WO2015023890A1 - Glycosylated pacap/vip analogues with enhanced cns penetration for treatment of neurodegenerative diseases - Google Patents

Abstract

A glycosylated pleiotropic peptide pituitary adenylate cyclase-activating polypeptide (PACAP) which can both agonize PAC, receptors, causing neuroprotective effects, and antagonize VPAC receptors, causing anti-inflammation in several models of acute neuronal damage and neurodegenerative diseases, including ALS, PA, migraines, and certain forms of dementia, is described. Also described is a method of relieving symptoms of ALS, PA, migraines, and certain forms of dementia, comprising administering to a subject in need thereof an effective amount of a glycosylated PACAP.

Description

GLYCOSYLATED PACAP/VIP ANALOGUES WITH ENHANCED CNS PENETRATION FOR TREATMENT OF NEURODEGENERATIVE DISEASES

The present invention relates to glycopeptides for treatment of neurodegenerative diseases. The invention is particularly applicable in connection for the treatment of amyotrophic lateral sclerosis (ALS) and Parkinson's Disease (PD), Alzheimer's Disease (AD), Huntington's Disease (HD), and migraine attacks, as well as certain forms of dementia and will be described in connection with such utility, although other utilities are contemplated.

Endogenous opioid peptides, lumped together under the generic term endorphins, have been the subject of intense study since their discovery in the mid 1970's¹.

Neuropeptides have the potential for extremely selective pharmacological intervention with fewer side effects. If these naturally occurring opioid peptides and their derivatives could be rendered permeable to the blood-brain barrier (BBB), then a new vista of psychopharmacology would be opened to exploration and exploitation. After three decades of research, many potent and selective opioid agonists have been developed, and stability problems have been largely overcome. The remaining problem that prevents the use of opioid peptides as drugs is poor bioavailability, which is primarily due to poor penetration of the BBB². The BBB is composed of endothelial cells in the

cerebrovascular capillary beds³. The BBB acts as a lipophilic barrier to undesired chemical substances, and admits vital nutrients for proper function of the CNS⁴. The flow is bi-directional, allowing for export of materials from the CNS (efflux transport) and the import of materials from the blood (influx transport). The BBB represents not only a physical obstacle, but a metabolic one as well, possessing both oxidative enzymes and peptidases such as aminopeptidase, arylamidase and enkephalinase. Thus, metabolically unstable substances (e.g. peptides) are generally degraded before they reach the CNS. It should also be noted that entry to the CNS does not guarantee that a drug will accumulate in useful concentrations, as many peptides are rapidly exported back to the bloodstream⁵. Several strategies have been reported to overcome the BBB penetration problem, including substitution of unnatural amino acids⁶, the use of conformational constraints,⁷ and the addition of lipophilic side chains or other transport vectors . Glycosylation has proven to be a successful methodology to improve both the stability and bioavailability of short peptide "messages" by incorporation of the peptide pharmacophore into a glycopeptide⁹. Previous BBB penetration studies with opioid glycopeptide agonists based on enkephalins have shown up to 3-fold increases in the rate of brain delivery of these compounds compared with the unglycosylated parent peptides'". Recent studies with glycopeptides in artificial membrane systems indicate that amphipathicity of the glycopeptides is an important factor in BBB penetration^{1 1}. In addition, there is evidence that suggests that the type of glycosylation can alter tissue distribution patterns , BBB penetration and peptide/receptor interactions ' .

Endogenous Opioid Peptides. The endogenous neuropeptide β-endorphin is a 31 residue naturally occurring opioid peptide agonist that binds to μ and δ receptors. Its N- terminal 5 residues are identical to the Met-Enkephalin sequence, and may be considered to be the pharmacophore or "opioid message." It was shown some time ago that the C- terminal region of β-endorphin has an amphipathic a-helical structure that plays a role in the receptor binding and opioid agonism¹⁵ and may induce resistance to proteolysis¹⁶. According to Schwyzer, the -terminal sequence is the essential "message," and the C- terminal helical region is the "address" that limits delivery of the message to a subset of otherwise available opioid receptors¹⁷. Kaiser and co-workers proposed that 13- endorphin consists of the Met-enkephalin peptide sequence at the N-terminus, a hydrophilic linker region from residues 6 through 12, and an amphophilic helical region between the helix breaker residues Pro(l 3) and Gly(30) ¹⁸. This was later proven by synthesizing a number of B-endorphin mimics with artificial C-terminal helical regions with amphipathic character¹⁹. These de novo amphipathic helices were not homologous with the B-endorphin C-terminal region, and they were shown to be largely a-helical by circular dichroism (CD) measurements. These hybrid structures showed good opioid agonism in vitro when compared to B-endorphin. These studies strongly suggested that the overall amphipathicity of the C-terminal helix plays a key role in the selectivity of these compounds, rather than the identity of specific amino acid residues present in the C-terminal²⁰. Dynorphin A (1 -17) is also an endogenous opioid peptide, but it binds preferentially to the κ opioid receptor and has an N-terminal message segment identical to Leu-Enkephalin²' . It has been suggested that an address sequence in the C-terminal region imparts selectivity for κ receptors²². Dynorphin A displayed an extended and/or random coil structure when subjected to structural analysis by various spectroscopic measurements²³. A 2D ( 1 ) H-NMR study in DPC micelle shows that Dynorphin A( l -17) contains a less ordered N-terminal segment, a well defined a-helix segment spanning between Phe(4) and Pro( 10) or Lys( 1 1 ), and a B-turn from Trp( 14) to Gln( 17) ²⁴. Based on NMR results, the authors concluded that both the a-helix and the C-terminal B-turn are due to dynorphin-micelle interactions, and may be important structural features of the full-length peptide when bound to the cell membrane in vivo. Studies by Luna²⁵ also support the notion that a helical structure in the message segment of Dynorphin A(l-17) is significant. The biological importance of helical C-tenninal address segments in larger opioid peptides has been further supported by the recent work by Kyle and co-workers²⁶. They successfully synthesized several potent nociceptin (NC) peptide analogs exploiting the a-helix-promoting residues a-aminoisobutyric acid (Aib) and N-methyl alanine (MeAla) at the C-terminus of NC. Nociceptin is the endogenous ligand for the recently identified opioid receptor-like 1 receptor (ORL-1 ). Thus, it seems logical to approach the design of opioid agonist B-endorphin or dynorphin peptide analogs by combining C- terminal amphipathic helical address segments that can also promote BBB, for penetration by virtue of glycosylation. The foregoing discussion of the prior art derives from my prior U.S. Patent No. 7,803,764 with Bilsky, in which we provide certain amphipathic glycopeptides which are capable of crossing the blood-brain-barrier (BBB), for treating a variety of neurological and behavior disorders including pain, anxiety, depression, obesity, anorexia nervosa, phobias, schizophrenia, Parkinson's Disease (PD) and Alzheimer's Disease (AD).

It is an object of the present invention to provide glycopeptides that penetrate the blood-brain-barriers (BBB) for treatment of neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS), Parkinson's Disease (PD), Alzheimer's Disease (AD), Huntington's Disease (HD), and migraine attacks, as well as certain forms of dementia.

More particularly, we have discovered a new variation of glycosylated pleiotropic peptides, pituitary adenylate cyclase-activating polypeptide (PACAP) or vasoactive intestinal peptide (VIP), which can both agonize PAQ VI i & VIP₂ receptors, causing neuroprotective effects, or in their N-terminal truncated forms, canantagonize these receptors, causing anti-inflammation in several models of acute neuronal damage and neurodegenerative diseases, including ALS, PD, AD, HD, migraines, and certain forms of dementia.

The present invention also provides a method of relieving symptoms of ALS, PD, AD, HD, migraines, and certain forms of dementia, comprising administering to a subject in need thereof an effective amount of a glycosylated PACAP or VI P analogue.

Further features and advantages of the present invention can be seen from the following detailed description, taken in connection with the accompanying drawings wherein: Figs, la, lb and l c show the effects of glycosylated PACAP agonist 2 on cultured PC 12 cells. Fig. l a shows individual PC 12 control cells at 0 hrs do not produce neurite-like extensions. Fig. l b shows a positive control PC 12 cell cultured in the presence of PACAP produce neurite-like extensions. Fig. 1 c shows a PC 12 cell cultured in the presence of PACAP glycopeptide 3. Cells with process outgrowth having a length of > 2X the cell body width are considered to be differentiated; and

Fig. 2a and 2b show direct and indirect effects of C/VIP agonists and antagonists. Before the compositions and methods of the disclosure are described, it is to be understood that this disclosure is not limited to the particular processes, compositions, or methodologies described, as these may vary. It is also to be understood that the terminology used in the description is for the purpose of describing the particular versions or embodiments only, and is not intended to limit the scope of the present disclosure which will be limited only by the appended claims.

It must be noted that, as used herein, and in the appended claims, the singular forms "a", "an" and "the" include plural reference unless the context clearly dictates otherwise. Unless defined otherwise, all technical and scientific terms used herein have the same meanings as commonly understood by one of ordinary skill in the art. Although any methods similar or equivalent to those described herein can be used in the practice or testing of embodiments of the present disclosure, the preferred methods are now described. All publications and references mentioned herein are incorporated by reference. Nothing herein is to be construed as an admission that the disclosure is not entitled to antedate such disclosure by virtue of prior disclosure.

As used herein, the term "about" means plus or minus 10% of the numerical value of the number with which it is being used. Therefore, about 50% means in the range of 45%-55%.

"Administering" when used in conjunction with a therapeutic means to administer a therapeutic directly into or onto a target tissue or to administer a therapeutic to a patient whereby the therapeutic positively impacts the tissue to which it is targeted.

"Administering" a composition may be accomplished by oral or rectal administration, injection, infusion, inhalation, absorption or by any method in combination with other known techniques. Such combination techniques include heating, radiation and ultrasound.

The term "improves" is used to convey that the present disclosure changes the appearance, form, characteristics and/or physical attributes of the tissue to which it is being provided, applied or administered. "Improves" may also refer to the overall physical state of an individual to whom an active agent has been administered. For example, the overall physical state of an individual may "improve" if one or more symptoms of a neurodegenerative disorder are alleviated by administration of an active agent.

As used herein, the term "therapeutic" means an agent utilized to treat, combat, ameliorate or prevent an unwanted condition or disease of a patient.

The terms "therapeutically effective amount" or "therapeutic dose" as used herein are interchangeable and may refer to the amount of an active agent or pharmaceutical compound or composition that elicits a biological or medicinal response in a tissue, system, animal, individual or human that is being sought by a researcher, veterinarian, medical doctor or other clinician. A biological or medicinal response may include, for example, one or more of the following: (1 ) preventing a disease, condition or disorder in an individual that may be predisposed to the disease, condition or disorder but does not yet experience or display pathology or symptoms of the disease, condition or disorder, (2) inhibiting a disease, condition or disorder in an individual that is experiencing or displaying the pathology or symptoms of the disease, condition or disorder or arresting further development of the pathology and/or symptoms of the disease, condition or disorder, and (3) ameliorating a disease, condition or disorder in an individual that is experiencing or exhibiting the pathology or symptoms of the disease, condition or disorder or reversing the pathology and/or symptoms experienced or exhibited by the individual.

The term "treating" may be taken to mean prophylaxis of a specific disorder, disease or condition, alleviation of the symptoms associated with a specific disorder, disease or condition and/or prevention of the symptoms associated with a specific disorder, disease or condition. In some embodiments, the term refers to slowing the progression of the disorder, disease or condition or alleviating the symptoms associated with the specific disorder, disease or condition. In some embodiments, the term refers to slowing the progression of the disorder, disease or condition. In some embodiments, the term refers to alleviating the symptoms associated with the specific disorder, disease or condition. In some embodiments, the term refers to restoring function, which was impaired or lost due to a specific disorder, disease or condition.

The term "patient" generally refers to any living organism to which the compounds described herein, are administered and may include, but is not limited to, any non-human mammal, primate or human. Such "patients" may or may not be exhibiting the signs, symptoms or pathology of the particular diseased state.

The term "pharmaceutical composition" shall mean a composition including at least one active ingredient, whereby the composition is amenable to investigation for a specified, efficacious outcome in a mammal (for example, without limitation, a human). Those of ordinary skill in the art will understand and appreciate the techniques appropriate for determining whether an active ingredient has a desired efficacious outcome based upon the needs of the artisan. A pharmaceutical composition may, for example, contain an AKT inhibitor or a pharmaceutically acceptable salt of an AKT inhibitor as the active ingredient.

For the purposes of this disclosure, a "salt" is any acid addition salt, preferably a pharmaceutically acceptable acid addition salt, including but not limited to, halogenic acid salts such as hydrobromic, hydrochloric, hydrofluoric and hydroiodic acid salt; an inorganic acid salt such as, for example, nitric, perchloric, sulfuric and phosphoric acid salt; an organic acid salt such as, for example, sulfonic acid salts (methanesulfonic, trifluoromethan sulfonic, ethanesulfonic, benzenesulfonic or /7-toluenesulfonic), acetic, malic, fumaric, succinic, citric, benzoic, gluconic, lactic, mandelic, mucic, pamoic, pantothenic, oxalic and maleic acid salts; and an amino acid salt such as aspartic or glutamic acid salt. The acid addition salt may be a mono- or di-acid addition salt, such as a di-hydrohalogenic, di-sulfuric, di-phosphoric or di-organic acid salt. In all cases, the acid addition salt is used as an achiral reagent which is not selected on the basis of any expected or known preference for interaction with or precipitation of a specific optical isomer of the products of this disclosure.

"Pharmaceutically acceptable salt" is meant to indicate those salts which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of a patient without undue toxicity, irritation, allergic response and the like, and are commensurate with a reasonable benefit/risk ratio. Pharmaceutically acceptable salts are well known in the art. For example, Berge et al. (1977) J. Pharm. Sciences, Vol 6. 1 -19, which is hereby incorporated by reference in its entirety, describes pharmaceutically acceptable salts in detail.

As used herein, the term "daily dose amount" refers to the amount of pramipexole per day that is administered or prescribed to a patient. This amount can be administered in multiple unit doses or in a single unit dose, in a single time during the day or at multiple times during the day. A "dose amount" as used herein, is generally equal to the dosage of the active ingredient, which may be administered per day. For example, an effective dose amount may be between about 0.1 and 10 milligrams per kilo, administered 1 -2 times a day.

The term "unit dose" as used herein may be taken to indicate a discrete amount of the therapeutic composition that contains a predetermined amount of the active compound. The amount of the active compound is generally equal to the dosage of the active ingredient, which may be administered one or more times per day. For example, the unit dose may be a fraction of the desired daily dose which may be given in fractional increments, such as, for example, one-half or one-third the dosage.

The present invention is based on the recent discovery that Penetration of the blood-brain barrier (BBB) by peptides^26,27,28'^29,30,31 as well as their stability in vivo³² is significantly enhanced by glycosylation.^''³ As used herein, the terms "glycosylation" and "glycosylated" means that an amino acid residue is functionalized with a glycosyl group. A glycosyl group is composed of saccharide units. These terms are well-known in the field of peptide and protein chemistry and have such meanings as used herein. In preferred embodiments, the glycosyl group has at most 8 saccharide units. More preferably, the glycosyl group has at most 4 saccharide units. In another embodiment, the glycosyl group is at most a disaccharide, i.e., the glycosyl group has at most 2 saccharide units. Thus, the total number of saccharide units may be from 1 to 8, inclusive of all specific values and ranges therebetween. Examples of glycosyl groups include β-D- glucose, β-maltose, β-lactose, β-melibiose and β-maltotriose. Other examples include sucrose, trehalose, saccharose, maltose, cellobiose, gentibiose, isomaltose and primeveose. Other glycosyl groups include galactose, xylose, mannose, manosaminic acid, fucose, GalNAc, GlcNAc, idose, iduronic acid, glucuronic acid and sialic acid.

We have discovered that a new variation of a glycosylated pleiotropic peptide pituitary adenylate cyclase-activating polypeptide (PACAP) has demonstrated neuroprotective and anti-inflammatory properties^34,33 in several models of acute neuronal damage and neurodegenerative diseases,³⁶ including the S0D1 (G93A) mouse model of ALS, when injected into the brain.³⁷ Vasoactive intestinal peptide (VIP) is a closely related secretin-class peptide.

PACAP is a neuropeptide consisting of 38 amino acids with the following amino acid sequence (from the N- to the C-terminus):

His-Ser-Asp-Gly-Ile-Phe-Thr-Asp-Ser- (SEQ ID NO. 2)

Tyr-Ser-Arg-Tyr-Arg-Lys-Gln-Met-Ala- Val-Lys-Lys-Tyr-Leu-Ala-Ala-Val-Leu- Gly-Lys-Arg-Tyr-Lys-Gln-Arg-Val-Lys-Asn-Lys.

Two forms of the peptide have been identified: PACAP-38 and PACAP-27 which is shortened at the C-terminus. PACAP-27, which presents a 68% homology to VIP, has the following amino acid sequence (from the N- to the C-terminal amide):

His-Ser-Asp-Gly-Ile-Phe-Thr-Asp-Ser-Tyr-Ser-Arg-Tyr-Arg-Lys-Gln-Met-Ala-Val-Lys- Lys-Tyr-Leu- A la- A la- Val-Leu-N H₂.

PACAP-38 has the following amino acid sequence (from the N- to the C-terminal amide):

His-Ser-Asp-Gly-Ile-Phe-Thr-Asp-Ser-Tyr-Ser-Arg-Tyr-Arg-Lys-Gln-Met-Ala-Val-Lys- Lys-Tyr-Leu-Ala-Ala-Val-Leu₂7-Gly-Lys-Arg-Tyr-Lys-Gln-Arg-Val-Lys-Asn-Lys38- NH₂

PACAP, which, as noted above exists in 2 forms, either a 27- or 38-amino acid C-terminal peptide amide, was first isolated from ovine hypothalamus, and is known to regulate the development, maintenance, function, and plasticity of the nervous system, providing neuroprotective and neurotrophic support (i.e., see Figure 1). PACAP has been shown to activate 3 closely-related G protein coupled receptors: PACi, which has much higher affinity for PACAP, VPAC, and VPAC₂ which bind both PACAP and VIP. They are expressed on neurons, microglia, and also by many other cell types. Constitutive expression of PACAP and its receptor PACi may confer neuroprotection to central visceromotor neurons via the PACi receptor. PACAP also promotes cytodestructive functions of microglia (M l amoeboid - M2 hypertrophic phenotype), thought to drive ALS disease progression via the VPACi receptor. Thus, the ideal drugs for neuroprotection would be PACi agonists at motor neurons to promote neuroprotection in case of ALS, or dopaminergic neurons in case of PD, or hippocampal neurons in case of AD, and in each case VPACi antagonists at microglia to reduce inflammation by maintaining the Ml ('alternatively activated'/resolving anti- inflammatory cells) phenotype vs. the M2 (the classical, proinflammatory macrophages) microglia phenotype or Tau-opathies.

In order to develop drugs for treatment of ALS, PD, AD, and I I D we synthesized glycopeptide analogs of PACAP with different binding properties to either be only a PACi agonist or only a VPACi antagonist. Suitable methods for preparing glycopeptides are well-known. The well-known methods of solid phase peptide synthesis can be used to prepare the glycopeptides of the present invention. It is preferred that the glycosyl group be linked to the amino acid sequence by an O-linkage to a side chain in the address segment of the sequence. See Tetrahedron Asymmetry 16, 65-75 (2005), incorporated herein by reference, and U.S. Pat. No. 5,727,254. We then tested the neuroprotective effects of the PAQ agonist and the anti-inflammatory effects of the VPACi antagonist in cell culture models (Figure 2) and we tested their stability and BBB penetration in vivo. This work sets the stage for studies to test the successful therapeutic candidates in vivo in ' preclinical models of ALS and PD.

PC 12 cell lines were derived from a pheochromocytoma of the rat adrenal medulla, and are widely used to study the synthesis and release of catecholamines. PC 12 and genetically modified PC12 cells have been used to investigate neuroprotective mechanisms, and to evaluate neuroprotective drug candidates for neurodegenerative diseases. Examples of the effects of PACAP27 and the PACAP glycoside 3 are shown in Figure 1. NSC-34 cells are a hybrid cell line produced by fusion of neuroblastoma with mouse motor neuron-enriched primary spinal cord cells and has been extensively used as a model system for cholinergic motor neurons. NSC-34 cells can be challenged with toxins, i.e. glutamate (2 niM), or expression of a mutant Cu/Zn-binding superoxide dismutase (SOD1/G93A) to mimic ALS. SH-SY5Y cells are a neuroblastoma cell line with dopaminergic phenotype and can be challenged with toxins like 6- hydroxydopamine (25 μΜ) or the pesticide rotenone (50 liM) to mimic PD. Based on our results in the PC 12 cells we expect and currently evaluate both neuroprotective and neurorestorative effects of the specific PAQ agonist in PC 12, NSC-34 and SH-SY5Y cell lines. The effects of the VPACi antagonist on microglia can be studied using (a) cultured EOC 2 cells, an immortalized cell line derived from the mouse brain used as a microglia model, and (b) microglia isolated from mouse brain. After pre- incubation with the VP AC, antagonist the microglia can be activated by treatment with either lipopolysaccharides (LPS) or interleukin-4 (IL-4) and markers of Ml vs. M2 microglia, including the macrophage mannose receptor (MMR), iNOS (inducible nitric oxide synthase), arginase 1 (Argl ) and the chemokine receptor CXCR3 with Fluorescence- activated cell sorting (FACS) are measured. The results are reported in Table 1 below.

Paracrine signaling is of endogenous secretins (PACV'VPAC) is shown at left. The experimental design of the proposed studies is shown on the right. Initial binding and activation of the glycopeptides was assessed in Millipore's Ready-to-Assay™ cells that express PAQ & VPACi receptors, and provide a go|no-go choke point ( <=> ) for the studies. After indicating activity, cultured PC 12, NSC-34, SH-SY5Y and EOC 2 cells provide information on the protective, restorative and anti-inflammatory effects of the glycopeptides. Stability and drug delivery properties of the glycopeptides can be evaluated in vitro and in vivo in rat. Results of each round of assays inform the design|redesign process (dotted arrows).

To quantify the CNS penetration and lifetime of the candidate drugs, we performed in vivo microdialysis to evaluate the pharmacokinetics and pharmacodynamics of the synthesized peptides. Rats were anesthetized and microdialysis probes implanted in the central nervous system. Dialysate samples were collected for analysis and then the rats were injected (i.p. at 3 different doses) with a cocktail containing multiple synthesized peptides. The samples were analyzed using liquid chromatography coupled to a mass spectrometer. This sensitive and information- rich detection scheme will allow each peptide to be identified and then quantified in the dialysate. The amount of each peptide that is measured in the dialysate is dependent on the stability of each peptide in vivo and its ability to cross the BBB.

Table 1. PACAP/VIP Peptide/GIycopeptides. Only the first 5 structures studied are depicted. The 2nd amino acid, L-Ser2 will be replaced by its D-enantiomer, D-Ser2 (s) to promote beta-turn formation at the N-terminus and enhanced agonism at the PAC,, VPAC, & VPAC₂ receptors, which will also render the peptide chains resistant to DPP- IV peptidases. The easily oxidized 17th amino acid, L-IVlet 1 7 will be replaced by the isosteric L-/w- Leucine, £. Truncation of the initial 5 amino acids HSDGI- or HSDAV- should produce antagonists. Further modification of positions 4, 5, & 6, (N-terminal domain), or positions 13, 24 & 25 (J-domain) should produce PACAPWIP hybrids with unique patterns of agonism/antagonism at PAC_t, VPACi & VPAC₂. The glycoside S* is cither the (3-glucoside or lactoside of 1.-Serine.

Millipore Ready-to-Assav™ VPAG - VIP & PACAP and PAG VIP/PACAP Receptor Frozen Cells were used to assess the agonist (+) or antagonist (-) activity of the glycopeptides.

In use, an effective amount of the PACAP- VIP glycopeptides of the present invention is administered to a patient in need of treatment in a therapeutically effective unit dose delivery amount of between about 0.1 and 10 milligrams per kilo, typically 1 - 2 doses per day, or even less frequently. The PACAP- VIP glycopeptides may be delivered in a pharmaceutically acceptable carrier.

Pharmaceutical formulations and pharmaceutical compositions are well known in the art, and can be found, for example, in Remington's Pharmaceutical Sciences, Mack Publishing Co., Easton, Pa., USA, which is hereby incorporated by reference in its entirety. Any formulations described therein or otherwise known in the art are embraced by embodiments of the disclosure.

Pharmaceutical excipients are well known in the art and include, but are not limited to, saccharides such as, for example, lactose or sucrose, mannitol or sorbitol, cellulose preparations, calcium phosphates such as tricalcium phosphate or calcium hydrogen phosphate, as well as binders, such as, starch paste such as, for example, maize starch, wheat starch, rice starch, potato starch, gelatin, tragacanth, methyl cellulose, hydroxypropylmethylcellulose, sodium carboxymethylcellulose, polyvinyl pyrrolidone or combinations thereof.

In particular embodiments, pharmaceutical formulations may include the active compound described and embodied above, a pharmaceutically acceptable carrier or excipient and any number of additional or auxiliary components known in the pharmaceutical arts such as, for example, binders, fillers, disintegrating agents, sweeteners, wetting agents, colorants, sustained release agents, and the like, and in certain embodiments, the pharmaceutical composition may include one or more secondary active agents. Disintegrating agents, such as starches as described above, carboxymethyl-starch, cross-linked polyvinyl pyrrolidone, agar, alginic acid or a salt thereof, such as sodium alginate and combinations thereof. Auxiliary agents may include, for example, flow-regulating agents and lubricants, such as silica, talc, stearic acid or salts thereof, such as magnesium stearate or calcium stearate, polyethylene glycol and combinations thereof. In certain embodiments, dragee cores may be prepared with suitable coatings that are resistant to gastric juices, such as concentrated saccharide solutions, which may contain, for example, gum arabic, talc, polyvinyl pyrrolidone, polyethylene glycol, titanium dioxide, lacquer solutions and suitable organic solvents or solvent mixtures and combinations thereof. In order to produce coatings resistant to gastric juices, solutions of suitable cellulose preparations, such as acetylcellulose phthalate or hydroxypropylmethyl-cellulose phthalate may also be used. In still other embodiments, dye stuffs or pigments may be added to the tablets or dragee coatings, for example, for identification or in order to characterize combinations of active compound doses.

Pharmaceutical compositions of the disclosure can be administered to any animal, and in particular, any mammal, that may experience a beneficial effect as a result of being administered a compound of the disclosure including, but not limited to, humans, canines, felines, livestock, horses, cattle, sheep, and the like. The dosage or amount of at least one compound according to the disclosure provided pharmaceutical compositions of embodiments may vary and may depend, for example, on the use of the

pharmaceutical composition, the mode of administration or delivery of the

pharmaceutical composition, the disease indication being treated, the age, health, weight, etc. of the recipient, concurrent treatment, if any, frequency of treatment, and the nature of the effect desired and so on. Various embodiments of the disclosure include pharmaceutical compositions that include one or more compounds of the disclosure in an amount sufficient to treat or prevent diseases such as, for example, cancer. An effective amount of the one or more compounds may vary and may be, for example, from about 0.1 to 10 milligrams per kilo, typically 1 -2 doses per day.

The pharmaceutical compositions of the disclosure can be administered by any means that achieve their intended purpose. For example, routes of administration encompassed by the disclosure include, but are not limited to, subcutaneous, intravenous, intramuscular, intraperitoneal, buccal, or ocular routes, rectally, parenteral ly,

intrasystemically, intravaginally, topically (as by powders, ointments, drops or transdermal patch), oral or nasal spray are contemplated in combination with the above described compositions. Embodiments of the disclosure also include methods for preparing

pharmaceutical compositions as described above by, for example, conventional mixing, granulating, dragee-making, dissolving, lyophilizing processes and the like. For example, pharmaceutical compositions for oral use can be obtained by combining the one or more active compounds with one or more solid excipients and, optionally, grinding the mixture.

Suitable auxiliaries may then be added and the mixture may be processed to form granules which may be used to form tablets or dragee cores. Other pharmaceutical solid preparations include push- fit capsules containing granules of one or more compound of the disclosure that can, in some embodiments, be mixed, for example, with fillers, binders, lubricants, stearate, stabilizers or combinations thereof. Push-fit capsules are well known and may be made of gelatin alone or gelatin in combination with one or more plasticizer such as glycerol or sorbitol to form a soft capsule. In embodiments in which soft capsules are utilized, compounds of the disclosure may be dissolved or suspended in one or more suitable liquids, such as, fatty oils or liquid paraffin and, in some cases, one or more stabilizers.

Liquid dosage formulations suitable for oral administration are also encompassed by embodiments of the disclosure. Such embodiments, may include one or more compounds of the disclosure in pharmaceutically acceptable emulsions, solutions, suspensions, syrups, and elixirs that may contain, for example, one or more inert diluents commonly used in the art such as, but not limited to, water or other solvents, solubilizing agents and emulsifters such as ethyl alcohol, isopropyl alcohol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1 ,3 -butylene glycol, dimethyl formamide, oils (for example, cottonseed, groundnut, corn, germ, olive, castor, and sesame oils), glycerol, fatty acid derivatives of glycerol (for example, labrasol), tetrahydrofurfuryl alcohol, polyethylene glycols and fatty acid esters of sorbitan, and mixtures thereof. Suspensions may further contain suspending agents as, for example, ethoxylated isostearyl alcohols, polyoxyethylene sorbitol and sorbitan esters, microcrystalline cellulose, aluminum metahydroxide, bentonite, agar-agar, and tragacanth, and mixtures thereof.

Formulations for parenteral administration may include one or more compounds of the disclosure in water-soluble form, for example, water-soluble salts, alkaline solutions, and cyclodextrin inclusion complexes in a physiologically acceptable diluent which may be administered by injection. Physiologically acceptable diluent of such embodiments, may include, for example, sterile liquids such as water, saline, aqueous dextrose, other pharmaceutically acceptable sugar solutions; alcohols such as ethanol, isopropanol or hexadecyl alcohol; glycols such as propylene glycol or polyethylene glycol; glycerol ketals such as 2.2-dimethyl-I,3-dioxolane-4-methanol; ethers such as poly(ethyleneglycol)400; pharmaceutically acceptable oils such as fatty acid, fatty acid ester or glyceride, or an acetylated fatty acid glyceride. In some embodiments, formulations suitable for parenteral administration may additionally include one or more pharmaceutically acceptable surfactants, such as a soap or detergent; suspending agent such as pectin, carbomers, methylcellulose, hydroxy propy 1 met hy Ice 1 lu lose, or carboxymethylcellulose; an emulsifying agent; pharmaceutically acceptable adjuvants or combinations thereof. Additional pharmaceutically acceptable oils which may be useful in such formulations include those of petroleum, animal, vegetable or synthetic origin including, but not limited to, peanut oil, soybean oil, sesame oil, cottonseed oil, olive oil, sunflower oil, petrolatum, and mineral oil; fatty acids such as oleic acid, stearic acid, and isostearic acid; and fatty acid esters such as ethyl oleate and isopropyl myristate.

Additional suitable detergents include, for example, fatty acid alkali metal, ammonium, and triethanolamine salts; cation ic detergents such as dimethyl dialkyl ammonium halides, alkyl pyridinium halides, and alkylamine acetates; and anionic detergents, such as alkyl, aryl, and olefin sulfonates, alkyl, olefin, ether and monoglyceride sulfates, and sulfosuccinates. In some embodiments, non-ionic detergents including, but not limited to, fatty amine oxides, fatty acid alkanolamides and polyoxyethylenepolypropylene copolymers or amphoteric detergents such as alkyl-P-aminopropionates and 2- alkylimidazoline quaternary salts, and mixtures thereof may be useful in parenteral formulations of the disclosure.

Pharmaceutical compositions for parenteral administration may contain from about 0.5 to about 25% by weight of one or more of the compounds of the disclosure and from about 0.05% to about 5% suspending agent in an isotonic medium. In various embodiments, the injectable solution should be sterile and should be fluid to the extent that it can be easily loaded into a syringe. In addition, injectable pharmaceutical compositions may be stable under the conditions of manufacture and storage and may be preserved against the contaminating action of microorganisms such as bacteria and fungi.

Topical administration includes administration to the skin or mucosa, including surfaces of the lung and eye. Compositions for topical administration, may be prepared as a dry powder which may be pressurized or non-pressurized. In non-pressurized powder compositions, the active ingredients in admixture are prepared as a finely divided powder. In such embodiments, at least 95% by weight of the particles of the admixture may have an effective particle size in the range of 0.01 to 10 micrometers. In some embodiments, the finely divided admixture powder may be additionally mixed with an inert carrier such as a sugar having a larger particle size, for example, of up to 100 micrometers in diameter. Alternatively, the composition may be pressurized using a compressed gas, such as nitrogen or a liquefied gas propellant. In embodiments, in which a liquefied propellant medium is used, the propellant may be chosen such that the compound and/or an admixture including the compound do not dissolve in the propellant to any substantial extent. In some embodiments, a pressurized form of the composition may also contain a surface-active agent. The surface-active agent may be a liquid or solid non-ionic surface-active agent or may be a solid anionic surface-active agent, which in certain embodiments, may be in the form of a sodium salt.

Compositions for rectal administration may be prepared by mixing the compounds or compositions of the disclosure with suitable non-irritating excipients or carriers such as for example, cocoa butter, polyethylene glycol or a suppository wax. Such carriers may be solid at room temperature but liquid at body temperature and therefore melt in the rectum and release the drugs.

In still other embodiments, the compounds or compositions of the disclosure can be administered in the form of liposomes. Liposomes are generally derived from phospholipids or other lipid substances that form mono- or multi-lamellar hydrated liquid crystals when dispersed in an aqueous medium. Any non-toxic, physiologically acceptable and metabolizab!e lipid capable of forming liposomes can be used, and in particular embodiments, the lipids utilized may be natural and/or synthetic phospholipids and phosphatidyl cholines (lecithins). Methods to form liposomes are known in the art (see, for example, Prescott, Ed., Meth. Cell Biol. 14:33 (1976), which is hereby incorporated by reference in its entirety). Compositions including one or more compound s of the disclosure in liposome form can contain, for example, stabilizers, preservatives, excipients and the like.

In general, methods of embodiments of the disclosure may include the step of administering or providing an "effective amount" or a "therapeutically effective amount" of a compound or composition of the disclosure to an individual. In such embodiments, an effective amount of the compounds of the disclosure may be any amount that produces the desired effect. As described above, this amount may vary depending on, for example, the circumstances under which the compound or composition is administered (e.g., to incite treatment or prophylactically), the type of individual, the size, health, etc. of the individual and so on. The dosage may further vary based on the severity of the condition. For example, a higher dose may be administered to treat an individual with a well-developed metastatic condition, compared to the amount used to prevent a subject from developing the metastatic condition. Those skilled in the art can discern the proper dosage based on such factors. For example, in some embodiments, the dosage may be within the range of about 0.01 mg/kg body weight to about 10 mg/kg body weight.

The administration schedule may also vary. For example, in some embodiments, the compounds or compositions of the disclosure may be administered in a single dose once per day or once per week. In other embodiments, the compounds or compositions of the disclosure may be administered in one or two or more doses per day. For example, in one embodiment, an effective amount for a single day may be divided into separate dosages that may contain the same or a different amount of the compound or composition and may be administered several times throughout a single day. Without wishing to be bound by theory, the dosage per administration and frequency of administration may depend, for example, on the specific compound or composition used, the condition being treated, the severity of the condition being treated, and the age, weight, and general physical condition of the individual to which the compound or composition is administered and other medications which the individual may be taking. In another exemplary embodiment, treatment may be initiated with smaller dosages that are less than the optimum dose of the compound, and the dosage may be increased incrementally until a more optimum dosage is achieved.

In each of the embodiments above, the compound administered can be provided as a pharmaceutical composition including compound as described above and a pharmaceutically acceptable excipient or a pure form of the compound may be administered.

In additional embodiments, the compound or composition of the disclosure may be used alone or in combination with one or more additional agents. For example, in some embodiments, a compound or composition of disclosure may be formulated with one or more additional anti-cancer agents or combinations thereof such that the pharmaceutical composition obtained including the compound or composition of the disclosure and the one or more additional agents can be delivered to an individual in a single dose. In other embodiments, the compound or composition of the disclosure may be formulated as a separate pharmaceutical composition that is delivered in a separate dose from pharmaceutical compositions including the one or more additional agents. In such embodiments, two or more pharmaceutical compositions may be administered to deliver effective amounts of a compound or composition of the disclosure and the one or more additional agents.

The PACAP-VTP glycopeptides of the present invention have several significant advantages.

1. By only binding PACi and VPAC receptors and nothing else, the protein has a very narrow range of influence. Side effects therefore, are at a minimum.

2. The protein itself is a variant on an endogenous protein, PACAP. This both allows the protein to cross the blood-brain barrier and diminishes potential immune response, allowing the protein to carry out its function.

3. The invention treats one of the causes of ALS, PD, AD, HD and migraines and forms of dementia rather than just treating symptoms. Thus, the protein has stronger effects than symptom-treating drugs.

Various changes may be made in the above disclosure without departing from the spirit and scope thereof.

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1 ^

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Sequence ID No. 2:

His Ser Asp Gly He Phe T r Asp Ser Tyr Ser Arg Tyr Arg Lys Gin Met Ala Val Lys Lys Tyr Leu Ala Ala Val Leu Gly Lys Arg Tyr Lys Gin Arg Val Lys Asn Lys NH₂ Sequence ID No. 3:

His Ser Asp Gly He Phe Thr Asp Ser Tyr Ser Arg Tyr Arg Lys Gin Met Ala Val Lys Lys Tyr Leu Ala Ala Val Leu

Claims

Claims:

1. A pharmaceutical composition comprising a glycosolated pleiotropic peptide pituitary adenylate cyclase-activating polypeptide (PACAP) in a

pharmaceutically acceptable carrier.

2. The pharmaceutical composition of claim 1 , wherein the PACAP comprises a 27-amino acid peptide.

3. The pharmaceutical composition of claim 1 , wherein the PACAP comprises a 38-amino acid peptide.

4. A method for treating and rel ieving symptoms of neurodegenerative disease comprising administering to an individual in need thereof, a therapeutically effective amount of a glycosolated pleiotropic peptide pituitary adenylate cyclase- activating polypeptide (PACAP).

5. The method of claim 4, wherein the method comprises the administration of an effective amount of PACAP-27.

6. The method of claim 4, wherein said method comprises the administration of an effective amount of PACAP-38.

7. The method of any of claims 4-6, wherein the neurodegenerative disease is selected from the group consisting of amyotrophic lateral sclerosis (ALS), Parkinson's Disease (PD), migraine attacks, and dementia.

8. The method of any of claims 4-6, wherein the therapeutically effective amount comprises an unit dose amount of between 0.1 and 10 milligrams per kilo.

9. The method of claim 8, wherein the dose is administered once a day.

10. The method of claim 8, wherein the dose is administered twice a day.