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Definitions

• IRMs immune response modifiers
• TLRs Toll-like receptors
• IRMs may be useful for treating a wide variety of diseases and conditions.
• certain IRMs may be useful for treating viral diseases (e.g., human papilloma virus, hepatitis, herpes), neoplasias (e.g., basal cell carcinoma, squamous cell carcinoma, actinic keratosis, melanoma), T H 2- mediated diseases (e.g., asthma, allergic rhinitis, atopic dermatitis), and auto-immune diseases.
• viral diseases e.g., human papilloma virus, hepatitis, herpes
• neoplasias e.g., basal cell carcinoma, squamous cell carcinoma, actinic keratosis, melanoma
• T H 2- mediated diseases e.g., asthma, allergic rhinitis, atopic dermatitis
• Certain IRMs may also be useful, for example, as vaccine adj
• IRMs are imidazoquinoline amine derivatives (see, e.g., U.S. Pat. No. 4,689,338 (Gerster)), but other compound classes are known as well (see, e.g., U.S. Pat. Nos. 5,446,153 (Lindstrom et al.); 6,194,425 (Gerster et al.); and 6,1 10,929 (Gerster et al.); and International Publication Number WO2005/079195 (Hays et al.).
• the present invention provides, in one aspect, a new compound useful for inducing cytokine biosynthesis.
• the compound i.e., N-(4- ⁇ [4-amino-2-butyl-lH-imidazo[4,5-c]quinolin-l- yl]oxy ⁇ butyl)octadecanamide
• formula (I) N-(4- ⁇ [4-amino-2-butyl-lH-imidazo[4,5-c]quinolin-l- yl]oxy ⁇ butyl)octadecanamide
• the compound of Formula I has unexpectedly beneficial properties in terms of biologic activity. It is particularly desirable for incorporation into liposome based formulations. It appears that such formulations are surprisingly effective at boosting localized immune response with reduced systemic TNF induction.
• the present invention further provides methods of inducing cytokine biosynthesis in an animal, treating a viral infection and/or treating a neoplastic disease in an animal by administering an effective amount of a compound of Formula I to the animal.
• the present invention further provides a method of vaccinating an animal comprising administering an effective amount of a compound of Formula I to the animal as a vaccine adjuvant.
• the invention further provides pharmaceutical compositions comprising a pharmaceutically acceptable carrier and a therapeutically effective amount of a compound of Formula I.
• the pharmaceutical composition further comprises an antigen (e.g., a vaccine).
• the compound of Formula I is incorporated in a homogeneously dispersed formulation.
• the compound of Formula I is incorporated in an emulsified formulation.
• the compound of Formula I is incorporated in an oil- in- water formulation (for example formulations comprising soybean oil, TWEEN 80, SPAN 85, and PBS).
• the compound of Formula I is incorporated into a liposome -based formulation.
• the compound of Formula I Used as a vaccine adjuvant to an antigen vaccine, the compound of Formula I increases the antibody response to the vaccine. It can decrease the amount of antigen vaccine required to achieve a desired ⁇ therapeutically effective antibody response. For example, it can reduce the amount of vaccine antigen needed by 2-fold, 10-fold, 15-fold, 25-fold, 50-fold, or as much as 100-fold or more.
• the compound of Formula I is useful for a wide range purposes, including but not limited to such things as a vaccine adjuvant for influenza vaccines.
• the compound of Formula I in combination with an influenza vaccine antigen provides protection for HlNl influenza infection (as well as influenza A, B, and swine flu).
• the compound of Formula I when used as a vaccine adjuvant, the compound of Formula I in combination with an influenza vaccine antigen provides protection for HlNl influenza infection (as well as influenza A, B, and swine flu).
• Formula I in combination with hemagglutinin antigens provides protection for HlNl influenza infection.
• the compound of Formula I induces cytokine production primarily at the site of administration (or at a local site of application) and can do so without substantial systemic cytokine induction, which may be important for reducing side effects.
• the compound of Formula I can induce TNF production primarily at the site of administration (or at a local site of application) without inducing systemic TNF levels above the background level (i.e. the level measured systemically prior to
• subcutaneous injection of the compound of Formula I can be used to induce cytokine production (such as TNF production) in the local draining lymph nodes, but not peripheral lymph nodes.
• cytokine production such as TNF production
• subcutaneous injection of the compound of Formula I can induce cytokine production (such as TNF production) in the local draining lymph nodes at levels at least 2 times, 3 times, 5 times, 10 times, or as much as 100 times greater or more than in the peripheral lymph nodes
• N-(4- ⁇ [4-amino-2- butyl-lH-imidazo[4,5-c]quinolin-l-yl]oxy ⁇ butyl)hexadecanamide may be synthesized using a similar synthetic route and may also be used for the same uses, pharmaceutical compositions, and formulations as the compound of Formula one set forth herein.
• “Ameliorate” refers to any reduction in the extent, severity, frequency, and/or likelihood of a symptom or clinical sign characteristic of a particular condition.
• Antigen refers to any substance that may be bound by an antibody in a manner that is immunospecific to some degree.
• “Induce” and variations thereof refer to any measurable increase in cellular activity.
• induction of an immune response may include, for example, an increase in the production of a cytokine, activation, proliferation, or maturation of a population of immune cells, and/or other indicator of increased immune function.
• “Liposome” or “liposome based” as used herein refers generally to a self - assembling particle composed of amphipathic molecules such as, but not limited to lipid, lipid-like, or polymeric substances. They can also include lipopeptides and glycolipids.
• Symptom refers to any subjective evidence of disease or of a patient's condition.
• “Therapeutic” and variations thereof refer to a treatment that ameliorates one or more existing symptoms or clinical signs associated with a condition.
• Treatment or variations thereof refer to reducing, limiting progression, ameliorating, preventing, or resolving, to any extent, the symptoms or signs related to a condition.
• the compound N-(4- ⁇ [4-amino-2-butyl- lH-imidazo[4,5-c]quinolin- 1 - yl]oxy ⁇ butyl)octadecanamide described herein may be in any of its pharmaceutically acceptable forms including solid, semi-solid, solvate (e.g., hydrate), wholly or partially dissolved (e.g., in a pharmaceutical composition), or dispersed in a pharmaceutically acceptable carrier.
• any pharmaceutically acceptable salt form of the compound of Formula I (N-(4- ⁇ [4-amino-2-butyl-lH- imidazo[4,5-c]quinolin- l-yl]oxy ⁇ butyl)octadecanamide) may also be used.
• the resulting solid was washed with water (60 mL) and dried under vacuum for 4 hours to provide 4.59 g of crude N-(4-chloroquinolin-3- yl)valeramide as brown flakes.
• the crude product was recrystallized from heptane (10 mL) and the recovered product was further purified by soxhlet extraction using refluxing heptane for 16 hours.
• the collection flask from the soxhlet extraction apparatus was cooled in a freezer for 2 hours.
• the resulting solid was collected by filtration and dried under vacuum to yield 2.00 g of N-(4-chloroquinolin-3- yl)valeramide as a white solid.
• N-(4-chloroquinolin-3-yl)valeramide (1.97 g), benzyl (4-aminooxybutyl)carbamate (2.99 g), triethylamine (0.89 g) and 2-propanol (40.69 g) were combined and heated at 80 °C for 3.5 hours.
• the reaction was cooled to room temperature, filtered, and the filtrate concentrated under reduced pressure.
• Dichloromethane (20 mL) was added to the resulting solid and the mixture was stirred for twenty minutes. Undissolved solid was removed by filtration and the filtrate was washed with two 10 mL portions of water that had been made slightly acidic by the addition of 20 drops of hydrochloric acid (1.2 M).
• the dichloromethane solution was transferred to a distillation apparatus and 1-pentanol (50 mL) was added. This was warmed to 40° C and the dichoromethane was removed under reduced pressure. Concentrated hydrochloric acid (50 ml) was then added and the reaction was stirred and heated to 80°. After 1 1 hoursr, the solution was cooled to room temperature and diluted with water (100 mL). The aqueous fraction was separated from the 1-pentanol and the 1-pentanol was extracted with water (25 mL). The aqueous fractions were combined. 1 -Pentanol (50 mL) was added to the combined aqueous fraction and this was cooled in an ice-bath.
• the maleate salt of l-(4-aminobutoxy)-2-butyl-lH-imidazo[4,5-c]quinolin-4-amine was prepared by dissolving maleic acid (4.83 g) in 1-pentanol (50 mL) and adding it with stirring to the solution of l-(4- aminobutoxy)-2-butyl-lH-imidazo[4,5-c]quinolin-4-amine in 1-pentanol. The resulting precipitate was collected by filtration and dried to yield 7.69 g of l-(4-aminobutoxy)-2-butyl-lH-imidazo[4,5-c]quinolin- 4-amine bis maleate salt.
• the fumarate salt of l-(4-aminobutoxy)-2-butyl-lH-imidazo[4,5-c]quinolin-4- amine was prepared by the following procedure. l-(4-aminobutoxy)-2-butyl-lH-imidazo[4,5-c]quinolin- 4-amine (6.53 g) was dissolved in 2-propanol (75 mL) and decolorizing carbon was added. The reaction was heated to reflux, filtered while hot, and cooled to room temperature. A solution of fumaric acid (2.5 g) in 2-propanol was added and the reaction was heated at reflux temperature for 5 minutes. Upon cooling to room temperature a precipitate formed. Filtration followed by drying the product under vacuum yielded 6.6 g of l-(4-aminobutoxy)-2-butyl-lH-imidazo[4,5-c]quinolin-4-amine fumarate.
• the semi-pure product was purified by flash column chromatography two more times using a 90: 10 dichloromethane/methanol isocratic elution, followed by a 95:5 dichloromethane/methanol isocratic elution
• the fractions containing product were concentrated to yield 1.12 g of N-(4- ⁇ [4-amino-2-butyl-lH- imidazo[4,5-c]quinolin- 1 -yl]oxy ⁇ butyl)octadecanamide as an off white waxy solid.
• the vaccine adjuvant activity of N-(4- ⁇ [4-amino-2-butyl-lH-imidazo[4,5-c]quinolin-l- yl]oxy ⁇ butyl)octadecanamide was evaluated in mice immunized with recombinant hemagglutinin 1 ( ⁇ ).
• IgG2a antigen specific antibody response was measured using five different preparations (1. ⁇ alone (control); 2. ⁇ + resiquimod (comparator preparation); 3. ⁇ + Cmpd of Example 1 formulated in dioleoylphosphatidylcholine (DOPC) (liposome formulation); 3. ⁇ + Cmpd of Example 1 ; 5. ⁇ + DOPC (control).
• the Cmpd of Example 1 and resiquimod were individually prepared as aqueous suspensions in phosphate buffered saline (PBS).
• the Cmpd of Example 1 formulated in DOPC liposome formulation was prepared as follows. A stock solution of the Cmpd of Example 1 was prepared in chloroform at a concentration of 10 mg/ml. A stock solution of dioleoylphosphatidylcholine (DOPC) was also prepared in chloroform at a concentration of 10 mg/ml. Aliquots of each stock solution were combined to provide a solution containing DOPC and the Cmpd of Example 1 at a mass ratio of 10: 1, respectively. The solution was blown to dryness and resuspended in sterile PBS by probe sonication.
• DOPC dioleoylphosphatidylcholine
• mice Groups of 5 mice each were immunized subcutaneously with 10 ⁇ g of ⁇ antigen in PBS, alone or in combination with 1 mg/Kg of the compounds cited in Table 1.
• DOPC control animals received the same amount of DOPC as that prepared with the Cmpd of Example 1.
• the mice were boosted with the same combinations 2 weeks and 4 weeks following the initial immunization.
• the mice were bled and the HA-specific IgG2a titers were determined. This determination was performed by serial dilution of the serum samples by standard serum ELISA in HA-coated microtiter plates. IgG2a data is presented as the serum dilution achieving the end point (2X baseline) and is the geometric mean for the 5 mice per group.
• IFNgamma Antigen dependent interferon-gamma
• spleenocyte cultures established from the same animals for which IgG2a antibody responses were determined in Example 2.
• the spleens from the animals were removed, combined to form two pools for each group of 5 animals, minced to create single cell suspensions, and placed in culture in 96 well microtiter plates. Each pool generated three wells for a control PBS challenge and three wells for a 10 mg HA challenge.
• the cultures were then incubated at 37 °C for 72 hours.
• the medium was then removed and the interferon- gamma generated was measured (pg/ml) by an ELISA assay (Table 2).
• the IFNgamma data is reported as the geometric mean value for each pool using triplicate measurements.
• mice The effect of N-(4- ⁇ [4-amino-2-butyl- lH-imidazo[4,5-c]quinolin-l-yl]oxy ⁇ butyl)octadecanamide (Cmpd of Example 1) to induce the formation of systemic tumor necrosis factor (TNF) in vivo was evaluated in mice.
• Systemic TNF induction was measured using four different preparations (1. PBS (control); 2. resiquimod (comparator preparation); 3. resiquimod formulated in
• dioleoylphosphatidylcholine (comparator preparation); 4. Cmpd of Example 1 formulated in dioleoylphosphatidylcholine (DOPC) (liposomes).
• Example 1 Compound of Example 1 formulated in dioleoylphosphatidylcholine (DOPC) liposomes was prepared as described in Example 2.
• Resiquimod formulated in DOPC was prepared in an analogous manner to the Cmpd of Example 1 in DOPC.
• the resiquimod preparation was made as an aqueous suspension in PBS.
• mice were injected subcutaneously with preparations containing 1 mg/Kg of each test compound (i.e. resiquimod or Cmpd of Example 1). At one hour and at three hours post dose, the mice were bled and systemic TNF was measured in the serum (pg/mL) by ELISA assay. The results are presented as the geometric means obtained for each group of five animals.
• mice Groups of 5 mice each were immunized subcutaneously with 10 ⁇ g of ⁇ antigen, alone or with increasing amounts of N-(4- ⁇ [4-amino-2-butyl- lH-imidazo[4,5-c]quinolin- 1- yl]oxy ⁇ butyl)octadecanamide (Cmpd of Example l)/DOPC as cited in Table 4.
• the mice were boosted with the same combinations 2 weeks and 4 weeks following initial immunization.
• the mice were bled and the HA-specific IgG2a titers were determined. This determination was performed by serial dilution of the serum samples by standard serum ELISA in HA-coated microtiter plates.
• IgG2a data is the serum dilution achieving the end point (2X baseline) and is the geometric mean for the 5 mice per group.
• Antigen dependent interferon-gamma (IFNgamma) responses were determined in spleenocyte cultures established from the same animals for which IgG2a antibody responses were determined in Example 5.
• the spleens from the animals were removed, combined to form two pools for each group of 5 animals, minced to create single cell suspensions, and placed in culture in 96 well microtiter plates. Each pool generated three wells for a control PBS challenge and three wells for a 10 mg HA challenge.
• the cultures were then incubated at 37 °C for 72 hours.
• the medium was then removed and the interferon- gamma generated was measured (pg/ml) by an ELISA assay (Table 5).
• the IFNgamma data is reported as the geometric mean value for each pool using triplicate measurements.
• N-(4- ⁇ [4-amino-2-butyl- lH-imidazo[4,5-c]quinolin- 1 - yl]oxy ⁇ butyl)octadecanamide (Cmpd of Example 1) was determined.
• the human peripheral blood mononuclear cells were prepared from human volunteers and placed in culture in 96 well microtiter plates. The Cmpd of Example 1 was added to the wells at the following concentrations: 30, 10, 3.3, 1.1, 0.37, 0.13, 0.043, and 0.014 ⁇ . The cells were then incubated overnight at 37 °C. The medium was removed and TNF concentration (ng/mL) was measured by ELISA assay (Table 6).
• mice were evaluated in Balb/c male mice (Charles River, Wilmington, MA) infected intranasally with mouse-adapted ⁇ 1 ⁇ 1 A/Puerto Rico/8/34 (obtained from American Type Culture Collection, Manassas, VA).
• mice were immunized with 1. PBS; 2. 10 ⁇ g ⁇ ; or 3. 10 ⁇ g ⁇ + 0.1 mg/Kg of Cmpd of Example 1 in DOPC liposomes, respectively.
• mice Two weeks prior to infection, the same groups were boosted with their corresponding immunizing doses. Survival of mice was monitored for 1 1 days following intranasal infection and the data is presented in Table 7 as percent survival on each day.
• One mouse from group 1 and two mice from group 2 failed to achieve infection as determined from lack of weight loss within the first 3 days of infection. Therefore, by day 5 group 1 was comprised of 9 mice, group 2 was comprised of 8 mice, and groups 3 and 4 were comprised of 10 mice, each.
• mice were sacrificed 1 1 days following tumor injection, tumors were measured at their major and minor diameters, and the products of the two measurements were determined. The mean tumor size in mm 2 +/- standard deviation (s.d.) for each group was determined. The results are presented in Table 8.
• mice immunized with varying amounts of ⁇ with and without Cmpd of Example 1 The dose sparing activity of N-(4- ⁇ [4-amino-2-butyl-lH-imidazo[4,5-c]quinolin- l- yl]oxy ⁇ butyl)octadecanamide (Cmpd of Example 1) was evaluated in mice immunized with varying amounts of ⁇ with and without Cmpd of Example 1.
• Groups of five Balb/c male mice (Charles River, Wilmington, MA) were immunized with 1 ⁇ g, 5 ⁇ g, or 15 ⁇ g of ⁇ with or without 0.1 mg/kg of Cmpd of Example 1. The mice were then boosted with the same preparations at 2 weeks and at 4 weeks post immunization.
• mice were bled and titers of HA-specific IgGl and IgG2a were determined by serial dilution of the serum samples using a standard serum ELISA assay in HA-coated microtiter plates.
• the IgGl and IgG2a data is presented in Table 9 as the serum dilution that achieved the end point (2X baseline) and is the geometric mean for 5 mice per group.
• the addition of 0.1 mg/Kg of Cmpd of Example 1 to HA greatly enhanced the antibody response to this antigen.
• Cmpd of Example 1 The local in vivo activity of N-(4- ⁇ [4-amino-24outyl-lH-imidazo[4,5-c]quinolin- l- yl]oxy ⁇ butyl)octadecanamide (Cmpd of Example 1) was evaluated in groups of four Balb/c male mice (Charles River) and compared to the activity of resiquimod (a comparator compound). Solutions of the Cmpd of Example 1 or resiquimod were injected subcutaneously into four separate groups of mice for evaluation at the time points of 1 hour, 3 hour, 6 hours, and 18 hours post dose. The final dose for either compound was 1.0 mg/kg.
• mice were bled, sacrificed, and the draining axial and brachial lymph nodes were removed and placed in RNA preservation fluid (RNAlater reagent obtained from Ambion Corporation, Austin, TX). Serum samples were analyzed for TNF protein concentration (pg/ml) by ELISA as a measure of systemic presence of this cytokine.
• the draining lymph nodes were processed for measurement of TNF mRNA gene expression by quantitative PCR (7900 ⁇ Thermocycler obtained from Applied Biosystems, Carlsbad, CA). The data reported (Table 10) is the mean +/- standard deviation (s.d.) for each group. The "not detected" level for serum TNF concentration was less than 10 pg/ml.
• the present invention thus provides the compound of Formula I, as well as pharmaceutical compositions and formulations thereof.
• the compound of Formula I is incorporated into a liposome based formulation.
• an antigen may be formulated within the lumen of the self - assembling liposome particle.
• Such liposomes would include composites of such substances in proportions best suited to yield stable particles of desired sizes and diameters. Sizes can be of the sub micron range to mimic viral pathogens and micron size to mimic bacterial antigens. These sizes can be controlled by particle composition and process of formation.
• the compound of Formula I (e.g., in a pharmaceutical composition disclosed herein) is administered to a localized tissue region, such as into a tumor mass.
• the compound of Formula I is administered to localized tissue, such as a tumor mass, in a liposome formulation.
• a cancer vaccine may also be included.
• a “localized tissue region” will generally be a relatively small portion of the body, e.g., less than
• the localized tissue region will typically be on the order of no more than about 500 cubic centimeters (cm 3 ), often less than about 100 cm 3 , and in many instances 10 cm 3 or less.
• the localized tissue region will be 1 cm 3 or less (e.g., for small tumor nodules, viral lesions, or vaccination sites).
• the localized tissue region may be a particularly large region, up to several liters, for example, to treat metastasized cancer within the entire peritoneal cavity.
• the localized tissue region may be, for example, a cancer, a viral infected lesion, or organ, or vaccination site. It may be, for example, a solid tumor, lymph tissue, reticuloendothelial system, bone marrow, mucosal tissue, etc.
• the localized tissue region may be, e.g., a breast cancer tumor, stomach cancer tumor, lung cancer tumor, head or neck cancer tumor, colorectal cancer tumor, renal cell carcinoma tumor, pancreatic cancer tumor, basal cell carcinoma tumor, cervical cancer tumor, melanoma cancer tumor, prostate cancer tumor, ovarian cancer tumor, or bladder cancer tumor. Delivery of the compound of Formula I to a localized tissue region may be in conjunction with image guiding techniques using, for example, ultrasound, MRI, and real-time X-ray (fluoroscopy).
• the pharmaceutical composition further comprises an antigen in an amount effective to generate an immune response against the antigen.
• the antigen is a vaccine.
• Vaccines include any material administered to raise either humoral and/or cell mediated immune response, such as live or attenuated viral and bacterial immunogens and inactivated viral, tumor- derived, protozoal, organism- derived, fungal, and bacterial immunogens, toxoids, toxins, polysaccharides, proteins, glycoproteins, peptides, cellular vaccines (e.g., using dendritic cells), DNA vaccines, recombinant proteins,
• Exemplary vaccines include vaccines for cancer, BCG, cholera, plague, typhoid, hepatitis A, B, and C, influenza A and B, parainfluenza, polio, rabies, measles, mumps, rubella, yellow fever, tetanus, diphtheria, hemophilus influenza b, tuberculosis, meningococcal and pneumococcal vaccines, adenovirus, HIV, chicken pox, cytomegalovirus, dengue, feline leukemia, fowl plague, HSV- 1 and HSV-2, hog cholera, Japanese encephalitis, respiratory syncytial virus, rotavirus, papilloma virus, severe acute respiratory syndrome (SARS), anthrax, and yellow fever. See also, e.g., vaccines disclosed in International Publication No. WO 02/24225 (Thomsen et al.).
• Antigens can be co-delivered with a compound of Formula I, for example, in admixture in a pharmaceutical composition according to the present invention.
• Such pharmaceutical compositions may include the compound in Formula I in liposomes. This may allow the compound of Formula I to reach, for example, antigen presenting cells at or around the same time as the antigen.
• the compound of Formula I and the antigen may be administered separately at or about the same time.
• Co-delivering a vaccine adjuvant e.g., an IRM compound such as a compound of Formula I
• an antigen to an immune cell can increase the immune response to the antigen and improve antigen-specific immunological memory.
• Optimal delivery may occur, for example, when the adjuvant and the antigen are processed within an antigen presenting cell at the same time.
• a compound of Formula I may be administered in any other suitable manner (e.g., non-parenterally or parenterally).
• non-parenterally refers to administration through the digestive tract, including by oral ingestion.
• Parenterally refers to administration other than through the digestive tract which would include nasal (e.g., transmucosally by inhalation), topical, ophthalmic, and buccal adminstration, but in practice usually refers to injection (e.g., intravenous, intramuscular, subcutaneous, intratumoral, or transdermal) using, for example, conventional needle injection, injection using a microneedle array, or any other known method of injection.
• the compound of Formula I may be provided in any pharmaceutical composition suitable for administration to a subject and may be present in the pharmaceutical composition in any suitable form (e.g., a solution, a suspension, an emulsion, or any form of mixture).
• the pharmaceutical composition may be formulated with any pharmaceutically acceptable excipient, carrier, or vehicle.
• the pharmaceutically acceptable carrier comprises water (e.g., phosphate or citrate buffered saline).
• the pharmaceutically acceptable carrier comprises an oil (e.g., corn, sesame, squalene, cottonseed, soybean, or safflower oil).
• the pharmaceutical composition may further include one or more additives including skin penetration enhancers, colorants, fragrances, flavorings, moisturizers, thickeners, suspending agents, surfactants, and dispersing agents.
• the pharmaceutical compositions and methods of the present disclosure can include other additional active agents, e.g., in admixture or administered separately.
• additional agents can include a chemotherapeutic agent, a cytotoxoid agent, an antibody, an antiviral agent, a cytokine, a tumor necrosis factor receptor (TNFR) agonist, or an additional immune response modifier.
• TNFR agonists that may be delivered in conjunction with the compound of Formula I include CD40 receptor agonists, such as disclosed in copending application U.S. Patent Publication 2004/0141950 (Noelle et al.).
• Other active ingredients for use in combination with an IRM preparation of the present invention include those disclosed in, e.g., U.S. Patent Publication No. 2003/0139364 (Krieg et al.).
• a pharmaceutical composition according to the present invention may be a conventional topical dosage formulation (e.g., a cream, an ointment, an aerosol formulation, a non-aerosol spray, a gel, or a lotion).
• a conventional topical dosage formulation e.g., a cream, an ointment, an aerosol formulation, a non-aerosol spray, a gel, or a lotion.
• suitable types of formulations are described, for example, in U.S. Pat. No. 5,238,944 (Wick et al.); U.S. Pat. No. 5,939,090 (Beaurline et al.); U.S. Pat. No. 6,245,776
• the compound of Formula I has been shown to induce the production of TNF-a as described above.
• the ability to induce TNF production indicates that the compound of Formula I is useful as an immune response modifier that can modulate the immune response in a number of different ways, rendering it useful in the treatment of a variety of disorders.
• Other cytokines whose production may be induced by the administration of the compound of Formula I generally include Type I interferons (e.g., INF-a), IL-1, IL-6, IL-8, IL-10, IL- 12, MIP-1, MCP-1, and a variety of other cytokines. Among other effects, these and other cytokines inhibit virus production and tumor cell growth, making the compound of Formula I useful in the treatment of viral diseases and neoplastic diseases.
• the invention provides a method of inducing cytokine biosynthesis in an animal comprising administering an effective amount of the compound of Formula I (e.g., in a pharmaceutical composition) to the animal.
• the animal to which the compound of Formula I is administered for induction of cytokine biosynthesis may have a disease (e.g., a viral or neoplastic disease), and administration of the compound may provide therapeutic treatment.
• the compound of Formula I may be administered to the animal before the animal acquires the disease so that administration of the compound of Formula I may provide a prophylactic treatment.
• the compound of Formula I may affect other aspects of the innate immune response.
• natural killer cell activity may be stimulated, an effect that may be due to cytokine induction.
• IRM activity of the compound of Formula I also may include activating macrophages, which in turn stimulate secretion of nitric oxide and the production of additional cytokines.
• IRM activity of the compound of Formula I also may include inducing cytokine production by T cells, activating T cells specific to an antigen, and/or activating dendritic cells.
• IRM activity of the compound of Formula I may include proliferation and differentiation of B-lymphocytes. IRM activity of the compound of Formula I also may affect the acquired immune response.
• IRM activity can include inducing the production of the T helper type 1 (T H 1) cytokine IFN- ⁇ and/or inhibiting the production of the T helper type 2 (T H 2) cytokines IL-4, IL-5 and/or IL-13.
• T H 1 T helper type 1
• T H 2 T helper type 2
• Exemplary conditions that may be treated by administering the compound of Formula I include: (a) viral diseases such as diseases resulting from infection by an adenovirus, a herpesvirus (e.g., HSV-I, HSV-II, CMV, or VZV), a poxvirus (e.g., an orthopoxvirus such as variola or vaccinia, or molluscum contagiosum), a picornavirus (e.g., rhinovirus or enterovirus), an orthomyxovirus (e.g., influenzavirus), a paramyxovirus (e.g., parainfluenzavirus, mumps virus, measles virus, and respiratory syncytial virus (RSV)), a coronavirus (e.g., SARS), a papovavirus (e.g., papillomaviruses, such as those that cause genital warts, common warts, or plantar warts), a hepadnavirus (
• bacterial diseases such as diseases resulting from infection by bacteria of, for example, the genus Escherichia, Enterobacter, Salmonella, Staphylococcus, Shigella, Listeria, Aerobacter,
• chlamydia other infectious diseases such as chlamydia, fungal diseases (e.g., candidiasis, aspergillosis, histoplasmosis, or cryptococcal meningitis), or parasitic diseases (e.g., malaria, Pneumocystis carnii pneumonia, leishmaniasis, cryptosporidiosis, toxoplasmosis, and trypanosome infection);
• fungal diseases e.g., candidiasis, aspergillosis, histoplasmosis, or cryptococcal meningitis
• parasitic diseases e.g., malaria, Pneumocystis carnii pneumonia, leishmaniasis, cryptosporidiosis, toxoplasmosis, and trypanosome infection
• parasitic diseases e.g., malaria, Pneumocystis carnii pneumonia, leishmaniasis, cryptosporidiosis, toxoplasmosis, and try
• neoplastic diseases such as intraepithelial neoplasias, cervical dysplasia, actinic keratosis, basal cell carcinoma, squamous cell carcinoma, renal cell carcinoma, Kaposi's sarcoma, melanoma, leukemias (e.g., myelogenous leukemia, chronic lymphocytic leukemia, multiple myeloma, non-rethelial neoplasias, cervical dysplasia, actinic keratosis, basal cell carcinoma, squamous cell carcinoma, renal cell carcinoma, Kaposi's sarcoma, melanoma, leukemias (e.g., myelogenous leukemia, chronic lymphocytic leukemia, multiple myeloma, non-
• Hodgkin's lymphoma cutaneous T-cell lymphoma, B-cell lymphoma, and hairy cell leukemia
• breast cancer lung cancer, prostate cancer, colon cancer, and other cancers
• atopic diseases such as atopic dermatitis or eczema, eosinophilia, asthma, allergy, allergic rhinitis, and Ommen's syndrome;
• thrombocythaemia thrombocythaemia, multiple sclerosis, discoid lupus, and alopecia areata; and (g) diseases associated with wound repair such as inhibition of keloid formation and other types of scarring (e.g., enhancing wound healing, including chronic wounds).
• the mechanism for the antiviral and antitumor activity of the compound of Formula I may be due in substantial part to enhancement of the immune response by induction of various important cytokines (e.g., at least one of tumor necrosis factor, interferons, or interleukins).
• important cytokines e.g., at least one of tumor necrosis factor, interferons, or interleukins.
• Such compounds have been shown to stimulate a rapid release of certain monocyte/macrophage-derived cytokines and are also capable of stimulating B cells to secrete antibodies which play an important role in these IRM
• the compound of Formula I can be used in combination with other therapies such as the active agents mentioned above and other procedures (e.g., chemoablation, laser ablation, cryotherapy, and surgical excision).
• therapies such as the active agents mentioned above and other procedures (e.g., chemoablation, laser ablation, cryotherapy, and surgical excision).
• An amount of a compound effective to induce cytokine biosynthesis is an amount sufficient to cause one or more cell types, such as monocytes, macrophages, dendritic cells and B-cells to produce an amount of one or more cytokines such as, for example, IFN-a, TNF-a, IL-1, IL-6, IL-10 and IL- 12 that is increased over a background level of such cytokines.
• the precise amount will vary according to factors known in the art but is expected to be a dose of about 100 nanograms per kilograms (ng/kg) to about 50 milligrams per kilogram (mg/kg), in some embodiments about 10 micrograms per kilogram ⁇ g/kg) to about 5 mg/kg.
• the invention also provides a method of treating a viral infection in an animal and a method of treating a neoplastic disease in an animal comprising administering an effective amount of a compound or pharmaceutical composition of the invention to the animal.
• An amount effective to treat or inhibit a viral infection is an amount that will cause a reduction in one or more of the manifestations of viral infection, such as viral lesions, viral load, rate of virus production, and mortality as compared to untreated control animals.
• the precise amount that is effective for such treatment will vary according to factors known in the art but is expected to be a dose of about 100 ng/kg to about 50 mg/kg, in some embodiments about 10 ⁇ g/kg to about 5 mg/kg.
• An amount of a compound or pharmaceutical composition effective to treat a neoplastic condition is an amount that will cause a reduction in tumor size or in the number of tumor foci. Again, the precise amount will vary according to factors known in the art but is expected to be a dose of about 100 ng/kg to about 50 mg/kg, in some embodiments about 10 ⁇ g/kg to about 5 mg/kg.
• the methods of the present invention may be performed on any suitable subject.
• Suitable subjects include animals such as humans, non-human primates, rodents, dogs, cats, horses, pigs, sheep, goats, or cows.
• composition of a formulation suitable for practicing the invention the precise amount of a compound of Formula I effective for methods according to the present invention, and the dosing regimen, for example, will vary according to factors known in the art including the nature of the carrier, the state of the subject's immune system (e.g., suppressed, compromised, stimulated), the method of administering the compound of Formula I, and the species to which the formulation is being administered. Accordingly, it is not practical to set forth generally the composition of a formulation that includes a compound of Formula I, an amount of a compound of Formula I that constitutes an effective amount, or a dosing regimen that is effective for all possible applications. Those of ordinary skill in the art, however, can readily determine appropriate formulations, amounts of the compound of Formula I, and dosing regimen with due consideration of such factors.
• the methods of the present invention include administering a compound of Formula I to a subject in a formulation, for example, having a concentration of the compound from about 0.0001% to about 20% (unless otherwise indicated, all percentages provided herein are weight/weight with respect to the total formulation), although in some embodiments the compound of Formula I may be administered using a formulation that provides the compound in a concentration outside of this range.
• the method includes administering to a subject a formulation that includes from about 0.01% to about 1% of the compound of Formula I, for example, a formulation that includes about 0.1 % to about 0.5% compound of Formula I.
• the methods of the present invention include administering sufficient compound to provide a dose of, for example, from about 100 ng/kg to about 50 mg/kg to the subject, although in some embodiments the methods may be performed by administering compound in a dose outside this range.
• the method includes administering sufficient compound to provide a dose of from about 10 ⁇ g/kg to about 5 mg/kg to the subject, for example, a dose of from about 100 ⁇ g/kg to about 1 mg/kg.
• the methods of the present invention may include administering sufficient compound to provide a dose of, for example, from about 0.01 mg/m 2 to about 10 mg/m 2 .
• the dose may be calculated using actual body weight obtained just prior to the beginning of a treatment course. For the dosages calculated in this way, body surface area
• the compound of Formula I may be administered, for example, from a single dose to multiple doses per week, although in some embodiments the methods of the present invention may be performed by administering the compound of Formula I at a frequency outside this range. In some embodiments, the compound of Formula I may be administered from about once per month to about five times per week. In some embodiments, the compound of Formula I is administered once per week.
• the compound of Formula I can be formulated to provide reduced systemic levels of the compound while inducing a high levels of cytokines, it is believed to be very useful for providing an enhanced local immune response while minimizing undesirable systemic side effects. This may be advantageous for many uses, such as direct administration to a tumor and/or as a vaccine adjuvant. Objects and advantages of this invention are illustrated by the above examples, but the particular materials and amounts thereof recited, as well as other conditions and details, should not be construed to unduly limit this invention.

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