerative disease is initiated during a prodromal phase.

25. The method of claim 23, wherein the neuropsychiatry disease is schizophrenia.

26. The method of claim 23, wherein the neurodegenerative disease is sporadic or hereditary.

27. The method of claim 23, wherein the disruption of neuronal intracellular transport, neurite architecture, or neuronal migration is associated with DISCI truncation.

28. The method of claim 23, wherein the microtubule stabilizing compound is other than taxol or a taxol analog.

29. The method of claim 28, wherein the microtubule stabilizing compound is other than taxol, a taxol analog, or coumarin compound.

30. The method of claim 29, wherein the microtubule stabilizing compound is dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any combination, or both, thereof.

31. A method for treating a neurodegenerative or neuropsychiatric disease characterized by the disruption of neuronal intracellular transport, neurite architecture, or neuronal migration, comprising: co-administering to a patient suspected of suffering from such disease, an amount of taxol, coumarin compound, dictyostatin, discodermolide, eleutherobin, sarcodictyin A or B, epothilone, FRl 82877, laulimalide, isolaulimalide, peloruside, taccalonolide, or tubercidin, or any analog, or any homolog, or any combination, or both, or a pharmaceutically acceptable salt or composition thereof, effective to diminish the disruption, or suppress the symptoms, of the disease or diseases from which the patient suffers.

32. The method of claim 31, wherein discodermolide, a discodermolide analog, or a discodermolide homolog is co-administered with taxol, a taxol analog, or a taxol homolog; said co-administration being in predetermined amounts and at times effective to relieve at least one symptom or effect of the disease.

33. The method of claim 32, wherein the co-administration is substantially simultaneous.

34. The method of claim 32, wherein the neurodegenerative disease is initiated during a prodromal phase.

35. The method of claim 32, wherein the neuropsychiatric disease is schizophrenia.

36. The method of claim 32, wherein the neurodegenerative disease is sporadic or hereditary.

37. The method of claim 32, wherein the disruption of neuronal intracellular transport, neurite architecture, or neuronal migration is associated with DISCI truncation.