Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
  • A61K31/403—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with carbocyclic rings, e.g. carbazole
  • A61K31/404—Indoles, e.g. pindolol
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
  • A61K31/4164—1,3-Diazoles
  • A61K31/4184—1,3-Diazoles condensed with carbocyclic rings, e.g. benzimidazoles
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D235/00—Heterocyclic compounds containing 1,3-diazole or hydrogenated 1,3-diazole rings, condensed with other rings
  • C07D235/02—Heterocyclic compounds containing 1,3-diazole or hydrogenated 1,3-diazole rings, condensed with other rings condensed with carbocyclic rings or ring systems
  • C07D235/04—Benzimidazoles; Hydrogenated benzimidazoles
  • C07D235/18—Benzimidazoles; Hydrogenated benzimidazoles with aryl radicals directly attached in position 2
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D401/00—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom
  • C07D401/02—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings
  • C07D401/04—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings directly linked by a ring-member-to-ring-member bond

Definitions

• the present invention relates to methods for preventing and/or treating aging-associated cognitive impairment and neuroinflammation by administering to a subject a Ppargcla activator 2-(4-tert-butylphenyl)-lH-benzimidazole, 2-[4-(l,l-dimethylethyl)phenyl]-lH-benzimidazole.
• Microglia are immune ceils that are located only in the CNS. Microglia originate from a yolk-sac hematopoietic progenitor, which populates the brain during embryogenesis (Ginhoux et al Science 2009). During homeostatic conditions, microglia carry out reparative processes such as debris clearance. They also produce an arsenal of inflammatory mediators, which could be released upon receiving pathological stimuli, to initiate and sustain neuroinflammation. Similar to other immune cells, microglial activation is a bio-energetically demanding process. What currently remains elusive is how microglial metabolism becomes maladaptive and contributes to the inflammatory transformation of these cells.
• Yong The Neuroscientist, 16:408-420, 2010 reports that inflammation of the central nervous system (CNS) (neuroinflammation) is a feature of all neurological disorders, and microglia activation results in elevation of many inflammatory mediators within the CNS.
• CNS central nervous system
• Aging is associated with a progressive loss of tissue function, resulting in an increased susceptibility to aging-related disorders.
• a consequence of physiological aging is a greater susceptibility to memory impairment following an immune challenge such as infection, surgery, or traumatic brain injury.
• the neuroinflammatory response produced by these challenges, results in increased and sustained production of pro-inflammatory cytokines in the otherwise healthy aging brain.
• Sensitized microglia are a primary source of this exaggerated neuroinflammatory response and appear to be a hallmark of the aging brain.
• the causes and effects of aging-induced microglial sensitization include dysregulation of the neuroendocrine system, potentiation of neuroinflammatory responses following an immune challenge, and the impairment of memory (Barrientos et al, Neuroscience 309:84-99, 2015).
• AD Alzheimer's disease
• the inventors have discovered that Ppargcla, a pleotropic regulator of cellular metabolism in many cell types including microglia, is an important regulator of aging- associated neuropathic disorders.
• the inventors have discovered a connection between Ppargcl activation in microglia and its effect on the cognitive and motor functions of the whole organism.
• activating Ppargcla with compounds such as ZLN005 ameliorates microglial dysfunction and improves cognitive performance in older animals.
• the present invention is directed to a method for preventing or treating age- associated cognitive impairment or neuroinfiammation.
• the method comprises the step of administering a Ppargcla activator to a subject in need thereof, in an amount effective to prevent, arrest, or reverse the development of aging-related symptoms.
• Preventing refers to arresting or slowing progression of age-associated cognitive impairment or neuroinfiammation.
• Treating refers to reverse, alleviate, or reduce age- associated cognitive dysfunction or neuroinfiammation.
• the subject is an aging subject (45-60 years old) or an old subject (over 60 years old).
• microglia in older mice are more glycolytic, evidenced by their increased utilization of glucose as its energy substrate and an upregulation of the glucose transporter Slc2al . Treating these older animals with ZLN005 led to a signifi cant inhibition of glucose uptake as well as Slc2al expression in microglia.
• TNF Tumor necrosis factor
• cytokine cell signaling protein
• CCL2 chemokine ligand 2
• compositions comprising one or more pharmaceutically acceptable carriers and an active compound of 2-(4-tert-butylphenyl)-lH- benzimidazole, 2-[4-(l , 1 -dimethyl ethyl)phenyl]- IH-benzimidazole (ZLN005), or a
• pharmaceutically acceptable salt or solvate in the pharmaceutical compositions in general is in an amount of about 0,01 -20% (w/w) for a topical formulation; about 0.1-5% for an injectable formulation, 0.1-5% for a patch formulation, about 1-90% for a tablet formulation, and 1-100% for a capsule formulation.
• the pharmaceutical composition can be in a dosage form such as tablets, capsules, granules, fine granules, powders, syrups, suppositories, injectable solutions, patches, or the like.
• the pharmaceutical composition can be an aerosol suspension of respirable particles comprising the active compound, which the subject inhales.
• the respirable particles can be liquid or solid, with a particle size sufficiently small to pass through the mouth and larynx upon inhalation. In general, particles having a size of about I to 10 microns, preferably 1-5 microns, are considered respirable.
• the active compound is incorporated into any acceptable carrier, including creams, gels, lotions or other types of suspensions that can stabilize the active compound and deliver it to the affected area by topical applications.
• any acceptable carrier including creams, gels, lotions or other types of suspensions that can stabilize the active compound and deliver it to the affected area by topical applications.
• the above pharmaceutical composition can be prepared by conventional methods.
• Pharmaceutically acceptable carriers which are inactive ingredients, can be selected by those skilled in the art using conventional criteria.
• Pharmaceutically acceptable carriers include, but are not limited to, non-aqueous based solutions, suspensions, emulsions, microemulsions, micellar solutions, gels, and ointments.
• the pharmaceutically acceptable carriers may also contain ingredients that include, but are not limited to, saline and aqueous electrolyte solutions; ionic and nonionic osmotic agents such as sodium chloride, potassium chloride, glycerol, and dextrose; pH adjusters and buffers such as salts of hydroxide, phosphate, citrate, acetate, borate, and trolamine; antioxidants such as salts, acids and/or bases of bisulfite, sulfite, metabi sulfite, thiosuifite, ascorbic acid, acetyl cysteine, cysteine, glutathione, butylated hydroxy ani sole, butyl ated hydroxytoluene, tocopherols, and ascorbyl palmitate; surfactants such as lecithin, phospholipids, including but not limited to
• methylcellulose and their salts petroleum derivatives such as mineral oil and white petrolatum; fats such as lanolin, peanut oil, palm oil, soybean oil; mono-, di-, and
• triglycerides polymers of acrylic acid such as carboxypolym ethylene gel, and
• hvdrophobically modified cross-linked acrylate copolymer polysaccharides such as dextrans and glycosaminogl yeans such as sodium hyaluronate.
• Such pharmaceutically acceptable carriers may be preserved against bacterial contamination using well-known preservatives, these include, but are not limited to, benzalkonium chloride, ethyl enediaminetetraacetic acid and its salts, benzethonium chloride, chlorhexidine, chlorobutanol, methylparaben, thimerosal, and phenyl ethyl alcohol, or may be formulated as a non-preserved formulation for either single or multiple use.
• a tablet formulation or a capsule formulation of the active compound may contain other excipients that have no bioactivity and no reaction with the active compound.
• Excipients of a tablet or a capsule may include fillers, binders, lubricants and glidants, disintegrators, wetting agents, and release rate modifiers. Binders promote the adhesion of particles of the formulation and are important for a tablet formulation. Examples of excipients of a tablet or a capsule include, but not limited to, carboxymethylcellulose, cellulose,
• ethyl cellulose hydroxypropylmethylcellulose, methylcellulose, karaya gum, starch, tragacanth gum, gelatin, magnesium stearate, titanium dioxide, poiyi acrylic acid), and
• a tablet formulation may contain inactive ingredients such as colloidal silicon dioxide, crospovidone, hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, sodium starch glycol ate, and/or titanium dioxide.
• a capsule formulation may contain inactive ingredients such as gelatin, magnesium stearate, and/or titanium dioxide.
• a patch formulation of the active compound may comprise some inactive ingredients such as 1,3 -butyl ene glycol, dihydroxyaluminum aminoacetate, ⁇ £ sodium edetate, D- sorbitol, gelatin, kaolin, methylparaben, polysorbate 80, povidone, propylene glycol, propylparaben, sodium carboxymethylcellulose, sodium polyacrylate, tartaric acid, titanium dioxide, and purified water,
• a patch formulation may also contain skin permeability enhancer such as lactate esters (e.g., iauryl lactate) or di ethylene glycol monoethyl ether.
• Topical formulations including the active compound can be in a form of gel, cream, lotion, liquid, emulsion, ointment, spray, solution, and suspension.
• the inactive ingredients in the topical formulations for example include, but not limited to, diethylene glycol monoethyl ether (emollient/permeation enhancer), DMSO (solubility enhancer), silicone elastomer (rheology/texture modifier), caprylic/capric triglyceride, (emollient), octisalate, (emollient/UV filter), silicone fluid (emollient/diluent), squalene (emollient), sunflower oil (emollient), and silicone dioxide (thickening agent).
• diethylene glycol monoethyl ether emollient/permeation enhancer
• DMSO solubility enhancer
• silicone elastomer rheology/texture modifier
• caprylic/capric triglyceride e
• the present invention is directed to a method of preventing and/or treating aging- related cognitive impairment and/or neuroinflammation.
• the method prevents aging-related cognitive impairment and neuroinflammation of the central nervous system and/or reduces or reverses these symptoms once developed.
• the method comprises the steps of first identifying a subject in need thereof, and administering to the subject the active compound of ZLN005, in an amount effective to treat aging-related symptoms.
• An effective amount is an amount effective to treat an aging-related condition by reducing its symptoms.
• the method reverses or reduces behavioral dysfunctions in an older or aging patient. In one embodiment, the method suppresses neuroinflammation as well as systemic inflammation of the subject. In one embodiment, the method suppresses metabolic abnormalities of microglia in the brain of the subject.
• the pharmaceutical composition of the present invention can be applied by local administration and systemic administration.
• Local administration includes topical administration.
• Systemic administration includes, but not limited to oral, parenteral (such as intravenous, intramuscular, subcutaneous or rectal), and inhaled administration.
• parenteral such as intravenous, intramuscular, subcutaneous or rectal
• inhaled administration By systemic administration, the active compound first reaches plasma and then distributes into target tissues.
• Oral administration is a preferred route of administration for the present invention.
• Dosing of the composition can vary based on the extent of the injury and each patient's individual response.
• plasma concentrations of the active compound delivered can vary; but are generally Ixl0 "1 -lxl 0 "4 moles/liter, and preferably Ixl0 "8 -lxl0 " ⁇ moles/liter.
• the pharmaceutical composition is administrated orally to the subject.
• the dosage for oral administration is generally 1-100, and preferably 1-50, or 1-25 mg/kg/day.
• the active compound can be applied orally to an adult human at 50- 1000 mg/dosage, or 100-600 mg dosage, 1-4 times a day, depends on the patient's condition and weight.
• the phannaceutical composition is administrated subcutaneouslv to the subject.
• the dosage for subcutaneous administration is generally 0.3-20, and preferably 0.3-3 mg/kg/day.
• the composition is applied topically onto the affected area and rubbed into it.
• the composition is topically applied at least 1 or 2 times a day, or 3 to 4 times per day, depending on the medical issue and the disease pathology.
• the topical composition comprises about 0.01-20%, or 0.05-20%, or 0.1-20%, or 0.2-15%, 0.5-10, or 1-5 % (w/w) of the active compound.
• 0.2-10 mL of the topical composition is applied to the individual per dose.
• the active compound passes through skin and is delivered to the site of discomfort.
• the present invention is useful in treating a mammal subject, such as humans, horses, dogs and cats.
• the present invention is particularly useful in treating humans.
• Example L Ppargcla activator ZLN005 suppresses metabolic, dysfunction in microglia in older mice
• methylcellulose vehicle or ZLN005 (Sigma) at 25mg/kg in vehicle, starting at 37 weeks of age.
• PBS- perfused brain tissues of sacrificed animals were digested with Collagenase I and processed for flow cytometry (Ginhoux et al Science, 330:841-5, 2010).
• Brain microglia were phenotyped with 2- BDG (2-(A' ' -(7 ⁇ nitrobenz-2-oxa ⁇ l,3 ⁇ diazol-4-yl)amino)-2-deoxyglucose, Invitrogen) and anti-Slc2al antibody (RnD) for flow cytometric acquisition (LSRII, BD) and analysis (Flow Jo).
• 2- BDG 2-(A' ' -(7 ⁇ nitrobenz-2-oxa ⁇ l,3 ⁇ diazol-4-yl)amino)-2-deoxyglucose, Invitrogen
• RnD anti-Slc2al antibody
• Y-axis represents % of microglia that either express glucose transporter Slc2al or have taken up glucose fluorescent analog 2-NBDG.
• ANOVA was used for statistical analysis. The results show that microglia in older mice exhibited a glycolytic activation phenotype, evidenced by a significant increase in Slc2al expression as well as 2-NBDG uptake in vehicle treated older mice when compared with young mice (p-values ⁇ 0.01). The results also show that by administering ZLN005 to older animals, Slc2al expression and glucose uptake in microglia of these treated animals decreased, and thus their metabolic dysfunctions were alleviated, (p-values ⁇ 0.05).
• methylcellulose vehicle or ZLN005 (Sigma) at 25mg/kg in vehicle, starting at 37 weeks of age.
• Treated older animals n 6
• non-treated older animals or aged animals i n b
• PBS-perfused brain tissues of sacrificed animals were digested with Collagenase I and processed for flow cytometry (Ginhoux et al Science, 330:841-5, 2010). Brain microglia were phenotyped with fluorochrome-labeled antibodies to CCL2 and TNF-a (Biolegend) for flow cytometric acquisition (LSRII, BD) and analysis (FlowJo).
• Y-axis represents % of microglia that express CCL2 or TNF- ⁇ .
• ANOVA was used for statistical analysis. The results show that microglia in older mice exhibited an inflammatory phenotype, evidenced by a significant increase in CCL2 and TNF-a production in vehicle-treated older mice when compared with young mice. The results also show that by administering ZLN005 to older animals, CCL2 and TNF-a production in microglia of these treated, older animals decreased and thus neuroinflammation was suppressed (p-values ⁇ 0.05 for TNF-a and ⁇ 0.01 for CCL2).
• TNF-a levels in serum of young mice, vehicle-treated older mice, and ZLN-treated older mice were measured by ELISA to determine TNF-a levels which indicated systemic inflammation.
• the results are summarized in Figure 3; Y-axis represents the concentration of TNF-a in serum.
• the results show that by administering ZLN005 to older animals, TNF-a levels in serum of these treated and older animals decreased and thus systemic inflammation was suppressed when compared with vehicle-treated older animal (p- value ⁇ 0.05). Unpaired t-test was used for statistical analysis.
• Results in FIG. 4 reveal that older mice treated with vehicle had a higher average score than those treated with ZLN005 (p-value ⁇ 0.05), indicating that ZLN005 reduced the anxiety phenotype and corrected behavioral dysfunction in older mice (!) 8-9 mice per group). Unpaired t-test was used for statistical analysis.

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