WO2019213234A1 - Triazolopyrimidines, their preparation and use - Google Patents

Triazolopyrimidines, their preparation and use Download PDF

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Publication number
WO2019213234A1
WO2019213234A1 PCT/US2019/030172 US2019030172W WO2019213234A1 WO 2019213234 A1 WO2019213234 A1 WO 2019213234A1 US 2019030172 W US2019030172 W US 2019030172W WO 2019213234 A1 WO2019213234 A1 WO 2019213234A1
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alkyl
present
compound
absent
independently
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PCT/US2019/030172
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French (fr)
Inventor
Konstantin Petrukhin
Kirsten Alison Rinderspacher
Shi-Xian Deng
Andras Varadi
Boglarka RACZ
Peter Bernstein
Patricia C. Weber
Donald W. Landry
Andrew S. Wasmuth
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The Trustees Of Columbia University In The City Of New York
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Publication of WO2019213234A1 publication Critical patent/WO2019213234A1/en
Priority to US17/085,791 priority Critical patent/US12168664B2/en

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    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D487/00—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, not provided for by groups C07D451/00 - C07D477/00
    • C07D487/02—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, not provided for by groups C07D451/00 - C07D477/00 in which the condensed system contains two hetero rings
    • C07D487/04—Ortho-condensed systems
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D209/00—Heterocyclic compounds containing five-membered rings, condensed with other rings, with one nitrogen atom as the only ring hetero atom
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P27/00—Drugs for disorders of the senses
    • A61P27/02—Ophthalmic agents
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D519/00—Heterocyclic compounds containing more than one system of two or more relevant hetero rings condensed among themselves or condensed with a common carbocyclic ring system not provided for in groups C07D453/00 or C07D455/00

Definitions

  • Age-related macular degeneration is the leading cause of blindness in developed countries. It is estimated that 62.9 million individuals worldwide have the most prevalent atrophic (dry) form of AMD; 8 million of them are Americans. Due to increasing life expectancy and current demographics, this number is expected to triple by 2020. There is currently no FDA-approved treatment for dry AMD. Given the lack of treatment and high prevalence, development of drugs for dry AMD is of utmost importance. Clinically, atrophic AMD represents a slowly progressing neurodegenerative disorder in which specialized neurons (rod and cone photoreceptors) die in the central part of the retina called macula (1) .
  • RPE retinal pigment epithelium
  • Fig. 1 histopathological and clinical imaging studies indicate that photoreceptor degeneration in dry AMD is triggered by abnormalities in the retinal pigment epithelium (RPE) that lies beneath photoreceptors and provides critical metabolic support to these light-sensing neuronal cells.
  • RPE retinal pigment epithelium
  • Experimental and clinical data indicate that excessive accumulation of cytotoxic autofluorescent lipid-protein-retinoid aggregates (lipofuscin) in the RPE is a major trigger of dry AMD (2-9) .
  • lipofuscin cytotoxic autofluorescent lipid-protein-retinoid aggregates
  • STGD Stargardt Disease
  • the major cytotoxic component of RPE lipofuscin is pyridinium bisretinoid A2E (Fig. 1) .
  • Additional cytotoxic bisretinoids are isoA2E, atRAL di-PE, and A2-DHP-PE (40, 41). Formation of A2E and other lipofuscin bisretinoids, such as A2-DHP-PE (A2-dihydropyridine- phosphatidylethanolamine) and atRALdi-PE (all-trans-retinal dimer- phosphatidylethanolamine ) , begins in photoreceptor cells in a non- enzymatic manner and can be considered as a by-product of the properly functioning visual cycle.
  • A2-DHP-PE A2-dihydropyridine- phosphatidylethanolamine
  • atRALdi-PE all-trans-retinal dimer- phosphatidylethanolamine
  • A2E is a product of condensation of all-trans retinaldehyde with phosphatidyl-ethanolamine which occurs in the retina in a non- enzymatic manner and, as illustrated in Fig. 4, can be considered a by-product of a properly functioning visual cycle (10) .
  • Light-induced isomerization of 11-cis retinaldehyde to its all-trans form is the first step in a signaling cascade that mediates light perception.
  • the visual cycle is a chain of biochemical reactions that regenerate visual pigment (11-cis retinaldehyde conjugated to opsin) following exposure to light.
  • partial pharmacological inhibition of the visual cycle may represent a treatment strategy for dry AMD and other disorders characterized by excessive accumulation of lipofuscin (25— 27, 40, 41) .
  • the present invention provides a compound having the structure:
  • Ri, R2, R3, R C , and Rs are each independently H, halogen, CF3, OCF 3 alkyl, haloalkyl, aryl or heteroaryl;
  • X is N or CR 6 ,
  • R 6 is H, OH, or halogen
  • A is absent or present, and when present
  • a and b are each a bond that is present or absent;
  • Xi is N, NH or NR10
  • Ri 0 is alkyl, alkenyl or alkynyl
  • X 2 is C or N
  • X 3 is CH or N
  • R 7 , Re and R 9 are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl -NH 2 , alkyl-OAc alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (0) -N (CH 3 ) 2 , C(0)-NHCH 3 , NHC (O) -N (CH 3 ) 2, CN or CF 3 , wherein
  • Xi, X 2 and X 3 are each N, a is present and b is absent; or
  • Xi is NH, X 2 is C, X 3 is CH, a is absent and b is present; or
  • Xi is N, X 2 is N, X 3 is CH, a is present and b is absent; or
  • Xi is NH or NR 10 , X 2 is C, X 3 is N, a is absent and b is present, wherein when Xi is NH, X 2 is C, X 3 is N, a is absent and b is present, then one of R 7 , Re and R 9 is other than H, or B has the structure:
  • X 4 and X 5 are each, independently, is N or CH;
  • R 11 , R 12 and R 3 are each, independently, H, halogen, alkyl, alkenyl, alkynyl alkyl-OH, alkyl-NH 2 , alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 ,
  • Fig. 1 Structure of bisretinoid A2E, a cytotoxic component of retinal lipofuscin.
  • Fig. 2 Structure of bisretinoid atRAL di-PE (all-trans retinal dimer-phosphatidyl ethanolamine ) , a cytotoxic component of retinal lipofuscin.
  • R1 and R2 refer to various fatty acid constituents.
  • Fig. 3 Structure of bisretinoid A2-DHP-PE, a cytotoxic component of retinal lipofuscin.
  • A2E biosynthesis begins when a portion of all-trans-retinal escapes the visual cycle (yellow box) and non-enzymatically reacts with phosphatidyl- ethanolamine forming the A2E precursor, A2-PE. Uptake of serum retinol to the RPE (gray box) fuels the cycle.
  • Fig. 5 Three-dimensional structure of the RBP4 -TTR-retinol complex. Tetrameric TTR is shown in blue, light blue, green and yellow (large boxed region) . RBP is shown in red (unboxed region) and retinol is shown in gray (small boxed region) (28) .
  • Fig. 6 Structure of fenretinide, [N- ( 4 -hydroxyphenyl ) retinamide , 4HRP] , a retinoid RBP4 antagonist.
  • Fig. 7 Schematic depiction of the HTRF-based assay format for character! zation of RBP4 antagonists disrupting retinol -induced RBP4- TTR interaction.
  • Fig. 8 Schematic depiction of the in vitro TR-FRET-based PPARy-NCOR interaction assay to be used as a counter-screen.
  • GST-tagged PPARy fragment interacts with biotinylated NCOR peptide in the absence of ligand generating FRET.
  • Test compounds specific for RBP4 should not affect the signal.
  • Compounds with PPARy agonistic activity induce conformation changes in the ligand binding domain of PPARy leading to disruption of the PPARy-NCOR interaction which is registered as a decrease in the FRET signal.
  • Fig. 9A Serum RBP4 reduction in mice treated with single 15 mg/kg dose of compound of 7a .
  • Fig. 9B Serum RBP4 reduction in mice treated with single 25 mg/kg dose of compound of 7a . Serum RBP4 reduction, absolute values ⁇ g/ml Plasma RBP4) . Single dose 25 mg/kg PO, mice, serum RPB4 values.
  • Fig. 9C Serum RBP4 reduction in mice treated with single 35 mg/kg dose of compound of 7a .
  • Fig. 9D Dose-dependent RBP4 reduction after oral dosing of 7a .
  • Fig. 10A Serum RBP4 reduction in mice treated with single 25 mg/kg dose of compound of 7p . Serum RBP4 reduction, absolute values ⁇ g/ l Plasma RBP4 ) . Single dose 25 mg/kg PO, mice, serum RPB4 values.
  • Fig. 10B Serum RBP4 reduction in mice treated with single 35 mg/kg dose of compound of 7p . Serum RBP4 reduction, absolute values ⁇ g/ml Plasma RBP4) . Single dose 35 mg/kg PO, mice, serum RPB4 values.
  • Fig. 11 Serum RPB4 levels in three groups of mice at baseline and at end of 8-week treatment period with 7a .
  • Fig. 12 Effect of 7a treatment on bisretinoid accumulation in eyes of Abca4 ⁇ / ⁇ mice. Detailed Description of the Invention
  • the present invention provides a compound having the structure:
  • Ri, R 2 , R 3 , R ⁇ , and Rs are each independently H, halogen, CF 3 , OCF3 alkyl, haloalkyl, aryl or heteroaryl;
  • X is N or CRe
  • R 6 is H, OH, or halogen
  • ⁇ is absent or present, and when present is
  • a and b are each a bond that is present or absent;
  • Xi is N, NH or NR10
  • Ri 0 is alkyl, alkenyl or alkynyl
  • X2 is C or N;
  • X 3 is CH or N;
  • R 7 , R8 and Rg are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl ⁇ NH 2 , alkyl-OAc alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 ,
  • Xi , X 2 and X 3 are each N , a is present and b is absent; or
  • Xi is NH, X 2 is C , X 3 is CH , a is absent and b is present; or
  • Xi is N , X 2 is N , X 3 is CH , a is present and b is absent; or
  • Xi is NH or NR 10 , X 2 is C , X 3 is N , a is absent and b is present, wherein when Xi is NH , X 2 is C , X 3 is N , a is absent and b is present, then one of R ? , Re and Rg is other than H , or B has the structure:
  • X 4 and X 5 are each, independently, is N or CH;
  • R 11 , R I2 and R I3 are each, independently, H, halogen, alkyl, alkenyl , alkynyl alkyl-OH, alkyl-NH 2 , alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C (0) -NH 2 , C(0)-N(CH 3 ) 2 , C(0)-NHCH 3 , NHC(O) -N(CH 3 ) 2 , CN or CF 3 , or a pharmaceutically acceptable salt thereof.
  • Ri, R 2 , R 3 , R ⁇ , and Rs are each independently H, halogen, CF 3 or C 1 -C 4 alkyl.
  • B has the structure:
  • Rii, R 12 and Ri 3 are each, independently, H, halogen, alkyl, alkenyl, alkynyl alkyl-OH, alkyl-Nth, alkyl-OAc, alkyl-0 (CO) -alkyl , alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 ,
  • the present invention also provides a compound having the structure:
  • Ri, R 2 , R 3/ R 4, and R 3 are each independently H, halogen, CF 3 or C 1 -C 4 alkyl ;
  • X is N or CR 6 ,
  • A is absent or present, and when present is
  • a and b are each a bond that is present or absent;
  • Xi is N, NH or NR i0 ,
  • X 2 is C or N
  • X 3 is CH or N
  • R 7 , Re and R 9 are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-NH 2 , alkyl-OAc alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 ,
  • Xi, X 2 and X 3 are each N, a is present and b is absent; or
  • Xi is NH, X 2 is C, X 3 is CH, a is absent and b is present; or
  • Xi is N, X 2 is N, X 3 is CH, a is present and b is absent; or
  • Xi is NH or NR 10 , X 2 is C, X 3 is N, a is absent and b is present, wherein when Xi is NH, X 2 is C, X 3 is N, a is absent and b is present, then one of R 7 , Rs and Rg is other than H, or B has the structure:
  • R 11 , R 12 and Ri 3 are each, independently, H, halogen, alkyl, alkenyl, alkynyl alkyl-OH, alkyl-NH 2 , alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 ,
  • the compound having the structure is:
  • the compound having the structure is:
  • the compound having the structure is:
  • the present invention also provides a compound having the structure
  • Ri, R 2 , R 3 , R*, and R 5 are each independently H, halogen, CF 3 , OCF 3 , alkyl, haloalkyl, aryl or heteroaryl; and
  • a and b are each a bond that is present or absent;
  • X is N, NH or NR 10 ,
  • X 2 is C or N;
  • X 3 is CH or N;
  • R 7 , Rg and Rg are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alky-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 , C (0) -N (CH 3 ) 2, C (0) -
  • Xi, X2 and X 3 are each N, a is present and b is absent; or
  • Xi is NH, X2 is C, X 3 is CH, a is absent ,and b is present; or
  • Xi is N, X 2 is N, X 3 is CH, a is present and b is absent; or
  • Xi is NH or NR10, X2 is C, X 3 is N, a is absent and b is present, wherein when Xi is NH, X 2 is C, X 3 is N, a is absent and b is present, then one of R7, Rs and Rg is other than H, or B has the structure:
  • X 4 and X5 are each, independently, is N or CH;
  • R , R12 and Ri 3 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alky-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 , C (O) -N (CH 3 ) 2, C(0)-NHCH 3 , NHC (0) -N (CH 3 ) 2,
  • Ri, R2, R 3 , Rn and R 5 are each independently H, halogen, CF 3 or C1-C4 alkyl.
  • B has the structure:
  • Rii, R 12 and R 13 are ' each, independently, H, halogen, alkyl, alkenyl, alkynyl alkyl-OH, alkyl-NH 2 , alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 ,
  • the present invention also provides a compound having the structure:
  • Ri, R 2 , R 3 , R 4, and Rs are each independently H, halogen, CF 3 , OCF 3 , alkyl, haloalkyl, aryl or heteroaryl;
  • Y is alkyl
  • A is absent or present, and when present is and B has the structure:
  • a and b are each a bond that is present or absent;
  • Xi is N, NH or NRio,
  • X 2 is C or N
  • X3 is CH or N
  • R 7 , Rg and R 9 are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-NH 2 , alkyl-OAc, alky-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 , C (0) -N (CH 3) 2, C(0)-
  • Xi, X 2 and X 3 are each N, a is present and b is absent; or
  • Xi is NH, X 2 is C, X 3 is CH, a is absent and b is present; or
  • Xi is N, X 2 is N, X 3 is CH, a is present and b is absent; or
  • Xi is NH or NR10, X 2 is C, X 3 is N, a is absent and b is present, wherein when Xi is NH, X 2 is C, X 3 is N, a is absent and b is present, then one of R ? , Re and Rg is other than H, or B has the structure:
  • X4 and Xs are each, independently, is N or CH;
  • R11, R I2 and Ri 3 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH 2 , alkyl-OAc, alky-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)OH, C(0)-NH 2 , C (O) -N (CH 3 ) 2 , C(0)-NHCH 3 , NHC (O) -N (CH3) r,
  • Ri, R 2 , R 3 , R 4 , and R 5 are each independently H, halogen, CF 3 or C 1 -C 4 alkyl.
  • R 5 is independently H, halogen, CF 3 or C 1 -C 4 alkyl.
  • Rii, R12 and R13 are each, independently, H, halogen, alkyl, alkenyl, alkynyl alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 ,
  • B has the structure:
  • a and b are each a bond that is present or absent;
  • Xi is N, NH or NRio
  • R X o is alkyl, alkenyl or alkynyl
  • X2 is C or N
  • X3 is CH or N
  • R 7 , Re and Rg are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-Nlh, alkyl-OAc alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 ,
  • Xi, X2 and X 3 are each N , a is present and b is absent; or
  • Xi is NH , X2 is C , X 3 is CH , a is absent and b is present; or
  • Xi is N , X2 is N , X 3 is CH , a is present and b is absent; or
  • Xi is NH or NR 10 , 2 is C, X 3 is N , a is absent and b is present, wherein when Xi is NH , X 2 is C , X 3 is N , a is absent and b is present, then one of R ? , Re and Rg is other than H .
  • B has the structure:
  • Rn , R 12 and RI 3 are each, independently, H, halogen, alkyl, alkenyl, alkynyl alkyl-OH, alkyl-NH 2 , alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 ,
  • the compound wherein B has the structure:
  • R 7 , Re and Rg are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH 2 , alkyl-OAc, alkyl-O-alkyl , haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 , C (0) -N ( CH 3 ) 2 , C(0)-NHCH 3 , NHC (0) -N (CH 3 ) 2, CN, or CF 3 .
  • the compound wherein B has the structure:
  • R7, Re and R9 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH 2 , alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 , C (0) -N (CH 3 ) 2, C(0)-NHCH 3 , NHC (O) -N (CH 3 ) 2 ,
  • the compound wherein B has the structure:
  • R 7 , Re and Rg are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)OH, C(0)-NH 2 , C (O) -N (CH 3 ) 2, C(0)-NHCH 3 , NHC (0) -N (CH 3 ) 2,
  • the compound wherein B has the structure:
  • R 7 , R 8 and R g are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH 2 , alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl , C(0)0H, C(0)-NH 2 , C (0) -N (CH 3 ) 2, C(0)-NHCH 3 , NHC (0) -N (CH 3 ) 2,
  • Rio is alkyl, alkenyl or alkynyl.
  • R- 7 , Re and R 9 are each, independently, H, Cl, Br, F, OCH 3 , OCEBCPh, CF 3 , CN, CH 3 , CH3CH3, C ( 0 ) OH or C(0)-NH 2
  • the compound wherein R 7 , Re and R9 are each, independently, H, CH2CH2OH, CH 2 CH 2 OCH 3 , CH 2 CH 2 OAc, CH 2 CH 2 CI, CH2CH2F or CH 2 CH 2 Br .
  • the compound wherein R 7 , R8 and R9 are each, independently, H, halogen or alkyl.
  • the compound wherein B has the structure:
  • the compound wherein R 7 , Re and Rg are each, independently, H, CH 3 , Br, Cl, F, CH 2 CH 2 OH, CH 2 CH 2 OCH 3 , CH 2 CH 2 OAc, CH 2 CH 2 CI, CH 2 CH 2 F or CH 2 CH 2 Br.
  • the compound wherein B has the structure:
  • the compound wherein R 7 and R 9 are each, independently, H, CH 3 , Br, Cl, F, CH 2 CH 2 OH, CH 2 CH 2 OCH 3 , CH 2 CH 2 OAC, CH 2 CH 2 C1, CH 2 CH 2 F or CH 2 CH 2 Br.
  • the compound wherein B has the structure:
  • the compound wherein R 7 , Re and R 9 are each, independently, H, CH 3 , Br, Cl, F, CH 2 CH 2 OH, CH 2 CH 2 OCH 3 , CH 2 CH 2 OAc, CH 2 CH 2 C1, CH 2 CH 2 F or CH 2 CH 2 Br .
  • the compound wherein B has the structure:
  • the compound wherein R7 and R9 are each, independently, H, CH 3 , Br, Cl, F, CH2CH2OH, CH 2 CH 2 OCH 3 , CH 2 CH 2 OAc, CH 2 CH 2 C1, CH2CH2F or CH 2 CH 2 Br .
  • the compound wherein B has the structure:
  • the compound wherein R7, Rs and Rg are each, independently, H, CH 3 , Br, Cl, F, CH 2 CH 2 OH, CH 2 CH 2 OCH 3 , CH 2 CH 2 OAc, CH 2 CH 2 C1, CH 2 CB 2 F or CH 2 CH 2 Br.
  • the compound wherein B has the structure:
  • the compound wherein R 7 and Rg are each, independently, H, CH 3 , Br, Cl, F, CH 2 CH 2 OH, CH 2 CH 2 OCH 3 , CH 2 CH 2 OAC, CH 2 CH 2 C1, CH 2 CH 2 F or CH 2 CH 2 Br .
  • the compound wherein B has the structure:
  • the compound wherein R 7 , Re and Rg are each, independently, H, CH 3 , Br, Cl, F, CH2CH2OH, CH 2 CH 2 OCH 3 , CH 2 CH 2 OAc, CH 2 CH 2 C1, CH 2 CH 2 F or CH 2 CH 2 Br; and Rio is alkyl.
  • the compound wherein B has the structure:
  • the compound wherein R 7 and Rg are each, independently, H, CH 3 , Br, Cl, F, CH 2 CH 2 OH, CH2CH 2 OCH 3 , CH 2 CH 2 OAc, CH 2 CH 2 C1 , CH 2 CH 2 F or CH 2 CH 2 Br; and Rio is alkyl.
  • the compound wherein B has the structure:
  • Rn, R12 and Ri3 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH 2 , alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl , C(0)0H, C(0)-NH 2 , C (0) -N (CH 3 ) 2 , C(0)-NHCH 3 , NHC (0) -N (CH 3 ) 2,
  • the compound wherein B has the structure:
  • Rn, R12 and R13 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH 2 , alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H,- C(0)-NH 2 , C (0) -N (CH 3) 2, C(0)-NHCH 3 , NHC (0) -N (CH 3) 2,
  • the compound wherein B has the structure:
  • R11, R12 and R 33 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH 2 , alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 , C (0) -N (CH 3 ) 2, C(0)-NHCH 3 , NHC (0) -N (CH 3 ) 2, CN, or CF 3 .
  • the compound wherein B has the structure:
  • Rn, R12 and R I3 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH 2 , alkyl-OAc, alkyl-O-alkyl , haloalkyl, cycloalkyl, 0-alkyl, NH-alkyl, C(0)0H, C(0)-NH 2 , C (O) -N (CH 3 ) 2 , C(0)-NHCH 3 , NHC (0) -N (CH 3 ) 2 , CN, or CF 3 .
  • the compound Rn, Rn and R I3 are each, independently, H, Cl, Br, F, OCRs, OCH 2 CH 3 , CF 3 , CN, CH 3 , CH 3 CH 3 , C(0)0H or C(0)-NH 2 .
  • the compound Rn, R and R are each, independently, H, CH 2 CH 2 OH, CH 2 CH 2 OCH 3 , CH 2 CH 2 OAc, CH 2 CH 2 C1, CH 2 CH 2 F or CH 2 CH 2 Br .
  • the compound Rn, R12 and R I3 are each, independently, H, halogen or alkyl.
  • the compound wherein two of Rn, Rn and Rn are each H and the remaining one of Rn, Rn and R 33 is other than H.
  • the compound wherein one of Rn, Rn and R is H and the remaining two of Rn, R12 and Rn are each other than H.
  • the compound wherein B has the structure:
  • the compound wherein Rn, R 12 and R 13 are each, independently, H, CH 3 , Br, Cl, F, CH 2 CH 2 OH, CH 2 CH 2 OCH 3 , CH 2 CH 2 OAc, CH 2 CH 2 C1, CH 2 CH 2 F or CH 2 CH 2 Br.
  • the compound wherein B has the structure:
  • the compound wherein Rn and R 13 are each, independently, H, CH 3 , Br, Cl, F, CH 2 CH 2 OH, CH 2 CH 2 OCH 3 , CH 2 CH 2 OAc, CH 2 CH 2 CI, CH 2 CH 2 F or CH 2 CH 2 Br .
  • the compound wherein X is N. In some embodiments, the compound wherein X is CH.
  • Ri, R 2 , R 3 , R 4 , and R 5 are each H, t-Bu, Cl, F, or CF 3 .
  • Ri, R 2 , R 3 , and R 4 are each H;
  • R 5 is CF 3 or t-Bu.
  • Ri, R 3 and R 4 are each H;
  • R 2 is halogen
  • Rs is CF 3 or t-Bu.
  • Ri, R 2 , R 3 , and R 4 are each H, Rs is CFs or t-Bu.
  • Ri, R 2 , R 3 , and R are each H,
  • R 5 is CF 3 .
  • Ri, R 2 , R 3 , R 4 , and R 5 are each H, methyl, ethyl, phenyl, t-Bu, i-Pr, Cl, Br, F or CF 3 ;
  • Ri, R 2 , R 3 , and R are each H;
  • Rs is -H, methyl, ethyl, i-Pr or phenyl.
  • Ri, R 2 , R 3 , R 4 , and R 5 are each H, methyl, ethyl, phenyl, t-Bu, i-Pr, OCF 3 , CF 3 , OCF 2 CF 3 , CF 2 CF 3 , Cl, Br, or F.
  • Ri, R 2 , R 3 , and R 4 are each H;
  • Rs is -H, OCF 3 , CF 2 CF 3 , methyl, ethyl, ⁇ -Pr or phenyl.
  • the compound wherein one of Ri, R 2 , R 3 , R ⁇ i, and R 3 ⁇ 4 is other than H.
  • the compound wherein two of Ri, R 2 , R 3 , R 4 , and Rs are other than H.
  • the compound wherein two or more of Ri, R 2 , R 3 ,
  • R 4 , and Rs are other than H.
  • the compound wherein three of Ri, R 3 , R 3 , R 4 , and Rs are other than H. In some embodiments, the compound wherein three or more of Ri, R 2 , R3, R 4 , and Rs are other than H.
  • B is other than
  • Ri, R 2 , R 3 , R 4, and Rs are each independently H, halogen, CF 3 , C 1 -C 12 alkyl, aryl or heteroaryl . In any embodiment of any of the above compounds, Ri, R 2 , R3, R 4 , and Rs are each independently H, halogen, CF 3 , CR-Ce alkyl, aryl or heteroaryl .
  • Ri, R 2 , R 3 , R , and Rs are each independently H, halogen, CF 3 , C 1 -C 4 alkyl, aryl or heteroaryl .
  • the compound is more active than the corresponding compound where Ri, R 2 , R3, R 4, and Rs are each H.
  • the compound corresponding to compound 10a where Ri, R 2 , R 3 , R 4 , and Rs are each H is less active.
  • the position of the substitution at the Ri or Rs position on the phenyl ring of, e.g., compounds lOa-lOd increases activity relative to the corresponding compounds where Ri, R 2 , R 3 , 4 , and Rs are each H.
  • the claimed compounds each containing a substitution at the Ri or Rs position have improved activity in RBP4 assays and reduced or no substantial activity in PPARy assays.
  • the present invention provides a pharmaceutical composition
  • a pharmaceutical composition comprising a compound of the present invention and a pharmaceutically acceptable carrier .
  • the present invention provides a method for treating a disease characterized by excessive lipofuscin accumulation in the retina in a mammal afflicted therewith comprising administering to the mammal an effective amount of a compound of the present invention or a composition of the present invention.
  • the present invention provides a method for lowering the serum concentration of RBP4 in a mammal comprising administering to the mammal an effective amount of a compound of the present invention or a composition of the present invention.
  • the disease is further characterized by bisretinoid-mediated macular degeneration.
  • the amount of the compound is effective to lower the serum concentration of RBP4 in the mammal.
  • the amount of the compound is effective to lower the retinal concentration of a bisretinoid in lipofuscin in the mammal.
  • the bisretinoid is A2E. In some embodiments of the method, wherein the bisretinoid is isoA2E. In some embodiments of the method, wherein the bisretinoid is A2-DHP-PE. In some embodiments of the method, wherein the bisretinoid is atRAL di-PE.
  • the disease characterized by excessive lipofuscin accumulation in the retina is Age-Related Macular Degeneration.
  • the disease characterized by excessive lipofuscin accumulation in the retina is dry (atrophic) Age-Related Macular Degeneration.
  • the disease characterized by excessive lipofuscin accumulation in the retina is Stargardt Disease .
  • the disease characterized by excessive lipofuscin accumulation in the retina is Best disease.
  • the disease characterized by excessive lipofuscin accumulation in the retina is adult vitelliform maculopathy. In some embodiments of the method, wherein the disease characterized by excessive lipofuscin accumulation in the retina is Stargardt-like macular dystrophy.
  • bisretinoid-mediated macular degeneration is Age- Related Macular Degeneration or Stargardt Disease. In some embodiments, the bisretinoid-mediated macular degeneration is Age- Related Macular Degeneration. In some embodiments, the bisretinoid- mediated macular degeneration is dry (atrophic) Age-Related Macular Degeneration .
  • the bisretinoid-mediated macular degeneration is Stargardt Disease. In some embodiments, the bisretinoid-mediated macular degeneration is Best disease. In some embodiments, the bisretinoid-mediated macular degeneration is adult vitelliform maculopathy. In some embodiments, the bisretinoid-mediated macular degeneration is Stargardt-like macular dystrophy.
  • the bisretinoid- mediated macular degeneration may comprise the accumulation of lipofuscin deposits in the retinal pigment epithelium.
  • the amount of the compound is administered to the eye of the mammal.
  • the amount of the compound is administered topically to the eye of the mammal.
  • bisretinoid lipofuscin is lipofuscin containing a cytotoxic bisretinoid.
  • Cytotoxic bisretinoids include but are not necessarily limited to A2E, isoA2E, atRAL di-PE, and A2-DHP-PE (Figs. 1, 2, and 3) .
  • the B groups described herein may be attached to the following compounds by amide coupling or similar coupling methods known to one skilled in the art to prepare the compounds of the present application.
  • a mixture of the above amine (1 equiv) , desired carboxylic acid "B" group (1 equiv), triethylamine (Et3N) (3 equiv), and 2-(lH- benzotriazole-l-yl ) -1,1,3, 3-tetramethyluronium hexafluorophosphate ( HBTU ) (1.5 equiv) in DMF (0.25 M) are stirred at room temperature until the reaction is complete by LC-MS.
  • the mixture is diluted with H2O and extracted with EtOAc.
  • the combined organic extracts are washed with H 2 0, brine, dried over Na 2 SO ⁇ i , filtered, and concentrated under reduced pressure.
  • the resulting residue is purified by silica gel chromatography (typical eluents included either a mixture of or hexanes and EtOAc or a mixture of CH2CI2 and a 90:9:1 mixture of CH 2 Cl2/CH30H/concentrated NH4OH) to afford the desired Carboxamide.
  • silica gel chromatography typically eluents included either a mixture of or hexanes and EtOAc or a mixture of CH2CI2 and a 90:9:1 mixture of CH 2 Cl2/CH30H/concentrated NH4OH
  • each stereogenic carbon may be of the R or S configuration.
  • isomers arising from such asymmetry e.g., all enantiomers and diastereomers
  • Such isomers can be obtained in substantially pure form by classical separation techniques and by stereochemically controlled synthesis, such as those described in "Enantiomers, Racemates and Resolutions" by J. Jacques, A. Collet and S. Wilen, Pub. John Wiley & Sons, NY, 1981.
  • the resolution may be carried out by preparative chromatography on a chiral column.
  • the subject invention is also intended to include all isotopes of atoms occurring on the compounds disclosed herein.
  • Isotopes include those atoms having the same atomic number but different mass numbers.
  • isotopes of hydrogen include tritium and deuterium.
  • isotopes of carbon include C-13 and C- 14.
  • any notation of a carbon in structures throughout this application when used without further notation, are intended to represent all isotopes of carbon, such as 12 C, 13 C, or 14 C.
  • any compounds containing 13 C or 14 C may specifically have the structure of any of the compounds disclosed herein.
  • any notation of a hydrogen in structures throughout this application when used without further notation, are intended to represent all isotopes of hydrogen, such as 3 H, 2 H, or 3 H .
  • any compounds containing 2 H or 3 H may specifically have the structure of any of the compounds disclosed herein.
  • Isotopically-labeled compounds can generally be prepared by conventional techniques known to those skilled in the art using appropriate isotopically-labeled reagents in place of the non-labeled reagents employed.
  • substitution refers to a functional group as described above in which one or more bonds to a hydrogen atom contained therein are replaced by a bond to non-hydrogen or non-carbon atoms, provided that normal valencies are maintained and that the substitution results in a stable compound.
  • Substituted groups also include groups in which one or more bonds to a carbon (s) or hydrogen (s) atom are replaced by one or more bonds, including double or triple bonds, to a heteroatom.
  • substituent groups include the functional groups described above, and halogens (i.e., E, Cl, Br, and I); alkyl groups, such as methyl, ethyl, n- propyl, isopropryl, n-butyl, tert-butyl, and trifluoromethyl ; hydroxyl; alkoxy groups, such as methoxy, ethoxy, n-propoxy, and isopropoxy; aryloxy groups, such as phenoxy; arylalkyloxy, such as benzyloxy (phenylmethoxy) and p-trifluoromethylbenzyloxy (4- trifluoromethylphenylmethoxy) ; heteroaryloxy groups; sulfonyl groups, such as trifluoromethanesulfonyl, methanesulfonyl , and p- toluenesulfonyl ; nitro, nitrosyl; mercapto; sulf
  • substituted compound can be independently substituted by one or more of the disclosed or claimed substituent moieties, singly or plurally.
  • independently substituted it is meant that the (two or more) substituents can be the same or different.
  • the substituents may be substituted or unsubstituted, unless specifically defined otherwise.
  • alkyl, heteroalkyl, monocyclic, bicyclic, aryl, heteroaryl and heterocyclic groups can be further substituted by replacing one or more hydrogen atoms with alternative non-hydrogen groups.
  • non-hydrogen groups include, but are not limited to, halo, hydroxy, mercapto, amino, carboxy, cyano and carbamoyl .
  • substituents and substitution patterns on the compounds used in the method of the present invention can be selected by one of ordinary skill in the art to provide compounds that are chemically stable and that can be readily synthesized by techniques known in the art from readily available starting materials. If a substituent is itself substituted with more than one group, it is understood that these multiple groups may be on the same carbon or on different carbons, so long as a stable structure results.
  • alkyl includes both branched and straight-chain saturated aliphatic hydrocarbon groups having a specified number of carbon atoms and may be unsubstituted or substituted.
  • Ci-C n as in “Ci-C n alkyl” is defined to include groups having 1, 2, ...., n-1 or n carbons in a linear or branched arrangement.
  • C1-C6, as in "C1-C6 alkyl” is defined to include groups having 1, 2, 3, 4, 5, or 6 carbons in a linear or branched arrangement, and specifically includes methyl, ethyl, n-propyl, isopropyl, n-butyl, t-butyl, pentyl, and hexyl. Unless otherwise specified contains one to ten carbons.
  • Alkyl groups can be unsubstituted or substituted with one or more substituents, including but not limited to halogen, alkoxy, alkylthio, trifluoromethyl, difluoromethyl , methoxy, and hydroxyl.
  • C1-C4 alkyl includes both branched and straight- chain C1-C4 alkyl.
  • alkenyl refers to a non-aromatic hydrocarbon radical, straight or branched, containing at least 1 carbon to carbon double bond, and up to the maximum possible number of non-aromatic carbon-carbon double bonds may be present, and may be unsubstituted or substituted.
  • C2-C6 alkenyl means an alkenyl radical having 2, 3, 4, 5, or 6 carbon atoms, and up to 1, 2, 3, 4, or 5 carbon-carbon double bonds respectively.
  • Alkenyl groups include ethenyl, propenyl, butenyl and cyclohexenyl .
  • heteroalkyl includes both branched and straight-chain saturated aliphatic hydrocarbon groups having at least 1 heteroatom within the chain or branch.
  • cycloalkyl includes cyclic rings of alkanes of three to eight total carbon atoms, or any number within this range (i.e., cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl or cyclooctyl ) .
  • heterocycloalkyl is intended to mean a 5- to 10- membered nonaromatic ring containing from 1 to 4 heteroatoms selected from the group consisting of 0, N and S, and includes bicyclic groups.
  • Heterocyclyl therefore includes, but is not limited to the following: imidazolyl, piperazinyl, piperidinyl, pyrrolidinyl , morpholinyl, thiomorpholinyl , tetrahydropyranyl, dihydropiperidinyl , tetrahydrothiophenyl and the like. If the heterocycle contains nitrogen, it is understood that the corresponding N-oxides thereof are also encompassed by this definition.
  • aryl is intended to mean any stable monocyclic, bicyclic or polycyclic carbon ring of up to 10 atoms in each ring, wherein at least one ring is aromatic, and may be unsubstituted or substituted.
  • aryl elements include but are not limited to: phenyl, p-toluenyl ( 4 -methylphenyl ) , naphthyl, tetrahydro- naphthyl, indanyl, phenanthryl, anthryl or acenaphthyl .
  • the aryl substituent is bicyclic and one ring is non-aromatic, it is understood that attachment is via the aromatic ring.
  • alkylaryl refers to alkyl groups as described above wherein one or more bonds to hydrogen contained therein are replaced by a bond to an aryl group as described above. It is understood that an "alkylaryl” group is connected to a core molecule through a bond from the alkyl group and that the aryl group acts as a substituent on the alkyl group.
  • arylalkyl moieties include, but are not limited to, benzyl (phenylmethyl ) , p-trifluoromethylbenzyl (4- trifluoromethylphenylmethyl ) , 1-phenylethyl , 2-phenylethyl , 3- phenylpropyl , 2-phenylpropyl and the like.
  • heteroaryl represents a stable monocyclic, bicyclic or polycyclic ring of up to 10 atoms in each ring, wherein at least one ring is aromatic and contains from 1 to 4 heteroatoms selected from the group consisting of 0, N and S.
  • Bicyclic aromatic heteroaryl groups include but are not limited to phenyl, pyridine, pyrimidine or pyridizine rings that are (a) fused to a 6-membered aromatic (unsaturated) heterocyclic ring having one nitrogen atom; (b) fused to a 5- or 6-membered aromatic (unsaturated) heterocyclic ring having two nitrogen atoms; (c) fused to a 5-membered aromatic (unsaturated) heterocyclic ring having one nitrogen atom together with either one oxygen or one sulfur atom; or (d) fused to a 5-membered aromatic (unsaturated) heterocyclic ring having one heteroatom selected from O, N or S .
  • Heteroaryl groups within the scope of this definition include but are not limited to: benzoimidazolyl , benzofuranyl, benzofurazanyl , benzopyrazolyl , benzotriazolyl , benzothiophenyl , benzoxazolyl , carbazolyl, carbolinyl, cinnolinyl, furanyl, indolinyl, indolyl, indolazinyl, indazolyl, isobenzofuranyl , isoindolyl, isoquinolyl, isothiazolyl , isoxazolyl, naphthpyridinyl , oxadiazolyl, oxazolyl, oxazoline, isoxazoline, oxetanyl, pyranyl, pyrazinyl, pyrazolyl, pyridazinyl, pyridopyridinyl , pyridazinyl
  • heteroaryl substituent is bicyclic and one ring is non-aromatic or contains no heteroatoms, it is understood that attachment is via the aromatic ring or via the heteroatom containing ring, respectively. If the heteroaryl contains nitrogen atoms, it is understood that the corresponding N-oxides thereof are also encompassed by this definition.
  • “monocycle” includes any stable polycyclic carbon ring of up to 10 atoms and may be unsubstituted or substituted. Examples of such non-aromatic monocycle elements include but are not limited to: cyclobutyl, cyclopentyl, cyclohexyl, and cycloheptyl. Examples of such aromatic monocycle elements include but are not limited to: phenyl.
  • heteromonocycle includes any monocycle containing at least one heteroatom.
  • bicycle includes any stable polycyclic carbon ring of up to 10 atoms that is fused to a polycyclic carbon ring of up to 10 atoms with each ring being independently unsubstituted or substituted.
  • non-aromatic bicycle elements include but are not limited to: decahydronaphthalene .
  • aromatic bicycle elements include but are not limited to: naphthalene.
  • heterocycle includes any bicycle containing at least one heteroatom.
  • the compounds used in the method of the present invention may be prepared by techniques well known in organic synthesis and familiar to a practitioner ordinarily skilled in the art. However, these may not be the only means by which to synthesize or obtain the desired compounds .
  • the compounds of present invention may be prepared by techniques described in Vogel's Textbook of Practical Organic Chemistry, A. I. Vogel, A. R . Tatchell, B.S. E’urnis, A.J. Hannaford, P.W.G. Smith, (Prentice Hall) 5 th Edition (1996), March's Advanced Organic Chemistry: Reactions, Mechanisms, and Structure, Michael B. Smith, Jerry March, (Wiley-Interscience) 5 th Edition (2007), and references therein, which are incorporated by reference herein. However, these may not be the only means by which to synthesize or obtain the desired compounds.
  • the compounds of the present invention may be prepared by techniques described herein.
  • the synthetic methods used to prepare the compounds of Examples 1 may be used to prepare additional compounds.
  • Another aspect of the invention comprises a compound of the present invention as a pharmaceutical composition.
  • the term "pharmaceutically active agent” means any substance or compound suitable for administration to a subject and furnishes biological activity or other direct effect in the treatment, cure, mitigation, diagnosis, or prevention of disease, or affects the structure or any function of the subject.
  • Pharmaceutically active agents include, but are not limited to, substances and compounds described in the Physicians' Desk Reference (PDR Network, LLC; 64th edition; November 15, 2009) and "Approved Drug Products with Therapeutic Equivalence Evaluations" (U.S. Department Of Health And Human Services, 30 th edition, 2010), which are hereby incorporated by reference.
  • compositions which have pendant carboxylic acid groups may be modified in accordance with the present invention using standard esterification reactions and methods readily available and known to those having ordinary skill in the art of chemical synthesis. Where a pharmaceutically active agent does not possess a carboxylic acid group, the ordinarily skilled artisan will be able to design and incorporate a carboxylic acid group into the pharmaceutically active agent where esterification may subsequently be carried out so long as the modification does not interfere with the pharmaceutically active agent's biological activity or effect.
  • the compounds of the present invention may be in a salt form.
  • a “salt” is a salt of the instant compounds which has been modified by making acid or base salts of the compounds.
  • the salt is pharmaceutically acceptable.
  • pharmaceutically acceptable salts include, but are not limited to, mineral or organic acid salts of basic residues such as amines; alkali or organic salts of acidic residues such as phenols.
  • the salts can be made using an organic or inorganic acid.
  • Such acid salts are chlorides, bromides, sulfates, nitrates, phosphates, sulfonates, formates, tartrates, maleates, malates, citrates, benzoates, salicylates, ascorbates, and the like .
  • Phenolate salts are the alkaline earth metal salts, sodium, potassium or lithium.
  • pharmaceutically acceptable salt in this respect, refers to the relatively non-toxic, inorganic and organic acid or base addition salts of compounds of the present invention.
  • salts can be prepared in situ during the final isolation and purification of the compounds of the invention, or by separately treating a purified compound of the invention in its free base or free acid form with a suitable organic or inorganic acid or base, 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, napthylate, mesylate, glucoheptonate , lactobionate, and laurylsulphonate salts and the like. (See, e.g., Berge et al. (1977) "Pharmaceutical Salts", J. Pharrri. Sci. 66:1-19) .
  • treating means preventing, slowing, halting, or reversing the progression of a disease or infection. Treating may also mean improving one or more symptoms of a disease or infection.
  • the compounds of the present invention may be administered in various forms, including those detailed herein.
  • the treatment with the compound may be a component of a combination therapy or an adjunct therapy, i.e., the subject or patient in need of the drug is treated or given another drug for the disease in conjunction with one or more of the instant compounds.
  • This combination therapy can be a sequential therapy where the patient is treated first with one drug and then the other or the two drugs are given simultaneously.
  • These can be administered independently by the same route or by two or more different routes of administration depending on the dosage forms employed .
  • a "pharmaceutically acceptable carrier” is a pharmaceutically acceptable solvent, suspending agent or vehicle, for delivering the instant compounds to the animal or human.
  • the carrier may be liquid or solid and is selected with the planned manner of administration in mind.
  • Liposomes are also a pharmaceutically acceptable carrier.
  • the dosage of the compounds administered in treatment will vary depending upon factors such as the pharmacodynamic characteristics of a specific chemotherapeutic agent and its mode and route of administration; the age, sex, metabolic rate, absorptive efficiency, health and weight of the recipient; the nature and extent of the symptoms; the kind of concurrent treatment being administered; the frequency of treatment with; and the desired therapeutic effect.
  • a dosage unit of the compounds used in the method of the present invention may comprise a single compound or mixtures thereof with additional agents.
  • the compounds can be administered in oral dosage forms as tablets, capsules, pills, powders, granules, elixirs, tinctures, suspensions, syrups, and emulsions.
  • the compounds may also be administered in intravenous (bolus or infusion), intraperitoneal , subcutaneous, or intramuscular form, or introduced directly, e.g. by injection, topical application, or other methods, into or onto a site of infection, all using dosage forms well known to those of ordinary skill in the pharmaceutical arts.
  • the compounds used in the method of the present invention can be administered in admixture with suitable pharmaceutical diluents, extenders, excipients, or carriers (collectively referred to herein as a pharmaceutically acceptable carrier) suitably selected with respect to the intended form of administration and as consistent with conventional pharmaceutical practices.
  • a pharmaceutically acceptable carrier suitably selected with respect to the intended form of administration and as consistent with conventional pharmaceutical practices.
  • the unit will be in a form suitable for oral, rectal, topical, intravenous or direct injection or parenteral administration.
  • the compounds can be administered alone or mixed with a pharmaceutically acceptable carrier.
  • This carrier can be a solid or liquid, and the type of carrier is generally chosen based on the type of administration being used.
  • the active agent can be co-administered in the form of a tablet or capsule, liposome, as an agglomerated powder or in a liquid form.
  • suitable solid carriers include lactose, sucrose, gelatin and agar.
  • Capsule or tablets can be easily formulated and can be made easy to swallow or chew; other solid forms include granules, and bulk powders. Tablets may contain suitable binders, lubricants, diluents, disintegrating agents, coloring agents, flavoring agents, flow-inducing agents, and melting agents.
  • suitable liquid dosage forms include solutions or suspensions in water, pharmaceutically acceptable fats and oils, alcohols or other organic solvents, including esters, emulsions, syrups or elixirs, suspensions, solutions and/or suspensions reconstituted from non-effervescent granules and effervescent preparations reconstituted from effervescent granules.
  • Such liquid dosage forms may contain, for example, suitable solvents, preservatives, emulsifying agents, suspending agents, diluents, sweeteners, thickeners, and melting agents.
  • Oral dosage forms optionally contain flavorants and coloring agents.
  • Parenteral and intravenous forms may also include minerals and other materials to make them compatible with the type of injection or delivery system chosen.
  • Tablets may contain suitable binders, lubricants, disintegrating agents, coloring agents, flavoring agents, flow-inducing agents, and melting agents.
  • the active drug component can be combined with an oral, non-toxic, pharmaceutically acceptable, inert carrier such as lactose, gelatin, agar, starch, sucrose, glucose, methyl cellulose, magnesium stearate, dicalcium phosphate, calcium sulfate, mannitol, sorbitol and the like.
  • Suitable binders include starch, gelatin, natural sugars such as glucose or beta-lactose, corn sweeteners, natural and synthetic gums such as acacia, tragacanth, or sodium alginate, carboxymethylcellulose, polyethylene glycol, waxes, and the like.
  • Lubricants used in these dosage forms include sodium oleate, sodium stearate, magnesium stearate, sodium benzoate, sodium acetate, sodium chloride, and the like.
  • Disintegrators include, without limitation, starch, methyl cellulose, agar, bentonite, xanthan gum, and the like.
  • the compounds used in the method of the present invention may also be administered in the form of liposome delivery systems, such as small unilamellar vesicles, large unilamellar vesicles, and multilamellar vesicles.
  • Liposomes can be formed from a variety of phospholipids, such as cholesterol, stearylamine , or phosphatidylcholines.
  • the compounds may be administered as components of tissue-targeted emulsions .
  • the compounds used in the method of the present invention may also be coupled to soluble polymers as targetable drug carriers or as a prodrug.
  • soluble polymers include polyvinylpyrrolidone, pyran copolymer, polyhydroxylpropylmethacrylamide-phenol, polyhydroxyethylasparta- midephenol, or polyethyleneoxide-polylysine substituted with palmitoyl residues.
  • the compounds may be coupled to a class of biodegradable polymers useful in achieving controlled release of a drug, for example, polylactic acid, polyglycolic acid, copolymers of polylactic and polyglycolic acid, polyepsilon caprolactone , polyhydroxy butyric acid, polyorthoesters, polyacetals, polydihydropyrans , polycyanoacylates , and crosslinked or amphipathic block copolymers of hydrogels.
  • a class of biodegradable polymers useful in achieving controlled release of a drug
  • a drug for example, polylactic acid, polyglycolic acid, copolymers of polylactic and polyglycolic acid, polyepsilon caprolactone , polyhydroxy butyric acid, polyorthoesters, polyacetals, polydihydropyrans , polycyanoacylates , and crosslinked or amphipathic block copolymers of hydrogels.
  • Gelatin capsules may contain the active ingredient compounds and powdered carriers, such as lactose, starch, cellulose derivatives, magnesium stearate, stearic acid, and the like. Similar diluents can be used to make compressed tablets. Both tablets and capsules can be manufactured as immediate release products or as sustained release products to provide for continuous release of medication over a period of hours. Compressed tablets can be sugar coated or film coated to mask any unpleasant taste and protect the tablet from the atmosphere, or enteric coated for selective disintegration in the gastrointestinal tract .
  • the oral drug components are combined with any oral, non-toxic, pharmaceutically acceptable inert carrier such as ethanol, glycerol, water, and the like.
  • suitable liquid dosage forms include solutions or suspensions in water, pharmaceutically acceptable fats and oils, alcohols or other organic solvents, including esters, emulsions, syrups or elixirs, suspensions, solutions and/or suspensions reconstituted from non-effervescent granules and effervescent preparations reconstituted from effervescent granules.
  • Such liquid dosage forms may contain, for example, suitable solvents, preservatives, emulsifying agents, suspending agents, diluents, sweeteners, thickeners, and melting agents.
  • Liquid dosage forms for oral administration can contain coloring and flavoring to increase patient acceptance.
  • water a suitable oil, saline, aqueous dextrose (glucose), and related sugar solutions and glycols such as propylene glycol or polyethylene glycols are suitable carriers for parenteral solutions.
  • Solutions for parenteral administration preferably contain a water-soluble salt of the active ingredient, suitable stabilizing agents, and if necessary, buffer substances.
  • Antioxidizing agents such as sodium bisulfite, sodium sulfite, or ascorbic acid, either alone or combined, are suitable stabilizing agents.
  • citric acid and its salts and sodium EDTA are also used.
  • parenteral solutions can contain preservatives, such as benzalkonium chloride, methyl- or propyl paraben, and chlorobutanol .
  • preservatives such as benzalkonium chloride, methyl- or propyl paraben, and chlorobutanol .
  • Suitable pharmaceutical carriers are described in Remington's Pharmaceutical Sciences, Mack Publishing Company, a standard reference text in this field.
  • the compounds used in the method of the present invention may also be administered in intranasal form via use of suitable intranasal vehicles, or via transdermal routes, using those forms of transdermal skin patches well known to those of ordinary skill in that art.
  • the dosage administration will generally be continuous rather than intermittent throughout the dosage regimen.
  • Parenteral and intravenous forms may also include minerals and other materials to make them compatible with the ' type of injection or delivery system chosen.
  • Binding of a desired RBP4 antagonist displaces retinol and induces hindrance for RBP4-TTR interaction resulting in the decreased FRET signal (Fig. 7) .
  • Bacterially expressed MBP-RBP4 and untagged TTR were used in this assay.
  • the maltose binding protein (MBP) -tagged human RBP4 fragment (amino acids 19-201) was expressed in the Gold ( DE3 ) pLysS E. coli strain (Stratagene) using the pMAL-c4x vector.
  • recombinant RBP4 was purified from the soluble fraction using the ACTA FPLC system (GE Healthcare) equipped with the 5-ml the MBP Trap HP column.
  • Human untagged TTR was purchased from Calbiochem. Untagged TTR was labeled directly with Eu 3+ Cryptate-NHS using the HTRF Cryptate Labeling kit from CisBio following the manufacturer's recommendations.
  • HTRF assay was performed in white low volume 384 well plates (Greiner- Bio) in a final assay volume of 16 m ⁇ per well.
  • the reaction buffer contained 10 mM Tris-HCl pH 7.5, 1 mM DTT, 0.05% NP-40, 0.05% Prionex, 6% glycerol, and 400 mM KF.
  • Each reaction contained 60 nM MBP-RBP4 and 2 nM TTR-Eu along with 26.7nM of anti-MBP antibody conjugated with d2 (Cisbio) . Titration of test compounds in this assay was conducted in the presence of 1 mM retinol. All reactions were assembled in the dark under dim red light and incubated overnight at +4°C wrapped in aluminum foil. TR-FRET signal was measured in the SpectraMax M5e Multimode Plate Reader (Molecular Device) .
  • the TR-FRET signal was expressed as the ratio of fluorescence intensity: Flu66s/Flue2o x 10,000.
  • Untagged human RBP4 purified from the urine of tubular proteinuria patients was purchased from Fitzgerald Industries International. It was biotinylated using the EZ-Link Sulfo-NHS-LC-Biotinylation kit from Pierce following the manufacturer's recommendations. Binding experiments were performed in 96-well plates (OptiPlate, PerkinElmer) in a final assay volume of 100 m ⁇ per well in SPA buffer (IX PBS, pH 7.4, ImM EDTA, 0.1%BSA, 0.5%CHAPS) .
  • SPA buffer IX PBS, pH 7.4, ImM EDTA, 0.1%BSA, 0.5%CHAPS
  • the reaction mix contained 10 nM 3 H-Retinol ( 48.7Ci /mmol ; PerkinElmer) , 0.3 mg/well Streptavidin-PVT beads, 50 nM biotinylated RBP4 and a test compound. Nonspecific binding was determined in the presence of 20 mM of unlabeled retinol.
  • the reaction mix was assembled in the dark under dim red light. The plates were sealed with clear tape (TopSeal- ⁇ : 96-well microplate, PerkinElmer) , wrapped in the aluminum foil, and allowed to equilibrate 6 hours at room temperature followed by overnight incubation at +4°C. Radiocounts were measured using a TopCount NXT counter (Packard Instrument Company) .
  • PPARy agonists significantly safety issues are associated with the clinical use of PPARy agonists (increased risk of death, myocardial infarction, stroke, congestive heart failure, hepatotoxicity , peripheral edema, weight gain and carcinogenicity 1 4 ) .
  • the PPARy assay is based on agonist-sensitive interaction of the GST- tagged ligand-binding domain (LBD) of the nuclear receptor PPARy with the biotinylated corepressor NCOR peptide (Fig. 8) .
  • ligand-binding domain of PPARy (amino acids 176-477, GenBank accession number NP 005028) was subcloned into the Sall-Notl sites of pGEX-6p- 3 vector.
  • ligand-binding domain of PPARy amino acids 176-477, GenBank accession number NP 005028
  • Sall-Notl sites of pGEX-6p- 3 vector After the introduction of expression plasmid to the BL21- Gold ( DE3 ) pLysS E.coli strain (Stratagene) recombinant protein (GST- tagged PPARy-LBD) was purified from 1 L cultures using AKTA FPLC system (GE Healthcare) equipped with 5-ml GST Trap HP.
  • Biotin-Ahx aminohexanoic acid
  • ADPASNLGLEDI IRKALMGSF-NH2
  • Eu (K) -anti-GST Ab Eu 3+ Cryptate conjugated mouse monoclonal antibody anti-glutathione S-transferase from Cisbio (Cat no. 61GSTKLA) - 320 nM, reconstituted in water
  • Streptavidin-XL665 XL665-conj ugated streptavidin from Cisbio (Cat no. 610SAXLA) - 20 uM, reconstituted in water
  • 5x HTRF buffer 50 mM Tris-HCl pH 7.5; 5 mM DTT ; 0.25% NP-40;
  • Assay reactions are performed in a final volume of 16 ul .
  • Final concentrations of components are: GST- PPARy, 7nM; NCOR2 peptide, 300 nM; Rosiglitazone (positive control), 20 mM.
  • Working solution was made containing lx HTRF buffer and 100 mM KF (lx, 100) .
  • the following three reagent solutions were prepared: PPARy: 18.7 nM PPARg in lx, 100
  • NCOR2 1200 nM NCOR2 in lx, 100
  • Rosiglitazone (positive control): 80 uM in lx, 100
  • Streptavidin-XL665, 20 uM Rosiglitazone or test compounds The plate was incubated for 16 hrs at 4°C.
  • HTRF signal was measured in the SpectraMax M5e Multimode Plate Reader (Molecular Device) . Fluorescence was excited at 337 nm. Two readings per well were taken: Reading 1 for time-gated energy transfer from Eu (K) to XL665 (337 nm excitation, 668 nm emission, counting delay 50 microseconds, counting window 400 microseconds) and Reading 2 for Eu(K) time-gated fluorescence (337 nm excitation, 620 nm emission, counting delay 50 microseconds, counting window 400 microseconds). The signal was expressed as the ratio of fluorescence intensity: 10,000.
  • Serum RBP4 was measured using the RBP4 (mouse/rat) dual ELISA kit (AdipoGen) following the manufacturer's instructions.
  • Step 1 Lithium bis (trimethylsilyl ) amide (LiHMDS) was added via syringe to a yellow-orange solution of terfc-butyl-5- oxooctahydrocyclopenta [ c] pyrrole-2-carboxylate (1) (1.4 M) in anhydrous tetrahydrofuran (THF) , stirred at -78 °C. The reaction mixture was stirred at -78 °C for lh 45 min, after which a solution of N-phenyltrifluoromethanesul fonimide (0.9 M) in anhydrous THF was added portionwise.
  • LiHMDS Lithium bis (trimethylsilyl ) amide
  • Step 2 Compound 2 (0.04 M) (1 equiv) and the respective boronic acid (2.5 equiv) were stirred in a 1:2 mixture of 2 M aqueous sodium carbonate and 1 , 2-dimethoxyethane .
  • the reaction mixture was evacuated and purqed with argon.
  • Tetrakis ( triphenylphosphine ) palladium ( 0 ) (0.1 equiv) was added, and , the reaction mixture was evacuated and purged with argon. It was heated to and stirred at 80 °C for 6 h, after which it was allowed to cool to room temperature. Ethyl acetate was added and the reaction mixture was concentrated in vacuo. An additional volume of ethyl acetate was added. The organic and aqueous layers were separated. The organic layer was washed with brine (2x) and dried with anhydrous sodium sulfate. The solvent was evaporated in vacuo. The resulting crude material was purified via normal phase silica gel column chromatography (hexanes followed by 20 % ethyl acetate in hexanes followed by ethyl acetate) .
  • Step 3 Compound 3 (0.5 M) was stirred in methanol. .
  • the reaction mixture was evacuated and purged with argon. 10 % Palladium on carbon was added.
  • the reaction mixture was evacuated and purged with argon. Then it was evacuated and purged three times with hydrogen, after which a steady stream of hydrogen was allowed to pass through the reaction mixture.
  • the reaction mixture was stirred overnight, then filtered through a celite pad with methanol. The filtrate was concentrated in vacuo. The resulting crude material was carried on to the next step.
  • Step 4 Compound 4 (0.7 M) (1 equiv) was stirred in methylene chloride at 0 °C. A 2-M solution of HC1 in diethyl ether (5.6 equiv) was added portionwise. The reaction mixture was allowed to warm to room temperature and was stirred overnight. Subsequent addition of diethyl ether resulted in the formation of a precipitate, which was isolated via vacuum filtration.
  • Step 5 The hydrochloric acid salt , 5, (0.14 M) (1 equiv) , the respective carboxylic acid (1 equiv) , and (benzotriazol-1- yloxy) tris (dimethylamino) phosphoniu hexafluorophosphate (BOP) (1.5 equiv) were stirred in anhydrous DMF at room temperature. Diisopropylethylamine (3.0 equiv) was added via syringe. The reaction mixture was stirred overnight, after which distilled water was added. The resulting precipitate was isolated via vacuum filtration.
  • the compounds of the present invention are advantageous in that they were tested in a PPARy agonist assay and were inactive as PPARy agonists (Table 2) .
  • PPARy activation has been implicated as a cause of weight gain in humans (43) .
  • the compounds of the present invention do not substantially activate PPARy, thereby avoiding an unwanted side effect, e.g. weight gain, of treatment of the disclosed retinol diseases.
  • the main objective of this study was to demonstrate in vivo target engagement and establish a proof of in vivo activity in mice.
  • the effect of oral compound administration was studied in mice.
  • Three doses of compound 7a and two doses of 7p were tested in Balb/c mice assay for reduction of serum RBP4.
  • the doses used were 15 mg/kg, 25 g/kg and 35 g/kg for 7a (Figs. 9A- C) .
  • 7a induced a maximum RBP4 reduction of 83% at the 4 hr.
  • 7a induced a maximum RBP4 reduction of 86% at the 6 hr timepoint.
  • 7a induced a maximum RBP4 reduction of 89% at the 8 hr timepoint.
  • 7a induced significant dose-dependent RBP4 lowering in mice (Fig. 9D) with the maximal RBP4 reduction of 89% at the highest dose.
  • An additional aspect of the invention provides analogs of the compounds 7a and 7p containing similar "B" groups that are active as RBP4 antagonists. These compounds analogously bind to RBP4 and antagonize retinol-dependent RBP4-TTR interaction without substantially activating PPARy.
  • Age-dependent accumulation of cytotoxic lipofuscin in the RPE matches the age-dependent increase in the prevalence of the atrophic (dry) form of age-related macular degeneration (AMD) and represents an important pathogenic factor in etiology and progression of dry AMD.
  • Excessive accumulation of toxic lipofuscin in the retina represents a primary pathologic defect in Stargardt disease.
  • Lipofuscin bisretinoids (exemplified by bisretinoid N-retinylidene-N- retinylethanolamine, A2E) mediate lipofuscin toxicity in the AMD and Stargardt disease retina.
  • Enhanced bisretinoid synthesis and excessive lipofuscin accumulation can be faithfully mimicked in the mouse Abca4 ⁇ 7 ⁇ model . Genetic ablation of the Abca4 transporter leads to the massive accumulation of toxic lipofuscin pigments in the retinal pigment epithelium.
  • the compound was formulated into a standard mouse chow to provide the daily oral dosing of 35 mg/kg.
  • Long-term 8-week dosing of the compound formulated into a chow was conducted in Abca4 ⁇ mice.
  • the second group of age-matched Abca4 / mice was kept on a standard Picolab 5053 chow.
  • the age-matched reference group of C57BL/6J (wild-type control) was used for defining the basal level of A2E in mice in the absence of the Abca4 ablation; the C57BL/6J mice were kept on a standard Picolab 5053 chow.
  • Blood samples for assessing the serum levels of RBP4 were collected at pre-dose and after 8.weeks of treatment.
  • An amount of a compound of the present application is administered to the eye of a subject afflicted with Age-Related Macular Degeneration, dry (atrophic) Age-Related Macular Degeneration, Stargardt Disease, Best disease, adult vitelliform maculopathy or Stargardt-like macular dystrophy.
  • the amount of the compound is effective to treat the subj ect .
  • Age-related macular degeneration is the leading cause of blindness in developed countries. Its prevalence is higher than that of Alzheimer's disease. There is no treatment for the most common dry form of AMD. Dry AMD is triggered by abnormalities in the retinal pigment epithelium (RPE) that lies beneath the photoreceptor cells and provides critical metabolic support to these light-sensing cells. RPE dysfunction induces secondary degeneration of photoreceptors in the central part of the retina called the macula. Experimental data indicate that high levels of lipofuscin induce degeneration of RPE and the adjacent photoreceptors in atrophic AMD retinas.
  • RPE retinal pigment epithelium
  • A2E formation occurs in the retina in a non-enzymatic manner and can be considered a byproduct of a properly functioning visual cycle.
  • A2E formation could lead to delay in visual loss in patients with dry AMD and STGD. It was suggested that small molecule visual cycle modulators may reduce the formation of ⁇ 2E in the retina and prolong RPE and photoreceptor survival in patients with dry AMD and STGD.
  • Rates of the A2E production in the retina depend on the influx of all-trans retinol from serum to the RPE.
  • RPE retinol uptake depends on serum retinol concentrations.
  • Pharmacological downregulation of serum retinol is a valid treatment strategy for dry AMD and STGD.
  • Serum retinol is maintained in circulation as a tertiary complex with retinol-binding protein (RBP4) and transthyretin (TTR) . Without interacting with TTR, the RBP4-retinol complex is rapidly cleared due to glomerular filtration. Retinol binding to RBP4 is required for formation of the RBP4-TTR complex; apo-RBP4 does not interact with TTR.
  • the retinol-binding site on RBP4 is sterically proximal to the interface mediating the RBP4-TTR interaction.
  • the data herein show that small molecule RBP4 antagonists displacing retinol from RBP4 and disrupting the RBP4-TTR interaction will reduce serum retinol concentration, inhibit retinol uptake into the retina and act as indirect visual cycle inhibitors reducing the formation of cytotoxic A2E.
  • Serum retinol is bound to retinol-binding protein (RBP4) and maintained in circulation as a tertiary complex with RBP4 and transthyretin (TTR) (Fig. 5). Without interacting with TTR, the RBP4-retinol complex is rapidly cleared from circulation due to glomerular filtration. Additionally, formation of the RBP4 -TTR-retinol complex is required for receptor- mediated all-trans retinol uptake from serum to the retina.
  • RBP4 retinol-binding protein
  • TTR transthyretin
  • visual cycle modulators may reduce the formation of toxic bisretinoids and prolong RPE and photoreceptor survival in dry AMD. Rates of the A2E production depend on the influx of all-trans retinol from serum to the RPE. Formation of the tertiary retinol-binding protein 4 (RBP4)- transthyretin (TTR) -retinol complex in serum is required for retinol uptake from circulation to the RPE. Retinol-binding site on RBP4 is sterically proximal to the interface mediating the RBP4-TTR interaction. RBP4 antagonists that compete with serum retinol for binding to RBP4 while blocking the RBP4-TTR interaction would reduce serum retinol, partially reduce visual cycle retinoid concentration, and inhibit the formation of cytotoxic bisretinoids.
  • RBP4 antagonists that compete with serum retinol for binding to RBP4 while blocking the RBP4-TTR interaction would reduce serum retinol, partially
  • RBP4 represents an attractive drug target for indirect pharmacological modulation of the visual cycle and A2E formation.
  • the retinol-binding site on RBP4 is sterically proximal to the interface mediating the RBP4-TTR interaction.
  • Retinol antagonists competing with serum retinol for binding to RBP4 while blocking the RBP4-TTR interaction would reduce serum RBP4 and retinol levels which would lead to reduced uptake of retinol to the retina.
  • the outcome would be visual cycle modulation which is manifested in partial reduction of visual cycle retinoids that serve as precursors of bisretinoid synthesis with subsequent reduction in the A2E synthesis.
  • fenretinide [N— ( 4— hydroxyphenyl) retinamide, 4HRP] (Fig. 6) previously considered as a cancer treatment (29) was found to bind to RBP4, displace all-'trans retinol from RBP4 (13), and disrupt the RBP4-TTR interaction (13,14). Fenretinide was shown to reduce serum RBP4 and retinol (15), inhibit ocular all-trans retinol uptake and slow down the visual cycle (11). Importantly, fenretinide administration reduced A2E production in an animal model of excessive bisretinoid accumulation, Abca4 -/- mice (11) .
  • fenretinide validated RBP4 as a drug target for dry AMD.
  • fenretinide is non-selective and toxic.
  • fenretinide is an extremely active inducer of apoptosis in many cell types (16-19), including the retinal pigment epithelium cells (20).
  • fenretinide ' s adverse effects are mediated by its action as a ligand of a nuclear receptor RAR (21— 24) .
  • RAR nuclear receptor
  • fenretinide is reported to stimulate formation of hemangiosarcomas in mice.
  • fenretinide is teratogenic, which makes its use problematic in Stargardt disease patients of childbearing age.
  • the compounds of the present invention displace retinol from RBP4 , disrupt retinol-induced RBP4-TTR interaction, and reduce serum REBP4 levels.
  • the compounds of the present invention reduce serum RBP4 concentration in mice and inhibit bisretinoid accumulation in the Abca4 -/- mouse model of excessive lipofuscinogenesis which indicates usefulness a treatment for dry AMD and Stargardt disease.
  • Peroxisome proliferator-activated receptor gamma PPARY is a ligand- dependent transcription factor that belongs to the nuclear receptor protein family.
  • PPARy As most nuclear receptors, PPARy has a DNA-binding domain (mediates docking to regulatory genomic regions) and ligand binding domain (LBD) which is responsible for binding small molecule natural or synthetic ligands that change the conformation of the LBD.
  • PPARy agonists are compounds that bind to the ligand binding domain of this nuclear receptor leading to its conformational changes and recruitment of transcriptional co-activators leading to enhanced expression of the target genes.
  • PPARy agonists such as rosiglitazone (brand name Avandia) and pioglitazone (brand name Actos) , have been used for treatment of diabetes.
  • PPARy agonists are highly restricted due to their mechanism-based adverse effects such as increased risk of death, myocardial infarction, stroke, congestive heart failure, hepatotoxicity , peripheral edema, weight gain and carcinogenicity (44-47).
  • Our data shows that some of the previously described RBP4 antagonists may act as PPARy agonists.
  • Cross-reactivity of RBP4 antagonists with PPARy would be a highly undesirable attribute.
  • the present invention describes potent and selective RBP4 antagonists that lack the PPARy liability.
  • the present invention relates to small molecules for the treatment of macular degeneration and Stargardt Disease.
  • Disclosed herein is the ophthalmic use of the small molecule as non-retinoid RBP4 antagonists.
  • the compounds of Examples 1-19 have been shown to bind RBP4 in vitro and/or to antagonize RBP4-TTR interaction in vitro at biologically significant concentrations.
  • Additional compounds described herein, which are analogs of Examples 1-19 analogously bind RBP4 in vitro and antagonize RBP4-TTR interaction in vitro at biologically significant concentrations.
  • the compounds described herein unexpectedly fail to activate PPARy, which has been implicated to cause weight gain in hum subjects.
  • the present invention identified non-retinoid RBP4 antagonists that are useful for the treatment of dry AMD and other conditions characterized by excessive accumulation of lipofuscin. Without wishing to be bound by any scientific theory, as accumulation of lipofuscin seems to be a direct cause of RPE and photoreceptor demise in AMD and STGD retina, the compounds described herein are disease-modifying agents since they directly address the root cause of these diseases.
  • the present invention provides novel methods of treatment that will preserve vision in AMD and Stargardt disease patients, and patients' suffering from conditions characterized by excessive accumulation of lipofuscin.
  • RPE morphometric analysis of macular, equatorial, and peripheral cells. Investigative Ophthalmology and Visual Science 25 (1984), pp. 195-200.
  • N- ( 4 -hydroxyphenyl ) retinamide induces apoptosis in human retinal pigment epithelial cells: retinoic acid receptors regulate apoptosis, reactive oxygen species generation, and the expression of heme oxygenase-1 and Gaddl53.
  • Classical and novel retinoids their targets in cancer therapy. Leukemia. 2002 Apr ; 16 ( 4 ) : 463-72 Samuel W, Kutty RK, Nagineni S, Vij ayasarathy C, Chandraratna
  • N- ( 4 -hydroxyphenyl ) retinamide induces apoptosis in human retinal pigment epithelial cells: retinoic acid receptors regulate apoptosis, reactive oxygen species generation, and the expression of heme oxygenase-1 and Gaddl53. J Cell Physiol. 2006 Dec ; 209 ( 3 ) : 854 - 65
  • Nuclear receptors have distinct affinities fo coactivators: characterization by FRET. Mol. Endocrinol.
  • Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes . Nature . 2005 Jul 21 ; 436 ( 7049 ) : 356- 62. 40. Kim SR, Jang YP, Jockusch S, Fishkin NE, Turro NJ, Sparrow JR.
  • Nissen SE Wolski K, Topol EJ. Effect of muraglitazar on death and major adverse cardiovascular events in patients with type 2 diabetes mellitus. Jama. 2005 ; 294 ( 20 ): 2581-2586. 47. Nissen SE. Perspective: effect of rosiglitazone on cardiovascular outcomes. Current cardiology reports. 2007 ; 9 ( 5 ) :343-344.

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Abstract

The present invention provides a compound having the structure: Formula (I) wherein R1, R2, R3, R4 and R5 are each independently H, halogen, CF3, C1-C4 alkyl, aryl or heteroaryl,· X is N or CR6, wherein R6 is H, OH, or halogen; A is absent or present, and when present is Formula (II) or Formula (III); B has the structure: Formula (IV) or Formula (V) or a pharmaceutically acceptable salt thereof.

Description

TRIAZOLOPYRIMIDINES, THEIR PREPARATION AND USE
This application claims priority of U.S. Provisional Application No. 62/665,047, filed May 1, 2018, the contents of which are hereby incorporated by reference.
Throughout this application, certain publications are referenced in parentheses. Full citations for these publications may be found immediately preceding the claims. The disclosures oil these publications in their entireties are hereby incorporated by reference into this application in order to describe more fully the state of the art to which this invention relates.
Government Support
This invention was made with government support under Grant number NS074476 awarded by the National Institutes of Health. The government has certain rights in the invention.
Background of the Invention
Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries. It is estimated that 62.9 million individuals worldwide have the most prevalent atrophic (dry) form of AMD; 8 million of them are Americans. Due to increasing life expectancy and current demographics, this number is expected to triple by 2020. There is currently no FDA-approved treatment for dry AMD. Given the lack of treatment and high prevalence, development of drugs for dry AMD is of utmost importance. Clinically, atrophic AMD represents a slowly progressing neurodegenerative disorder in which specialized neurons (rod and cone photoreceptors) die in the central part of the retina called macula (1) . Histopathological and clinical imaging studies indicate that photoreceptor degeneration in dry AMD is triggered by abnormalities in the retinal pigment epithelium (RPE) that lies beneath photoreceptors and provides critical metabolic support to these light-sensing neuronal cells. Experimental and clinical data indicate that excessive accumulation of cytotoxic autofluorescent lipid-protein-retinoid aggregates (lipofuscin) in the RPE is a major trigger of dry AMD (2-9) . In addition to AMD, dramatic accumulation of lipofuscin is the hallmark of Stargardt Disease ( STGD) , an inherited form of juvenile-onset macular degeneration. The major cytotoxic component of RPE lipofuscin is pyridinium bisretinoid A2E (Fig. 1) . Additional cytotoxic bisretinoids are isoA2E, atRAL di-PE, and A2-DHP-PE (40, 41). Formation of A2E and other lipofuscin bisretinoids, such as A2-DHP-PE (A2-dihydropyridine- phosphatidylethanolamine) and atRALdi-PE (all-trans-retinal dimer- phosphatidylethanolamine ) , begins in photoreceptor cells in a non- enzymatic manner and can be considered as a by-product of the properly functioning visual cycle.
A2E is a product of condensation of all-trans retinaldehyde with phosphatidyl-ethanolamine which occurs in the retina in a non- enzymatic manner and, as illustrated in Fig. 4, can be considered a by-product of a properly functioning visual cycle (10) . Light-induced isomerization of 11-cis retinaldehyde to its all-trans form is the first step in a signaling cascade that mediates light perception. The visual cycle is a chain of biochemical reactions that regenerate visual pigment (11-cis retinaldehyde conjugated to opsin) following exposure to light.
As cytotoxic bisretinoids are formed during the course of a normally functioning visual cycle, partial pharmacological inhibition of the visual cycle may represent a treatment strategy for dry AMD and other disorders characterized by excessive accumulation of lipofuscin (25— 27, 40, 41) . Summary of the Invention
The present invention provides a compound having the structure:
Figure imgf000005_0001
wherein
Ri, R2, R3, RC, and Rs are each independently H, halogen, CF3, OCF3 alkyl, haloalkyl, aryl or heteroaryl;
X is N or CR6,
wherein R6 is H, OH, or halogen;
A is absent or present, and when present
Figure imgf000005_0002
B has the structure:
Figure imgf000005_0003
wherein
a and b are each a bond that is present or absent;
Xi is N, NH or NR10,
wherein Ri0 is alkyl, alkenyl or alkynyl; X2 is C or N;
X3 is CH or N;
R7, Re and R9 are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl -NH2, alkyl-OAc alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (0) -N (CH3) 2, C(0)-NHCH3, NHC (O) -N (CH3) 2, CN or CF3, wherein
Xi, X2 and X3 are each N, a is present and b is absent; or
Xi is NH, X2 is C, X3 is CH, a is absent and b is present; or
Xi is N, X2 is N, X3 is CH, a is present and b is absent; or
Xi is NH or NR10, X2 is C, X3 is N, a is absent and b is present, wherein when Xi is NH, X2 is C, X3 is N, a is absent and b is present, then one of R7, Re and R9 is other than H, or B has the structure:
Figure imgf000006_0001
wherein
X4 and X5 are each, independently, is N or CH; and
R11, R12 and R3 are each, independently, H, halogen, alkyl, alkenyl, alkynyl alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2,
C (0) -N (CH3) 2, C (0) -NHCH3, NHC (O) -N (CH3) 2, CN or CF3, or a pharmaceutically acceptable salt thereof. Brief Description of the Figures
Fig. 1. Structure of bisretinoid A2E, a cytotoxic component of retinal lipofuscin.
Fig. 2. Structure of bisretinoid atRAL di-PE (all-trans retinal dimer-phosphatidyl ethanolamine ) , a cytotoxic component of retinal lipofuscin. R1 and R2 refer to various fatty acid constituents.
Fig. 3. Structure of bisretinoid A2-DHP-PE, a cytotoxic component of retinal lipofuscin.
Fig. 4. Visual cycle and biosynthesis of A2E. A2E biosynthesis begins when a portion of all-trans-retinal escapes the visual cycle (yellow box) and non-enzymatically reacts with phosphatidyl- ethanolamine forming the A2E precursor, A2-PE. Uptake of serum retinol to the RPE (gray box) fuels the cycle.
Fig. 5. Three-dimensional structure of the RBP4 -TTR-retinol complex. Tetrameric TTR is shown in blue, light blue, green and yellow (large boxed region) . RBP is shown in red (unboxed region) and retinol is shown in gray (small boxed region) (28) .
Fig. 6. Structure of fenretinide, [N- ( 4 -hydroxyphenyl ) retinamide , 4HRP] , a retinoid RBP4 antagonist.
Fig. 7. Schematic depiction of the HTRF-based assay format for character! zation of RBP4 antagonists disrupting retinol -induced RBP4- TTR interaction.
Fig. 8. Schematic depiction of the in vitro TR-FRET-based PPARy-NCOR interaction assay to be used as a counter-screen. GST-tagged PPARy fragment interacts with biotinylated NCOR peptide in the absence of ligand generating FRET. Test compounds specific for RBP4 should not affect the signal. Compounds with PPARy agonistic activity induce conformation changes in the ligand binding domain of PPARy leading to disruption of the PPARy-NCOR interaction which is registered as a decrease in the FRET signal.
Fig. 9A: Serum RBP4 reduction in mice treated with single 15 mg/kg dose of compound of 7a . Serum RBP4 reduction, absolute values (pg/ml Plasma RBP4 ) . Single dose 15 mg/kg PO, mice, serum RPB4 values.
Fig. 9B: Serum RBP4 reduction in mice treated with single 25 mg/kg dose of compound of 7a . Serum RBP4 reduction, absolute values ^g/ml Plasma RBP4) . Single dose 25 mg/kg PO, mice, serum RPB4 values.
Fig. 9C: Serum RBP4 reduction in mice treated with single 35 mg/kg dose of compound of 7a . Serum RBP4 reduction, absolute values (m /ihΐ Plasma RBP4). Single dose 35 mg/kg PO, mice, serum RPB4 values.
Fig. 9D: Dose-dependent RBP4 reduction after oral dosing of 7a .
Fig. 10A: Serum RBP4 reduction in mice treated with single 25 mg/kg dose of compound of 7p . Serum RBP4 reduction, absolute values ^g/ l Plasma RBP4 ) . Single dose 25 mg/kg PO, mice, serum RPB4 values.
Fig. 10B: Serum RBP4 reduction in mice treated with single 35 mg/kg dose of compound of 7p . Serum RBP4 reduction, absolute values ^g/ml Plasma RBP4) . Single dose 35 mg/kg PO, mice, serum RPB4 values.
Fig. 11: Serum RPB4 levels in three groups of mice at baseline and at end of 8-week treatment period with 7a .
Fig. 12: Effect of 7a treatment on bisretinoid accumulation in eyes of Abca4~/~ mice. Detailed Description of the Invention
The present invention provides a compound having the structure:
Figure imgf000009_0001
wherein
Ri, R2, R3, R^, and Rs are each independently H, halogen, CF3, OCF3 alkyl, haloalkyl, aryl or heteroaryl;
X is N or CRe,
wherein R6 is H, OH, or halogen;
Ά is absent or present, and when present is
Figure imgf000009_0002
B has the structure:
Figure imgf000009_0003
wherein
a and b are each a bond that is present or absent;
Xi is N, NH or NR10,
wherein Ri0 is alkyl, alkenyl or alkynyl;
X2 is C or N; X3 is CH or N;
R7, R8 and Rg are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl~NH2, alkyl-OAc alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2,
C (0) -N (CH3) 2, C(0)-NHCH3, NHC(O) -N(CH3)2, CN or CF3, wherein
Xi , X2 and X3 are each N , a is present and b is absent; or
Xi is NH, X2 is C , X3 is CH , a is absent and b is present; or
Xi is N , X2 is N , X3 is CH , a is present and b is absent; or
Xi is NH or NR10 , X2 is C , X3 is N , a is absent and b is present, wherein when Xi is NH , X2 is C , X3 is N , a is absent and b is present, then one of R? , Re and Rg is other than H , or B has the structure:
Figure imgf000010_0001
wherein
X4 and X5 are each, independently, is N or CH; and
R11, RI2 and RI3 are each, independently, H, halogen, alkyl, alkenyl , alkynyl alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C (0) -NH2, C(0)-N(CH3)2, C(0)-NHCH3, NHC(O) -N(CH3)2, CN or CF3, or a pharmaceutically acceptable salt thereof.
In one embodiment of the above compound, wherein Ri, R2, R3, R^, and Rs are each independently H, halogen, CF3 or C1-C4 alkyl.
In one embodiment of the above compound, B has the structure:
Figure imgf000011_0001
wherein
Rii, R12 and Ri3 are each, independently, H, halogen, alkyl, alkenyl, alkynyl alkyl-OH, alkyl-Nth, alkyl-OAc, alkyl-0 (CO) -alkyl , alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2,
C (0) -N (CH3) 2, C(0)-NHCH3, NHC(O) -N (CH3) 2, CN or CF3.
The present invention also provides a compound having the structure:
Figure imgf000011_0002
wherein
Ri, R2, R3/ R4, and R3 are each independently H, halogen, CF3 or C1-C4 alkyl ;
X is N or CR6,
wherein Rs is H, OH, or halogen;
A is absent or present, and when present is
Figure imgf000011_0003
B has the structure:
Figure imgf000012_0001
wherein
a and b are each a bond that is present or absent;
Xi is N, NH or NRi0,
wherein Rio is alkyl, alkenyl or alkynyl;
X2 is C or N;
X3 is CH or N;
R7, Re and R9 are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-NH2, alkyl-OAc alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2,
C (0) -N (CH3) 2, C(0)-NHCH3, NHC(0)-N(CH3)2, CN or CF3, wherein
Xi, X2 and X3 are each N, a is present and b is absent; or
Xi is NH, X2 is C, X3 is CH, a is absent and b is present; or
Xi is N, X2 is N, X3 is CH, a is present and b is absent; or
Xi is NH or NR10, X2 is C, X3 is N, a is absent and b is present, wherein when Xi is NH, X2 is C, X3 is N, a is absent and b is present, then one of R7, Rs and Rg is other than H, or B has the structure:
Figure imgf000012_0002
wherein
R11, R12 and Ri3 are each, independently, H, halogen, alkyl, alkenyl, alkynyl alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2,
C (0) -N (CHa) 2, C(0)-NHCH3, NHC ( 0 ) -N ( CH3 ) 2 , CN or CF3, or a pharmaceutically acceptable salt thereof.
In some embodiments, the compound having the structure:
Figure imgf000013_0001
In some embodiments, the compound having the structure:
Figure imgf000013_0002
In some embodiments, the compound having the structure:
Figure imgf000014_0001
The present invention also provides a compound having the structure
Figure imgf000014_0002
Ri, R2, R3, R*, and R5 are each independently H, halogen, CF3, OCF3, alkyl, haloalkyl, aryl or heteroaryl; and
B has the structure;
Figure imgf000014_0003
wherein
a and b are each a bond that is present or absent;
X is N, NH or NR10,
wherein Rio is alkyl, alkenyl or alkynyl;
X2 is C or N; X3 is CH or N;
R7, Rg and Rg are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alky-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (0) -N (CH3) 2, C (0) -
NHCH3, NHC (0) -N (CH3) 2, CN, or CF3, wherein
Xi, X2 and X3 are each N, a is present and b is absent; or
Xi is NH, X2 is C, X3 is CH, a is absent ,and b is present; or
Xi is N, X2 is N, X3 is CH, a is present and b is absent; or
Xi is NH or NR10, X2 is C, X3 is N, a is absent and b is present, wherein when Xi is NH, X2 is C, X3 is N, a is absent and b is present, then one of R7, Rs and Rg is other than H, or B has the structure:
Figure imgf000015_0001
Wherein
X4 and X5 are each, independently, is N or CH; and
R , R12 and Ri3 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alky-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (O) -N (CH3) 2, C(0)-NHCH3, NHC (0) -N (CH3) 2,
CN, or CF3, or a pharmaceutically acceptable salt thereof.
In one embodiment of the above compound, wherein Ri, R2, R3, Rn and R5 are each independently H, halogen, CF3 or C1-C4 alkyl.
In one embodiment of the above compound, B has the structure:
Figure imgf000016_0001
wherein
Rii, R12 and R13 are ' each, independently, H, halogen, alkyl, alkenyl, alkynyl alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2,
C (O) -N (CH3) 2, C(0)-NHCH3, NHC (O) -N (CH3) 2, CN or CF3.
The present invention also provides a compound having the structure:
Figure imgf000016_0002
wherein
Ri, R2, R3, R4, and Rs are each independently H, halogen, CF3, OCF3, alkyl, haloalkyl, aryl or heteroaryl;
Y is alkyl;
A is absent or present, and when present is
Figure imgf000016_0003
and B has the structure:
Figure imgf000016_0004
wherein
a and b are each a bond that is present or absent; Xi is N, NH or NRio,
wherein Rio is alkyl, alkenyl or alkynyl;
X2 is C or N;
X3 is CH or N;
R7, Rg and R9 are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alky-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (0) -N (CH3) 2, C(0)-
NHCH3, NHC(0)-N(CH3)2, CN, or CF3, wherein
Xi, X2 and X3 are each N, a is present and b is absent; or
Xi is NH, X2 is C, X3 is CH, a is absent and b is present; or
Xi is N, X2 is N, X3 is CH, a is present and b is absent; or
Xi is NH or NR10, X2 is C, X3 is N, a is absent and b is present, wherein when Xi is NH, X2 is C, X3 is N, a is absent and b is present, then one of R?, Re and Rg is other than H, or B has the structure:
Figure imgf000017_0001
wherein
X4 and Xs are each, independently, is N or CH; and
R11, RI2 and Ri3 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alky-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)OH, C(0)-NH2, C (O) -N (CH3) 2, C(0)-NHCH3, NHC (O) -N (CH3) r,
CN, or CF3, or a pharmaceutically acceptable salt thereof.
In one embodiment of the above compound, wherein Ri, R2, R3, R4, and R5 are each independently H, halogen, CF3 or C1-C4 alkyl. In one embodiment of the above compound B has the structure:
Figure imgf000018_0001
wherein
Rii, R12 and R13 are each, independently, H, halogen, alkyl, alkenyl, alkynyl alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2,
C (0) -N (CH3) 2, C(0)-NHCH3, NHC(0)-N(CH3)2, CN or CF3.
In some embodiment, the compound having the structure:
Figure imgf000018_0002
In some embodiments, wherein one of Ri, R2, R3, R-s, and R3 is other than
H.
In some embodiments, wherein two of Ri, R2, R3, R4, and Rs are other than H.
In some embodiments, B has the structure:
Figure imgf000018_0003
wherein
a and b are each a bond that is present or absent;
Xi is N, NH or NRio,
wherein RXo is alkyl, alkenyl or alkynyl;
X2 is C or N;
X3 is CH or N;
R7 , Re and Rg are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-Nlh, alkyl-OAc alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2,
C (O) -N (CH3) 2, C(0)-NHCH3, NHC (0) -N (CH3) 2, CN or CF3, wherein
Xi, X2 and X3 are each N , a is present and b is absent; or
Xi is NH , X2 is C , X3 is CH , a is absent and b is present; or
Xi is N , X2 is N , X3 is CH , a is present and b is absent; or
Xi is NH or NR10 , 2 is C, X3 is N , a is absent and b is present, wherein when Xi is NH , X2 is C , X3 is N , a is absent and b is present, then one of R? , Re and Rg is other than H .
In some embodiments, B has the structure:
Figure imgf000019_0001
wherein
Rn , R12 and RI3 are each, independently, H, halogen, alkyl, alkenyl, alkynyl alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2,
C (0) -N (CH3) 2, C(0)-NHCH3, NHC (O) -N (CH3) 2, CN or CF3.
In some embodiments, the compound wherein B has the structure:
Figure imgf000020_0001
R7, Re and Rg are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-O-alkyl , haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (0) -N ( CH3) 2 , C(0)-NHCH3, NHC (0) -N (CH3) 2, CN, or CF3.
In some embodiments, the compound wherein B has the structure:
Figure imgf000020_0002
R7, Re and R9 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (0) -N (CH3) 2, C(0)-NHCH3, NHC (O) -N (CH3) 2,
CN, or CF3.
In some embodiments, the compound wherein B has the structure:
Figure imgf000020_0003
R7, Re and Rg are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)OH, C(0)-NH2, C (O) -N (CH3) 2, C(0)-NHCH3, NHC (0) -N (CH3) 2,
CN, or CF3.
In some embodiments, the compound wherein B has the structure:
Figure imgf000020_0004
R7, R8 and Rg are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl , C(0)0H, C(0)-NH2, C (0) -N (CH3) 2, C(0)-NHCH3, NHC (0) -N (CH3) 2,
CN, or CF3; and
Rio is alkyl, alkenyl or alkynyl.
In some embodiments, the compound wherein
R-7, Re and R9 are each, independently, H, Cl, Br, F, OCH3, OCEBCPh, CF3, CN, CH3, CH3CH3, C ( 0 ) OH or C(0)-NH2
In some embodiments, the compound wherein R7, Re and R9 are each, independently, H, CH2CH2OH, CH2CH2OCH3, CH2CH2OAc, CH2CH2CI, CH2CH2F or CH2CH2Br .
In some embodiments, the compound wherein R7, R8 and R9 are each, independently, H, halogen or alkyl.
In some embodiments, the compound wherein two of R7, R8 and R9 are each H and the remaining one of R7, R8 and Rg is other than H.
In some embodiments, the compound wherein one of R7, Re and R9 is H and the remaining two of R7, Re and Rg are each other than H.
In some embodiments, the compound wherein B has the structure:
Figure imgf000021_0001
In some embodiments, the compound wherein R7, Re and Rg are each, independently, H, CH3, Br, Cl, F, CH2CH2OH, CH2CH2OCH3, CH2CH2OAc, CH2CH2CI, CH2CH2F or CH2CH2Br.
In some embodiments, the compound wherein B has the structure:
Figure imgf000022_0001
In some embodiments, the compound wherein R7 and R9 are each, independently, H, CH3, Br, Cl, F, CH2CH2OH, CH2CH2OCH3, CH2CH2OAC, CH2CH2C1, CH2CH2F or CH2CH2Br.
In some embodiments, the compound wherein B has the structure:
Figure imgf000022_0002
In some embodiments, the compound wherein R7, Re and R9 are each, independently, H, CH3, Br, Cl, F, CH2CH2OH, CH2CH2OCH3, CH2CH2OAc, CH2CH2C1, CH2CH2F or CH2CH2Br .
In some embodiments, the compound wherein B has the structure:
Figure imgf000022_0003
In some embodiments, the compound wherein R7 and R9 are each, independently, H, CH3, Br, Cl, F, CH2CH2OH, CH2CH2OCH3, CH2CH2OAc, CH2CH2C1, CH2CH2F or CH2CH2Br .
In some embodiments, the compound wherein B has the structure:
Figure imgf000023_0001
In some embodiments, the compound wherein R7, Rs and Rg are each, independently, H, CH3, Br, Cl, F, CH2CH2OH, CH2CH2OCH3, CH2CH2OAc, CH2CH2C1, CH2CB2F or CH2CH2Br.
In some embodiments, the compound wherein B has the structure:
Figure imgf000023_0002
In some embodiments, the compound wherein R7 and Rg are each, independently, H, CH3, Br, Cl, F, CH2CH2OH, CH2CH2OCH3, CH2CH2OAC, CH2CH2C1, CH2CH2F or CH2CH2Br .
In some embodiments, the compound wherein B has the structure:
Figure imgf000023_0003
In some embodiments, the compound wherein R7, Re and Rg are each, independently, H, CH3, Br, Cl, F, CH2CH2OH, CH2CH2OCH3, CH2CH2OAc, CH2CH2C1, CH2CH2F or CH2CH2Br; and Rio is alkyl.
In some embodiments, the compound wherein B has the structure:
Figure imgf000023_0004
In some embodiments, the compound wherein R7 and Rg are each, independently, H, CH3, Br, Cl, F, CH2CH2OH, CH2CH2OCH3, CH2CH2OAc, CH2CH2C1 , CH2CH2F or CH2CH2Br; and Rio is alkyl.
In some embodiments, the compound wherein B has the structure:
Figure imgf000024_0001
wherein
Rn, R12 and Ri3 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl , C(0)0H, C(0)-NH2, C (0) -N (CH3) 2, C(0)-NHCH3, NHC (0) -N (CH3) 2,
CN, or CF3.
In some embodiments, the compound wherein B has the structure:
Figure imgf000024_0002
wherein
Rn, R12 and R13 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H,- C(0)-NH2, C (0) -N (CH3) 2, C(0)-NHCH3, NHC (0) -N (CH3) 2,
CN, or CF3.
In some embodiments, the compound wherein B has the structure:
Figure imgf000024_0003
wherein
R11, R12 and R33 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (0) -N (CH3) 2, C(0)-NHCH3, NHC (0) -N (CH3) 2, CN, or CF3.
In some embodiments, the compound wherein B has the structure:
Figure imgf000025_0001
wherein
Rn, R12 and RI3 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-O-alkyl , haloalkyl, cycloalkyl, 0-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (O) -N (CH3) 2, C(0)-NHCH3, NHC (0) -N (CH3) 2, CN, or CF3.
In some embodiments, the compound Rn, Rn and RI3 are each, independently, H, Cl, Br, F, OCRs, OCH2CH3, CF3, CN, CH3, CH3CH3, C(0)0H or C(0)-NH2.
In some embodiments, the compound Rn, R and R are each, independently, H, CH2CH2OH, CH2CH2OCH3, CH2CH2OAc, CH2CH2C1, CH2CH2F or CH2CH2Br .
In some embodiments, the compound Rn, R12 and RI3 are each, independently, H, halogen or alkyl.
In some embodiments, the compound wherein two of Rn, Rn and Rn are each H and the remaining one of Rn, Rn and R33 is other than H.
In some embodiments, the compound wherein one of Rn, Rn and R is H and the remaining two of Rn, R12 and Rn are each other than H.
In some embodiments, the compound wherein B has the structure:
Figure imgf000026_0001
In some embodiments, the compound wherein Rn, R12 and R13 are each, independently, H, CH3, Br, Cl, F, CH2CH2OH, CH2CH2OCH3, CH2CH2OAc, CH2CH2C1, CH2CH2F or CH2CH2Br.
In some embodiments, the compound wherein B has the structure:
Figure imgf000026_0002
In some embodiments, the compound wherein Rn and R13 are each, independently, H, CH3, Br, Cl, F, CH2CH2OH, CH2CH2OCH3, CH2CH2OAc, CH2CH2CI, CH2CH2F or CH2CH2Br .
In some embodiments, the compound wherein X is N. In some embodiments, the compound wherein X is CH.
In some embodiments, the compound wherein
Ri, R2, R3, R4, and R5 are each H, t-Bu, Cl, F, or CF3.
In some embodiments, the compound wherein
Ri, R2, R3, and R4 are each H; and
R5 is CF3 or t-Bu.
In some embodiments, the compound wherein
Ri, R3 and R4 are each H;
R2 is halogen;
Rs is CF3 or t-Bu.
In some embodiments, the compound wherein
Ri, R2, R3, and R4 are each H, Rs is CFs or t-Bu.
In some embodiments, the compound wherein
Ri, R2, R3, and R are each H,
R5 is CF3.
In some embodiments, the compound wherein
Ri, R2, R3, R4, and R5 are each H, methyl, ethyl, phenyl, t-Bu, i-Pr, Cl, Br, F or CF3;
In some embodiments, the compound wherein
wherein
Ri, R2, R3, and R are each H;
Rs is -H, methyl, ethyl, i-Pr or phenyl.
In some embodiments, the compound wherein
Ri, R2, R3, R4, and R5 are each H, methyl, ethyl, phenyl, t-Bu, i-Pr, OCF3, CF3, OCF2CF3, CF2CF3, Cl, Br, or F.
In some embodiments, the compound wherein
Ri, R2, R3, and R4 are each H;
Rs is -H, OCF3, CF2CF3, methyl, ethyl, ί-Pr or phenyl.
In some embodiments, the compound wherein one of Ri, R2, R3, R<i, and R¾ is other than H.
In some embodiments, the compound wherein two of Ri, R2, R3, R4, and Rs are other than H.
In some embodiments, the compound wherein two or more of Ri, R2, R3,
R4, and Rs are other than H.
In some embodiments, the compound wherein three of Ri, R3, R3, R4, and Rs are other than H. In some embodiments, the compound wherein three or more of Ri, R2, R3, R4, and Rs are other than H.
In some embodiments, the compound wherein having the structure:
Figure imgf000028_0001
Figure imgf000029_0001
a pharmaceutically acceptable salt thereof.
In some embodiments, the compound wherein having the structure:
Figure imgf000029_0002
a pharmaceutically acceptable salt thereof . In some embodiments, the compound wherein having the structure:
Figure imgf000030_0001
a pharmaceutically acceptable salt thereof.
In some embodiments, B is other than
Figure imgf000030_0002
In any embodiment of any of the above compounds, Ri, R2, R3, R4, and Rs are each independently H, halogen, CF3, C1-C12 alkyl, aryl or heteroaryl . In any embodiment of any of the above compounds, Ri, R2, R3, R4, and Rs are each independently H, halogen, CF3, CR-Ce alkyl, aryl or heteroaryl .
In any embodiment of any Of the above compounds, Ri, R2, R3, R, and Rs are each independently H, halogen, CF3, C1-C4 alkyl, aryl or heteroaryl .
In any embodiment of any of the above compounds where one of Ri, R2, R3, R4, and Rs is other than H, the compound is more active than the corresponding compound where Ri, R2, R3, R4, and Rs are each H. For example, the compound corresponding to compound 10a where Ri, R2, R3, R4, and Rs are each H is less active. Without being bound by any specific theory, it is believed that the position of the substitution at the Ri or Rs position on the phenyl ring of, e.g., compounds lOa-lOd increases activity relative to the corresponding compounds where Ri, R2, R3, 4, and Rs are each H. The claimed compounds each containing a substitution at the Ri or Rs position have improved activity in RBP4 assays and reduced or no substantial activity in PPARy assays.
The present invention provides a pharmaceutical composition comprising a compound of the present invention and a pharmaceutically acceptable carrier .
The present invention provides a method for treating a disease characterized by excessive lipofuscin accumulation in the retina in a mammal afflicted therewith comprising administering to the mammal an effective amount of a compound of the present invention or a composition of the present invention.
The present invention provides a method for lowering the serum concentration of RBP4 in a mammal comprising administering to the mammal an effective amount of a compound of the present invention or a composition of the present invention. In some embodiments of the method, wherein the disease is further characterized by bisretinoid-mediated macular degeneration.
In some embodiments of the method, wherein the amount of the compound is effective to lower the serum concentration of RBP4 in the mammal.
In some embodiments of the method, wherein the amount of the compound is effective to lower the retinal concentration of a bisretinoid in lipofuscin in the mammal.
In some embodiments of the method, wherein the bisretinoid is A2E. In some embodiments of the method, wherein the bisretinoid is isoA2E. In some embodiments of the method, wherein the bisretinoid is A2-DHP-PE. In some embodiments of the method, wherein the bisretinoid is atRAL di-PE.
In some embodiments of the method, wherein the disease characterized by excessive lipofuscin accumulation in the retina is Age-Related Macular Degeneration.
In some embodiments of the method, wherein the disease characterized by excessive lipofuscin accumulation in the retina is dry (atrophic) Age-Related Macular Degeneration.
In some embodiments of the method, wherein the disease characterized by excessive lipofuscin accumulation in the retina is Stargardt Disease .
In some embodiments of the method, wherein the disease characterized by excessive lipofuscin accumulation in the retina is Best disease.
In some embodiments of the method, wherein the disease characterized by excessive lipofuscin accumulation in the retina is adult vitelliform maculopathy. In some embodiments of the method, wherein the disease characterized by excessive lipofuscin accumulation in the retina is Stargardt-like macular dystrophy.
In some embodiments, bisretinoid-mediated macular degeneration is Age- Related Macular Degeneration or Stargardt Disease. In some embodiments, the bisretinoid-mediated macular degeneration is Age- Related Macular Degeneration. In some embodiments, the bisretinoid- mediated macular degeneration is dry (atrophic) Age-Related Macular Degeneration .
In some embodiments, the bisretinoid-mediated macular degeneration is Stargardt Disease. In some embodiments, the bisretinoid-mediated macular degeneration is Best disease. In some embodiments, the bisretinoid-mediated macular degeneration is adult vitelliform maculopathy. In some embodiments, the bisretinoid-mediated macular degeneration is Stargardt-like macular dystrophy. The bisretinoid- mediated macular degeneration may comprise the accumulation of lipofuscin deposits in the retinal pigment epithelium.
In some embodiments of the method, the amount of the compound is administered to the eye of the mammal.
In some embodiments of the method, the amount of the compound is administered topically to the eye of the mammal.
As used herein, "bisretinoid lipofuscin" is lipofuscin containing a cytotoxic bisretinoid. Cytotoxic bisretinoids include but are not necessarily limited to A2E, isoA2E, atRAL di-PE, and A2-DHP-PE (Figs. 1, 2, and 3) .
Figure imgf000034_0001
The compounds of the present application having the above structure may be synthesized using the methods disclosed in WO 2014/15201, published September 25, 2014, or WO 2015/168286, published November 5, 2015, the contents of each of which are hereby incorporated by reference.
Figure imgf000034_0002
The compounds of the present application having the above structure may be synthesized according to the methods disclosed in WO 2014/152018, published September 25, 2014, or WO 2014/151936, published September 25, 2014, the contents of each of which are hereby incorporated by reference.
Figure imgf000034_0003
The compounds of the present application having the above structure may be synthesized according to the methods disclosed in WO 2014/151959, published September 25, 2014, the contents of which are hereby incorporated by reference.
The B groups described herein may be attached to the following compounds by amide coupling or similar coupling methods known to one skilled in the art to prepare the compounds of the present application.
Figure imgf000035_0001
For example, a mixture of the above amine (1 equiv) , desired carboxylic acid "B" group (1 equiv), triethylamine (Et3N) (3 equiv), and 2-(lH- benzotriazole-l-yl ) -1,1,3, 3-tetramethyluronium hexafluorophosphate ( HBTU ) (1.5 equiv) in DMF (0.25 M) are stirred at room temperature until the reaction is complete by LC-MS. The mixture is diluted with H2O and extracted with EtOAc. The combined organic extracts are washed with H20, brine, dried over Na2SO<i, filtered, and concentrated under reduced pressure. The resulting residue is purified by silica gel chromatography (typical eluents included either a mixture of or hexanes and EtOAc or a mixture of CH2CI2 and a 90:9:1 mixture of CH2Cl2/CH30H/concentrated NH4OH) to afford the desired Carboxamide.
Except where otherwise specified, when the structure of a compound of this invention includes an asymmetric carbon atom, it is understood that the compound occurs as a racemate, racemic mixture, and isolated single enantiomer. All such isomeric forms of these compounds are expressly included in this invention. Except where otherwise specified, each stereogenic carbon may be of the R or S configuration. It is to be understood accordingly that the isomers arising from such asymmetry (e.g., all enantiomers and diastereomers ) are included within the scope of this invention, unless indicated otherwise. Such isomers can be obtained in substantially pure form by classical separation techniques and by stereochemically controlled synthesis, such as those described in "Enantiomers, Racemates and Resolutions" by J. Jacques, A. Collet and S. Wilen, Pub. John Wiley & Sons, NY, 1981. For example, the resolution may be carried out by preparative chromatography on a chiral column.
The subject invention is also intended to include all isotopes of atoms occurring on the compounds disclosed herein. Isotopes include those atoms having the same atomic number but different mass numbers. By way of general example and without limitation, isotopes of hydrogen include tritium and deuterium. Isotopes of carbon include C-13 and C- 14.
It will be noted that any notation of a carbon in structures throughout this application, when used without further notation, are intended to represent all isotopes of carbon, such as 12C, 13C, or 14C. Furthermore, any compounds containing 13C or 14C may specifically have the structure of any of the compounds disclosed herein.
It will also be noted that any notation of a hydrogen in structures throughout this application, when used without further notation, are intended to represent all isotopes of hydrogen, such as 3H, 2H, or 3H . Furthermore, any compounds containing 2H or 3H may specifically have the structure of any of the compounds disclosed herein.
Isotopically-labeled compounds can generally be prepared by conventional techniques known to those skilled in the art using appropriate isotopically-labeled reagents in place of the non-labeled reagents employed.
The term "substitution", "substituted" and "substituent" refers to a functional group as described above in which one or more bonds to a hydrogen atom contained therein are replaced by a bond to non-hydrogen or non-carbon atoms, provided that normal valencies are maintained and that the substitution results in a stable compound. Substituted groups also include groups in which one or more bonds to a carbon (s) or hydrogen (s) atom are replaced by one or more bonds, including double or triple bonds, to a heteroatom. Examples of substituent groups include the functional groups described above, and halogens (i.e., E, Cl, Br, and I); alkyl groups, such as methyl, ethyl, n- propyl, isopropryl, n-butyl, tert-butyl, and trifluoromethyl ; hydroxyl; alkoxy groups, such as methoxy, ethoxy, n-propoxy, and isopropoxy; aryloxy groups, such as phenoxy; arylalkyloxy, such as benzyloxy (phenylmethoxy) and p-trifluoromethylbenzyloxy (4- trifluoromethylphenylmethoxy) ; heteroaryloxy groups; sulfonyl groups, such as trifluoromethanesulfonyl, methanesulfonyl , and p- toluenesulfonyl ; nitro, nitrosyl; mercapto; sulfanyl groups, such as methylsulfanyl , ethylsulfanyl and propylsulfanyl ; cyano; amino groups, such as amino, methylamino, dimethylamino, ethylamino, and diethylamino; and carboxyl. Where multiple substituent moieties are disclosed or claimed, the substituted compound can be independently substituted by one or more of the disclosed or claimed substituent moieties, singly or plurally. By independently substituted, it is meant that the (two or more) substituents can be the same or different.
In the compounds used in the method of the present invention, the substituents may be substituted or unsubstituted, unless specifically defined otherwise.
In the compounds used in the method of the present invention, alkyl, heteroalkyl, monocyclic, bicyclic, aryl, heteroaryl and heterocyclic groups can be further substituted by replacing one or more hydrogen atoms with alternative non-hydrogen groups. These include, but are not limited to, halo, hydroxy, mercapto, amino, carboxy, cyano and carbamoyl .
It is understood that substituents and substitution patterns on the compounds used in the method of the present invention can be selected by one of ordinary skill in the art to provide compounds that are chemically stable and that can be readily synthesized by techniques known in the art from readily available starting materials. If a substituent is itself substituted with more than one group, it is understood that these multiple groups may be on the same carbon or on different carbons, so long as a stable structure results.
In choosing the compounds used in the method of the present invention, one of ordinary skill in the art will recognize that the various substituents, i.e., Ri, R2, etc. are to be chosen in conformity with well-known principles of chemical structure connectivity.
As used herein, "alkyl" includes both branched and straight-chain saturated aliphatic hydrocarbon groups having a specified number of carbon atoms and may be unsubstituted or substituted. Thus, Ci-Cn as in "Ci-Cn alkyl" is defined to include groups having 1, 2, ...., n-1 or n carbons in a linear or branched arrangement. For example, C1-C6, as in "C1-C6 alkyl" is defined to include groups having 1, 2, 3, 4, 5, or 6 carbons in a linear or branched arrangement, and specifically includes methyl, ethyl, n-propyl, isopropyl, n-butyl, t-butyl, pentyl, and hexyl. Unless otherwise specified contains one to ten carbons. Alkyl groups can be unsubstituted or substituted with one or more substituents, including but not limited to halogen, alkoxy, alkylthio, trifluoromethyl, difluoromethyl , methoxy, and hydroxyl.
As used herein, "C1-C4 alkyl" includes both branched and straight- chain C1-C4 alkyl.
As used herein, "alkenyl" refers to a non-aromatic hydrocarbon radical, straight or branched, containing at least 1 carbon to carbon double bond, and up to the maximum possible number of non-aromatic carbon-carbon double bonds may be present, and may be unsubstituted or substituted. For example, "C2-C6 alkenyl" means an alkenyl radical having 2, 3, 4, 5, or 6 carbon atoms, and up to 1, 2, 3, 4, or 5 carbon-carbon double bonds respectively. Alkenyl groups include ethenyl, propenyl, butenyl and cyclohexenyl . As used herein, "heteroalkyl" includes both branched and straight-chain saturated aliphatic hydrocarbon groups having at least 1 heteroatom within the chain or branch.
As used herein, "cycloalkyl" includes cyclic rings of alkanes of three to eight total carbon atoms, or any number within this range (i.e., cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl or cyclooctyl ) .
As used herein, "heterocycloalkyl" is intended to mean a 5- to 10- membered nonaromatic ring containing from 1 to 4 heteroatoms selected from the group consisting of 0, N and S, and includes bicyclic groups. "Heterocyclyl" therefore includes, but is not limited to the following: imidazolyl, piperazinyl, piperidinyl, pyrrolidinyl , morpholinyl, thiomorpholinyl , tetrahydropyranyl, dihydropiperidinyl , tetrahydrothiophenyl and the like. If the heterocycle contains nitrogen, it is understood that the corresponding N-oxides thereof are also encompassed by this definition.
As used herein, "aryl" is intended to mean any stable monocyclic, bicyclic or polycyclic carbon ring of up to 10 atoms in each ring, wherein at least one ring is aromatic, and may be unsubstituted or substituted. Examples of such aryl elements include but are not limited to: phenyl, p-toluenyl ( 4 -methylphenyl ) , naphthyl, tetrahydro- naphthyl, indanyl, phenanthryl, anthryl or acenaphthyl . In cases where the aryl substituent is bicyclic and one ring is non-aromatic, it is understood that attachment is via the aromatic ring.
The term "alkylaryl" refers to alkyl groups as described above wherein one or more bonds to hydrogen contained therein are replaced by a bond to an aryl group as described above. It is understood that an "alkylaryl" group is connected to a core molecule through a bond from the alkyl group and that the aryl group acts as a substituent on the alkyl group. Examples of arylalkyl moieties include, but are not limited to, benzyl (phenylmethyl ) , p-trifluoromethylbenzyl (4- trifluoromethylphenylmethyl ) , 1-phenylethyl , 2-phenylethyl , 3- phenylpropyl , 2-phenylpropyl and the like.
The term "heteroaryl" as used herein, represents a stable monocyclic, bicyclic or polycyclic ring of up to 10 atoms in each ring, wherein at least one ring is aromatic and contains from 1 to 4 heteroatoms selected from the group consisting of 0, N and S. Bicyclic aromatic heteroaryl groups include but are not limited to phenyl, pyridine, pyrimidine or pyridizine rings that are (a) fused to a 6-membered aromatic (unsaturated) heterocyclic ring having one nitrogen atom; (b) fused to a 5- or 6-membered aromatic (unsaturated) heterocyclic ring having two nitrogen atoms; (c) fused to a 5-membered aromatic (unsaturated) heterocyclic ring having one nitrogen atom together with either one oxygen or one sulfur atom; or (d) fused to a 5-membered aromatic (unsaturated) heterocyclic ring having one heteroatom selected from O, N or S . Heteroaryl groups within the scope of this definition include but are not limited to: benzoimidazolyl , benzofuranyl, benzofurazanyl , benzopyrazolyl , benzotriazolyl , benzothiophenyl , benzoxazolyl , carbazolyl, carbolinyl, cinnolinyl, furanyl, indolinyl, indolyl, indolazinyl, indazolyl, isobenzofuranyl , isoindolyl, isoquinolyl, isothiazolyl , isoxazolyl, naphthpyridinyl , oxadiazolyl, oxazolyl, oxazoline, isoxazoline, oxetanyl, pyranyl, pyrazinyl, pyrazolyl, pyridazinyl, pyridopyridinyl , pyridazinyl, pyridyl, pyrimidyl, pyrrolyl, quinazolinyl, quinolyl, quinoxalinyl , tetrazolyl, tetrazolopyridyl , thiadiazolyl, thiazolyl, thienyl, triazolyl, azetidinyl, aziridinyl, 1 , 4-dioxanyl , hexahydroazepinyl , dihydrobenzoimidazolyl , dihydrobenzofuranyl , dihydrobenzothiophenyl , dihydrobenzoxa zolyl , dihydrofuranyl , dihydroimidazolyl , dihydroindolyl , dihydroisooxa zolyl, dihydroisothiazolyl , dihydrooxadiazolyl , dihydrooxazolyl , dihydropyrazinyl , dihydropyrazolyl , dihydropyridinyl , dihydropyrimidinyl , dihydropyrrolyl , dihydroquinolinyl , dihydrotetrazolyl , dihydrothiadiazolyl, dihydrothiazolyl , dihydrothienyl , dihydrotriazolyl , dihydroazetidinyl , methylenedioxybenzoyl , tetrahydrofuranyl , tetrahydrothienyl , acridinyl , carbazolyl , cinnolinyl, quinoxalinyl, pyrrazolyl, indolyl , benzotriazolyl , benzothiazolyl , benzoxazolyl , isoxazolyl, isothiazolyl, furanyl, thienyl, benzothienyl, benzofuranyl , quinolinyl, isoquinolinyl, oxazolyl, isoxazolyl, indolyl, pyrazinyl, pyridazinyl, pyridinyl, pyrimidinyl, pyrrolyl, tetra-hydroquinoline . In cases where the heteroaryl substituent is bicyclic and one ring is non-aromatic or contains no heteroatoms, it is understood that attachment is via the aromatic ring or via the heteroatom containing ring, respectively. If the heteroaryl contains nitrogen atoms, it is understood that the corresponding N-oxides thereof are also encompassed by this definition. As used herein, "monocycle" includes any stable polycyclic carbon ring of up to 10 atoms and may be unsubstituted or substituted. Examples of such non-aromatic monocycle elements include but are not limited to: cyclobutyl, cyclopentyl, cyclohexyl, and cycloheptyl. Examples of such aromatic monocycle elements include but are not limited to: phenyl. As used herein, "heteromonocycle" includes any monocycle containing at least one heteroatom.
As used herein, "bicycle" includes any stable polycyclic carbon ring of up to 10 atoms that is fused to a polycyclic carbon ring of up to 10 atoms with each ring being independently unsubstituted or substituted. Examples of such non-aromatic bicycle elements include but are not limited to: decahydronaphthalene . Examples of such aromatic bicycle elements include but are not limited to: naphthalene. As used herein, "heterobicycle" includes any bicycle containing at least one heteroatom.
The compounds used in the method of the present invention may be prepared by techniques well known in organic synthesis and familiar to a practitioner ordinarily skilled in the art. However, these may not be the only means by which to synthesize or obtain the desired compounds .
The compounds of present invention may be prepared by techniques described in Vogel's Textbook of Practical Organic Chemistry, A. I. Vogel, A. R . Tatchell, B.S. E’urnis, A.J. Hannaford, P.W.G. Smith, (Prentice Hall) 5th Edition (1996), March's Advanced Organic Chemistry: Reactions, Mechanisms, and Structure, Michael B. Smith, Jerry March, (Wiley-Interscience) 5th Edition (2007), and references therein, which are incorporated by reference herein. However, these may not be the only means by which to synthesize or obtain the desired compounds.
The compounds of the present invention may be prepared by techniques described herein. The synthetic methods used to prepare the compounds of Examples 1 may be used to prepare additional compounds.
The various R groups attached to the aromatic rings of the compounds disclosed herein may be added to the rings by standard procedures, for example, those set forth in Advanced Organic Chemistry: Part B: Reaction and Synthesis, Francis Carey and Richard Sundberg, (Springer) 5th ed. Edition. (2007), the content of which is hereby incorporated by reference.
Another aspect of the invention comprises a compound of the present invention as a pharmaceutical composition.
As used herein, the term "pharmaceutically active agent" means any substance or compound suitable for administration to a subject and furnishes biological activity or other direct effect in the treatment, cure, mitigation, diagnosis, or prevention of disease, or affects the structure or any function of the subject. Pharmaceutically active agents include, but are not limited to, substances and compounds described in the Physicians' Desk Reference (PDR Network, LLC; 64th edition; November 15, 2009) and "Approved Drug Products with Therapeutic Equivalence Evaluations" (U.S. Department Of Health And Human Services, 30th edition, 2010), which are hereby incorporated by reference. Pharmaceutically active agents which have pendant carboxylic acid groups may be modified in accordance with the present invention using standard esterification reactions and methods readily available and known to those having ordinary skill in the art of chemical synthesis. Where a pharmaceutically active agent does not possess a carboxylic acid group, the ordinarily skilled artisan will be able to design and incorporate a carboxylic acid group into the pharmaceutically active agent where esterification may subsequently be carried out so long as the modification does not interfere with the pharmaceutically active agent's biological activity or effect.
The compounds of the present invention may be in a salt form. As used herein, a "salt" is a salt of the instant compounds which has been modified by making acid or base salts of the compounds. In the case of compounds used to treat a disease, the salt is pharmaceutically acceptable. Examples of pharmaceutically acceptable salts include, but are not limited to, mineral or organic acid salts of basic residues such as amines; alkali or organic salts of acidic residues such as phenols. The salts can be made using an organic or inorganic acid. Such acid salts are chlorides, bromides, sulfates, nitrates, phosphates, sulfonates, formates, tartrates, maleates, malates, citrates, benzoates, salicylates, ascorbates, and the like . Phenolate salts are the alkaline earth metal salts, sodium, potassium or lithium. The term "pharmaceutically acceptable salt" in this respect, refers to the relatively non-toxic, inorganic and organic acid or base addition salts of compounds of the present invention. These salts can be prepared in situ during the final isolation and purification of the compounds of the invention, or by separately treating a purified compound of the invention in its free base or free acid form with a suitable organic or inorganic acid or base, 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, napthylate, mesylate, glucoheptonate , lactobionate, and laurylsulphonate salts and the like. (See, e.g., Berge et al. (1977) "Pharmaceutical Salts", J. Pharrri. Sci. 66:1-19) .
Aa salt or pharmaceutically acceptable salt is contemplated for all compounds disclosed herein. As used herein, "treating" means preventing, slowing, halting, or reversing the progression of a disease or infection. Treating may also mean improving one or more symptoms of a disease or infection.
The compounds of the present invention may be administered in various forms, including those detailed herein. The treatment with the compound may be a component of a combination therapy or an adjunct therapy, i.e., the subject or patient in need of the drug is treated or given another drug for the disease in conjunction with one or more of the instant compounds. This combination therapy can be a sequential therapy where the patient is treated first with one drug and then the other or the two drugs are given simultaneously. These can be administered independently by the same route or by two or more different routes of administration depending on the dosage forms employed .
As used herein, a "pharmaceutically acceptable carrier" is a pharmaceutically acceptable solvent, suspending agent or vehicle, for delivering the instant compounds to the animal or human. The carrier may be liquid or solid and is selected with the planned manner of administration in mind. Liposomes are also a pharmaceutically acceptable carrier.
The dosage of the compounds administered in treatment will vary depending upon factors such as the pharmacodynamic characteristics of a specific chemotherapeutic agent and its mode and route of administration; the age, sex, metabolic rate, absorptive efficiency, health and weight of the recipient; the nature and extent of the symptoms; the kind of concurrent treatment being administered; the frequency of treatment with; and the desired therapeutic effect.
A dosage unit of the compounds used in the method of the present invention may comprise a single compound or mixtures thereof with additional agents. The compounds can be administered in oral dosage forms as tablets, capsules, pills, powders, granules, elixirs, tinctures, suspensions, syrups, and emulsions. The compounds may also be administered in intravenous (bolus or infusion), intraperitoneal , subcutaneous, or intramuscular form, or introduced directly, e.g. by injection, topical application, or other methods, into or onto a site of infection, all using dosage forms well known to those of ordinary skill in the pharmaceutical arts.
The compounds used in the method of the present invention can be administered in admixture with suitable pharmaceutical diluents, extenders, excipients, or carriers (collectively referred to herein as a pharmaceutically acceptable carrier) suitably selected with respect to the intended form of administration and as consistent with conventional pharmaceutical practices. The unit will be in a form suitable for oral, rectal, topical, intravenous or direct injection or parenteral administration. The compounds can be administered alone or mixed with a pharmaceutically acceptable carrier. This carrier can be a solid or liquid, and the type of carrier is generally chosen based on the type of administration being used. The active agent can be co-administered in the form of a tablet or capsule, liposome, as an agglomerated powder or in a liquid form. Examples of suitable solid carriers include lactose, sucrose, gelatin and agar. Capsule or tablets can be easily formulated and can be made easy to swallow or chew; other solid forms include granules, and bulk powders. Tablets may contain suitable binders, lubricants, diluents, disintegrating agents, coloring agents, flavoring agents, flow-inducing agents, and melting agents. Examples of suitable liquid dosage forms include solutions or suspensions in water, pharmaceutically acceptable fats and oils, alcohols or other organic solvents, including esters, emulsions, syrups or elixirs, suspensions, solutions and/or suspensions reconstituted from non-effervescent granules and effervescent preparations reconstituted from effervescent granules. Such liquid dosage forms may contain, for example, suitable solvents, preservatives, emulsifying agents, suspending agents, diluents, sweeteners, thickeners, and melting agents. Oral dosage forms optionally contain flavorants and coloring agents. Parenteral and intravenous forms may also include minerals and other materials to make them compatible with the type of injection or delivery system chosen.
Techniques and compositions for making dosage forms useful in the present invention are described in the following references: 7 Modern Pharmaceutics, Chapters 9 and 10 (Banker & Rhodes, Editors, 1979) ; Pharmaceutical Dosage Forms: Tablets (Lieberman et al., 1981); Ansel, Introduction to Pharmaceutical Dosage Forms 2nd Edition (1976); Remington's Pharmaceutical Sciences, 17th ed. (Mack Publishing Company, Easton, Pa., 1985); Advances in Pharmaceutical Sciences (David Ganderton, Trevor Jones, Eds., 1992); Advances in Pharmaceutical Sciences Vol . 7. (David Ganderton, Trevor Jones, James McGinity, Eds., 1995); Aqueous Polymeric Coatings for Pharmaceutical Dosage Forms (Drugs and the Pharmaceutical Sciences, Series 36 (James McGinity, Ed., 1989); Pharmaceutical Particulate Carriers: Therapeutic Applications: Drugs and the Pharmaceutical Sciences, Vol 61 (Alain Rolland, Ed., 1993); Drug Delivery to the Gastrointestinal Tract (Ellis Horwood Books in the Biological Sciences. Series in Pharmaceutical Technology; J. G. Hardy, S. S. Davis, Clive G. Wilson, Eds.); Modem Pharmaceutics Drugs and the Pharmaceutical Sciences, Vol 40 (Gilbert S. Banker, Christopher T. Rhodes, Eds.). All of the aforementioned publications are incorporated by reference herein.
Tablets may contain suitable binders, lubricants, disintegrating agents, coloring agents, flavoring agents, flow-inducing agents, and melting agents. For instance, for oral administration in the dosage unit form of a tablet or capsule, the active drug component can be combined with an oral, non-toxic, pharmaceutically acceptable, inert carrier such as lactose, gelatin, agar, starch, sucrose, glucose, methyl cellulose, magnesium stearate, dicalcium phosphate, calcium sulfate, mannitol, sorbitol and the like. Suitable binders include starch, gelatin, natural sugars such as glucose or beta-lactose, corn sweeteners, natural and synthetic gums such as acacia, tragacanth, or sodium alginate, carboxymethylcellulose, polyethylene glycol, waxes, and the like. Lubricants used in these dosage forms include sodium oleate, sodium stearate, magnesium stearate, sodium benzoate, sodium acetate, sodium chloride, and the like. Disintegrators include, without limitation, starch, methyl cellulose, agar, bentonite, xanthan gum, and the like.
The compounds used in the method of the present invention may also be administered in the form of liposome delivery systems, such as small unilamellar vesicles, large unilamellar vesicles, and multilamellar vesicles. Liposomes can be formed from a variety of phospholipids, such as cholesterol, stearylamine , or phosphatidylcholines. The compounds may be administered as components of tissue-targeted emulsions .
The compounds used in the method of the present invention may also be coupled to soluble polymers as targetable drug carriers or as a prodrug. Such polymers include polyvinylpyrrolidone, pyran copolymer, polyhydroxylpropylmethacrylamide-phenol, polyhydroxyethylasparta- midephenol, or polyethyleneoxide-polylysine substituted with palmitoyl residues. Furthermore, the compounds may be coupled to a class of biodegradable polymers useful in achieving controlled release of a drug, for example, polylactic acid, polyglycolic acid, copolymers of polylactic and polyglycolic acid, polyepsilon caprolactone , polyhydroxy butyric acid, polyorthoesters, polyacetals, polydihydropyrans , polycyanoacylates , and crosslinked or amphipathic block copolymers of hydrogels.
Gelatin capsules may contain the active ingredient compounds and powdered carriers, such as lactose, starch, cellulose derivatives, magnesium stearate, stearic acid, and the like. Similar diluents can be used to make compressed tablets. Both tablets and capsules can be manufactured as immediate release products or as sustained release products to provide for continuous release of medication over a period of hours. Compressed tablets can be sugar coated or film coated to mask any unpleasant taste and protect the tablet from the atmosphere, or enteric coated for selective disintegration in the gastrointestinal tract . For oral administration in liquid dosage form, the oral drug components are combined with any oral, non-toxic, pharmaceutically acceptable inert carrier such as ethanol, glycerol, water, and the like. Examples of suitable liquid dosage forms include solutions or suspensions in water, pharmaceutically acceptable fats and oils, alcohols or other organic solvents, including esters, emulsions, syrups or elixirs, suspensions, solutions and/or suspensions reconstituted from non-effervescent granules and effervescent preparations reconstituted from effervescent granules. Such liquid dosage forms may contain, for example, suitable solvents, preservatives, emulsifying agents, suspending agents, diluents, sweeteners, thickeners, and melting agents.
Liquid dosage forms for oral administration can contain coloring and flavoring to increase patient acceptance. In general, water, a suitable oil, saline, aqueous dextrose (glucose), and related sugar solutions and glycols such as propylene glycol or polyethylene glycols are suitable carriers for parenteral solutions. Solutions for parenteral administration preferably contain a water-soluble salt of the active ingredient, suitable stabilizing agents, and if necessary, buffer substances. Antioxidizing agents such as sodium bisulfite, sodium sulfite, or ascorbic acid, either alone or combined, are suitable stabilizing agents. Also used are citric acid and its salts and sodium EDTA. In addition, parenteral solutions can contain preservatives, such as benzalkonium chloride, methyl- or propyl paraben, and chlorobutanol . Suitable pharmaceutical carriers are described in Remington's Pharmaceutical Sciences, Mack Publishing Company, a standard reference text in this field.
The compounds used in the method of the present invention may also be administered in intranasal form via use of suitable intranasal vehicles, or via transdermal routes, using those forms of transdermal skin patches well known to those of ordinary skill in that art. To be administered in the form of a transdermal delivery system, the dosage administration will generally be continuous rather than intermittent throughout the dosage regimen. Parenteral and intravenous forms may also include minerals and other materials to make them compatible with the 'type of injection or delivery system chosen.
Each embodiment disclosed herein is contemplated as being applicable to each of the other disclosed embodiments. Thus, all combinations of the various elements described herein are within the scope of the invention.
This invention will be better understood by reference to the Experimental Details which follow, but those skilled in the art will readily appreciate that the specific experiments detailed are only illustrative of the invention as described more fully in the claims which follow thereafter.
Experimental Details
Materials and Methods
TR-FRET assay for retinol-induced RBP4-TTR interaction
Binding of a desired RBP4 antagonist displaces retinol and induces hindrance for RBP4-TTR interaction resulting in the decreased FRET signal (Fig. 7) . Bacterially expressed MBP-RBP4 and untagged TTR were used in this assay. For the use in the TR-FRET assay, the maltose binding protein (MBP) -tagged human RBP4 fragment (amino acids 19-201) was expressed in the Gold ( DE3 ) pLysS E. coli strain (Stratagene) using the pMAL-c4x vector. Following cell lysis, recombinant RBP4 was purified from the soluble fraction using the ACTA FPLC system (GE Healthcare) equipped with the 5-ml the MBP Trap HP column. Human untagged TTR was purchased from Calbiochem. Untagged TTR was labeled directly with Eu3+ Cryptate-NHS using the HTRF Cryptate Labeling kit from CisBio following the manufacturer's recommendations. HTRF assay was performed in white low volume 384 well plates (Greiner- Bio) in a final assay volume of 16 mΐ per well. The reaction buffer contained 10 mM Tris-HCl pH 7.5, 1 mM DTT, 0.05% NP-40, 0.05% Prionex, 6% glycerol, and 400 mM KF. Each reaction contained 60 nM MBP-RBP4 and 2 nM TTR-Eu along with 26.7nM of anti-MBP antibody conjugated with d2 (Cisbio) . Titration of test compounds in this assay was conducted in the presence of 1 mM retinol. All reactions were assembled in the dark under dim red light and incubated overnight at +4°C wrapped in aluminum foil. TR-FRET signal was measured in the SpectraMax M5e Multimode Plate Reader (Molecular Device) . Fluorescence was excited at 337 nm and two readings per well were taken: Reading 1 for time gated energy transfer from Eu(K) to d2 (337 nm excitation, 668 nm emission, counting delay 75 microseconds, counting window 100 microseconds) and Reading 2 for Eu(K) time-gated fluorescence (337 nm excitation, 620 nm emission, counting delay 400 microseconds, counting window 400 microseconds) . The TR-FRET signal was expressed as the ratio of fluorescence intensity: Flu66s/Flue2o x 10,000. Scintillation proximity RBP4 binding assay
Untagged human RBP4 purified from the urine of tubular proteinuria patients was purchased from Fitzgerald Industries International. It was biotinylated using the EZ-Link Sulfo-NHS-LC-Biotinylation kit from Pierce following the manufacturer's recommendations. Binding experiments were performed in 96-well plates (OptiPlate, PerkinElmer) in a final assay volume of 100 mΐ per well in SPA buffer (IX PBS, pH 7.4, ImM EDTA, 0.1%BSA, 0.5%CHAPS) . The reaction mix contained 10 nM 3H-Retinol ( 48.7Ci /mmol ; PerkinElmer) , 0.3 mg/well Streptavidin-PVT beads, 50 nM biotinylated RBP4 and a test compound. Nonspecific binding was determined in the presence of 20 mM of unlabeled retinol. The reaction mix was assembled in the dark under dim red light. The plates were sealed with clear tape (TopSeal-Ά: 96-well microplate, PerkinElmer) , wrapped in the aluminum foil, and allowed to equilibrate 6 hours at room temperature followed by overnight incubation at +4°C. Radiocounts were measured using a TopCount NXT counter (Packard Instrument Company) .
PPARy agonist assay
Significant safety issues are associated with the clinical use of PPARy agonists (increased risk of death, myocardial infarction, stroke, congestive heart failure, hepatotoxicity , peripheral edema, weight gain and carcinogenicity1 4) . We wanted to characterize the compounds we identified in a pilot screen as potential PPARy agonists. The PPARy assay is based on agonist-sensitive interaction of the GST- tagged ligand-binding domain (LBD) of the nuclear receptor PPARy with the biotinylated corepressor NCOR peptide (Fig. 8) .
The following reagents were used for the PPARy agonist assay implementation:
1. GST-PPARy_LBD :
Bacterially expressed protein fragment. For bacterial expression, ligand-binding domain of PPARy (amino acids 176-477, GenBank accession number NP 005028) was subcloned into the Sall-Notl sites of pGEX-6p- 3 vector. After the introduction of expression plasmid to the BL21- Gold ( DE3 ) pLysS E.coli strain (Stratagene) recombinant protein (GST- tagged PPARy-LBD) was purified from 1 L cultures using AKTA FPLC system (GE Healthcare) equipped with 5-ml GST Trap HP.
2. Biotinylated NCOR2 peptide :
Biotin-Ahx ( aminohexanoic acid) -ADPASNLGLEDI IRKALMGSF-NH2
1 mM stock in DMSO
3. Eu (K) -anti-GST Ab: Eu3+ Cryptate conjugated mouse monoclonal antibody anti-glutathione S-transferase from Cisbio (Cat no. 61GSTKLA) - 320 nM, reconstituted in water
4. Streptavidin-XL665 : XL665-conj ugated streptavidin from Cisbio (Cat no. 610SAXLA) - 20 uM, reconstituted in water
5. Rosiglitazone (positive control) .
Cayman Chemicals Cat # 71740. 20 mM stock in DMSO.
DMSO: Hybri-Max grade, Sigma cat # D2650
Buffers :
6. 5x HTRF buffer: 50 mM Tris-HCl pH 7.5; 5 mM DTT ; 0.25% NP-40;
0.25% BSA; 30% glycerol.
7. 4M KF solution.
Made from potassium fluoride powder, Fluka cat # 60238
Assay reactions are performed in a final volume of 16 ul . Final concentrations of components are: GST- PPARy, 7nM; NCOR2 peptide, 300 nM; Rosiglitazone (positive control), 20 mM. Working solution was made containing lx HTRF buffer and 100 mM KF (lx, 100) . The following three reagent solutions were prepared: PPARy: 18.7 nM PPARg in lx, 100
NCOR2 : 1200 nM NCOR2 in lx, 100
Rosiglitazone (positive control): 80 uM in lx, 100
In well of the 384-well assay plate, mix 6 ul of PPARy solution, 4 ul of NCOR2 solution and 4 mΐ of Rosi solution. Test compounds diluted from DMSO stocks to 4x assay concentration in lx HTRF, 100 mM KF buffer may be dispensed to well instead of Rosi. Negative control wells contained DMSO solvent alone; positive control well contained 10 uM biotin. Detection mix containing 6 nM of Eu ( K) -anti-GST Ab and 336 nM of Streptavidin-XL665 was prepared in lxHTRF, 100 mM KF assay buffer. Two mΐ of detection mix was added per well. Final concentrations of assay components in a 16-ul reaction mix are: 7 nM GST-PPARy__LBD, 300 nM NCOR2 , 0.75 nM Eu (K) -anti-GST Ab, 42 nM
Streptavidin-XL665, 20 uM Rosiglitazone or test compounds. The plate was incubated for 16 hrs at 4°C.
HTRF signal was measured in the SpectraMax M5e Multimode Plate Reader (Molecular Device) . Fluorescence was excited at 337 nm. Two readings per well were taken: Reading 1 for time-gated energy transfer from Eu (K) to XL665 (337 nm excitation, 668 nm emission, counting delay 50 microseconds, counting window 400 microseconds) and Reading 2 for Eu(K) time-gated fluorescence (337 nm excitation, 620 nm emission, counting delay 50 microseconds, counting window 400 microseconds). The signal was expressed as the ratio of fluorescence intensity:
Figure imgf000053_0001
10,000.
Pharmacodynamic studies of 7a and 7p in Balb/c mice following a single oral administration
Animal protocols were approved by the Institutional Animal Care and Use Committee of Columbia University and complied with guidelines set forth by The Association for Research in Vision and Ophthalmology. Compounds were prepared as a suspension in 0.9% NaCl, 2% Tween 80 for oral administration. Compounds were administered to Balb/c mice in a volume of 100 pL through oral gavage . The doses used were 15 mg/kg, 25 mg/kg and 35 mg/kg for 7a while two doses, 25 mg/kg and 35 mg/kg, were tested for DENG-31 ( FFB-0000082 ) . Blood samples were collected at pre-dose and 1 hr, 2hr, 4 hr, 6 hr, 8 hr, and 24 hr timepoints. Whole blood was drawn into a centrifuge tube and was let clot at room temperature for 30 min followed by centrifugation at 2,000 x g for 15 minutes at +4°C to collect serum. Serum RBP4 was measured using the RBP4 (mouse/rat) dual ELISA kit (AdipoGen) following the manufacturer's instructions.
Effect of 7a on accumulation of N-retinylidene-N-retinylethanolamine (A2E) in eyes of the Abca4/~ mice
Animal protocols were approved by the Institutional Animal Care and Use Committee of Columbia University and complied with guidelines set forth by The Association for Research in Vision and Ophthalmology. Ten week-old Abca4 null mutant mice (129/SV x C57BL/6J) bred as previously described26 ' 27 were used in the study. Abca4~7~ (knockout) and C57BL/6J (wild-type control) mice were raised under 12 h on-off cyclic lighting with an in-cage illuminance of 30-50 lux. For long term oral dosing 7a was formulated into Purina’ 5035 rodent chow at Research Diets, Inc. (New Brunswick, NJ) to ensure consistent 35 mg/kg daily oral dosing. Animals were administered the AKR-XI-85 -containing chow for 8 weeks. Blood samples were collected at baseline and at the end of the dosing period for serum RBP4 measurements. Whole blood was drawn into a centrifuge tube and was let clot at room temperature for 30 min followed by centrifugation at 2,000 x g for 15 minutes at +4°C to collect serum. Serum RBP4 was measured using the RBP4 (mouse/rat) dual ELISA kit (AdipoGen) following the manufacturer's instructions.
After the completion of dosing, animals were euthanized and posterior eyecups consisting of sclera, choroid and RPE were prepared from enucleated eyes according to the standard techniques. Eyecups were combined in pools and shipped on dry ice to EyeCRO LLC, Oklahoma City, OK for the Ά2E analysis. A previously established HPLC method (Journal of Biological Chemistry, 275, 29354-29360) was utilized for quantifying A2E in mouse eyecups. Quantitation of A2E was conducted by manually integrating the A2E peak (approximately 12-min elution time) which was identified by the co-elution with the synthetic A2E standard and by characteristic absorbance spectrum. Calibration was conducted using the known amounts of synthetic A2E. All samples were processed at EyeCRO in a masked manner.
Example 1. Synthesis of Compounds
Figure imgf000055_0001
Scheme 1. General synthetic pathway
General Procedure :
Step 1: Lithium bis (trimethylsilyl ) amide (LiHMDS) was added via syringe to a yellow-orange solution of terfc-butyl-5- oxooctahydrocyclopenta [ c] pyrrole-2-carboxylate (1) (1.4 M) in anhydrous tetrahydrofuran (THF) , stirred at -78 °C. The reaction mixture was stirred at -78 °C for lh 45 min, after which a solution of N-phenyltrifluoromethanesul fonimide (0.9 M) in anhydrous THF was added portionwise. The reaction mixture was stirred at -78 °C for another 2 h, after which it was allowed to warm to room temperature. It was concentrated in vacuo and purified via normal phase silica gel column chromatography (0 % to 15 % ethyl acetate in hexanes). Step 2: Compound 2 (0.04 M) (1 equiv) and the respective boronic acid (2.5 equiv) were stirred in a 1:2 mixture of 2 M aqueous sodium carbonate and 1 , 2-dimethoxyethane . The reaction mixture was evacuated and purqed with argon. Tetrakis ( triphenylphosphine ) palladium ( 0 ) (0.1 equiv) was added, and, the reaction mixture was evacuated and purged with argon. It was heated to and stirred at 80 °C for 6 h, after which it was allowed to cool to room temperature. Ethyl acetate was added and the reaction mixture was concentrated in vacuo. An additional volume of ethyl acetate was added. The organic and aqueous layers were separated. The organic layer was washed with brine (2x) and dried with anhydrous sodium sulfate. The solvent was evaporated in vacuo. The resulting crude material was purified via normal phase silica gel column chromatography (hexanes followed by 20 % ethyl acetate in hexanes followed by ethyl acetate) .
Step 3: Compound 3 (0.5 M) was stirred in methanol. .The reaction mixture was evacuated and purged with argon. 10 % Palladium on carbon was added. The reaction mixture was evacuated and purged with argon. Then it was evacuated and purged three times with hydrogen, after which a steady stream of hydrogen was allowed to pass through the reaction mixture. The reaction mixture was stirred overnight, then filtered through a celite pad with methanol. The filtrate was concentrated in vacuo. The resulting crude material was carried on to the next step.
Step 4: Compound 4 (0.7 M) (1 equiv) was stirred in methylene chloride at 0 °C. A 2-M solution of HC1 in diethyl ether (5.6 equiv) was added portionwise. The reaction mixture was allowed to warm to room temperature and was stirred overnight. Subsequent addition of diethyl ether resulted in the formation of a precipitate, which was isolated via vacuum filtration.
Step 5: The hydrochloric acid salt , 5, (0.14 M) (1 equiv) , the respective carboxylic acid (1 equiv) , and (benzotriazol-1- yloxy) tris (dimethylamino) phosphoniu hexafluorophosphate (BOP) (1.5 equiv) were stirred in anhydrous DMF at room temperature. Diisopropylethylamine (3.0 equiv) was added via syringe. The reaction mixture was stirred overnight, after which distilled water was added. The resulting precipitate was isolated via vacuum filtration.
Figure imgf000057_0001
7a : Off-white solid; Yield: 87 %; 1H NMR (400 MHz, (CDC13) ) : d 8.95 (d, J= 6.8 Hz, 1H), 8.92 (dd, J= 3.6, 1.6 Hz, 1H) , 7.60 (d, J = 8.0 Hz, 1H), 7.51 (d, J = 6.0 Hz, 2H), 7.28 (d, J= 7.2 Hz, 1H) , 7.24 (dd, J = 6.8, 4.8 Hz, 1H), 4.17 (s, 2H), 3.93 (d, J= 5.6 Hz, 2H) , 3.56- 3.50 (m, 1H) , 2.95-2.88 (m, 2H), 2.37 (doublet of pentets, J = 37.6, 6.8 Hz, 2H ) , 1.69-1.57 (m, 2H) ; 13C NMR (101 MHz, (CDC13 ) ) : d 161.6, 159.4, 155.7, 155.0, 142.9, 136.5, 132.3, 128.0 (2C), 126.2 , 125.8
( 2C) , 111.5, 54.2, 52.6, 44.1, 43.0, 41.6, 41.4, 41.1; LC-MS (M++H) : 402; EI+ HRMS (m/ z) : [M]+ calcd. for C20H18N5OF3: 401.14635, Found :
401.14615.
Figure imgf000057_0002
7b : Off-white solid; Yield: 72 %; 1H NMR (400 MHz, (CDC13 ) ) : d 8.95 (dd, J = 6.8, 2.0 Hz, 1H) , 8.92 (dd, J= 4.4, 2.0 Hz, 1H) , 7.60 (d, J - 8.0 Hz, 1H), 7.51 (d, J= 6.8 Hz, 2H) , 7.30-7.27 (m, 1H) , 7.23 (dd, J = 7.2, 4.4 Hz , 1H) 4.18-4.17 (m, 2H), 3.93 (d, J = 6.0 Hz, 1H), 3.56-3.49 (m, 1H), 2.95-2.86 (m, 2H), 2.37 (doublet of pentets, J =
36.8, 7.2 Hz, 2H ) , 1.69-1.57 (m, 3H) ; 13C NMR (101 MHz, (CDC13) ) : d
161.6, 159.4, 155.7 (2C), 136.5 (2C), 132.2, 128.0 (2C), 126.2 (3C), 111.5, 54.2, 52.6, 44.2, 43.0, 41.6, 41.4, 41.2; LC-MS (M++H) : 402; EI+ HRMS (m/ z) : [M]+ ealcd. for C20H18N5OF3: 401.14635, Found:
401.14542.
Figure imgf000058_0001
7c : Orange solid; Yield: 78 %; 1H NMR (400 MHz, (CDC13 ) ) : d 9.05 (d, J = 2.4 Hz, 1H), 8.91 (d, J = 2.4 Hz, 1H) , 7.61 (d, J = 7.2 Hz, 1H), 7.52 (s, 2H ) , 7.31-7.28 (m, 1H) , 4.14 (d, J = 5.6 Hz, 1H) , 3.93 (d,
J = 5.6 Hz, 1H), 3.55-3.49 (m, 1H) , 2.96-2.86 (m, 2H) , 2.62 (d, J = 8.8 Hz, 1H) , 2.37 (doublet of pentets, J = 36.4, 7.2 Hz, 2H), 1.69- 1.56 (m, 3H ) ; LC-MS (M++H) : 480; EI+ HRMS (m/z) : [M] + calcd. for C20H17N5OBrF3: 479.05686, Found: 479.05726.
Figure imgf000058_0002
7d : Pale-pink solid; Yield: 98 %; 1H NMR (400 MHz , (CDC13) ) : d 8.77 (d, J = 4.8 Hz, 1H), 7.60 (d, J = 7.6 Hz, 1H), 7. 54 (d, J = 8.0 Hz, 1H), 7.50 (d, J - 8.0 Hz, 1H) , 7.28 (d, J= 7.6 Hz, 1H) , 7.04 (d, J = 3.6 Hz, 1H), 4.14 (d, J = 5.6 Hz, 2H), 3.93 (d, J= 5.6 Hz, 2H) , 3.57-
3.48 (m, 1H), 2.94 (s, 3H) , 2.92-2.86 (m, 2H) , 2.36 (doublet of pentets, J = 41.2, 6.4 Hz, 2H), 1.69-1.58 (m, 2H); 13C NMR (101 MHz, (CDC13 ) ) : d 161.0, 154.9 (2C), 132.2 (2C) , 128.0 ( 2C ) , 126.2 ( 2C ) ,
125.8 ( 2C ) , 111.0, 54.2, 52.5, 44.1, 43.0, 41.7, 41.5, 41.1, 17.6; LC-MS (M++H) : 416; EI+ HRMS (m/z) : [M]+ calcd. for C21H20N5OF3:
415.16200, Found: 415.16092.
Figure imgf000059_0001
7e : Pale-orange solid; Yield: 89 %; 1H NMR (400 MHz, (CDC13) ) : 5 8.77
(d, J = 2.4 Hz, 1H) , 8.70 (s, 1H) , 7.60 (d, J = 8.0 Hz, 1H), 7.53-
7.46 (m, 2H ) , 7.28 (d, J= 7.6 Hz, 1H) , 4.21-4.12 (m, 2H), 3.92 (d, J = 5.6 Hz, 2H) , 3.57-3.48 (m, 1H) , 2.95-2.83 (m, 2H) , 2.51 (s , 3H),
2.36 (doublet of pentets, J = 36.0, 6.8 Hz, 2H) , 1.68-1.56 (m , 2H) ;
13C NMR (101 MHz, (CDC13 ) ) : 5161.1, 159.6, 158.0, 153.9, 142.9, 134.2, 132.2, 128.0, 126.2, 125.9, 125.8, 125.7, 121.8, 54.2, 52.6, 44.2,
43.0, 41.6, 41.4, 41.1, 15.6; LC-MS (M++H) : 416; EI+ HRMS (m/z) : [M] + calcd . for C21H20N5OF3: 415.16200, Found: 415.16163.
Figure imgf000059_0002
7f : Pale-orange solid; Yield: 38 %; 1H NMR (400 MHz, ( CDC13 ) ) : d 7.60
(d, J = 8.0 Hz, 1H) , 7.51 (dd, J = 14.4, 7.6 Hz, 2H), 7.28 (d, J = 7.6 Hz, 1H) , 6.90 (s, 1H), 4.19 (dd, J= 12.4, 3.2 Hz, 1H), 4.13 (dd, J = 12.4, 6.8 Hz, 1H ), 3.92 (d, J = 5.2 Hz, 2H) , 3.55-3.49 (m, 1H) , 2.87 (s, 3H ) , 2.70 (s, 3H) , 2.64 (d, J = 9.6 Hz, 1H) , 2.35 (doublet of pentets, J = 40.0, 6.8 Hz, 2H) , 1.69-1.56 (m, 3H); 13C NMR (101
MHz, (CDC13) ) : 5 165.9, 160.7, 160.0, 147.5 (2C), 132.3, 128.0 (2C), 126.2 ( 2C) , 125.8 (2C) , 111.9, 54.3, 52.5, 44.1, 43.0, 41.7, 41.5, 41.1, 25.3, 17.3; LC-MS (M++H) : 430; EI+ HRMS (m/z): [M] + calcd. for
C22H22N50F3: 429.17765, Found: 429.17711.
Figure imgf000060_0001
7g : Off-white solid; Yield: 70 %; 1H NMR (400 MHz, (CDC13) ) : d 8.77 (d, J = 4.4 Hz, 1H), 7.60 (d, J = 8.0 Hz, 1H), 7.53 (d, J = 8.0 Hz, 1H ) , 7.49 (d, J = 7.6 Hz, 1H) , 7.28 (d, d = 8.0 Hz, 1H), 7.04 (d, J = 4.4 Hz, 1H) , 4.14 (d, J= 5.6 Hz, 2H), 3.93 (d, J= 6.0 Hz, 2H), 3.57-
3.47 (m, 1H), 2.93 (s, 3H) , 2.92-2.83 (m, 2H) , 2.37 (doublet of pentets, J = 41.2, 6.4 Hz, 2H) , 1.69-1.56 (m, 2H) ; 13C NMR (101 MHz,
( CDC13 ) ) : d 160.9, 159.9, 155.2, 155.0, 148.9, 142.9, 132.2, 128.0, 126.2, 125.8 (2C) , 125.7, 123.4, 111.0, 54.2, 44.1, 43.0, 41.6, 41.4, 41.1, 17.5; LC-MS (M++H) : 416.
Figure imgf000060_0002
7h : Tan solid ; Yield: 59 %; 1H NMR (400 MHz, (CDC13) ) : d 8.95 (dd,
J = 4.8, 2.0 Hz , 1H) , 8.92 (dd, J = 3.6, 2.0 Hz, 1H), 7.60 (dd, J = 8.8, 6.0 Hz, 1H), 7.23 (dd, J = 6.8, 4.0 Hz, 1H), 7.19 (d, J = 10.8 Hz, 1H ) , 6.96 (t, J = 6.0 Hz, 1H), 4.18 (d, J = 4.4 Hz, 2H), 3.93 (d,
J = 4.8 Hz, 2H ) , 3.52-3.49 (m, 1H) , 2.94-2.88 (m, 2H) , 2.38 (doublet of pentets, J = 30.8, 6.8 Hz, 2H) , 1.63-1.53 (m, 2H); 13C NMR (101
MHz, (CDC13 ) ) : d 161.5, 159.4, 155.7, 155.0, 136.5, 128.4 , 115.1,
114.9, 113.5, 113.3, 111.5, 54.2, 52.5, 44.0, 43.0,41.6, 41 .4, 41.1; LC-MS (M'+H) : 420.
Figure imgf000061_0001
7i : Tan solid; Yield: 60 %; 1H NMR (400 MHz, ((CD3)zSO): d 8. 94 (s, 1H), 8.83 (s, 1H) , 7.69-7.52 (m, 1H) , 7.21 (d, J = 12.0 Hz, 1H) , 6.95 (s, 1H), 4.18 (s, 2H) , 4.01 (s, 2H) , 3.91 (s, 2H) , 3.51 (s, 1H) , 3.03 (s, 2H ) , 2.90 (s, 2H) , 2.50-2.32 (m, 2H) , 1.41-1.25 (m, 3H) ; LC-MS
(M++H) : 464; EI+ HRMS (m/ z) : [M] + calcd. for C22H21N502F4 : 463.16314,
Found: 463.16196.
Figure imgf000061_0002
7j : 1H NMR (400 MHz, CDG13) : d 8.7 (s, broad , 2H ) , 7.5 (d, 1H), 7.4 (m, 2H ) , 7.2 (m, 1H) , 4.2 (m, 2H) , 4.0 (m, 2H) , 3.9 (m, 2H) , 3.5 (m, 1H), 3.3 (m, 2H ) , 2.9 (m, 2H) , 2.3 (m, 2H) , 1.5 (m, 2H) . MS: 446
(M+l)
Figure imgf000061_0003
7k : 1H NMR (400 MHz, CDC13) : d 8.7 (s, broad , 2H ), 7.5 (d, 1H), 7.4 (m, 2H ) , 7.2 (m, 1H), 4.1 (m, 4H) , 3.8 (m, 2H) , 3.6 (m) , 3.4 (s, 3H),
3.3 (m, 2H), 2.9 (m, 2H) , 2.3 (m, 2H) , 1.5 (m) . MS: 460 (M+l)
Figure imgf000062_0001
7n : 1H NMR (400 MHz, CDC13 ) : d 8.7 (s, broad , 2H ), 7.5 (d, 1H), 7.4 (m, 2H), 7.2 (m, 1H), 4.1 (m, 4H), 3.8 (m, 2H) , 3.6 (m) , 3.3 (m, 2H) , 2.9 (m, 2H ) , 2.3 (m, 2H) , 1.5 (m) . MS: 464 (M+l)
Figure imgf000063_0001
7p : 1H NMR (400 MHz, CDC13) : d 8.9 (s, 1H), 8.8 (s, 1H), 7.4 (m, 1H) ,
6.7 (m, 1H), 6.6 (m, 1H) , 4.3 (m, 2H) , 4.0 (m, 2H) , 3.8 (m, 2H) , 3.6 (m, 2H) , 3.4 (m, 2H) , 3.2 (m, 2H) , 2.9 (m, 2H) . MS: 465 (M+l)
Example 2 : RPB4 Assay
The compounds listed below were tested in two in vitro assays, RBP4 binding (SPA) and retinol-dependent RBP4-TTR interaction ( HTRF) (Table 1) . The compounds bound to RBP4 and/or antagonized retinol-dependent
RBP4-TTR interaction. This activity indicates that the compounds reduce the levels of serum RBP4 and retinol. Table 1.
Figure imgf000064_0001
Example 3: PPARy Assay
The compounds of the present invention are advantageous in that they were tested in a PPARy agonist assay and were inactive as PPARy agonists (Table 2) . PPARy activation has been implicated as a cause of weight gain in humans (43) . The compounds of the present invention do not substantially activate PPARy, thereby avoiding an unwanted side effect, e.g. weight gain, of treatment of the disclosed retinol diseases.
Table 2.
Figure imgf000065_0001
Example 4: Metabolism Assay
The compounds listed below were tested in various metabolic stability and CYP inhibition assays. The results are described in Table 3. Table 3.
Figure imgf000066_0001
Compounds 7a, 7e, 7g and 7p show good metabolic stability and no appreciable CYP P450 inhibition indicating satisfactory drug-like properties .
Example 5 : Serum RBP4 Reduction
The main objective of this study was to demonstrate in vivo target engagement and establish a proof of in vivo activity in mice. In order to attain this objective, the effect of oral compound administration was studied in mice. Three doses of compound 7a and two doses of 7p were tested in Balb/c mice assay for reduction of serum RBP4.
The doses used were 15 mg/kg, 25 g/kg and 35 g/kg for 7a (Figs. 9A- C) . At the 15 mg/kg dose, 7a induced a maximum RBP4 reduction of 83% at the 4 hr. At the 25 mg/kg dose, 7a induced a maximum RBP4 reduction of 86% at the 6 hr timepoint. At the 35 mg/kg dose, 7a induced a maximum RBP4 reduction of 89% at the 8 hr timepoint. In summary, 7a induced significant dose-dependent RBP4 lowering in mice (Fig. 9D) with the maximal RBP4 reduction of 89% at the highest dose. Two doses, 25 mg/kg and 35 mg/kg, were tested for 7p (Figs. 10A-B) . At the 25 mg/kg dose, 7p induced a maximum RBP4 reduction of 89% at the 6 hr timepoint. At the 35 mg/kg dose, 7p induced a maximum RBP4 reduction of 87% at the 6 hr timepoint. Overall, at both doses 7p induced robust reduction of serum RBP4.
Example 6: RPB4 binding of Additional Compounds
An additional aspect of the invention provides analogs of the compounds 7a and 7p containing similar "B" groups that are active as RBP4 antagonists. These compounds analogously bind to RBP4 and antagonize retinol-dependent RBP4-TTR interaction without substantially activating PPARy.
Example 7 : Efficacy in a Mammalian Model
Age-dependent accumulation of cytotoxic lipofuscin in the RPE matches the age-dependent increase in the prevalence of the atrophic (dry) form of age-related macular degeneration (AMD) and represents an important pathogenic factor in etiology and progression of dry AMD. Excessive accumulation of toxic lipofuscin in the retina represents a primary pathologic defect in Stargardt disease. Lipofuscin bisretinoids (exemplified by bisretinoid N-retinylidene-N- retinylethanolamine, A2E) mediate lipofuscin toxicity in the AMD and Stargardt disease retina. Enhanced bisretinoid synthesis and excessive lipofuscin accumulation can be faithfully mimicked in the mouse Abca4~ 7~ model . Genetic ablation of the Abca4 transporter leads to the massive accumulation of toxic lipofuscin pigments in the retinal pigment epithelium.
To assess pre-clinical efficacy of 7a in the mouse Abca4 / model, the compound was formulated into a standard mouse chow to provide the daily oral dosing of 35 mg/kg. Long-term 8-week dosing of the compound formulated into a chow was conducted in Abca4 ~ mice. The second group of age-matched Abca4 / mice was kept on a standard Picolab 5053 chow. The age-matched reference group of C57BL/6J (wild-type control) was used for defining the basal level of A2E in mice in the absence of the Abca4 ablation; the C57BL/6J mice were kept on a standard Picolab 5053 chow. Blood samples for assessing the serum levels of RBP4 were collected at pre-dose and after 8.weeks of treatment.
Approximately 70% serum RBP4 reduction was documented in 7a treated mice at the end of the 8-week treatment (Fig. 11) . RBP4 levels in two other groups did not significantly change. Following the 8 weeks of dosing, the eyecups of treated and untreated Abca4~/~ mice, as well as the eyecups of the reference C57BL/6J wild type mice, were collected and subjected to the quantitative A2E analysis. This analysis revealed statistically significant 69% A2E reduction (p=0.0007) in the 7a- treated mice as compared to the control chow-treated Ahca4 / animals (Fig. 12) . This significant inhibition of bisretinoid synthesis in treated animals provided evidence of pre-clinical efficacy of AKR-XI- 85 in the mouse Abca4~/ model of enhanced retinal lipofuscinogenesis ,
An amount of a compound of the present application is administered to the eye of a subject afflicted with Age-Related Macular Degeneration, dry (atrophic) Age-Related Macular Degeneration, Stargardt Disease, Best disease, adult vitelliform maculopathy or Stargardt-like macular dystrophy. The amount of the compound is effective to treat the subj ect .
Example 8 : Significance of Nitrogen Positions
The following compounds were tested in two in vitro assays, RBP4 binding (SPA) and retinol-dependent RBP4-TTR interaction (HTRF) (Table 4) . The compounds were significantly less active than the compounds listed in Table 1.
Figure imgf000068_0001
Table 4.
Figure imgf000069_0002
Without being bound by any specific theory, it is believed that the position of the N on the biaryl ring of compounds 8a and 8b reduces activity relative to, for example, compound 7a. The claimed compounds each containing a N at a position analogous to compounds 7a and 7g (below) have improved activity in RBP4 assays and reduced or no substaritial activity in PPARy assays.
Figure imgf000069_0001
Example 9: RPB4 Assay of additional compounds
The compounds listed below were prepared using the procedure described herein and tested in two in vitro assays, RBP4 binding (SPA) and retinol-dependent RBP4-TTR interaction (HTRF) (Table 5) . The compounds bound to RBP4 and/or antagonized retinol-dependent RBP4-TTR interaction. This activity indicates that the compounds reduce the levels of serum RBP4 and retinol. Table 5.
Figure imgf000070_0001
Discussion
Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries. Its prevalence is higher than that of Alzheimer's disease. There is no treatment for the most common dry form of AMD. Dry AMD is triggered by abnormalities in the retinal pigment epithelium (RPE) that lies beneath the photoreceptor cells and provides critical metabolic support to these light-sensing cells. RPE dysfunction induces secondary degeneration of photoreceptors in the central part of the retina called the macula. Experimental data indicate that high levels of lipofuscin induce degeneration of RPE and the adjacent photoreceptors in atrophic AMD retinas. In addition to AMD, dramatic accumulation of lipofuscin is the hallmark of Stargardt's disease (STGD) , an inherited form of juvenile onset macular degeneration. One of the major cytotoxic components of RPE lipofuscin is a pyridinium bisretinoid A2E. A2E formation occurs in the retina in a non-enzymatic manner and can be considered a byproduct of a properly functioning visual cycle. Given the established cytotoxic effects of A2E on RPE and photoreceptors, inhibition of A2E formation could lead to delay in visual loss in patients with dry AMD and STGD. It was suggested that small molecule visual cycle modulators may reduce the formation of Ά2E in the retina and prolong RPE and photoreceptor survival in patients with dry AMD and STGD. Rates of the A2E production in the retina depend on the influx of all-trans retinol from serum to the RPE. RPE retinol uptake depends on serum retinol concentrations. Pharmacological downregulation of serum retinol is a valid treatment strategy for dry AMD and STGD. Serum retinol is maintained in circulation as a tertiary complex with retinol-binding protein (RBP4) and transthyretin (TTR) . Without interacting with TTR, the RBP4-retinol complex is rapidly cleared due to glomerular filtration. Retinol binding to RBP4 is required for formation of the RBP4-TTR complex; apo-RBP4 does not interact with TTR. Importantly, the retinol-binding site on RBP4 is sterically proximal to the interface mediating the RBP4-TTR interaction. Without wishing to be bound by any scientific theory, the data herein show that small molecule RBP4 antagonists displacing retinol from RBP4 and disrupting the RBP4-TTR interaction will reduce serum retinol concentration, inhibit retinol uptake into the retina and act as indirect visual cycle inhibitors reducing the formation of cytotoxic A2E.
As rates of the A2E production in the retina depend on the influx of all-trans retinol from serum to the RPE (Fig. 4), it has been suggested that partial pharmacological down-regulation of serum retinol may represent a target area in dry AMD treatment (11) . Serum retinol is bound to retinol-binding protein (RBP4) and maintained in circulation as a tertiary complex with RBP4 and transthyretin (TTR) (Fig. 5). Without interacting with TTR, the RBP4-retinol complex is rapidly cleared from circulation due to glomerular filtration. Additionally, formation of the RBP4 -TTR-retinol complex is required for receptor- mediated all-trans retinol uptake from serum to the retina.
Without wishing to be bound by any scientific theory, visual cycle modulators may reduce the formation of toxic bisretinoids and prolong RPE and photoreceptor survival in dry AMD. Rates of the A2E production depend on the influx of all-trans retinol from serum to the RPE. Formation of the tertiary retinol-binding protein 4 (RBP4)- transthyretin (TTR) -retinol complex in serum is required for retinol uptake from circulation to the RPE. Retinol-binding site on RBP4 is sterically proximal to the interface mediating the RBP4-TTR interaction. RBP4 antagonists that compete with serum retinol for binding to RBP4 while blocking the RBP4-TTR interaction would reduce serum retinol, partially reduce visual cycle retinoid concentration, and inhibit the formation of cytotoxic bisretinoids.
RBP4 represents an attractive drug target for indirect pharmacological modulation of the visual cycle and A2E formation. The retinol-binding site on RBP4 is sterically proximal to the interface mediating the RBP4-TTR interaction. Retinol antagonists competing with serum retinol for binding to RBP4 while blocking the RBP4-TTR interaction would reduce serum RBP4 and retinol levels which would lead to reduced uptake of retinol to the retina. The outcome would be visual cycle modulation which is manifested in partial reduction of visual cycle retinoids that serve as precursors of bisretinoid synthesis with subsequent reduction in the A2E synthesis. A synthetic retinoid called fenretinide [N— ( 4— hydroxyphenyl) retinamide, 4HRP] (Fig. 6) previously considered as a cancer treatment (29) was found to bind to RBP4, displace all-'trans retinol from RBP4 (13), and disrupt the RBP4-TTR interaction (13,14). Fenretinide was shown to reduce serum RBP4 and retinol (15), inhibit ocular all-trans retinol uptake and slow down the visual cycle (11). Importantly, fenretinide administration reduced A2E production in an animal model of excessive bisretinoid accumulation, Abca4 -/- mice (11) . Pre-clinical experiments with fenretinide validated RBP4 as a drug target for dry AMD. However, fenretinide is non-selective and toxic. Independent of its activity as an antagonist of retinol binding to RBP4 , fenretinide is an extremely active inducer of apoptosis in many cell types (16-19), including the retinal pigment epithelium cells (20). It has been suggested that fenretinide ' s adverse effects are mediated by its action as a ligand of a nuclear receptor RAR (21— 24) . Additionally, similar to other retinoids, fenretinide is reported to stimulate formation of hemangiosarcomas in mice. Moreover, fenretinide is teratogenic, which makes its use problematic in Stargardt disease patients of childbearing age.
As fenretinide' S safety profile may be incompatible with long-term dosing in individuals with blinding but non-life threatening conditions, identification of new classes of RBP4 antagonists is of significant importance. The compounds of the present invention displace retinol from RBP4 , disrupt retinol-induced RBP4-TTR interaction, and reduce serum REBP4 levels. The compounds of the present invention reduce serum RBP4 concentration in mice and inhibit bisretinoid accumulation in the Abca4 -/- mouse model of excessive lipofuscinogenesis which indicates usefulness a treatment for dry AMD and Stargardt disease. Peroxisome proliferator-activated receptor gamma (PPARY) is a ligand- dependent transcription factor that belongs to the nuclear receptor protein family. As most nuclear receptors, PPARy has a DNA-binding domain (mediates docking to regulatory genomic regions) and ligand binding domain (LBD) which is responsible for binding small molecule natural or synthetic ligands that change the conformation of the LBD. PPARy agonists are compounds that bind to the ligand binding domain of this nuclear receptor leading to its conformational changes and recruitment of transcriptional co-activators leading to enhanced expression of the target genes. PPARy agonists, such as rosiglitazone (brand name Avandia) and pioglitazone (brand name Actos) , have been used for treatment of diabetes. However, the clinical use of PPARy agonists is highly restricted due to their mechanism-based adverse effects such as increased risk of death, myocardial infarction, stroke, congestive heart failure, hepatotoxicity , peripheral edema, weight gain and carcinogenicity (44-47). Our data shows that some of the previously described RBP4 antagonists may act as PPARy agonists. Cross-reactivity of RBP4 antagonists with PPARy would be a highly undesirable attribute. The present invention describes potent and selective RBP4 antagonists that lack the PPARy liability.
The present invention relates to small molecules for the treatment of macular degeneration and Stargardt Disease. Disclosed herein is the ophthalmic use of the small molecule as non-retinoid RBP4 antagonists. The compounds of Examples 1-19 have been shown to bind RBP4 in vitro and/or to antagonize RBP4-TTR interaction in vitro at biologically significant concentrations. Additional compounds described herein, which are analogs of Examples 1-19 analogously bind RBP4 in vitro and antagonize RBP4-TTR interaction in vitro at biologically significant concentrations. The compounds described herein unexpectedly fail to activate PPARy, which has been implicated to cause weight gain in hum subjects.
Currently, there is no FDA-approved treatment for dry AMD or Stargardt disease, which affects millions of patients. An over the counter, non- FDA-approved cocktail of antioxidant vitamins and zinc (AREDS formula) is claimed to be beneficial in a subset of dry AMD patients. There are no treatments for Stargardt disease. The present invention identified non-retinoid RBP4 antagonists that are useful for the treatment of dry AMD and other conditions characterized by excessive accumulation of lipofuscin. Without wishing to be bound by any scientific theory, as accumulation of lipofuscin seems to be a direct cause of RPE and photoreceptor demise in AMD and STGD retina, the compounds described herein are disease-modifying agents since they directly address the root cause of these diseases. The present invention provides novel methods of treatment that will preserve vision in AMD and Stargardt disease patients, and patients' suffering from conditions characterized by excessive accumulation of lipofuscin.
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Claims

What is claimed is:
1. A compound having the structure
Figure imgf000083_0001
wherein
Ri, R2, R3, R4, and Rs are each independently H, halogen, alkyl, haloalkyl, O-haloalkyl, aryl or heteroaryl;
X is N or CR6,
wherein R6 is H, OH, or halogen;
A is absent or present, and when present
Figure imgf000083_0002
B has the structure:
Figure imgf000083_0003
wherein
a and b are each a bond that is present or absent;
Xi is N, NH or NR10,
wherein Rio is alkyl, alkenyl or alkynyl;
X2 is C or N;
X3 is CH or N; R7, Rg and Rg are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-NH2, alkyl-OAc alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (O) -N (CH3) 2, C(0)-NHCH3, NHC (0) -N (CH3) 2, CN or CF3, wherein
Xi, X2 and X3 are each N, a is present and b is absent; or
Xi is NH, X2 is C, X3 is CH, a is absent and b is present; or
Xi is N, X2 is N, X3 is CH, a is present and b is absent; or
Xi is NH or NRio, X2 is C, X3 is N, a is absent and b is present, wherein when Xi is NH, X2 is C, X3 is N, a is absent and b is present, then one of R7, Rs and Rg is other than H, or B has the structure:
Figure imgf000084_0001
wherein
Xi and Xs are each, independently, is N or CH; and
R11, R12 and R33 are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-0 (CO) -alkyl , alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2,
C (O) -N (CH3) 2, C(0)-NHCH3, NHC (O) -N (CH3) 2, CN or CF3, or a pharmaceutically acceptable salt thereof.
2. The compound of claim 1 having the structure:
Figure imgf000085_0001
wherein
Ri, R2, R3, R, and R5 are each independently H, halogen, CF3 or C1-C4 alkyl;
X is N or CR6,
wherein R6 is H, OH, or halogen;
A is absent or present, and when present is
Figure imgf000085_0002
B has the structure:
Figure imgf000085_0003
wherein
a and b are each a bond that is present or absent;
Xx is N, NH or NR10,
wherein Rio is alkyl, alkenyl or alkynyl;
X2 is G or N;
X3 is CH or N; R7, R8 and Rg are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl~NH2, alkyl-OAc alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (0) -N (CH3) 2, C(0)-NHCH3, NHC(0)-N(CH3)2, CN or CF3, wherein
Xi, X2 and X3 are each N, a is present and b is absent; or
Xi is NH, X2 is C, X3 is CH, a is absent and b is present; or
Xi is N, X2 is N, X3 is CH, a is present and b is absent; or
Xi is NH or NRio, X2 is C, X3 is N, a is absent and b is present, wherein when Xi is NH, X2 is C, X3 is N, a is absent and b is present, then one of R7, Re and Rg is other than H, or B has the structure:
Figure imgf000086_0001
wherein
Rn, R12 and R13 are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-0- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (0) -N (CH3) 2, C(0)-NHCH3, NHC(0)-N(CH3)2, CN or CF3, or a pharmaceutically acceptable salt thereof.
3. The compound of claim 1 having the structure
Figure imgf000087_0001
4. The compound of any one of claims 1-3,
wherein one of Ri, R2, R3, R4, and R5 is other than H.
5. The compound of any one of claims 1-3,
wherein two of Ri, R2, R3, R4, and Rs are other than H.
6. The compound of any one of claims 1-5, wherein B has the structure:
Figure imgf000088_0001
R7, Re and Rg are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (O) -N (CH3) 2, C(0)-NHCH3, NHC (O) -N (CH3) 2,
CN, or CF3; or
Figure imgf000088_0002
R7, Rs and R9 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (O) -N (CH3) 2, C(0)-NHCH3, NHC (O) -N (CH3) 2,
CN, or CF3; or
Figure imgf000088_0003
R7, Re and Rg are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl ,
NH-alkyl, C(0)0H C (O) -NH C(0)-N(CH3)2 C (O) -NHCH3 NHC(0)-N(CH3)2
CN, or CF3; or
Figure imgf000088_0004
R7 , Re and Rg are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (0) -N (CH3) 2 , C(0)-NHCH3, NHC (0) -N (CH3) 2 ,
CN, or CF3; and
Rio is alkyl, alkenyl or alkynyl.
7. The compound of claim 6, wherein
R7 , R8 and Rg are each, independently, H, Cl, Br, F, 0CH3, OCH2CH3 , CF3, CN, CH3, CH3CH3, C (0) OH or C(0)-NH2.
8. The compound of claim 6, wherein
R7 , Rg and Rg are each, independently, H, CH2CH2OH, CH2CH2OCH3, CH2CH2OAc, CH2CH2C1, CH2CH2F or CH2CH2Br.
9. The compound of claim 6, wherein
R7 , Rg and Rg are each, independently, H , halogen or alkyl.
10. The compound of claim 6, wherein two of R-; , Re and Rg are each H and the remaining one of R7 , Rg and R9 is other than H; or wherein one of R7 , R8 and Rg is H and the remaining two of R7 , Re and Rg are each other than H.
11. The compound of claim 6, wherein B has the structure:
Figure imgf000089_0001
Figure imgf000090_0001
12. The compound of any one of claims 1-5, wherein B has the structure :
Figure imgf000090_0002
wherein
Rii, Ri2 and R13 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-O-alkyl , haloalkyl, cycloalkyl, 0-alkyl, NH-alkyl, C{0)0H, C(0)-NH2, C (O) -N (CH3) 2, C(0)-NHCH3, NHC (0) -N (CH3) 2,
CN, or CF3.
13. The compound of claim 12, wherein
R11, R12 and R33 are each, independently, H, Cl, Br, F, OCH3, OCH2CH3,
CF3, CN, CH3, CH3CH3, C(0)0H or C(0)-NH2.
14. The compound of claim 12, wherein
Rii, Ri2 and R13 are each, independently, H, CH2CH2OH, CH2CH2OCH3, CH2CH2OAc, CH2CH2CI, CH2CH2F or CH2CH2Br.
15. The compound of any one of claim 12-14, wherein two of Ru , R12 and R13 are each H and the remaining one of Ru , R12 and R13 is other than H; or wherein one of Ru , R12 and R13 is H and the remaining two of Ru , R12 and R13 are each other than H.
16. The compound of claim 12, wherein B has the structure:
Figure imgf000091_0001
17. The compound of any one of claims 12-16,
wherein X is N.
18. The compound of any one of claims 12-16,
wherein X is CH.
19. The compound of any one of claims 1-18,
wherein
Ri, R2, R3 , R4, and R5 are each H, t-Bu, Cl, Br, F or CF3;
20. The compound of any one of claims 1-18,
wherein
Ri, R2, R3, R4, and Rs are each H, methyl, ethyl, phenyl, t-Bu, i-Pr, OCF3, CF3, OCF2CF3, CF2CF3, Cl, Br, or F.
21. The compound of any one of claims 1-18,
wherein
Ri, R2, R3, and R4 are each H;
R5 is CF3 or t-Bui
22. The compound of any one of claims 1-18, wherein
Ri, R , R / and R are each H;
R is -H, OCF3, CF2CF3, methyl, ethyl, i-Pr or phenyl.
23. The compound of any one of claims 1-18,
wherein
Ri, R3 and R are each H;
R is halogen;
R is CF3 or t-Bu.
24. The compound of claim 1 having the structure:
Figure imgf000092_0001
Figure imgf000093_0001
a pharmaceutically acceptable salt thereof.
25. The compound of claim 1 having the structure:
Figure imgf000093_0002
Figure imgf000094_0001
a pharmaceutically acceptable salt thereof.
26. The compound of claim 1 having the structure:
Figure imgf000094_0002
a pharmaceutically acceptable salt thereof.
27. A compound having the structure:
Figure imgf000095_0001
wherein
Ri, R2, R3, R4, and Rs are each independently H, halogen, CF3, OCF3, alkyl, haloalkyl, aryl or heteroaryl; and
B has the structure:
Figure imgf000095_0002
wherein
a and b are each a bond that is present or absent;
Xi is N, NH or NR10,
wherein Rio is alkyl, alkenyl or alkynyl;
X2 is C or N;
X3 is CH or N;
R7, Re and Rg are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alky-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (O) -N (CH3) 2, C (O) -
NHCH3, NHC(O) -N (CH3) 2, CN, or CF3, wherein
Xi, X2 and X3 are each N, a is present and b is absent; or
Xi is NH, X2 is C, X3 is CH, a is absent and b is present; or
Xi is N, X2 is N, 3 is CH, a is present and b is absent; or Xi is NH or NRio, X2 is C, X3 is N, a is absent and b is present, wherein when Xi is NH, X2 is C, X3 is N, a is absent and b is present, then one of R7, R8 and R9 is other than H, or B has the structure:
Figure imgf000096_0001
wherein
Xi and X5 are each, independently, is N or CH; and
R11, RX2 and R13 are each, independently, H, halogen, alkyl, alkenyl, alkynyl alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2,
C (0) -N (CH3) 2, C(0)-NHCH3, NHC(0)-N(CH3)2, CN or CF3, or a pharmaceutically acceptable salt thereof.
28. The compound of claim 27,
wherein
Ri, R2, R3, R4, and R5 are each independently H, halogen, CF3 or C1-C4 alkyl, aryl or heteroaryl; and
B has the structure:
Figure imgf000096_0002
wherein
a and b are each a bond that is present or absent;
Xi is N, NH or NR10,
wherein R;o is alkyf>, alkenyl or alkynyl;
X2 is C or N;
X3 is CH or N; R7, Ra and Rg are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-NH2, alkyl-OAc, al ky-O-alkyl , haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (0) -N (CH3) 2, C(O)-
NHCHa, NHC (0) -N (CH3) 2, CN, or CF3, wherein
Xi , X2 and X3 are each N , a is present and b is absent; or
Xi is NH , X2 is C , X3 is CH , a is absent and b is present; or
Xi is N, X2 is N , X3 is CH , a is present and b is absent; or
Xi is NH or NRio , X2 is C , X3 is N, a is absent and b is present, wherein when Xi is NH , X2 is C , X3 is N , a is absent and b is present, then one of R7 , Re and Rg is other than H , or B has the structure:
Figure imgf000097_0001
wherein
Rn , RI2 arid Ri3 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alky-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (0) -N ( CH3) 2, C(0)-NHCH3, NHC (0) -N (CH3) 2,
CN, or CF3, or a pharmaceutically acceptable salt thereof.
29. A compound having the structure:
Figure imgf000097_0002
wherein
Ri, R2, R3, R4, and R5 are each independently H, halogen, CF3, OCF3, alkyl, haloalkyl, aryl or heteroaryl; and
Y is alkyl;
A is absent or present, and when present is
Figure imgf000098_0001
B has the structure:
Figure imgf000098_0002
wherein
a and b are each a bond that is present or absent;
Xi is N, NH or NRio,
wherein Rio is alkyl, alkenyl or alkynyl;
X2 is C or N;
X3 is CH or N;
R7, R8 and R9 are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-NH2, alkyl-OAc, al ky-O-alkyl , haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (O) - (CH3) 2, C(O)-
NHCH3, NHC (O) -N (CH3) 2, CN, or CF3, wherein
Xi, X2 and X3 are each N, a is present and b is absent; or
Xi is NH, X2 is C, X3 is CH, a is absent and b is present; or
Xi is N, X2 is N, X3 is CH, a is present and b is absent; or
Xi is NH or NR10, X2 is C, X3 is N, a is absent and b is present, wherein when Xi is NH, X2 is C, X3 is N, a is absent and b is present, then one of R7, Re and R9 is other than H, or B has the structure:
Figure imgf000099_0001
wherein
X4 and X5 are each, independently, is N or CH; and
R11, R12 and R13 are each, independently, H, halogen, alkyl, alkenyl, alkynyl alkyl-OH, alkyl-NH2, alkyl-OAc, alkyl-0 (CO) -alkyl, alkyl-O- alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2,
C (O) -N (CH3) 2, C(0)-NHCH3, NHC (O) -N (CH3) 2, CN or CF3, or a pharmaceutically acceptable salt thereof.
30. The compound of claim 29,
wherein
Ri, R2, R3, R4, and Rs are each independently H, halogen, CF3 or C1-C4 alkyl aryl or heteroaryl;
Y is alkyl;
A is absent or present, and when present is
Figure imgf000099_0002
and B has the structure:
Figure imgf000099_0003
wherein
a and b are each a bond that is present or absent;
Xi is N, NH or NR10,
wherein Rio is alkyl, alkenyl or alkynyl;
X2 is C or N;
X3 is CH or N; R7, Rg and Rg are each, independently, H, halogen, alkyl, alkenyl, alkynyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alky-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)-NH2, C (0) -N (CH3) 2, C (0) -
NHCH3, NHC (0) -N (CH3) 2, CN, or CF3, wherein
Xi, X2 and X3 are each N, a is present and b is absent; or
Xi is NH, X2 is C, X3 is CH, a is absent and b is present; or
Xi is N, X2 is N, X3 is CH, a is present and b is absent; or
Xi is NH or NR10, X2 is C, X3 is N, a is absent and b is present, wherein when Xi is NH, X2 is C, X3 is N, a is absent and b is present, then one of R7, Rs and Rg is other than H, or B has the structure:
Figure imgf000100_0001
wherein
R11, R12 and RI3 are each, independently, H, halogen, alkyl, alkyl-OH, alkyl-NH2, alkyl-OAc, alky-O-alkyl, haloalkyl, cycloalkyl, O-alkyl, NH-alkyl, C(0)0H, C(0)~NH2, C (0) -N (CH3) 2, C(0)-NHCH3, NHC (O) -N (CH3) 2,
CN, or CF3, or a pharmaceutically acceptable salt thereof.
31. The compound of claim 29 or 30 having the structure:
Figure imgf000100_0002
32. A pharmaceutical composition comprising the compound of any one of claims 1-31 and a pharmaceutically acceptable carrier.
33. A method for treating a disease characterized by excessive lipofuscin accumulation in the retina in a mammal afflicted therewith comprising administering to the mammal an effective amount of a compound of any one of claims 1-31 or a composition of claim 32.
34. The method of claim 32, wherein the disease is further characterized by bisretinoid-mediated macular degeneration.
35. The method of claim 33 or 34, wherein the amount of the compound is effective to lower the serum concentration of RBP4 in the mammal without substantially activating PPAR gamma in the mammal.
36. The method of any one of claims 33-35, wherein the amount of the compound is effective to lower the retinal concentration of a bisretinoid in lipofuscin in the mammal.
37. The method of claim 36, wherein the bisretinoid is A2E, isoA2E, A2-DHP-PE or atRAL di-PE.
38. The method of any one of claims 33-37, wherein the disease characterized by excessive lipofuscin accumulation in the retina is Age-Related Macular Degeneration, dry (atrophic) Age-Related Macular Degeneration, Stargardt Disease, Best disease, adult vitelliform maculopathy or Stargardt-like macular dystrophy.
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