WO2018191350A1 - Methods for hair follicle stem cell proliferation - Google Patents

Methods for hair follicle stem cell proliferation Download PDF

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Publication number
WO2018191350A1
WO2018191350A1 PCT/US2018/027054 US2018027054W WO2018191350A1 WO 2018191350 A1 WO2018191350 A1 WO 2018191350A1 US 2018027054 W US2018027054 W US 2018027054W WO 2018191350 A1 WO2018191350 A1 WO 2018191350A1
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concentration
pharmaceutical composition
compound
sag
halo
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PCT/US2018/027054
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French (fr)
Inventor
Christopher Loose
Bradley Tait
Rajesh Manchanda
Will MCLEAN
Megan S. HARRISON
Sara STRECKER
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Frequency Therapeutics, Inc.
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Priority to EP18721575.1A priority Critical patent/EP3609998A1/en
Priority to AU2018250591A priority patent/AU2018250591A1/en
Priority to CN201880038439.XA priority patent/CN110869492A/en
Priority to US16/604,203 priority patent/US20200113913A1/en
Priority to CA3057499A priority patent/CA3057499A1/en
Priority to JP2019555663A priority patent/JP2020516282A/en
Publication of WO2018191350A1 publication Critical patent/WO2018191350A1/en
Priority to IL26950319A priority patent/IL269503A/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/55Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
    • A61K31/551Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole having two nitrogen atoms, e.g. dilazep
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/4427Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems
    • A61K31/4436Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems containing a heterocyclic ring having sulfur as a ring hetero atom
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/506Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim not condensed and containing further heterocyclic rings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/535Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one oxygen as the ring hetero atoms, e.g. 1,2-oxazines
    • A61K31/53751,4-Oxazines, e.g. morpholine
    • A61K31/53771,4-Oxazines, e.g. morpholine not condensed and containing further heterocyclic rings, e.g. timolol
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/56Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
    • A61K31/575Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of three or more carbon atoms, e.g. cholane, cholestane, ergosterol, sitosterol
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/36Skin; Hair; Nails; Sebaceous glands; Cerumen; Epidermis; Epithelial cells; Keratinocytes; Langerhans cells; Ectodermal cells
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0012Galenical forms characterised by the site of application
    • A61K9/0014Skin, i.e. galenical aspects of topical compositions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00Drugs for dermatological disorders
    • A61P17/14Drugs for dermatological disorders for baldness or alopecia
    • CCHEMISTRY; METALLURGY
    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12NMICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N5/00Undifferentiated human, animal or plant cells, e.g. cell lines; Tissues; Cultivation or maintenance thereof; Culture media therefor
    • C12N5/06Animal cells or tissues; Human cells or tissues
    • C12N5/0602Vertebrate cells
    • C12N5/0625Epidermal cells, skin cells; Cells of the oral mucosa
    • C12N5/0627Hair cells
    • C12N5/0628Hair stem cells; Hair progenitors
    • CCHEMISTRY; METALLURGY
    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12NMICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N2501/00Active agents used in cell culture processes, e.g. differentation
    • C12N2501/40Regulators of development
    • C12N2501/41Hedgehog proteins; Cyclopamine (inhibitor)
    • CCHEMISTRY; METALLURGY
    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12NMICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N2501/00Active agents used in cell culture processes, e.g. differentation
    • C12N2501/40Regulators of development
    • C12N2501/415Wnt; Frizzeled
    • CCHEMISTRY; METALLURGY
    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12NMICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N2501/00Active agents used in cell culture processes, e.g. differentation
    • C12N2501/999Small molecules not provided for elsewhere

Definitions

  • the present invention relates to methods of using one or more sonic hedgehog
  • the stem cells in hair follicles are dermal papilla stem cells in the Dermal Papilla.
  • the one or more Wnt activator is one or more glycogen synthase (GSK) inhibitor.
  • the one or more GSK inhibitor is one or more lH-pyrrole-2,5-dione compound.
  • Stem cells exhibit an extraordinary ability to generate multiple cell types in the body. Besides embryonic stem cells, tissue specific stem cells serve a critical role during development as well as in homeostasis and injury repair in the adult. Stem cells renew themselves through proliferation as well as generate tissue specific cell types through differentiation. The characteristics of different stem cells vary from tissue to tissue, and are determined by their intrinsic genetic and epigenetic status. However, the balance between self- renewal and differentiation of different stem cells are all stringently controlled. Uncontrolled self-renewal may lead to overgrowth of stem cells and possibly tumor formation, while uncontrolled differentiation may exhaust the stem cell pool, leading to an impaired ability to sustain tissue homeostasis. Thus, stem cells continuously sense their environment and appropriately respond with proliferation, differentiation or apoptosis.
  • tissue stem cells from different tissues share a limited number of signaling pathways for the regulation of their self-renewal and differentiation, albeit in a very context dependent manner. Some of these pathways are the Wnt and GSK3 pathways.
  • Hair loss e.g. alopecia
  • Hair loss is a disorder caused by an interruption in the body's cycle of hair production. Hair loss can occur anywhere on the body, but most commonly affects the scalp. On average, the scalp has 100,000 hairs that cycle through periods of growing, resting, falling out, and regenerating. Although not a life-threatening condition, and primarily a 'cosmetic' issue, hair loss affects quality of life. In an image-oriented society, hair loss has a significant impact on an individual's emotional state. Hair loss may be linked to a person's genetics, although many medical and behavioral conditions may interrupt the growth cycle and cause hair loss.
  • the present disclosure provides methods of using one or more Sonic Hedgehog
  • the present disclosure also provides pharmaceutical compositions of one or more Shh pathway activator and one or more Wnt agonist. These compositions are useful, for example, in treating diseases associated with hair loss, such as alopecia.
  • the present disclosure provides a method of expanding a population of stem cells of hair follicles, said method comprising contacting the stem cells with one or more Sonic Hedgehog (Shh) pathway activator and one or more Wnt agonist.
  • the present disclosure provides a method of facilitating the generation of hair follicle epithelial cells, the method comprising treating stem cells of hair follicles with one or more Sonic Hedgehog (Shh) pathway activator and one or more Wnt agonist.
  • the stem cells are dermal papilla stem cells. In another embodiment, the stem cells are hair follicle stem cells. In some embodiments, the stem cells comprise keratinocytes, melanocytes, dermal papilla cells, bulge cells, or a combination thereof. In some embodiments, the stem cells are in a subject. In some embodiments of the methods described herein, the expression of Glil, Krtl5, CD34, Lgr5, Lgr6, Lrigl, Sox2, CD133, Vimentin, Versican and/or alkaline phosphatase is increased in hair follicles.
  • the present disclosure provides a method of treating a subject who has, or is at risk of developing, a disease associated with absence or lack of hair follicle epithelial cells, the method comprising administering to said subject one or more Sonic Hedgehog (Shh) pathway activator and one or more Wnt agonist.
  • Sonic Hedgehog (Shh) pathway activator and one or more Wnt agonist.
  • the disease is selected from telogen effluvium, anagen effluvium, androgenetic alopecia, alopecia areata, tinea capitis, lichen planopilaris, cicatricial alopecia, discoid lupus erythematosus, folliculitis decalvans, dissecting cellulitis of the scalp, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, trichotillomania, traction alopecia, and hypotrichosis.
  • the present disclosure provides a method of treating a subject who has, or is at risk of developing, alopecia, the method comprising administering to said subject one or more Sonic Hedgehog (Shh) pathway activator and one or more Wnt agonist.
  • Sonic Hedgehog (Shh) pathway activator and one or more Wnt agonist.
  • the subject administered the one or more Shh pathway activator and the one or more Wnt agonist has improved hair growth, improved hair density and/or improved regenerative cycling of hair follicles compared to a subject not administered the one or more Shh pathway activator and the one or more Wnt agonist.
  • the present disclosure provides a pharmaceutical composition
  • a pharmaceutical composition comprising: a pharmaceutically-acceptable carrier and (i) a Wnt agonist, or a pharmaceutically-acceptable salt thereof, and (ii) a Sonic Hedgehog (Shh) pathway activator, or a pharmaceutically-acceptable salt thereof.
  • the one or more Shh pathway activator is at a concentration of about 5x to about lOOOx of an effective in vitro Shh pathway activation concentration. In certain embodiments, the one or more Shh pathway activator is at a concentration of about lOx to about lOOx of an effective in vitro Shh pathway activation concentration. In some embodiments, the one or more Shh pathway activator is at a concentration of about 20x to about 5 Ox of an effective in vitro Shh pathway activation concentration. In certain embodiments, the one or more Wnt agonist is at a concentration of about 5x to about 1 OOOx of an effective in vitro Wnt agonist concentration.
  • the one or more Wnt agonist is at a concentration of about lOx to about lOOx of an effective in vitro Wnt agonist concentration. In some embodiments, the one or more Wnt agonist is at a concentration of about 20x to about 50x of an effective in vitro Wnt agonist concentration.
  • Shh pathway activator comprises a Smoothened agonist. In other embodiments, the Shh pathway activator comprises Smoothened ciliary accumulation enhancers. In certain embodiments of the methods and compositions disclosed herein, the one or more Shh pathway activator is selected from Table 1 or Table 2. In further embodiments of the methods and compositions disclosed herein, the one or more Shh pathway activator is selected from Purmorphamine, SAG, 20-alpha hydroxy cholesterol, and SAG HC1.
  • the one or more Wnt agonist is selected from Table 3.
  • the one or more Wnt agonist is a GSK3 -alpha inhibitor or a GSK3-beta inhibitor.
  • the GSK3-alpha inhibitor is selected from Table 5.
  • the GSK3-beta inhibitor is selected from Table 4.
  • the one or more Wnt agonist is a compound of Formula (I),
  • Q 2 is C or N
  • Q 3 is C or N
  • R 1 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C 4 alkynyl, -CN, -OH, -0-Ci-C 4 alkyl, -NH2, -NHC(0)R la , and -S(0) 2 NH 2 ; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R la is Ci-C4alkyl;
  • R 2 is selected from the group consisting of halo, Ci-C4alkyl, Ci-C4alkenyl, Ci- C4alkynyl,
  • R 2a is Ci- C4alkyl
  • R 3 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C 4 alkynyl, -CN, -OH, -0-Ci-C 4 alkyl, -NH2, -NHC(0)R a , and -S(0) 2 NH 2 ; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R a is Ci-C4alkyl;
  • -Z-W-X-Y- is -C(R Z ) 2 -C(R W ) 2 -N(R X )-C(R Y ) 2 -, -C(R Z ) 2 -C(R W ) 2 -CH(R X )-C(R Y ) 2 -, or -C(R W ) 2 -CH(R X )-C(R Y ) 2 -;
  • each R z is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both R z groups together form C3-C6cycloalkyl or oxo;
  • each R w is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both R w groups together form C3-C6cycloalkyl or oxo; or R z and R w together with the carbons to which they are attached form a C3- C6cycloalkyl;
  • R x is selected from the group consisting of -COR xl , -S0 2 R X1 , heteroaryl, and -(Ci- C4alkylene)-(C3-C8cycloalkyl), and wherein the-(Ci-C4alkylene)-(C3-C8cycloalkyl) is optionally substituted with one to four halo on the Ci-C4alkylene;
  • R X1 is heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, -[C(R xla ) 2 ] P -CN, -CF 3 , Ci-C 4 alkyl, -(CH 2 ) P -OH, -[C(R xla ) 2 ] P -OH, -[C(R xla ) 2 ] P -0-Ci- C 4 alkyl, -NHCOCi-C 4 alkyl, -CONHCi-C 4 alkyl, -COH, -C0 2 H, -[C(R xla ) 2 ] P -COO-Ci- C 4 alkyl, -(CH 2 ) P -NH 2 , -[C(R xla ) 2 ] P -NH 2 , -[C(R xla ) 2 ] P -NH 2
  • each R Y is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both R Y groups together form C3-C6cycloalkyl or oxo;
  • n 0, 1, or 2.
  • the compounds of Formula I have one or more of the following features:
  • Q 1 is CH or N
  • Q 2 is C or N
  • Q 3 is C or N
  • R 1 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C 4 alkynyl,-CN, -OH, -0-Ci-C 4 alkyl, -NH 2 , -NHC(0)R a , and -S(0) 2 NH 2 ; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R la is Ci-C4alkyl; R 2 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C 4 alkynyl,-CN, -OH, -0-Ci-C 4 alkyl, -NH 2 , -NH(Ci-C 4 alkyl), -N(Ci-C4alkyl) 2 , - NHC(0)R 2a , and -S(0)2NH2; where
  • R 3 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C 4 alkynyl, -CN, -OH, -0-Ci-C 4 alkyl, -NH 2 , -NHC(0)R a , and -S(0) 2 NH 2 ; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R a is Ci-C4alkyl;
  • Q 7 is selected from S, O, CH2, and NR Q7 ; wherein R Q7 is hydrogen or optionally substituted Ci-C4alkyl;
  • -Z-W-X-Y- is -C(R Z ) 2 -C(R W ) 2 -N(R X )-C(R Y ) 2 -, -C(R Z ) 2 -C(R W ) 2 -CH(R X )-C(R Y ) 2 -, or -C(R W ) 2 -CH(R X )-C(R Y ) 2 -;
  • each R z is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both R z groups together form C3-C6cycloalkyl or oxo;
  • each R w is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both R w groups together form C3-C6cycloalkyl or oxo;
  • R x is selected from the group consisting of hydrogen, R X1 , -COR xl , -S0 2 R X1 , -(Ci- C4alkylene)-R xl , and wherein the -(Ci-C4alkylene)-R xl is optionally substituted with one to four halo on the Ci-C4alkylene; wherein R X1 is C3-C8cycloalkyl, heteroaryl, or heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, -[C(R xla ) 2 ] P -CN, -CF 3 , -Ci-C 4 alkyl, -(CH 2 ) P -OH, - [C(R xla ) 2 ] P -OH, -[C(R xla ) 2 ] P -0-Ci-C4alky
  • each R Y is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both R Y groups together form C3-C6cycloalkyl or oxo;
  • n 0, 1, or 2.
  • the one or more Wnt agonist is a compound of Formula lb:
  • Q 1 is CH or N
  • Q 2 is C or N
  • Q 3 is C or N
  • Q 1 , Q 2 , and Q 3 are N; and provided that when Q 1 is CH and Q 3 is C, Q 2 is not N;
  • R 1 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C 4 alkynyl,-CN, -OH, -0-Ci-C 4 alkyl, -NH 2 , -NHC(0)R a , and -S(0) 2 NH 2 ; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R la is Ci-C4alkyl;
  • R 2 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C 4 alkynyl, -CN, -OH, -0-Ci-C 4 alkyl, -NH 2 , -NH(Ci-C 4 alkyl), -N(Ci-C 4 alkyl) 2 , - NHC(0)R 2a , and -S(0) 2 NH 2 ; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R 2a is Ci-C4alkyl;
  • R 3 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C 4 alkynyl,-CN, -OH, -0-Ci-C 4 alkyl, -NH 2 , -NHC(0)R 3a , and -S(0) 2 NH 2 ; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R a is Ci-C4alkyl;
  • each Q 6 is independently selected from CR Q6 and N; wherein R Q6 is hydrogen, halo, - CN, lower alkyl, or substituted alkyl;
  • Q 7 is selected from S, O, CH2, and NR Q7 ; wherein R Q7 is hydrogen or optionally substituted Ci-C4alkyl;
  • -Z-W-X-Y- is -C(R Z ) 2 -C(R W ) 2 -N(R X )-C(R Y ) 2 -, -C(R Z ) 2 -C(R W ) 2 -CH(R X )-C(R Y ) 2 -, or -C(R W ) 2 -CH(R X )-C(R Y ) 2 -;
  • each R z is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both R z groups together form C3-C6cycloalkyl or oxo;
  • each R w is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both R w groups together form C3-C6cycloalkyl or oxo;
  • R x is selected from the group consisting of hydrogen, R X1 , -COR xl , -S0 2 R X1 , -(Ci- C4alkylene)-R xl , and wherein the -(Ci-C4alkylene)-R xl is optionally substituted with one to four halo on the Ci-C4alkylene; wherein R X1 is C3-Cscycloalkyl, heteroaryl, or heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, -[C(R xla ) 2 ] P -CN, -CF 3 , Ci-C 4 alkyl, -(CH 2 ) P -OH, - [C(R xla ) 2 ] P -OH, -[C(R xla ) 2 ] P -0-Ci-C4alkyl,
  • each R Y is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both R Y groups together form C3-C6cycloalkyl or oxo;
  • n 0, 1, or 2.
  • the one or more Wnt agonist is selected from Table 6. In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is selected from CHIR99021, LY2090314, AZD1080, GSK3 inhibitor XXII, Compound 1-6, Compound 1-7, and Compound 1-12.
  • the one or more Wnt agonist is selected from CHIR99021, LY2090314, AZD1080, GSK3 inhibitor XXII, Compound 1-6, Compound 1-7, and Compound 1-12 and the one or more Shh pathway activator is selected from Purmorphamine, SAG, 20-alpha hydroxy cholesterol, and SAG HC1.
  • the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is Purmorphamine.
  • CHIR99021 is at a concentration of about 100 nM to about 10 ⁇ and Purmorphamine is at a concentration of about 100 nM to about 10 ⁇ .
  • CHIR99021 is at a concentration of about 100 ⁇ to about 10 mM and Purmorphamine is at a concentration of about 100 ⁇ to about 10 mM.
  • the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is SAG.
  • CHIR99021 is at a concentration of about 100 nM to about 10 ⁇ and SAG is at a concentration of about 1 nM to about 100 nM.
  • CHIR99021 is at a concentration of about 100 ⁇ to about 10 mM and SAG is at a concentration of about 1 ⁇ ⁇ about 100 ⁇ .
  • the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
  • CHIR99021 is at a concentration of about 100 nM to about 10 ⁇ and 20-alpha hydroxy cholesterol is at a concentration of about 1 ⁇ to about 100 ⁇ . In certain embodiments, CHIR99021 is at a concentration of about 100 ⁇ to about 10 mM and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
  • the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is SAG HCl.
  • CHIR99021 is at a concentration of about 100 nM to about 10 ⁇ and SAG HCl is at a concentration of about 10 nM to about 1 ⁇ .
  • CHIR99021 is at a concentration of about 100 ⁇ to about 10 mM and SAG HCl is at a concentration of about 10 ⁇ to about 1 mM.
  • the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is Purmorphamine.
  • LY2090314 is at a concentration of about 1 nM to about 100 nM and Purmorphamine is at a concentration of about 100 nM to about 10 ⁇ .
  • LY2090314 is at a concentration of about 1 ⁇ to about 100 ⁇ and Purmorphamine is at a concentration of about 100 ⁇ to about 10 mM.
  • the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is SAG.
  • LY2090314 is at a concentration of about 1 nM to about 100 nM and SAG is at a concentration of about 1 nM to about 100 nM.
  • LY2090314 is at a concentration of about 1 ⁇ to about 100 ⁇ and SAG is at a concentration of about 1 ⁇ to about 100 ⁇ .
  • the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
  • LY2090314 is at a concentration of about 1 nM to about 100 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 ⁇ to about 100 ⁇ .
  • LY2090314 is at a concentration of about 1 ⁇ to about 100 ⁇ and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
  • the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is SAG HCl.
  • LY2090314 is at a concentration of about 1 nM to about 100 nM and SAG HCl is at a concentration of about 10 nM to about 1 ⁇ .
  • LY2090314 is at a concentration of about 1 ⁇ to about 100 ⁇ and SAG HCl is at a concentration of about 10 ⁇ to about 1 mM.
  • the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is Purmorphamine.
  • AZD1080 is at a concentration of about 1 ⁇ to about 100 ⁇ and Purmorphamine is at a concentration of about 100 nM to about 10 ⁇ .
  • AZD1080 is at a concentration of about 1 mM to about 100 mM and Purmorphamine is at a concentration of about 100 ⁇ to about 10 mM.
  • the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is SAG.
  • AZD1080 is at a concentration of about 1 ⁇ to about 100 ⁇ and SAG is at a concentration of about 1 nM to about 100 nM.
  • AZD1080 is at a concentration of about 1 mM to about 100 mM and SAG is at a concentration of about 1 ⁇ to about 100 ⁇ .
  • the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
  • AZD1080 is at a concentration of about 1 ⁇ to about 100 ⁇ and 20-alpha hydroxy cholesterol is at a concentration of about 1 ⁇ to about 100 ⁇ .
  • AZD1080 is at a concentration of about 1 mM to about 100 mM and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
  • the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is SAG HCl.
  • AZD1080 is at a concentration of about 1 ⁇ to about 100 ⁇ and SAG HCl is at a concentration of about 10 nM to about 1 ⁇ .
  • AZD1080 is at a concentration of about 1 mM to about 100 mM and SAG HCl is at a concentration of about 10 ⁇ to about 1 mM.
  • the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is Purmorphamine.
  • GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 ⁇ and Purmorphamine is at a concentration of about 100 nM to about 10 ⁇ .
  • GSK3 inhibitor XXII is at a concentration of about 100 ⁇ to about 10 mM and Purmorphamine is at a concentration of about 100 ⁇ to about 10 mM.
  • the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is SAG.
  • GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 ⁇ and SAG is at a concentration of about 1 nM to about 100 nM.
  • GSK3 inhibitor XXII is at a concentration of about 100 ⁇ to about 10 mM and SAG is at a concentration of about 1 ⁇ to about 100 ⁇ .
  • the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
  • GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 ⁇ and 20-alpha hydroxy cholesterol is at a concentration of about 1 ⁇ to about 100 ⁇ .
  • GSK3 inhibitor XXII is at a concentration of about 100 ⁇ to about 10 mM and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
  • the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is SAG HCl.
  • GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 ⁇ and SAG HCl is at a concentration of about 10 nM to about 1 ⁇ .
  • GSK3 inhibitor XXII is at a concentration of about 100 ⁇ to about 10 mM and SAG HCl is at a concentration of about 10 ⁇ to about 1 mM.
  • the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is Purmorphamine.
  • Compound 1-6 is at a concentration of about 1 nM to about 100 nM and Purmorphamine is at a concentration of about 100 nM to about 10 ⁇ .
  • Compound 1-6 is at a concentration of about 1 ⁇ to about 100 ⁇ and Purmorphamine is at a concentration of about 100 ⁇ to about 10 mM.
  • the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is SAG.
  • Compound 1-6 is at a concentration of about 1 nM to about 100 nM and SAG is at a concentration of about 1 nM to about 100 nM.
  • Compound 1-6 is at a concentration of about 1 ⁇ to about 100 ⁇ and SAG is at a concentration of about 1 ⁇ ⁇ about 100 ⁇ .
  • the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is 20- alpha hydroxy cholesterol.
  • Compound 1-6 is at a concentration of about 1 nM to about 100 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 ⁇ to about 100 ⁇ .
  • Compound 1-6 is at a concentration of about 1 ⁇ to about 100 ⁇ and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
  • the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is SAG HCl.
  • Compound 1-6 is at a concentration of about 1 nM to about 100 nM and SAG HCl is at a concentration of about 10 nM to about 1 ⁇ .
  • Compound 1-6 is at a concentration of about 1 ⁇ to about 100 ⁇ and SAG HCl is at a concentration of about 10 ⁇ to about 1 mM.
  • the one or more Wnt agonist is Compound 1-7 and the one or more Shh pathway activator is Purmorphamine.
  • Compound 1-7 is at a concentration of about 1 nM to about 100 nM and Purmorphamine is at a concentration of about 100 nM to about 10 ⁇ .
  • Compound 1-7 is at a concentration of about 1 ⁇ to about 100 ⁇ and Purmorphamine is at a concentration of about 100 ⁇ to about 10 mM.
  • Compound 1-7 and the one or more Shh pathway activator is SAG.
  • Compound 1-7 is at a concentration of about 1 nM to about 100 nM and SAG is at a concentration of about 1 nM to about 100 nM.
  • Compound 1-7 is at a concentration of about 1 ⁇ to about 100 ⁇ and SAG is at a concentration of about 1 ⁇ to about 100 ⁇ .
  • the one or more Wnt agonist is Compound 1-7 and the one or more Shh pathway activator is 20- alpha hydroxy cholesterol.
  • Compound 1-7 is at a concentration of about 1 nM to about 100 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 ⁇ to about 100 ⁇ .
  • Compound 1-7 is at a concentration of about 1 ⁇ to about 100 ⁇ and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
  • the one or more Wnt agonist is Compound 1-7 and the one or more Shh pathway activator is SAG HCl.
  • Compound 1-7 is at a concentration of about 1 nM to about 100 nM and SAG HCl is at a concentration of about 10 nM to about 1 ⁇ .
  • Compound 1-7 is at a concentration of about 1 ⁇ to about 100 ⁇ and SAG HCl is at a concentration of about 10 ⁇ to about 1 mM.
  • the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is Purmorphamine.
  • Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and Purmorphamine is at a concentration of about 100 nM to about 10 ⁇ .
  • Compound 1-12 is at a concentration of about 10 ⁇ to about 1000 ⁇ and Purmorphamine is at a concentration of about 100 ⁇ to about 10 mM.
  • the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is SAG.
  • Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and SAG is at a concentration of about 1 nM to about 100 nM.
  • Compound 1-12 is at a concentration of about 10 ⁇ to about 1000 ⁇ and SAG is at a concentration of about 1 ⁇ to about 100 ⁇ .
  • the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is 20- alpha hydroxy cholesterol.
  • Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 ⁇ to about 100 ⁇ .
  • Compound 1-12 is at a concentration of about 10 ⁇ to about 1000 ⁇ and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
  • the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is SAG HCl.
  • Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and SAG HCl is at a concentration of about 10 nM to about 1 ⁇ .
  • Compound 1-12 is at a concentration of about 10 ⁇ to about 1000 ⁇ and SAG HCl is at a concentration of about 10 ⁇ to about 1 mM.
  • FIG. 1A-FIG. ID show that Shh and Wnt activation promote DP growth and hair growth induction.
  • FIG. 1A DP cells treated in control conditions show small and few colonies.
  • FIG. IB DP cells treated Shh pathway activator (Purmorphamine 1 ⁇ ) show slightly larger and more abundant colonies than FIG. 1A.
  • FIG. 1C DP cells treated Wnt activator (CHIR99021 4 ⁇ ) show more abundant colonies than FIG. 1A.
  • FIG. ID A combination of a Shh pathway activator (Purmorphamine 1 ⁇ ) and Wnt activator (CHIR99021 4 ⁇ ) show many large DP colonies. 8 days in culture. Scale bars 1000 ⁇ .
  • FIG. 2A-FIG. 2D show that Shh pathway activation with multiple Wnt activation molecules promote DP (dermal papilla) growth and hair growth induction.
  • FIG. 2A DP cells treated in control conditions show small and few colonies.
  • FIG. 2B DP cells treated with Shh pathway activator (Purmorphamine 1 ⁇ ) show slightly larger and more abundant colonies than FIG. 2A.
  • FIG. 2C DP cells treated with Wnt activator (Compound I- 7 10 nM) show more abundant colonies than FIG. 2A.
  • FIG. 2D A combination of a Shh pathway activator (Purmorphamine 1 ⁇ ) and a Wnt activator (Compound 1-7 10 nM) show many large DP colonies. 10 days in culture. Scale the same for all figures; see scale bar in Fig. 2D, 200 ⁇ .
  • FIG. 3A-FIG. 3F show that multiple Shh molecules with Wnt activation promote DP growth and hair growth induction.
  • FIG.3A DP cells treated with Purmorphamine (1 ⁇ ) alone form colonies.
  • FIG. 3D DP cells treated with GSK3 inhibitor (Compound 1-7, 10 nM) and Purmorphamine (1 ⁇ ) form more colonies and are larger than colonies treated with Purmorphamine alone.
  • FIG. 3B DP cells treated with SAG (3 nM) alone form colonies.
  • FIG. 3E DP cells treated with GSK3 inhibitor (Compound 1-7, 10 nM) and SAG (3 nM) form more colonies that are larger than colonies treated with SAG alone.
  • FIG. 3A DP cells treated with Purmorphamine (1 ⁇ ) alone form colonies.
  • FIG. 3D DP cells treated with GSK3 inhibitor (Compound 1-7, 10 nM) and Purmorphamine (1 ⁇ ) form more colonies and are larger than colonies treated with Purmorphamine alone.
  • FIG. 3B DP cells treated
  • FIG. 3C DP cells treated with SAG HCl (500 nM) alone form colonies.
  • FIG. 3F DP cells treated with GSK3 inhibitor (Compound 1-7, 10 nM) and SAG HCl (500 nM) form more colonies that are larger than colonies treated with SAG HCl alone. Scale bars 1000 ⁇ .
  • FIG. 4A-FIG. 4D show that Shh and Wnt activation promote DP growth and hair growth induction.
  • FIG. 4A DP cells treated in control conditions show small and few Alkaline Phosphatase (Alp) colonies.
  • FIG. 4B DP cells treated with Shh pathway activator (Purmorphamine 1 ⁇ ) show few Alp colonies.
  • FIG.4C Follicles treated with a Wnt activator (Compound 1-7 10 nM) show small Alp colonies.
  • FIG. 4D A combination of a Shh pathway activator (Purmorphamine 1 ⁇ ) and a Wnt activator (Compound 1-7 10 nM) show large and many Alp colonies.
  • Alkaline Phosphatase is a marker of DP cells and used to show DP cells that have hair induction capability. 10 days in culture. Scale bars 0.5 mm.
  • FIG. 5A-FIG. 5D show that Shh and Wnt activation promote DP growth and hair growth induction.
  • FIG. 5A A combination of a Shh pathway activator (Purmorphamine 1 ⁇ ) and a Wnt activator (Compound 1-7 10 nM) generate colonies expressing the DP marker Vimentin.
  • FIG. 5B A combination of a Shh pathway activator (Purmorphamine 1 ⁇ ) and a Wnt activator (Compound 1-7 10 nM) generate colonies expressing the DP marker of hair induction Versican. EdU demonstrates that colonies are actively dividing in these conditions.
  • FIG. 5A A combination of a Shh pathway activator (Purmorphamine 1 ⁇ ) and a Wnt activator (Compound 1-7 10 nM) generate colonies expressing the DP marker of hair induction Versican.
  • EdU demonstrates that colonies are actively dividing in these conditions.
  • FIG. 5A A combination of a Shh pathway activator (Purmorphamine
  • FIG. 5C A combination of a Shh pathway activator (Purmorphamine 1 ⁇ ) and a Wnt activator (Compound 1-7 10 nM) generate colonies expressing the DP and stem cell marker Sox2.
  • FIG. 5D A combination of a Shh pathway activator (Purmorphamine 1 ⁇ ) and Wnt activator (Compound 1-7 10 nM) generate colonies expressing the DP marker of hair induction CD133. 10 days in culture. Scale bars 50 ⁇ .
  • FIG. 6A-FIG. 6B show that Shh and Wnt activation promote DP growth and hair growth induction.
  • FIG. 6A Control treated follicles show Alkaline Phosphatase (Alp) at the base of the hair follicle.
  • FIG. 6B Follicles treated with a Wnt activator (Compound 1-7 10 nM) and Shh pathway (Purmorphamine 1 ⁇ ) activator show larger DP.
  • Alkaline Phosphatase is a marker of DP cells and used to show DP cells that have hair induction capability. 7 days in culture. Scale bars 1 mm.
  • the term “approximately” or “about” refers to a range of values that fall within 25%, 20%, 19%, 18%, 17%, 16%, 15%, 14%, 13%, 12%, 11%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, or less in either direction (greater than or less than) of the stated reference value unless otherwise stated or otherwise evident from the context (except where such number would exceed 100% of a possible value).
  • additive effect refers to an effect wherein two or more substances or actions used in combination produce a total effect, the same as the arithmetic sum of the individual effects.
  • administering refers to introducing a substance into a subject.
  • administration is intradermal injection, topical, transdermal or oral.
  • administration is directly to the scalp.
  • administration is directly to the skin via an implant delivery system.
  • causing to be administered refers to administration of a second component after a first component has already been administered (e.g. , at a different time and/or by a different actor).
  • an “antibody” refers to an immunoglobulin polypeptide, or fragment thereof, having immunogen binding ability.
  • an "agonist” is an agent that causes an increase in the expression or activity of a target gene, protein, or a pathway, respectively. Therefore, an agonist can bind to and activate its cognate receptor in some fashion, which directly or indirectly brings about this physiological effect on the target gene or protein. An agonist can also increase the activity of a pathway through modulating the activity of pathway components, for example, through inhibiting the activity of negative regulators of a pathway. Therefore, a "Wnt agonist" can be defined as an agent that increases the activity of Wnt pathway, which can be measured by increased TCF/LEF-mediated transcription in a cell.
  • a "Wnt agonist” can be a true Wnt agonist that bind and activate a Frizzled receptor family member, including any and all of the Wnt family proteins, an inhibitor of intracellular beta-catenin degradation, and activators of TCF/LEF.
  • an "antagonist” refers to an agent that binds to a receptor or protein, and which in turn decreases or eliminates binding by other molecules.
  • Anti-sense refers to a nucleic acid sequence, regardless of length, that is complementary to the coding strand or mRNA of a nucleic acid sequence. Antisense RNA can be introduced to an individual cell, tissue or organanoid. An anti-sense nucleic acid can contain a modified backbone, for example, phosphorothioate, phosphorodithioate, or other modified backbones known in the art, or may contain non-natural intemucleoside linkages.
  • Biocompatible Matrix as used herein is a polymeric carrier that is acceptable for administration to humans for the release of therapeutic agents.
  • a Biocompatible Matrix may be a biocompatible gel or foam.
  • Cell Density as used herein in connection with a specific cell type is the mean number of that cell type per area in a Representative Microscopy Sample.
  • the cell types may include but are not limited to hair follicle stem cells, dermal papilla stem cells, keratinocytes, melanocytes, and bulge cells.
  • the Cell Density may be assessed with a given cell type in a given organ or tissue, including but not limited to, a hair follicle.
  • Complementary nucleic acid sequence refers to a nucleic acid sequence capable of hybridizing with another nucleic acid sequence comprised of complementary nucleotide base pairs.
  • hybridize is meant pair to form a double-stranded molecule between complementary nucleotide bases (e.g., adenine (A) forms a base pair with thymine (T), as does guanine (G) with cytosine (C) in DNA) under suitable conditions of stringency.
  • A adenine
  • T thymine
  • G guanine
  • C cytosine
  • Cross-Sectional Cell Density as used herein in connection with a specific cell type is the mean number of that cell type per area of cross section through a tissue in a Representative Microscopy Sample. Cross sections of a given tissue can also be used to determine the number of cells in a given plane. Typically, Cross-sectional Cell Density will be measured by analyzing whole mount preparations of a given tissue and counting the number of a given specific cell type across a given distance in cross sections taken along a portion of the epithelia, as described in a Representative Microscopy Sample.
  • DP hair follicle culture assay or "DP hair follicle culture assay” refers to a method of using intact hair follicles to quantify the number of Dermal Papilla (DP) cells or size of the DP area within the follicle when measured at the end of the assay.
  • DP cells are cells that express alkaline phosphatase (AP), and/or Versican, and/or Vimentin, and/or Sox2, and/or CD133.
  • microdissection is used to remove intact hair follicles from a specimen. Each hair is trimmed close to the follicle apex and about 3-5 hair follicles are distributed in wells. Culture media with growth factors and/or small molecules are added to the wells, and the follicles are incubated at 37°C. Growth is monitored for one or more desired period of time. EVOS ® transmitted light images may be taken at one or more desired period of time.
  • Hair follicles may be processed for alkaline phosphatase staining, 5-ethynyl-2'- deoxy uridine (EdU) staining and/or immunofluorescence to detect markers such as Vimentin, Sox2, Versican, CD133, etc.
  • EdU 5-ethynyl-2'- deoxy uridine
  • the total area of a hair follicle staining positive for DP markers may be analyzed and hair shaft growth may be monitored over time. Details of the protocol are provided in the Examples section of the present disclosure.
  • DP stem cell or DP cell refers to a cell in the dermal papilla of a hair follicle having the capacity to self-renew.
  • Differentiation Period is the duration of time in which there is an Effective Sternness Driver Concentration.
  • Effective Shh Concentration is the minimum concentration of a Shh pathway activator that creates a >50% increase in the number of Dermal Papilla (DP) spheroids, size of DP spheroids, or number of DP cells in cell culture when combined with a Sternness Driver, measured at the end of the Stem Cell Proliferation Assay using dermal papilla, compared to the respective increase in the number of Dermal Papilla (DP) spheroids, size of DP spheroids, or number of DP cells in cell culture in absence of a Shh pathway activator with all other components present at the same concentration, measured at the end of the Stem Cell Proliferation Assay using dermal papilla cells.
  • Effectivee in vitro Shh Pathway Activation Concentration refers to the "Effective Shh Concentration" in vitro.
  • Effective Wnt Agonist Concentration is the minimum concentration of a Wnt pathway agonist that creates a >50% increase in the number of Dermal Papilla (DP) spheroids, size of DP spheroids, or number of DP cells in cell culture, measured at the end of the Stem Cell Proliferation Assay using dermal papilla, compared to the respective increase in the number of Dermal Papilla (DP) spheroids, size of DP spheroids, or number of DP cells in cell culture in the absence of the Wnt pathway agonist with all other components present at the same concentration, measured at the end of the Stem Cell Proliferation Assay using dermal papilla.
  • Effectivee in vitro Wnt Agonist Concentration refers to the "Effective Wnt Agonist Concentration" in vitro.
  • Effective Release Rate (mass/time) as used herein is the Effective
  • the 'Effective Sternness Driver Concentration may be the "Effective Wnt Agonist Concentration”.
  • Endgraft or “engraftment” refers to the process of stem or progenitor cell incorporation into a tissue of interest in vivo through contact with existing cells of the tissue.
  • Epigenitor cell refers to a multipotent cell which has the potential to become restricted to cell lineages resulting in epithelial cells.
  • Epithelial stem cell refers to a multipotent cell which has the potential to become committed to multiple cell lineages, including cell lineages resulting in epithelial cells.
  • “Fragment” refers to a portion of a polypeptide or nucleic acid molecule. This portion contains, preferably, at least 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, or 90% of the entire length of the reference nucleic acid molecule or polypeptide.
  • a fragment may contain 10, 20, 30, 40, 50, 60, 70, 80, 90, or 100, 200, 300, 400, 500, 600, 700, 800, 900, or 1000 nucleotides or amino acids.
  • GSK3 inhibitor is a composition that inhibits the activity of GSK3, GSK-
  • GSK3beta As used interchangeably herein are acronyms for glycogen synthase kinase 3 beta.
  • GSK3beta inhibitor is a composition that inhibits the activity of GSK3beta.
  • Hair follicle stem cell refers to a multipotent cell in a region of a hair follicle distinct from the dermal papilla that has the capacity to self-renew and to differentiate into multiple cell lineages.
  • Hybridize refers to pairing to form a double-stranded molecule between complementary nucleotide bases (e.g., adenine (A) forms a base pair with thymine (T), as does guanine (G) with cytosine (C) in DNA) under suitable conditions of stringency.
  • adenine (A) forms a base pair with thymine (T)
  • G guanine
  • C cytosine
  • an “inhibitor” refers to an agent that causes a decrease in the expression or activity of a target gene or protein, respectively.
  • An “antagonist” can be an inhibitor, but is more specifically an agent that binds to a receptor, and which in turn decreases or eliminates binding by other molecules.
  • an "inhibitory nucleic acid” is a double-stranded RNA, RNA interference, miRNA, siRNA, shRNA, or antisense RNA, or a portion thereof, or a mimetic thereof, that when administered to a mammalian cell results in a decrease in the expression of a target gene.
  • a nucleic acid inhibitor comprises at least a portion of a target nucleic acid molecule, or an ortholog thereof, or comprises at least a portion of the complementary strand of a target nucleic acid molecule.
  • expression of a target gene is reduced by 10%, 25%, 50%, 75%, or even 90-100%.
  • Increasing refers to increasing by at least 5%, for example, 5, 6, 7, 8, 9, 10,
  • Intradermal administration refers to administration of a medication, pharmaceutical composition or compound into the dermis, just below the epidermis.
  • Isolated refers to a material that is free to varying degrees from components which normally accompany it as found in its native state. "Isolate” denotes a degree of separation from original source or surroundings.
  • Lineage Tracing as used herein is using a mouse line that enables fate tracing of any cell that expresses a target gene at the time of reporter induction. Examples include Glil, Krtl5, CD34, Lgr5, Lgr6, Lrigl, Sox2, CD133, Vimentin, Versican and/or alkaline phosphatase.
  • mammal refers to any mammal including but not limited to human, mouse, rat, sheep, monkey, goat, rabbit, hamster, horse, cow or pig.
  • Mean Release Time is the time in which one-half of an agent is released into phosphate buffered saline from a carrier in a Release Assay.
  • “Native Morphology” as used herein is means that tissue organization largely reflects the organization in a healthy tissue.
  • Non-human mammal refers to any mammal that is not a human.
  • the term "number" of cells can be 0, 1, or more cells.
  • Organic organoid or “epithelial organoid” refers to a cell cluster or aggregate that resembles an organ, or part of an organ, and possesses cell types relevant to that particular organ.
  • Population of cells refers to any number of cells greater than 1, but is preferably at least 1X10 3 cells, at least 1X10 4 cells, at least at least 1X10 5 cells, at least 1X10 6 cells, at least 1X10 7 cells, at least 1X10 8 cells, at least 1X10 9 cells, or at least 1X10 10 cells.
  • Progenitor cell refers to a cell that, like a stem cell, has the tendency to differentiate into a specific type of cell, but is already more specific than a stem cell and is pushed to differentiate into its "target” cell.
  • Reference means a standard or control condition (e.g., untreated with a test agent or combination of test agents).
  • Release Assay is a test in which the rate of release of an agent from a Biocompatible Matrix through dialysis membrane to a saline environment.
  • An exemplary Release Assay may be performed by placing 30 microliters of a composition in 1 ml Phosphate Buffered Saline inside saline dialysis bag with a suitable cutoff, and placing the dialysis bag within 10 mL of Phosphate Buffered Saline at 37 °C.
  • the dialysis membrane size may be chosen based on agent size in order to allow the agent being assessed to exit the membrane. For small molecule release, a 3.5-5 kDa cutoff may be used.
  • the Release Rate for a composition may change over time and may be measured in 1 hour increments.
  • Representative Microscopy Sample describes a sufficient number of fields of view within a cell culture system, a portion of extracted tissue, or an entire extracted organ that the average feature size or number being measured can reasonably be said to represent the average feature size or number if all relevant fields were measured.
  • a Representative Microscopy sample can include measurements within a field of view, which can be measured as cells per a given distance.
  • a Representative Microscopy sample can be used to assess morphology, such as cell-cell contacts, hair follicle architecture, and cellular components (e,g. , bundles, synapses).
  • SAG as used herein for a compound means the compound structure identified as CAS 912545-86-9.
  • SAG HO as used herein for a compound means the compound structure identified as CAS 912545-86-9 as a hydrochloride salt.
  • sample refers to a volume or mass obtained, provided, and/or subjected to analysis.
  • a sample is or comprises a tissue sample, cell sample, a fluid sample, and the like.
  • a sample is taken from (or is) a subject (e.g., a human or animal subject).
  • a tissue sample is or comprises brain, hair (including roots), buccal swabs, blood, saliva, semen, muscle, or from any internal organs, or cancer, precancerous, or tumor cells associated with any one of these.
  • a fluid may be, but is not limited to, urine, blood, ascites, pleural fluid, spinal fluid, and the like.
  • a body tissue can include, but is not limited to, brain, skin, muscle, endometrial, uterine, and cervical tissue or cancer, precancerous, or tumor cells associated with any one of these.
  • a body tissue is brain tissue or a brain tumor or cancer.
  • a “sample” is a "primary sample” in that it is obtained from a source (e.g., a subject); in some embodiments, a “sample” is the result of processing of a primary sample, for example to remove certain potentially contaminating components and/or to isolate or purify certain components of interest.
  • RNA refers to a double stranded RNA. Optimally, an siRNA is 18, 19, 20,
  • dsRNAs can be introduced to an individual cell or culture system. Such siRNAs are used to downregulate mRNA levels or promoter activity.
  • Sonic Hedgehog (Shh) pathway activator or “Sonic Hedgehog (Shh) activator” refers to a compound or factor that activates the Sonic Hedgehog signaling pathway.
  • Sonic Hedgehog (Shh) pathway activators may be a SMO agonist, Ptchl inhibitor, SUFU inhibitor, activator of GLI1 transcription, or other components such that the Sonic Hedgehog pathway or its interactions, e.g. VEGF, FLkl, MEK, ERK, Notch/Hes, NANOG, SOX2, MYC, MYCN, are increased.
  • “Stem cell” refers to a multipotent cell having the capacity to self-renew and to differentiate into multiple cell lineages.
  • “Stem cells of hair follicles” refer to both stem cells found in the dermal papilla of the hair follicle ("dermal papilla stem cells”, “DP stem cells” or “DP cells”) and stem cells found in another region of the hair follicle ("hair follicle stem cells”).
  • Stem Cell Differentiation Assay as used herein is an assay to determine the differentiation capacity of stem cells.
  • Stem Cell Assay as used herein is an assay in which a cell or a cell population are tested for a series of criteria to determine whether the cell or cell population are stem cells or enriched in stem cells or stem cell markers.
  • stem cell characteristics such as expression of Stem Cell Markers, and further optionally are tested for stem cell function, including the capacity of self-renewal and differentiation.
  • Stem Cell Proliferator as used herein is a compound or factor that induces an increase in a population of cells which have the capacity for self-renewal and differentiation.
  • Stem Cell Proliferation Assay is an assay to determine the capacity for agent(s) to induce the creation of stem cells from a starting cell population.
  • the Stem Cell Proliferation Assay using dermal papilla refers to the increase in the number of Dermal Papilla (DP) spheroids, size of DP spheroids, or number of DP cells at the end of the assay compared to the respective number of Dermal Papilla (DP) spheroids, size of DP spheroids, or number of DP cells at the start of the assay.
  • DP cells refer to cells that express Alkaline Phosphatase (AP), and/or Versican, and/or Vimentin, and/or Sox2, and/or CD133. Briefly, microdissection is used to remove intact hair follicles from a specimen. The cells of the hair follicles are treated with cell dissociation enzymes and strained to obtain a single cell suspension. The single cells are then suspended in media with growth factors, plated at a given cell density in wells and incubated at 37°C. Growth is monitored for one or more desired period of time. EVOS ® transmitted light images can be taken.
  • Spheroids can be collected for immunoblotting, qPCR, flow cytometry, and/or applied to glass bottom dishes for alkaline phosphatase staining, 5-ethynyl-2'-deoxyuridine (EdU) staining and/or immunofluorescence to detect markers such as Vimentin, Sox2, Versican, CD133, etc. Details of the protocol are provided in the Examples section of the present disclosure.
  • stem Cell Markers can be defined as gene products (e.g. protein, RNA, etc) that specifically expressed in stem cells.
  • One type of stem cell marker is gene products that are directly and specifically support the maintenance of stem cell identity. Examples include Glil, Krtl5, CD34, Lgr5, Lgr6, Lrigl, Sox2, CD133, Vimentin, Versican and/or alkaline phosphatase. Additional stem cell markers can be identified using assays that were described in the literature. To determine whether a gene is required for maintenance of stem cell identity, gain-of-function and loss-of-function studies can be used. In gain-of- function studies, over expression of specific gene product (the stem cell marker) would help maintain the stem cell identity.
  • stem cell marker is gene that only expressed in stem cells but does not necessary to have specific function to maintain the identity of stem cells. This type of markers can be identified by comparing the gene expression signature of sorted stem cells and non-stem cells by assays such as micro-array and qPCR. This type of stem cell marker can be found in the literature, (e.g. Liu Q. et al., Int J Biochem Cell Biol. 2015 60:99-111. www.ncbi.nlm.nih.gov/pubmed/25582750).
  • stem cell markers include Ccdcl21, GdflO, Opcml, Phex, etc.
  • the expression of stem cell markers such as CD133 or Sox2 in a given cell or cell population can be measure using assays such as qPCR, immunohistochemistry, western blot, and RNA hybridization.
  • the expression of stem cell markers can also be measured using transgenic cells express reporters which can indicate the expression of the given stem cell markers, e.g. Versican-GFP, CD133-GFP or Sox2-GFP. Flow cytometry analysis can then be used to measure the activity of reporter expression. Fluorescence microscopy can also be used to directly visualize the expression of reporters.
  • the expression of stem cell markers may further be determined using microarray analysis for global gene expression profile analysis.
  • the gene expression profile of a given cell population or purified cell population can be compared with the gene expression profile of the stem cell to determine similarity between the 2 cell populations.
  • Stem cell function can be measured by colony forming assay or sphere forming assay, self-renewal assay and differentiation assay.
  • colony (or sphere) forming assay when cultured in appropriate culture media, the stem cell should be able to form colonies, on cell culture surface (e.g. cell culture dish) or embedded in cell culture substrate (e.g. Matrigel) or be able to form spheres when cultured in suspension.
  • colony/sphere forming assay single stem cells are seeded at low cell density in appropriate culture media and allowed to proliferate for a given period of time (7-10 days).
  • Colony formed are then counted and scored for stem cell marker expression as an indicator of sternness of the original cell.
  • the colonies that formed are then picked and passaged to test its self- renewal and differentiation potential.
  • the cells In self-renewal assay, when cultured in appropriate culture media, the cells should maintain stem cell marker (e.g. CD133) expression over at least one (e.g. 1, 2, 3, 4, 5, 10, 20, etc.) cell divisions.
  • stem cell marker e.g. CD133
  • a Stem Cell Differentiation Assay when cultured in appropriate differentiation media, the cells should be able to generate hair cell which can be identified by hair cell marker expression measured by qPCR, immunostaining, western blot, RNA hybridization or flow cytometry.
  • Sternness Driver as used herein is a composition that induces proliferation of cells of a given cell type, upregulates gene(s) or biomarker(s) in cells, or maintains gene or biomarker expression in cells, while maintaining the potential for self-renewal and the potential to differentiate into cells of a given cell type, for example, a hair follicle epithelial cell.
  • sternness drivers upregulate at least one biomarker of post-natal stem cells. Sternness Drivers include but are not limited to Wnt agonists and GSK3 inhibitors.
  • Subject includes humans and mammals (e.g., mice, rats, pigs, cats, dogs, and horses).
  • subjects are mammals, particularly primates, especially humans.
  • subjects are livestock such as cattle, sheep, goats, cows, swine, and the like; poultry such as chickens, ducks, geese, turkeys, and the like; and domesticated animals particularly pets such as dogs and cats.
  • subject mammals will be, for example, rodents (e.g., mice, rats, hamsters), rabbits, primates, or swine such as inbred pigs and the like.
  • TGF Beta inhibitor as used herein is a composition that reduces activity of
  • BMP inhibitor as used herein is a composition that reduces activity of BMP.
  • Notch activator as used herein is a composition that increases Notch pathway activity.
  • mTOR inhibitor as used herein is a composition that reduces the mechanistic target of rapamycin (mTOR) activity.
  • tissue is an ensemble of similar cells from the same origin that together carry out a specific function.
  • Treating as used herein in connection with a cell population means delivering a substance to the population to effect an outcome.
  • the substance may be directly (or even indirectly) delivered to the population.
  • the substance may be delivered by administration to the host subject.
  • Wnt activation is an activation of the Wnt signaling pathway.
  • Wnt agonist as used herein is any compound, protein, peptide, or agent that activates the Wnt signaling pathway.
  • alkyl refers to a straight or branched saturated hydrocarbon.
  • an alkyl group can have 1 to 8 carbon atoms (i.e., (Ci-Cs) alkyl) or
  • alkenyl refers to a linear or branched hydrocarbon radical which includes one or more double bonds and can include divalent radicals, having from 2 to about 15 carbon atoms.
  • alkenyl groups include but are not limited to, ethenyl, propenyl, butenyl, and higher homologs and isomers.
  • alkynyl refers to a linear or branched hydrocarbon radical which includes one or more triple bonds and can include divalent radicals, having from
  • alkynyl groups include but are not limited to, ethynyl, propynyl, butynyl, and higher homologs and isomers.
  • halo or halogen as used herein refers to fluoro, chloro, bromo and iodo.
  • aryl refers to a single all carbon aromatic ring or a multiple condensed all carbon ring system wherein at least one of the rings is aromatic.
  • an aryl group can have 6 to 20 carbon atoms, 6 to 14 carbon atoms, or 6 to 12 carbon atoms.
  • Aryl includes a phenyl radical.
  • Aryl also includes multiple condensed ring systems (e.g., ring systems comprising 2, 3 or 4 rings) having about 9 to 20 carbon atoms in which at least one ring is aromatic and wherein the other rings may be aromatic or not aromatic (i.e., carbocycle).
  • Such multiple condensed ring systems may be optionally substituted with one or more (e.g., 1, 2 or 3) oxo groups on any carbocycle portion of the multiple condensed ring system.
  • the rings of the multiple condensed ring system can be connected to each other via fused, spiro and bridged bonds when allowed by valency requirements. It is to be understood that the point of attachment of a multiple condensed ring system, as defined above, can be at any position of the ring system including an aromatic or a carbocycle portion of the ring.
  • heteroaryl refers to a single aromatic ring that has at least one atom other than carbon in the ring, wherein the atom is selected from the group consisting of oxygen, nitrogen and sulfur; the term also includes multiple condensed ring systems that have at least one such aromatic ring, which multiple condensed ring systems are further described below.
  • the term includes single aromatic rings of from about 1 to 6 carbon atoms and about 1-4 heteroatoms selected from the group consisting of oxygen, nitrogen and sulfur in the rings.
  • the sulfur and nitrogen atoms may also be present in an oxidized form provided the ring is aromatic.
  • the term also includes multiple condensed ring systems (e.g., ring systems comprising 2, 3 or 4 rings) wherein a heteroaryl group, as defined above, can be condensed with one or more rings selected from heteroaryls (to form for example a naphthyridinyl such as 1,8-naphthyridinyl), heterocycles, (to form for example a 1,2,3,4- tetrahydronaphthyridinyl such as l,2,3,4-tetrahydro-l,8-naphthyridinyl), carbocycles (to form for example 5,6,7,8-tetrahydroquinolyl) and aryls (to form for example indazolyl) to form the multiple condensed ring system.
  • heteroaryls to form for example a naphthyridinyl such as 1,8-naphthyridinyl
  • heterocycles to form for example a 1,2,3,4- te
  • a heteroaryl (a single aromatic ring or multiple condensed ring system) has about 1-20 carbon atoms and about 1-6 heteroatoms within the heteroaryl ring.
  • Such multiple condensed ring systems may be optionally substituted with one or more (e.g., 1, 2, 3 or 4) oxo groups on the carbocycle or heterocycle portions of the condensed ring.
  • the rings of the multiple condensed ring system can be connected to each other via fused, spiro and bridged bonds when allowed by valency requirements. It is to be understood that the individual rings of the multiple condensed ring system may be connected in any order relative to one another.
  • the point of attachment of a multiple condensed ring system (as defined above for a heteroaryl) can be at any position of the multiple condensed ring system including a heteroaryl, heterocycle, aryl or carbocycle portion of the multiple condensed ring system and at any suitable atom of the multiple condensed ring system including a carbon atom and heteroatom (e.g., a nitrogen).
  • cycloalkyl refers to a saturated or partially saturated ring structure having about 3 to about 8 ring members that has only carbon atoms as ring atoms and can include divalent radicals.
  • examples of cycloalkyl groups include but are not limited to, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cyclohexene, cyclopentenyl, cyclohexenyl.
  • heterocyclyl or “heterocyclic” refer to monocyclic or polycyclic 3 to 24-membered rings containing carbon and heteroatoms selected from oxygen, phosphorous, nitrogen, or sulfur and wherein there are no delocalized ⁇ electrons (aromaticity) shared among the ring carbon or heteroatoms.
  • Heterocyclyl rings include, but are not limited to, oxetanyl, azetadinyl, tetrahydrofuranyl, pyrrolidinyl, oxazolinyl, oxazolidinyl, thiazolinyl, thiazolidinyl, pyranyl, thiopyranyl, tetrahydropyranyl, dioxalinyl, piperidinyl, morpholinyl, thiomorpholinyl, thiomorpholinyl S-oxide, thiomorpholinyl S-dioxide, piperazinyl, azepinyl, oxepinyl, diazepinyl, tropanyl, and homotropanyl.
  • a heterocyclyl or heterocycloalkyl ring can also be fused or bridged, e.g., can be a bicyclic ring.
  • the term “approximately” or “about” refers to a range of values that fall within 25%, 20%, 19%, 18%, 17%, 16%, 15%, 14%, 13%, 12%, 1 1%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1 %, or less in either direction (greater than or less than) of the stated reference value unless otherwise stated or otherwise evident from the context (except where such number would exceed 100% of a possible value).
  • phrases "pharmaceutically acceptable” is employed herein to refer to those compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio.
  • pharmaceutically acceptable carrier includes without limitation any adjuvant, carrier, excipient, glidant, sweetening agent, diluent, preservative, dye/colorant, flavor enhancer, surfactant, wetting agent, dispersing agent, suspending agent, stabilizer, isotonic agent, solvent, surfactant, or emulsifier which has been approved by the United States Food and Drug Administration as being acceptable for use in humans or domestic animals.
  • Exemplary pharmaceutically acceptable carriers include, but are not limited to, to sugars, such as lactose, glucose and sucrose; starches, such as corn starch and potato starch; cellulose, and its derivatives, such as sodium carboxymethyl cellulose, ethyl cellulose and cellulose acetate; tragacanth; malt; gelatin; talc; cocoa butter, waxes, animal and vegetable fats, paraffins, silicones, bentonites, silicic acid, zinc oxide; oils, such as peanut oil, cottonseed oil, safflower oil, sesame oil, olive oil, corn oil and soybean oil; glycols, such as propylene glycol; polyols, such as glycerin, sorbitol, mannitol and polyethylene glycol; esters, such as ethyl oleate and ethyl laurate; agar; buffering agents, such as magnesium hydroxide and aluminum hydroxide; alginic acid; pyrogen- free water
  • “Pharmaceutically acceptable salt” includes both acid and base addition salts.
  • “Pharmaceutically acceptable acid addition salt” refers to those salts which retain the biological effectiveness and properties of the free bases, which are not biologically or otherwise undesirable, and which are formed with inorganic acids such as, but are not limited to, hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid and the like, and organic acids such as, but not limited to, acetic acid, 2,2-dichloroacetic acid, adipic acid, alginic acid, ascorbic acid, aspartic acid, benzenesulfonic acid, benzoic acid, 4- acetamidobenzoic acid, camphoric acid, camphor- 10-sulfonic acid, capric acid, caproic acid, caprylic acid, carbonic acid, cinnamic acid, citric acid, cyclamic acid, dodecylsulfuric acid, ethane- 1 ,2-disulfonic acid, ethanesulfonic acid, 2-hydroxye
  • ene-2-sulfonic acid l-hydroxy-2-naphthoic acid, nicotinic acid, oleic acid, orotic acid, oxalic acid, palmitic acid, pamoic acid, propionic acid, pyroglutamic acid, pyruvic acid, salicylic acid, 4-aminosalicylic acid, sebacic acid, stearic acid, succinic acid, tartaric acid, thiocyanic acid, / toluenesulfonic acid, trifluoroacetic acid, undecylenic acid, and the like.
  • “Pharmaceutically acceptable base addition salt” refers to those salts which retain the biological effectiveness and properties of the free acids, which are not biologically or otherwise undesirable. These salts are prepared from addition of an inorganic base or an organic base to the free acid. Salts derived from inorganic bases include, but are not limited to, the sodium, potassium, lithium, ammonium, calcium, magnesium, iron, zinc, copper, manganese, aluminum salts and the like. For example, inorganic salts include, but are not limited to, ammonium, sodium, potassium, calcium, and magnesium salts.
  • Salts derived from organic bases include, but are not limited to, salts of primary, secondary, and tertiary amines, substituted amines including naturally occurring substituted amines, cyclic amines and basic ion exchange resins, such as ammonia, isopropylamine, trimethylamine, diethylamine, triethylamine, tripropylamine, diethanolamine, ethanolamine, deanol, 2- dimethylaminoethanol, 2-diethylaminoethanol, dicyclohexylamine, lysine, arginine, histidine, caffeine, procaine, hydrabamine, choline, betaine, benethamine, benzathine, ethylenediamine, glucosamine, methylglucamine, theobromine, triethanolamine, tromethamine, purines, piperazine, piperidine, N-ethylpiperidine, polyamine resins and the like.
  • Example organic bases used in certain embodiments include is
  • wetting agents such as sodium lauryl sulfate and magnesium stearate, as well as coloring agents, release agents, coating agents, sweetening, flavoring and perfuming agents, preservatives and antioxidants can also be present in the compositions.
  • antioxidants examples include: (1) water soluble antioxidants, such as ascorbic acid, cysteine hydrochloride, sodium bisulfate, sodium metabisulfite, sodium sulfite and the like; (2) oil-soluble antioxidants, such as ascorbyl palmitate, butylated hydroxyanisole (BHA), butylated hydroxy toluene (BHT), lecithin, propyl gallate, alpha-tocopherol, and the like; and (3) metal chelating agents, such as citric acid, ethylenediamine tetraacetic acid (EDTA), sorbitol, tartaric acid, phosphoric acid, and the like.
  • water soluble antioxidants such as ascorbic acid, cysteine hydrochloride, sodium bisulfate, sodium metabisulfite, sodium sulfite and the like
  • oil-soluble antioxidants such as ascorbyl palmitate, butylated hydroxyanisole (BHA), butylated hydroxy toluene (BHT), le
  • compositions described herein can be formulated in any manner suitable for a desired delivery route, e.g., transtympanic injection, transtympanic wicks and catheters, and injectable depots.
  • formulations include all physiologically acceptable compositions incuding derivatives or prodrugs, solvates, stereoisomers, racemates, or tautomers thereof with any physiologically acceptable carriers, diluents, and/or excipients.
  • the present disclosure relates to a method of expanding a population of stem cells of hair follicles, said method comprising contacting the stem cells with one or more stem cell proliferator, wherein the one or more stem cell proliferator is one or more Sonic Hedgehog pathway (Shh) activator and one or more Wnt agonist.
  • the one or more stem cell proliferator is one or more Sonic Hedgehog pathway (Shh) activator and one or more Wnt agonist.
  • the present disclosure relates to a method of facilitating the generation of hair follicle epithelial cells, the method comprising treating stem cells of hair follicles with one or more Sonic Hedgehog pathway (Shh) activator and one or more Wnt agonist.
  • Sh Sonic Hedgehog pathway
  • the stem cells are dermal papilla stem cells. In another embodiment, the stem cells are hair follicle stem cells. In some embodiments, the stem cells comprise keratinocytes, melanocytes, dermal papilla cells, bulge cells, or a combination thereof. In some embodiments, the stem cells are in a subject.
  • the present disclosure provides methods to induce self-renewal of a population of stem cells in hair follicles by activating the Shh pathway and the Wnt pathway.
  • the pathways are activated with small molecules or proteins.
  • a compound when applied in vitro to dermal papilla (DP) stem cells in hair follicles induces the DP stem cells to proliferate to a high degree and in high purity in a Stem Cell Proliferation Assay using dermal papilla cells, and also allows an increase in the number of DP cells and/or DP area within a hair follicle in a DP hair follicle culture assay.
  • DP dermal papilla
  • the one or more Shh pathway activator and one or more Wnt agonist induces and maintains stem cell properties by producing stem cells that can divide and maintain the ability to have a high proportion of the resulting cells differentiate into cells of the hair follicle.
  • the proliferating stem cells express stem cell markers which may include one or more of Glil, Krtl5, CD34, Lgr5, Lgr6, Lrigl, Sox2, CD133, Vimentin, Versican and/or alkaline phosphatase.
  • the present disclosure provides a method of treating a subject who has, or is at risk of developing, a disease associated with absence or lack of hair follicle epithelial cells, the method comprising administering to said subject one or more Sonic Hedgehog pathway (Shh) activator and one or more Wnt agonist.
  • Sh Sonic Hedgehog pathway
  • the disease is selected from telogen effluvium, anagen effluvium, androgenetic alopecia, alopecia areata, tinea capitis, lichen planopilaris, cicatricial alopecia, discoid lupus erythematosus, folliculitis decalvans, dissecting cellulitis of the scalp, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, trichotillomania, traction alopecia, and hypotrichosis.
  • the present disclosure provides a method of treating a subject who has, or is at risk of developing, alopecia, the method comprising administering to said subject one or more Sonic Hedgehog pathway (Shh) activator and one or more Wnt agonist.
  • Sh Sonic Hedgehog pathway
  • the present disclosure provides a pharmaceutical composition
  • a pharmaceutical composition comprising: a pharmaceutically-acceptable carrier and (i) a Wnt agonist, or a pharmaceutically-acceptable salt thereof, and (ii) a Sonic Hedgehog (Shh) pathway activator, or a pharmaceutically-acceptable salt thereof.
  • the one or more Shh pathway activator is at a concentration of about 5x to about lOOOx of an effective in vitro Shh pathway activation concentration. In certain embodiments, the one or more Shh pathway activator is at a concentration of about lOx to about lOOx of an effective in vitro Shh pathway activation concentration. In some embodiments, the one or more Shh pathway activator is at a concentration of about 20x to about 5 Ox of an effective in vitro Shh pathway activation concentration. In certain embodiments, the one or more Wnt agonist is at a concentration of about 5x to about 1 OOOx of an effective in vitro Wnt agonist concentration.
  • the one or more Wnt agonist is at a concentration of about lOx to about lOOx of an effective in vitro Wnt agonist concentration. In some embodiments, the one or more Wnt agonist is at a concentration of about 20x to about 50x of an effective in vitro Wnt agonist concentration.
  • the Shh pathway activator comprises a Smoothened agonist. In other embodiments, the Shh pathway activator comprises Smoothened ciliary accumulation enhancers. In some embodiments of the methods and compositions disclosed herein, the one or more Shh pathway activator is selected from the group consisting of a SAG, an oxysterol, a Purmorphamine analogue, a GSA-10 analogue, polydatin, glucocorticoids, hedgehog polypeptides, inositol derivatives, sterols, peroxiredoxin 2, RACK1, Dhh, and Ihh. In some embodiments, the one or more Shh pathway activator is selected from Table 1. In some embodiments, the one or more Shh pathway activator is selected from Table 2.
  • the one or more Shh pathway activator is Purmo hamine (CAS 483367-10-8). In further embodiments of the methods and compositions disclosed herein, the one or more Shh pathway activator is selected from Purmorphamine, SAG, 20-alpha hydroxy cholesterol, and SAG HC1.
  • the one or more SAG compounds is a compound of Formula II:
  • R is independently one or more -H, halogen, -Ci-Cioalkyl, -C3- Ciocycloalkyl, -OCi-Cioalkyl, -CN, Aryl, Substituted Aryl, Heteroaryl, Substituted Heteroaryl; wherein the substitution can one or more -H, halogen, -OH, -OCi-C6alkyl, -Ci-C6alkyl, -CN, NH2, -NHS0 2 -Ci-C 6 alkyl, -NHCO-Ci-Cealkyl, -S0 2 -Ci-C 6 alkyl, -CONH2, -CONH-Ci- Cealkyl, COOH, -COO-Ci-Cealkyl;
  • R 1 is independently one or more -H, halogen, -Ci-C3alkyl, -OH, -O-Ci- C 3 alkyl.
  • Classes of Wnt agonist (Wnt activator) for use in various embodiments of the compositions and methods disclosed herein include but are not limited to those listed in Column A of Table 3.
  • Specific Wnt agonists for use in various embodiments of the compositions and methods disclosed herein include but are not limited to those listed in Column B of Table 3.
  • All agents listed in Table 3 column B are understood to include derivatives or pharmaceutically-acceptable salts thereof.
  • All classes listed in Table 3 column A are understood to include both agents comprising that class and derivatives or pharmaceutically-acceptable salts thereof.
  • the one or more Wnt activator or agonist is one or more GSK inhibitor.
  • the GSK inhibitor is a GSK3-beta inhibitor.
  • Classes of GSK3-beta inhibitor for use in various embodiments of the compositions and methods disclosed herein include, but are not limited to, those listed in Column A of Table 4.
  • Specific GSK3-beta inhibitors for use in various embodiments of the compositions and methods disclosed herein include but are not limited to those listed in Column B of Table 4. All agents listed in Table 4 column B are understood to include derivatives or pharmaceutically-acceptable salts thereof. All classes listed in Table 4 column A are understood to include both agents comprising that class and derivatives or pharmaceutically-acceptable salts thereof.
  • the one or more Wnt activator or agonist is one or more GSK inhibitor.
  • the GSK inhibitor is a GSK3-alpha inhibitor.
  • Classes of GSK3-alpha inhibitor for use in various embodiments of the compositions and methods disclosed herein include, but are not limited to, those listed in Column A of Table 5.
  • Specific GSK3-alpha inhibitors for use in various embodiments of the compositions and methods disclosed herein include but are not limited to those listed in Column B of Table 5. All agents listed in Table 5 column B are understood to include derivatives or pharmaceutically-acceptable salts thereof. All classes listed in Table 5 column A are understood to include both agents comprising that class and derivatives or pharmaceutically-acceptable salts thereof.
  • the GSK3 inhibitor is selected from the group consisting of Valproic Acid Sodium Salt, CT20026, CHIR99021 (CT99021), CHIR98014 (CT98014), CHIR98023 (CT98023), CHIR98024 (CT98024), TCS 2002, Compound 39, Compound 29, Compound 33, TCS 21311, LY2090314, 603281-31-8, Compound 34, Compound 14d, Compound 15b, Compound 20x, AZD-1080, Kenpaullone, Cazpaullone, GSK-3 Inhibitor XXII, Compound 4a, Compound 4t, Compound 4z, Pyrazolopyridine 9, Compound 14, Compound 23, Compound 14, Compound 18, and Compound 19.
  • the GSK3 inhibitor is selected from the group consisting of Valproic Acid Sodium Salt, CHIR99021 (CT99021), CHIR98014 (CT98014), CHIR98023 (CT98023), CHIR98024 (CT98024), Compound 39, Compound 29, LY2090314, 603281-31-8, Compound 34, Compound 14d, Compound 15b, Compound 20x, AZD-1080, Cazpaullone, GSK-3 Inhibitor XXII, Compound 4t, Compound 4z, Pyrazolopyridine 9, Compound 14, Compound 23, Compound 14, Compound 18, and Compound 19.
  • the one or more GSK inhibitor is a compound of Formula (I),
  • the compounds of Formula I have one or more of the following features:
  • the present disclosure provides a compound of formula (I) for use in the methods disclosed herein and that is not disclosed in WO 2003/076442 (PCT/US03/05050), which is incorporated herein by reference.
  • R x is -COR xl or -S0 2 R X1 .
  • R X1 is heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents that is halo. In certain embodiments, R X1 is heterocyclic which is deuterated. In certain embodiments, the heterocyclic is monocyclic or bicyclic. In certain embodiments, the heterocyclic contains one to three nitrogens (i.e., 1, 2, or 3 nitrogens) and/ or one to three oxygens (i.e., 1, 2, or 3 oxygens). In certain embodiments, the heterocyclic contains one nitrogen and/ or one oxygen. In certain embodiments, the heterocyclic contains one nitrogen. In certain embodiments, the heterocyclic contains two nitrogens. In certain embodiments, the heterocyclic contains one nitrogen and one oxygen.
  • R X1 is piperidine or 8-oxa-3-azabicyclo[3.2.1]octane, both optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, Ci-C4alkyl, -(CH2) P -OH, -(CH2) P -NH2; wherein p is 1, 2, or 3.
  • R X1 is piperidine, optionally substituted with one to two halo substituents.
  • R X1 is piperidine, optionally substituted with - (CH 2 )p-OH.
  • the heterocyclic is optionally substituted with Ci-C4alkyl, -(CH2) P -OH, or -(CH2) P -NH2; wherein p is 1, 2, or 3.
  • R X1 is heterocyclic substituted with Ci-C4alkyl.
  • R X1 is heterocyclic substituted with -(CH2)p-OH; wherein p is 1, 2, or 3.
  • R X1 is heterocyclic substituted with -CH2-OH.
  • R X1 is heterocyclic substituted with -(CH2) P -NH2; wherein p is 1, 2, or 3.
  • R X1 is heterocyclic substituted with -CH2-NH2.
  • R X1 is heterocyclic, wherein the heterocyclic is optionally substituted with -[C(R xla )2] P -CN.
  • R X1 is heterocyclic substituted with -[C(R xla ) 2 ] P -OH, -[C(R xla ) 2 ] P -0-Ci-C4alkyl, -NHCOCi- C 4 alkyl, -CONHCi-C 4 alkyl, COH, -CO2H, -[C(R xla ) 2 ] P -COO-Ci-C4alkyl, -[C(R xla ) 2 ] P -NH 2 , -[C(R xla ) 2 ] P -NH-Ci-C4alkyl, or -[C(R xla ) 2 ] P -N-(Ci-C4alkyl
  • R X1 is heterocyclic, wherein the heterocyclic is optionally substituted with -CONHCi-C4alkyl, - COH, -CO2H, or -[C(R xla ) 2 ] P -COO-Ci-C4alkyl.
  • each R xla is independently selected from the group consisting of hydrogen and halo.
  • both R xla groups together form C3-C6cycloalkyl, such as cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
  • R x is heteroaryl.
  • the heteroaryl is monocyclic or bicyclic.
  • the heteroaryl contains one to three nitrogens (i.e., 1, 2, or 3 nitrogens) and/ or one to three oxygens (i.e., 1, 2, or 3 oxygens).
  • the heteroaryl contains one nitrogen and/ or one oxygen.
  • the heteroaryl contains one nitrogen.
  • the heteroaryl contains two nitrogens. eteroaryl contains one
  • R is
  • R x is -(Ci-C4alkylene)-(C3-C8cycloalkyl).
  • the-(Ci-C4alkylene)-(C3-C8cycloalkyl) is substituted with one to two halo on the Ci-C4alkylene.
  • the C3-Cscycloalkyl is cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
  • R x is -(Ci-C4alkylene)-(C3- C8cycloalkyl), wherein the -(Ci-C4alkylene)-(C3-C8cycloalkyl) is optionally substituted with one or two halo on the Ci-C4alkylene and wherein C3-C8cycloalkyl is cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
  • R x is -(Ci-C4alkylene)-(C3- C8cycloalkyl), wherein the -(Ci-C4alkylene)-(C3-C8cycloalkyl) is optionally substituted with one or two halo on the Ci-C4alkylene and wherein C3-C8cycloalkyl is cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
  • R x is
  • the one or more GSK inhibitor is a compound having the Formula (la),
  • the one or more GSK inhibitor is a compound having the Formula (lb),
  • Q 1 is CH; Q 2 is N; and Q 3 is C. In certain embodiments, Q 1 is N; Q 2 is C; and Q 3 is N. In certain embodiments, Q 1 is CH; Q 2 is C; and Q 3 is N. In certain embodiments, 1 is N; Q 2 is N; and Q 3 is C.
  • R 1 is hydrogen or halo.
  • R 1 is Ci-C4alkyl, wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH.
  • R 1 is Ci-C4alkynyl, -CN, -OH, or -S(0)2NH 2 .
  • R 1 is -NH 2 or - NHC(0)R la , wherein R la is Ci-C4alkyl.
  • R 1 is Ci-C4alkenyl.
  • R 1 is -0-Ci-C4alkyl.
  • R 2 is hydrogen or halo.
  • R 2 is Ci-C4alkyl, wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH.
  • R 2 is Ci-C4alkynyl, -CN, -OH, or -S(0)2NH 2 .
  • R 2 is -NH 2 or - NHC(0)R 2a , wherein R 2a is Ci-C 4 alkyl.
  • R 2 is -S(0) 2 NH 2 .
  • R 2 is Ci-C4alkenyl.
  • R 2 is -O- Ci-C4alkyl. In certain embodiments, R 2 is -NH 2 , -NH(Ci-C4alkyl), or -N(Ci-C4alkyl) 2 .
  • R 2 is selected from the group consisting of halo, Ci- C 4 alkyl, Ci-C 4 alkenyl, Ci-C4alkynyl, -CN, -OH, -0-Ci-C 4 alkyl, -NH 2 , -NH(Ci-C 4 alkyl), - N(Ci-C4alkyl) 2 , -NHC(0)R 2a , and -S(0) 2 NH 2 ; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R 2a is Ci-C4alkyl.
  • R 2 is selected from the group consisting of halo, Ci-C 4 alkyl, Ci-C 4 alkynyl, -CN, -OH, -NH 2 , -NHC(0)R 2a , and -S(0) 2 NH 2 ; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R 2a is Ci-C4alkyl. In certain embodiments, R 2 is not hydrogen.
  • R 3 is hydrogen or halo.
  • R 3 is Ci-C4alkyl, wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH.
  • R 3 is Ci-C4alkynyl, -CN, -OH, or -S(0) 2 NH 2 .
  • R 3 is -NH 2 or - NHC(0)R a , wherein R a is Ci-C4alkyl.
  • R 3 is Ci-C4alkenyl.
  • R 3 is -0-Ci-C4alkyl. ertain embodiments, Ar is certain embodiments, Ar is certain embodiments, Ar is
  • Ar is . In certain embodiments, Ar is diments, Ar
  • Ar is
  • Ar is lected from S, O, CH2, and NR Q7 ;
  • R Q7 is hydrogen or optionally substituted Ci-C4alkyl.
  • Ar is .
  • Ar is lected from S, O, CH2, and NR Q7 ;
  • R Q7 is hydrogen or optionally substituted Ci-C4alkyl.
  • Q 7 is selected from S, O, CH2, and NR Q7 ;
  • R Q7 is hydrogen or optionally substituted Ci-C4alkyl.
  • each Q 6 is independently selected from CR Q6 and N;
  • R Q6 is hydrogen, halo, -CN, lower alkyl, or substituted alkyl.
  • -Z-W-X-Y- is -C(R Z ) 2 -C(R W ) 2 -N(R X )-C(R Y ) 2 -.
  • -Z-W-X-Y- is -C(R Z ) 2 -C(R W ) 2 -CH(R X )-C(R Y ) 2 -.
  • -Z-W-X-Y- is -C(R W ) 2 -CH(R X )-C(R Y ) 2 -.
  • each R z is independently selected from the group consisting of hydrogen and halo.
  • both R z groups together form C3- C6cycloalkyl, such as cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
  • both R z groups together form oxo.
  • R z and R w together with the carbons to which they are attached form a C3-C6cycloalkyl, such as cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
  • each R w is independently selected from the group consisting of hydrogen and halo.
  • both R w groups together form C3- C6cycloalkyl, such as cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
  • both R w groups together form oxo.
  • R z and R w together with the carbons to which they are attached form a C3-C6cycloalkyl, such as cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
  • each R Y is independently selected from the group consisting of hydrogen and halo.
  • both R Y groups together form C3- C6cycloalkyl, such as cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
  • both R Y groups together form oxo.
  • R x is H.
  • R x is R X1 , which is C3-C8cycloalkyl, heteroaryl, or heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, Ci-C4alkyl, -(CH 2 ) P - OH, -[C(R xla ) 2 ]p-OH, -[C(R xla ) 2 ]p-0-Ci-C 4 alkyl, -NHCOCi-C 4 alkyl, -CONHCi-C 4 alkyl, - (CH 2 )p-NH 2 , -[C(R xla ) 2 ] P -NH 2 , -[C(R xla ) 2 ] P -NH-C(R xla ) 2 ] P -NH-Ci-C4alkyl
  • R x is -COR xl or -S0 2 R X1 .
  • R x is -(Ci-C4alkylene)-R xl , wherein the -(Ci-C4alkylene)-R xl is optionally substituted with one to four halo on the Ci- C4alkylene. In certain embodiments, the -(Ci-C4alkylene)-R xl is substituted with one to four halo on the Ci-C4alkylene. In certain embodiments, the -(Ci-C4alkylene)-R xl is substituted with one or two halo on the Ci-C4alkylene.
  • R x is -(Ci-C4alkylene)- R X1 , wherein the -(Ci-C4alkylene)-R xl is optionally substituted with one or two halo on the Ci-C4alkylene and wherein X1 is cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
  • R x is
  • R X1 is C3-C8cycloalkyl. In certain embodiments, R X1 is cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
  • R X1 is heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents that is halo.
  • R X1 is heterocyclic which is deuterated.
  • the heterocyclic is monocyclic or bicyclic.
  • the heterocyclic contains one to three nitrogens (i.e., 1, 2, or 3 nitrogens) and/ or one to three oxygens (i.e., 1, 2, or 3 oxygens).
  • the heterocyclic contains one nitrogen and/ or one oxygen.
  • the heterocyclic contains one nitrogen.
  • the heterocyclic contains two nitrogens.
  • the heterocyclic contains one nitrogen and one oxygen.
  • R X1 is heterocyclic, wherein the heterocyclic is the heterocyclic is optionally substituted with Ci-C4alkyl, -(CH2) P -OH, or - (CH2)p-NH2; wherein p is 1 , 2, or 3.
  • R X1 is heterocyclic substituted with Ci-C4alkyl.
  • R X1 is heterocyclic substituted with -(CH2) P -OH; wherein p is 1 , 2, or 3.
  • R X1 is heterocyclic substituted with -(CH2)- OH.
  • R X1 is heterocyclic substituted with -(CH2) P -NH2; wherein p is 1, 2, or 3.
  • R X1 is heterocyclic substituted with -(CH2)-NH2.
  • R X1 is heterocyclic, wherein the heterocyclic is optionally substituted with -[C(R xla )2] P -CN.
  • R X1 is heterocyclic substituted with -[C(R xla ) 2 ] P -OH, -[C(R xla ) 2 ] P -0-Ci-C4alkyl, -NHCOCi- C 4 alkyl, -[C(R xla ) 2 ] P -NH 2 , -[C(R xla ) 2 ] P -NH-Ci-C4alkyl, or -[C(R xla ) 2 ] P -N-(Ci-C4alkyl)2.
  • R X1 is heterocyclic, wherein the heterocyclic is optionally substituted with -CONHCi-C 4 alkyl, -COH, -CO2H, or -[C(R xla ) 2 ] P -COO-Ci-C4alkyl.
  • each R xla is independently selected from the group consisting of hydrogen and halo.
  • both R xla groups together form C3-C6cycloalkyl, such as cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
  • R X1 is heteroaryl.
  • the heteroaryl is monocyclic or bicyclic.
  • the heteroaryl contains one to three nitrogens (i.e., 1 , 2, or 3 nitrogens) and/ or one to three oxygens (i.e., 1, 2, or 3 oxygens).
  • the heteroaryl contains one nitrogen and/ or one oxygen.
  • the heteroaryl contains one nitrogen.
  • the heteroaryl contains two nitrogens.
  • the heteroaryl contains one nitrogen and one oxygen.
  • R X1 is
  • R x is -CON(R X2 )2. In certain embodiments, R x is -CON(R X2 )2, wherein R X2 is hydrogen or methyl. In certain embodiments, R x is -CONH2. In certain embodiments, R x is -CON(R X2 )2, wherein R X2 is Ci-C4alkyl. In certain embodiments, R x is -CON(R X2 )2, wherein R X2 is methyl.
  • n is 0. In certain embodiments, m is 1. In certain embodiments, m is 2.
  • Ar is and Q is CH; Q 2 is N; Q 3 is C; Q 4 is C; and Q 5 is C.
  • Ar is and Q 1 is CH; Q 2 is N; Q 3 is C; Q 4 is C; and Q 5 is C.
  • the one or more GSK inhibitor is of formula:
  • R 2 is hydrogen or halo
  • -Z-W-X-Y- is -C(R Z ) 2 -C(R W ) 2 -N(R X )-C(R Y ) 2 -;
  • R x is -COR xl .
  • the one or more GSK inhibitor is of formula:
  • R 2 is Ci-C4alkyl, wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH;
  • -Z-W-X-Y- is -C(R Z ) 2 -C(R W ) 2 -N(R X )-C(R Y ) 2 -;
  • R x is -COR xl .
  • the one or more GSK inhibitor is of formula:
  • R 2 is Ci-C 4 alkynyl, -CN, -OH, -S(0) 2 NH 2 , -NH 2 or -NHC(0)R 2a ;
  • -Z-W-X-Y- is -C(R Z ) 2 -C(R W ) 2 -N(R X )-C(R Y ) 2 -;
  • R x is -COR xl .
  • GSK inhibitors for use in the methods of the present disclosure are presented in Table 6.
  • structures depicted herein are also meant to include compounds which differ only in the presence of one or more isotopically enriched atoms.
  • compounds having the present structure except for the replacement of a hydrogen atom by deuterium or tritium, or the replacement of a carbon atom by 1 C or 14 C, or the replacement of a nitrogen atom by 15 N, or the replacement of an oxygen atom with 17 0 or 18 0 are within the scope of the present disclosure.
  • Such isotopically labeled compounds are useful as research or diagnostic tools.
  • deuteration can be used to slow metabolism and thus potentially improve the compound half-life. Any or all hydrogens in the compound can be replaced with deuterium.
  • the GSK inhibitor is Compound 1-7 [3-(2-(4,4- difluoropiperidine- 1 -carbony l)-9-fluoro- 1 ,2,3 ,4-tetrahy dro- [ 1 ,4] diazepino [6,7,1 -hi] indol-7- yl)-4-(irnidazo[l,2-a]pyridin-3-yl)-lH-pyrrole-2,5-dione].
  • the Wnt signaling pathway target (for example, for inhibition) is selected from the group consisting of AES (TLE/groucho), adenomatous polyposis coli (APC), ARHU, ARHV, AXIN1, AXIN2, ⁇ -catenin, BMP4, BTRC (b-TrCP), CCND1, CCND2, CCND3, CD44, CDX1, CLD N 1 (claudin-1), COL1A1, CTBP1, CTBP2, CTN BI, CTN B1P1 (ICAT), DKK 1, DKK2, DKK3, DKK4, Dsh, DVL2, EGR1, EFNB1 (ephrinB 1), ENPP2 (autotaxin), EP300, FBXW1B, FGF4, FO SL 1 (Fra-1), FRAT1, FRAT2, FRZB (FRP-3), FST (follistatin), FZD1, FZD2, FZD3, FZD4, FZD5,
  • the methods presented here are useful for the preparation of pharmaceutical formulations for the prophylaxis and/or treatment of diseases associated with absence or lack of hair follicle epithelial cells, such as nonscarring alopecias (for example, telogen effluvium, anagen effluvium, androgenetic alopecia, and alopecia areata), scarring alopecias (for example, tinea capitis, lichen planopilaris, cicatricial alopecia, discoid lupus erythematosus, folliculitis decalvans, dissecting cellulitis of the scalp, frontal fibrosing alopecia and central centrifugal cicatricial alopecia), trichotillomania, traction alopecia, and hypotrichosis.
  • nonscarring alopecias for example, telogen effluvium, anagen effluvium, androgenetic alopecia, and
  • the treated cells exhibit stem-like behavior in that the treated cells have the capacity to proliferate and differentiate and, more specifically, differentiate into hair follicle epithelial cells.
  • the Shh pathway activators and Wnt agonists induce and maintain the cells to produce daughter stem cells that can divide for many generations and maintain the ability to have a high proportion of the resulting cells differentiate into hair follicle epithelial cells.
  • the proliferating stem cells express stem cell markers which may include Glil, Krtl5, CD34, Lgr5, Lgr6, Lrigl, Sox2, Versican, alkaline phosphatase (AP), Vimentin, CD133, CD200, ID2, DKK3, WIF1, FZD1, FZD2, PHLDA1, Follistatin and/or DI02.
  • AP activity has been used as a marker to detect the presence of DP (Dermal Papilla) and is regarded as an indicator for hair inductivity.
  • Handjiski et al. show that pelage DP of mice expressed strong and persistent AP activity throughout the entire hair cycle.
  • CD133 is a known hematopoetic iPSC marker.
  • CD133 is expressed in DP cells of early anagen mouse skin. CD133 expression correlates with hair inductive properties (Yang and Cotsarelis. J Dermatol Sci (2010) 57(1): 2-11).
  • Vimentin is a mesenchymal marker present in DP and dermal fibroblast cells (Rendl et al. PLOS Biol (2005) 3(11): e331).
  • Versican is expressed in DP cells in follicles in anagen. Versican expression correlates with hair inductive properties (Yang and Cotsarelis. J Dermatol Sci (2010) 57(1): 2-11).
  • Sox2 is a common marker of stem cells. Sox2-expressing cells are required for formation of awl/auchene follicles in a hair reconstitution assay (Driskell et al. Development (2009) 136(16): 2815-2823).
  • the method of the present disclosure may be used to maintain, or even transiently increase sternness ⁇ i.e., self-renewal) of pre-existing stem cells in a hair follicle prior to significant hair follicle cell formation.
  • the pre-existing stem cells in a hair follicle comprise keratinocytes, melanocytes, dermal papilla cells and/or bulge cells. Morphological analyses with immunostaining (including cell counts) and lineage tracing across a Representative Microscopy Sample may be used to confirm expansion of one or more of these cell-types.
  • the methods of the present disclosure achieve these goals without the use of genetic manipulation. Germ-line manipulation is not a therapeutically desirable approach to treating hair loss.
  • the therapy preferably involves the administration of a small molecule, peptide, antibody, or other non-nucleic acid molecule or nucleic acid delivery vector unaccompanied by gene therapy.
  • the therapy involves the administration of a small organic molecule.
  • hair maintenance or restoration is achieved through the use of a (non-genetic) therapeutic that is administered, for example, intradermally, transdermally, topically or orally.
  • the methods of the present disclosure have the capacity to maintain, in the daughter cells, the capacity to differentiate into may lineages of hair follicle epithelial cells.
  • the maintenance of this capacity may be indirectly observed by an improvement in a subject's hair density, hair growth or ability of hair follicles to go through regenerative cycling.
  • the maintenance of this capacity may be directly observed by an increase in the number of DP cells relative to a starting population or indirectly by measuring activity of one or more DP stem cell markers.
  • the stem cell population is of an in vivo subject
  • the method is a treatment for hair loss (e.g. , wherein the generation of hair follicle epithelial cells from the expanded population of stem cells results in partial or full recovery of hair loss).
  • the present disclosure is directed to a method of facilitating generation of dermal papilla cells, the method comprising: administering a composition of the present disclosure to expand the population of dermal papilla cells.
  • the compounds can regenerate hair in a mammal.
  • the dermal papilla cell population is of an in vivo subject.
  • the dermal papilla cell population is of an in vivo subject for the treatment for alopecia.
  • the present disclosure provides a method of generating dermal papilla cells using a composition of the present disclosure to proliferate dermal papilla cells in an initial population in vivo, resulting in an expanded population of dermal papilla cells.
  • the administering step is carried out by performing one or more injections into the dermis (e.g. intradermal administration).
  • the administration is topical and directed to the region of skin exhibiting hair loss.
  • the administration is oral.
  • the administration is transdermal and directed to the region of skin exhibiting hair loss.
  • the skin is roughened or wounded before the administration of the therapy.
  • one or more needles are applied to the skin before the therapy is applied.
  • the administering step comprises administering one or more Shh pathway activator, one or more Wnt agonist, or a combination of one or more Shh pathway activator and one or more Wnt agonist in a sustained manner.
  • the stem cells are DP stem cells. In certain embodiments, the stem cells are hair follicle stem cells. In some embodiments, the stem cells comprise keratinocytes, melanocytes, dermal papilla cells and/or bulge cells.
  • the method further comprises performing high throughput screening using the generated hair follicle epithelial cells.
  • the method comprises using the generated hair follicle epithelial cells to screen molecules for toxicity against hair follicle epithelial cells.
  • the method comprises using the generated hair follicle epithelial cells to screen molecules for ability to improve survival of hair follicle epithelial cells (e.g. , hair follicle epithelial cells exposed to said molecules).
  • the method further comprises performing high throughput screening using the generated expanded population of stem cells. In certain embodiments, the method further comprises using the generated stem cells to screen molecules for toxicity against stem cells and/or their progeny. In certain embodiments, the method comprises using the generated stem cells to screen molecules for ability to improve survival of stem cells and/or their progeny.
  • the disclosure is directed to a method of generating hair follicle epithelial cells, the method comprising: proliferating stem cells of hair follicles (e.g. , of an in vitro, ex vivo, or in vivo sample/subject), resulting in an expanded population of stem cells of hair follicles (e.g. , such that the expanded population is a factor of at least 1.25, 1.5, 1.75, 2, 3, 5, 10, or 20 greater than the initial stem cell population); and facilitating generation of hair follicle epithelial cells from the expanded population of hair follicle stem cells.
  • proliferating stem cells of hair follicles e.g. , of an in vitro, ex vivo, or in vivo sample/subject
  • an expanded population of stem cells of hair follicles e.g. , such that the expanded population is a factor of at least 1.25, 1.5, 1.75, 2, 3, 5, 10, or 20 greater than the initial stem cell population
  • the disclosure is directed to a method of generating hair follicle epithelial cells, the method comprising administering a compound or composition provided herein to a cell population in one or more hair follicle of a subject, thereby facilitating generation of hair follicle epithelial cells.
  • the present disclosure provides pharmaceutical compositions comprising: a pharmaceutically-acceptable carrier and (i) a Wnt agonist, or a pharmaceutically-acceptable salt thereof, and (ii) a Sonic Hedgehog (Shh) activator, or a pharmaceutically-acceptable salt thereof.
  • the Wnt agonist comprises a GSK3-alpha inhibitor.
  • the Wnt agonist comprises a GSK3-beta inhibitor.
  • the Shh pathway activator comprises a Smoothened agonist.
  • the Shh pathway activator comprises Smoothen ciliary accumulation enhancers.
  • the composition is adapted for administration to the skin.
  • compositions comprising a pharmaceutically-acceptable carrier and (i) a Wnt agonist, a GSK3-alpha inhibitor, or a GSK3-beta inhibitor and (ii) a Sonic Hedgehog activator, Smoothened agonist, Smoothened ciliary accumulation enhancers, or a pharmaceutically-acceptable salt thereof.
  • the composition is adapted for administration to the skin.
  • the Wnt agonist, GSK3 -alpha inhibitor, or GSK3-beta inhibitor is selected from CHIR99021, LY2090314, AZD1080, GSK3 inhibitor XXII, Compound 1-6, Compound 1-7, and Compound 1-12.
  • the Shh pathway activator is selected from Purmorphamine, SAG, 20-alpha hydroxy cholesterol, and SAG HC1.
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is at a concentration of about 0.01 ⁇ to 1000 mM, about 0.1 ⁇ to 1000 mM, about 1 ⁇ to 100 mM, about 10 ⁇ to 10 mM, about 1 ⁇ to 10 ⁇ , about 10 ⁇ to 100 ⁇ , about 100 ⁇ to 1000 ⁇ , about 1 mM to 10 mM, or about 10 mM to 100 mM.
  • the Wnt agonist, GSK3- alpha inhibitor, or GSK3-beta inhibitor is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is at a concentration of about 0.01 nM to 1000 ⁇ , about 0.1 nM to 1000 ⁇ , about 1 nM to 100 ⁇ , about 10 nM to 10 ⁇ , about 1 nM to 10 nM, about 10 nM to 100 nM, about 100 nM to 1000 nM, about 1 ⁇ to 10 ⁇ , or about 10 ⁇ ⁇ 100 ⁇ .
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is CHIR99021, which is at a concentration of about 1 ⁇ to 1000 mM, about 10 ⁇ to 100 mM, about 100 ⁇ to 100 mM, about 1 mM to 10 mM, or about 10 mM.
  • the Wnt agonist, GSK3- alpha inhibitor, or GSK3-beta inhibitor is CHIR99021, which is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist, GSK3- alpha inhibitor, or GSK3-beta inhibitor is CHIR99021, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is CHIR99021, which is at a concentration of about 1 nM to 1000 ⁇ , about 10 nM to 100 ⁇ , about 100 nM to 100 ⁇ , about 100 nM to 1 ⁇ , about 1 ⁇ to 10 ⁇ , or about 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 ⁇ .
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is LY2090314, which is at a concentration of about 0.01 ⁇ to 1000 mM, about 0.1 ⁇ to 10 mM, about 1 ⁇ to 1 mM, about 10 ⁇ , about 20 ⁇ , about 30 ⁇ , about 40 ⁇ , or about 50 ⁇ .
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is LY2090314, which is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is LY2090314, which is at about lx, 3x, 10x, 30x, 100x, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist, GSK3 -alpha inhibitor, or GSK3-beta inhibitor is LY2090314, which is at a concentration of about 0.01 nM to 1000 ⁇ , about 0.1 nM to 10 ⁇ , about 1 nM to 1 ⁇ , about 1 nM to 100 nM, about 1 nM to 50 nM, or about 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 nM.
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is AZD1080, which is at a concentration of about 0.1 ⁇ to 1000 mM, about 1 ⁇ to 1000 mM, about 10 ⁇ to 100 mM, about 100 ⁇ to 10 mM, about 1 mM to 10 mM, or about 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 mM.
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is AZD1080, which is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is AZD1080, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is AZD1080, which is at a concentration of about 1 nM to 1000 ⁇ , about 10 nM to 1000 ⁇ , about 100 nM to 100 ⁇ , about 1 ⁇ to 10 ⁇ , or about 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 ⁇ .
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is GSK3 inhibitor XXII, which is at a concentration of about 0.1 ⁇ to 1000 mM, about 1 ⁇ to 100 mM, about 10 ⁇ to 10 mM, about 100 ⁇ to 10 mM, about 100 ⁇ to 1 mM, or about 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 mM.
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is GSK3 inhibitor XXII, which is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration.
  • GSK3 inhibitor XXII is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Stern
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is GSK3 inhibitor XXII, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is GSK3 inhibitor XXII, which is at a concentration of about 0.1 nM to 1000 ⁇ , about 1 nM to 100 ⁇ , about 10 nM to 10 ⁇ , about 100 nM to 1 ⁇ , or about 0.5 ⁇ .
  • the Wnt agonist is Compound 1-6, which is at a concentration of about 0.01 ⁇ to 1000 mM, about 0.1 ⁇ to 10 mM, about 1 ⁇ to 1 mM, about 10 ⁇ to 1 mM, about 125 ⁇ , about 250 ⁇ , about 500 ⁇ , or about 750 ⁇ .
  • the Wnt agonist is Compound 1-6, which is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist is Compound 1-6, which is about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist is Compound 1-6, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist is Compound 1-6, which is at a concentration of about 0.01 nM to 1000 ⁇ , about 0.1 nM to 10 ⁇ , about 1 nM to 1 ⁇ , about 10 nM to 100 nM, about 25 nM, about 25 nM, or about 75 nM.
  • the Wnt agonist is Compound 1-7, which is at a concentration of about 0.01 ⁇ to 1000 mM, about 0.1 ⁇ to 10 mM, about 1 ⁇ to 1 mM, about 10 ⁇ , about 20 ⁇ , about 30 ⁇ , about 40 ⁇ , or about 50 ⁇ .
  • the Wnt agonist is Compound 1-7, which is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist is Compound 1-7, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist is Compound 1-7, which is at a concentration of about 0.01 nM to 1000 ⁇ , about 0.1 nM to 10 ⁇ , about 1 nM to 1 ⁇ , about 1 nM to 100 nM, about 5 nM, about 10 nM or about 20 nM.
  • the Wnt agonist is Compound 1-12, which is at a concentration of about 0.01 ⁇ to 1000 mM, about 0.1 ⁇ to 10 mM, about 1 ⁇ to 1 mM, about 10 ⁇ to 1 mM, about 125 ⁇ , about 250 ⁇ , about 500 ⁇ , or about 750 ⁇ .
  • the Wnt agonist is Compound 1-12, which is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist is Compound 1-12, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration.
  • the Wnt agonist is Compound 1-12, which is at a concentration of about 0.01 nM to 1000 ⁇ , about 0.1 nM to 10 ⁇ , about 1 nM to 1 ⁇ , about 10 nM to 100 nM, about 25 nM about 50 nM or about 75 nM.
  • the Sonic Hedgehog (Shh) activator is at a concentration of about 0.01 ⁇ to 1000 mM, about 0.1 ⁇ to 1000 mM, about 1 ⁇ to 100 mM, about 0.1 ⁇ to 1 ⁇ , about 1 ⁇ to 10 ⁇ , about 10 ⁇ to 100 ⁇ , about 100 ⁇ to 1 mM, about 1 mM to 10 mM, or about 100 mM to 1000 mM, or about 10 mM to 100 mM, or about 100 mM to 1000 mM.
  • the Shh pathway activator is at a concentration ratio of about 0.1 to 1,000,000 fold relative to its Effective Shh Concentration, or about 1 to 100,000 fold relative to its Effective Shh Concentration, or about 10 to 10,000 fold relative to its Effective Shh Concentration, or about 100 to 1000 fold relative to its Effective Shh Concentration, or about 1000 fold relative to its Effective Shh Concentration.
  • the Shh pathway activator is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Shh Concentration.
  • the Shh pathway activator is at a concentration of about 0.01 nM to 1000 ⁇ , or about 0.1 nM to 1000 ⁇ , about 1 nM to 100 ⁇ , about 10 nM to 10 ⁇ , about 1 nM to 10 nM, about 10 nM to 100 nM, about 100 nM to 1000 nM, about 1 ⁇ to 10 ⁇ , about 10 ⁇ to 100 ⁇ , or about 100 ⁇ to 1000 ⁇ .
  • the Shh pathway activator is SAG (CAS 912545-86-9), which is at a concentration of about 0.01 ⁇ to 1000 mM, about 0.1 ⁇ to 10 mM, about 1 ⁇ to 1 mM, about 10 ⁇ to 100 ⁇ , about 10 ⁇ , about 20 ⁇ , about 25 ⁇ , about 50 ⁇ .
  • the Shh pathway activator is SAG (CAS 912545-86-9), which is at a concentration ratio of about 0.1 to 1,000,000 fold relative to its Effective Shh Concentration, or about 1 to 100,000 fold relative to its Effective Shh Concentration, or about 10 to 10,000 fold relative to its Effective Shh Concentration, or about 100 to 1000 fold relative to its Effective Shh Concentration, or about 1000 fold relative to its Effective Shh Concentration.
  • the Shh pathway activator is SAG (CAS 912545-86-9), which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Shh Concentration.
  • the Shh pathway activator is SAG (CAS 912545-86-9), which is at a concentration of about 0.001 nM to 1000 ⁇ , about 0.01 nM to 10 ⁇ , about 0.1 nM to 1 ⁇ , about 1 nM to 100 nM, 1 nM to 10 nM, about 1 nM, about 2 nM, about 3 nM, about 4 nM, about 5 nM, about 6 nM, about 7 nM, about 9 nM, or about 10 nM.
  • SAG CAS 912545-86-9
  • the Shh pathway activator is 20-alpha hydroxy cholesterol, which is at a concentration of about 0.01 ⁇ to 1000 mM, about 0.1 ⁇ to 100 mM, about 1 ⁇ to 10 mM, about 10 ⁇ to 1 mM, about 125 ⁇ , about 250 ⁇ , about 500 ⁇ , or about 1000 ⁇ .
  • the Shh pathway activator is 20-alpha hydroxy cholesterol, which is at a concentration ratio of about 0.1 to 1,000,000 fold relative to its Effective Shh Concentration, or about 1 to 100,000 fold relative to its Effective Shh Concentration, or about 10 to 10,000 fold relative to its Effective Shh Concentration, or about 100 to 1000 fold relative to its Effective Shh Concentration, or about 1000 fold relative to its Effective Shh Concentration.
  • the Shh pathway activator is 20-alpha hydroxy cholesterol, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Shh Concentration.
  • the Shh pathway activator is 20-alpha hydroxy cholesterol, which is at a concentration of about 0.01 nM to 1000 ⁇ , about 0.1 nM to 100 ⁇ , about 1 nM to 10 ⁇ , about 10 nM to 1 ⁇ , about 25 nM, about 50 nM, about 100 nM, about 200 nM, or about 500 nM.
  • the Shh pathway activator is SAG HC1 (CAS 912545-86-9), which is at a concentration of about 1 ⁇ to 1000 mM, or about 10 ⁇ to 1000 mM, or about 100 ⁇ to 10 mM, or about 1 mM.
  • the Shh pathway activator is SAG HC1, which is at a concentration ratio of about 0.1 to 1,000,000 fold relative to its Effective Shh Concentration, or about 1 to 100,000 fold relative to its Effective Shh Concentration, or about 10 to 10,000 fold relative to its Effective Shh Concentration, or about 100 to 1000 fold relative to its Effective Shh Concentration, or about 1000 fold relative to its Effective Shh Concentration.
  • the Shh pathway activator is SAG HC1, which is at about lx, 3x, lOx, 3 Ox, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Shh Concentration.
  • the Shh pathway activator is SAG HC1, which is at a concentration of about 1 nM to 1000 ⁇ , about 10 nM to 100 ⁇ , about 100 nM to 10 ⁇ , about 125 nM, about 250 nM, or about 500 nM, or about 750 nM.
  • the Shh pathway activator is Purmorphamine, which is at a concentration of about 1 ⁇ to 1000 mM, or about 10 ⁇ to 1000 mM, or about 100 ⁇ to 10 mM, or about 2 mM.
  • the Shh pathway activator is Purmorphamine, which is at a concentration ratio of about 0.1 to 1,000,000 fold relative to its Effective Shh Concentration, or about 1 to 100,000 fold relative to its Effective Shh Concentration, or about 10 to 10,000 fold relative to its Effective Shh Concentration, or about 100 to 1000 fold relative to its Effective Shh Concentration, or about 1000 fold relative to its Effective Shh Concentration.
  • the Shh pathway activator is Purmorphamine, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Shh Concentration.
  • the Shh pathway activator is Purmorphamine, which is at a concentration of about 1 nM to 1000 ⁇ , about 10 nM to 100 ⁇ , about 100 nM to 10 ⁇ , about 1 ⁇ to 10 ⁇ , about 1 ⁇ , about 2 ⁇ , about 3 ⁇ , about 4 ⁇ , about 5 ⁇ , or about 6 ⁇ .
  • CHIR99021 is at a concentration of about 100 nM to about 10 ⁇ in combination with Purmorphamine at a concentration of about 100 nM to about 10 ⁇ . In certain embodiments, CHIR99021 is at a concentration of about 100 nM to about 10 ⁇ in combination with SAG at a concentration of about 1 nM to about 100 nM. In certain embodiments, CHIR99021 is at a concentration of about 100 nM to about 10 ⁇ in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 ⁇ to about 100 ⁇ . In certain embodiments, CHIR99021 is at a concentration of about 100 nM to about 10 ⁇ in combination with SAG HC1 at a concentration of about 10 nM to about 1 ⁇ .
  • LY2090314 is at a concentration of about 1 nM to about 100 nM in combination with Purmorphamine at a concentration of about 100 nM to about 10 ⁇ . In certain embodiments, LY2090314 is at a concentration of about 1 nM to about 100 nM in combination with SAG at a concentration of about 1 nM to about 100 nM. In certain embodiments, LY2090314 is at a concentration of about 1 nM to about 100 nM in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 ⁇ to about 100 ⁇ . In certain embodiments, LY2090314 is at a concentration of about 1 nM to about 100 nM in combination with SAG HC1 at a concentration of about 10 nM to about 1 ⁇ .
  • AZD1080 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with Purmorphamine at a concentration of about 100 nM to about 10 ⁇ . In certain embodiments, AZD1080 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with SAG at a concentration of about 1 nM to about 100 nM. In certain embodiments, AZD1080 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 ⁇ to about 100 ⁇ . In certain embodiments, AZD1080 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with SAG HC1 at a concentration of about 10 nM to about 1 ⁇ .
  • GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 ⁇ in combination with Purmorphamine at a concentration of about 100 nM to about 10 ⁇ . In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 ⁇ in combination with SAG at a concentration of about 1 nM to about 100 nM. In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 ⁇ in combination with 20- alpha hydroxy cholesterol at a concentration of about 1 ⁇ to about 100 ⁇ . In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 ⁇ in combination with SAG HC1 at a concentration of about 10 nM to about 1 ⁇ .
  • Compound 1-6 is at a concentration of about 1 nM to about 100 nM in combination with Purmorphamine at a concentration of about 100 nM to 10 ⁇ . In certain embodiments, Compound 1-6 is at a concentration of about 1 nM to about 100 nM in combination with SAG at a concentration of about 1 nM to about 100 nM. In certain embodiments, Compound 1-6 is at a concentration of about 1 nM to about 100 nM in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 ⁇ to about 100 ⁇ . In certain embodiments, Compound 1-6 is at a concentration of about 1 nM to about 100 nM in combination with SAG HC1 at a concentration of about 10 nM to about 1 ⁇ .
  • Compound 1-7 is at a concentration of about 1 nM to about 100 nM in combination with Purmorphamine at a concentration of about 100 nM to about 10 ⁇ . In certain embodiments, Compound 1-7 is at a concentration of about 1 nM to about 100 nM in combination with SAG at a concentration of about 1 nM to about 100 nM. In certain embodiments, Compound 1-7 is at a concentration of about 1 nM to about 100 nM in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 ⁇ to about 100 ⁇ . In certain embodiments, Compound 1-7 is at a concentration of about 1 nM to about 100 nM in combination with SAG HC1 at a concentration of about 10 nM to about 1 ⁇ .
  • Compound 1-12 is at a concentration of about 10 nM to about 1000 nM in combination with Purmorphamine at a concentration of about 100 nM to about 10 ⁇ . In certain embodiments, Compound 1-12 is at a concentration of about 10 nM to about 1000 nM in combination with SAG at a concentration of about 1 nM to about 100 nM. In certain embodiments, Compound 1-12 is at a concentration of about 10 nM to about 1000 nM in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 ⁇ to about 100 ⁇ . In certain embodiments, Compound 1-12 is at a concentration of about 10 nM to about 1000 nM in combination with SAG HC1 at a concentration of about 10 nM to about 1 ⁇ .
  • CHIR99021 is at a concentration of about 100 ⁇ to about 10 mM in combination with Purmorphamine at a concentration of about 100 ⁇ to about 10 mM. In certain embodiments, CHIR99021 is at a concentration of about 100 ⁇ to about 10 mM in combination with SAG at a concentration of about 1 ⁇ to about 100 ⁇ . In certain embodiments, CHIR99021 is at a concentration of about 100 ⁇ to about 10 mM in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 mM to about 100 mM.
  • CHIR99021 is at a concentration of about 100 ⁇ to about 10 mM in combination with SAG HC1 at a concentration of about 10 ⁇ to about 1 mM.
  • LY2090314 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with Purmorphamine at a concentration of about 100 ⁇ to about 10 mM.
  • LY2090314 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with SAG at a concentration of about 1 ⁇ to about 100 ⁇ .
  • LY2090314 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 mM to about 100 mM. In certain embodiments, LY2090314 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with SAG HC1 at a concentration of about 10 ⁇ to about 1 mM.
  • AZD1080 is at a concentration of about 1 mM to about 100 mM in combination with Purmorphamine at a concentration of about 100 ⁇ to about 10 mM. In certain embodiments, AZD1080 is at a concentration of about 1 mM to about 100 mM in combination with SAG at a concentration of about 1 ⁇ to about 100 ⁇ . In certain embodiments, AZD1080 is at a concentration of about 1 mM to about 100 mM in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 mM to about 100 mM. In certain embodiments, AZD1080 is at a concentration of about 1 mM to about 100 mM in combination with SAG HC1 at a concentration of about 10 ⁇ to about 1 mM.
  • GSK3 inhibitor XXII is at a concentration of about 100 ⁇ to about 10 mM in combination with Purmorphamine at a concentration of about 100 ⁇ to about 10 mM. In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 ⁇ to about 10 mM in combination with SAG at a concentration of about 1 ⁇ to about 100 ⁇ . In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 ⁇ to about 10 mM in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 mM to about 100 mM. In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 ⁇ to about 10 mM in combination with SAG HC1 at a concentration of about 10 ⁇ to about 1 mM.
  • Compound 1-6 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with Purmorphamine at a concentration of about 100 ⁇ to about 10 mM. In certain embodiments, Compound 1-6 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with SAG at a concentration of about 1 ⁇ to about 100 ⁇ . In certain embodiments, Compound 1-6 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 mM to about 100 mM. In certain embodiments, Compound 1-6 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with SAG HC1 at a concentration of about 10 ⁇ to about 1 mM.
  • Compound 1-7 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with Purmorphamine at a concentration of about 100 ⁇ to about 10 mM. In certain embodiments, Compound 1-7 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with SAG at a concentration of about 1 ⁇ to about 100 ⁇ . In certain embodiments, Compound 1-7 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 mM to about 100 mM. In certain embodiments, Compound 1-7 is at a concentration of about 1 ⁇ to about 100 ⁇ in combination with SAG HC1 at a concentration of about 10 ⁇ to about 1 mM.
  • Compound 1-12 is at a concentration of about 10 ⁇ to about 1000 ⁇ in combination with Purmorphamine at a concentration of about 100 ⁇ to about 10 mM. In certain embodiments, Compound 1-12 is at a concentration of about 10 ⁇ to about 1000 ⁇ in combination with SAG at a concentration of about 1 ⁇ to about 100 ⁇ . In certain embodiments, Compound 1-12 is at a concentration of about 10 ⁇ to about 1000 ⁇ in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 mM to about 100 mM. In certain embodiments, Compound 1-12 is at a concentration of about 10 ⁇ to about 1000 ⁇ in combination with SAG HC1 at a concentration of about 10 ⁇ to about 1 mM.
  • the Shh pathway activator is SAG (CAS 912545-86-9) or SAG-HC1 in combination with a Wnt agonist selected from one or more of an SFRP1 inhibitor (for example, WAY-316606), a SFRP2 inhibitor, a SFRP3 inhibitor, a SFRP4 inhibitor, a SFRP5 inhibitor, a cyclosporine or an analog thereof (for example, cyclosporine A (CsA), PSC833 (Valspodar)), a DKK1 inhibitor (for example, WAY-262611), and a WIF1 inhibitor.
  • an SFRP1 inhibitor for example, WAY-316606
  • a SFRP2 inhibitor for example, a SFRP3 inhibitor, a SFRP4 inhibitor, a SFRP5 inhibitor
  • a cyclosporine or an analog thereof for example, cyclosporine A (CsA), PSC833 (Valspodar)
  • a DKK1 inhibitor for example, WAY-262611
  • SAG is at a concentration of about 1 ⁇ to 1000 mM, or about 10 ⁇ to 1000 mM, or about 100 ⁇ to 10 mM, or about 1 mM.
  • SAG HC1 is at a concentration ratio of about 0.1 to 1,000,000 fold relative to its Effective Shh Concentration, or about 1 to 100,000 fold relative to its Effective Shh Concentration, or about 10 to 10,000 fold relative to its Effective Shh Concentration, or about 100 to 1000 fold relative to its Effective Shh Concentration, or about 1000 fold relative to its Effective Shh Concentration.
  • SAG HCl is at about lx, 3x, lOx, 3 Ox, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Shh Concentration. In some embodiments, SAG HCl is at a concentration of about 1 nM to 1000 ⁇ , about 10 nM to 100 ⁇ , about 100 nM to 10 ⁇ , about 125 nM, about 250 nM, or about 500 nM, or about 750 nM
  • Hair follicles develop through complex morphogenetic processes resulting from reciprocal molecular interactions between epithelium and underlying mesenchyme during embryonic development. Each hair follicle goes through regenerative cycling. The hair cycle consists of phases of growth (anagen), degeneration (catagen) and rest (telogen). In catagen, hair follicle stem cells are maintained in the bulge. Then the resting follicle re-enters anagen (regeneration) when proper molecular signals are provided. During late telogen to early anagen transition, signals from the dermal papilla (DP) stimulate the hair germ and quiescent bulge stem cells to become activated.
  • DP dermal papilla
  • stem cells in the bulge give rise to hair germs, then the transient amplifying cells in the matrix of the new follicle proliferate rapidly to form a new hair filament.
  • follicles undergo apoptosis.
  • the hair filament remains in the telogen follicle to become a club hair, which later is detached during exogen.
  • Hh Hedgehog pathway
  • Secreted Hh proteins act in a concentration- and time-dependent manner to initiate a series of cellular responses that range from survival and proliferation to cell fate specification and differentiation.
  • Proper levels of Hh signaling require the regulated production, processing, secretion and trafficking of Hh ligands- in mammals this includes Sonic (Shh), Indian (Ihh) and Desert (Dhh).
  • Hh ligands are synthesized as precursor proteins that undergo autocatalytic cleavage and concomitant cholesterol modification at the carboxy terminus and palmitoylation at the amino terminus, resulting in a secreted, dually- lipidated protein.
  • Hh ligands are released from the cell surface through the combined actions of Dispatched and Scube2, and subsequently trafficked over multiple cells through interactions with the cell surface proteins LRP2 and the Glypican family of heparan sulfate proteoglycans (GPCl-6). Hh proteins initiate signaling through binding to the canonical receptor Patched (PTCH1) and to the co-receptors GAS1, CDON and BOC.
  • PTCH1 canonical receptor Patched
  • GAS1 co-receptors
  • SMO GPCR-like protein Smoothened
  • GLI proteins also traffic through cilia and in the absence of Hh signaling are sequestered by SUFU and Kif7, allowing for GLI phosphorylation by PKA, GSK3 and CK1, and subsequent processing into transcriptional repressors (through cleavage of the carboxy -terminus) or targeting for degradation (mediated by the E3 ubiquitin ligase ⁇ -TrCP).
  • GLI proteins are differentially phopshorylated and processed into transcriptional activators that induce expression of Hh target genes, many of which are components of the pathway (e.g. PTCHl and GLI1).
  • Hh pathway antagonists PTCHl, PTCH2 and Hhipl
  • Hh ligand function PTCHl, PTCH2 and Hhipl
  • GLI protein degradation mediated by the E3 ubiquitin ligase adaptor protein, SPOP.
  • Hh signaling is responsible for the initiation of a growing number of cancers including, classically, basal cell carcinoma, edulloblastoma, and rhabdomyosarcoma; more recently overactive Hh signaling has been implicated in pancreatic, lung, prostate, ovarian, and breast cancer.
  • the compounds described herein may be made from commercially available starting materials or synthesized using known organic, inorganic, and/or enzymatic processes.
  • the compounds of the present invention can be prepared in a number of ways well known to those skilled in the art of organic synthesis.
  • compounds of the disclosure can be synthesized using the methods described below, together with synthetic methods known in the art of synthetic organic chemistry, or variations thereon as appreciated by those skilled in the art. These methods include but are not limited to those methods described below.
  • com ound 1-11 is an embodiment wherein Q 1 is CH; Q 2 is N; and
  • Q 3 is C; R 2 is bromo; Ar is ; and -Z-W-X-Y- is.
  • Compounds of formula 1 and the allylic aldehyde are commercially available starting materials. Alternatively, compounds of formula 1 and the allylic aldehyde can be synthesized via a variety of different synthetic routes using commercially available starting materials and/or starting materials prepared by conventional synthetic methods.
  • compound 1 and an allylic aldehyde are reacted to form compound 2 in a condensation reaction in a suitable solvent such as acetonitrile at a temperature, for example, from about 40 ° C to 100 ° C.
  • a suitable solvent such as acetonitrile
  • compound 3 is reacted with ammonia to form compound 3 in a suitable solvent such as methanol at a temperature, for example, in the range from 0°C to room temperature.
  • Compound 3 can be used in a coupling reaction to be discussed below.
  • compound 5 may be prepared from an alkylation of compound 4 with an alkyl halide in the presence of a base, such as an alkali metal hydride, such as sodium hydride.
  • a base such as an alkali metal hydride, such as sodium hydride.
  • the reaction can be run in a suitable solvent, such as dimethylformamide (DMF) at a temperature, for example, in the range from 0°C to room temperature.
  • DMF dimethylformamide
  • Compound 6 may be prepared from the reduction of compound 5.
  • Suitable reduction reagents include borane pyridine complex.
  • the reaction can be run in a suitable solvent, such as acetic acid at a temperature, for example, in the range from 0°C to room temperature.
  • Compound 7 may be prepared from reaction of compound 6. The reaction is carried with formaldehyde in the presence of acid such as sulfuric acid and acetic acid.
  • Compound 8 may be prepared from protection of the amino group of compound 7.
  • Suitable reagents include BOC anhydride.
  • the reaction can be run in a suitable solvent, such as tetrahydrofuran (THF) at a temperature, for example, in the range from 0°C to room temperature.
  • THF tetrahydrofuran
  • Core 1 may be prepared from the dehydrogenation of compound 8.
  • Suitable reagents include DDQ (2,3-dichloro-5,6-dicyano-l,4-benzoquinone).
  • the reaction can be run in a suitable solvent, such as tetrahydrofuran (THF) at a temperature, for example, in the range from 0°C to room temperature.
  • THF tetrahydrofuran
  • Compound 10 may be prepared from core 1 by deprotection of the amino group and then the subsequent reaction with acyl halide.
  • the deprotection of the amino group can be performed under acidic conditions, if the protecting group is BOC.
  • reaction with an acyl halide can result in compound 10.
  • the reaction can be run in a suitable solvent, such as dimethylformamide (DMF) at a temperature, for example, in the range from 0°C to room temperature.
  • DMF dimethylformamide
  • Compound 11 may be prepared from compound 10 by an acylation reaction, such as a Friedel Crafts acylation reaction.
  • an acyl halide is reacted with compound 10 in a suitable solvent, such as methylene chloride at a temperature, for example, in the range from 30°C to 100°C.
  • a suitable solvent such as methylene chloride
  • the product is then reacted an alcohol and base to form an ester, as in compound 11.
  • the crude compound was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 100: 1 to 20: 1) to give the compound (24 g) as yellow oil.
  • To a solution of the compound (24 g) in THF (100 mL) was added HCl (0.5 N, 80 mL) drop wised at room temperature. The mixture was stirred at room temperature for 1 hr. TLC (petroleum ether/EtOAc 5/1) showed the reaction was completed.

Abstract

The present invention relates to compositions of Sonic Hedgehog (Shh) pathway activators and Wnt agonists and methods of using them to induce self-renewal of hair follicle stem cells, including inducing the hair follicle stem cells to proliferate while maintaining, in the daughter cells, the capacity to differentiate into hair follicle epithelial cells.

Description

METHODS FOR HAIR FOLLICLE STEM CELL PROLIFERATION
RELATED APPLICATIONS
[0001] This application claims priority to U.S. Application Nos. 62/620,709, filed
January 23, 2018, and 62/484,279, filed April 11, 2017, the entire contents of each of which are incorporated herein by reference.
FIELD OF THE INVENTION
[0002] The present invention relates to methods of using one or more sonic hedgehog
(Shh) pathway activator and one or more Wnt pathway activator for inducing, promoting, or enhancing the growth, proliferation, and/or regeneration of stem cells in hair follicles while maintaining, in the daughter cells, the capacity to differentiate into epithelial cells of the hair follicle. In one embodiment, the stem cells in hair follicles are dermal papilla stem cells in the Dermal Papilla. In some embodiments, the one or more Wnt activator is one or more glycogen synthase (GSK) inhibitor. In some embodiments, the one or more GSK inhibitor is one or more lH-pyrrole-2,5-dione compound.
BACKGROUND OF THE INVENTION
[0003] Stem cells exhibit an extraordinary ability to generate multiple cell types in the body. Besides embryonic stem cells, tissue specific stem cells serve a critical role during development as well as in homeostasis and injury repair in the adult. Stem cells renew themselves through proliferation as well as generate tissue specific cell types through differentiation. The characteristics of different stem cells vary from tissue to tissue, and are determined by their intrinsic genetic and epigenetic status. However, the balance between self- renewal and differentiation of different stem cells are all stringently controlled. Uncontrolled self-renewal may lead to overgrowth of stem cells and possibly tumor formation, while uncontrolled differentiation may exhaust the stem cell pool, leading to an impaired ability to sustain tissue homeostasis. Thus, stem cells continuously sense their environment and appropriately respond with proliferation, differentiation or apoptosis. It would be desirable to drive regeneration by controlling the timing and extent of stem cell proliferation and differentiation. Controlling the proliferation with small molecules that are cleared over time would allow for control of the timing and extent of stem cell proliferation and differentiation. Remarkably, tissue stem cells from different tissues share a limited number of signaling pathways for the regulation of their self-renewal and differentiation, albeit in a very context dependent manner. Some of these pathways are the Wnt and GSK3 pathways.
[0004] Hair loss, e.g. alopecia, is a disorder caused by an interruption in the body's cycle of hair production. Hair loss can occur anywhere on the body, but most commonly affects the scalp. On average, the scalp has 100,000 hairs that cycle through periods of growing, resting, falling out, and regenerating. Although not a life-threatening condition, and primarily a 'cosmetic' issue, hair loss affects quality of life. In an image-oriented society, hair loss has a significant impact on an individual's emotional state. Hair loss may be linked to a person's genetics, although many medical and behavioral conditions may interrupt the growth cycle and cause hair loss.
[0005] There is no curative therapy for hair loss. Current treatments involve topical medications such as the antihypertensive vasodilator minoxidil or immunosuppressive steroid cream. Corticosteroid therapy can also be administered by injections. Oral prescription medications such as finasteride, antiandrogens and antifungal medications are also used. However, the treatments can be accompanied by adverse effects of the medications and patients can relapse if treatment is discontinued. Hair loss can also be treated cosmetically by dermatography and hairpieces, but these cosmetic solutions do not offer a cure either.
[0006] Thus, there remains a long felt need for new compounds that can preserve/promote the function of cells in the hair follicle to combat hair loss.
SUMMARY OF THE INVENTION
[0007] The present disclosure provides methods of using one or more Sonic Hedgehog
(Shh) pathway activator and one or more Wnt agonist to induce the self-renewal of stem cells in hair follicles. The present disclosure also provides pharmaceutical compositions of one or more Shh pathway activator and one or more Wnt agonist. These compositions are useful, for example, in treating diseases associated with hair loss, such as alopecia.
[0008] In one aspect, the present disclosure provides a method of expanding a population of stem cells of hair follicles, said method comprising contacting the stem cells with one or more Sonic Hedgehog (Shh) pathway activator and one or more Wnt agonist. [0009] In another aspect, the present disclosure provides a method of facilitating the generation of hair follicle epithelial cells, the method comprising treating stem cells of hair follicles with one or more Sonic Hedgehog (Shh) pathway activator and one or more Wnt agonist.
[0010] In one embodiment, the stem cells are dermal papilla stem cells. In another embodiment, the stem cells are hair follicle stem cells. In some embodiments, the stem cells comprise keratinocytes, melanocytes, dermal papilla cells, bulge cells, or a combination thereof. In some embodiments, the stem cells are in a subject. In some embodiments of the methods described herein, the expression of Glil, Krtl5, CD34, Lgr5, Lgr6, Lrigl, Sox2, CD133, Vimentin, Versican and/or alkaline phosphatase is increased in hair follicles.
[0011] In another aspect, the present disclosure provides a method of treating a subject who has, or is at risk of developing, a disease associated with absence or lack of hair follicle epithelial cells, the method comprising administering to said subject one or more Sonic Hedgehog (Shh) pathway activator and one or more Wnt agonist. In some embodiments, the disease is selected from telogen effluvium, anagen effluvium, androgenetic alopecia, alopecia areata, tinea capitis, lichen planopilaris, cicatricial alopecia, discoid lupus erythematosus, folliculitis decalvans, dissecting cellulitis of the scalp, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, trichotillomania, traction alopecia, and hypotrichosis.
[0012] In another aspect, the present disclosure provides a method of treating a subject who has, or is at risk of developing, alopecia, the method comprising administering to said subject one or more Sonic Hedgehog (Shh) pathway activator and one or more Wnt agonist.
[0013] In some embodiments, the subject administered the one or more Shh pathway activator and the one or more Wnt agonist has improved hair growth, improved hair density and/or improved regenerative cycling of hair follicles compared to a subject not administered the one or more Shh pathway activator and the one or more Wnt agonist.
[0014] In yet another aspect, the present disclosure provides a pharmaceutical composition comprising: a pharmaceutically-acceptable carrier and (i) a Wnt agonist, or a pharmaceutically-acceptable salt thereof, and (ii) a Sonic Hedgehog (Shh) pathway activator, or a pharmaceutically-acceptable salt thereof.
[0015] In some embodiments of the methods and compositions disclosed herein, the one or more Shh pathway activator is at a concentration of about 5x to about lOOOx of an effective in vitro Shh pathway activation concentration. In certain embodiments, the one or more Shh pathway activator is at a concentration of about lOx to about lOOx of an effective in vitro Shh pathway activation concentration. In some embodiments, the one or more Shh pathway activator is at a concentration of about 20x to about 5 Ox of an effective in vitro Shh pathway activation concentration. In certain embodiments, the one or more Wnt agonist is at a concentration of about 5x to about 1 OOOx of an effective in vitro Wnt agonist concentration. In some embodiments, the one or more Wnt agonist is at a concentration of about lOx to about lOOx of an effective in vitro Wnt agonist concentration. In some embodiments, the one or more Wnt agonist is at a concentration of about 20x to about 50x of an effective in vitro Wnt agonist concentration.
[0016] In some embodiments of the methods and compositions disclosed herein, the
Shh pathway activator comprises a Smoothened agonist. In other embodiments, the Shh pathway activator comprises Smoothened ciliary accumulation enhancers. In certain embodiments of the methods and compositions disclosed herein, the one or more Shh pathway activator is selected from Table 1 or Table 2. In further embodiments of the methods and compositions disclosed herein, the one or more Shh pathway activator is selected from Purmorphamine, SAG, 20-alpha hydroxy cholesterol, and SAG HC1.
[0017] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is selected from Table 3. In certain embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is a GSK3 -alpha inhibitor or a GSK3-beta inhibitor. In further embodiments of the methods and compositions disclosed herein, the GSK3-alpha inhibitor is selected from Table 5. In yet further embodiments of the methods and compositions disclosed herein, the GSK3-beta inhibitor is selected from Table 4.
[0018] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is a compound of Formula (I),
Figure imgf000006_0001
tiarmaceutically acceptable salts and tautomers thereof, wherein: Q1 is CH or N;
Q2 is C or N;
Q3 is C or N;
wherein at least one of Q1, Q2, and Q3 is N;
R1 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl, -CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)Rla, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein Rla is Ci-C4alkyl;
R2 is selected from the group consisting of halo, Ci-C4alkyl, Ci-C4alkenyl, Ci- C4alkynyl,
-CN, -OH, -0-Ci-C4alkyl, -NH2, -NH(Ci-C4alkyl), -N(Ci-C4alkyl)2, -NHC(0)R2a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents
independently selected from the group consisting of halo and -OH; and wherein R2a is Ci- C4alkyl;
R3 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl, -CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R a is Ci-C4alkyl;
Figure imgf000007_0001
-Z-W-X-Y- is -C(RZ)2-C(RW)2-N(RX)-C(RY)2-, -C(RZ)2-C(RW)2-CH(RX)-C(RY)2-, or -C(RW)2-CH(RX)-C(RY)2-;
each Rz is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rz groups together form C3-C6cycloalkyl or oxo;
each Rw is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rw groups together form C3-C6cycloalkyl or oxo; or Rz and Rw together with the carbons to which they are attached form a C3- C6cycloalkyl;
Rx is selected from the group consisting of -CORxl, -S02RX1, heteroaryl, and -(Ci- C4alkylene)-(C3-C8cycloalkyl), and wherein the-(Ci-C4alkylene)-(C3-C8cycloalkyl) is optionally substituted with one to four halo on the Ci-C4alkylene;
wherein RX1 is heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, -[C(Rxla)2]P-CN, -CF3, Ci-C4alkyl, -(CH2)P-OH, -[C(Rxla)2]P-OH, -[C(Rxla)2]P-0-Ci- C4alkyl, -NHCOCi-C4alkyl, -CONHCi-C4alkyl, -COH, -C02H, -[C(Rxla)2]P-COO-Ci- C4alkyl, -(CH2)P-NH2, -[C(Rxla)2]P-NH2, -[C(Rxla)2]P-NH-Ci-C4alkyl, -[C(Rxla)2]P-N-(Ci- C4alkyl)2; wherein p is 0, 1, 2, or 3; wherein each Rxla is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rxla groups together form C3-C6cycloalkyl;
each RY is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both RY groups together form C3-C6cycloalkyl or oxo; and
m is 0, 1, or 2.
[0019] In some embodiments of the methods and compositions disclosed herein, the compounds of Formula I have one or more of the following features:
a) provided that the compound is not
Figure imgf000008_0001
Figure imgf000009_0001
Figure imgf000009_0002
and pharmaceutically acceptable salts and tautomers thereof, wherein:
Q1 is CH or N;
Q2 is C or N;
Q3 is C or N;
wherein at least one of Q1, Q2, and Q3 is N;
R1 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl,-CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein Rla is Ci-C4alkyl; R2 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl,-CN, -OH, -0-Ci-C4alkyl, -NH2, -NH(Ci-C4alkyl), -N(Ci-C4alkyl)2, - NHC(0)R2a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R2a is Ci-C4alkyl;
R3 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl, -CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R a is Ci-C4alkyl;
Figure imgf000010_0001
optionally substituted with deuterium, halo, alkyl, alkoxy, and CN;
Q7 is selected from S, O, CH2, and NRQ7; wherein RQ7 is hydrogen or optionally substituted Ci-C4alkyl;
-Z-W-X-Y- is -C(RZ)2-C(RW)2-N(RX)-C(RY)2-, -C(RZ)2-C(RW)2-CH(RX)-C(RY)2-, or -C(RW)2-CH(RX)-C(RY)2-;
each Rz is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rz groups together form C3-C6cycloalkyl or oxo;
each Rw is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rw groups together form C3-C6cycloalkyl or oxo;
or Rz and Rw together with the carbons to which they are attached form a C3- C6cycloalkyl;
Rx is selected from the group consisting of hydrogen, RX1, -CORxl, -S02RX1, -(Ci- C4alkylene)-Rxl, and wherein the -(Ci-C4alkylene)-Rxl is optionally substituted with one to four halo on the Ci-C4alkylene; wherein RX1 is C3-C8cycloalkyl, heteroaryl, or heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, -[C(Rxla)2]P-CN, -CF3, -Ci-C4alkyl, -(CH2)P-OH, - [C(Rxla)2]P-OH, -[C(Rxla)2]P-0-Ci-C4alkyl, NHCOCi-C4alkyl, CONHCi-C4alkyl, COH, - C02H, -[C(Rxla)2]P-COO-Ci-C4alkyl, -(CH2)P-NH2, -[C(Rxla)2]P-NH2, -[C(Rxla)2]P-NH-Ci- C4alkyl, -[C(Rxla)2]P-N-(Ci-C4alkyl)2; wherein p is 0, 1, 2, or 3; wherein each Rxla is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci- C4alkyl, or both Rxla groups together form C3-C6cycloalkyl;
each RY is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both RY groups together form C3-C6cycloalkyl or oxo; and
m is 0, 1, or 2.
[0021] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is a compound of Formula lb:
Figure imgf000011_0001
and pharmaceutically acceptable salts and tautomers thereof, wherein:
Q1 is CH or N;
Q2 is C or N;
Q3 is C or N;
wherein at least one of Q1, Q2, and Q3 is N; and provided that when Q1 is CH and Q3 is C, Q2 is not N;
R1 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl,-CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein Rla is Ci-C4alkyl;
R2 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl, -CN, -OH, -0-Ci-C4alkyl, -NH2, -NH(Ci-C4alkyl), -N(Ci-C4alkyl)2, - NHC(0)R2a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R2a is Ci-C4alkyl;
R3 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl,-CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R3a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R a is Ci-C4alkyl;
Figure imgf000012_0001
with deuterium, halo, alkyl, alkoxy, and CN;
each Q6 is independently selected from CRQ6 and N; wherein RQ6 is hydrogen, halo, - CN, lower alkyl, or substituted alkyl;
Q7 is selected from S, O, CH2, and NRQ7; wherein RQ7 is hydrogen or optionally substituted Ci-C4alkyl;
-Z-W-X-Y- is -C(RZ)2-C(RW)2-N(RX)-C(RY)2-, -C(RZ)2-C(RW)2-CH(RX)-C(RY)2-, or -C(RW)2-CH(RX)-C(RY)2-;
each Rz is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rz groups together form C3-C6cycloalkyl or oxo;
each Rw is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rw groups together form C3-C6cycloalkyl or oxo;
or Rz and Rw together with the carbons to which they are attached form a C3- C6cycloalkyl;
Rx is selected from the group consisting of hydrogen, RX1, -CORxl, -S02RX1, -(Ci- C4alkylene)-Rxl, and wherein the -(Ci-C4alkylene)-Rxl is optionally substituted with one to four halo on the Ci-C4alkylene; wherein RX1 is C3-Cscycloalkyl, heteroaryl, or heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, -[C(Rxla)2]P-CN, -CF3, Ci-C4alkyl, -(CH2)P-OH, - [C(Rxla)2]P-OH, -[C(Rxla)2]P-0-Ci-C4alkyl, -NHCOCi-C4alkyl, CONHCi-C4alkyl, COH, - C02H, -[C(Rxla)2]P-COO-Ci-C4alkyl, -(CH2)P-NH2, -[C(Rxla)2]P-NH2, -[C(Rxla)2]P-NH-Ci- C4alkyl, -[C(Rxla)2]P-N-(Ci-C4alkyl)2; wherein p is 0, 1, 2,or 3; wherein each Rxla is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci- C4alkyl, or both Rxla groups together form C3-C6cycloalkyl;
each RY is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both RY groups together form C3-C6cycloalkyl or oxo; and
m is 0, 1, or 2.
[0022] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is selected from Table 6. In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is selected from CHIR99021, LY2090314, AZD1080, GSK3 inhibitor XXII, Compound 1-6, Compound 1-7, and Compound 1-12.
[0023] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is selected from CHIR99021, LY2090314, AZD1080, GSK3 inhibitor XXII, Compound 1-6, Compound 1-7, and Compound 1-12 and the one or more Shh pathway activator is selected from Purmorphamine, SAG, 20-alpha hydroxy cholesterol, and SAG HC1.
[0024] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is Purmorphamine. In some embodiments, CHIR99021 is at a concentration of about 100 nM to about 10 μΜ and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ. In certain embodiments, CHIR99021 is at a concentration of about 100 μΜ to about 10 mM and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
[0025] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is SAG. In some embodiments, CHIR99021 is at a concentration of about 100 nM to about 10 μΜ and SAG is at a concentration of about 1 nM to about 100 nM. In certain embodiments, CHIR99021 is at a concentration of about 100 μΜ to about 10 mM and SAG is at a concentration of about 1 μΜ ίο about 100 μΜ. [0026] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol. In some embodiments, CHIR99021 is at a concentration of about 100 nM to about 10 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, CHIR99021 is at a concentration of about 100 μΜ to about 10 mM and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
[0027] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is SAG HCl. In some embodiments, CHIR99021 is at a concentration of about 100 nM to about 10 μΜ and SAG HCl is at a concentration of about 10 nM to about 1 μΜ. In certain embodiments, CHIR99021 is at a concentration of about 100 μΜ to about 10 mM and SAG HCl is at a concentration of about 10 μΜ to about 1 mM.
[0028] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is Purmorphamine. In some embodiments, LY2090314 is at a concentration of about 1 nM to about 100 nM and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ. In certain embodiments, LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
[0029] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is SAG. In some embodiments, LY2090314 is at a concentration of about 1 nM to about 100 nM and SAG is at a concentration of about 1 nM to about 100 nM. In certain embodiments, LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
[0030] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol. In some embodiments, LY2090314 is at a concentration of about 1 nM to about 100 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM. [0031] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is SAG HCl. In some embodiments, LY2090314 is at a concentration of about 1 nM to about 100 nM and SAG HCl is at a concentration of about 10 nM to about 1 μΜ. In certain embodiments, LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ and SAG HCl is at a concentration of about 10 μΜ to about 1 mM.
[0032] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is Purmorphamine. In some embodiments, AZD1080 is at a concentration of about 1 μΜ to about 100 μΜ and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ. In certain embodiments, AZD1080 is at a concentration of about 1 mM to about 100 mM and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
[0033] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is SAG. In some embodiments, AZD1080 is at a concentration of about 1 μΜ to about 100 μΜ and SAG is at a concentration of about 1 nM to about 100 nM. In certain embodiments, AZD1080 is at a concentration of about 1 mM to about 100 mM and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
[0034] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol. In some embodiments, AZD1080 is at a concentration of about 1 μΜ to about 100 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, AZD1080 is at a concentration of about 1 mM to about 100 mM and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
[0035] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is SAG HCl. In some embodiments, AZD1080 is at a concentration of about 1 μΜ to about 100 μΜ and SAG HCl is at a concentration of about 10 nM to about 1 μΜ. In certain embodiments, AZD1080 is at a concentration of about 1 mM to about 100 mM and SAG HCl is at a concentration of about 10 μΜ to about 1 mM.
[0036] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is Purmorphamine. In some embodiments, GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ. In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
[0037] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is SAG. In some embodiments, GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ and SAG is at a concentration of about 1 nM to about 100 nM. In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
[0038] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol. In some embodiments, GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
[0039] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is SAG HCl. In some embodiments, GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ and SAG HCl is at a concentration of about 10 nM to about 1 μΜ. In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM and SAG HCl is at a concentration of about 10 μΜ to about 1 mM.
[0040] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is Purmorphamine. In some embodiments, Compound 1-6 is at a concentration of about 1 nM to about 100 nM and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ. In certain embodiments, Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
[0041] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is SAG. In some embodiments, Compound 1-6 is at a concentration of about 1 nM to about 100 nM and SAG is at a concentration of about 1 nM to about 100 nM. In certain embodiments, Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ and SAG is at a concentration of about 1 μΜ ίο about 100 μΜ.
[0042] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is 20- alpha hydroxy cholesterol. In some embodiments, Compound 1-6 is at a concentration of about 1 nM to about 100 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
[0043] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is SAG HCl. In some embodiments, Compound 1-6 is at a concentration of about 1 nM to about 100 nM and SAG HCl is at a concentration of about 10 nM to about 1 μΜ. In certain embodiments, Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ and SAG HCl is at a concentration of about 10 μΜ to about 1 mM.
[0044] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is Compound 1-7 and the one or more Shh pathway activator is Purmorphamine. In some embodiments, Compound 1-7 is at a concentration of about 1 nM to about 100 nM and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ. In certain embodiments, Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
[0045] In some embodiments of the methods and compositions disclosed herein,
Compound 1-7 and the one or more Shh pathway activator is SAG. In some embodiments, Compound 1-7 is at a concentration of about 1 nM to about 100 nM and SAG is at a concentration of about 1 nM to about 100 nM. In certain embodiments, Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
[0046] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is Compound 1-7 and the one or more Shh pathway activator is 20- alpha hydroxy cholesterol. In some embodiments, Compound 1-7 is at a concentration of about 1 nM to about 100 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
[0047] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is Compound 1-7 and the one or more Shh pathway activator is SAG HCl. In some embodiments, Compound 1-7 is at a concentration of about 1 nM to about 100 nM and SAG HCl is at a concentration of about 10 nM to about 1 μΜ. In certain embodiments, Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ and SAG HCl is at a concentration of about 10 μΜ to about 1 mM.
[0048] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is Purmorphamine. In some embodiments, Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ. In certain embodiments, Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
[0049] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is SAG. In some embodiments, Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and SAG is at a concentration of about 1 nM to about 100 nM. In certain embodiments, Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
[0050] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is 20- alpha hydroxy cholesterol. In some embodiments, Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
[0051] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is SAG HCl. In some embodiments, Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and SAG HCl is at a concentration of about 10 nM to about 1 μΜ. In certain embodiments, Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ and SAG HCl is at a concentration of about 10 μΜ to about 1 mM.
[0052] Other objects and features will be in part apparent and in part pointed out hereinafter.
BRIEF DESCRIPTION OF THE DRAWINGS
[0053] FIG. 1A-FIG. ID show that Shh and Wnt activation promote DP growth and hair growth induction. FIG. 1A: DP cells treated in control conditions show small and few colonies. FIG. IB: DP cells treated Shh pathway activator (Purmorphamine 1 μΜ) show slightly larger and more abundant colonies than FIG. 1A. FIG. 1C: DP cells treated Wnt activator (CHIR99021 4 μΜ) show more abundant colonies than FIG. 1A. FIG. ID: A combination of a Shh pathway activator (Purmorphamine 1 μΜ) and Wnt activator (CHIR99021 4 μΜ) show many large DP colonies. 8 days in culture. Scale bars 1000 μηι.
[0054] FIG. 2A-FIG. 2D show that Shh pathway activation with multiple Wnt activation molecules promote DP (dermal papilla) growth and hair growth induction. FIG. 2A: DP cells treated in control conditions show small and few colonies. FIG. 2B: DP cells treated with Shh pathway activator (Purmorphamine 1 μΜ) show slightly larger and more abundant colonies than FIG. 2A. FIG. 2C: DP cells treated with Wnt activator (Compound I- 7 10 nM) show more abundant colonies than FIG. 2A. FIG. 2D: A combination of a Shh pathway activator (Purmorphamine 1 μΜ) and a Wnt activator (Compound 1-7 10 nM) show many large DP colonies. 10 days in culture. Scale the same for all figures; see scale bar in Fig. 2D, 200 μιη.
[0055] FIG. 3A-FIG. 3F show that multiple Shh molecules with Wnt activation promote DP growth and hair growth induction. FIG.3A: DP cells treated with Purmorphamine (1 μΜ) alone form colonies. FIG. 3D: DP cells treated with GSK3 inhibitor (Compound 1-7, 10 nM) and Purmorphamine (1 μΜ) form more colonies and are larger than colonies treated with Purmorphamine alone. FIG. 3B: DP cells treated with SAG (3 nM) alone form colonies. FIG. 3E: DP cells treated with GSK3 inhibitor (Compound 1-7, 10 nM) and SAG (3 nM) form more colonies that are larger than colonies treated with SAG alone. FIG. 3C: DP cells treated with SAG HCl (500 nM) alone form colonies. FIG. 3F: DP cells treated with GSK3 inhibitor (Compound 1-7, 10 nM) and SAG HCl (500 nM) form more colonies that are larger than colonies treated with SAG HCl alone. Scale bars 1000 μιη. [0056] FIG. 4A-FIG. 4D show that Shh and Wnt activation promote DP growth and hair growth induction. FIG. 4A: DP cells treated in control conditions show small and few Alkaline Phosphatase (Alp) colonies. FIG. 4B: DP cells treated with Shh pathway activator (Purmorphamine 1 μΜ) show few Alp colonies. FIG.4C: Follicles treated with a Wnt activator (Compound 1-7 10 nM) show small Alp colonies. FIG. 4D: A combination of a Shh pathway activator (Purmorphamine 1 μΜ) and a Wnt activator (Compound 1-7 10 nM) show large and many Alp colonies. Alkaline Phosphatase is a marker of DP cells and used to show DP cells that have hair induction capability. 10 days in culture. Scale bars 0.5 mm.
[0057] FIG. 5A-FIG. 5D show that Shh and Wnt activation promote DP growth and hair growth induction. FIG. 5A: A combination of a Shh pathway activator (Purmorphamine 1 μΜ) and a Wnt activator (Compound 1-7 10 nM) generate colonies expressing the DP marker Vimentin. FIG. 5B: A combination of a Shh pathway activator (Purmorphamine 1 μΜ) and a Wnt activator (Compound 1-7 10 nM) generate colonies expressing the DP marker of hair induction Versican. EdU demonstrates that colonies are actively dividing in these conditions. FIG. 5C: A combination of a Shh pathway activator (Purmorphamine 1 μΜ) and a Wnt activator (Compound 1-7 10 nM) generate colonies expressing the DP and stem cell marker Sox2. FIG. 5D: A combination of a Shh pathway activator (Purmorphamine 1 μΜ) and Wnt activator (Compound 1-7 10 nM) generate colonies expressing the DP marker of hair induction CD133. 10 days in culture. Scale bars 50 μηι.
[0058] FIG. 6A-FIG. 6B show that Shh and Wnt activation promote DP growth and hair growth induction. FIG. 6A: Control treated follicles show Alkaline Phosphatase (Alp) at the base of the hair follicle. FIG. 6B: Follicles treated with a Wnt activator (Compound 1-7 10 nM) and Shh pathway (Purmorphamine 1 μΜ) activator show larger DP. Alkaline Phosphatase is a marker of DP cells and used to show DP cells that have hair induction capability. 7 days in culture. Scale bars 1 mm.
DEFINITIONS
[0059] In this application, the use of "or" means "and/or" unless stated otherwise. As used in this application, the term "comprise" and variations of the term, such as "comprising" and "comprises," are not intended to exclude other additives, components, integers or steps. As used in this application, the terms "about" and "approximately" are used as equivalents. Any numerals used in this application with or without about/approximately are meant to cover any normal fluctuations appreciated by one of ordinary skill in the relevant art. In certain embodiments, the term "approximately" or "about" refers to a range of values that fall within 25%, 20%, 19%, 18%, 17%, 16%, 15%, 14%, 13%, 12%, 11%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, or less in either direction (greater than or less than) of the stated reference value unless otherwise stated or otherwise evident from the context (except where such number would exceed 100% of a possible value).
[0060] An "additive effect" refers to an effect wherein two or more substances or actions used in combination produce a total effect, the same as the arithmetic sum of the individual effects.
[0061] "Administration" refers to introducing a substance into a subject. In some embodiments, administration is intradermal injection, topical, transdermal or oral. In some embodiments, administration is directly to the scalp. In some embodiments, administration is directly to the skin via an implant delivery system. In certain embodiments "causing to be administered" refers to administration of a second component after a first component has already been administered (e.g. , at a different time and/or by a different actor).
[0062] An "antibody" refers to an immunoglobulin polypeptide, or fragment thereof, having immunogen binding ability.
[0063] As used herein, an "agonist" is an agent that causes an increase in the expression or activity of a target gene, protein, or a pathway, respectively. Therefore, an agonist can bind to and activate its cognate receptor in some fashion, which directly or indirectly brings about this physiological effect on the target gene or protein. An agonist can also increase the activity of a pathway through modulating the activity of pathway components, for example, through inhibiting the activity of negative regulators of a pathway. Therefore, a "Wnt agonist" can be defined as an agent that increases the activity of Wnt pathway, which can be measured by increased TCF/LEF-mediated transcription in a cell. Therefore, a "Wnt agonist" can be a true Wnt agonist that bind and activate a Frizzled receptor family member, including any and all of the Wnt family proteins, an inhibitor of intracellular beta-catenin degradation, and activators of TCF/LEF.
[0064] An "antagonist" refers to an agent that binds to a receptor or protein, and which in turn decreases or eliminates binding by other molecules.
[0065] "Anti-sense" refers to a nucleic acid sequence, regardless of length, that is complementary to the coding strand or mRNA of a nucleic acid sequence. Antisense RNA can be introduced to an individual cell, tissue or organanoid. An anti-sense nucleic acid can contain a modified backbone, for example, phosphorothioate, phosphorodithioate, or other modified backbones known in the art, or may contain non-natural intemucleoside linkages.
[0066] "Biocompatible Matrix" as used herein is a polymeric carrier that is acceptable for administration to humans for the release of therapeutic agents. A Biocompatible Matrix may be a biocompatible gel or foam.
[0067] "Cell Density" as used herein in connection with a specific cell type is the mean number of that cell type per area in a Representative Microscopy Sample. The cell types may include but are not limited to hair follicle stem cells, dermal papilla stem cells, keratinocytes, melanocytes, and bulge cells. The Cell Density may be assessed with a given cell type in a given organ or tissue, including but not limited to, a hair follicle.
[0068] "Complementary nucleic acid sequence" refers to a nucleic acid sequence capable of hybridizing with another nucleic acid sequence comprised of complementary nucleotide base pairs. By "hybridize" is meant pair to form a double-stranded molecule between complementary nucleotide bases (e.g., adenine (A) forms a base pair with thymine (T), as does guanine (G) with cytosine (C) in DNA) under suitable conditions of stringency. (See, e.g., Wahl, G. M. and S. L. Berger (1987) Methods Enzymol. 152:399; Kimmel, A. R. (1987) Methods Enzymol. 152:507).
[0069] "Cross-Sectional Cell Density" as used herein in connection with a specific cell type is the mean number of that cell type per area of cross section through a tissue in a Representative Microscopy Sample. Cross sections of a given tissue can also be used to determine the number of cells in a given plane. Typically, Cross-sectional Cell Density will be measured by analyzing whole mount preparations of a given tissue and counting the number of a given specific cell type across a given distance in cross sections taken along a portion of the epithelia, as described in a Representative Microscopy Sample.
[0070] "Decreasing" or "Decreases" refers to decreasing by at least 5%, for example,
5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 99 or 100%, for example, as compared to the level of reference.
[0071] "Decreases" also means decreases by at least 1-fold, for example, 1, 2, 3, 4, 5,
6, 7, 8, 9, 10, 15, 20, 30, 40, 50, 60, 70, 80, 90, 100, 200, 500, 1000-fold or more, for example, as compared to the level of a reference. [0072] "Dermal Papilla hair follicle culture assay" or "DP hair follicle culture assay" refers to a method of using intact hair follicles to quantify the number of Dermal Papilla (DP) cells or size of the DP area within the follicle when measured at the end of the assay. DP cells are cells that express alkaline phosphatase (AP), and/or Versican, and/or Vimentin, and/or Sox2, and/or CD133. Briefly, microdissection is used to remove intact hair follicles from a specimen. Each hair is trimmed close to the follicle apex and about 3-5 hair follicles are distributed in wells. Culture media with growth factors and/or small molecules are added to the wells, and the follicles are incubated at 37°C. Growth is monitored for one or more desired period of time. EVOS® transmitted light images may be taken at one or more desired period of time. Hair follicles may be processed for alkaline phosphatase staining, 5-ethynyl-2'- deoxy uridine (EdU) staining and/or immunofluorescence to detect markers such as Vimentin, Sox2, Versican, CD133, etc. The total area of a hair follicle staining positive for DP markers may be analyzed and hair shaft growth may be monitored over time. Details of the protocol are provided in the Examples section of the present disclosure.
[0073] "Dermal Papilla stem cell" or "DP stem cell" or "DP cell" refers to a cell in the dermal papilla of a hair follicle having the capacity to self-renew.
[0074] "Differentiation Period" as used herein is the duration of time in which there is an Effective Sternness Driver Concentration.
[0075] "Effective Concentration" may be the "Effective Sternness Driver
Concentration" for a Sternness Driver, "Effective Shh Concentration" for a Shh pathway activator, or "Effective Wnt Agonist Concentration" for a Wnt Agonist.
[0076] "Effective Shh Concentration" is the minimum concentration of a Shh pathway activator that creates a >50% increase in the number of Dermal Papilla (DP) spheroids, size of DP spheroids, or number of DP cells in cell culture when combined with a Sternness Driver, measured at the end of the Stem Cell Proliferation Assay using dermal papilla, compared to the respective increase in the number of Dermal Papilla (DP) spheroids, size of DP spheroids, or number of DP cells in cell culture in absence of a Shh pathway activator with all other components present at the same concentration, measured at the end of the Stem Cell Proliferation Assay using dermal papilla cells. "Effective in vitro Shh Pathway Activation Concentration" refers to the "Effective Shh Concentration" in vitro.
[0077] "Effective Wnt Agonist Concentration" is the minimum concentration of a Wnt pathway agonist that creates a >50% increase in the number of Dermal Papilla (DP) spheroids, size of DP spheroids, or number of DP cells in cell culture, measured at the end of the Stem Cell Proliferation Assay using dermal papilla, compared to the respective increase in the number of Dermal Papilla (DP) spheroids, size of DP spheroids, or number of DP cells in cell culture in the absence of the Wnt pathway agonist with all other components present at the same concentration, measured at the end of the Stem Cell Proliferation Assay using dermal papilla. "Effective in vitro Wnt Agonist Concentration" refers to the "Effective Wnt Agonist Concentration" in vitro.
[0078] "Effective Release Rate" (mass/time) as used herein is the Effective
Concentration (mass/volume) * 30 / 1 hour.
[0079] "Effective Sternness Driver Concentration" is the minimum concentration of a
Sternness Driver that induces at least 50% increase in number of cells of a given cell type in a Stem Cell Proliferation Assay compared to the number of cells of a given cell type in a Stem Cell Proliferation Assay performed without the Sternness Driver and with all other components present at the same concentrations. In certain instances, the 'Effective Sternness Driver Concentration" may be the "Effective Wnt Agonist Concentration".
[0080] "Eliminate" means to decrease to a level that is undetectable.
[0081] "Engraft" or "engraftment" refers to the process of stem or progenitor cell incorporation into a tissue of interest in vivo through contact with existing cells of the tissue. "Epithelial progenitor cell" refers to a multipotent cell which has the potential to become restricted to cell lineages resulting in epithelial cells.
[0082] "Epithelial stem cell" refers to a multipotent cell which has the potential to become committed to multiple cell lineages, including cell lineages resulting in epithelial cells.
[0083] "Fragment" refers to a portion of a polypeptide or nucleic acid molecule. This portion contains, preferably, at least 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, or 90% of the entire length of the reference nucleic acid molecule or polypeptide. A fragment may contain 10, 20, 30, 40, 50, 60, 70, 80, 90, or 100, 200, 300, 400, 500, 600, 700, 800, 900, or 1000 nucleotides or amino acids.
[0084] "GSK3 inhibitor" is a composition that inhibits the activity of GSK3, GSK-
3alpha, and/or GSK-3beta.
[0085] "GSK3beta," "GSK3 ," and "GSK3B" as used interchangeably herein are acronyms for glycogen synthase kinase 3 beta. [0086] "GSK3beta inhibitor" is a composition that inhibits the activity of GSK3beta.
[0087] "Hair follicle stem cell" refers to a multipotent cell in a region of a hair follicle distinct from the dermal papilla that has the capacity to self-renew and to differentiate into multiple cell lineages.
[0088] "Hybridize" refers to pairing to form a double-stranded molecule between complementary nucleotide bases (e.g., adenine (A) forms a base pair with thymine (T), as does guanine (G) with cytosine (C) in DNA) under suitable conditions of stringency. (See, e.g., Wahl, G. M. and S. L. Berger (1987) Methods Enzymol. 152:399; Kimmel, A. R. (1987) Methods Enzymol. 152: 507).
[0089] An "inhibitor" refers to an agent that causes a decrease in the expression or activity of a target gene or protein, respectively. An "antagonist" can be an inhibitor, but is more specifically an agent that binds to a receptor, and which in turn decreases or eliminates binding by other molecules.
[0090] As used herein, an "inhibitory nucleic acid" is a double-stranded RNA, RNA interference, miRNA, siRNA, shRNA, or antisense RNA, or a portion thereof, or a mimetic thereof, that when administered to a mammalian cell results in a decrease in the expression of a target gene. Typically, a nucleic acid inhibitor comprises at least a portion of a target nucleic acid molecule, or an ortholog thereof, or comprises at least a portion of the complementary strand of a target nucleic acid molecule. Typically, expression of a target gene is reduced by 10%, 25%, 50%, 75%, or even 90-100%.
[0091] "Increases" also means increases by at least 1 -fold, for example, 1 , 2, 3, 4, 5, 6,
7, 8, 9, 10, 15, 20, 30, 40, 50, 60, 70, 80, 90, 100, 200, 500, 1000-fold or more, for example, as compared to the level of a as compared to the level of a reference standard.
[0092] "Increasing" refers to increasing by at least 5%, for example, 5, 6, 7, 8, 9, 10,
15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 99, 100% or more, for example, as compared to the level of a reference.
[0093] "Intradermal administration" refers to administration of a medication, pharmaceutical composition or compound into the dermis, just below the epidermis.
[0094] "Isolated" refers to a material that is free to varying degrees from components which normally accompany it as found in its native state. "Isolate" denotes a degree of separation from original source or surroundings. [0095] "Lineage Tracing" as used herein is using a mouse line that enables fate tracing of any cell that expresses a target gene at the time of reporter induction. Examples include Glil, Krtl5, CD34, Lgr5, Lgr6, Lrigl, Sox2, CD133, Vimentin, Versican and/or alkaline phosphatase.
[0096] "Mammal" refers to any mammal including but not limited to human, mouse, rat, sheep, monkey, goat, rabbit, hamster, horse, cow or pig.
[0097] "Mean Release Time" as used herein is the time in which one-half of an agent is released into phosphate buffered saline from a carrier in a Release Assay.
[0098] "Native Morphology" as used herein is means that tissue organization largely reflects the organization in a healthy tissue.
[0099] "Non-human mammal", as used herein, refers to any mammal that is not a human.
[00100] As used in relevant context herein, the term "number" of cells can be 0, 1, or more cells.
[0100] "Organoid" or "epithelial organoid" refers to a cell cluster or aggregate that resembles an organ, or part of an organ, and possesses cell types relevant to that particular organ.
[0101] "Population" of cells refers to any number of cells greater than 1, but is preferably at least 1X103 cells, at least 1X104 cells, at least at least 1X105 cells, at least 1X106 cells, at least 1X107 cells, at least 1X108 cells, at least 1X109 cells, or at least 1X1010 cells.
[0102] "Progenitor cell" as used herein refers to a cell that, like a stem cell, has the tendency to differentiate into a specific type of cell, but is already more specific than a stem cell and is pushed to differentiate into its "target" cell.
[0103] "Reference" means a standard or control condition (e.g., untreated with a test agent or combination of test agents).
[0104] "Release Assay" as used herein is a test in which the rate of release of an agent from a Biocompatible Matrix through dialysis membrane to a saline environment. An exemplary Release Assay may be performed by placing 30 microliters of a composition in 1 ml Phosphate Buffered Saline inside saline dialysis bag with a suitable cutoff, and placing the dialysis bag within 10 mL of Phosphate Buffered Saline at 37 °C. The dialysis membrane size may be chosen based on agent size in order to allow the agent being assessed to exit the membrane. For small molecule release, a 3.5-5 kDa cutoff may be used. The Release Rate for a composition may change over time and may be measured in 1 hour increments.
[0105] "Representative Microscopy Sample" as used herein describes a sufficient number of fields of view within a cell culture system, a portion of extracted tissue, or an entire extracted organ that the average feature size or number being measured can reasonably be said to represent the average feature size or number if all relevant fields were measured. A Representative Microscopy sample can include measurements within a field of view, which can be measured as cells per a given distance. A Representative Microscopy sample can be used to assess morphology, such as cell-cell contacts, hair follicle architecture, and cellular components (e,g. , bundles, synapses).
[0106] "SAG" as used herein for a compound means the compound structure identified as CAS 912545-86-9.
[0107] "SAG HO" as used herein for a compound means the compound structure identified as CAS 912545-86-9 as a hydrochloride salt.
[0108] The term "sample" refers to a volume or mass obtained, provided, and/or subjected to analysis. In some embodiments, a sample is or comprises a tissue sample, cell sample, a fluid sample, and the like. In some embodiments, a sample is taken from (or is) a subject (e.g., a human or animal subject). In some embodiments, a tissue sample is or comprises brain, hair (including roots), buccal swabs, blood, saliva, semen, muscle, or from any internal organs, or cancer, precancerous, or tumor cells associated with any one of these. A fluid may be, but is not limited to, urine, blood, ascites, pleural fluid, spinal fluid, and the like. A body tissue can include, but is not limited to, brain, skin, muscle, endometrial, uterine, and cervical tissue or cancer, precancerous, or tumor cells associated with any one of these. In an embodiment, a body tissue is brain tissue or a brain tumor or cancer. Those of ordinary skill in the art will appreciate that, in some embodiments, a "sample" is a "primary sample" in that it is obtained from a source (e.g., a subject); in some embodiments, a "sample" is the result of processing of a primary sample, for example to remove certain potentially contaminating components and/or to isolate or purify certain components of interest.
[0109] "Self-renewal" refers to the process by which a stem cell divides to generate one (asymmetric division) or two (symmetric division) daughter cells with development potentials that are indistinguishable from those of the mother cell. Self-renewal involves both proliferation and the maintenance of an undifferentiated state. [0110] "siRNA" refers to a double stranded RNA. Optimally, an siRNA is 18, 19, 20,
21, 22, 23 or 24 nucleotides in length and has a 2 base overhang at its 3' end. These dsRNAs can be introduced to an individual cell or culture system. Such siRNAs are used to downregulate mRNA levels or promoter activity.
[0111] "Sonic Hedgehog (Shh) pathway activator" or "Sonic Hedgehog (Shh) activator" refers to a compound or factor that activates the Sonic Hedgehog signaling pathway. Sonic Hedgehog (Shh) pathway activators may be a SMO agonist, Ptchl inhibitor, SUFU inhibitor, activator of GLI1 transcription, or other components such that the Sonic Hedgehog pathway or its interactions, e.g. VEGF, FLkl, MEK, ERK, Notch/Hes, NANOG, SOX2, MYC, MYCN, are increased.
[0112] "Stem cell" refers to a multipotent cell having the capacity to self-renew and to differentiate into multiple cell lineages. "Stem cells of hair follicles" refer to both stem cells found in the dermal papilla of the hair follicle ("dermal papilla stem cells", "DP stem cells" or "DP cells") and stem cells found in another region of the hair follicle ("hair follicle stem cells").
[0113] "Stem Cell Differentiation Assay" as used herein is an assay to determine the differentiation capacity of stem cells.
[0114] "Stem Cell Assay" as used herein is an assay in which a cell or a cell population are tested for a series of criteria to determine whether the cell or cell population are stem cells or enriched in stem cells or stem cell markers. In a stem cell assay, the cell/cell population are tested for stem cell characteristics such as expression of Stem Cell Markers, and further optionally are tested for stem cell function, including the capacity of self-renewal and differentiation.
[0115] "Stem Cell Proliferator" as used herein is a compound or factor that induces an increase in a population of cells which have the capacity for self-renewal and differentiation.
[0116] "Stem Cell Proliferation Assay" as used herein is an assay to determine the capacity for agent(s) to induce the creation of stem cells from a starting cell population. The Stem Cell Proliferation Assay using dermal papilla refers to the increase in the number of Dermal Papilla (DP) spheroids, size of DP spheroids, or number of DP cells at the end of the assay compared to the respective number of Dermal Papilla (DP) spheroids, size of DP spheroids, or number of DP cells at the start of the assay. DP cells refer to cells that express Alkaline Phosphatase (AP), and/or Versican, and/or Vimentin, and/or Sox2, and/or CD133. Briefly, microdissection is used to remove intact hair follicles from a specimen. The cells of the hair follicles are treated with cell dissociation enzymes and strained to obtain a single cell suspension. The single cells are then suspended in media with growth factors, plated at a given cell density in wells and incubated at 37°C. Growth is monitored for one or more desired period of time. EVOS® transmitted light images can be taken. Spheroids can be collected for immunoblotting, qPCR, flow cytometry, and/or applied to glass bottom dishes for alkaline phosphatase staining, 5-ethynyl-2'-deoxyuridine (EdU) staining and/or immunofluorescence to detect markers such as Vimentin, Sox2, Versican, CD133, etc. Details of the protocol are provided in the Examples section of the present disclosure.
[0117] "Stem Cell Markers" as used herein can be defined as gene products (e.g. protein, RNA, etc) that specifically expressed in stem cells. One type of stem cell marker is gene products that are directly and specifically support the maintenance of stem cell identity. Examples include Glil, Krtl5, CD34, Lgr5, Lgr6, Lrigl, Sox2, CD133, Vimentin, Versican and/or alkaline phosphatase. Additional stem cell markers can be identified using assays that were described in the literature. To determine whether a gene is required for maintenance of stem cell identity, gain-of-function and loss-of-function studies can be used. In gain-of- function studies, over expression of specific gene product (the stem cell marker) would help maintain the stem cell identity. While in loss-of-function studies, removal of the stem cell marker would cause loss of the stem cell identity or induced the differentiation of stem cells. Another type of stem cell marker is gene that only expressed in stem cells but does not necessary to have specific function to maintain the identity of stem cells. This type of markers can be identified by comparing the gene expression signature of sorted stem cells and non-stem cells by assays such as micro-array and qPCR. This type of stem cell marker can be found in the literature, (e.g. Liu Q. et al., Int J Biochem Cell Biol. 2015 60:99-111. www.ncbi.nlm.nih.gov/pubmed/25582750). Potential stem cell markers include Ccdcl21, GdflO, Opcml, Phex, etc. The expression of stem cell markers such as CD133 or Sox2 in a given cell or cell population can be measure using assays such as qPCR, immunohistochemistry, western blot, and RNA hybridization. The expression of stem cell markers can also be measured using transgenic cells express reporters which can indicate the expression of the given stem cell markers, e.g. Versican-GFP, CD133-GFP or Sox2-GFP. Flow cytometry analysis can then be used to measure the activity of reporter expression. Fluorescence microscopy can also be used to directly visualize the expression of reporters. The expression of stem cell markers may further be determined using microarray analysis for global gene expression profile analysis. The gene expression profile of a given cell population or purified cell population can be compared with the gene expression profile of the stem cell to determine similarity between the 2 cell populations. Stem cell function can be measured by colony forming assay or sphere forming assay, self-renewal assay and differentiation assay. In colony (or sphere) forming assay, when cultured in appropriate culture media, the stem cell should be able to form colonies, on cell culture surface (e.g. cell culture dish) or embedded in cell culture substrate (e.g. Matrigel) or be able to form spheres when cultured in suspension. In colony/sphere forming assay, single stem cells are seeded at low cell density in appropriate culture media and allowed to proliferate for a given period of time (7-10 days). Colony formed are then counted and scored for stem cell marker expression as an indicator of sternness of the original cell. Optionally, the colonies that formed are then picked and passaged to test its self- renewal and differentiation potential. In self-renewal assay, when cultured in appropriate culture media, the cells should maintain stem cell marker (e.g. CD133) expression over at least one (e.g. 1, 2, 3, 4, 5, 10, 20, etc.) cell divisions. In a Stem Cell Differentiation Assay, when cultured in appropriate differentiation media, the cells should be able to generate hair cell which can be identified by hair cell marker expression measured by qPCR, immunostaining, western blot, RNA hybridization or flow cytometry.
[0118] "Sternness Driver" as used herein is a composition that induces proliferation of cells of a given cell type, upregulates gene(s) or biomarker(s) in cells, or maintains gene or biomarker expression in cells, while maintaining the potential for self-renewal and the potential to differentiate into cells of a given cell type, for example, a hair follicle epithelial cell. Generally, sternness drivers upregulate at least one biomarker of post-natal stem cells. Sternness Drivers include but are not limited to Wnt agonists and GSK3 inhibitors.
[0119] "Subject" includes humans and mammals (e.g., mice, rats, pigs, cats, dogs, and horses). In many embodiments, subjects are mammals, particularly primates, especially humans. In some embodiments, subjects are livestock such as cattle, sheep, goats, cows, swine, and the like; poultry such as chickens, ducks, geese, turkeys, and the like; and domesticated animals particularly pets such as dogs and cats. In some embodiments (e.g., particularly in research contexts) subject mammals will be, for example, rodents (e.g., mice, rats, hamsters), rabbits, primates, or swine such as inbred pigs and the like.
[0120] "Synergy" or "synergistic effect" is an effect which is greater than the sum of each of the effects taken separately; a greater than additive effect. [0121] "TGF Beta inhibitor" as used herein is a composition that reduces activity of
TGF Beta.
[0122] "BMP inhibitor" as used herein is a composition that reduces activity of BMP.
[0123] "Notch activator" as used herein is a composition that increases Notch pathway activity.
[0124] "mTOR" inhibitor" as used herein is a composition that reduces the mechanistic target of rapamycin (mTOR) activity.
[0125] "Tissue" is an ensemble of similar cells from the same origin that together carry out a specific function.
[0126] "Treating" as used herein in connection with a cell population means delivering a substance to the population to effect an outcome. In the case of in vitro populations, the substance may be directly (or even indirectly) delivered to the population. In the case of in vivo populations, the substance may be delivered by administration to the host subject.
[0127] "Wnt activation" as used herein is an activation of the Wnt signaling pathway.
[0128] "Wnt agonist" as used herein is any compound, protein, peptide, or agent that activates the Wnt signaling pathway.
[0129] The term "alkyl" as used herein refers to a straight or branched saturated hydrocarbon. For example, an alkyl group can have 1 to 8 carbon atoms (i.e., (Ci-Cs) alkyl) or
1 to 6 carbon atoms (i.e., (C1-C6 alkyl) or 1 to 4 carbon atoms.
[0130] The term "alkenyl" as used herein refers to a linear or branched hydrocarbon radical which includes one or more double bonds and can include divalent radicals, having from 2 to about 15 carbon atoms. Examples of alkenyl groups include but are not limited to, ethenyl, propenyl, butenyl, and higher homologs and isomers.
[0131] The term "alkynyl" as used herein refers to a linear or branched hydrocarbon radical which includes one or more triple bonds and can include divalent radicals, having from
2 to about 15 carbon atoms. Examples of alkynyl groups include but are not limited to, ethynyl, propynyl, butynyl, and higher homologs and isomers.
[0132] The term "halo" or "halogen" as used herein refers to fluoro, chloro, bromo and iodo. [0133] The term "aryl" as used herein refers to a single all carbon aromatic ring or a multiple condensed all carbon ring system wherein at least one of the rings is aromatic. For example, an aryl group can have 6 to 20 carbon atoms, 6 to 14 carbon atoms, or 6 to 12 carbon atoms. Aryl includes a phenyl radical. Aryl also includes multiple condensed ring systems (e.g., ring systems comprising 2, 3 or 4 rings) having about 9 to 20 carbon atoms in which at least one ring is aromatic and wherein the other rings may be aromatic or not aromatic (i.e., carbocycle). Such multiple condensed ring systems may be optionally substituted with one or more (e.g., 1, 2 or 3) oxo groups on any carbocycle portion of the multiple condensed ring system. The rings of the multiple condensed ring system can be connected to each other via fused, spiro and bridged bonds when allowed by valency requirements. It is to be understood that the point of attachment of a multiple condensed ring system, as defined above, can be at any position of the ring system including an aromatic or a carbocycle portion of the ring.
[0134] The term "heteroaryl" as used herein refers to a single aromatic ring that has at least one atom other than carbon in the ring, wherein the atom is selected from the group consisting of oxygen, nitrogen and sulfur; the term also includes multiple condensed ring systems that have at least one such aromatic ring, which multiple condensed ring systems are further described below. Thus, the term includes single aromatic rings of from about 1 to 6 carbon atoms and about 1-4 heteroatoms selected from the group consisting of oxygen, nitrogen and sulfur in the rings. The sulfur and nitrogen atoms may also be present in an oxidized form provided the ring is aromatic. The term also includes multiple condensed ring systems (e.g., ring systems comprising 2, 3 or 4 rings) wherein a heteroaryl group, as defined above, can be condensed with one or more rings selected from heteroaryls (to form for example a naphthyridinyl such as 1,8-naphthyridinyl), heterocycles, (to form for example a 1,2,3,4- tetrahydronaphthyridinyl such as l,2,3,4-tetrahydro-l,8-naphthyridinyl), carbocycles (to form for example 5,6,7,8-tetrahydroquinolyl) and aryls (to form for example indazolyl) to form the multiple condensed ring system. Thus, a heteroaryl (a single aromatic ring or multiple condensed ring system) has about 1-20 carbon atoms and about 1-6 heteroatoms within the heteroaryl ring. Such multiple condensed ring systems may be optionally substituted with one or more (e.g., 1, 2, 3 or 4) oxo groups on the carbocycle or heterocycle portions of the condensed ring. The rings of the multiple condensed ring system can be connected to each other via fused, spiro and bridged bonds when allowed by valency requirements. It is to be understood that the individual rings of the multiple condensed ring system may be connected in any order relative to one another. It is also to be understood that the point of attachment of a multiple condensed ring system (as defined above for a heteroaryl) can be at any position of the multiple condensed ring system including a heteroaryl, heterocycle, aryl or carbocycle portion of the multiple condensed ring system and at any suitable atom of the multiple condensed ring system including a carbon atom and heteroatom (e.g., a nitrogen).
[0135] The term "cycloalkyl" as used herein refers to a saturated or partially saturated ring structure having about 3 to about 8 ring members that has only carbon atoms as ring atoms and can include divalent radicals. Examples of cycloalkyl groups include but are not limited to, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cyclohexene, cyclopentenyl, cyclohexenyl.
[0136] The terms "heterocyclyl" or "heterocyclic" refer to monocyclic or polycyclic 3 to 24-membered rings containing carbon and heteroatoms selected from oxygen, phosphorous, nitrogen, or sulfur and wherein there are no delocalized π electrons (aromaticity) shared among the ring carbon or heteroatoms. Heterocyclyl rings include, but are not limited to, oxetanyl, azetadinyl, tetrahydrofuranyl, pyrrolidinyl, oxazolinyl, oxazolidinyl, thiazolinyl, thiazolidinyl, pyranyl, thiopyranyl, tetrahydropyranyl, dioxalinyl, piperidinyl, morpholinyl, thiomorpholinyl, thiomorpholinyl S-oxide, thiomorpholinyl S-dioxide, piperazinyl, azepinyl, oxepinyl, diazepinyl, tropanyl, and homotropanyl. A heterocyclyl or heterocycloalkyl ring can also be fused or bridged, e.g., can be a bicyclic ring.
[0137] The use of "or" means "and/or" unless stated otherwise. As used in this application, the term "comprise" and variations of the term, such as "comprising" and "comprises," are not intended to exclude other additives, components, integers or steps. As used in this application, the terms "about" and "approximately" are used as equivalents. Any numerals used in this application with or without about/approximately are meant to cover any normal fluctuations appreciated by one of ordinary skill in the relevant art. In certain embodiments, the term "approximately" or "about" refers to a range of values that fall within 25%, 20%, 19%, 18%, 17%, 16%, 15%, 14%, 13%, 12%, 1 1%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1 %, or less in either direction (greater than or less than) of the stated reference value unless otherwise stated or otherwise evident from the context (except where such number would exceed 100% of a possible value).
[0138] The phrase "pharmaceutically acceptable" is employed herein to refer to those compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio.
[0139] As used herein "pharmaceutically acceptable carrier, diluent or excipient" includes without limitation any adjuvant, carrier, excipient, glidant, sweetening agent, diluent, preservative, dye/colorant, flavor enhancer, surfactant, wetting agent, dispersing agent, suspending agent, stabilizer, isotonic agent, solvent, surfactant, or emulsifier which has been approved by the United States Food and Drug Administration as being acceptable for use in humans or domestic animals. Exemplary pharmaceutically acceptable carriers include, but are not limited to, to sugars, such as lactose, glucose and sucrose; starches, such as corn starch and potato starch; cellulose, and its derivatives, such as sodium carboxymethyl cellulose, ethyl cellulose and cellulose acetate; tragacanth; malt; gelatin; talc; cocoa butter, waxes, animal and vegetable fats, paraffins, silicones, bentonites, silicic acid, zinc oxide; oils, such as peanut oil, cottonseed oil, safflower oil, sesame oil, olive oil, corn oil and soybean oil; glycols, such as propylene glycol; polyols, such as glycerin, sorbitol, mannitol and polyethylene glycol; esters, such as ethyl oleate and ethyl laurate; agar; buffering agents, such as magnesium hydroxide and aluminum hydroxide; alginic acid; pyrogen- free water; isotonic saline; Ringer's solution; ethyl alcohol; phosphate buffer solutions; and any other compatible substances employed in pharmaceutical formulations.
[0140] "Pharmaceutically acceptable salt" includes both acid and base addition salts.
[0141] "Pharmaceutically acceptable acid addition salt" refers to those salts which retain the biological effectiveness and properties of the free bases, which are not biologically or otherwise undesirable, and which are formed with inorganic acids such as, but are not limited to, hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid and the like, and organic acids such as, but not limited to, acetic acid, 2,2-dichloroacetic acid, adipic acid, alginic acid, ascorbic acid, aspartic acid, benzenesulfonic acid, benzoic acid, 4- acetamidobenzoic acid, camphoric acid, camphor- 10-sulfonic acid, capric acid, caproic acid, caprylic acid, carbonic acid, cinnamic acid, citric acid, cyclamic acid, dodecylsulfuric acid, ethane- 1 ,2-disulfonic acid, ethanesulfonic acid, 2-hydroxyethanesulfonic acid, formic acid, fumaric acid, galactaric acid, gentisic acid, glucoheptonic acid, gluconic acid, glucuronic acid, glutamic acid, glutaric acid, 2-oxo-glutaric acid, glycerophosphoric acid, glycolic acid, hippuric acid, isobutyric acid, lactic acid, lactobionic acid, lauric acid, maleic acid, malic acid, malonic acid, mandelic acid, methanesulfonic acid, mucic acid, naphthalene-l,5-disulfonic acid, naphtha! ene-2-sulfonic acid, l-hydroxy-2-naphthoic acid, nicotinic acid, oleic acid, orotic acid, oxalic acid, palmitic acid, pamoic acid, propionic acid, pyroglutamic acid, pyruvic acid, salicylic acid, 4-aminosalicylic acid, sebacic acid, stearic acid, succinic acid, tartaric acid, thiocyanic acid, / toluenesulfonic acid, trifluoroacetic acid, undecylenic acid, and the like.
[0142] "Pharmaceutically acceptable base addition salt" refers to those salts which retain the biological effectiveness and properties of the free acids, which are not biologically or otherwise undesirable. These salts are prepared from addition of an inorganic base or an organic base to the free acid. Salts derived from inorganic bases include, but are not limited to, the sodium, potassium, lithium, ammonium, calcium, magnesium, iron, zinc, copper, manganese, aluminum salts and the like. For example, inorganic salts include, but are not limited to, ammonium, sodium, potassium, calcium, and magnesium salts. Salts derived from organic bases include, but are not limited to, salts of primary, secondary, and tertiary amines, substituted amines including naturally occurring substituted amines, cyclic amines and basic ion exchange resins, such as ammonia, isopropylamine, trimethylamine, diethylamine, triethylamine, tripropylamine, diethanolamine, ethanolamine, deanol, 2- dimethylaminoethanol, 2-diethylaminoethanol, dicyclohexylamine, lysine, arginine, histidine, caffeine, procaine, hydrabamine, choline, betaine, benethamine, benzathine, ethylenediamine, glucosamine, methylglucamine, theobromine, triethanolamine, tromethamine, purines, piperazine, piperidine, N-ethylpiperidine, polyamine resins and the like. Example organic bases used in certain embodiments include isopropylamine, diethylamine, ethanolamine, trimethylamine, dicyclohexylamine, choline and caffeine.
[0143] Wetting agents, emulsifiers and lubricants, such as sodium lauryl sulfate and magnesium stearate, as well as coloring agents, release agents, coating agents, sweetening, flavoring and perfuming agents, preservatives and antioxidants can also be present in the compositions.
[0144] Examples of pharmaceutically-acceptable antioxidants include: (1) water soluble antioxidants, such as ascorbic acid, cysteine hydrochloride, sodium bisulfate, sodium metabisulfite, sodium sulfite and the like; (2) oil-soluble antioxidants, such as ascorbyl palmitate, butylated hydroxyanisole (BHA), butylated hydroxy toluene (BHT), lecithin, propyl gallate, alpha-tocopherol, and the like; and (3) metal chelating agents, such as citric acid, ethylenediamine tetraacetic acid (EDTA), sorbitol, tartaric acid, phosphoric acid, and the like.
[0145] Compounds or compositions described herein can be formulated in any manner suitable for a desired delivery route, e.g., transtympanic injection, transtympanic wicks and catheters, and injectable depots. Typically, formulations include all physiologically acceptable compositions incuding derivatives or prodrugs, solvates, stereoisomers, racemates, or tautomers thereof with any physiologically acceptable carriers, diluents, and/or excipients.
DETAILED DESCRIPTION OF THE INVENTION
[0146] A description of example embodiments of the disclosure follows.
[0147] The present disclosure relates to a method of expanding a population of stem cells of hair follicles, said method comprising contacting the stem cells with one or more stem cell proliferator, wherein the one or more stem cell proliferator is one or more Sonic Hedgehog pathway (Shh) activator and one or more Wnt agonist.
[0148] In another aspect, the present disclosure relates to a method of facilitating the generation of hair follicle epithelial cells, the method comprising treating stem cells of hair follicles with one or more Sonic Hedgehog pathway (Shh) activator and one or more Wnt agonist.
[0149] In one embodiment, the stem cells are dermal papilla stem cells. In another embodiment, the stem cells are hair follicle stem cells. In some embodiments, the stem cells comprise keratinocytes, melanocytes, dermal papilla cells, bulge cells, or a combination thereof. In some embodiments, the stem cells are in a subject.
[0150] In certain embodiments, therefore, the present disclosure provides methods to induce self-renewal of a population of stem cells in hair follicles by activating the Shh pathway and the Wnt pathway. Preferably, the pathways are activated with small molecules or proteins. For example, a compound when applied in vitro to dermal papilla (DP) stem cells in hair follicles induces the DP stem cells to proliferate to a high degree and in high purity in a Stem Cell Proliferation Assay using dermal papilla cells, and also allows an increase in the number of DP cells and/or DP area within a hair follicle in a DP hair follicle culture assay. In one such embodiment, the one or more Shh pathway activator and one or more Wnt agonist induces and maintains stem cell properties by producing stem cells that can divide and maintain the ability to have a high proportion of the resulting cells differentiate into cells of the hair follicle. Further, the proliferating stem cells express stem cell markers which may include one or more of Glil, Krtl5, CD34, Lgr5, Lgr6, Lrigl, Sox2, CD133, Vimentin, Versican and/or alkaline phosphatase. [0151] In another aspect, the present disclosure provides a method of treating a subject who has, or is at risk of developing, a disease associated with absence or lack of hair follicle epithelial cells, the method comprising administering to said subject one or more Sonic Hedgehog pathway (Shh) activator and one or more Wnt agonist. In some embodiments, the disease is selected from telogen effluvium, anagen effluvium, androgenetic alopecia, alopecia areata, tinea capitis, lichen planopilaris, cicatricial alopecia, discoid lupus erythematosus, folliculitis decalvans, dissecting cellulitis of the scalp, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, trichotillomania, traction alopecia, and hypotrichosis.
[0152] In another aspect, the present disclosure provides a method of treating a subject who has, or is at risk of developing, alopecia, the method comprising administering to said subject one or more Sonic Hedgehog pathway (Shh) activator and one or more Wnt agonist.
[0153] In yet another aspect, the present disclosure provides a pharmaceutical composition comprising: a pharmaceutically-acceptable carrier and (i) a Wnt agonist, or a pharmaceutically-acceptable salt thereof, and (ii) a Sonic Hedgehog (Shh) pathway activator, or a pharmaceutically-acceptable salt thereof.
[0154] In some embodiments of the methods and compositions disclosed herein, the one or more Shh pathway activator is at a concentration of about 5x to about lOOOx of an effective in vitro Shh pathway activation concentration. In certain embodiments, the one or more Shh pathway activator is at a concentration of about lOx to about lOOx of an effective in vitro Shh pathway activation concentration. In some embodiments, the one or more Shh pathway activator is at a concentration of about 20x to about 5 Ox of an effective in vitro Shh pathway activation concentration. In certain embodiments, the one or more Wnt agonist is at a concentration of about 5x to about 1 OOOx of an effective in vitro Wnt agonist concentration. In some embodiments, the one or more Wnt agonist is at a concentration of about lOx to about lOOx of an effective in vitro Wnt agonist concentration. In some embodiments, the one or more Wnt agonist is at a concentration of about 20x to about 50x of an effective in vitro Wnt agonist concentration.
[0155] In some embodiments of the methods and compositions disclosed herein, the
Shh pathway activator comprises a Smoothened agonist. In other embodiments, the Shh pathway activator comprises Smoothened ciliary accumulation enhancers. In some embodiments of the methods and compositions disclosed herein, the one or more Shh pathway activator is selected from the group consisting of a SAG, an oxysterol, a Purmorphamine analogue, a GSA-10 analogue, polydatin, glucocorticoids, hedgehog polypeptides, inositol derivatives, sterols, peroxiredoxin 2, RACK1, Dhh, and Ihh. In some embodiments, the one or more Shh pathway activator is selected from Table 1. In some embodiments, the one or more Shh pathway activator is selected from Table 2. In certain embodiments, the one or more Shh pathway activator is Purmo hamine (CAS 483367-10-8). In further embodiments of the methods and compositions disclosed herein, the one or more Shh pathway activator is selected from Purmorphamine, SAG, 20-alpha hydroxy cholesterol, and SAG HC1.
[0156] Table 1. Exemplary Shh pathway activators for use in compositions and methods of the present disclosure
Figure imgf000038_0001
Compounds 35 PLoS Biol (2016) 14(2):
SAG (HH-Ag) 566172-68-7
(Cis/trans) el 002375
PLoS Biol (2016) 14(2):
SAG (HH-Ag) Compounds 35 (Trans) 1186398-30-0
el 002375
PLoS Biol (2016) 14(2):
SAG (HH-Ag) Compounds 36 946002-48-8
el 002375
STEROLS US 2008/013319
Compound 35 ACS Med. Chem. Lett.
STEROLS 27241-03-8
(0.54-0.65 μΜ) (2012) 3(10): 828-833
Journal of Cellular
STEROLS Oxy34 24339-14-8 Biochemistry (2011)
112(6): 1673-1684
Bioorganic & Medicinal Chemistry Letters (2012)
STEROLS Oxy49 (3 μΜ) 1059591-82-0 22(18): 5893-5897;
ACS Med. Chem. Lett. 2012, 3, 828-833
20(S)- Biomaterials (2014)
STEROLS 516-72-3
hy droxy cholesterol 35(26): 7336-7345
PLoS One (2015) 10(12): e0144550;
STEROLS Halcinonide 3093-35-4
PNAS (2010) 107(20): 9323-9328
PLoS One (2015) 10(12): e0144550;
STEROLS Clobetasol 25122-41-2
PNAS (2010) 107(20): 9323-9328
PLoS One (2015) 10(12): e0144550;
STEROLS Fluticasone 90566-53-3
PNAS (2010) 107(20): 9323-9328
STEROLS PNAS (2010) 107(20):
Fluocinonide 356-12-7
9323-9328
Triamcinolone ChemMedChem (2014)
STEROLS 76-25-5
acetonide 9(1): 27-37
Purmorphamine
Analogues
Biomaterials (2014)
35(26): 7336-7345;
Purmorphamine Purmorphamine 483367-10-8 Chem. Biol. (2004) 11(9):
1229-1238;
JACS (2002) 124(49):
14520-14521 ChemMedChem (2014)
9(1): 27-37;
Purmorphamine Compound 40 841221-62-3
Cells Tissues Organs (2012) 197(2): 89- 102
ChemMedChem (2014) 9(1): 27-37;
Purmorphamine Compound 38 1394159-22-8
Cells Tissues Organs (2012) 197(2): 89- 102
Molecules and Cells
Purmorphamine 96547 (#70) 1160569-67-4
(2008), 26(4): 380-386
GSA-10 Analogues
European Journal of Medicinal
Chemistry (2016) 121 :
GSA-10 GSA-10 300833-95-8
747-757;
Molecular Pharmacology (2013) 84(2): 303
European Journal of Medicinal
GSA-10 Compound 11 353777-56-7
Chemistry (2016) 121 : 747-757
European Journal of
GSA-10 Compound 20 1990524-02-1 Medicinal
Chemistry (2016) 121 : 747-757
European Journal of
GSA-10 Compound 35 331963-09-8 Medicinal
Chemistry (2016) 121 : 747-757
European Journal of Medicinal
GSA-10 Compound 12 300837-51-8
Chemistry (2016) 121 : 747-757
Polydatin
Polydatin, a glucoside Food and Chemical
Polydatin 65914-17-2
of resveratrol Toxicology (2016), 96:
215-225
PI4P Cell Chemical Biology phosphatidylinositol 4- (2017) 24(3): 252-280;
PI4P
phosphate (PI4P)
PLoS Biol (2016) 14(2): el 002375
Patents
CAS
number or
Assignee
Shh pathway
activator
SAG (HH-Ag) CUR-0201365 946047-59-2 US2010/038833
SAG (HH-Ag) CUR-0236715 946048-09-5 US2010/038833
SAG (HH-Ag) CUR-0201784 946047-85-4 US2010/038833
SAG (HH-Ag) Curis HH-Ag WO 2001/074344 A2
SAG (HH-Ag) Curis HH-Ag WO 2008/057468 Al
SAG (HH-Ag) Curis HH-Ag WO 2008/057469 Al
SAG (HH-Ag) Curis HH-Ag WO 2008/057497 A2
SAG (HH-Ag) Curis HH-Ag US 2002/0198236 Al
SAG (HH-Ag) Curis HH-Ag US 2003/0139457 Al
Aderans Research
SAG (HH-Ag) HH-Ag WO 2010/148094 Al
Institute
Aderans Research
SAG (HH-Ag) HH-Ag US 2012/0095445
Institute
GSA-10 Centre National de la GSA-10
US 8957091 B2 Recherche Scientifique analogues
GSA-10 Centre National de la GSA-10
US 2012/0121693 Al Recherche Scientifique analogues
GSA-10 Centre National de la GSA-10
US 2013/0236912 Al Recherche Scientifique analogues
GSA-10 Centre National de la GSA-10
WO 2012/066479 Al Recherche Scientifique analogues
Sterols THE REGENTS OF
THE UNIVERSITY Oxysterols US 9526737 B2 OF CALIFORNIA
Sterols THE REGENTS OF
THE UNIVERSITY Oxysterols WO 2008/115469 A2 OF CALIFORNIA
Sterols THE REGENTS OF
THE UNIVERSITY Oxysterols WO 2009/073186 Al OF CALIFORNIA Sterols THE REGENTS OF
THE UNIVERSITY Oxysterols WO 2014/179756 Al OF CALIFORNIA
Sterols Fate Therapeutics Oxysterols WO 2012/024581 A2
Sterols Fate Therapeutics Oxysterols WO 2012/024583 A2
Sterols Fate Therapeutics Oxysterols WO 2012/024584 A2
Glucocorticoid
Sterols Duke WO 2011/109711 Al s
Hedge Hog
Peptides Elizabeth Wang US 2002/0151460 Al
Polypeptides
Hedge Hog
Peptides Ontogeny WO 99/20298 Al
Polypeptides
Hedge Hog
Peptides Strasspharma WO 2014/085523 Al
Polypeptides
Purmorphamin
Purmorphamine Scripps and IRM US 2004/0157864 Al e
Purmorphamin
Purmorphamine Biomatcell WO 2012/115575 Al e
HH-Ag HH-Ag US 2005/0070578 Al
Barbara Brooke Inositol
PI4P US 2009/0214474 Al
Jennings Derivatives
Sterols Sterols WO 00/41545 A2
Proteins
Oncotarget (2016) 7(52):
Proteins Peroxiredoxin 2
86816-86828
Journal of Biological
Proteins RACK1 Chemistry (2012)
287(11): 7845-7858
Journal of Biology
Desert Hedgehog
Proteins (2002). Agonizing
(Dhh)
Hedgehog. 1(2): 7
Journal of Biology
Proteins Indian Hedgehog (Ihh) (2002). Agonizing
Hedgehog. 1(2): 7
[0157] In some embodiments of the methods and compositions disclosed herein, the one or more SAG compounds is a compound of Formula II:
Figure imgf000043_0001
[0158] Formula 11
[0159] wherein R is independently one or more -H, halogen, -Ci-Cioalkyl, -C3- Ciocycloalkyl, -OCi-Cioalkyl, -CN, Aryl, Substituted Aryl, Heteroaryl, Substituted Heteroaryl; wherein the substitution can one or more -H, halogen, -OH, -OCi-C6alkyl, -Ci-C6alkyl, -CN, NH2, -NHS02-Ci-C6alkyl, -NHCO-Ci-Cealkyl, -S02-Ci-C6alkyl, -CONH2, -CONH-Ci- Cealkyl, COOH, -COO-Ci-Cealkyl;
[0160] wherein R1 is independently one or more -H, halogen, -Ci-C3alkyl, -OH, -O-Ci- C3 alkyl.
[0161] Table 2. Exemplary Shh pathway activators for use in compositions and methods of the present disclosure
Figure imgf000043_0002
[0162] Classes of Wnt agonist (Wnt activator) for use in various embodiments of the compositions and methods disclosed herein include but are not limited to those listed in Column A of Table 3. Specific Wnt agonists for use in various embodiments of the compositions and methods disclosed herein include but are not limited to those listed in Column B of Table 3. All agents listed in Table 3 column B are understood to include derivatives or pharmaceutically-acceptable salts thereof. All classes listed in Table 3 column A are understood to include both agents comprising that class and derivatives or pharmaceutically-acceptable salts thereof.
[0163] Table 3. Exemplary Wnt agonists (Wnt activators) for use in compositions and methods of the present disclosure
Figure imgf000044_0001
Wnt agonists
Column A Column B CAS Number sFRP-1 inhibitor WAY 316606 915759-45-4
(Dimethylamino)propyl)-2-ethyl-5-
(phenylsulfonyl)benzenesulfonami
de 915754-88-0
Cyclosporine A (CsA) 59865-13-3
PSC833 (Valspodar) 121584-18-7
Cyclosporine analogs
DKKl inhibitor WAY-262611 1123231-07-1
Axin HLY78 854847-61-3
Axin SKL2001 909089-13-0
Cpdl 1357473-75-6
Cpd2 1228659-47-9 van-Gogh-like receptor
proteins (Vangl) Compound 109 1314885-81-8
Disrupts the Axin Complex ISX 9 832115-62-5
Compound 71 1622429-71-3
Compound 2 1360540-82-4
MEK Selumetinib (AZD6244) 606143-52-6
Radicicol 12772-57-5
WO 2016029021 Al
Target Undetermined Diketones ; WO 2012024404
Al
Diketones 1622429-56-4
Diketones 1360540-88-0
Diketones 1360540-89-1
Diketones 1622429-79-1
Diketones 1622429-75-7
Diketones 1622429-74-6
Diketones 1622430-76-5
Diketones 1622430-31-2
Diketones 1622430-52-7
Diketones 1622429-67-7
Diketones 1622429-65-5
Diketones 1622429-69-9
[0164] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt activator or agonist is one or more GSK inhibitor. In certain embodiments, the GSK inhibitor is a GSK3-beta inhibitor. Classes of GSK3-beta inhibitor for use in various embodiments of the compositions and methods disclosed herein include, but are not limited to, those listed in Column A of Table 4. Specific GSK3-beta inhibitors for use in various embodiments of the compositions and methods disclosed herein include but are not limited to those listed in Column B of Table 4. All agents listed in Table 4 column B are understood to include derivatives or pharmaceutically-acceptable salts thereof. All classes listed in Table 4 column A are understood to include both agents comprising that class and derivatives or pharmaceutically-acceptable salts thereof.
[0165] Table 4. Exemplary GSK-beta inhibitors for use in compositions and methods of the present disclosure
Figure imgf000046_0001
Table 4. GSI^ Inhibitors
Column A Column B CAS Number
Class Agent
5-lodo-indirubin-3'-
Indirubins monoxime 331467-03-9 lndirubin-5-sulfonic
Indirubins acid sodium salt 331467-05-1
Indirubins Indirubin 479-41-4
Indirubins GSK-3 Inhibitor X 740841-15-0
Inorganic atom Lithium Chloride
Inorganic atom Beryllium
Inorganic atom Zinc
Inorganic atom Tungstate
Isonicotinamides Compound 39 1772824-10-8
Isonicotinamides Compound 29 1772823-37-6
Isonicotinamides Compound 33 1772823-64-9
Azaindolylmaleimide Compound 29 436866-61-4
Azaindolylmaleimide Compound 46 682807-74-5
Bisindolylmaleimide Compound 5a 436866-54-5
Bisindolylmaleimide GF109203x 176504-36-2
Bisindolylmaleimide Ro318220 125314-64-9
Bisindolylmaleimide X
Bisindolylmaleimide HCI 131848-97-0
Enzastaurin
Bisindolylmaleimide (LY317615) 170364-57-5
Maleimide 15 264217-24-5
Maleimide SB-216763 280744-09-4
Maleimide SB-415286 (SB-41528) 264218-23-7
Maleimide 3F8 159109-11-2
Maleimide TCS 21311 1260181-14-3
Maleimide GSK-3 inhibitor 1 603272-51-1
Maleimide LY2090314 603288-22-8
Maleimide 603281-31-8 603281-31-8
Maleimide I M-12 1129669-05-1
Maleimide Compound 34 396091-16-0
Maleimide KT 5720 108068-98-0
Maleimide Isogranulatimide 244148-46-7
Maleimide GSK^ Inhibitor XI 626604-39-5
Maleimide BIP-135 941575-71-9
Maleimide CP21R7 125314-13-8
Maleimide Tivantinib 905854-02-6
Organometallic Compound lambda- 1291104-51-2,
OS1 1292843-11-8
Organometallic H B12 800384-87-6
Organometallic DW12 861251-33-4
Organometallic N P309 937810-13-4 Table 4. GSI^ Inhibitors
Column A Column B CAS Number
Class Agent
Organometallic (RRu)-HB1229
Organometallic (RRu)-NP549
Compound 3 1498285-39-4,
Organometallic 1498285-48-5
Organometallic Compound (R)-DW12 1047684-07-0
Isoindolone Staurosporine 62996-74-1
GSK-3beta Inhibitor
Pyrazolone XXVI 871843-09-3
Manzamines Manzamine A 104196-68-1
Oxadiazol TC-G 24 1257256-44-2
Oxadiazol Compound 14d 1374671-64-3
Oxadiazol Compound 15b 1374671-66-5
Oxadiazol Compound 20x 1005201-80-8
Oxadiazol GSK-3 Inhibitor II 478482-75-6
Oxadiazol GSK3 Inhibitor, 2 1377154-01-2
Oxindole SU9516 77090-84-1
Oxindole AZD1080 612487-72-6
Paullone Kenpaullone 142273-20-9
Paullone Cmpd 17b 408532-42-3
Paullones Azakenpaullone 676596-65-9
Paullones Alsterpaullone 237430-03-4
Alsterpaullone CN
Paullones Ethyl 852529-97-0
Paullones Cazpaullone 914088-64-5
Peptide FRATtide
Peptide L803
Peptides L803-mts
Pyrazole GSK-3 Inhibitor XXI I 1195901-31-5
Pyrazole Compound 4a 1627557-91-8
Pyrazole Compound 4t 1627558-10-4
Pyrazole Compound 4z 1627558-16-0
Pyrazole AT 7519 844442-38-2
Pyrazolopyridine Pyrazolopyridine 9 923029-74-7
Pyrazolopyridine Pyrazolopyridine 18 405221-39-8
Pyrazolopyridine Pyrazolopyridine 34 583039-27-4
Pyrazolopyridines Compound 14 583038-63-5
Pyrazolopyridines Compound 23 583038-76-0
Pyrazolopyridines Compound 14 583038-63-5
Pyrazolopyridazines Compound 18 405223-20-3
Pyrazolopyridazines Compound 19 405223-71-4
NSC 693868
Pyrazoloquinoxaline (Compound 1) 40254-90-8 Table 4. GSI^ Inhibitors
Column A Column B CAS Number
Class Agent
Pyridinone Compound 150 1282042-18-5
Quinazolin GSK-3 Inhibitor XI I I 404828-08-6
Quinolinecarb VP0.7 331963-23-6
Quinolinecarboxamide 1132813-46-7
Quinolinecarboxamide 1132812-98-6
Quinolinecarboxamide 950727-66-9
NSC 693868
Pyrazoloquinoxaline (Compound 1) 40254-90-8
Halomethylketones Compound 17 62673-69-2
Halomethylketones GSK-3 β Inhibitor VI I 99-73-0
Halomethylketones GSK^ Inhibitor VI 62673-69-2
Furanosesquiterpenes Palinurin 254901-27-4
Furanosesquiterpenes Tricantin 853885-55-9
Thiadiazolidindiones GSK^ Inhibitor 1 327036-89-5
Thiadiazolidindiones N P031115 1400575-57-6
Thiadiazolidindiones N P031112 (Tideglusib) 865854-05-3
Triazolpyrimidine Compound 90 91322-11-1
Triazolpyrimidine Compound 92 1043429-30-6
GSK^ Inh. VI I I AR-
Urea A014418 487021-52-3
Urea A-1070722 1384424-80-9
Pyrrolopyridinyl Compound 27 2025388-25-2
Pyrrolopyridinyl Compound 12 2025388-10-5
Publication N P-103 No Structure
Publication CG-301338 No Structure
Publication SAR 502250 No Structure
Publication XD-4241 No Structure
Publication CEP-16805 No Structure
Publication AZ13282107 No Structure
Publication SAR 502250 (Sanofi) 1073653-58-3
Publication AR79
Publication AZ13282107
Patent GI 179186X
Patent CT118637
Patent CP-70949
Patent GW784752X
Patent GW784775X
Publication CT73911
Publication LY2064827
Publication 705701
Publication 708244 Table 4. GSI^ Inhibitors
Column A Column B CAS Number
Class Agent
Publication 709125
Patent WO 2008077138 Al
Patent WO 2003037891 Al
Patent US 8207216 B2
Patent US 8071591 B2
Patent CN 1319968 C
Patent US 7514445 B2
Patent CN 101341138 B
Patent EP 1961748 A2
Patent WO 2010104205 Al
Patent US 20100292205 Al
Patent WO 2014003098 Al
Patent WO 2011089416 Al
Patent EP 1739087 Al
Patent WO 2001085685 Al
Patent US 20070088080 Al
Patent WO 2006018633 Al
Patent WO 2009017453 Al
Patent WO 2014050779 Al
Patent WO2006100490A1/EP
1863904 Al
Patent WO 2014013255 Al
Patent WO2009017455 Al
Patent EP 2765188 Al
Patent WO 2014083132 Al
Patent US 8771754 B2
Patent WO 2013124413 Al
Patent WO 2014059383 Al
Patent WO 2010075551 Al
Patent US 8686042 B2
Patent WO 2007102770 Al
J. Med. Chem. 2016, 59, 9018-9034
[0166] In some embodiments of the methods and compositions disclosed herein, the one or more Wnt activator or agonist is one or more GSK inhibitor. In certain embodiments, the GSK inhibitor is a GSK3-alpha inhibitor. Classes of GSK3-alpha inhibitor for use in various embodiments of the compositions and methods disclosed herein include, but are not limited to, those listed in Column A of Table 5. Specific GSK3-alpha inhibitors for use in various embodiments of the compositions and methods disclosed herein include but are not limited to those listed in Column B of Table 5. All agents listed in Table 5 column B are understood to include derivatives or pharmaceutically-acceptable salts thereof. All classes listed in Table 5 column A are understood to include both agents comprising that class and derivatives or pharmaceutically-acceptable salts thereof.
[0167] Table 5. Exemplary GSK3-alpha inhibitors for use in compositions and methods of the present disclosure
Figure imgf000051_0001
Organometallic Compound lambda- 1291104-51- 0.9 6 6.8 OS 1 2 1292843- 11-8
Organometallic Compound 3 1498285-39- 3 10 3.3
4 1498285- 48-5
Organometallic Compound (R)- 1047684-07- 0.5 1 2
DW12 0
Pyrazolo- BRD4003 chiral 1597439-60- 4800 10,200 2.1 tetrahydroquinolinon 5
e
Pyrazolo- BRD4003 chiral 1597439-59- 161 232 1.4 tetrahydroquinolinon 2
e
Pyrazolo- Compound 8 1597439-01- 18 87 4.8 tetrahydroquinolinon 4
e
Pyrazolo- Compound 9 1597439-02- 62 156 2.5 tetrahydroquinolinon 5
e 2056261-29- 9
Pyrazolo- Compound 11 1597439-12- 32 102 3.2 tetrahydroquinolinon 7
e
Pyrazolo- BRD1172 1597438-86- 3 10 3.3 tetrahydroquinolinon 2
e
Pyrazolo- Compound 16 1597440-17- 8 26 3.2 tetrahydroquinolinon 9
e
Pyrazolo- BRD1652 1597438-93- 0.4 4 10 tetrahydroquinolinon 1
e
Urea AR-A014418 487021-52-3 28 116 4.1
CREB knockdown
ACS Chem. Biol. (2016) 11: 1952-1963
PLoS One (2016) 11(4): e0153075
[0168] In certain embodiments of the methods and compositions described herein, the GSK3 inhibitor is selected from the group consisting of Valproic Acid Sodium Salt, CT20026, CHIR99021 (CT99021), CHIR98014 (CT98014), CHIR98023 (CT98023), CHIR98024 (CT98024), TCS 2002, Compound 39, Compound 29, Compound 33, TCS 21311, LY2090314, 603281-31-8, Compound 34, Compound 14d, Compound 15b, Compound 20x, AZD-1080, Kenpaullone, Cazpaullone, GSK-3 Inhibitor XXII, Compound 4a, Compound 4t, Compound 4z, Pyrazolopyridine 9, Compound 14, Compound 23, Compound 14, Compound 18, and Compound 19. [0169] In certain embodiments of the methods and compositions described herein, the GSK3 inhibitor is selected from the group consisting of Valproic Acid Sodium Salt, CHIR99021 (CT99021), CHIR98014 (CT98014), CHIR98023 (CT98023), CHIR98024 (CT98024), Compound 39, Compound 29, LY2090314, 603281-31-8, Compound 34, Compound 14d, Compound 15b, Compound 20x, AZD-1080, Cazpaullone, GSK-3 Inhibitor XXII, Compound 4t, Compound 4z, Pyrazolopyridine 9, Compound 14, Compound 23, Compound 14, Compound 18, and Compound 19.
[0170] In some embodiments of the methods and compositions described herein, the one or more GSK inhibitor is a compound of Formula (I),
Figure imgf000053_0001
and pharmaceutically acceptable salts and tautomers thereof, wherein Q1, Q2, Q3, R1, R2, R3, Ar, -Z-W-X-Y- and m are as defined above for Formula I.
[0171] In some embodiments of the methods and compositions disclosed herein, the compounds of Formula I have one or more of the following features:
a) provided that the compound is not
Figure imgf000053_0002
Figure imgf000054_0001
[0172] In certain embodiments, the present disclosure provides a compound of formula (I) for use in the methods disclosed herein and that is not disclosed in WO 2003/076442 (PCT/US03/05050), which is incorporated herein by reference.
[0173] In certain embodiments of formula (I), Rx is -CORxl or -S02RX1.
Figure imgf000054_0002
O , and O [0175] In certain embodiments, RX1 is heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents that is halo. In certain embodiments, RX1 is heterocyclic which is deuterated. In certain embodiments, the heterocyclic is monocyclic or bicyclic. In certain embodiments, the heterocyclic contains one to three nitrogens (i.e., 1, 2, or 3 nitrogens) and/ or one to three oxygens (i.e., 1, 2, or 3 oxygens). In certain embodiments, the heterocyclic contains one nitrogen and/ or one oxygen. In certain embodiments, the heterocyclic contains one nitrogen. In certain embodiments, the heterocyclic contains two nitrogens. In certain embodiments, the heterocyclic contains one nitrogen and one oxygen.
[0176] In certain embodiments, RX1 is piperidine or 8-oxa-3-azabicyclo[3.2.1]octane, both optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, Ci-C4alkyl, -(CH2)P-OH, -(CH2)P-NH2; wherein p is 1, 2, or 3. In certain embodiments, RX1 is piperidine, optionally substituted with one to two halo substituents. In certain embodiments, RX1 is piperidine, optionally substituted with - (CH2)p-OH.
[0177] In certain embodiments of formula (I), the heterocyclic is optionally substituted with Ci-C4alkyl, -(CH2)P-OH, or -(CH2)P-NH2; wherein p is 1, 2, or 3. In certain embodiments, RX1 is heterocyclic substituted with Ci-C4alkyl. In certain embodiments, RX1 is heterocyclic substituted with -(CH2)p-OH; wherein p is 1, 2, or 3. In certain embodiments, RX1 is heterocyclic substituted with -CH2-OH. In certain embodiments, RX1 is heterocyclic substituted with -(CH2)P-NH2; wherein p is 1, 2, or 3. In certain embodiments, RX1 is heterocyclic substituted with -CH2-NH2.
[0178] In certain embodiments of formula (I), RX1 is heterocyclic, wherein the heterocyclic is optionally substituted with -[C(Rxla)2]P-CN. In certain embodiments, RX1 is heterocyclic substituted with -[C(Rxla)2]P-OH, -[C(Rxla)2]P-0-Ci-C4alkyl, -NHCOCi- C4alkyl, -CONHCi-C4alkyl, COH, -CO2H, -[C(Rxla)2]P-COO-Ci-C4alkyl, -[C(Rxla)2]P-NH2, -[C(Rxla)2]P-NH-Ci-C4alkyl, or -[C(Rxla)2]P-N-(Ci-C4alkyl)2. In certain embodiments, RX1 is heterocyclic, wherein the heterocyclic is optionally substituted with -CONHCi-C4alkyl, - COH, -CO2H, or -[C(Rxla)2]P-COO-Ci-C4alkyl. [0179] In certain embodiments of formula (I), each Rxla is independently selected from the group consisting of hydrogen and halo. In certain embodiments, both Rxla groups together form C3-C6cycloalkyl, such as cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
[0180] In certain embodiments of formula (I), Rx is heteroaryl. In certain embodiments, the heteroaryl is monocyclic or bicyclic. In certain embodiments, the heteroaryl contains one to three nitrogens (i.e., 1, 2, or 3 nitrogens) and/ or one to three oxygens (i.e., 1, 2, or 3 oxygens). In certain embodiments, the heteroaryl contains one nitrogen and/ or one oxygen. In certain embodiments, the heteroaryl contains one nitrogen. In certain embodiments, the heteroaryl contains two nitrogens. eteroaryl contains one
Figure imgf000056_0001
nitrogen and one oxygen. In certain embodiments, R is
[0181] In certain embodiments of formula (I), Rx is -(Ci-C4alkylene)-(C3-C8cycloalkyl). In certain embodiments, the-(Ci-C4alkylene)-(C3-C8cycloalkyl) is substituted with one to two halo on the Ci-C4alkylene. In certain embodiments, the C3-Cscycloalkyl is cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl. In certain embodiments, Rx is -(Ci-C4alkylene)-(C3- C8cycloalkyl), wherein the -(Ci-C4alkylene)-(C3-C8cycloalkyl) is optionally substituted with one or two halo on the Ci-C4alkylene and wherein C3-C8cycloalkyl is cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl. In certain embodiments, Rx
Figure imgf000056_0002
[0182] In some embodiments of the methods and compositions disclosed herein, the one or more GSK inhibitor is a compound having the Formula (la),
Figure imgf000056_0003
and pharmaceutically acceptable salts and tautomers thereof, wherein Q1, Q2, Q3, R1, R2, R3, Ar, -Z-W-X-Y- and m are as defined above for Formula (la).
[0183] In some embodiments of the methods and compositions disclosed herein, the one or more GSK inhibitor is a compound having the Formula (lb),
Figure imgf000057_0001
and pharmaceutically acceptable salts and tautomers thereof, wherein Q1, Q2, Q3, R1, R2, R3, Ar, -Z-W-X-Y- and m are as defined above for Formula (lb).
[0184] In certain embodiments, Q1 is CH; Q2 is N; and Q3 is C. In certain embodiments, Q1 is N; Q2 is C; and Q3 is N. In certain embodiments, Q1 is CH; Q2 is C; and Q3 is N. In certain embodiments, 1 is N; Q2 is N; and Q3 is C.
[0185]
Figure imgf000057_0002
selected from the roup
consisting of
Figure imgf000057_0003
[0186] In certain embodiments, R1 is hydrogen or halo. In certain embodiments, R1 is Ci-C4alkyl, wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH. In certain embodiments, R1 is Ci-C4alkynyl, -CN, -OH, or -S(0)2NH2. In certain embodiments, R1 is -NH2 or - NHC(0)Rla, wherein Rla is Ci-C4alkyl. In certain embodiments, R1 is Ci-C4alkenyl. In certain embodiments, R1 is -0-Ci-C4alkyl.
[0187] In certain embodiments, R2 is hydrogen or halo. In certain embodiments, R2 is Ci-C4alkyl, wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH. In certain embodiments, R2 is Ci-C4alkynyl, -CN, -OH, or -S(0)2NH2. In certain embodiments, R2 is -NH2 or - NHC(0)R2a, wherein R2a is Ci-C4alkyl. In certain embodiments, R2 is -S(0)2NH2. [0188] In certain embodiments, R2 is Ci-C4alkenyl. In certain embodiments, R2 is -O- Ci-C4alkyl. In certain embodiments, R2 is -NH2, -NH(Ci-C4alkyl), or -N(Ci-C4alkyl)2.
[0189] In certain embodiments, R2 is selected from the group consisting of halo, Ci- C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl, -CN, -OH, -0-Ci-C4alkyl, -NH2, -NH(Ci-C4alkyl), - N(Ci-C4alkyl)2, -NHC(0)R2a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R2a is Ci-C4alkyl. In certain embodiments, R2 is selected from the group consisting of halo, Ci-C4alkyl, Ci-C4alkynyl, -CN, -OH, -NH2, -NHC(0)R2a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R2a is Ci-C4alkyl. In certain embodiments, R2 is not hydrogen.
[0190] In certain embodiments, R3 is hydrogen or halo. In certain embodiments, R3 is Ci-C4alkyl, wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH. In certain embodiments, R3 is Ci-C4alkynyl, -CN, -OH, or -S(0)2NH2. In certain embodiments, R3 is -NH2 or - NHC(0)R a, wherein R a is Ci-C4alkyl. In certain embodiments, R3 is Ci-C4alkenyl. In certain embodiments, R3 is -0-Ci-C4alkyl. ertain embodiments, Ar is certain embodiments, Ar is
certain embodiments, Ar is
Figure imgf000058_0001
. In certain embodiments, Ar is diments, Ar
is
Figure imgf000058_0002
. In certain embodiments, . In certain embodiments, Ar is In certain
embodiments, Ar i In certain
embodiments, Ar is
[0192] In certain
Figure imgf000059_0001
embodiments of Formula (la), Ar In certain
embo . In certain embodiments of Formula (la),
Ar is
Figure imgf000059_0002
lected from S, O, CH2, and NRQ7; wherein
RQ7 is hydrogen or optionally substituted Ci-C4alkyl.
[0193] In certain embodiments of Formula (lb), Ar is
Figure imgf000059_0003
. In certain
embo . In certain embodiments of Formula (lb),
Ar is
Figure imgf000059_0004
lected from S, O, CH2, and NRQ7; wherein
RQ7 is hydrogen or optionally substituted Ci-C4alkyl. In certain embodiments of Formula
(lb),
Figure imgf000059_0005
Q7 is selected from S, O, CH2, and NRQ7; wherein
RQ7 is hydrogen or optionally substituted Ci-C4alkyl. In certain embodiments of Formula
Figure imgf000059_0006
(lb), Ar is , wherein each Q6 is independently selected from CRQ6 and N; wherein
RQ6 is hydrogen, halo, -CN, lower alkyl, or substituted alkyl. [0194] In certain embodiments, -Z-W-X-Y- is -C(RZ)2-C(RW)2-N(RX)-C(RY)2-. In certain embodiments, -Z-W-X-Y- is -C(RZ)2-C(RW)2-CH(RX)-C(RY)2-. In certain embodiments, -Z-W-X-Y- is -C(RW)2-CH(RX)-C(RY)2-.
[0195] In certain embodiments, each Rz is independently selected from the group consisting of hydrogen and halo. In certain embodiments, both Rz groups together form C3- C6cycloalkyl, such as cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl. In certain embodiments, both Rz groups together form oxo. In certain embodiments, Rz and Rw together with the carbons to which they are attached form a C3-C6cycloalkyl, such as cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
[0196] In certain embodiments, each Rw is independently selected from the group consisting of hydrogen and halo. In certain embodiments, both Rw groups together form C3- C6cycloalkyl, such as cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl. In certain embodiments, both Rw groups together form oxo. In certain embodiments, Rz and Rw together with the carbons to which they are attached form a C3-C6cycloalkyl, such as cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
[0197] In certain embodiments, each RY is independently selected from the group consisting of hydrogen and halo. In certain embodiments, both RY groups together form C3- C6cycloalkyl, such as cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl. In certain embodiments, both RY groups together form oxo.
[0198] In certain embodiments of Formula (la) and (lb), Rx is H. In certain embodiments of Formula (la) and (lb), Rx is RX1, which is C3-C8cycloalkyl, heteroaryl, or heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, Ci-C4alkyl, -(CH2)P- OH, -[C(Rxla)2]p-OH, -[C(Rxla)2]p-0-Ci-C4alkyl, -NHCOCi-C4alkyl, -CONHCi-C4alkyl, - (CH2)p-NH2, -[C(Rxla)2]P-NH2, -[C(Rxla)2]P-NH-Ci-C4alkyl, -[C(Rxla)2]P-N-(Ci-C4alkyl)2; wherein p is 0, 1, 2, or 3; wherein each Rxla is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rxla groups together form C3-C6cycloalkyl.
[0199] In certain embodiments of Formula (la) and (lb), Rx is -CORxl or -S02RX1.
Figure imgf000061_0001
[0201] In certain embodiments of Formula (la) and (lb), Rx is -(Ci-C4alkylene)-Rxl, wherein the -(Ci-C4alkylene)-Rxl is optionally substituted with one to four halo on the Ci- C4alkylene. In certain embodiments, the -(Ci-C4alkylene)-Rxl is substituted with one to four halo on the Ci-C4alkylene. In certain embodiments, the -(Ci-C4alkylene)-Rxl is substituted with one or two halo on the Ci-C4alkylene. In certain embodiments, Rx is -(Ci-C4alkylene)- RX1, wherein the -(Ci-C4alkylene)-Rxl is optionally substituted with one or two halo on the Ci-C4alkylene and wherein X1 is cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl. In certain embodiments, Rx is
Figure imgf000061_0002
[0202] In certain embodiments of Formula (la) and (lb), RX1 is C3-C8cycloalkyl. In certain embodiments, RX1 is cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
[0203] In certain embodiments of Formula (la) and (lb), RX1 is heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents that is halo. In certain embodiments, RX1 is heterocyclic which is deuterated. In certain embodiments, the heterocyclic is monocyclic or bicyclic. In certain embodiments, the heterocyclic contains one to three nitrogens (i.e., 1, 2, or 3 nitrogens) and/ or one to three oxygens (i.e., 1, 2, or 3 oxygens). In certain embodiments, the heterocyclic contains one nitrogen and/ or one oxygen. In certain embodiments, the heterocyclic contains one nitrogen. In certain embodiments, the heterocyclic contains two nitrogens. In certain embodiments, the heterocyclic contains one nitrogen and one oxygen. [0204] In certain embodiments of Formula (la) and (lb), RX1 is heterocyclic, wherein the heterocyclic is the heterocyclic is optionally substituted with Ci-C4alkyl, -(CH2)P-OH, or - (CH2)p-NH2; wherein p is 1 , 2, or 3. In certain embodiments, RX1 is heterocyclic substituted with Ci-C4alkyl. In certain embodiments, RX1 is heterocyclic substituted with -(CH2)P-OH; wherein p is 1 , 2, or 3. In certain embodiments, RX1 is heterocyclic substituted with -(CH2)- OH. In certain embodiments, RX1 is heterocyclic substituted with -(CH2)P-NH2; wherein p is 1, 2, or 3. In certain embodiments, RX1 is heterocyclic substituted with -(CH2)-NH2.
[0205] In certain embodiments of Formula (la) and (lb), RX1 is heterocyclic, wherein the heterocyclic is optionally substituted with -[C(Rxla)2]P-CN. In certain embodiments, RX1 is heterocyclic substituted with -[C(Rxla)2]P-OH, -[C(Rxla)2]P-0-Ci-C4alkyl, -NHCOCi- C4alkyl, -[C(Rxla)2]P-NH2, -[C(Rxla)2]P-NH-Ci-C4alkyl, or -[C(Rxla)2]P-N-(Ci-C4alkyl)2. In certain embodiments, RX1 is heterocyclic, wherein the heterocyclic is optionally substituted with -CONHCi-C4alkyl, -COH, -CO2H, or -[C(Rxla)2]P-COO-Ci-C4alkyl.
[0206] In certain embodiments of Formula (la) and (lb), each Rxla is independently selected from the group consisting of hydrogen and halo. In certain embodiments, both Rxla groups together form C3-C6cycloalkyl, such as cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
[0207] In certain embodiments of Formula (la) and (lb), RX1 is heteroaryl. In certain embodiments, the heteroaryl is monocyclic or bicyclic. In certain embodiments, the heteroaryl contains one to three nitrogens (i.e., 1 , 2, or 3 nitrogens) and/ or one to three oxygens (i.e., 1, 2, or 3 oxygens). In certain embodiments, the heteroaryl contains one nitrogen and/ or one oxygen. In certain embodiments, the heteroaryl contains one nitrogen. In certain embodiments, the heteroaryl contains two nitrogens. In certain embodiments, the heteroaryl contains one nitrogen and one oxygen. In certain embodiments, RX1 is
Figure imgf000062_0001
[0208] In certain embodiments of Formula (la) and (lb), Rx is -CON(RX2)2. In certain embodiments, Rx is -CON(RX2)2, wherein RX2 is hydrogen or methyl. In certain embodiments, Rx is -CONH2. In certain embodiments, Rx is -CON(RX2)2, wherein RX2 is Ci-C4alkyl. In certain embodiments, Rx is -CON(RX2)2, wherein RX2 is methyl.
[0209] In certain embodiments, m is 0. In certain embodiments, m is 1. In certain embodiments, m is 2.
Figure imgf000063_0001
[0210] In one variation of the compounds disclosed herein, Ar is and Q is CH; Q2 is N; Q3 is C; Q4 is C; and Q5 is C.
[0211] In one variation of the compounds disclosed herein, Ar is
Figure imgf000063_0002
and Q1 is CH; Q2 is N; Q3 is C; Q4 is C; and Q5 is C.
[0212] In some embodiments of the methods and compositions disclosed herein, the one or more GSK inhibitor is of formula:
Figure imgf000063_0003
having one, two, three, or more of the following features:
Figure imgf000063_0004
b) Q1 is CH; Q2 is N; and Q3 is C;
c) R2 is hydrogen or halo;
d) -Z-W-X-Y- is -C(RZ)2-C(RW)2-N(RX)-C(RY)2-;
e) Rx is -CORxl.
[0213] In some embodiments of the methods and compositions disclosed herein, the one or more GSK inhibitor is of formula:
Figure imgf000063_0005
having one, two, three, or more of the following features:
Figure imgf000064_0001
b) Q1 is CH; Q2 is N; and Q3 is C;
c) R2 is Ci-C4alkyl, wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH;
d) -Z-W-X-Y- is -C(RZ)2-C(RW)2-N(RX)-C(RY)2-;
e) Rx is -CORxl.
[0214] In some embodiments of the methods and compositions disclosed herein, the one or more GSK inhibitor is of formula:
Figure imgf000064_0002
having one, two, three, or more of the following features:
Figure imgf000064_0003
b) Q1 is CH; Q2 is N; and Q3 is C;
c) R2 is Ci-C4alkynyl, -CN, -OH, -S(0)2NH2, -NH2 or -NHC(0)R2a;
d) -Z-W-X-Y- is -C(RZ)2-C(RW)2-N(RX)-C(RY)2-;
e) Rx is -CORxl.
[0215] Nonlimiting examples of GSK inhibitors for use in the methods of the present disclosure are presented in Table 6.
[0216] Table 6. Exemplary compounds for use in compositions and methods of the present disclosure
Figure imgf000065_0001
Figure imgf000066_0001
Figure imgf000067_0001
Figure imgf000068_0001
Figure imgf000069_0001
Figure imgf000070_0001
[0217] The present disclosure also provides for the following compounds and pharmaceutically acceptable salts thereof for use in the methods and compositions disclosed herein.
Figure imgf000070_0002
[0218] Unless otherwise stated, structures depicted herein are also meant to include compounds which differ only in the presence of one or more isotopically enriched atoms. For example, compounds having the present structure except for the replacement of a hydrogen atom by deuterium or tritium, or the replacement of a carbon atom by 1 C or 14C, or the replacement of a nitrogen atom by 15N, or the replacement of an oxygen atom with 170 or180 are within the scope of the present disclosure. Such isotopically labeled compounds are useful as research or diagnostic tools. In certain embodiments, deuteration can be used to slow metabolism and thus potentially improve the compound half-life. Any or all hydrogens in the compound can be replaced with deuterium.
[0219] In certain embodiments, the GSK inhibitor is Compound 1-7 [3-(2-(4,4- difluoropiperidine- 1 -carbony l)-9-fluoro- 1 ,2,3 ,4-tetrahy dro- [ 1 ,4] diazepino [6,7,1 -hi] indol-7- yl)-4-(irnidazo[l,2-a]pyridin-3-yl)-lH-pyrrole-2,5-dione].
[0220] In certain embodiments, the Wnt signaling pathway target (for example, for inhibition) is selected from the group consisting of AES (TLE/groucho), adenomatous polyposis coli (APC), ARHU, ARHV, AXIN1, AXIN2, β-catenin, BMP4, BTRC (b-TrCP), CCND1, CCND2, CCND3, CD44, CDX1, CLD N 1 (claudin-1), COL1A1, CTBP1, CTBP2, CTN BI, CTN B1P1 (ICAT), DKK 1, DKK2, DKK3, DKK4, Dsh, DVL2, EGR1, EFNB1 (ephrinB 1), ENPP2 (autotaxin), EP300, FBXW1B, FGF4, FO SL 1 (Fra-1), FRAT1, FRAT2, FRZB (FRP-3), FST (follistatin), FZD1, FZD2, FZD3, FZD4, FZD5, FZD6, FZD7, FZD8, FZD9, FZD10, GAS(gastrin), GIPC2, GIPC3, GJA1 (connexin43), GSK3A, glycogen synthase kinase-3B (GSK-313), ICAM1, ID2, ID3, JUN, LEFI, LRP5, LRP6, MFRP, MMP7, MMP26, MSXl, MSX2, MYC, N K D 1, NKD2, NOS2A (iNOS), PITX2, PLAUR (uPAR), serine/threonine protein phosphatase 2A (PP2A), PPN, PPP2R5D (B56 PP2A), PTGS2 (Cox-2), RET, SFRP1 (Secreted Frizzled Related Protein-1, including SFRP1 inhibitors), SFRP2 (FRP-2), SFRP4 (FRP-4), SFRP5, SMOH, SOX17, T (brachyury), TCF, VANGL1, VEGF, WIF1, WISP1, WISP2, WISP3, a Wnt protein, a Wnt receptor, and any analogue or homologue thereof.
[0221] Among other things, the methods presented here are useful for the preparation of pharmaceutical formulations for the prophylaxis and/or treatment of diseases associated with absence or lack of hair follicle epithelial cells, such as nonscarring alopecias (for example, telogen effluvium, anagen effluvium, androgenetic alopecia, and alopecia areata), scarring alopecias (for example, tinea capitis, lichen planopilaris, cicatricial alopecia, discoid lupus erythematosus, folliculitis decalvans, dissecting cellulitis of the scalp, frontal fibrosing alopecia and central centrifugal cicatricial alopecia), trichotillomania, traction alopecia, and hypotrichosis.
[0222] When stem cells in hair follicles are treated with the Shh pathway activators and Wnt agonists of the present disclosure, whether the population is in vivo or in vitro, the treated cells exhibit stem-like behavior in that the treated cells have the capacity to proliferate and differentiate and, more specifically, differentiate into hair follicle epithelial cells. Preferably, the Shh pathway activators and Wnt agonists induce and maintain the cells to produce daughter stem cells that can divide for many generations and maintain the ability to have a high proportion of the resulting cells differentiate into hair follicle epithelial cells. In certain embodiments, the proliferating stem cells express stem cell markers which may include Glil, Krtl5, CD34, Lgr5, Lgr6, Lrigl, Sox2, Versican, alkaline phosphatase (AP), Vimentin, CD133, CD200, ID2, DKK3, WIF1, FZD1, FZD2, PHLDA1, Follistatin and/or DI02. AP activity has been used as a marker to detect the presence of DP (Dermal Papilla) and is regarded as an indicator for hair inductivity. Handjiski et al. (Br J Dermatol (1994) 131(3): 303-310) show that pelage DP of mice expressed strong and persistent AP activity throughout the entire hair cycle. CD133 (promininl) is a known hematopoetic iPSC marker. CD133 is expressed in DP cells of early anagen mouse skin. CD133 expression correlates with hair inductive properties (Yang and Cotsarelis. J Dermatol Sci (2010) 57(1): 2-11). Vimentin is a mesenchymal marker present in DP and dermal fibroblast cells (Rendl et al. PLOS Biol (2005) 3(11): e331). Versican is expressed in DP cells in follicles in anagen. Versican expression correlates with hair inductive properties (Yang and Cotsarelis. J Dermatol Sci (2010) 57(1): 2-11). Sox2 is a common marker of stem cells. Sox2-expressing cells are required for formation of awl/auchene follicles in a hair reconstitution assay (Driskell et al. Development (2009) 136(16): 2815-2823).
[0223] In some embodiments, the method of the present disclosure may be used to maintain, or even transiently increase sternness {i.e., self-renewal) of pre-existing stem cells in a hair follicle prior to significant hair follicle cell formation. In some embodiments, the pre-existing stem cells in a hair follicle comprise keratinocytes, melanocytes, dermal papilla cells and/or bulge cells. Morphological analyses with immunostaining (including cell counts) and lineage tracing across a Representative Microscopy Sample may be used to confirm expansion of one or more of these cell-types.
[0224] Advantageously, the methods of the present disclosure achieve these goals without the use of genetic manipulation. Germ-line manipulation is not a therapeutically desirable approach to treating hair loss. In general, the therapy preferably involves the administration of a small molecule, peptide, antibody, or other non-nucleic acid molecule or nucleic acid delivery vector unaccompanied by gene therapy. In certain embodiments, the therapy involves the administration of a small organic molecule. Preferably, hair maintenance or restoration is achieved through the use of a (non-genetic) therapeutic that is administered, for example, intradermally, transdermally, topically or orally.
[0225] In addition to expanding stem cells of hair follicles, the methods of the present disclosure have the capacity to maintain, in the daughter cells, the capacity to differentiate into may lineages of hair follicle epithelial cells. In in vivo populations, the maintenance of this capacity may be indirectly observed by an improvement in a subject's hair density, hair growth or ability of hair follicles to go through regenerative cycling. In in vitro populations, the maintenance of this capacity may be directly observed by an increase in the number of DP cells relative to a starting population or indirectly by measuring activity of one or more DP stem cell markers.
[0226] In certain embodiments, the stem cell population is of an in vivo subject, and the method is a treatment for hair loss (e.g. , wherein the generation of hair follicle epithelial cells from the expanded population of stem cells results in partial or full recovery of hair loss).
[0227] In certain embodiments, the present disclosure is directed to a method of facilitating generation of dermal papilla cells, the method comprising: administering a composition of the present disclosure to expand the population of dermal papilla cells. In certain embodiments, the compounds can regenerate hair in a mammal. In certain embodiments, the dermal papilla cell population is of an in vivo subject. In certain embodiments, the dermal papilla cell population is of an in vivo subject for the treatment for alopecia. In certain embodiments, the present disclosure provides a method of generating dermal papilla cells using a composition of the present disclosure to proliferate dermal papilla cells in an initial population in vivo, resulting in an expanded population of dermal papilla cells.
[0228] In certain embodiments, the administering step is carried out by performing one or more injections into the dermis (e.g. intradermal administration). In some embodiments, the administration is topical and directed to the region of skin exhibiting hair loss. In some embodiments, the administration is oral. In some embodiments, the administration is transdermal and directed to the region of skin exhibiting hair loss. [0229] In some embodiments, the skin is roughened or wounded before the administration of the therapy. In some embodiments, one or more needles are applied to the skin before the therapy is applied.
[0230] In certain embodiments, the administering step comprises administering one or more Shh pathway activator, one or more Wnt agonist, or a combination of one or more Shh pathway activator and one or more Wnt agonist in a sustained manner.
[0231] In some embodiments, the stem cells are DP stem cells. In certain embodiments, the stem cells are hair follicle stem cells. In some embodiments, the stem cells comprise keratinocytes, melanocytes, dermal papilla cells and/or bulge cells.
[0232] In certain embodiments, the method further comprises performing high throughput screening using the generated hair follicle epithelial cells. In certain embodiments, the method comprises using the generated hair follicle epithelial cells to screen molecules for toxicity against hair follicle epithelial cells. In certain embodiments, the method comprises using the generated hair follicle epithelial cells to screen molecules for ability to improve survival of hair follicle epithelial cells (e.g. , hair follicle epithelial cells exposed to said molecules).
[0233] In certain embodiments, the method further comprises performing high throughput screening using the generated expanded population of stem cells. In certain embodiments, the method further comprises using the generated stem cells to screen molecules for toxicity against stem cells and/or their progeny. In certain embodiments, the method comprises using the generated stem cells to screen molecules for ability to improve survival of stem cells and/or their progeny.
[0234] In another aspect, the disclosure is directed to a method of generating hair follicle epithelial cells, the method comprising: proliferating stem cells of hair follicles (e.g. , of an in vitro, ex vivo, or in vivo sample/subject), resulting in an expanded population of stem cells of hair follicles (e.g. , such that the expanded population is a factor of at least 1.25, 1.5, 1.75, 2, 3, 5, 10, or 20 greater than the initial stem cell population); and facilitating generation of hair follicle epithelial cells from the expanded population of hair follicle stem cells.
[0235] In another aspect, the disclosure is directed to a method of generating hair follicle epithelial cells, the method comprising administering a compound or composition provided herein to a cell population in one or more hair follicle of a subject, thereby facilitating generation of hair follicle epithelial cells. [0236] In another aspect, the present disclosure provides pharmaceutical compositions comprising: a pharmaceutically-acceptable carrier and (i) a Wnt agonist, or a pharmaceutically-acceptable salt thereof, and (ii) a Sonic Hedgehog (Shh) activator, or a pharmaceutically-acceptable salt thereof. In some embodiments, the Wnt agonist comprises a GSK3-alpha inhibitor. In other embodiments, the Wnt agonist comprises a GSK3-beta inhibitor. In some embodiments, the Shh pathway activator comprises a Smoothened agonist. In certain embodiments, the Shh pathway activator comprises Smoothen ciliary accumulation enhancers. In some embodiments, the composition is adapted for administration to the skin.
[0237] Certain embodiments relate to pharmaceutical compositions, comprising a pharmaceutically-acceptable carrier and (i) a Wnt agonist, a GSK3-alpha inhibitor, or a GSK3-beta inhibitor and (ii) a Sonic Hedgehog activator, Smoothened agonist, Smoothened ciliary accumulation enhancers, or a pharmaceutically-acceptable salt thereof. In some embodiments, the composition is adapted for administration to the skin.
[0238] In some embodiments of the methods and compositions described herein, the Wnt agonist, GSK3 -alpha inhibitor, or GSK3-beta inhibitor is selected from CHIR99021, LY2090314, AZD1080, GSK3 inhibitor XXII, Compound 1-6, Compound 1-7, and Compound 1-12.
[0239] In certain embodiments, the Shh pathway activator is selected from Purmorphamine, SAG, 20-alpha hydroxy cholesterol, and SAG HC1.
[0240] In certain embodiments of the compositions and methods provided herein, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is at a concentration of about 0.01 μΜ to 1000 mM, about 0.1 μΜ to 1000 mM, about 1 μΜ to 100 mM, about 10 μΜ to 10 mM, about 1 μΜ to 10 μΜ, about 10 μΜ to 100 μΜ, about 100 μΜ to 1000 μΜ, about 1 mM to 10 mM, or about 10 mM to 100 mM. In some embodiments, the Wnt agonist, GSK3- alpha inhibitor, or GSK3-beta inhibitor is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration. In further embodiments, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration. In yet further embodiments, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is at a concentration of about 0.01 nM to 1000 μΜ, about 0.1 nM to 1000 μΜ, about 1 nM to 100 μΜ, about 10 nM to 10 μΜ, about 1 nM to 10 nM, about 10 nM to 100 nM, about 100 nM to 1000 nM, about 1 μΜ to 10 μΜ, or about 10 μΜ ίο 100 μΜ.
[0241] In certain embodiments of the compositions and methods provided herein, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is CHIR99021, which is at a concentration of about 1 μΜ to 1000 mM, about 10 μΜ to 100 mM, about 100 μΜ to 100 mM, about 1 mM to 10 mM, or about 10 mM. In some embodiments, the Wnt agonist, GSK3- alpha inhibitor, or GSK3-beta inhibitor is CHIR99021, which is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist, GSK3- alpha inhibitor, or GSK3-beta inhibitor is CHIR99021, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is CHIR99021, which is at a concentration of about 1 nM to 1000 μΜ, about 10 nM to 100 μΜ, about 100 nM to 100 μΜ, about 100 nM to 1 μΜ, about 1 μΜ to 10 μΜ, or about 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 μΜ.
[0242] In certain embodiments of the compositions and methods provided herein, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is LY2090314, which is at a concentration of about 0.01 μΜ to 1000 mM, about 0.1 μΜ to 10 mM, about 1 μΜ to 1 mM, about 10 μΜ, about 20 μΜ, about 30 μΜ, about 40 μΜ, or about 50 μΜ. In some embodiments, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is LY2090314, which is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is LY2090314, which is at about lx, 3x, 10x, 30x, 100x, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist, GSK3 -alpha inhibitor, or GSK3-beta inhibitor is LY2090314, which is at a concentration of about 0.01 nM to 1000 μΜ, about 0.1 nM to 10 μΜ, about 1 nM to 1 μΜ, about 1 nM to 100 nM, about 1 nM to 50 nM, or about 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 nM.
[0243] In certain embodiments of the compositions and methods provided herein, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is AZD1080, which is at a concentration of about 0.1 μΜ to 1000 mM, about 1 μΜ to 1000 mM, about 10 μΜ to 100 mM, about 100 μΜ to 10 mM, about 1 mM to 10 mM, or about 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 mM. In some embodiments, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is AZD1080, which is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is AZD1080, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is AZD1080, which is at a concentration of about 1 nM to 1000 μΜ, about 10 nM to 1000 μΜ, about 100 nM to 100 μΜ, about 1 μΜ to 10 μΜ, or about 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 μΜ.
[0244] In certain embodiments of the compositions and methods provided herein, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is GSK3 inhibitor XXII, which is at a concentration of about 0.1 μΜ to 1000 mM, about 1 μΜ to 100 mM, about 10 μΜ to 10 mM, about 100 μΜ to 10 mM, about 100 μΜ to 1 mM, or about 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 mM. In some embodiments, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is GSK3 inhibitor XXII, which is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is GSK3 inhibitor XXII, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist, GSK3-alpha inhibitor, or GSK3-beta inhibitor is GSK3 inhibitor XXII, which is at a concentration of about 0.1 nM to 1000 μΜ, about 1 nM to 100 μΜ, about 10 nM to 10 μΜ, about 100 nM to 1 μΜ, or about 0.5 μΜ.
[0245] In certain embodiments of the compositions and methods provided herein, the Wnt agonist is Compound 1-6, which is at a concentration of about 0.01 μΜ to 1000 mM, about 0.1 μΜ to 10 mM, about 1 μΜ to 1 mM, about 10 μΜ to 1 mM, about 125 μΜ, about 250 μΜ, about 500 μΜ, or about 750 μΜ. In some embodiments, the Wnt agonist is Compound 1-6, which is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist is Compound 1-6, which is about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist is Compound 1-6, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist is Compound 1-6, which is at a concentration of about 0.01 nM to 1000 μΜ, about 0.1 nM to 10 μΜ, about 1 nM to 1 μΜ, about 10 nM to 100 nM, about 25 nM, about 25 nM, or about 75 nM.
[0246] In certain embodiments of the compositions and methods provided herein, the Wnt agonist is Compound 1-7, which is at a concentration of about 0.01 μΜ to 1000 mM, about 0.1 μΜ to 10 mM, about 1 μΜ to 1 mM, about 10 μΜ, about 20 μΜ, about 30 μΜ, about 40 μΜ, or about 50 μΜ. In some embodiments, the Wnt agonist is Compound 1-7, which is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist is Compound 1-7, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist is Compound 1-7, which is at a concentration of about 0.01 nM to 1000 μΜ, about 0.1 nM to 10 μΜ, about 1 nM to 1 μΜ, about 1 nM to 100 nM, about 5 nM, about 10 nM or about 20 nM.
[0247] In certain embodiments of the compositions and methods provided herein, the Wnt agonist is Compound 1-12, which is at a concentration of about 0.01 μΜ to 1000 mM, about 0.1 μΜ to 10 mM, about 1 μΜ to 1 mM, about 10 μΜ to 1 mM, about 125 μΜ, about 250 μΜ, about 500 μΜ, or about 750 μΜ. In some embodiments, the Wnt agonist is Compound 1-12, which is at a concentration ratio of about 0.01 to 1,000,000 fold relative to its Effective Sternness Driver Concentration, or about 0.1 to 100,000 fold relative to its Effective Sternness Driver Concentration, or about 1 to 10,000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 5000 fold relative to its Effective Sternness Driver Concentration, or about 50 to 2000 fold relative to its Effective Sternness Driver Concentration, or about 100 to 1000 fold relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist is Compound 1-12, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Sternness Driver Concentration. In some embodiments, the Wnt agonist is Compound 1-12, which is at a concentration of about 0.01 nM to 1000 μΜ, about 0.1 nM to 10 μΜ, about 1 nM to 1 μΜ, about 10 nM to 100 nM, about 25 nM about 50 nM or about 75 nM.
[0248] In certain embodiments of the compositions and methods provided herein, the Sonic Hedgehog (Shh) activator is at a concentration of about 0.01 μΜ to 1000 mM, about 0.1 μΜ to 1000 mM, about 1 μΜ to 100 mM, about 0.1 μΜ to 1 μΜ, about 1 μΜ to 10 μΜ, about 10 μΜ to 100 μΜ, about 100 μΜ to 1 mM, about 1 mM to 10 mM, or about 100 mM to 1000 mM, or about 10 mM to 100 mM, or about 100 mM to 1000 mM. In some embodiments, the Shh pathway activator is at a concentration ratio of about 0.1 to 1,000,000 fold relative to its Effective Shh Concentration, or about 1 to 100,000 fold relative to its Effective Shh Concentration, or about 10 to 10,000 fold relative to its Effective Shh Concentration, or about 100 to 1000 fold relative to its Effective Shh Concentration, or about 1000 fold relative to its Effective Shh Concentration. In some embodiments, the Shh pathway activator is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Shh Concentration. In some embodiments, the Shh pathway activator is at a concentration of about 0.01 nM to 1000 μΜ, or about 0.1 nM to 1000 μΜ, about 1 nM to 100 μΜ, about 10 nM to 10 μΜ, about 1 nM to 10 nM, about 10 nM to 100 nM, about 100 nM to 1000 nM, about 1 μΜ to 10 μΜ, about 10 μΜ to 100 μΜ, or about 100 μΜ to 1000 μΜ.
[0249] In certain embodiments of the compositions and methods provided herein, the Shh pathway activator is SAG (CAS 912545-86-9), which is at a concentration of about 0.01 μΜ to 1000 mM, about 0.1 μΜ to 10 mM, about 1 μΜ to 1 mM, about 10 μΜ to 100 μΜ, about 10 μΜ, about 20 μΜ, about 25 μΜ, about 50 μΜ. In some embodiments, the Shh pathway activator is SAG (CAS 912545-86-9), which is at a concentration ratio of about 0.1 to 1,000,000 fold relative to its Effective Shh Concentration, or about 1 to 100,000 fold relative to its Effective Shh Concentration, or about 10 to 10,000 fold relative to its Effective Shh Concentration, or about 100 to 1000 fold relative to its Effective Shh Concentration, or about 1000 fold relative to its Effective Shh Concentration. In some embodiments, the Shh pathway activator is SAG (CAS 912545-86-9), which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Shh Concentration. In some embodiments, the Shh pathway activator is SAG (CAS 912545-86-9), which is at a concentration of about 0.001 nM to 1000 μΜ, about 0.01 nM to 10 μΜ, about 0.1 nM to 1 μΜ, about 1 nM to 100 nM, 1 nM to 10 nM, about 1 nM, about 2 nM, about 3 nM, about 4 nM, about 5 nM, about 6 nM, about 7 nM, about 9 nM, or about 10 nM.
[0250] In certain embodiments of the compositions and methods provided herein, the Shh pathway activator is 20-alpha hydroxy cholesterol, which is at a concentration of about 0.01 μΜ to 1000 mM, about 0.1 μΜ to 100 mM, about 1 μΜ to 10 mM, about 10 μΜ to 1 mM, about 125 μΜ, about 250 μΜ, about 500 μΜ, or about 1000 μΜ. In some embodiments, the Shh pathway activator is 20-alpha hydroxy cholesterol, which is at a concentration ratio of about 0.1 to 1,000,000 fold relative to its Effective Shh Concentration, or about 1 to 100,000 fold relative to its Effective Shh Concentration, or about 10 to 10,000 fold relative to its Effective Shh Concentration, or about 100 to 1000 fold relative to its Effective Shh Concentration, or about 1000 fold relative to its Effective Shh Concentration. In some embodiments, the Shh pathway activator is 20-alpha hydroxy cholesterol, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Shh Concentration. In some embodiments, the Shh pathway activator is 20-alpha hydroxy cholesterol, which is at a concentration of about 0.01 nM to 1000 μΜ, about 0.1 nM to 100 μΜ, about 1 nM to 10 μΜ, about 10 nM to 1 μΜ, about 25 nM, about 50 nM, about 100 nM, about 200 nM, or about 500 nM. [0251] In certain embodiments of the compositions and methods provided herein, the Shh pathway activator is SAG HC1 (CAS 912545-86-9), which is at a concentration of about 1 μΜ to 1000 mM, or about 10 μΜ to 1000 mM, or about 100 μΜ to 10 mM, or about 1 mM. In some embodiments, the Shh pathway activator is SAG HC1, which is at a concentration ratio of about 0.1 to 1,000,000 fold relative to its Effective Shh Concentration, or about 1 to 100,000 fold relative to its Effective Shh Concentration, or about 10 to 10,000 fold relative to its Effective Shh Concentration, or about 100 to 1000 fold relative to its Effective Shh Concentration, or about 1000 fold relative to its Effective Shh Concentration. In some embodiments, the Shh pathway activator is SAG HC1, which is at about lx, 3x, lOx, 3 Ox, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Shh Concentration. In some embodiments, the Shh pathway activator is SAG HC1, which is at a concentration of about 1 nM to 1000 μΜ, about 10 nM to 100 μΜ, about 100 nM to 10 μΜ, about 125 nM, about 250 nM, or about 500 nM, or about 750 nM.
[0252] In certain embodiments of the compositions and methods provided herein, the Shh pathway activator is Purmorphamine, which is at a concentration of about 1 μΜ to 1000 mM, or about 10 μΜ to 1000 mM, or about 100 μΜ to 10 mM, or about 2 mM. In some embodiments, the Shh pathway activator is Purmorphamine, which is at a concentration ratio of about 0.1 to 1,000,000 fold relative to its Effective Shh Concentration, or about 1 to 100,000 fold relative to its Effective Shh Concentration, or about 10 to 10,000 fold relative to its Effective Shh Concentration, or about 100 to 1000 fold relative to its Effective Shh Concentration, or about 1000 fold relative to its Effective Shh Concentration. In some embodiments, the Shh pathway activator is Purmorphamine, which is at about lx, 3x, lOx, 30x, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Shh Concentration. In some embodiments, the Shh pathway activator is Purmorphamine, which is at a concentration of about 1 nM to 1000 μΜ, about 10 nM to 100 μΜ, about 100 nM to 10 μΜ, about 1 μΜ to 10 μΜ, about 1 μΜ, about 2 μΜ, about 3 μΜ, about 4 μΜ, about 5 μΜ, or about 6 μΜ.
[0253] In certain embodiments of the compositions and methods described herein, CHIR99021 is at a concentration of about 100 nM to about 10 μΜ in combination with Purmorphamine at a concentration of about 100 nM to about 10 μΜ. In certain embodiments, CHIR99021 is at a concentration of about 100 nM to about 10 μΜ in combination with SAG at a concentration of about 1 nM to about 100 nM. In certain embodiments, CHIR99021 is at a concentration of about 100 nM to about 10 μΜ in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, CHIR99021 is at a concentration of about 100 nM to about 10 μΜ in combination with SAG HC1 at a concentration of about 10 nM to about 1 μΜ.
[0254] In certain embodiments of the compositions and methods described herein, LY2090314 is at a concentration of about 1 nM to about 100 nM in combination with Purmorphamine at a concentration of about 100 nM to about 10 μΜ. In certain embodiments, LY2090314 is at a concentration of about 1 nM to about 100 nM in combination with SAG at a concentration of about 1 nM to about 100 nM. In certain embodiments, LY2090314 is at a concentration of about 1 nM to about 100 nM in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, LY2090314 is at a concentration of about 1 nM to about 100 nM in combination with SAG HC1 at a concentration of about 10 nM to about 1 μΜ.
[0255] In certain embodiments of the compositions and methods described herein, AZD1080 is at a concentration of about 1 μΜ to about 100 μΜ in combination with Purmorphamine at a concentration of about 100 nM to about 10 μΜ. In certain embodiments, AZD1080 is at a concentration of about 1 μΜ to about 100 μΜ in combination with SAG at a concentration of about 1 nM to about 100 nM. In certain embodiments, AZD1080 is at a concentration of about 1 μΜ to about 100 μΜ in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, AZD1080 is at a concentration of about 1 μΜ to about 100 μΜ in combination with SAG HC1 at a concentration of about 10 nM to about 1 μΜ.
[0256] In certain embodiments of the compositions and methods described herein, GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ in combination with Purmorphamine at a concentration of about 100 nM to about 10 μΜ. In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ in combination with SAG at a concentration of about 1 nM to about 100 nM. In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ in combination with 20- alpha hydroxy cholesterol at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ in combination with SAG HC1 at a concentration of about 10 nM to about 1 μΜ.
[0257] In certain embodiments of the compositions and methods described herein, Compound 1-6 is at a concentration of about 1 nM to about 100 nM in combination with Purmorphamine at a concentration of about 100 nM to 10 μΜ. In certain embodiments, Compound 1-6 is at a concentration of about 1 nM to about 100 nM in combination with SAG at a concentration of about 1 nM to about 100 nM. In certain embodiments, Compound 1-6 is at a concentration of about 1 nM to about 100 nM in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, Compound 1-6 is at a concentration of about 1 nM to about 100 nM in combination with SAG HC1 at a concentration of about 10 nM to about 1 μΜ.
[0258] In certain embodiments of the compositions and methods described herein, Compound 1-7 is at a concentration of about 1 nM to about 100 nM in combination with Purmorphamine at a concentration of about 100 nM to about 10 μΜ. In certain embodiments, Compound 1-7 is at a concentration of about 1 nM to about 100 nM in combination with SAG at a concentration of about 1 nM to about 100 nM. In certain embodiments, Compound 1-7 is at a concentration of about 1 nM to about 100 nM in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, Compound 1-7 is at a concentration of about 1 nM to about 100 nM in combination with SAG HC1 at a concentration of about 10 nM to about 1 μΜ.
[0259] In certain embodiments of the compositions and methods described herein, Compound 1-12 is at a concentration of about 10 nM to about 1000 nM in combination with Purmorphamine at a concentration of about 100 nM to about 10 μΜ. In certain embodiments, Compound 1-12 is at a concentration of about 10 nM to about 1000 nM in combination with SAG at a concentration of about 1 nM to about 100 nM. In certain embodiments, Compound 1-12 is at a concentration of about 10 nM to about 1000 nM in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, Compound 1-12 is at a concentration of about 10 nM to about 1000 nM in combination with SAG HC1 at a concentration of about 10 nM to about 1 μΜ.
[0260] In certain embodiments of the compositions and methods described herein, CHIR99021 is at a concentration of about 100 μΜ to about 10 mM in combination with Purmorphamine at a concentration of about 100 μΜ to about 10 mM. In certain embodiments, CHIR99021 is at a concentration of about 100 μΜ to about 10 mM in combination with SAG at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, CHIR99021 is at a concentration of about 100 μΜ to about 10 mM in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 mM to about 100 mM. In certain embodiments, CHIR99021 is at a concentration of about 100 μΜ to about 10 mM in combination with SAG HC1 at a concentration of about 10 μΜ to about 1 mM. [0261] In certain embodiments of the compositions and methods described herein, LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ in combination with Purmorphamine at a concentration of about 100 μΜ to about 10 mM. In certain embodiments, LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ in combination with SAG at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 mM to about 100 mM. In certain embodiments, LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ in combination with SAG HC1 at a concentration of about 10 μΜ to about 1 mM.
[0262] In certain embodiments of the compositions and methods described herein, AZD1080 is at a concentration of about 1 mM to about 100 mM in combination with Purmorphamine at a concentration of about 100 μΜ to about 10 mM. In certain embodiments, AZD1080 is at a concentration of about 1 mM to about 100 mM in combination with SAG at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, AZD1080 is at a concentration of about 1 mM to about 100 mM in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 mM to about 100 mM. In certain embodiments, AZD1080 is at a concentration of about 1 mM to about 100 mM in combination with SAG HC1 at a concentration of about 10 μΜ to about 1 mM.
[0263] In certain embodiments of the compositions and methods described herein, GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM in combination with Purmorphamine at a concentration of about 100 μΜ to about 10 mM. In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM in combination with SAG at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 mM to about 100 mM. In certain embodiments, GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM in combination with SAG HC1 at a concentration of about 10 μΜ to about 1 mM.
[0264] In certain embodiments of the compositions and methods described herein, Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ in combination with Purmorphamine at a concentration of about 100 μΜ to about 10 mM. In certain embodiments, Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ in combination with SAG at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 mM to about 100 mM. In certain embodiments, Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ in combination with SAG HC1 at a concentration of about 10 μΜ to about 1 mM.
[0265] In certain embodiments of the compositions and methods described herein, Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ in combination with Purmorphamine at a concentration of about 100 μΜ to about 10 mM. In certain embodiments, Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ in combination with SAG at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 mM to about 100 mM. In certain embodiments, Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ in combination with SAG HC1 at a concentration of about 10 μΜ to about 1 mM.
[0266] In certain embodiments of the compositions and methods described herein, Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ in combination with Purmorphamine at a concentration of about 100 μΜ to about 10 mM. In certain embodiments, Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ in combination with SAG at a concentration of about 1 μΜ to about 100 μΜ. In certain embodiments, Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ in combination with 20-alpha hydroxy cholesterol at a concentration of about 1 mM to about 100 mM. In certain embodiments, Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ in combination with SAG HC1 at a concentration of about 10 μΜ to about 1 mM.
[0267] In certain embodiments of the compositions and methods provided herein, the Shh pathway activator is SAG (CAS 912545-86-9) or SAG-HC1 in combination with a Wnt agonist selected from one or more of an SFRP1 inhibitor (for example, WAY-316606), a SFRP2 inhibitor, a SFRP3 inhibitor, a SFRP4 inhibitor, a SFRP5 inhibitor, a cyclosporine or an analog thereof (for example, cyclosporine A (CsA), PSC833 (Valspodar)), a DKK1 inhibitor (for example, WAY-262611), and a WIF1 inhibitor. In some embodiments, SAG is at a concentration of about 1 μΜ to 1000 mM, or about 10 μΜ to 1000 mM, or about 100 μΜ to 10 mM, or about 1 mM. In some embodiments, SAG HC1 is at a concentration ratio of about 0.1 to 1,000,000 fold relative to its Effective Shh Concentration, or about 1 to 100,000 fold relative to its Effective Shh Concentration, or about 10 to 10,000 fold relative to its Effective Shh Concentration, or about 100 to 1000 fold relative to its Effective Shh Concentration, or about 1000 fold relative to its Effective Shh Concentration. In some embodiments, SAG HCl is at about lx, 3x, lOx, 3 Ox, lOOx, 300x, lOOOx, 3000x, 5000x relative to its Effective Shh Concentration. In some embodiments, SAG HCl is at a concentration of about 1 nM to 1000 μΜ, about 10 nM to 100 μΜ, about 100 nM to 10 μΜ, about 125 nM, about 250 nM, or about 500 nM, or about 750 nM
[0268] Hair Follicle Growth
[0269] Hair follicles develop through complex morphogenetic processes resulting from reciprocal molecular interactions between epithelium and underlying mesenchyme during embryonic development. Each hair follicle goes through regenerative cycling. The hair cycle consists of phases of growth (anagen), degeneration (catagen) and rest (telogen). In catagen, hair follicle stem cells are maintained in the bulge. Then the resting follicle re-enters anagen (regeneration) when proper molecular signals are provided. During late telogen to early anagen transition, signals from the dermal papilla (DP) stimulate the hair germ and quiescent bulge stem cells to become activated. In anagen, stem cells in the bulge give rise to hair germs, then the transient amplifying cells in the matrix of the new follicle proliferate rapidly to form a new hair filament. After catagen, follicles undergo apoptosis. The hair filament remains in the telogen follicle to become a club hair, which later is detached during exogen. These regenerative cycles continue repetitively throughout the lifetime of an organism.
[0270] Hedgehog Pathway
[0271] The evolutionarily conserved Hedgehog (Hh) pathway is essential for normal embryonic development and plays critical roles in adult tissue maintenance, renewal and regeneration. Secreted Hh proteins act in a concentration- and time-dependent manner to initiate a series of cellular responses that range from survival and proliferation to cell fate specification and differentiation. Proper levels of Hh signaling require the regulated production, processing, secretion and trafficking of Hh ligands- in mammals this includes Sonic (Shh), Indian (Ihh) and Desert (Dhh). All Hh ligands are synthesized as precursor proteins that undergo autocatalytic cleavage and concomitant cholesterol modification at the carboxy terminus and palmitoylation at the amino terminus, resulting in a secreted, dually- lipidated protein. Hh ligands are released from the cell surface through the combined actions of Dispatched and Scube2, and subsequently trafficked over multiple cells through interactions with the cell surface proteins LRP2 and the Glypican family of heparan sulfate proteoglycans (GPCl-6). Hh proteins initiate signaling through binding to the canonical receptor Patched (PTCH1) and to the co-receptors GAS1, CDON and BOC. Hh binding to PTCHl results in derepression of the GPCR-like protein Smoothened (SMO) that results in SMO accumulation in cilia and phosphorylation of its cytoplasmic tail. SMO mediates downstream signal transduction that includes dissociation of GLI proteins (the transcriptional effectors of the Hh pathway) from kinesin-family protein, Kif7, and the key intracellular Hh pathway regulator SUFU. GLI proteins also traffic through cilia and in the absence of Hh signaling are sequestered by SUFU and Kif7, allowing for GLI phosphorylation by PKA, GSK3 and CK1, and subsequent processing into transcriptional repressors (through cleavage of the carboxy -terminus) or targeting for degradation (mediated by the E3 ubiquitin ligase β-TrCP). In response to activation of Hh signaling, GLI proteins are differentially phopshorylated and processed into transcriptional activators that induce expression of Hh target genes, many of which are components of the pathway (e.g. PTCHl and GLI1). Feedback mechanisms include the induction of Hh pathway antagonists (PTCHl, PTCH2 and Hhipl) that interfere with Hh ligand function, and GLI protein degradation mediated by the E3 ubiquitin ligase adaptor protein, SPOP. In addition to vital roles during normal embryonic development and adult tissue homeostasis, aberrant Hh signaling is responsible for the initiation of a growing number of cancers including, classically, basal cell carcinoma, edulloblastoma, and rhabdomyosarcoma; more recently overactive Hh signaling has been implicated in pancreatic, lung, prostate, ovarian, and breast cancer.
Methods of Making Compounds
[0272] The compounds described herein may be made from commercially available starting materials or synthesized using known organic, inorganic, and/or enzymatic processes.
[0273] The compounds of the present invention can be prepared in a number of ways well known to those skilled in the art of organic synthesis. By way of example, compounds of the disclosure can be synthesized using the methods described below, together with synthetic methods known in the art of synthetic organic chemistry, or variations thereon as appreciated by those skilled in the art. These methods include but are not limited to those methods described below.
[0274] A representative synthesis for subject compounds is shown in Scheme 1.
Figure imgf000088_0001
[0275] In Scheme 1, com ound 1-11 is an embodiment wherein Q1 is CH; Q2 is N; and
Q3 is C; R2 is bromo; Ar is
Figure imgf000088_0002
; and -Z-W-X-Y- is. Compounds of formula 1 and the allylic aldehyde are commercially available starting materials. Alternatively, compounds of formula 1 and the allylic aldehyde can be synthesized via a variety of different synthetic routes using commercially available starting materials and/or starting materials prepared by conventional synthetic methods.
[0276] With continued reference to Scheme 1, compound 1 and an allylic aldehyde are reacted to form compound 2 in a condensation reaction in a suitable solvent such as acetonitrile at a temperature, for example, from about 40°C to 100°C. Compound 2 is reacted with ammonia to form compound 3 in a suitable solvent such as methanol at a temperature, for example, in the range from 0°C to room temperature. Compound 3 can be used in a coupling reaction to be discussed below.
[0277] With continued reference to Scheme 1, compound 5 may be prepared from an alkylation of compound 4 with an alkyl halide in the presence of a base, such as an alkali metal hydride, such as sodium hydride. The reaction can be run in a suitable solvent, such as dimethylformamide (DMF) at a temperature, for example, in the range from 0°C to room temperature.
[0278] Compound 6 may be prepared from the reduction of compound 5. Suitable reduction reagents include borane pyridine complex. The reaction can be run in a suitable solvent, such as acetic acid at a temperature, for example, in the range from 0°C to room temperature.
[0279] Compound 7 may be prepared from reaction of compound 6. The reaction is carried with formaldehyde in the presence of acid such as sulfuric acid and acetic acid.
[0280] Compound 8 may be prepared from protection of the amino group of compound 7. Suitable reagents include BOC anhydride. The reaction can be run in a suitable solvent, such as tetrahydrofuran (THF) at a temperature, for example, in the range from 0°C to room temperature.
[0281] Core 1 may be prepared from the dehydrogenation of compound 8. Suitable reagents include DDQ (2,3-dichloro-5,6-dicyano-l,4-benzoquinone). The reaction can be run in a suitable solvent, such as tetrahydrofuran (THF) at a temperature, for example, in the range from 0°C to room temperature.
[0282] Compound 10 may be prepared from core 1 by deprotection of the amino group and then the subsequent reaction with acyl halide. The deprotection of the amino group can be performed under acidic conditions, if the protecting group is BOC. Then reaction with an acyl halide can result in compound 10. The reaction can be run in a suitable solvent, such as dimethylformamide (DMF) at a temperature, for example, in the range from 0°C to room temperature.
[0283] Compound 11 may be prepared from compound 10 by an acylation reaction, such as a Friedel Crafts acylation reaction. In this reaction, an acyl halide is reacted with compound 10 in a suitable solvent, such as methylene chloride at a temperature, for example, in the range from 30°C to 100°C. The product is then reacted an alcohol and base to form an ester, as in compound 11.
[0284] Compound 11 and Compound 3 are reacted to form the lH-pyrrole-2,5-dione compound. The reaction is carried out in an inert organic solvent such as dimethylformamide, tetrahydrofuran, and the like and in the presence of a base such as potassium tert-butoxide.
Synthetic Schemes
Synthetic Scheme 1
Figure imgf000090_0001
Core 2
Synthetic Scheme 2
Figure imgf000091_0001
Compound 1-1
Synthetic Scheme 3
Figure imgf000091_0002
core 2 Compound I-2
Synthetic Scheme 4
Figure imgf000092_0001
19 Compound I-3
Synthetic Scheme 5
Figure imgf000092_0002
Synthetic Scheme 6
Figure imgf000093_0001
Figure imgf000093_0002
Synthetic Scheme 8
Figure imgf000094_0001
34 35 Compound 1-7
Figure imgf000094_0002
36 37 Compound 1-8
Figure imgf000094_0003
Synthetic Scheme 9
Figure imgf000095_0001
Synthetic Scheme 10
Figure imgf000096_0001
Figure imgf000096_0002
Synthetic Scheme 12
Figure imgf000097_0001
63 64 Compound 1-28
Experimental Procedures;
Synthesis of intermediate 2.
Figure imgf000097_0002
1
[0285] To a solution of intermediate 1 (20 g, 213 mmol) in MeCN (540 mL) was ethyl (E)-4-oxo-butenoate (28.6 g, 223 mmol). The reaction mixture was heated to 80 °C and stirred for 6 hrs. The reaction mixture was concentrated under reduced pressure, the residue was purified by flash column chromatography (eluted with Dichloromethane/MeOH from 1:0 to 200: 1) to give the crude intermediate 2 (25 g) as brown solid.
Synthesis of intermediate 3.
Figure imgf000098_0001
2 3
[0286] To a solution of crude intermediate 2 (25 g) in MeOH (100 mL) was added NLb/MeOH (6 M, 100 mL). The reaction mixture was stirred at room temperature overnight. The mixture was poured into EtOAc (500 mL), and then filtered. The filter cake was dried in vacuo to give intermediate 3 (13 g, 35% for two steps) as a brown solid.
[0287] ¾ NMR (DMSO-c e, 400 MHz): δ (ppm) 8.30 (d, J=6.8Hz, 1H), 7.60 (s br, 1H), 7.54 (d, J=5.2Hz, 1H), 7.41 (s, 1H), 7.19-7.23 (m, 1H), 7.06 (s br, 1H), 6.89-6.93 (m, 1H), 3.80 (s, 2H).
Synthesis of intermediate 5.
Figure imgf000098_0002
[0288] To a solution of intermediate 4 (100 g, 0.51 mol) in DMF (1000 mL) was added NaH (60%, 61 g, 1.53 mol) at 0 °C. The mixture was stirred at room temperature for 20 mins. 2-chloroethylamine hydrochloride (89.2 g, 0.77 mol) was added to the mixture in portions at 0 °C. The mixture was stirred at room temperature for 2 hrs. TLC (Petroleum Ether/EtOAc=5/l) showed the reaction was complete. The mixture was poured into ice-water and extracted with EtOAc (600 mL x3). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum to give intermediate 5 (110 g, 90 %) as yellow oil.
[0289] ¾ NMR (CDCh, 400 MHz): δ (ppm) 7.74-7.75 (d, 1H, J=1.2 Hz), 7.21-7.29 (m, 2H), 7.13-7.14 (d, 1H. J=3.2Hz), 6.44-6.45 (d, 1H, J=2.8Hz), 4.14-4.17 (t, 2H, J=6 Hz), 3.08- 3.11 (t, 2H, J=6 Hz).
Synthesis of intermediate 6.
Figure imgf000099_0001
[0290] To a solution of intermediate 5 (150 g, 0.63 mol) in AcOH (720 mL) was added Borane pyridine complex (9.3 M, 135.5 mL, 1.26 mol) at room temperature under N2. The mixture was stirred at room temperature for overnight. Then the mixture was adjusted pH = 9-10 with aqueous NaOH, extracted with EtOAc (800 mLx3). The combined organic phases were concentrated in vacuum to give crude compound. Water (720 mL) was added to the crude compound, followed by the slow addition of concentrated HC1 (240 mL). The mixture was stirred at room temperature for 30 mins, adjusted pH = 10-11 with aqueous NaOH, extracted with EtOAc (800 mLx3), concentrated to give crude compound. To a solution of the crude compound in methyl tertiary butyl ether (500 mL) was added AcOH (28 mL) at room temperature. The mixture was stirred at room temperature for 30 mins, then filtered, the filter cake was washed with methyl tertiary butyl ether, dried to give intermediate 6 (120 g, 63.5 %) as white solid.
[0291] ¾ NMR (DMSO-de, 400 MHz): δ (ppm) 7.14 (s, 1H), 7.09-7.12 (d, 1H, J=8.4 Hz), 6.43-6.45 (d, 1H, J=8.4 Hz), 3.33-3.37 (t, 2H, J=8.4 Hz), 3.06-3.09 (t, 2H, J=6.6 Hz), 2.87-2.92 (t, 2H, J=8.4 Hz), 2.76-2.79 (t, 2H, J=6.6 Hz).
Synthesis of intermediate 7.
Figure imgf000099_0002
[0292] To a solution of H2SO4 (12.6 mL) in AcOH (80 mL) and HCHO (37% aqueous, 660 mL) was added intermediate 6 (100 g, 0.33 mol) in portions at room temperature. The mixture was stirred at 50 °C for 20 mins. Then the mixture was adjusted pH = 9-10 with aqueous NaOH, extracted with EtOAc (800 mLx3), concentrated to give crude intermediate 7 (100 g) as yellow solid, which was used directly for the next step without purification.
Synthesis of intermediate 8.
Figure imgf000100_0001
7 8
[0293] A mixture of intermediate 7 (100 g, crude) and aqueous K2CO3 (300 mL, 1 M) in THF (700 mL) was added (Βο Ο (94.4 g) at room temperature. The mixture was stirred at room temperature for overnight. TLC (dichloromethane/MeOH=10/l) showed the reaction was complete. Then H2O was added, extracted with EtOAc (500 mLx3). The combined organic phases were washed with brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 50: 1 to 5: 1) to give intermediate 8 (75 g, 64.6% for two steps) as yellow solid.
[0294] ¾ NMR (CDCh, 400 MHz): δ (ppm) 7.11 (bs, 1H), 6.99 (bs, 1H), 4.30-4.37 (m, 2H), 3.68 (m, 2H), 3.36-3.40 (m, 2H), 2.96-3.01 (m, 4H), 1.41 (s, 9H).
Synthesis of core 1.
Figure imgf000100_0002
8 core 1
[0295] To a solution of intermediate 8 (49 g, 0.14 mol) in THF (490 mL) was added a solution of DDQ (37.9 g, 0.17 mol) in THF (490 mL) at 0 °C under N2. The mixture was stirred at 0 °C for 15 mins. TLC (petroleum ether/EtOAc=5/l) showed the reaction was complete. Then the mixture was poured into aq. Na2CCb and extracted with EtOAc (400 mL x2). The combined organic phases were washed with brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 50: 1 to 10: 1) to give core 1 (24 g, 49%) as yellow solid.
[0296] ¾ NMR (CDCh, 400 MHz): δ (ppm) 7.63 (bs, 1H), 7.04-7.15 (m, 2H), 6.46-6.47 (d, 1H, J=3.2 Hz), 4.76-4.83 (m, 2H), 4.25 (m, 2H), 3.92 (m, 2H), 1.42-1.45 (m, 9H).
Synthesis of Intermediate 10
Figure imgf000101_0001
[0297] To a solution of core 1 (10 g, 28.5 mmol) in dichloromethane (100 mL) was added HCl/dioxane (7 M, 50 mL) at room temperature. The mixture was stirred at room temperature for 1 hr. TLC (petroleum ether/EtOAc=5/l) showed the reaction was complete. The solvent was concentrated in vacuum to give white solid.
[0298] To a solution of the white solid and 1 -Piperidinecarbonyl chloride (4.6 g, 31.3mmol) in DMF (100 mL) was added EtsN (8.6 g, 85.5 mmol) below 5 °C. The mixture was stirred at room temperature for 1 hr. TLC (dichloromethane/MeOH=10/l) showed the reaction was complete. Then the mixture was poured into ice-water and extracted with EA (200 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 20: 1 to 1 : 1) to give intermediate 10 (7.5 g, 72.8%) as yellow solid.
[0299] ¾ NMR (CDCh, 400 MHz): δ (ppm) 7.86 (d, J=1.6Hz, 1H), 7.26 (s, 1H), 7.02 (t, J=1.6Hz, 1H), 6.47 (d, J=3.2Hz, 1H), 4.63 (s, 2H), 4.22-4.20 (t, J= 4.8Hz, 2H), 3.98-4.00 (t, J = 4.8Hz, 2H), 3.18-3.19 (m, 4H), 1.58-1.40 (m, 6H).
Synthesis of intermediate 11.
Figure imgf000101_0002
10 11
[0300] To a solution of intermediate 10 (10 g, 27.6 mmol) in dichloromethane (100 mL) was added (COCl)2 (8.8 g, 69 mmol) at 0 °C under N2. The mixture was stirred at 40 °C for 1 hr. TLC (petroleum ether/EtOAc=l/l) showed the reaction was complete. Then a solution of NaOMe (3.7 g, 69 mmol) in MeOH (10 mL) was added at -60 °C under N2. The mixture was stirred at room temperature for 1 hr. Water was added, extracted with dichloromethane (100 mLx3). The combined organic phases were washed with brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 5: 1 to 1 :2) to give intermediate 11 (6 g, 48.5%) as yellow solid.
[0301] ¾ NMR (CDCh, 400 MHz): δ (ppm) 8.70 (d, J = 1.6Hz, 1H), 8.29 (s, 1H), 7.41 (s, 1H), 4.67 (s, 2H), 4.41-4.39 (m, 2H), 4.01-3.98 (m, 2H), 3.95 (s, 3H), 3.15-3.01 (m, 4H), 1.60-1.40 (m, 6H).
Synthesis of core 2.
Figure imgf000102_0001
Core 2
[0302] A solution of intermediate 11 (10 g, 22.3 mmol) and intermediate 3 (3.9 g, 22.3 mmol) in DMF (180 mL) was added a solution of t-BuOK (6.4 g, 19.0 mmol) in THF (100 mL) at 0-10 °C. The mixture was stirred at 0-10 °C for 15 mins. TLC (dichloromethane/MeOH=15/l) showed the reaction was complete. Then the mixture was poured into ice-water and extracted with EtOAc (100 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with petroleum ether/EtOAc/THF from 10:5: 1 to 1 : 1: 1) to give core 2 (6.5 g, 50.7%) as orange solid.
[0303] ¾ NMR (DMSO-d6, 400 MHz): δ (ppm) 11.25 (s, 1H), 8.02 (s, 1H), 7.91 (s, 1H), 7.65-7.68 (d, J = 6.8Hz, 1H), 7.59-7.61 (d, J = 6.8Hz, 1H), 7.19-7.23 (t, J = 7.6 Hz, 1H), 7.04 (s, 1H), 6.55-6.58 (t, J = 6.4 Hz, 1H), 6.08 (s, 1H), 4.63 (s, 2H), 4.50-4.62 (m, 2H), 3.82-3.86 (m, 2H), 2.94-3.06 (m, 4H), 1.40-1.60 (m, 6H).
[0304] LC/MS M+l=573.1
Synthesis of intermediate 12.
Figure imgf000103_0001
core 1 12
[0305] To a solution of core 1 (10 g, 28.5 mmol) in DMF (200 mL) was added Cul (5.4 g, 28.5 mmol) and methyl 2,2-difluoro-2-(fluorosulfonyl)acetate (19.2 g, 100 mmol) at room temperature under N2. The mixture is stirred at 80 °C for 2.5 hrs. TLC (petroleum ether/EtOAc=5/l) showed that the reaction was complete. The mixture was cooled to room temperature, and filtered. The filtrate was added water and extracted with EtOAc (100 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 20: 1 to 5: 1) to give intermediate 12 (5.5 g, 56.7%) as yellow solid.
[0306] ¾ NMR (CDCh, 400 MHz): δ (ppm) 7.81 (s, 1H), 7.13-7.28 (m, 2H), 6.62 (s, 1H), 4.92-4.84 (m, 2H), 4.22 (s, 2H), 3.98-3.97 (m, 2H), 1.40 (s, 9H).
Synthesis of intermediate 13.
Figure imgf000103_0002
12 13
[0307] To a solution of intermediate 12 (5.0 g, 14.7 mmol) in dichloromethane (75 mL) was added (COCl)2 (4.6 g, 36.7 mmol) under N2. The mixture was stirred at 40 °C for 1 hr. TLC (petroleum ether/EtOAc=l/l) showed the reaction was complete. Then a solution of NaOMe (1.98 g, 36.7 mmol) in MeOH (10 mL) was added at -60 °C under N2. The mixture was stirred at room temperature for 1 hr. Water was added, extracted with dichloromethane (100 mL x3). The combined organic phases were washed with brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 10: 1 to 5: 1) to give intermediate 13 (3.8g, 60.7%) as a yellow solid.
[0308] ¾ NMR (CDCb, 400 MHz): δ (ppm) 8.64 (s, 1H), 8.44 (s, 1H), 7.40-7.31 (m, 1H), 4.98-4.88 (m, 2H), 4.51-4.50 (m, 2H), 4.04-4.01 (m, 2H), 3.96 (s, 3H), 1.40 (s, 9H).
Synthesis of intermediate 14.
Figure imgf000104_0001
[0309] To a solution of intermediate 13 (5.5 g, 12.9 mmol) and intermediate 3 (2.25 g, 12.9 mmol) in DMF (110 mL) was added a solution of tBuOK (3.6 g, 32.2 mmol) in THF (10 mL) at 0-10 °C. The mixture was stirred at 0-10 °C for 15 min. TLC (petroleum ether/EtOAc=l/l) showed the reaction was complete. Then the mixture was poured into ice- water and extracted with EtOAc (100 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with dichloromethane/MeOH from 100: 1 to 30: 1) to give intermediate 14 (3.5 g, 58.3%) as orange solid.
[0310] ¾ NMR (CDC13, 400 MHz): δ (ppm) 8.16 (s, 1H), 8.02 (s, 1H), 7.96 (s, 1H), 7.35 (s, 1H), 7.27 (s, 1H), 7.12-7.08 (m, 2H)), 6.40-6.38 (m, 2H, 4.89-4.77 (m, 2H), 4.50 (s, 2H), 4.04 (s, 2H), 1.48-1.37 (m, 9H).
Synthesis of compound 1-1.
Figure imgf000104_0002
[0311] To a solution of intermediate 14 (5 g, 9.1 mmol) in dichloromethane (50 mL) was added HCl/dioxane (50 mL, 7M) at room temperature. The mixture was stirred at room temperature for 1 hr. TLC (dichloromethane/MeOH=15/l) showed the reaction was complete. The solvent was concentrated in vacuum to give white solid.
[0312] To a solution of the white solid and 1 -Piperidinecarbonyl chloride (1.8 g, 12.3mmol) in DMF (40 mL) was added Et3N (2.49 g, 24.6 mmol) at room temperature. The mixture was stirred at room temperature for 1 hr. TLC (dichloromethane/MeOH =10/1) showed the reaction was complete. Then the mixture was poured into ice-water and extracted with EtOAc (100 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with dichloromethane/THF from 20: 1 to 10: 1) to give compound I- 1 (3.0 g, 70%) as red solid.
[0313] ¾ NMR (DMSO-cfc, 400 MHz): δ (ppm) 11.30 (s, 1H), 8.17 (s, 1H), 7.93 (s, 1H), 7.64-7.60 (m, 2H), 7.19 (s, 1H), 6.56 (m, 1H), 6.31 (s, 1H), 4.77-4.69 (m, 2H), 4.68-4.60 (m, 2H), 3.95-3.85 (m, 2H), 3.10-2.90 (m, 4H), 1.55-1.35 (m, 6H).
[0314] LC/MS M+l 563.1
Synthesis of compound 1-2.
Figure imgf000105_0001
core 2 Compound 1-2
[0315] A solution of core 2 (5 g, 8.7 mmol) in N-Methyl-2-Pyrrolidone (50 mL) was added CuCN (2.5 g, 28 mol) at room temperature. The mixture was stirred at 150 °C for 6 hr under N2. Then the mixture was poured into ice-water and extracted with EtOAc (100 mL x4). The combined organic phases were washed with brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with dichloromethane/MeOH from 1 :0 to 50: 1) to give compound 1-2 (2.2 g, 49%) as orange solid. [0316] ¾ NMR (DMSO-ifc): 5 (ppm) 11.30 (s, 1H), 8.07 (s, 1H), 7.97 (s, 1H), 7.66-7.68 (d, 1H, J = 9.2 Hz), 7.54-7.56 (d, 1H, J = 6.8 Hz), 7.29 (s, 1H), 7.19-7.23 (t, J = 8 Hz, 1H),
6.53-6.57 (t, 1H, J = 6.8 Hz), 6.44 (s, 1H), 4.68 (S, 4H), 4.60-4.63 (m, 4H), 3.84-3.88 (m, 2H), 2.96-3.05 (m, 4H), 1.43-1.47 (m, 6H).
[0317] LC/MS M+l 520.1
Synthesis of intermediate 15.
Figure imgf000106_0001
core 1 15
[0318] To a solution of core 1 (50 g, 0.14 mol) in 1,4-dioxane (500 mL) was added Nal (42.7 g, 0.28 mol) and Cul (2.7g) and 2-Dimethylaminoethylamine (2.5g). The mixture was stirred at 140 °C overnight under N2. The mixture was filtered, the filter cake was washed with dichloromethane. The combined organic phases were concentrated in vacuum. The residue was washed with methyl tertiary butyl ether to give intermediate 15 (50 g, 88.0%) as yellow solid.
Synthesis of intermediate 16.
Figure imgf000106_0002
15 16
[0319] To a solution of intermediate 15 (10 g, 25.1mmol) in EtsN (120 mL) and THF (
60mL) at room temperature, then Pd(PPh3)2Ch (1.2g, 2.4mmol) and Cul (1.2g, 2.4mmol) was added under N2. Then ethynyltrimethylsilane (4.75g, 48.4mmol) was added drop wise. The mixture was stirred at 60 °C overnight. The mixture was concentrated in vacuum to remove Et3N. Then the mixture was poured into ice-water, extracted with CH2CI2 (300 mL χ2). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 100: 1 to 50: 1) to give intermediate 16 (6 g, 64.8 %) as yellow solid.
[0320] ¾ NMR (CDCh, 400 MHz): δ (ppm) 7.63-7.67 (m, 1H), 7.04-7.41 (m, 2H), 6.46- 6.49 (m, 1H), 4.77-4.84 (m, 2H), 4.23-4.29 (m, 2H), 3.90-3.97 (m, 2H), 1.43 (s, 9H), 0.26 (s, 9H).
Synthesis of intermediate 17.
Figure imgf000107_0001
16 17
[0321] A solution of intermediate 16 (10 g, 27 mmol) in dichloromethane (110 mL) was added (COCl)2 (8.5 g, 67.4 mmol) at 0°C under N2. The mixture was stirred at 40°C for 1 hr. TLC (petroleum ether/EtOAc=5/l) showed the reaction was complete. Then a solution of NaOMe (3.64 g, 67.4 mmol) in MeOH (10 mL) was added at -60°C under N2, The mixture was stirred at room temperature for 1 hr. Water was added, extracted with dichloromethane (100 mL x3). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 100: 1 to 5: 1) to give intermediate 17 (7 g, 56.7%) as yellow solid.
Synthesis of intermediate 18.
Figure imgf000108_0001
17 18
[0322] To a solution of intermediate 17 (8 g, 17.6 mmol) and intermediate 3 (3.1 g, 17.6 mmol) in DMF (80 mL) was added a solution of tBuOK (4.9 g, 44 mmol) in THF (30 mL) at 0-10 °C. The mixture was stirred at 0-10 °C for 15 min. TLC (petroleum ether/EtOAc=l/l) showed the reaction was complete. Then the mixture was poured into ice-water and extracted with EtOAc (100 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with dichloromethane/MeOH from 100: 1 to 50: 1) to give intermediate 18 (5 g, 49%) as orange solid.
Synthesis of intermediate 19.
Figure imgf000108_0002
[0323] To a solution of intermediate 18 (5 g, 8.6 mmol) in dichloromethane (50 mL) was added HCl/dioxane (50 mL, 7M) at room temperature. The mixture was stirred at room temperature for 1 hr. TLC (dichloromethane/MeOH=15/l) showed the reaction was complete. The solvent was concentrated in vacuum to give white solid.
[0324] To a solution of the white solid and 1 -Piperidinecarbonyl chloride (1.4 g, 9.5mmol) in DMF (50 mL) was added Et3N (2.6 g, 25.8 mmol) at room temperature. The mixture was stirred at room temperature for 1 hr. TLC (dichloromethane/MeOH =10/1) showed the reaction was complete. Then the mixture was poured into ice-water and extracted with EtOAc (100 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum to give the crude intermediate 19 (5.2 g), which was used directly for the next step without purification.
Synthesis of compound 1-3.
Figure imgf000109_0001
19 Compound I-3
[0325] To a solution of the crude intermediate 19 (5.2 g) in DMF (lOOmL) was added K2CO3 (2 g). The mixture was heated to 50 °C and stirred for 1 hr. Then the mixture was poured into ice-water and extracted with EtOAc (100 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with dichloromethane/MeOH from 100: 1 to 30: 1) to give compound 1-3 (3 g, 18.6% for two steps) as red solid.
[0326] ¾ NMR (DMSO-cfc, 400 MHz): δ (ppm) 11.26 (s, 1H), 8.02 (s, 1H), 7.92 (s, 1H), 7.65-7.59 (m, 2H), 7.20 (t, 1H, J = 8Hz), 6.97 (s, 1H), 6.58-6.55 (t, J = 6.8Hz, 1H), 6.18 (s, 1H), 4.63 (s, 2H), 4.50-4.60 (m, 2H), 3.80-3.90 (m, 2H), 3.75 (s, 1H), 2.95-3.05 (m, 4H), 1.46-1.35 (m, 6H).
[0327] LC/MS M+l 519.2
Synthesis of compound I- 10
Figure imgf000109_0002
core 2 Compound 1-10 [0328] A solution of core 2 (5 g, 8.8 mmol) in dioxane (50 mL) was added acetamide (3.1 g, 53.3 mmol), Cul (1.1 g, 5.8 mmol), K3PO3 (5.5 g, 26.4 mmol) at RT under N2. The mixture was stirred at room temperature for 20 mins. N N imethylethane-l,2-diamine (1.56 g, 17.8 mmol) was added, and then the mixture was stirred at 115 °C for 5 hrs under N2. TLC (dichloromethane/MeOH=15/l) showed the reaction was complete. Then the mixture was poured into ice-water and extracted with EtOAc/THF (3/1, 100 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with dichloromethane/MeOH from 200: 1 to 50:1) to give compound 1-10 (3 g, 62%) as red solid.
[0329] ¾ NMR (DMSO-cfc, 400 MHz): δ (ppm) 11.21 (s, 1H), 9.43 (s, 1H), 7.86 (s, 1H), 7.78 (s, 1H), 7.58-7.64 (m, 2H), 7.17-7.21 (t, 1H, J= 8.0 Hz), 7.00 (s, 1H), 6.77 (s, 1H), 6.56- 6.58 (t, 1H, J = 7.2 Hz), 4.60 (s, 2H), 4.40-4.50 (m, 2H), 3.80-3.88 (m, 2H) , 2.88-3.12 (m, 4H), 1.85 (s, 3H) , 1.15-1.20 (m, 6H).
[0330] LC/MS M+l 552.2
Synthesis of compound 1-4.
Figure imgf000110_0001
Compound 1-10 Compound I-4
[0331] A solution of compound 1-10 (3 g, 5.4 mmol) in EtOH (10 mL) was added HC1 (28 mL, 6 N) at room temperature. The mixture was stirred at 80 °C for 3 hrs. TLC (dichloromethane/MeOH =15/1) showed the reaction was complete. Then the mixture was poured into ice-water and extracted with dichloromethane (100 mL x2), then the water phase was adjusted pH=9-10 with aq.Na2CCb, extracted with dichloromethane (100 mL *6), concentrated in vacuum. The residue was washed with methyl tertiary butyl ether, filtered. The filter cake was dried in vacuo to give compound 1-4 (2.1 g, 75 %) as red solid.
[0332] ¾ NMR (DMSO-c¾ 400 MHz): δ (ppm) 11.19 (s, 1H), 7.86 (s, 1H), 7.84 (s, 1H), 7.62 (bs, 2H), 7.18-7.22 (t, lH, J= 7.2 Hz), 6.57-6.61 (t, lH, J= 6.8 Hz), 6.24 (s, 1H), 5.27 (s, 1H), 4.50 (s, 2H), 4.36-4.39 (m, 2H), 4.14-4.17 (m, 2H), 3.75-3.78 (m, 2H), 2.88-3.05 (m, 4H), 1.44-1.48 (m, 6H).
[0333] MS/LC M+1 511.1
Synthesis of intermediate 22.
Figure imgf000111_0001
21 22
[0334] To a solution of intermediate 21 (100 g, 0.59 mol) in dry toluene (890 mL) was added n-BuOH (131.6 g, 1.78 mol) and TsOH (10 g) at room temperature. The mixture was stirred at 120 °C for overnight, and removed the water using a Dean-stark apparatus. TLC (petroleum ether/EtOAc=5/l) showed the reaction was completed. The mixture was concentrated in vacuum to give crude intermediate 22. The crude intermediate 22 was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 100: 1 to 20: 1) to give intermediate 22 (120 g, 67.8%) as a yellow oil.
[0335] ¾ NMR (CDCb, 400 MHz): δ (ppm) 7.89-7.92 (dd, 1H, J=4.8Hz, 8.8 Hz), 7.51- 7.54 (dd, lH, J=2.8Hz, 9.6Hz), 7.09-7.14 (m, 1H), 6.04 (s, 1H), 3.50-3.56 (m, 4H), 1.55-1.62 (m, 4H), 1.33-1.42 (m, 4H), 0.83-0.93 (m, 6H).
Synthesis of intermediate 23.
Figure imgf000111_0002
22 23
[0336] To a solution of intermediate 22 (50 g, 0.17 mol) in dry THF (1500 mL) was added vinylmagnesium bromide solution (1 M, 668.8 mL, 668.8 mmol) drowpwised at -40 °C. The mixture was stirred at -40 °C for 1 hr. TLC (petroleum ether/EtOAc = 5/1) showed the reaction was completed Then the mixture was poured into aq.NH4Cl, extracted with EtOAc (300 mL x3), the organic phases were concentrated to give crude compound. The crude compound was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 100: 1 to 20: 1) to give the compound (24 g) as yellow oil. To a solution of the compound (24 g) in THF (100 mL) was added HCl (0.5 N, 80 mL) drop wised at room temperature. The mixture was stirred at room temperature for 1 hr. TLC (petroleum ether/EtOAc =5/1) showed the reaction was completed. The mixture was adjusted pH=10 with aq.NaOH, extracted with EtOAc (300 mL x3), concentrated in vacuum to give intermediate 23 (16 g, 58.8 %) as yellow solid.
[0337] ¾ NMR (CDCh, 400 MHz): δ (ppm) 10.06 (s, 1H), 7.62 (dd, 1H, J=2Hz, 9.2Hz), 7.38-7.41 (m, 2H), 6.60(t, 1H, J=2.4Hz).
Synthesis of intermediate 24.
Figure imgf000112_0001
[0338] To a solution of intermediate 23 (140 g, 0.86 mol) in MeOH (2100 mL) was added 2-aminoethanol (78 g, 1.3 mol) and Pd/C (14 g) at room temperature under N2. The mixture was stirred at room temperature for 2 hrs under N2. Then the mixture was stirred at room temperature for overnight under H2. The mixture was filtered, concentrated to give intermediate 24 (200 g, crude) as a yellow oil, which was used directly for the next step without purification.
Synthesis of intermediate 25.
Figure imgf000112_0002
24 25
[0339] A mixture of intermediate 24 (90 g, crude) and K2CO3 (467 mL, 1 M) in THF (1300 mL) was added B0C2O (141 g) at room temperature. The mixture was stirred at room temperature for overnight. TLC (dichloromethane/MeOH=10/l) showed the reaction was completed Then H2O was added, extracted with EtOAc (500 mL x3). The combined organic phases were washed with brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 10: 1 to 1 : 1) to give intermediate 25 (66.6 g, 56% for two steps) as yellow oil.
[0340] ¾ NMR (CDCh, 400 MHz): δ (ppm) 10.17 (s, 1H), 7.23-7.26 (m, 2H), 6.78-6.82 (dd, 1H, J = 9.2 Hz, J=2 Hz), 6.48-6.50 (t, 1H, J=2.4Hz), 4.67 (s, 2H), 3.66-3.71 (m, 2H), 3.25-35 (m, 2H), 1.40 (s, 9H).
Synthesis of intermediate 26.
Figure imgf000113_0001
25 26
[0341] To a solution of intermediate 25 (50 g, 0.26 mol) in THF (1000 mL) was added EtsN (79 g, 0.79 mol) and MS2O (55 g, 0.32 mol) at 0 °C under N2. The mixture was stirred at 0 °C for 2 hrs. TLC (petroleum ether/EtOAc=3/l) showed the reaction was completed. Then it was poured into ice- water and extracted with EtOAc (400 mL x2). The combined organic phases were washed with brine, dried over Na2S04 and concentrated in vacuum to give intermediate 26 (50 g, 79%) as yellow oil.
[0342] ¾ NMR (CDCh, 400 MHz): δ (ppm) 10.08 (bs, 1H), 7.24-7.29 (m, 2H), 6.81- 6.84 (m, 1H), 6.49-6.50 (d, 1H, J=2.4Hz), 4.67 (s, 2H), 4.28-4.31 (m, 2H), 3.48-3.52 (m, 2H), 2.79 (s, 3H), 1.51 (s, 9H).
Synthesis of intermediate 27.
Figure imgf000113_0002
[0343] A solution of intermediate 26 (65 g, 0.19 mol) in DMF (722 mL) was added NaH (60%, 11.5 g, 0.29 mol) at 0 °C. The mixture was stirred at 0 °C for 1 hr under N2. TLC (petroleum ether/EtOAc=3/l) showed the reaction was completed. Then the mixture was poured into ice-water and extracted with EtOAc (500 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 50: 1 to 10: 1) to give intermediate 27 (26 g, 53.2%) as yellow solid.
[0344] ¾ NMR (CDCb, 400 MHz): δ (ppm) 7.14-7.16 (d, 1H, J=8Hz), 7.07 (s, 1H), 6.72-6.83 (m, 1H), 6.48-6.49 (d, 1H, J=2.8Hz), 4.84 4.76 (s, 2H), 4.24-4.25 (m, 2H), 3.94 (m, 2H), 1.45-1.48 (m, 9H).
Synthesis of intermediate 28.
Figure imgf000114_0001
27 28
[0345] A solution of intermediate 27 (27.5 g, 95.0 mmol) in dichloromethane (900 mL) was added (COCl)2 (18 g, 142 mmol) at 0 °C under N2. The mixture was stirred at 0 °C for 2 hrs. TLC (petroleum ether/EtOAc=l/l) showed the reaction was completed. Then a solution of NaOMe (13.4 g, 247 mmol) in MeOH (40.8 mL) was added at -60 °C under N2. The mixture was stirred at room temperature for 1 hr. Water was added, extracted with dichloromethane (200 mL x3). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 20: 1 to 1 : 1) to give intermediate 28 (20 g, 56%) as white solid.
[0346] ¾ NMR (CDCb, 400 MHz): δ (ppm) 8.37 (s, 1H), 8.02-8.04 (d, 1H, J=8.4Hz), 6.84-6.91 (m, 1H), 4.80-4.90 (m, 2H), 4.44 (bs, 2H), 3.91-3.98 (m, 5H), 1.41-1.46 (m, 9H).
Synthesis of intermediate 29.
Figure imgf000115_0001
28 29
[0347] A solution of intermediate 28 (10 g, 26.5 mmol) and intermediate 3 (4.6 g, 26.5 mmol) in DMF (120 mL) was added A solution of tBuOK (7.4 g, 66.2 mmol) in THF (100 mL) at 0-10 °C. The mixture was stirred at 0-10 °C for 15 min. TLC (petroleum ether/EtOAc =1/1) showed the reaction was completed. Then the mixture was poured into ice-water and extracted with EtOAc (100 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 20: 1 to 1 : 1) to give intermediate 29 (7 g, 52.5%) as red solid.
[0348] ¾ NMR (DMSO-ύ ΟΟ MHz): δ (ppm) 11.07 (s, 1H), 8.02-8.01 (d, 1H, J=4Hz), 8.96 (s, 1H), 7.61-7.63 (t, 1H, J=8.8Hz), 7.45 (s, 1H), 7.17 (s, 1H), 6.57-6.64 (m, 1H), 6.47- 6.49 (d, 1H, J=8Hz), 5.77-5.80 (d, 1H J =8.4Hz), 4.73 4.78 (2H), 4.52 (bs, 2H), 3.96 (bs, 2H), 1.25-1.44 (m, 9H).
Synthesis of core 3.
Figure imgf000115_0002
29 core 3
[0349] A solution of intermediate 29 (5 g, 9.9 mmol) in dichloromethane (50 mL) was added HCl/dioxane (50 mL, 7M) at room temperature. The mixture was stirred at room temperature for 1 hr. TLC (dichloromethane/MeOH=15/l) showed the reaction was completed. The solvent was concentrated in vacuum. The residue was washed with methyl tertiary butyl ether, filtered. The filter cake was dried in vacuo to give core 3 (4 g, 91.9%) as orange solid.
[0350] ¾ NMR (DMSO-c e, 400 MHz): δ (ppm) 11.59 (s, 1H), 10.46 (bs, 2H), 8.49 (s, 1H), 8.18 (s, 1H), 8.08-8.12 (m, 2H, J=14Hz), 7.88-7.92 (t, 1H, J=8.0Hz), 7.25-7.29 (t, 1H, J=6.8Hz), 7.04-7.07 (m, 1H), 6.22-6.25 (m, 1H), 4.76 (bs, 2H), 4.62 (bs, 2H), 3.68 (bs, 2H).
Synthesis of intermediate 31.
Figure imgf000116_0001
30 31
[0351] A solution of intermediate 30 (20 g, 94 mmol) in dioxane (100 mL) was added HCl/dioxane (100 mL, 7M) at room temperature. The mixture was stirred at room temperature for 2 hrs. TLC (petroleum ether/EtOAc=3/l) showed the reaction was completed. The mixture was poured onto methyl tertiary butyl ether (300 mL), and filtered. The filter cake was dried in vacuo to give intermediate 31 hydrochloride (8 g, 57%) as white solid.
Synthesis of intermediate 32.
Figure imgf000116_0002
31 32
[0352] A solution of intermediate 31 hydrochloride (7 g, 47 mmol) in dichloromethane (180 mL) was added Et3N (14.2 g, 141 mmol) at room temperature. The mixture was stirred at room temperature for 10 min. Then a solution of Triphosgene (5.6 g, 19 mmol) in dichloromethane (20 mL) was added to the mixture at 0 °C -10 °C. The mixture was stirred at room temperature for 2 hrs. TLC (dichloromethane/MeOH=10/l) showed the reaction was completed. Then the mixture was washed with aq. NaHCCb, water, brine, dried over Na2S04 and concentrated in vacuum. The crude product was distilled in vacuum to afford intermediate 32 (2.5 g, 30.5%) as colorless oil.
Synthesis of compound 1-5.
Figure imgf000117_0001
32 Compound 1-5
[0353] A solution of core 3 (5 g, 11.45 mmol) in DMF (70 mL) was added Et3N (3.5 g, 34.35 mmol) at room temperature. The mixture was stirred at room temperature for 10 min. Then a solution of intermediate 32 (3.6 g, 20.5 mmol) in DMF (5 mL) was added to the mixture at 0 °C -10 °C. The mixture was stirred at room temperature for 2 hrs. TLC
(dichloromethane/MeOH =15/1) showed the reaction was completed. The mixture was poured into ice-water and extracted with methyl tertiary butyl ether to remove impurities, then extracted with EtOAc (100 mLx5). The combined EtOAc phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum to give the crude Compound I- 5 (4.5 g, crude) as an orange solid.
[0354] ¾ NMR (DMSO-c e, 400 MHz): δ (ppm) 11.3 (s, 1H), 9.58 (s, 1H), 8.05 (s, 1H), 7.92 (s, 1H), 7.65 (d, 1H, J=8.8Hz ), 7.60 (d, 1H, J=6.8Hz ), 7.21 (t, 1H, J=8Hz), 6.78 (d, 1H, J=9.6Hz), 6.58 (t, 1H, J=6.8Hz), 5.62 (d, 1H, J=2Hz), 4.64 (s, 2H), 4.55 (s, 2H), 3.85 (s, 2H), 3.21-3.37 (m, 2H), 2.73-2.76 (m, 2H), 1.75-1.76 (m, 2H), 1.33-1.47 (m, 3H).
Synthesis of compound 1-6.
Figure imgf000117_0002
33 Compound 1-6
[0355] To solution of crude intermediate 33 (4.5 g) in THF (100 mL) was added NaBFLt (0.16 g, 4.2 mmol) in portions below 5 °C. After addition, the reaction mixture was stirred below 5 °C for 0.5 hr. TLC (dichloromethane/MeOH =15/1) showed the reaction was completed. Then the mixture was poured into water and extracted with EtOAc (100 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with dichloromethane/MeOH from 200: 1 to 30: 1) to give compound 1-6 (3 g, 48% for two steps) as orange solid.
[0356] ¾NMR (DMSO-rf6, 400 MHz): δ (ppm) 11.24 (s, 1H), 8.06 (s, 1H), 7.92 (s, 1H), 7.64-7.66 (d, 1H, J=8.8Hz ), 7.59-7.61 (d, 1H, J=6.4Hz ), 7.18-7.22 (t, 1H J=8Hz), 6.78-6.80 (d, 1H, J=9.6Hz), 6.56-6.59 (t, 1H J=6.8Hz), 5.62-5.65 (d,d, 1H J=2Hz J=10Hz), 4.63 (s, 2H), 4.55 (s, 2H), 4.45-4.47 (t, 2H, J=5.2Hz), 3.85 (s, 2H), 3.40-3.43 (d, 2H J=12.4Hz), 3.23- 3.26 (t, 2H, J=4.8Hz), 2.58-2.65 (t, 2H, J=12Hz), 1.55-1.58 (d, 2H J=12.8Hz), 1.47-1.48 (d, 1H J=6.4Hz), 1.05-1.13 (m, 2H).
[0357] LC/MS M+l 543.1
Synthesis of intermediate 35.
Figure imgf000118_0001
34 35
[0358] A solution of intermediate 34 hydrochloride (8.6 g, 55.0 mmol) in dichloromethane (240 mL) was added Et3N (16.7g, 165.0mmol) at room temperature. The mixture was stirred at room temperature for 10 min. Then a solution of Triphosgene (6.5g
22.0 mmol) in dichloromethane (20 mL) was added to the mixture at 0 °C -10 °C. The mixture was stirred at room temperature for 2 hrs. TLC (dichloromethane/MeOH =10/1) showed the reaction was completed. Then the mixture was washed with aq. NaHCCb, water, brine, dried over Na2S04 and concentrated in vacuum. The crude product was distilled in vacuum to afford intermediate 35 (4.2 g, 42%) as colorless oil.
[0359] ¾ NMR (CDCb, 400 MHz) : δ (ppm) 3.80-3.85 (bs, 2H), 3.71 -3.75 (bs, 2H), 2.01 - 2.11 (m, 4H).
Synthesis of compound 1-7.
Figure imgf000119_0001
35 Compound 1-7
[0360] A solution of core 3 (3 g, 6.8 mmol) in DMF (40 mL) was added Et3N (2.1 g, 20.6 mmol) at room temperature. The mixture was stirred at room temperature for 10 min. Then a solution of intermediate 35 (1.4 g 7.5 mmol) in DMF (5 mL) was added to the mixture at 0
°C -10 °C. The mixture was stirred at room temperature for 2 hrs. TLC
(dichloromethane/MeOH =10/1) showed the reaction was completed. Then the mixture was poured into ice-water and extracted with methyl tertiary butyl ether to remove impurities, filtered. The filter cake was washed with water (100 mL χ 3), dissolved by dichloromethane (200 mL), washed with brine, dried over Na2S04 and concentrated in vacuum to give Compound 1-7 (2.2 g, 58%) as orange solid.
[0361] ¾ NMR (DMSO-ύ ΟΟ MHz): δ (ppm) 11.24 (s, 1H), 8.06 (s, 1H), 7.91 (s, 1H), 7.62-7.66 (m, 2H), 7.19-7.23 (t, 1H, J=8Hz), 6.84-6.86 (d, 1H, J=8.0Hz), 6.58-6.61 (t, 1H, J=6.4Hz), 5.63-5.66 (d, 1H, J=8.0Hz), 4.70 (s, 2H), 4.58 (bs, 2H), 3.90 (bs, 2H), 3.15 (bs, 4H), 1.93-1.96 (m, 4H).
[0362] LC/MS M+l 549.1
Synthesis of intermediate 37.
Figure imgf000119_0002
36 37
[0363] A solution of intermediate 36 hydrochloride (15 g, 100 mmol) in dichloromethane (430 mL) was added Et3N (30.6g, 300 mmol) at room temperature. The mixture was stirred at room temperature for 10 min. Then a solution of Triphosgene (11.9 g 40 mmol) in dichloromethane (20 mL) was added to the mixture at 0 °C -10 °C. The mixture was stirred at room temperature for 2 hrs. TLC (dichloromethane/MeOH =10/1) showed the reaction was completed. Then the mixture was washed with aq. NaHCCb, water, brine, dried over Na2S04 and concentrated in vacuum. The crude product was distilled in vacuum to afford intermediate 37 (9.2 g, 52%) as colorless oil.
[0364] ¾ NMR (CDCh, 400 MHz): δ (ppm) 4.40 (s, 2H), 3.90-3.94 (d, 2H, J=13.2Hz), 3.41-3.44 (d, lH, J=13.2Hz), 3.23-3.36 (d, 1H, J=12.8Hz), 1.90-2.04 (m, 2H), 1.80-1.86 (m, 2H).
Synthesis of compound 1-8.
Figure imgf000120_0001
37 Compound 1-8
[0365] A solution of core 3 (3 g, 6.8 mmol) in DMF (40 mL) was added Et3N (2.1 g, 20.6 mmol) at room temperature. The mixture was stirred at room temperature for 10 min. Then a solution of intermediate 37 (1.3g 7.5 mmol) in DMF (5 mL) was added to the mixture at 0
°C -10 °C. The mixture was stirred at room temperature for 2 hrs. TLC
(dichloromethane/MeOH =10/1) showed the reaction was completed. Then the mixture was poured into ice-water and extracted with EtOAc (100 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with dichloromethane/MeOH from 200: 1 to 50: 1) to give compound 1-8 (2.3 g, 62%) as orange solid.
[0366] ¾ NMR (DMSO-cfc, 400 MHz): δ (ppm) 11.24 (s, 1H), 8.05 (s, 1H), 7.92 (s, 1H), 7.60-7.66 (m, 2H), 7.20-7.24 (t, 1H, J=7.6Hz), 6.80-6.82 (d, 1H, J=9.2Hz), 6.57-6.59 (t, 1H J=6.8Hz), 5.64-5.67 (d, lH J=10Hz), 4.60 (s, 2H), 4.54 (bs, 2H), 4.19 (s, 2H), 3.84 (bs, 2H), 3.20-3.24 (d, 2H J=12.8Hz), 3.01-3.04 (d, 2H, J=12Hz), 1.74 (s, 4H).
[0367] LC/MS M+l 541.1
Synthesis of intermediate 39.
Figure imgf000121_0001
38 39
[0368] To a solution of intermediate 38 (20 g, 113 mmol) in MeOH (100 mL) was added HCl/MeOH (4 M, 100 mL), then stirred at room temperature overnight. The mixture was concentrated in vacuum. To the residue was added water (500 mL), then extracted with EtOAc (200 mL x4). The combined organic phases were washed with brine, dried over Na2S04 and concentrated in vacuum to give the crude intermediate 39 (21 g) as brown solid, which was used directly for the next step without purification.
Synthesis of intermediate 40.
Figure imgf000121_0002
39 40
[0369] To a solution of crude intermediate 39 (21 g) in MeOH (100 mL) was added NLb/MeOH (6 M, 100 mL). The reaction mixture was stirred at room temperature overnight. The mixture was poured into EtOAc (500 mL), and then filtered. The filter cake was dried in vacuo to give intermediate 40 (8 g, 40% for two steps) as off-white solid.
[0370] ¾ NMR (DMSO-c e, 400 MHz): δ (ppm) 7.86 (d, J=8.0Hz, 1H), 7.80 (s br, 1H), 7.72 (d, J=8.4Hz, 1H), 7.62-7.66 (m, 1H), 7.37-7.41 (m, 1H), 7.22 (s br, 1H), 3.88 (s, 2H).
Synthesis of intermediate 41.
Figure imgf000121_0003
[0371] To a solution of intermediate 28 (10 g, 26.5 mmol) and intermediate 40 (4.6 g, 26.5 mmol) in DMF (120 mL) was added a solution of tBuOK (7.4 g, 66.2 mmol) in THF (100 mL) at 0-10 °C. The mixture was stirred at 0-10 °C for 15 min. TLC (petroleum ether/EtOAc=l/l) showed the reaction was complete. Then the mixture was poured into ice- water and extracted with EtOAc (100 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was purified by flash column chromatography (eluted with petroleum ether/EtOAc from 10:5 to 1 :2) to give intermediate 41 (5 g, 37.5%) as red solid.
[0372] ¾ NMR (DMSO-i¾, 400 MHz): 5 (ppm) 11.07 (s, 1H), 8.02-8.01 (d, 1H, J=4Hz), 8.96 (s, 1H), 7.61-7.63 (t, 1H, J=8.8Hz), 7.45(s, 1H), 7.17 (s, 1H), 6.57-6.64 (m, 1H), 6.47- 6.49 (d, 1H, J=8Hz), 5.77-5.80 (d, 1H, J=8.4Hz), 4.73-4.78 (d, 2H), 4.52 (bs, 2H), 3.96 (bs, 2H), 1.25-1.44 (m, 9H).
Synthesis of intermediate 42.
Figure imgf000122_0001
[0373] A solution of intermediate 41 (5 g, 9.9 mmol) in dichloromethane (50 mL) was added HCl/dioxane (50 mL, 7M) at room temperature. The mixture was stirred at room temperature for 1 hr. TLC (dichloromethane/MeOH=15/l) showed the reaction was complete. The solvent was concentrated to give intermediate 42 (4 g, 92%) as orange solid.
[0374] ¾ NMR (DMSO-c e, 400 MHz): δ (ppm) 11.59 (s, 1H), 10.46 (s, 1H), 8.49 (s, 1H), 8.17 (s, 1H), 8.08-8.12 (m, 2H, J=14Hz), 7.88-7.92 (t, 1H, J=8.4Hz), 7.25-7.29 (t, 1H, J=13.6Hz), 7.04-7.07 (t, 1H, J=10 Hz), 6.22-6.25 (m, 1H), 4.76 (s, 2H), 4.62 (s, 2H), 4.45 (s, 2H), 3.68 (s, 2H).
Synthesis of compound 1-9.
Figure imgf000123_0001
42 Compound 1-9
[0375] To A solution of intermediate 42 (2 g, 4.9 mmol) and 1 -Piperidinecarbonyl chloride (1.1 g, 7.4 mmol) in DMF (20 mL) was added Et3N (1.5 g, 14.9 mmol) at room temperature. The mixture was stirred at room temperature for 30 min. TLC (dichloromethane/MeOH =15/1) showed the reaction was complete. The mixture was poured into ice-water and extracted with EtOAc (100 mL x4). The combined organic phases were washed with water, brine, dried over Na2S04 and concentrated in vacuum. The residue was washed with methyl tertiary butyl ether, filtered. The filter cake was dried in vacuum to give Compound 1-9 (1.1 g, 43.1%) as an orange solid.
[0376] ¾ NMR (DMSO-c e, 400 MHz): δ (ppm) 11.48 (s, 1H), 8.23 (s, 1H), 7.83-7.86 (d, 1H, J=8.8 Hz), 7.68-7.76 (m, 1H), 7.35-7.39 (t, 1H, J=7.6 Hz), 6.89-6.92 (m, 1H), 6.04- 6.07 (m, 1H), 4.66 (s, 2H), 4.57-4.65 (bs, 2H), 3.83-3.90 (m, 2H), 3.01-3.05 (m, 4H), 1.46- 1.49 (m, 6H).
[0377] LC/MS M+514.1
[0378] Synthesis of Compound 1-12
[0379] Compound 1-12 can be synthesized in a similar manner to Compound 1-7 using 3,3-difiuropiperdine as the starting material.
[0380] ¾ NMR (DMSO-cfc, 400 MHz): δ (ppm) 11.25 (s, 1H), 8.06 (s, 1H), 7.93 (s, 1H), 7.58-7.66 (m, 2H), 7.18-7.23 (t, 1H, J=8Hz), 6.81-6.79 (d, 1H, J=8.0Hz), 6.58-6.61 (t, 1H, J=6.4Hz), 5.65-5.67 (d, 1H, J=8.0Hz), 4.66 (s, 2H), 4.56 (bs, 2H), 3.88 (bs, 2H), 3.31-3.64 (bs, 2H), 3.07 (bs, 2H), 1.96-2.01 (bs, 2H), 1.69 (bs, 2H).
[0381] LC/MS M+l 549.1
[0382] Synthesis of Compound 1-13.
[0383] Compound 1-13 as shown in Synthetic Scheme 9.
Figure imgf000124_0001
43 44
[0384] The synthesis of Intermediate 44 is a similar manner as Intermediate 47, yield 43.1 %.
[0385] Ti NMR ^OO MHZ, CDCh) 51.47 (9H, s), 1.91-1.94 (2H, m), 3.37-3.56 (4H, m), 4.40-4.70 (1H, m), 4.71-4.74 (1H, m)
[0386] Synthesis of Intermediate 45:
Figure imgf000124_0002
[0387] The synthesis of Intermediate 45 is a similar manner as Intermediate 48, crude.
[0388] Synthesis of Compound 1-13:
Figure imgf000124_0003
45 Compound 1-13
[0389] The synthesis of Compound 1-13 in a similar manner as Compound 1-19, yield 20.7 % for two steps.
[0390] ¾ NMR (400 MHz, DMSO-de) 51.45-1.48 (1H, d, J = 9.2 Hz), 1.54-1.56 (1H, d, J = 9.2 Hz), 2.71-2.73 (1H, d, J = 9.2 Hz), 2.88-2.90 (1H, d, J = 8.4 Hz), 2.97-2.99 (1H, d, J = 9.6 Hz), 3.35-3.37 (1H, d, J = 8.0 Hz), 3.49 (1H, s), 3.75-3.76 (1H, m), 3.90-3.92 (1H, m), 4.04 (1H, s), 4.46-4.50 (1H, m), 4.58-4.74 (3H, m), 5.60-5.62 (1H, d, J = 8.4 Hz), 6.60-6.63 (1H, m), 6.78-6.80 (1H, d, J = 9.6 Hz), 7.20-7.24 (1H, m), 7.63-7.66 (2H, m), 7.90 (1H, s),
8.06 (1H, s).
[0391] LCMS purity is > 95%, Rt = 2.55 min; MS Calcd: 525.5; MS Found: 526.2 [M+l]+.
[0392] Synthesis of Compound 1-14
[0393] Compound 1-14 can be synthesized in a similar manner to Compound 1-8.
[0394] LC/MS M+l 548.2
[0395] Synthesis of Compound 1-15.
[0396] Compound 1-15 can be synthesized in a similar manner to Compound 1-7.
[0397] LC/MS M+l 556.2
[0398] Synthesis of Compound 1-16
[0399] Compound 1-16 can be synthesized in a similar manner to Compound 1-7.
[0400] LC/MS M+l 556.2
[0401] Synthesis of Compound 1-17
[0402] Compound 1-17 can be synthesized in a similar manner to Compound 1-7.
[0403] LC/MS M+l 599.2
[0404] Synthesis of Compound 1-18
[0405] Compound 1-18 can be synthesized in a similar manner to Compound 1-8.
[0406] LC/MS M+l 591.2
[0407] Synthesis of Compound 1-19
Figure imgf000125_0001
46 47
[0408] To a solution, Intermediate 46 (1.0 g, 4.67 mmol) in DCM (25 mL) was added Et3N (1.41 g, 14.0 mmol). The suspension was stirred and treated dropwise with Triphosgene (0.55 g, 1.87 mmol) in DCM (5 mL) at 0-10 °C. After addition was completed, the suspension was stirred for 2 hrs at room temperature. The reaction mixture poured into iced water (20 mL), extracted with DCM, and the organic layer was washed with NaHCCb (aq), brine, dried over Na2S04, filtered and concentrated in vacuum. The residue was purified by silica gel column chromatography to give Intermediate 47 (0.6 g, 46. 5 %) as colorless oil.
[0409] ¾ NMR (400 MHz, CDCh) δ 1.20-1.27 (2H, m), 1.41 (9H, s), 1.72-1.79 (3H, m), 2.84-2.90 (1H, m), 3.03-3.09 (3H, m), 4.32-4.35 (2H, m), 4.66 (1H, br s).
[0410] Synthesis of Compound 1-19:
Figure imgf000126_0001
[0411] To a solution of Core 3 (1.0 g, 2.29 mmol) in DMF (13 mL) was added Et3N (0.70 g, 6.87 mmol). The suspension was stirred and treated dropwise with Intermediate 47 (0.70 g, 2.52 mmol) in DMF (2 mL) at 0-10 °C. After addition was completed, the suspension was stirred for 2 hrs at room temperature. The reaction mixture was poured into iced water (60 mL), filtered and concentrated in vacuo to give Intermediate 48 (1.0 g, crude) as red solid
[0412] Synthesis of Compound 1-19
Figure imgf000126_0002
48 Compound 1-19
[0413] To a solution of Intermediate 48 (1.0 g, crude) in DCM (30 mL) was added HCl/dioxane (10 mL , 8 mol/L) at room temperature, and the mixture was stirred at room temperature for 2 hrs. The reaction mixture was filtered, and the filter cake was dissolved in water, adjusted to pH=8~9 with Na2CCb (aq), and filtered again, washed with water and concentrated in vacuo to give Compound 1-19 (130 mg, 10.5 %, two steps) as red solid. [0414] ¾ NMR (400 MHz, DMSO-d6) 51.03-l . l l (2H, m), 1.13-1.62 (3H, m), 2.44-2.82 (4H, m), 3.41-3.44 (2H, m), 3.85 (2H, m), 4.54 (2H, m), 4.64 (2H, m), 5.64-5.66 (1H, d, J = 9.6 Hz), 6.56-6.58 (1H, m), 6.78-6.81 (1H, m), 7.19-7.23 (1H, m), 7.60-7.66 (2H, m), 7.92 (1H, s), 8.06 (1H, s).
[0415] LCMS purity is > 95%, Rt = 2.77 min; MS Calcd: 541.6; MS Found: 542.2([M+1]+
[0416] Synthesis of Compound 1-20
Figure imgf000127_0001
49 50
[0417] To a solution of Intermediate 49 (15 g, 130.2 mmol) in DCM (1.5 L) was added Et3N (19.8 g, 195.3 mmol) and DMAP (0.8 g, 6.5 mmol). The suspension was stirred and treated dropwise with tert-butylchlorodiphenylsilane (53.7 g, 195.3 mmol) at 0-10 °C. After addition was completed, the suspension was stirred for 5 hrs at room temperature. The reaction mixture poured into iced water (500 mL), extracted with DCM (300 mLx2), and the organic layer was washed with brine(300 mLx2), dried over Na2S04, filtered and concentrated in vacuum to give Intermediate 50 (30 g, crude) as yellow oil.
[0418] Synthesis of Intermediate 51:
Figure imgf000127_0002
50 51
[0419] To a solution of Intermediate 50 (30 g, crude, 84.8 mmol) in DCM (900 mL) was added Et3N (25.8 g, 254.5 mmol). The suspension was stirred and treated dropwise with Triphosgene (10.1 g, 33.9 mmol) in DCM (50 mL) at 0-10 °C. After addition was completed, the suspension was stirred for 2 hrs at room temperature. The reaction mixture poured into iced water (300 mL), extracted with DCM, and the organic layer was washed with NaHCCb (aq), brine, dried over Na2S04, filtered and concentrated in vacuum. The residue was purified by silica gel column chromatography to give Intermediate 51 (3.1 g, 8.8 %) as colorless oil.
[0420] ¾ NMR (400 MHz, CDCh) 51.05 (9H, s), 1.22-1.29 (2H, m), 1.78-1.83 (3H, m), 2.84-2.90 (1H, m), 3.01-3.07 (1H, m), 3.50-3.51 (2H, d, J= 5.6 Hz), 4.30-4.34 (2H, m), 7.36- 7.45 (6H, m), 7.62-7.64 (4H, m)
[0421] Synthesis of Intermediate 52:
Figure imgf000128_0001
51 52
[0422] To a solution of Maleimide Core (1.6 g, 3.28 mmol) in DMF (15 mL) was added Et3N (1.0 g, 9.84 mmol). The suspension was stirred and treated dropwise with Intermediate 51 (1.5 g, 3.60 mmol) in DMF (5 mL) at 0-10 °C. After addition was completed, the suspension was stirred for 2 hrs at room temperature. The reaction mixture poured into iced water (80 mL), filtered and the filter cake was washed with water and MTBE concentrated in vacuo to give Intermediate 52 (0.98 g, crude) as red solid.
[0423] Synthesis of Compound 1-20:
Figure imgf000128_0002
52 Compound 1-20 [0424] To a solution of Intermediate 52 (0.98 g, crude) in THF (20 mL) was added TBAF (0.56 g, 1.77 mmol) in THF (10 mL) at room temperature, and the mixture was stirred at room temperature for 2 hrs at room temperature. The reaction mixture was poured into iced water (40 mL), filtered, and the filter cake was concentrated in vacuo, purified by silica gel column chromatography to give to Compound 1-20 (160 mg, 22.8 %) as orange solid.
[0425] ¾ NMR (400 MHz, DMSO-de) 51.05-1.13 (2H, m), 1.48-1.58 (3H, m), 2.54-2.67 (2H, m), 3.23-3.26 (2H, m), 3.40-3.44 (2H, m), 3.87-3.90 (2H, m) 4.44-4.47 (1H, m) 4.62- 4.69 (2H, m), 4.72 (2H, s), 6.31 (1H, s), 6.53-6.56 (1H, m), 7.14-7.20 (2H, m), 7.60-7.64 (2H, m), 7.92 (1H, s), 8.16 (1H, s), 11.29 (1H, s).
[0426] LCMS purity is > 95%, Rt = 2.87 min; MS Calcd: 592.6; MS Found: 593.2([M+1]+.
[0427] Synthesis of Compound 1-21
Figure imgf000129_0001
[0428] The synthesis of Intermediate 53 is a similar manner as Intermediate 52, crude.
[0429] Synthesis of Compound 1-21:
Figure imgf000129_0002
[0430] The synthesis of Compound 1-21 is the same as Compound 1-20, yield 28.6 %.
[0431] 1H NMR (400 MHz, DMSO-d6) 51.08-1.13 (2H, m), 1.47-1.56 (1H, m), 1.56-1.59 (2H, m), 2.58-2.65 (2H,m), 3.23-3.26 (2H, m), 3.40-3.43 (2H, m), 3.86 (2H, s), 4.45-4.61 (1H, m), 4.61(2H, s), 4.68 (2H, s), 6.44 (1H, s), 6.53-6.57 (1H, m), 7.19-7.24 (1H, m), 7.28 (1H, s), 7.54-7.56 (1H, d, J = 6.8 Hz), 7.67-7.69 (2H, d, J = 9.2 Hz), 7.98 (lH,s), 8.08 (1H, s), 11.32 (1H, s).
[0432] LCMS purity is > 95%, Rt = 3.41 min; MS Calcd: 549.6; MS Found: 550.2 [M+l]+.
[0433] Synthesis of Compounds 1-22, 23, 24, 25, 27 can be synthesized in a similar manner to Compound 1-7.
[0434] Synthesis of Compound 1-26
[0435] Compound 1-26 can be synthesized as shown in Synthetic Scheme 11.
[0436] Synthesis of Compound 1-28
[0437] Compound 1-28 can be synthesized as shown in Synthetic Scheme 12.
[0438] Synthesis of Compounds 1-29, 30 can be synthesized in a similar manner as the undeuterated material by utilizing the appropriate deuterated starting materials.
Administration
[0439] In certain embodiments, pharmaceutical formulations are adapted to administer the drug locally to an area of skin where hair loss is occurring. Liquid, gel or foam formulations may be used. It is also possible to apply the active ingredient topically or to employ a combination of delivery approaches.
[0440] Injection approaches include by osmotic pump, or, by combination with implanted biomaterial, and more preferably, by injection or infusion. Biomaterials that can aid in controlling release kinetics and distribution of drug include hydrogel materials, degradable materials. One class of materials that is most preferably used includes in situ gelling materials. Other materials include collagen or other natural materials including fibrin, gelatin, and decelluarized tissues. Gelfoam may also be suitable. [0441] Delivery may also be enhanced via alternate means including but not limited to agents added to the delivered composition such as penetration enhancers, or could be through devices via ultrasound, electroporation, or high speed jet.
[0442] With regard to human and veterinary treatment, the amount of a particular agent(s) that is administered may be dependent on a variety of factors, including the disorder being treated and the severity of the disorder; activity of the specific agent(s) employed; the age, body weight, general health, sex and diet of the patient; the time of administration, route of administration, and rate of excretion of the specific agent(s) employed; the duration of the treatment; drugs used in combination or coincidental with the specific agent(s) employed; the judgment of the prescribing physician or veterinarian; and like factors known in the medical and veterinary arts.
[0443] The agents described herein may be administered in a therapeutically effective amount to a subject in need of treatment. Administration of compounds described herein can be via any of suitable route of administration, particularly intradermally, orally or topically. Other routes include ingestion, or alternatively parenterally, for example intravenously, intra- arterially, intraperitoneally, intrathecally, intraventricularly, intraurethrally, intrasternally, intracranially, intramuscularly, intranasally, subcutaneously, sublingually, transdermally, or by inhalation or insufflations, or topical for absorption through the skin. Such administration may be as a single or multiple oral dose, defined number of ear drops, or a bolus injection, multiple injections, or as a short- or long-duration infusion. Implantable devices (e.g., implantable infusion pumps) may also be employed for the periodic parenteral delivery over time of equivalent or varying dosages of the particular formulation. For such parenteral administration, the compounds are preferably formulated as a sterile solution in water or another suitable solvent or mixture of solvents. The solution may contain other substances such as salts, sugars (particularly glucose or mannitol), to make the solution isotonic with blood, buffering agents such as acetic, citric, and/or phosphoric acids and their sodium salts, and preservatives.
[0444] Compounds and compositions described herein can be administered by a number of methods sufficient to deliver the compound to an area of skin with hair loss.
[0445] "Contacting" as used herein for administration of the compositions of the present disclosure, refers, in some embodiments, to bringing skin, in one embodiment, scalp, eyebrow, etc., into contact with one or more compound, factor, cell, etc. In another embodiment, the term refers to embedding the one or more compound, factor, cell, etc. into the skin region of interest. In another embodiment, the term refers to injecting the one or more compound, factor, cell, etc. into the skin region of interest. In another embodiment, the term refers to any other type of contacting known in the art. Each possibility represents a separate embodiment of the present disclosure.
[0446] In another embodiment, the step of contacting in methods of administering one or more compounds of the present disclosure comprises directly contacting the skin region of interest with the compound, RNA, protein, etc. In another embodiment, the step of contacting comprises indirectly contacting the skin region of interest via contacting another site or tissue of the subject, after which the compound, RNA, or protein is transported to the skin region of interest by a biological process; e.g, diffusion, active transport, or circulation in a fluid such as the blood, lymph, interstitial fluid, etc. Each possibility represents a separate embodiment of the present disclosure.
[0447] In particular embodiments, the compounds, compositions and formulations of the disclosure are locally administered, meaning that they are not administered systemically.
[0448] In some embodiments, composition provided herein is administered to a subject in need thereof once. In some embodiments, composition provided herein is administered to a subject in need thereof more than once. In some embodiments, a first administration of composition provided herein is followed by a second, third, fourth, or fifth administration of composition provided herein.
[0449] The number of times a compound is administered to an subject in need thereof depends on the discretion of a medical professional, the disorder, the severity of the disorder, and the subject's response to the formulation. In some embodiments, the compound disclosed herein is administered once to a subject in need thereof with a mild acute condition. In some embodiments, the compound disclosed herein is administered more than once to a subject in need thereof with a moderate or severe acute condition. In the case wherein the subject's condition does not improve, upon the doctor's discretion the compound may be administered chronically, that is, for an extended period of time, including throughout the duration of the subject's life in order to ameliorate or otherwise control or limit the symptoms of the subject's disease or condition.
[0450] In the case wherein the subject's status does improve, upon the doctor's discretion the compound may administered continuously; alternatively, the dose of drug being administered may be temporarily reduced or temporarily suspended for a certain length of time (i.e., a "drug holiday"). The length of the drug holiday varies between 2 days and 1 year, including by way of example only, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 10 days, 12 days, 15 days, 20 days, 28 days, 35 days, 50 days, 70 days, 100 days, 120 days, 150 days, 180 days, 200 days, 250 days, 280 days, 300 days, 320 days, 350 days, and 365 days. The dose reduction during a drug holiday may be from 10%- 100%, including by way of example only 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, and 100%.
[0451] Once the subject's hair density or hair growth has improved, a maintenance dose can be administered, if necessary. Subsequently, the dosage or the frequency of administration, or both, is optionally reduced, as a function of the symptoms, to a level at which the improved disease, disorder or condition is retained. In certain embodiments, subjects require intermittent treatment on a long-term basis upon any recurrence of symptoms.
[0452] In certain embodiments, the pharmaceutical formulations may also contain an additional agent selected from a Notch activator, HDAC inhibitor, a BMP4 antagonist, Noggin (Inhibits BMP4), Sox2, Vitamin D (calcitriol), Vitamin B (nicotinomide), Vitamin A, Vitamin C (pVc). Lgr4, p38/MAPK inhibition, ROCK inhibition, and/or Alk4/7 inhibition. In certain embodiments, the pharmaceutical formulations may also contain an epidermal growth factor (EGF), fibroblast growth factor (FGF), insulin-like growth factor (IGF), or a combination thereof.
Pharmaceutical compositions
[0453] The present disclosure provides pharmaceutical preparations comprising the present compounds. The present compounds may be conveniently formulated for administration with a biologically acceptable medium, such as water, buffered saline, polyol (for example, glycerol, propylene glycol, liquid polyethylene glycol and the like) or suitable mixtures thereof. The optimum concentration of the active ingredient(s) in the chosen medium may be determined empirically, according to procedures well known to medicinal chemists. As used herein, "biologically acceptable medium" includes any and all solvents, dispersion media, and the like which may be appropriate for the desired route of administration of the pharmaceutical preparation. The use of such media for pharmaceutically active substances is known in the art. Except insofar as any conventional media or agent is incompatible with the activity of the present compound, its use in the pharmaceutical preparation of the present invention is contemplated. Suitable vehicles and their formulation inclusive of other proteins are described, for example, in the book Remington's Pharmaceutical Sciences (Remington's Pharmaceutical Sciences. Mack Publishing Company, Easton, Pa., USA 1985). These vehicles include injectable "deposit formulations".
[0454] Pharmaceutical formulations of the present invention may also include veterinary compositions, e.g., pharmaceutical preparations of the present compounds suitable for veterinary uses, e.g., for the treatment of livestock, such as goats, horses, sheep, etc., or domestic animals, e.g., dogs, cats, rabbits, etc., or other animals, such as apes, monkeys, and chimpanzees.
[0455] The present compounds may be formulated for administration in any convenient way for use in human or veterinary medicine. In certain embodiments, the compound included in the pharmaceutical preparation may be active itself, or may be a prodrug, e.g., capable of being converted to an active compound in a physiological setting.
[0456] The present disclosure provides pharmaceutically acceptable compositions comprising a therapeutically effective amount of one or more of the compounds described above, formulated together with one or more pharmaceutically acceptable carriers (additives) and/or diluents. As described in detail below, the pharmaceutical compositions of the present invention may be specially formulated for administration in solid or liquid form, including those adapted for the following: (1) oral administration, for example, drenches (aqueous or non-aqueous solutions or suspensions), tablets, boluses, powders, granules, pastes for application to the tongue; (2) parenteral administration, for example, by subcutaneous, intramuscular or intravenous injection as, for example, a sterile solution or suspension; (3) topical application, for example, as a cream, ointment or spray applied to the skin; or (4) intravaginally or intrarectally, for example, as a pessary, cream or foam. However, in certain embodiments, the present compounds may be simply dissolved or suspended in sterile water. In certain embodiments, the pharmaceutical preparation is non-pyrogenic, i.e., does not elevate the body temperature of a patient. The phrase "therapeutically effective amount" as used herein means that amount of a compound, material, or composition comprising a compound of the present invention which is effective for producing some desired therapeutic effect in at least a sub-population of cells in an animal and thereby blocking the biological consequences of that pathway in the treated cells, at a reasonable benefit/risk ratio applicable to any medical treatment. [0457] The phrase "pharmaceutically acceptable" is employed herein to refer to those compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio.
[0458] The phrase "pharmaceutically acceptable carrier" as used herein means a pharmaceutically acceptable material, composition or vehicle, such as a liquid or solid filler, diluent, excipient, solvent or encapsulating material, useful for preparing a medically or therapeutically useful composition of the present compounds. Each carrier must be "acceptable" in the sense of being compatible with the other ingredients of the formulation and not injurious to the patient. Some examples of materials which may serve as pharmaceutically acceptable carriers include: (1) sugars, such as lactose, glucose and sucrose; (2) starches, such as corn starch and potato starch; (3) cellulose, and its derivatives, such as sodium carboxymethyl cellulose, ethyl cellulose and cellulose acetate; (4) powdered tragacanth; (5) malt; (6) gelatin; (7) talc; (8) excipients, such as cocoa butter and suppository waxes; (9) oils, such as peanut oil, cottonseed oil, safflower oil, sesame oil, olive oil, corn oil and soybean oil; (10) glycols, such as propylene glycol; (1 1) polyols, such as glycerin, sorbitol, mannitol and polyethylene glycol; (12) esters, such as ethyl oleate and ethyl laurate; (13) agar; (14) buffering agents, such as magnesium hydroxide and aluminum hydroxide; (15) alginic acid; (16) pyrogen-free water; (17) isotonic saline; (18) Ringer's solution; (19) ethyl alcohol; (20) phosphate buffer solutions; and (21) other non-toxic compatible substances employed in pharmaceutical formulations.
[0459] As set out above, certain embodiments of the present compounds may contain a basic functional group, such as amino or alkylamino, and are, thus, capable of forming pharmaceutically acceptable salts with pharmaceutically acceptable acids. The term "pharmaceutically acceptable salts" in this respect, refers to the relatively non-toxic, inorganic and organic acid addition salts of compounds of the present invention. These salts may be prepared in situ during the final isolation and purification of the compounds of the present invention, or by separately reacting a purified compound of the present invention in its free base form with a suitable organic or inorganic acid, and isolating the salt thus formed. Representative salts include the hydrobromide, hydrochloride, sulfate, bisulfate, phosphate, nitrate, acetate, valerate, oleate, palmitate, stearate, laurate, benzoate, lactate, phosphate, tosylate, citrate, maleate, fumarate, succinate, tartrate, naphthylate, mesylate, glucoheptonate, lactobionate, and laurylsulphonate salts and the like. (See, for example, Berge et al. (1977) "Pharmaceutical Salts", J. Pharm. Sci. 66: 1 -19)
[0460] The pharmaceutically acceptable salts of the present compounds include the conventional nontoxic salts or quaternary ammonium salts of the compounds, e.g., from nontoxic organic or inorganic acids. For example, such conventional nontoxic salts include those derived from inorganic acids such as hydrochloride, hydrobromic, sulfuric, sulfamic, phosphoric, nitric, and the like; and the salts prepared from organic acids such as acetic, propionic, succinic, glycolic, stearic, lactic, malic, tartaric, citric, ascorbic, palmitic, maleic, hydroxymaleic, phenylacetic, glutamic, benzoic, salicyclic, sulfanilic, 2-acetoxybenzoic, fumaric, toluenesulfonic, methanesulfonic, ethane disulfonic, oxalic, isothionic, and the like.
[0461] In other cases, the compounds of the present disclosure may contain one or more acidic functional groups and, thus, are capable of forming pharmaceutically acceptable salts with pharmaceutically acceptable bases. The term "pharmaceutically acceptable salts" in these instances refers to the relatively non-toxic, inorganic and organic base addition salts of compounds of the present invention. These salts may likewise be prepared in situ during the final isolation and purification of the compounds, or by separately reacting the purified compound in its free acid form with a suitable base, such as the hydroxide, carbonate or bicarbonate of a pharmaceutically acceptable metal cation, with ammonia, or with a pharmaceutically acceptable organic primary, secondary or tertiary amine. Representative alkali or alkaline earth salts include the lithium, sodium, potassium, calcium, magnesium, and aluminum salts and the like. Representative organic amines useful for the formation of base addition salts include ethylamine, diethylamine, ethyl enedi amine, ethanolamine, diethanol amine, piperazine and the like. (See, for example, Berge et al, supra)
[0462] Wetting agents, emulsifiers and lubricants, such as sodium lauryl sulfate and magnesium stearate, as well as coloring agents, release agents, coating agents, sweetening, flavoring and perfuming agents, preservatives and antioxidants may also be present in the compositions. Examples of pharmaceutically acceptable antioxidants include: (1) water soluble antioxidants, such as ascorbic acid, cysteine hydrochloride, sodium bisulfate, sodium metabisulfite, sodium sulfite and the like; (2) oil-soluble antioxidants, such as ascorbyl palmitate, butylated hydroxyanisole (BHA), butylated hydroxy toluene (BHT), lecithin, propyl gallate, alpha-tocopherol, and the like; and (3) metal chelating agents, such as citric acid, ethylenediamine tetraacetic acid (EDTA), sorbitol, tartaric acid, phosphoric acid, and the like. [0463] Formulations of the present disclosure include those suitable for oral, nasal, topical (including buccal and sublingual), rectal, vaginal and/or parenteral administration. The formulations may conveniently be presented in unit dosage form and may be prepared by any methods well known in the art of pharmacy. The amount of active ingredient which may be combined with a carrier material to produce a single dosage form will vary depending upon the host being treated, the particular mode of administration. The amount of active ingredient which may be combined with a carrier material to produce a single dosage form will generally be that amount of the compound which produces a therapeutic effect. Generally, out of one hundred per cent, this amount will range from about 1 per cent to about ninety- nine percent of active ingredient, preferably from about 5 per cent to about 70 per cent, most preferably from about 10 per cent to about 30 per cent.
[0464] Methods of preparing these formulations or compositions include the step of bringing into association a compound of the present disclosure with the carrier and, optionally, one or more accessory ingredients. In general, the formulations are prepared by uniformly and intimately bringing into association a compound of the present disclosure with liquid carriers, or finely divided solid carriers, or both, and then, if necessary, shaping the product.
[0465] Formulations of the present disclosure suitable for oral administration may be in the form of capsules, cachets, pills, tablets, lozenges (using a flavored basis, usually sucrose and acacia or tragacanth), powders, granules, or as a solution or a suspension in an aqueous or non-aqueous liquid, or as an oil-in-water or water-in-oil liquid emulsion, or as an elixir or syrup, or as pastilles (using an inert base, such as gelatin and glycerin, or sucrose and acacia) and/or as mouth washes and the like, each containing a predetermined amount of a compound of the present invention as an active ingredient. A compound of the present disclosure may also be administered as a bolus, electuary or paste.
[0466] In solid dosage forms of the present disclosure for oral administration (capsules, tablets, pills, dragees, powders, granules and the like), the active ingredient may be mixed with one or more pharmaceutically acceptable carriers, such as sodium citrate or dicalcium phosphate, and/or any of the following: (1) fillers or extenders, such as starches, lactose, sucrose, glucose, mannitol, and/or silicic acid; (2) binders, such as, for example, carboxymethylcellulose, alginates, gelatin, polyvinyl pyrrolidone, sucrose and/or acacia; (3) humectants, such as glycerol; (4) disintegrating agents, such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and sodium carbonate; (5) solution retarding agents, such as paraffin; (6) absorption accelerators, such as quaternary ammonium compounds; (7) wetting agents, such as, for example, cetyl alcohol and glycerol monostearate; (8) absorbents, such as kaolin and bentonite clay; (9) lubricants, such a talc, calcium stearate, magnesium stearate, solid polyethylene glycols, sodium lauryl sulfate, and mixtures thereof; and (10) coloring agents. In the case of capsules, tablets and pills, the pharmaceutical compositions may also comprise buffering agents. Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugars, as well as high molecular weight polyethylene glycols and the like.
[0467] A tablet may be made by compression or molding, optionally with one or more accessory ingredients. Compressed tablets may be prepared using binder (for example, gelatin or hydroxypropylmethyl cellulose), lubricant, inert diluent, preservative, disintegrant (for example, sodium starch glycolate or cross-linked sodium carboxymethyl cellulose), surface-active or dispersing agent. Molded tablets may be made by molding in a suitable machine a mixture of the powdered compound moistened with an inert liquid diluent. The tablets, and other solid dosage forms of the pharmaceutical compositions of the present invention, such as dragees, capsules, pills and granules, may optionally be scored or prepared with coatings and shells, such as enteric coatings and other coatings well known in the pharmaceutical-formulating art. They may also be formulated so as to provide slow or controlled release of the active ingredient therein using, for example, hydroxypropylmethyl cellulose in varying proportions to provide the desired release profile, other polymer matrices, liposomes and/or microspheres. They may be sterilized by, for example, filtration through a bacteria- retaining filter, or by incorporating sterilizing agents in the form of sterile solid compositions which may be dissolved in sterile water, or some other sterile injectable medium immediately before use. These compositions may also optionally contain opacifying agents and may be of a composition that they release the active ingredient(s) only, or preferentially, in a certain portion of the gastrointestinal tract, optionally, in a delayed manner. Examples of embedding compositions which may be used include polymeric substances and waxes. The active ingredient may also be in microencapsulated form, if appropriate, with one or more of the above-described excipients.
[0468] Liquid dosage forms for oral administration of the compounds of the present invention include pharmaceutically acceptable emulsions, microemulsions, solutions, suspensions, syrups and elixirs. In addition to the active ingredient, the liquid dosage forms may contain inert diluents commonly used in the art, such as, for example, water or other solvents, solubilizing agents and emulsifiers, such as ethyl alcohol, isopropyl alcohol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1,3-butylene glycol, oils (in particular, cottonseed, groundnut, corn, germ, olive, castor and sesame oils), glycerol, tetrahydrofuryl alcohol, polyethylene glycols and fatty acid esters of sorbitan, and mixtures thereof.
[0469] Besides inert diluents, the oral compositions may also include adjuvants such as wetting agents, emulsifying and suspending agents, sweetening, flavoring, coloring, perfuming and preservative agents.
[0470] Suspensions, in addition to the active compounds, may contain suspending agents as, for example, ethoxylated isostearyl alcohols, poly oxy ethylene sorbitol and sorbitan esters, microcrystalline cellulose, aluminum metahydroxide, bentonite, agar-agar and tragacanth, and mixtures thereof.
[0471] Formulations of the pharmaceutical compositions of the present disclosure for rectal or vaginal administration may be presented as a suppository, which may be prepared by mixing one or more of the present compounds with one or more suitable nonirritating excipients or carriers comprising, for example, cocoa butter, polyethylene glycol, a suppository wax or a salicylate, and which is solid at room temperature, but liquid at body temperature and, therefore, will melt in the rectum or vaginal cavity and release the active present compound.
[0472] Formulations of the present disclosure which may be useful for vaginal administration also include pessaries, tampons, creams, gels, pastes, foams or spray formulations containing such carriers as are known in the art to be appropriate.
[0473] Dosage forms for the topical or transdermal administration of a compound of this invention include powders, sprays, ointments, pastes, creams, lotions, gels, solutions, patches and inhalants. The active compound may be mixed under sterile conditions with a pharmaceutically acceptable carrier, and with any preservatives, buffers, or propellants which may be required.
[0474] The ointments, pastes, creams and gels may contain, in addition to an active compound of this invention, excipients, such as animal and vegetable fats, oils, waxes, paraffins, starch, tragacanth, cellulose derivatives, polyethylene glycols, silicones, bentonites, silicic acid, talc and zinc oxide, or mixtures thereof. Powders and sprays may contain, in addition to a compound of this invention, excipients such as lactose, talc, silicic acid, aluminum hydroxide, calcium silicates and polyamide powder, or mixtures of these substances. Sprays may additionally contain customary propellants, such as chlorofluorohydrocarbons and volatile unsubstituted hydrocarbons, such as butane and propane.
[0475] Transdermal patches have the added advantage of providing controlled delivery of a compound of the present invention to the body. Such dosage forms may be made by dissolving or dispersing the present compounds in the proper medium. Absorption enhancers may also be used to increase the flux of the present compounds across the skin. The rate of such flux may be controlled by either providing a rate controlling membrane or dispersing the compound in a polymer matrix or gel.
[0476] Examples of suitable aqueous and nonaqueous carriers which may be employed in the pharmaceutical compositions of the present disclosure include water, ethanol, polyols (such as glycerol, propylene glycol, polyethylene glycol, and the like), and suitable mixtures thereof, vegetable oils, such as olive oil, and injectable organic esters, such as ethyl oleate. Proper fluidity may be maintained, for example, by the use of coating materials, such as lecithin, by the maintenance of the required particle size in the case of dispersions, and by the use of surfactants. These compositions may also contain adjuvants such as preservatives, wetting agents, emulsifying agents and dispersing agents. Prevention of the action of microorganisms may be ensured by the inclusion of various antibacterial and antifungal agents, for example, paraben, chlorobutanol, phenol sorbic acid, and the like. It may also be desirable to include isotonic agents, such as sugars, sodium chloride, and the like into the compositions. In addition, prolonged absorption of the injectable pharmaceutical form may be brought about by the inclusion of agents which delay absorption such as aluminum monostearate and gelatin.
[0477] In some cases, in order to prolong the effect of a drug, it is desirable to slow the absorption of the drug from subcutaneous or intramuscular injection. This may be accomplished by the use of a liquid suspension of crystalline or amorphous material having poor water solubility. The rate of absorption of the drug then depends upon its rate of dissolution which, in turn, may depend upon crystal size and crystalline form. Alternatively, delayed absorption of a parenterally administered drug form is accomplished by dissolving or suspending the drug in an oil vehicle. [0478] Injectable depot forms may be made by forming microencapsulated matrices of the present compounds in biodegradable polymers such as polylactide- polyglycolide. Depending on the ratio of drug to polymer, and the nature of the particular polymer employed, the rate of drug release may be controlled. Examples of other biodegradable polymers include poly(orthoesters) and poly (anhydrides). Depot injectable formulations may also be prepared by entrapping the drug in liposomes or microemulsions which are compatible with body tissue.
[0479] When the compounds of the present disclosure may be administered as pharmaceuticals, to humans and animals, they may be given per se or as a pharmaceutical composition containing, for example, about 0.1 to 99.5% (more preferably, about 0.5 to 90%) of active ingredient in combination with a pharmaceutically acceptable carrier.
[0480] The addition of one or more of the present compounds of the present disclosure to animal feed may be accomplished by preparing an appropriate feed premix containing the active compound in an effective amount and incorporating the premix into the complete ration.
[0481] Alternatively, an intermediate concentrate or feed supplement containing the active ingredient may be blended into the feed. The way in which such feed premixes and complete rations may be prepared and administered are described in reference books (such as "Applied Animal Nutrition", W.H. Freedman and CO., San Francisco, U.S.A., 1969 or "Livestock Feeds and Feeding" O and B books, Corvallis, Ore., U.S.A., 1977).
Compositions with Poloxamers
[0482] In certain embodiments, the present disclosure provides a pharmaceutical composition comprising: a) a compound of the present disclosure and b) a poloxamer.
[0483] In certain embodiments, the pH of the pharmaceutical composition is between about 5 and about 9. In certain embodiments, the pH of the pharmaceutical composition is about 5, 6, 7, 8, or 9.
[0484] In certain embodiments, the solubility of the compound in the presence of the poloxamer is about 3-fold higher than the solubility of the compound at the same pH in the absence of poloxamer. In certain embodiments, the solubility of the compound in the presence of the poloxamer is about 2-, 3-, 4- or 5 -fold higher than the solubility of the compound at the same pH in the absence of poloxamer. [0485] In certain embodiments, the pharmaceutical formulations may also contain a poloxamer. Poloxamers are nonionic triblock copolymers composed of a central hydrophobic chain of polyoxypropylene (poly(propylene oxide)) flanked by two hydrophilic chains of polyoxyethylene (poly(ethylene oxide)). Poloxamers are often considered "functional excipients" because they are essential components and play an important role in a formulation.
[0486] In some embodiments, the poloxamer comprises at least one of Poloxamer 124, Poloxamer 188, Poloxamer 237, Poloxamer 338 or Poloxamer 407. In some embodiments, the poloxamer comprises mixtures of two or more of Poloxamer 124, Poloxamer 188, Poloxamer 237, Poloxamer 338 or Poloxamer 407. In some embodiments, the mixture of two or more poloxamers comprise Poloxamer 407 and Poloxamer 124. In another embodiment the Poloxamer comprises at least one of Poloxamer 188 and Poloxamer 407 or mixtures thereof. In some embodiments, the poloxamer is Poloxamer 407.
[0487] In some embodiments, the poloxamer is in a concentration between about 5 wt% and about 25 wt% relative to the composition. In some embodiments, the poloxamer is in a concentration between about 10 wt% and about 23 wt% relative to the composition. In some embodiments, the poloxamer is in a concentration between about 15 wt% and about 20 wt% relative to the composition. In some embodiments, the poloxamer is in a concentration is approximately 17 wt% relative to the composition. In some embodiments, the poloxamer is in a concentration is approximately 21 wt% relative to the composition.
[0488] In some embodiments, the poloxamer can be in a concentration between 21wt % and 40 wt % relative to the composition. In another embodiment the poloxamer is in a concentration between 21wt % and 30 wt % relative to the composition. In another embodiment the poloxamer is in a concentration between 23 wt % and 29 wt % relative to the composition. In another embodiment the poloxamer is in a concentration between 23 wt % and 27 wt % relative to the composition. In another embodiment the poloxamer is in a concentration of 25 wt % relative to the composition.
[0489] In some embodiments, the gelation temperature of the pharmaceutical composition is greater than about 10°C. In some embodiments, the gelation temperature of the pharmaceutical composition is between about 11°C and about 32°C. In some embodiments, the gelation temperature of the pharmaceutical composition is between about 15°C and about 30 °C. In some embodiments, the gelation temperature of the pharmaceutical composition is between about 20°C and about 28°C. In some embodiments, the gelation temperature of the pharmaceutical composition is between about 24°C and about 26°C.
[0490] In some embodiments, the gelation temperature of the pharmaceutical composition is about 15°C. In some embodiments, the gelation temperature of the pharmaceutical composition is about 20°C. In some embodiments, the gelation temperature of the pharmaceutical composition is about 24°C. In some embodiments, the gelation temperature of the pharmaceutical composition is about 26°C. In some embodiments, the gelation temperature of the pharmaceutical composition is about 28°C. In some embodiments, the gelation temperature of the pharmaceutical composition is about 30°C. In some embodiments, the gelation temperature of the pharmaceutical composition is about 32°C.
EXAMPLES
[0491] Materials and Methods
[0492] Stem Cell Proliferation Assay using dermal papilla
[0493] Dermal Papilla (DP) proliferation cell culture assay refers to a cell culture method to quantify the number of Dermal Papilla (DP) spheroids, size of DP spheroids, or number of DP cells in cell culture, which is measured at the end of the assay. DP cells refer to cells that express Alkaline Phosphatase (AP), and/or Versican, and/or Vimentin, and/or Sox2, and/or CD 133.
[0494] The protocol for the Stem Cell Proliferation Assay using dermal papilla is as follows:
[0495] Basal media: DMEM/high-glucose medium and F12, supplemented with N2 IX, B27 IX, Streptomycin sulfate (100 μg/ml), Amphotericin B (2.5 μg/ml), and lmM Hepes.
[0496] Microdissection is used to remove intact hair follicles from a specimen. Intact follicles are incubated for 40 min at 37°C in TrypLE™ (Thermo Fisher Scientific) with 1 mg/ml collagenase type 1 (sterilized using 0.2μιη syringe filter). The treated follicles are then triturated >30X using a 200 μΐ pipette tip. The volume is adjusted up to 1 ml with IX PBS. The treated follicles are then passed through a 40 μιτι cell strainer to obtain a single cell suspension. [0497] Twenty μΐ are applied to a cell counter to determine the number of cells per 1 ml. The remaining cell suspension is spun down at l,000xg for 5 min at 4°C.
[0498] Standard media is prepared supplemented with growth factors (IGF, EGF, and FGF2 at 50 ng/ml). The cells are suspended in standard media with growth factors at 120,000 cells/ml and 250 μΐ (30,000 cells) are applied to each well of a 24-well plate (Corning Costar, 3534).
[0499] Each treatment condition is prepared at 2X concentration, enough for 250 μΐ/well for a final dilution of lx in 500 μΐ. The final DMSO concentration is at about 0.2% for all.
[0500] 250 μΐ 2X treatment media is applied to each well to have a final media volume per well of 500 μΐ. The final treatment concentration per well is IX. The final cell density is 30,000 cells per well.
[0501] The cells are incubated at 37°C and growth is monitored for 10 days.
[0502] EVOS® transmitted light images are taken at 0, 5, 7, and 10 days in culture.
[0503] Spheroids are collected at 10 days in culture for immunoblotting, qPCR, or flow cytometry. Alternatively, spheroids may be applied to glass bottom dishes coated with poly- 1-lysine for alkaline phosphatase (AP) staining, 5 -ethynyl-2'-deoxy uridine (EdU) staining, and/or immunofluorescence for DP markers (e.g. Vimentin, Sox2, Versican, CD133) for microscopy.
[0504] Alternatively, cells or colonies may be assessed using microscopy to compare DP properties across conditions.
[0505] DP hair follicle culture assay
[0506] Dermal Papilla (DP) hair follicle culture assay refers to a method of using intact hair follicles to quantify the number of Dermal Papilla (DP) cells or size of the DP area within the follicle when measured at the end of the assay. DP cells are cells that express alkaline phosphatase (AP), and/or Versican, and/or Vimentin, and/or Sox2, and/or CD133.
[0507] The protocol for the DP hair follicle culture assay is as follows:
[0508] Basal media: DMEM/high-glucose medium and F12, supplemented with N2 IX, B27 IX, Streptomycin sulfate (100 μg/ml), Amphotericin B (2.5 μg/ml), and ImM Hepes.
[0509] Microdissection is used to remove intact hair follicles from a specimen. Each hair follicle is trimmed close to the follicle apex and transferred to a fresh dish with HBSS. 200 μΐ IX PBS is applied to wells of a 24-well plate. Using a 200 μΐ pipette cut wide bore, the hair follicles are carefully distributed in wells with 3-5 follicles per well.
[0510] The PBS is carefully removed from the wells, leaving the intact follicles, by pipetting. 0.5 ml media supplemented with growth factors (IGF, EGF, and FGF2 at 50ng/ml) and small molecules as desired are applied to each well.
[0511] The hair follicles are incubated at 37°C and growth monitored over 7 days.
[0512] EVOS® transmitted light images are taken at 0 DIV and 7 DIV.
[0513] Hair follicles are processed at 7 DIV for alkaline phosphatase (AP) staining, 5- ethynyl-2'-deoxy uridine (EdU staining), and/or immunofluorescence for DP markers (e.g. Vimentin, Sox2, Versican, CD133) for microscopy.
[0514] The total area staining positive for DP markers may be analyzed and hair shaft growth may be monitored over time.
[0515] Example 1
[0516] A Stem Cell Proliferation Assay using dermal papilla was carried out as described above in Materials and Methods, and DP colonies were analyzed by light microscopy. DP cells shown in FIG. 1A-FIG. ID were in culture for 8 days. DP cells treated in control conditions show small and few colonies (FIG. 1A). DP cells treated Shh pathway activator (Purmorphamine 1 μΜ) show slightly larger and more abundant colonies than DP cells treated in control conditions (FIG. IB). DP cells treated with Wnt activator (CHIR99021 4 μΜ) show more abundant colonies than DP cells treated in control conditions. A combination of a Shh pathway activator (Purmorphamine 1 μΜ) and Wnt activator (CHIR99021 4 μΜ) show many large DP colonies. Thus, Shh and Wnt activation promote dermal papilla (DP) growth and hair growth induction.
[0517] Example 2
[0518] A Stem Cell Proliferation Assay using dermal papilla was carried out as described above in Materials and Methods, and DP colonies were analyzed by light microscopy. DP cells shown in FIG. 2A-FIG. 2D were in culture for 10 days. DP cells treated in control conditions show small and few colonies (FIG. 2A). DP cells treated with Shh pathway activator (Purmorphamine 1 μΜ) show slightly larger and more abundant colonies than DP cells treated in control conditions (FIG. 2B). DP cells treated with Wnt activator (Compound 1-7 10 nM) show more abundant colonies than DP cells treated in control conditions (FIG. 2C). DP cells treated with a combination of a Shh pathway activator (Purmorphamine 1 μΜ) and a Wnt activator (Compound 1-7 10 nM) show many large DP colonies (FIG. 2D). Thus, Shh pathway activation with multiple Wnt activation molecules promote DP (dermal papilla) growth and hair growth induction (see Example 1 and this Example).
[0519] Example 3
[0520] A Stem Cell Proliferation Assay using dermal papilla was carried out as described above in Materials and Methods, and DP colonies were analyzed by light microscopy. DP cells treated with Shh pathway activator (Purmorphamine 1 μΜ) alone form colonies (FIG. 3A). DP cells treated with GSK3 inhibitor (Compound 1-7 10 nM) and Shh pathway activator (Purmorphamine 1 μΜ) form more colonies and are larger than colonies treated with Purmorphamine alone (FIG. 3D). DP cells treated with Shh pathway activator (SAG 3 nM) alone form colonies (FIG. 3B). DP cells treated with GSK3 inhibitor (Compound 1-7 10 nM) and Shh pathway activator (SAG 3 nM) form more colonies that are larger than colonies treated with SAG alone (FIG. 3E). DP cells treated with Shh pathway activator (SAG HCl 500 nM) alone form colonies (FIG. 3C). DP cells treated with GSK3 inhibitor (Compound 1-7 10 nM) and Shh pathway activator (SAG HCl) form more colonies that are larger than colonies treated with SAG HCl alone (FIG. 3F). Thus, multiple Shh molecules with Wnt activation promote DP growth and hair growth induction.
[0521] Example 4
[0522] A Stem Cell Proliferation Assay using dermal papilla was carried out as described above in Materials and Methods, and DP colonies were analyzed by alkaline phosphatase (AP) staining. Alkaline Phosphatase is a marker of DP cells and used to show DP cells that have hair induction capability. DP cells shown in FIG. 4A-FIG. 4D were in culture for 10 days. DP cells treated in control conditions show small and few Alkaline Phosphatase (Alp) colonies (FIG. 4A). DP cells treated with Shh pathway activator (Purmorphamine 1 μΜ) show few Alp colonies (FIG. 4B). DP cells treated with Wnt activator (Compound 1-7 10 nM) show few Alp colonies (FIG. 4C). DP cells treated with a combination of an Shh pathway activator (Purmorphamine 1 μΜ) and a Wnt activator (Compound 1-7 10 nM) show large and many Alp colonies (FIG. 4D). Thus, Shh and Wnt activation promote dermal papilla (DP) growth and hair growth induction.
[0523] Example 5 [0524] A Stem Cell Proliferation Assay using dermal papilla was carried out as described above in Materials and Methods, and DP colonies were analyzed by immunofluorescence for expression of DP cell markers and by EdU staining for cell division. DP cells shown in FIG. 5A-FIG. 5D were in culture for 10 days. DP cells treated with a combination of an Shh pathway activator (Purmorphamine 1 μΜ) and a Wnt activator generate colonies expressing the DP marker Vimentin (FIG. 5A). DP cells treated with a combination of an Shh pathway activator (Purmorphamine 1 μΜ) and a Wnt activator (Compound 1-7 10 nM) generate colonies expressing the DP marker of hair induction Vimentin, and EdU (5-ethynyl-2'- deoxyuridine) staining demonstrated that colonies were actively dividing in these conditions (FIG. 5B). DP cells treated with a combination of an Shh pathway activator (Purmorphamine 1 μΜ) and a Wnt activator (Compound 1-7 10 nM) generate colonies expressing the DP and stem cell marker Sox2 (FIG. 5C). DP cells treated with a combination of a Shh pathway activator (Purmorphamine 1 μΜ) and Wnt activator (Compound 1-7 10 nM) generate colonies expressing the DP marker of hair induction CD133 (FIG. 5D). Thus, Shh and Wnt activation promote dermal papilla (DP) growth and hair growth induction.
[0525] Example 6
[0526] A DP hair follicle cell culture assay was carried out as described above in Materials and Methods, and DP hair follicles were analyzed by alkaline phosphatase (AP) staining. Alkaline Phosphatase is a marker of DP cells and used to show DP cells that have hair induction capability. DP hair follicles shown in FIG. 6A-FIG. 6B were in culture for 7 days. Control treated follicles show Alkaline Phosphatase (Alp) at the base of the hair follicle (FIG. 6A). Follicles treated with a Wnt activator (Compound 1-7 10 nM) and Shh pathway activator (Purmorphamine 1 μΜ) show larger DP (FIG. 6B). Thus, Shh and Wnt activation promote dermal papilla (DP) growth and hair growth induction.
[0527] Example 7
[0528] Formulations for Topical Delivery
[0529] Table 7. Exemplary Formulations
Figure imgf000147_0001
[0530] Preparation of Stock solutions:
[0531] Component A Preparations
[0532] Preparation of 20% Poloxamer 407 Component A vehicle stock solution.
[0533] To prepare 1.5 L of 20% Poloxamer 407 in distilled water, 300g of Poloxamer 407 was dissolved in 1L distilled water. The solution was stirred at 300 rpm overnight in a cold room. Graduated cylinders and distilled water were prechilled. Distilled water was added to make a final volume of 1.5 L and the solution was stored at 4°C.
[0534] Poloxamer 407 vehicle stock solutions:
[0535] Vehicle PP5 for TA0-TA7 :
[0536] For 800 ml Vehicle PP5 (Poloxamer 407/PEG vehicle for 5% final DMSO formulations), 720 ml 20% Poloxamer 407 in distilled water, 16 ml PEG, and 24 ml distilled water were combined. 1.425 ml aliquots in 1.5 ml snap cap tubes were prepared.
[0537] Vehicle PP1 for TA8:
[0538] For 200 ml Vehicle PP1 (Poloxamer 407/PEG vehicle for 1% final DMSO formulations), 180 ml 20% Poloxamer 407 in distilled water, 4 ml PEG, and 14 ml distilled water were combined. 1.485 ml aliquots in 1.5 ml snap cap tubes were prepared.
[0539] Vehicle PP0.2 for TA9 and TA10: [0540] For 200 ml Vehicle PP0.2 (Poloxamer 407/PEG vehicle for 0.2% final DMSO formulations), 180 ml 20% Poloxamer 407 in distilled water, 4 ml PEG, and 15.6 ml distilled water were combined. 1.497 ml aliquots in 1.5 ml snap cap tubes were prepared.
[0541] Lubriderm for TA11 and TA12:
[0542] 2.85 ml aliquots in 5 ml snap cap tubes were prepared.
[0543] Drug stocks:
[0544] Preparation of 100 mM Compound 1-7. 109.7 mg of Compound 1-7 was dissolved in 2ml DMSO in a 5 ml snap-cap tube. The solution was heated in a stirring water bath (hotplate set to 80°C). The solution was vortexed to fully dissolve Compound 1-7.
[0545] Preparation of 10 mM Purmo hamine. 125 mg of Purmorphamine was dissolved in 25 ml DMSO in a 50 ml conical tube. The solution was protected from light.
[0546] Preparation of 50 mM Compound 1-7 and 10 mM Purmorphamine mixture. 274.3 mg Compound 1-7 was dissolved in 10 ml of 10 mM Purmorphamine. The solution was heated in a stirring water bath (hotplate set to 80°C) and vortexed to fully dissolve. The solution was protected from light.
[0547] Preparation of 100 mM Compound 1-7 and 10 mM Purmorphamine mixture. 109.7 mg Compound 1-7 was dissolved in 2 ml 10 mM Purmorphamine. The solution was heated in a stirring water bath (hotplate set to 80°C) and vortexed to fully dissolve. The solution was protected from light.
[0548] Component B Preparations
[0549] For TA0, 3.5 ml of DMSO was pipetted into a 5 ml snap cap tube.
[0550] For TA1, to prepare 50 mM Compound 1-7 in DMSO, 1.75 ml of 100 mM Compound 1-7 was added to 1.75 ml DMSO in a 5-ml snap cap tube. 100 μΐ aliquots were prepared.
[0551] For TA2, to prepare 10 mM Purmorphamine in DMSO, 3.5 ml of 10 mM Purmorphamine was added to a 5-ml snap cap tube. 100 μΐ aliquots were prepared.
[0552] For TA3, to prepare 0.2 μΜ Compound 1-7 and 20 μΜ Purmo hamine in DMSO, 7 μΐ of 0.1 mM Compound 1-7 and 7 μΐ of 10 mM Purmorphamine were added to 3.493 ml DMSO in a 5 ml snap cap tube. 100 μΐ aliquots were prepared. [0553] For TA4, to prepare 2 μΜ Compound 1-7 and 200 μΜ Purmo hamine in DMSO, 70 μΐ of 0.1 mM Compound 1-7 and 70 μΐ of 10 mM Purmorphamine were added to 3.429 ml DMSO in a 5 ml snap cap tube. 100 μΐ aliquots were prepared.
[0554] For TA5, to prepare 20 μΜ Compound 1-7 and 2 mM Purmorphamine in DMSO, 700 μΐ of 0.1 mM Compound 1-7 and 700 μΐ of 10 mM Purmorphamine were added to 2.799 ml DMSO in a 5 ml snap cap tube. 100 μΐ aliquots were prepared.
[0555] For TA6, to prepare 200 μΜ Compound 1-7 and 10 mM Purmorphamine in DMSO, 7 μΐ of 100 mM Compound 1-7 was added to 3.5 ml of 10 mM Purmorphamine in a 5 ml snap cap tube. 100 μΐ aliquots were prepared.
[0556] For TA7, to prepare 50 mM Compound 1-7 and 10 mM Purmorphamine in DMSO, 3.5 ml of mix of 50 mM Compound 1-7 was added with 10 mM Purmorphamine to a 5 ml snap cap tube. 100 μΐ aliquots were prepared.
[0557] For TA8, to prepare 100 mM Compound 1-7 and 10 mM Purmorphamine in DMSO, 1 ml of mix of 100 mM Compound 1-7 was added with 10 mM Purmorphamine to a 1.5 ml snap cap tube. 100 μΐ aliquots were prepared.
[0558] For TA9, to prepare 10 μΜ Compound 1-7 and 1 mM Purmorphamine in DMSO, 50 μΐ of 0.1 mM Compound 1-7 and 50 μΐ of 10 mM Purmorphamine were added to 0.449 ml DMSO in a 1.5 ml snap cap tube. 100 μΐ aliquots were prepared.
[0559] For TA10, to prepare 100 mM Compound 1-7 and 10 mM Purmorphamine in DMSO, 0.5 ml of mix of 100 mM Compound 1-7 was added with 10 mM Purmorphamine to a 1.5 ml snap cap tube. 100 μΐ aliquots were prepared.
[0560] For TA11, to prepare 2 μΜ Compound 1-7 and 200 μΜ Purmo hamine in DMSO, 120 μΐ 0.1 mM Compound 1-7 and 120 μΐ 10 mM Purmorphamine were added to 5.879 ml DMSO in a 15 ml conical tube. 200 μΐ aliquots were prepared.
[0561] For TA12, to prepare 50 mM Compound 1-7 and 10 mM Purmorphamine in DMSO, 6ml mix of 50 mM Compound 1-7 and 10 mM Purmorphamine were added to a 15 ml conical tube. 200 μΐ aliquots were prepared.
[0562] Formulation Preparations
[0563] TA0 [0564] One day's supply was prepared the day of application. One aliquot of DMSO was removed from -20°C and allowed to thaw at RT (~30min). The thawed aliquot was vortexed to mix and heated (60°C) if there was visible precipitate. The aliquot was briefly centrifuged if necessary.
[0565] One tube of vehicle PP5 was removed from 4°C. Keeping vehicle PP5 on ice, 75 μΐ of DMSO was added to 1.425 ml vehicle PP5 and kept on ice. About 5 min prior to application, TAO was placed at RT. Using positive displacement pipette to dispense, 200 μΐ was applied to each animal.
[0566] TA1
[0567] One day's supply was prepared the day of application. One aliquot of 50 mM Compound 1-7 in DMSO was removed from -20°C and allowed to thaw at RT (~30min). The thawed aliquot was vortexed to mix and heated (60°C) if there was visible precipitate. The aliquot was briefly centrifuged if necessary.
[0568] One tube of vehicle PP5 was removed from 4°C. Keeping vehicle PP5 on ice, 75 μΐ of 50mM Compound 1-7 in DMSO was added to 1.425 ml vehicle PP5 and vortexed. The tube was kept on ice (could become cloudy on ice, but would clarify at RT). About 5 min prior to application, TA1 was placed at RT. Using positive displacement pipette to dispense, 200 μΐ was applied to each animal.
[0569] TA2
[0570] One day's supply was prepared the day of application. One tube of 10 mM Purmorphamine in DMSO was removed from -20°C and allowed to thaw at RT (~30min). The thawed tube was vortexed to mix and heated (60°C) if there was visible precipitate. The tube was briefly centrifuged if necessary.
[0571] One tube of vehicle PP5 was removed from 4°C. Keeping vehicle PP5 on ice, 75 μΐ of lOmM Purmorphamine DMSO was added to 1.425 ml vehicle PP5 and vortexed. The tube was kept on ice. About 5 min prior to application, TA2 was placed at RT. Using positive displacement pipette to dispense, 200 μΐ was applied to each animal.
[0572] TA3
[0573] One day's supply was prepared the day of application. One tube of 0.2 μΜ Compound 1-7 and 20 μΜ Purmorphamine in DMSO was removed from -20°C and allowed to thaw at RT (~30min). The thawed tube was vortexed to mix and heated (60°C) if there was visible precipitate. The tube was briefly centrifuged if necessary.
[0574] One tube of vehicle PP5 was removed from 4°C. Keeping vehicle PP5 on ice, 75 μΐ of 0.2 μΜ Compound 1-7/20 μΜ Purmo hamine in DMSO was added to 1.425 ml vehicle PP5 and vortexed. The tube was kept on ice. About 5 min prior to application, TA3 was placed at RT. Using positive displacement pipette to dispense, 200 μΐ was applied to each animal.
[0575] TA4
[0576] One day's supply was prepared the day of application. One tube of 2 μΜ Compound 1-7/200 μΜ Purmorphamine in DMSO was removed from -20°C and allowed to thaw at RT (~30min). The thawed tube was vortexed to mix and heated (60°C) if there was visible precipitate. The tube was briefly centrifuged if necessary.
[0577] One tube of vehicle PP5 was removed from 4°C. Keeping vehicle PP5 on ice, 75 μΐ of 0.2 μΜ Compound 1-7/200 μΜ Purmorphamine in DMSO was added to 1.425 ml vehicle PP5 and vortexed. The tube was kept on ice. About 5 min prior to application, TA4 was placed at RT. Using positive displacement pipette to dispense, 200 μΐ was applied to each animal.
[0578] TA5
[0579] One day's supply was prepared the day of application. One tube of 20 μΜ Compound 1-7/2 mM Purmorphamine in DMSO was removed from -20°C and allowed to thaw at RT (~30min). The thawed tube was vortexed to mix and heated (60°C) if there was visible precipitate. The tube was briefly centrifuged if necessary.
[0580] One tube of vehicle PP5 was removed from 4°C. Keeping vehicle PP5 on ice, 20 μΜ Compound 1-7/2 mM Purmo hamine in DMSO was added to 1.425 ml vehicle PP5 and vortexed. The tube was kept on ice. About 5 min prior to application, TA5 was placed at RT. Using positive displacement pipette to dispense, 200 μΐ was applied to each animal.
[0581] TA6
[0582] One day's supply was prepared the day of application. One tube of 200 μΜ Compound 1-7/10 mM Purmorphamine in DMSO was removed from -20°C and allowed to thaw at RT (~30min). The thawed tube was vortexed to mix and heated (60°C) if there was visible precipitate. The tube was briefly centrifuged if necessary. [0583] One tube of vehicle PP5 was removed from 4°C. Keeping vehicle PP5 on ice, 200 μΜ Compound 1-7/10 mM Purmorphamine in DMSO was added to 1.425 ml vehicle PP5 and vortexed. The tube was kept on ice. About 5 min prior to application, TA6 was placed at RT. Using positive displacement pipette to dispense, 200 μΐ was applied to each animal.
[0584] TA7
[0585] One day's supply was prepared the day of application. One tube of 50 mM Compound 1-7/10 mM Purmorphamine in DMSO was removed from -20°C and allowed to thaw at RT (~30min). The thawed tube was vortexed to mix and heated (60°C) if there was visible precipitate. The tube was briefly centrifuged if necessary.
[0586] One tube of vehicle PP5 was removed from 4°C. Keeping vehicle PP5 on ice, 50 mM Compound 1-7/10 mM Purmorphamine in DMSO was added to 1.425 ml vehicle PP5 and vortexed. The tube was kept on ice (could become cloudy on ice, but would clarify at RT). About 5 min prior to application, TA7 was placed at RT. Using positive displacement pipette to dispense, 200 μΐ was applied to each animal.
[0587] TA8
[0588] One day's supply was prepared the day of application. One tube of 100 mM Compound 1-7/10 mM Purmorphamine in DMSO was removed from -20°C and allowed to thaw at RT (~30min). The thawed tube was vortexed to mix and heated (60°C) if there was visible precipitate. The tube was briefly centrifuged if necessary.
[0589] One tube of vehicle PP1 was removed from 4°C. Keeping vehicle PP1 on ice, 15 μΐ of 100 mM Compound 1-7/10 mM Purmorphamine in DMSO was added to 1.485 ml vehicle PP1 and vortexed. The tube was kept on ice. About 5 min prior to application, TA8 was placed at RT. Using positive displacement pipette to dispense, 200 μΐ was applied to each animal.
[0590] TA9
[0591] One day's supply was prepared the day of application. One tube of 10 μΜ Compound 1-7/1 mM Purmorphamine in DMSO was removed from -20°C and allowed to thaw at RT (~30min). The thawed tube was vortexed to mix and heated (60°C) if there was visible precipitate. The tube was briefly centrifuged if necessary.
[0592] One tube of vehicle PP0.2 was removed from 4°C. Keeping vehicle PP0.2 on ice, 3 μΐ of 10 μΜ Compound 1-7/1 mM Purmorphamine in DMSO was added to 1.497 ml vehicle PP0.2 and vortexed. The tube was kept on ice. About 5 min prior to application, TA9 was placed at RT. Using positive displacement pipette to dispense, 200 μΐ was applied to each animal.
[0593] TA10
[0594] One day's supply was prepared the day of application. One tube of 100 mM Compound 1-7/10 mM Purmorphamine in DMSO was removed from -20°C and allowed to thaw at RT (~30min). The thawed tube was vortexed to mix and heated (60°C) if there was visible precipitate. The tube was briefly centrifuged if necessary.
[0595] One tube of vehicle PP0.2 was removed from 4°C. Keeping vehicle PP0.2 on ice, 3 μΐ of 100 mM Compound 1-7/10 mM Purmorphamine in DMSO was added to 1.497 ml vehicle PP0.2 and vortexed. The tube was kept on ice. About 5 min prior to application, TA10 was placed at RT. Using positive displacement pipette to dispense, 200 μΐ was applied to each animal.
[0596] TA11
[0597] One day's supply was prepared the day of application. One tube of 2 μΜ Compound 1-7/200 μΜ Purmorphamine in DMSO was removed from -20°C and allowed to thaw at RT. The thawed tube was vortexed to mix and heated (60°C) if there was visible precipitate. The tube was briefly centrifuged if necessary.
[0598] 150 μΐ of 2 μΜ Compound 1-7/200 μΜ Purmorphamine in DMSO was added to 2.85 ml Lubriderm. The solution was vortexed. The bottom unmixed portion was pipetted to the top using positive displacement pipette, and the solution vortexed and centrifuged. The process was repeated until mixed. Material from tube sides was removed by tapping the tube or centrifuging briefly. Using positive displacement pipette to dispense, 200 μΐ was applied to each animal.
[0599] TA12
[0600] One day's worth (enough for 5 animals) of TA12 was prepared the day of application. One tube of 50 mM Compound 1-7/10 mM Purmo hamine in DMSO was removed from -20°C and allowed to thaw at RT. The thawed tube was vortexed to mix and heated (60°C) if there was visible precipitate. The tube was briefly centrifuged if necessary.
[0601] One tube of Lubriderm was set aside. [0602] 150 μΐ of 50 mM Compound 1-7/10 mM Purmorphamine in DMSO was added to 2.85 ml Lubriderm. The solution was vortexed. The bottom unmixed portion was pipetted to the top using positive displacement pipette, and the solution vortexed and centrifuged. The process was repeated until mixed. Material from tube sides was removed by tapping the tube or centrifuging briefly. Using positive displacement pipette to dispense, 200 μΐ was applied to each animal.
[0603] Additional methods of formulation include but are not limited to: creams, gels, oils, liquids, sprays, powders, nanoparticles, hydro-gels, emulsions, and emugels (see references below).
[0604] References on formulations:
[0605] Ashni Verma, Sukhdev Singh, Rupinder Kaur, Upendra K Jain. Topical Gels as Drug Delivery Systems: A Review. Int. J. Pharm. Sci. Rev. Res., 23(2), 2013, 60, 374-382.
[0606] Sonam Vats, Charu Saxena, TS Easwari, VK Shukla. Emulsion Based Gel Technique: Novel Approach for Enhancing Topical Drug Delivery of Hydrophobic Drugs. International Journal for Pharmaceutical Research Scholars (2014), 3(2), 649-660.
[0607] Loveleenpreetkaur Prabhjotkaur and MU. Khan. Topical formulations and Hydro-gel: An overview. International Journal of Advances in Pharmacy, Biology and Chemistry (2013), 2(1), 201-206.
[0608] Christian Wischke Eckart Riihl Andreas Lendlein. Dermal Drug Delivery by Nanocarriers. Journal of Controlled Release 242 (2016) 1-2.
[0609] William Wei Lim Chin, Johannes Parmentier, Michael Widzinski, En Hui Tan, Rajeev Gokhale. A Brief Literature and Patent Review of Nanosuspensions to a Final Drug Product. Journal of Pharmaceutical Sciences, October 2014, Vol. l03(10), pp. 2980-2999.
[0610] From the foregoing description, it will be apparent that variations and modifications may be made to the disclosure described herein to adopt it to various usages and conditions. Methods and materials are described herein for use in the present disclosure; other, suitable methods and materials known in the art can also be used. The materials, methods, and examples are illustrative only and not intended to be limiting. Such embodiments are also within the scope of the following claims. The recitation of a listing of elements in any definition of a variable herein includes definitions of that variable as any single element or combination (or subcombination) of listed elements. The recitation of an embodiment herein includes that embodiment as any single embodiment or in combination with any other embodiments or portions thereof. The teachings of all patents, published applications and references cited herein are incorporated by reference in their entirety. While this disclosure has been particularly shown and described with references to example embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the scope of the subject matter encompassed by the appended claims.

Claims

What is claimed is:
1. A method of expanding a population of stem cells of hair follicles, said method comprising contacting the stem cells with one or more Sonic Hedgehog (Shh) pathway activator and one or more Wnt agonist.
2. A method of facilitating the generation of hair follicle epithelial cells, the method comprising treating stem cells of hair follicles with one or more Sonic Hedgehog (Shh) pathway activator and one or more Wnt agonist.
3. A method of treating a subject who has, or is at risk of developing, a disease associated with absence or lack of hair follicle epithelial cells, the method comprising administering to said subject one or more Sonic Hedgehog (Shh) pathway activator and one or more Wnt agonist.
4. A method of treating a subject who has, or is at risk of developing, alopecia, the method comprising administering to said subject one or more Sonic Hedgehog (Shh) pathway activator and one or more Wnt agonist.
5. The method of claim 1 or 2, wherein the stem cells are dermal papilla stem cells.
6. The method of claim 1 or 2, wherein the stem cells are hair follicle stem cells.
7. The method of claim 1 or 2, wherein the stem cells comprise keratinocytes, melanocytes, dermal papilla cells, bulge cells, or a combination thereof.
8. The method of claim 1 or 2, wherein the stem cells are in a subject.
9. The method of claim 3, wherein the disease is selected from telogen effluvium, anagen effluvium, androgenetic alopecia, alopecia areata, tinea capitis, lichen planopilaris, cicatricial alopecia, discoid lupus erythematosus, folliculitis decalvans, dissecting cellulitis of the scalp, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, trichotillomania, traction alopecia, and hypotrichosis.
10. The method of claim 3 or 4, wherein the subject administered the one or more Shh pathway activator and the one or more Wnt agonist has improved hair growth, improved hair density and/or improved regenerative cycling of hair follicles compared to a subject not administered the one or more Shh pathway activator and the one or more Wnt agonist.
11. The method of any one of claims 1-10, wherein the one or more Shh pathway activator is at a concentration of about 5x to about lOOOx of an effective in vitro Shh pathway activation concentration.
12. The method of any one of claims 1-11, wherein the one or more Shh pathway activator is at a concentration of about lOx to about lOOx of an effective in vitro Shh pathway activation concentration.
13. The method of any one of claims 1-12, wherein the one or more Shh pathway activator is at a concentration of about 20x to about 5 Ox of an effective in vitro Shh pathway activation concentration.
14. The method of any one of claims 1-13, wherein the one or more Wnt agonist is at a concentration of about 5x to about lOOOx of an effective in vitro Wnt agonist concentration.
15. The method of any one of claims 1-14, wherein the one or more Wnt agonist is at a concentration of about lOx to about lOOx of an effective in vitro Wnt agonist concentration.
16. The method of any one of claims 1-15, wherein the one or more Wnt agonist is at a concentration of about 20x to about 5 Ox of an effective in vitro Wnt agonist concentration.
17. The method of any one of claims 1-16, wherein the one or more Shh pathway activator is selected from Table 1 or Table 2.
18. The method of any one of claims 1-17, wherein the one or more Shh pathway activator is selected from Purmorphamine, SAG, 20-alpha hydroxy cholesterol, and SAG HC1.
19. The method of any one of claims 1-18, wherein the one or more Wnt agonist is selected from Table 3.
20. The method of any one of claims 1-19, wherein the one or more Wnt agonist is a GSK3-alpha inhibitor or a GSK3-beta inhibitor.
21. The method of claim 20, wherein the GSK3-alpha inhibitor is selected from Table 5.
22. The method of claim 20, wherein the GSK3-beta inhibitor is selected from Table 4.
23. The method of any one of claims 1-18 and 20, wherein the one or more Wnt agonist is a compound of Formula I:
Figure imgf000159_0001
or a pharmaceutically acceptable salt or tautomer thereof, wherein:
Q1 is CH or N;
Q2 is C or N;
Q3 is C or N;
wherein at least one of Q1, Q2, and Q3 is N;
R1 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl,-CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)Rla, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein Rla is Ci-C4alkyl;
R2 is selected from the group consisting of halo, Ci-C4alkyl, Ci-C4alkenyl, Ci- C4alkynyl,
-CN, -OH, -0-Ci-C4alkyl, -NH2, -NH(Ci-C4alkyl), -N(Ci-C4alkyl)2, -NHC(0)R2a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents
independently selected from the group consisting of halo and -OH; and wherein R2a is Ci- C4alkyl; R3 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl,-CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R3a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R a is Ci-C4alkyl;
Figure imgf000160_0001
-Z-W-X-Y- is -C(RZ)2-C(RW)2-N(RX)-C(RY)2-, -C(RZ)2-C(RW)2-CH(RX)-C(RY)2-, or -C(RW)2-CH(RX)-C(RY)2-;
each Rz is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rz groups together form C3-C6cycloalkyl or oxo;
each Rw is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rw groups together form C3-C6cycloalkyl or oxo;
or Rz and Rw together with the carbons to which they are attached form a C3- C6cycloalkyl;
Rx is selected from the group consisting of -CORxl, -S02RX1, heteroaryl, and -(Ci- C4alkylene)-(C3-C8cycloalkyl), and wherein the-(Ci-C4alkylene)-(C3-C8cycloalkyl) is optionally substituted with one to four halo on the Ci-C4alkylene;
wherein RX1 is heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, -[C(Rxla)2]P-CN, -CF3, Ci-C4alkyl, -(CH2)P-OH, -[C(Rxla)2]P-OH, -[C(Rxla)2]P-0-Ci- C4alkyl, -NHCOCi-C4alkyl, -CONHCi-C4alkyl, -COH, -C02H, -[C(Rxla)2]P-COO-Ci- C4alkyl, -(CH2)P-NH2, -[C(Rxla)2]P-NH2, -[C(Rxla)2]P-NH-Ci-C4alkyl, -[C(Rxla)2]P-N-(Ci- C4alkyl)2; wherein p is 0, 1 , 2, or 3; wherein each Rxla is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rxla groups together form C3-C6cycloalkyl; each RY is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both RY groups together form C3-C6cycloalkyl or oxo; and
m is 0, 1, or 2;
provided that the compound is not
Figure imgf000161_0001
24. The method of claim 23, wherein Rx is -COR
25. The method of claim 24, wherein RX1 is piperidine or 8-oxa-3- azabicyclo[3.2.1]octane, both optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, Ci-C4alkyl, -(CH2)P- OH, -(CH2)p-NH2; wherein p is 1 , 2, or 3.
26. The method of claim 25, wherein RX1 is piperidine, optionally substituted with one to two halo substituents.
27. The method of claim 26, wherein the piperidine is optionally substituted with -(CH2)P- OH.
28. The method of claim 23, wherein Rx is heteroaryl.
29. The method of claim 28, wherein the heteroaryl is monocyclic or bicyclic.
30. The method of claim 28, wherein the heteroaryl contains one to three nitrogens.
31. The method of claim 23, wherein Rx is -(Ci-C4alkylene)-(C3-C8cycloalkyl).
32. The method of claim 31, wherein the-(Ci-C4alkylene)-(C3-C8cycloalkyl) is substituted with one or two halogens on the Ci-C4alkylene.
33. The method of claim 31, wherein the C3-Cscycloalkyl is cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
34. The method of any one of claims 1-18 and 20, wherein the one or more Wnt agonist is a compound of Formula la:
Figure imgf000162_0001
or a pharmaceutically acceptable salt or tautomer thereof, wherein:
Q1 is CH or N;
Q2 is C or N;
Q3 is C or N;
wherein at least one of Q1, Q2, and Q3 is N;
R1 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci- C4alkynyl, -CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein Rla is Ci-C4alkyl; R2 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl,-CN, -OH, -0-Ci-C4alkyl, -NH2, -NH(Ci-C4alkyl), -N(Ci-C4alkyl)2, - NHC(0)R2a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R2a is Ci-C4alkyl;
R3 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl, -CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R a is Ci-C4alkyl;
Figure imgf000163_0001
optionally substituted with deuterium, halo, alkyl, alkoxy, and CN;
Q7 is selected from S, O, CH2, and NRQ7; wherein RQ7 is hydrogen or optionally substituted Ci-C4alkyl;
-Z-W-X-Y- is -C(RZ)2-C(RW)2-N(RX)-C(RY)2-, -C(RZ)2-C(RW)2-CH(RX)-C(RY)2-, or -C(RW)2-CH(RX)-C(RY)2-;
each Rz is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rz groups together form C3-C6cycloalkyl or oxo;
each Rw is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rw groups together form C3-C6cycloalkyl or oxo;
or Rz and Rw together with the carbons to which they are attached form a C3- C6cycloalkyl;
Rx is selected from the group consisting of hydrogen, RX1, -CORxl, -S02RX1, -(Ci- C4alkylene)-Rxl, and wherein the -(Ci-C4alkylene)-Rxl is optionally substituted with one to four halo on the Ci-C4alkylene; wherein RX1 is C3-C8cycloalkyl, heteroaryl, or heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, -[C(Rxla)2]P-CN, -CF3, Ci-C4alkyl, -(CH2)P-OH, - [C(Rxla)2]P-OH, -[C(Rxla)2]P-0-Ci-C4alkyl, -NHCOCi-C4alkyl, CONHCi-C4alkyl, COH, - C02H, -[C(Rxla)2]p-COO-Ci-C4alkyl, -(CH2)P-NH2, -[C(Rxla)2]P-NH2, -[C(Rxla)2]P-NH-Ci- C4alkyl, -[C(Rxla)2]P-N-(Ci-C4alkyl)2; wherein p is 0, 1, 2, or 3; wherein each Rxla is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci- C4alkyl, or both Rxla groups together form C3-C6cycloalkyl;
each RY is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both RY groups together form C3-C6cycloalkyl or oxo; and
m is 0, 1, or 2.
35. The method of any one of claims 1-18 and 20, wherein the one or more Wnt agonist is a compound of Formula lb:
Figure imgf000164_0001
or a pharmaceutically acceptable salt or tautomer thereof, wherein:
Q1 is CH or N;
Q2 is C or N;
Q3 is C or N;
wherein at least one of Q1, Q2, and Q3 is N; and provided that when Q1 is CH and Q3 is C, Q2 is not N;
R1 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci- C4alkynyl, -CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein Rla is Ci-C4alkyl;
R2 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci- C4alkynyl,-CN, -OH, -0-Ci-C4alkyl, -NH2, -NH(Ci-C4alkyl), -N(Ci-C4alkyl)2, -NHC(0)R2a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R2a is Ci- C4alkyl;
R3 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci- C4alkynyl, -CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R a is Ci-C4alkyl;
Figure imgf000165_0001
; wherein Ar is optionally substituted with deuterium, halo, alkyl, alkoxy, and CN;
each Q6 is independently selected from CRQ6 and N; wherein CRQ6 is hydrogen, halo, -CN, lower alkyl, or substituted alkyl;
Q7 is selected from S, O, CH2, and NRQ7; wherein RQ7 is hydrogen or optionally substituted Ci-C4alkyl;
-Z-W-X-Y- is -C(RZ)2-C(RW)2-N(RX)-C(RY)2-, -C(RZ)2-C(RW)2-CH(RX)-C(RY)2-,
or -C(RW)2-CH(RX)-C(RY)2-;
each Rz is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rz groups together form C3-C6cycloalkyl or oxo;
each Rw is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rw groups together form C3-C6cycloalkyl or oxo;
or Rz and Rw together with the carbons to which they are attached form a C3-C6cycloalkyl;
Rx is selected from the group consisting of hydrogen, RX1, -CORxl, -S02RX1, -(Ci-
C4alkylene)-Rxl, and wherein the -(Ci-C4alkylene)-Rxl is optionally substituted with one to four halo on the Ci-C4alkylene; wherein RX1 is C3-C8cycloalkyl, heteroaryl, or heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, -[C(Rxla)2]P-CN, -CF3, Ci-C4alkyl, -(CH2)P-OH, -[C(Rxla)2]P- OH, -[C(Rxla)2]p-0-Ci-C4alkyl, -NHCOCi-C4alkyl, CONHCi-C4alkyl, COH, -C02H, - [C(Rxla)2]P-COO-Ci-C4alkyl, -(CH2)P-NH2, -[C(Rxla)2]P-NH2, -[C(Rxla)2]P-NH-Ci-C4alkyl, - [C(Rxla)2]P-N-(Ci-C4alkyl)2; wherein p is 0, 1, 2,or 3; wherein each Rxla is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rx groups together form C3-C6cycloalkyl;
each RY is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both RY groups together form C3-C6cycloalkyl or oxo; and
m is 0, 1, or 2.
36. The method of any one of claims 23-34, wherein Q1 is CH; Q2 is N; and Q3 is C.
37. The method of any one of claims 23-35, wherein Q1 is N; Q2 is C; and Q3 is N.
38. The method of any one of claims 23-35, wherein Q1 is CH; Q2 is C; and Q3 is N.
39. The method of any one of claims 23-35, wherein Q1 is N; Q2 is N; and Q3 is C.
40. The method of any one of claims 23-39, wherein R1 is hydrogen or halo.
41. The method of any one of claims 23-40, wherein R2 is halo.
42. The method of any one of claims 23-40, wherein R2 is selected from the group consisting of halo, -CF3, -CN, -C≡CH, -NH2, and -NHC(0)CH3.
43. The method of any one of claims 23-42, wherein R3 is hydrogen or halo.
44. The method of any one of claims 25-43, wherein Ar is
Figure imgf000166_0001
45. The method of any one of claims 23-44, wherein -Z-W-X-Y- is -C(RZ)2-C(RW)2- N(RX)-C(RY)2-.
46. The method of any one of claims 23-44, wherein -Z-W-X-Y- is -C(RZ)2-C(RW)2- CH(RX)-C(RY)2-.
47. The method of claim 45 or 46, wherein each Rz is independently selected from the group consisting of hydrogen and halo.
48. The method of claim 45 or 46, wherein both Rz groups together form C3- C6cycloalkyl.
49. The method of any one of claims 23-46, wherein Rz and Rw together with the carbons to which they are attached form a C3-C6cycloalkyl.
50. The method of any one of claims 23-44, wherein -Z-W-X-Y- is -C(RW)2-CH(RX)- C(RY)2-.
51. The method of any one of claims 23-50, wherein each Rw is independently selected from the group consisting of hydrogen and halo.
52. The method of any one of claims 23-50, wherein both Rw groups together form C3- C6cycloalkyl.
53. The method of any one of claims 23-52, wherein each RY is independently selected from the group consisting of hydrogen and halo.
54. The method of any one of claims 23-52, wherein both RY groups together form C3- C6cycloalkyl.
55. The method of any one of claims 34-54, wherein Rx is RX1, wherein RX1 is heteroaryl.
56. The method of any one of claims 34-54, wherein Rx is -CORxl.
57. The method of any one of claims 34-54, wherein Rx is -S02R]
58. The method of any one of claims 34-54, wherein Rx is -(Ci-C4alkylene)-Rxl.
59. The method of any one of claims 56-58, wherein RX1 is C3-C8cycloalkyl.
60. The method of any one of claims 56-58, wherein RX1 is heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents that is halo.
61. The method of any one of claims 1-18 and 20, wherein the one or more Wnt agonist is selected from Table 6.
62. The method of any one of claims 1-18 and 20, wherein the one or more Wnt agonist is selected from CHIR99021, LY2090314, AZD1080, GSK3 inhibitor XXII, Compound 1-6, Compound 1-7, and Compound 1-12.
63. The method of any one of claims 1-18 and 20, wherein the one or more Wnt agonist is selected from CHIR99021, LY2090314, AZD1080, GSK3 inhibitor XXII, Compound 1-6, Compound 1-7, and Compound 1-12 and the one or more Shh pathway activator is selected from Purmorphamine, SAG, 20-alpha hydroxy cholesterol, and SAG HC1.
64. The method of claim 63, wherein the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is Purmorphamine.
65. The method of claim 64, wherein CHIR99021 is at a concentration of about 100 nM to about 10 μΜ and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ.
66. The method of claim 64, wherein CHIR99021 is at a concentration of about 100 μΜ to about 10 mM and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
67. The method of claim 63, wherein the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is SAG.
68. The method of claim 67, wherein CHIR99021 is at a concentration of about 100 nM to about 10 μΜ and SAG is at a concentration of about 1 nM to about 100 nM.
69. The method of claim 67, wherein CHIR99021 is at a concentration of about 100 μΜ to about 10 mM and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
70. The method of claim 63, wherein the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
71. The method of claim 70, wherein CHIR99021 is at a concentration of about 100 nM to about 10 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ.
72. The method of claim 70, wherein CHIR99021 is at a concentration of about 100 μΜ to about 10 mM and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
73. The method of claim 63, wherein the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is SAG HC1.
74. The method of claim 73, wherein CHIR99021 is at a concentration of about 100 nM to about 10 μΜ and SAG HC1 is at a concentration of about 10 nM to about 1 μΜ.
75. The method of claim 73, wherein CHIR99021 is at a concentration of about 100 μΜ to about 10 mM and SAG HC1 is at a concentration of about 10 μΜ to about 1 mM.
76. The method of claim 63, wherein the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is Purmorphamine.
77. The method of claim 76, wherein LY2090314 is at a concentration of about 1 nM to about 100 nM and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ.
78. The method of claim 76, wherein LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
79. The method of claim 63, wherein the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is SAG.
80. The method of claim 79, wherein LY2090314 is at a concentration of about 1 nM to about 100 nM and SAG is at a concentration of about 1 nM to about 100 nM.
81. The method of claim 79, wherein LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
82. The method of claim 63, wherein the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
83. The method of claim 82, wherein LY2090314 is at a concentration of about 1 nM to about 100 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ.
84. The method of claim 82, wherein LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
85. The method of claim 63, wherein the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is SAG HC1.
86. The method of claim 85, wherein LY2090314 is at a concentration of about 1 nM to about 100 nM and SAG HC1 is at a concentration of about 10 nM to about 1 μΜ.
87. The method of claim 85, wherein LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ and SAG HC1 is at a concentration of about 10 μΜ to about 1 mM.
88. The method of claim 63, wherein the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is Purmorphamine.
89. The method of claim 88, wherein AZD1080 is at a concentration of about 1 μΜ to about 100 μΜ and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ.
90. The method of claim 88, wherein AZD1080 is at a concentration of about 1 mM to about 100 mM and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
91. The method of claim 63, wherein the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is SAG.
92. The method of claim 91, wherein AZD1080 is at a concentration of about 1 μΜ to about 100 μΜ and SAG is at a concentration of about 1 nM to about 100 nM.
93. The method of claim 91, wherein AZD1080 is at a concentration of about 1 mM to about 100 mM and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
94. The method of claim 63, wherein the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
95. The method of claim 94, wherein AZD1080 is at a concentration of about 1 μΜ to about 100 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ.
96. The method of claim 94, wherein AZD1080 is at a concentration of about 1 mM to about 100 mM and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
97. The method of claim 63, wherein the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is SAG HC1.
98. The method of claim 97, wherein AZD1080 is at a concentration of about 1 μΜ to about 100 μΜ and SAG HC1 is at a concentration of about 10 nM to about 1 μΜ.
99. The method of claim 97, wherein AZD1080 is at a concentration of about 1 mM to about 100 mM and SAG HC1 is at a concentration of about 10 μΜ to about 1 mM.
100. The method of claim 63, wherein the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is Purmorphamine.
101. The method of claim 100, wherein GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ.
102. The method of claim 100, wherein GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
103. The method of claim 63, wherein the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is SAG.
104. The method of claim 103, wherein GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ and SAG is at a concentration of about 1 nM to about 100 nM.
105. The method of claim 103, wherein GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
106. The method of claim 63, wherein the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
107. The method of claim 106, wherein GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ.
108. The method of claim 106, wherein GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
109. The method of claim 63, wherein the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is SAG HC1.
110. The method of claim 109, wherein GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ and SAG HCl is at a concentration of about 10 nM to about 1 μΜ.
111. The method of claim 109, wherein GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM and SAG HCl is at a concentration of about 10 μΜ to about 1 mM.
112. The method of claim 63, wherein the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is Purmorphamine.
113. The method of claim 112, wherein Compound 1-6 is at a concentration of about 1 nM to about 100 nM and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ.
114. The method of claim 112, wherein Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
115. The method of claim 63, wherein the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is SAG.
116. The method of claim 115, wherein Compound 1-6 is at a concentration of about 1 nM to about 100 nM and SAG is at a concentration of about 1 nM to about 100 nM.
117. The method of claim 115, wherein Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
118. The method of claim 63, wherein the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
119. The method of claim 118, wherein Compound 1-6 is at a concentration of about 1 nM to about 100 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ.
120. The method of claim 118, wherein Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
121. The method of claim 63, wherein the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is SAG HC1.
122. The method of claim 121, wherein Compound 1-6 is at a concentration of about 1 nM to about 100 nM and SAG HC1 is at a concentration of about 10 nM to about 1 μΜ.
123. The method of claim 121, wherein Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ and SAG HC1 is at a concentration of about 10 μΜ to about 1 mM.
124. The method of claim 63, wherein the one or more Wnt agonist is Compound 1-7 and the one or more Shh pathway activator is Purmorphamine.
125. The method of claim 124, wherein Compound 1-7 is at a concentration of about 1 nM to about 100 nM and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ.
126. The method of claim 124, wherein Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
127. The method of claim 63, wherein the one or more Wnt agonist is Compound 1-7 and the one or more Shh pathway activator is SAG.
128. The method of claim 127, wherein Compound 1-7 is at a concentration of about 1 nM to about 100 nM and SAG is at a concentration of about 1 nM to about 100 nM.
129. The method of claim 127, wherein Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
130. The method of claim 63, wherein the one or more Wnt agonist is Compound 1-7 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
131. The method of claim 130, wherein Compound 1-7 is at a concentration of about 1 nM to about 100 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ.
132. The method of claim 130, wherein Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
133. The method of claim 63, wherein the one or more Wnt agonist is Compound 1-7 and the one or more Shh pathway activator is SAG HC1.
134. The method of claim 133, wherein Compound 1-7 is at a concentration of about 1 nM to about 100 nM and SAG HC1 is at a concentration of about 10 nM to about 1 μΜ.
135. The method of claim 133, wherein Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ and SAG HC1 is at a concentration of about 10 μΜ to about 1 mM.
136. The method of claim 63, wherein the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is Purmorphamine.
137. The method of claim 136, wherein Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ.
138. The method of claim 136, wherein Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
139. The method of claim 63, wherein the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is SAG.
140. The method of claim 139, Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and SAG is at a concentration of about 1 nM to about 100 nM.
141. The method of claim 139, wherein Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
142. The method of claim 63, wherein the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
143. The method of claim 142, wherein Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ.
144. The method of claim 142, wherein Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
145. The method of claim 63, wherein the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is SAG HC1.
146. The method of claim 145, wherein Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and SAG HC1 is at a concentration of about 10 nM to about 1 μΜ.
147. The method of claim 145, wherein Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ and SAG HC1 is at a concentration of about 10 μΜ to about 1 mM.
148. The method of any one of claims 1-147, wherein the expression of Glil, Krtl5, CD34, Lgr5, Lgr6, Lrigl, Sox2, CD133, Vimentin, Versican and/or alkaline phosphatase is increased in hair follicles.
149. A pharmaceutical composition comprising: a pharmaceutically-acceptable carrier and (i) a Wnt agonist, or a pharmaceutically-acceptable salt thereof, and (ii) a Sonic Hedgehog (Shh) pathway activator, or a pharmaceutically-acceptable salt thereof.
150. The pharmaceutical composition of claim 149, wherein the one or more Shh pathway activator is at a concentration of about 5x to about lOOOx of an effective in vitro Shh activation concentration.
151. The pharmaceutical composition of claim 149 or 150, wherein the one or more Shh pathway activator is at a concentration of about lOx to about lOOx of an effective in vitro Shh activation concentration.
152. The pharmaceutical composition of any one of claims 149-151, wherein the one or more Shh pathway activator is at a concentration of about 20x to about 5 Ox of an effective in vitro Shh activation concentration.
153. The pharmaceutical composition of any one of claims 149-152, wherein the one or more Wnt agonist is at a concentration of about 5x to about lOOOx of an effective in vitro Wnt agonist concentration.
154. The pharmaceutical composition of any one of claims 149-153, wherein the one or more Wnt agonist is at a concentration of about lOx to about lOOx of an effective in vitro Wnt agonist concentration.
155. The pharmaceutical composition of any one of claims 149-154, wherein the one or more Wnt agonist is at a concentration of about 20x to about 5 Ox of an effective in vitro Wnt agonist concentration.
156. The pharmaceutical composition of any one of claims 149-155, wherein the one or more Shh pathway activator is selected from Table 1 or Table 2.
157. The pharmaceutical composition of any one of claims 149-156, wherein the one or more Shh pathway activator is selected from Purmorphamine, SAG, 20-alpha hydroxy cholesterol, and SAG HC1.
158. The pharmaceutical composition of any one of claims 149-157, wherein the one or more Wnt agonist is selected from Table 3.
159. The pharmaceutical composition of any one of claims 149-158, wherein the one or more Wnt agonist is a GSK3 -alpha inhibitor or a GSK3-beta inhibitor.
160. The pharmaceutical composition of claim 159, wherein the GSK3-alpha inhibitor is selected from Table 5.
161. The pharmaceutical composition of claim 159, wherein the GSK3-beta inhibitor is selected from Table 4.
162. The pharmaceutical composition of any one of claims 149-157 and 159, wherein the one or more Wnt agonist is a compound of Formula I:
Figure imgf000178_0001
or a pharmaceutically acceptable salt or tautomer thereof, wherein:
Q1 is CH or N;
Q2 is C or N;
Q3 is C or N;
wherein at least one of Q1, Q2, and Q3 is N;
R1 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl,-CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)Rla, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein Rla is Ci-C4alkyl;
R2 is selected from the group consisting of halo, Ci-C4alkyl, Ci-C4alkenyl, Ci- C4alkynyl,
-CN, -OH, -0-Ci-C4alkyl, -NH2, -NH(Ci-C4alkyl), -N(Ci-C4alkyl)2, -NHC(0)R2a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents
independently selected from the group consisting of halo and -OH; and wherein R2a is Ci- C4alkyl;
R3 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl,-CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R a is Ci-C4alkyl;
Figure imgf000179_0001
-Z-W-X-Y- is -C(RZ)2-C(RW)2-N(RX)-C(RY)2-, -C(RZ)2-C(RW)2-CH(RX)-C(RY)2-, or -C(RW)2-CH(RX)-C(RY)2-;
each Rz is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rz groups together form C3-C6cycloalkyl or oxo;
each Rw is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rw groups together form C3-C6cycloalkyl or oxo;
or Rz and Rw together with the carbons to which they are attached form a C3- C6cycloalkyl;
Rx is selected from the group consisting of -CORxl, -S02RX1, heteroaryl, and -(Ci- C4alkylene)-(C3-C8cycloalkyl), and wherein the-(Ci-C4alkylene)-(C3-C8cycloalkyl) is optionally substituted with one to four halo on the Ci-C4alkylene;
wherein RX1 is heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, -[C(Rxla)2]P-CN, -CF3, Ci-C4alkyl, -(CH2)P-OH, -[C(Rxla)2]P-OH, -[C(Rxla)2]P-0-Ci- C4alkyl, -NHCOCi-C4alkyl, -CONHCi-C4alkyl, -COH, -C02H, -[C(Rxla)2]P-COO-Ci- C4alkyl, -(CH2)P-NH2, -[C(Rxla)2]P-NH2, -[C(Rxla)2]P-NH-Ci-C4alkyl, -[C(Rxla)2]P-N-(Ci- C4alkyl)2; wherein p is 0, 1, 2, or 3; wherein each Rxla is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rxla groups together form C3-C6cycloalkyl;
each RY is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both RY groups together form C3-C6cycloalkyl or oxo; and
m is 0, 1, or 2;
provided that the compound is not
Figure imgf000180_0001
163. The pharmaceutical composition of claim 162, wherein Rx is -COR]
164. The pharmaceutical composition of claim 163, wherein RX1 is piperidine or 8-oxa-3- azabicyclo[3.2.1]octane, both optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, Ci-C4alkyl, -(CH2)P- OH, -(CH2)p-NH2; wherein p is 1 , 2, or 3.
165. The pharmaceutical composition of claim 164, wherein RX1 is piperidine, optionally substituted with one to two halo substituents.
166. The pharmaceutical composition of claim 165, wherein the piperidine is optionally substituted with -(CH2)P-OH.
167. The pharmaceutical composition of claim 162, wherein Rx is heteroaryl.
168. The pharmaceutical composition of claim 167, wherein the heteroaryl is monocyclic or bicyclic.
169. The pharmaceutical composition of claim 167, wherein the heteroaryl contains one to three nitrogens.
170. The pharmaceutical composition of claim 162, wherein Rx is -(Ci-C4alkylene)-(C3- C8cycloalkyl).
171. The compound of claim 170, wherein the-(Ci-C4alkylene)-(C3-C8cycloalkyl) is substituted with one or two halogens on the Ci-C4alkylene.
172. The compound of claim 170, wherein the C3-C8cycloalkyl is cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl.
173. The pharmaceutical composition of any one of claims 149-157 and 159, wherein the one or more Wnt agonist is a compound of Formula la:
Figure imgf000181_0001
or a pharmaceutically acceptable salt or tautomer thereof, wherein:
Q1 is CH or N;
Q2 is C or N;
Q3 is C or N;
wherein at least one of Q1, Q2, and Q3 is N;
R1 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci- C4alkynyl, -CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein Rla is Ci-C4alkyl; R2 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl,-CN, -OH, -0-Ci-C4alkyl, -NH2, -NH(Ci-C4alkyl), -N(Ci-C4alkyl)2, - NHC(0)R2a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R2a is Ci-C4alkyl;
R3 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci-C4alkynyl, -CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R a is Ci-C4alkyl;
Figure imgf000182_0001
optionally substituted with deuterium, halo, alkyl, alkoxy, and CN;
Q7 is selected from S, O, CH2, and NRQ7; wherein RQ7 is hydrogen or optionally substituted Ci-C4alkyl;
-Z-W-X-Y- is -C(RZ)2-C(RW)2-N(RX)-C(RY)2-, -C(RZ)2-C(RW)2-CH(RX)-C(RY)2-, or -C(RW)2-CH(RX)-C(RY)2-;
each Rz is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rz groups together form C3-C6cycloalkyl or oxo;
each Rw is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rw groups together form C3-C6cycloalkyl or oxo;
or Rz and Rw together with the carbons to which they are attached form a C3- C6cycloalkyl;
Rx is selected from the group consisting of hydrogen, RX1, -CORxl, -S02RX1, -(Ci- C4alkylene)-Rxl, and wherein the -(Ci-C4alkylene)-Rxl is optionally substituted with one to four halo on the Ci-C4alkylene; wherein RX1 is C3-C8cycloalkyl, heteroaryl, or heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, -[C(Rxla)2]P-CN, -CF3, Ci-C4alkyl, -(CH2)P-OH, - [C(Rxla)2]P-OH, -[C(Rxla)2]P-0-Ci-C4alkyl, -NHCOCi-C4alkyl, CONHCi-C4alkyl, COH, - C02H, -[C(Rxla)2]p-COO-Ci-C4alkyl, -(CH2)P-NH2, -[C(Rxla)2]P-NH2, -[C(Rxla)2]P-NH-Ci- C4alkyl, -[C(Rxla)2]P-N-(Ci-C4alkyl)2; wherein p is 0, 1, 2, or 3; wherein each Rxla is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci- C4alkyl, or both Rxla groups together form C3-C6cycloalkyl;
each RY is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both RY groups together form C3-C6cycloalkyl or oxo; and
m is 0, 1, or 2.
174. The pharmaceutical composition of any one of claims 149-157 and 159, wherein the one or more Wnt agonist is a compound of Formula lb:
Figure imgf000183_0001
or a pharmaceutically acceptable salt or tautomer thereof, wherein:
Q1 is CH or N;
Q2 is C or N;
Q3 is C or N;
wherein at least one of Q1, Q2, and Q3 is N; and provided that when Q1 is CH and Q3 is C, Q2 is not N;
R1 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci- C4alkynyl, -CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein Rla is Ci-C4alkyl;
R2 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci- C4alkynyl,-CN, -OH, -0-Ci-C4alkyl, -NH2, -NH(Ci-C4alkyl), -N(Ci-C4alkyl)2, -NHC(0)R2a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R2a is Ci- C4alkyl;
R3 is selected from the group consisting of hydrogen, halo, Ci-C4alkyl, Ci-C4alkenyl, Ci- C4alkynyl, -CN, -OH, -0-Ci-C4alkyl, -NH2, -NHC(0)R a, and -S(0)2NH2; wherein the alkyl is optionally substituted with one to 3 substituents independently selected from the group consisting of halo and -OH; and wherein R a is Ci-C4alkyl;
Figure imgf000184_0001
; wherein Ar is optionally substituted with deuterium, halo, alkyl, alkoxy, and CN;
each Q6 is independently selected from CRQ6 and N; wherein CRQ6 is hydrogen, halo, -CN, lower alkyl, or substituted alkyl;
Q7 is selected from S, O, CH2, and NRQ7; wherein RQ7 is hydrogen or optionally substituted Ci-C4alkyl;
-Z-W-X-Y- is -C(RZ)2-C(RW)2-N(RX)-C(RY)2-, -C(RZ)2-C(RW)2-CH(RX)-C(RY)2-, or -C(RW)2-CH(RX)-C(RY)2-;
each Rz is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rz groups together form C3-C6cycloalkyl or oxo;
each Rw is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rw groups together form C3-C6cycloalkyl or oxo;
or Rz and Rw together with the carbons to which they are attached form a C3-C6cycloalkyl;
Rx is selected from the group consisting of hydrogen, RX1, -CORxl, -S02RX1, -(Ci-
C4alkylene)-Rxl, and wherein the -(Ci-C4alkylene)-Rxl is optionally substituted with one to four halo on the Ci-C4alkylene; wherein RX1 is C3-C8cycloalkyl, heteroaryl, or heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents independently selected from the group consisting of deuterium, halo, -[C(Rxla)2]P-CN, -CF3, Ci-C4alkyl, -(CH2)P-OH, -[C(Rxla)2]P- OH, -[C(Rxla)2]p-0-Ci-C4alkyl, -NHCOCi-C4alkyl, CONHCi-C4alkyl, COH, -C02H, - [C(Rxla)2]P-COO-Ci-C4alkyl, -(CH2)P-NH2, -[C(Rxla)2]P-NH2, -[C(Rxla)2]P-NH-Ci-C4alkyl, - [C(Rxla)2]P-N-(Ci-C4alkyl)2; wherein p is 0, 1, 2,or 3; wherein each Rxla is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both Rxla groups together form C3-C6cycloalkyl;
each RY is independently selected from the group consisting of hydrogen, deuterium, halo, and Ci-C4alkyl, or both RY groups together form C3-C6cycloalkyl or oxo; and
m is 0, 1, or 2.
175. The pharmaceutical composition of any one of claims 162-173, wherein Q1 is CH; Q2 is N; and Q3 is C.
176. The pharmaceutical composition of any one of claims 162-174, wherein Q1 is N; Q2 is C; and Q3 is N.
177. The pharmaceutical composition of any one of claims 162-174, wherein Q1 is CH; Q2 is C; and Q3 is N.
178. The pharmaceutical composition of any one of claims 162-174, wherein Q1 is N; Q2 is N; and Q3 is C.
179. The pharmaceutical composition of any one of claims 162-178, wherein R1 is hydrogen or halo.
180. The pharmaceutical composition of any one of claims 162-179, wherein R2 is halo.
181. The pharmaceutical composition of any one of claims 162-179, wherein R2 is selected from the group consisting of halo, -CF3, -CN, -C≡CH, -NH2, and -NHC(0)CH3.
182. The pharmaceutical composition of any one of claims 162-181, wherein R3 is hydrogen or halo.
183. The pharmaceutical composition of any one of claims 162 and 164-182, wherein Ar is
Figure imgf000186_0001
184. The pharmaceutical composition of any one of claims 162-183, wherein -Z-W-X-Y- is -C(RZ)2-C(RW)2-N(RX)-C(RY)2-.
185. The pharmaceutical composition of any one of claims 162-183, wherein -Z-W-X-Y- is -C(RZ)2-C(RW)2-CH(RX)-C(RY)2-.
186. The pharmaceutical composition of claim 184 or 185, wherein each Rz is
independently selected from the group consisting of hydrogen and halo.
187. The pharmaceutical composition of claim 184 or 185, wherein both Rz groups together form C3-C6cycloalkyl.
188. The pharmaceutical composition of any one of claims 162-185, wherein Rz and Rw together with the carbons to which they are attached form a C3-C6cycloalkyl.
189. The pharmaceutical composition of any one of claims 162-183, wherein -Z-W-X-Y- is -C(RW)2-CH(RX)-C(RY)2-.
190. The pharmaceutical composition of any one of claims 162-189, wherein each Rw is independently selected from the group consisting of hydrogen and halo.
191. The pharmaceutical composition of any one of claims 162-189, wherein both Rw groups together form C3-C6cycloalkyl.
192. The pharmaceutical composition of any one of claims 162-191, wherein each RY is independently selected from the group consisting of hydrogen and halo.
193. The pharmaceutical composition of any one of claims 162-191, wherein both RY groups together form C3-C6cycloalkyl.
194. The pharmaceutical composition of any one of claims 173-193, wherein Rx is RX1, wherein RX1 is heteroaryl.
195. The pharmaceutical composition of any one of claims 173-193, wherein Rx is - CORxl.
196. The pharmaceutical composition of any one of claims 173-193, wherein Rx is - S02RX1.
197. The pharmaceutical composition of any one of claims 173-193, wherein Rx is -(Ci- C4alkylene)-Rxl.
198. The pharmaceutical composition of any one of claims 195-197, wherein RX1 is C3- C8cycloalkyl.
199. The pharmaceutical composition of any one of claims 195-197, wherein RX1 is heterocyclic, wherein the heterocyclic is optionally substituted with one to twelve substituents that is halo.
200. The pharmaceutical composition of any one of claims 149-157 and 159, wherein the one or more Wnt agonist is selected from Table 6.
201. The pharmaceutical composition of any one of claims 149-157 and 159, wherein the one or more Wnt agonist is selected from CHIR99021, LY2090314, AZD1080, GSK3 inhibitor XXII, Compound 1-6, Compound 1-7, and Compound 1-12.
202. The pharmaceutical composition of any one of claims 149-157 and 159, wherein the one or more Wnt agonist is selected from CHIR99021, LY2090314, AZD1080, GSK3 inhibitor XXII, Compound 1-6, Compound 1-7, and Compound 1-12 and the one or more Shh pathway activator is selected from Purmorphamine, SAG, 20-alpha hydroxy cholesterol, and SAG HC1.
203. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is Purmorphamine.
204. The pharmaceutical composition of claim 203, wherein CHIR99021 is at a concentration of about 100 nM to about 10 μΜ and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ.
205. The pharmaceutical composition of claim 203, wherein CHIR99021 is at a concentration of about 100 μΜ to about 10 mM and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
206. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is SAG.
207. The pharmaceutical composition of claim 206, wherein CHIR99021 is at a concentration of about 100 nM to about 10 μΜ and SAG is at a concentration of about 1 nM to about 100 nM.
208. The pharmaceutical composition of claim 206, wherein CHIR99021 is at a concentration of about 100 μΜ to about 10 mM and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
209. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
210. The pharmaceutical composition of claim 209, wherein CHIR99021 is at a concentration of about 100 nM to about 10 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ.
211. The pharmaceutical composition of claim 209, wherein CHIR99021 is at a concentration of about 100 μΜ to about 10 mM and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
212. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is CHIR99021 and the one or more Shh pathway activator is SAG HC1.
213. The pharmaceutical composition of claim 212, wherein CHIR99021 is at a concentration of about 100 nM to about 10 μΜ and SAG HCl is at a concentration of about lO nM to about 1 μΜ.
214. The pharmaceutical composition of claim 212, wherein CHIR99021 is at a concentration of about 100 μΜ to about 10 mM and SAG HCl is at a concentration of about 10 μΜ ίο about 1 mM.
215. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is Purmorphamine.
216. The pharmaceutical composition of claim 215, wherein LY2090314 is at a concentration of about 1 nM to about 100 nM and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ.
217. The pharmaceutical composition of claim 215, wherein LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
218. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is SAG.
219. The pharmaceutical composition of claim 218, wherein LY2090314 is at a concentration of about 1 nM to about 100 nM and SAG is at a concentration of about 1 nM to about 100 nM.
220. The pharmaceutical composition of claim 218, wherein LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
221. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
222. The pharmaceutical composition of claim 221, wherein LY2090314 is at a concentration of about 1 nM to about 100 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ.
223. The pharmaceutical composition of claim 221, wherein LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
224. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is LY2090314 and the one or more Shh pathway activator is SAG HCl.
225. The pharmaceutical composition of claim 224, wherein LY2090314 is at a concentration of about 1 nM to about 100 nM and SAG HCl is at a concentration of about 10 nM to about 1 μΜ.
226. The pharmaceutical composition of claim 224, wherein LY2090314 is at a concentration of about 1 μΜ to about 100 μΜ and SAG HCl is at a concentration of about 10 μΜ to about 1 mM.
227. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is Purmorphamine.
228. The pharmaceutical composition of claim 227, wherein AZD1080 is at a
concentration of about 1 μΜ to about 100 μΜ and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ.
229. The pharmaceutical composition of claim 227, wherein AZD1080 is at a
concentration of about 1 mM to about 100 mM and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
230. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is SAG.
231. The pharmaceutical composition of claim 230, wherein AZD1080 is at a
concentration of about 1 μΜ to about 100 μΜ and SAG is at a concentration of about 1 nM to about 100 nM.
232. The pharmaceutical composition of claim 230, wherein AZD1080 is at a
concentration of about 1 mM to about 100 mM and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
233. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
234. The pharmaceutical composition of claim 233, wherein AZD1080 is at a
concentration of about 1 μΜ to about 100 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ.
235. The pharmaceutical composition of claim 233, wherein AZD1080 is at a
concentration of about 1 mM to about 100 mM and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
236. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is AZD1080 and the one or more Shh pathway activator is SAG HCl.
237. The pharmaceutical composition of claim 236, wherein AZD1080 is at a
concentration of about 1 μΜ to about 100 μΜ and SAG HCl is at a concentration of about 10 nM to about 1 μΜ.
238. The pharmaceutical composition of claim 236, wherein AZD1080 is at a
concentration of about 1 mM to about 100 mM and SAG HCl is at a concentration of about 10 μΜ ίο about 1 mM.
239. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is Purmorphamine.
240. The pharmaceutical composition of claim 239, wherein GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ.
241. The pharmaceutical composition of claim 239, wherein GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
242. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is SAG.
243. The pharmaceutical composition of claim 242, wherein GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ and SAG is at a concentration of about 1 nM to about 100 nM.
244. The pharmaceutical composition of claim 242, wherein GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
245. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
246. The pharmaceutical composition of claim 245, wherein GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ.
247. The pharmaceutical composition of claim 245, wherein GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
248. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is GSK3 inhibitor XXII and the one or more Shh pathway activator is SAG HC1.
249. The pharmaceutical composition of claim 248, wherein GSK3 inhibitor XXII is at a concentration of about 100 nM to about 10 μΜ and SAG HCl is at a concentration of about lO nM to about 1 μΜ.
250. The pharmaceutical composition of claim 248, wherein GSK3 inhibitor XXII is at a concentration of about 100 μΜ to about 10 mM and SAG HCl is at a concentration of about 10 μΜ ίο about 1 mM.
251. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is Purmorphamine.
252. The pharmaceutical composition of claim 251, wherein Compound 1-6 is at a concentration of about 1 nM to about 100 nM and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ.
253. The pharmaceutical composition of claim 251, wherein Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
254. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is SAG.
255. The pharmaceutical composition of claim 254, wherein Compound 1-6 is at a concentration of about 1 nM to about 100 nM and SAG is at a concentration of about 1 nM to about 100 nM.
256. The pharmaceutical composition of claim 254, wherein Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
257. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
258. The pharmaceutical composition of claim 257, wherein Compound 1-6 is at a concentration of about 1 nM to about 100 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ.
259. The pharmaceutical composition of claim 257, wherein Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 rriM to about 100 mM.
260. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is Compound 1-6 and the one or more Shh pathway activator is SAG HCl.
261. The pharmaceutical composition of claim 260, wherein Compound 1-6 is at a concentration of about 1 nM to about 100 nM and SAG HCl is at a concentration of about 10 nM to about 1 μΜ.
262. The pharmaceutical composition of claim 260, wherein Compound 1-6 is at a concentration of about 1 μΜ to about 100 μΜ and SAG HCl is at a concentration of about 10 μΜ to about 1 mM.
263. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is Compound 1-7 and the one or more Shh pathway activator is Purmorphamine.
264. The pharmaceutical composition of claim 263, wherein Compound 1-7 is at a concentration of about 1 nM to about 100 nM and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ.
265. The pharmaceutical composition of claim 263, wherein Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
266. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is Compound 1-7 and the one or more Shh pathway activator is SAG.
267. The pharmaceutical composition of claim 266, wherein Compound 1-7 is at a concentration of about 1 nM to about 100 nM and SAG is at a concentration of about 1 nM to about 100 nM.
268. The pharmaceutical composition of claim 266, wherein Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
269. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is Compound 1-7 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
270. The pharmaceutical composition of claim 269, wherein Compound 1-7 is at a concentration of about 1 nM to about 100 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ.
271. The pharmaceutical composition of claim 269, wherein Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 rriM to about 100 mM.
272. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is Compound 1-7 and the one or more Shh pathway activator is SAG HCl.
273. The pharmaceutical composition of claim 272, wherein Compound 1-7 is at a concentration of about 1 nM to about 100 nM and SAG HCl is at a concentration of about 10 nM to about 1 μΜ.
274. The pharmaceutical composition of claim 272, wherein Compound 1-7 is at a concentration of about 1 μΜ to about 100 μΜ and SAG HCl is at a concentration of about 10 μΜ to about 1 mM.
275. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is Purmorphamine.
276. The pharmaceutical composition of claim 275, wherein Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and Purmorphamine is at a concentration of about 100 nM to about 10 μΜ.
277. The pharmaceutical composition of claim 275, wherein Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ and Purmorphamine is at a concentration of about 100 μΜ to about 10 mM.
278. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is SAG.
279. The pharmaceutical composition of claim 278, Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and SAG is at a concentration of about 1 nM to about 100 nM.
280. The pharmaceutical composition of claim 278, wherein Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ and SAG is at a concentration of about 1 μΜ to about 100 μΜ.
281. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is 20-alpha hydroxy cholesterol.
282. The pharmaceutical composition of claim 281, wherein Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and 20-alpha hydroxy cholesterol is at a concentration of about 1 μΜ to about 100 μΜ.
283. The pharmaceutical composition of claim 281, wherein Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ and 20-alpha hydroxy cholesterol is at a concentration of about 1 mM to about 100 mM.
284. The pharmaceutical composition of claim 202, wherein the one or more Wnt agonist is Compound 1-12 and the one or more Shh pathway activator is SAG HCl.
285. The pharmaceutical composition of claim 284, wherein Compound 1-12 is at a concentration of about 10 nM to about 1000 nM and SAG HCl is at a concentration of about lO nM to about 1 μΜ.
286. The pharmaceutical composition of claim 284, wherein Compound 1-12 is at a concentration of about 10 μΜ to about 1000 μΜ and SAG HCl is at a concentration of about 10 μΜ ίο about 1 mM.
287. The pharmaceutical composition of claim 149, wherein the Shh pathway activator comprises a Smoothened agonist.
288. The pharmaceutical composition of claim 149, wherein the Shh pathway activator comprises Smoothened ciliary accumulation enhancers.
289. The method of any one of the preceding claims, wherein the Shh pathway activator is SAG (CAS 912545-86-9) or SAG-HCl in combination with a Wnt agonist selected from one or more of an SFRP1 inhibitor (for example, WAY-316606), a SFRP2 inhibitor, a SFRP3 inhibitor, a SFRP4 inhibitor, a SFRP5 inhibitor, a cyclosporine or an analog thereof (for example, cyclosporine A (CsA), PSC833 (Valspodar)), a DKKl inhibitor (for example, WAY-262611), and a WIF1 inhibitor.
290. The pharmaceutical composition of any one of the preceding claims, wherein the Shh pathway activator is SAG (CAS 912545-86-9) or SAG-HCl in combination with a Wnt agonist selected from one or more of an SFRP1 inhibitor (for example, WAY-316606), a SFRP2 inhibitor, a SFRP3 inhibitor, a SFRP4 inhibitor, a SFRP5 inhibitor, a cyclosporine or an analog thereof (for example, cyclosporine A (CsA), PSC833 (Valspodar)), a DKK1 inhibitor (for example, WAY-262611), and a WIF1 inhibitor.
291. The method of any one of the preceding claims, wherein the skin is roughened or wounded before the administration of the therapy.
292. The method of any one of the preceding claims, wherein one or more needles are applied to the skin before the therapy is applied.
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