WO2020163188A1 - Compositions contenant de la n-acétylcystéine conjuguée à un intermédiaire de cycle tca - Google Patents

Compositions contenant de la n-acétylcystéine conjuguée à un intermédiaire de cycle tca Download PDF

Info

Publication number
WO2020163188A1
WO2020163188A1 PCT/US2020/016311 US2020016311W WO2020163188A1 WO 2020163188 A1 WO2020163188 A1 WO 2020163188A1 US 2020016311 W US2020016311 W US 2020016311W WO 2020163188 A1 WO2020163188 A1 WO 2020163188A1
Authority
WO
WIPO (PCT)
Prior art keywords
succinate
tca cycle
acetylcysteine
amino acid
compound
Prior art date
Application number
PCT/US2020/016311
Other languages
English (en)
Inventor
Andrew D. Levin
Original Assignee
Imbria Pharmaceuticals, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Imbria Pharmaceuticals, Inc. filed Critical Imbria Pharmaceuticals, Inc.
Publication of WO2020163188A1 publication Critical patent/WO2020163188A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19—Carboxylic acids, e.g. valproic acid
    • A61K31/194—Carboxylic acids, e.g. valproic acid having two or more carboxyl groups, e.g. succinic, maleic or phthalic acid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19—Carboxylic acids, e.g. valproic acid
    • A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
    • A61K31/197—Carboxylic acids, e.g. valproic acid having an amino group the amino and the carboxyl groups being attached to the same acyclic carbon chain, e.g. gamma-aminobutyric acid [GABA], beta-alanine, epsilon-aminocaproic acid or pantothenic acid
    • A61K31/198—Alpha-amino acids, e.g. alanine or edetic acid [EDTA]

Definitions

  • This application is related to compositions and methods for treating conditions associated with altered TCA cycle metabolism.
  • TCA tricarboxylic acid
  • Inherited disorders of the TCA cycle cause intellectual disability, various neurological problems, and death in young children, while the neurodegenerative diseases and cancers that are coupled to dysfunction of the TCA cycle lead to cognitive and physical disabilities and death in adults.
  • TCA cycle and its relationship to other intermediary metabolic pathways have been understood for decades, effective therapies for treating conditions associated with abnormal TCA cycle metabolism are lacking.
  • Efforts to develop compositions that restore TCA cycle metabolism by delivering TCA cycle metabolites have been unsatisfactory.
  • Compounds that provide unadulterated TCA cycle intermediates are challenging to administer orally due to the large amount of material that is needed to be taken by mouth and strong tastes or odors.
  • Existing compositions are inadequate to remedy dysfunction of the TCA cycle, and people continue to suffer and die from a variety of conditions related to abnormal TCA cycle metabolism.
  • the invention overcomes the challenges of administering large quantities of TCA intermediates by incorporating such intermediates into higher solubility molecules that can be metabolized to release the intermediates in the body.
  • the invention recognizes that conjugating N-acetylcysteine (NAC) to TCA cycle intermediates dramatically increases the solubility of those compounds. With improved solubility, the compounds can be administered orally at the high doses needed to treat conditions associated with altered TCA cycle metabolism.
  • NAC N-acetylcysteine
  • compositions that contain one or more TCA cycle intermediates conjugated to NAC.
  • the conjugates are highly soluble in water and can be cleaved in the body to release the TCA cycle intermediate for efficient delivery to target tissues.
  • the TCA cycle intermediate is succinate, and the amino acid is serine or tyrosine.
  • the conjugates may include multiple TCA intermediate-NAC moieties linked by a polyol, such as a C2-C20 polyol, as, for example, in glycerol trisuccinate triserine.
  • the invention also provides methods of treating a condition associated with altered TCA cycle metabolism by providing compositions of the invention.
  • compositions provide TCA cycle intermediates in water-soluble compounds, they are useful as therapeutic agents for treating conditions associated with abnormal TCA cycle metabolism. Due to the high solubility of the compounds, they are readily absorbed, circulate throughout the body and can be cleaved to make the TCA cycle intermediate available to target tissues.
  • the compounds are suitable for oral administration because the covalent linkage eliminates the taste or odor produced by free TCA cycle intermediates.
  • the compositions of the invention also result in better patient compliance with a therapeutic regimen compared to formulations that use free TCA cycle intermediates.
  • the invention provides compounds that include one or more TCA cycle intermediates or prodrugs thereof and N-acetylcysteine.
  • the compounds may include two or more TCA cycle intermediates or prodrugs thereof chemically linked to each other.
  • the compounds may include two or more copies of N-acetylcysteine.
  • the compounds may include one or more additional amino acids.
  • TCA cycle intermediates or prodrugs thereof are known in the art (such as those described in PCT/US2017/019000, the content of which is incorporated by reference herein in its entirety. Any such compounds may be conjugated with N-acetylcysteine to improve the solubility, and therefore oral availability of those compounds.
  • the TCA cycle intermediate or prodrug thereof is citrate, cis-aconitate, D-isocitrate, a-ketoglutarate, succinate, fumarate, malate, oxaloacetate, acetone, acetoacetate, b-hydroxybutyrate, b- ketopentanoate, or b-hydroxypentanoate.
  • N-acetylcysteine and/or one or more other amino acids may be conjugated to any carbon atom in a TCA intermediate.
  • N-acetylcysteine and/or one or more other amino acids are conjugated to a terminal carbon.
  • the TCA cycle intermediate may be succinate, N-acetylcysteine or another other amino acids may be conjugated to either or both terminal carbons in the succinate.
  • the additional amino acid may be any naturally-occurring or non-naturally -occurring amino acid.
  • the additional amino acid may be alanine, arginine, asparagine, aspartic acid, cysteine, glutamine, glutamic acid, glycine, histidine, isoleucine, leucine, lysine, methionine, phenylalanine, proline, serine, threonine, tryptophan, tyrosine, or valine.
  • the additional amino acid may be serine or tyrosine.
  • the two or more amino acids may be the same, i.e., multiple copies of the same molecular species, or they may be different.
  • any of the compounds described above may include one or more atoms that are enriched for an isotope.
  • the compounds may have one or more hydrogen atoms replaced with deuterium or tritium.
  • the isotopically enriched atom or atoms may be located at any position within the compound.
  • the compounds may have an octanokwater partition coefficient of less than 0.1, less than 0.01, less than 0.001, less than 0.0001, less than 0.0001, less than 0.00001, or less than 0.000001.
  • the invention provides methods of treating a condition associated with altered TCA cycle metabolism in a subject.
  • the methods include providing the subject with a composition of the invention, such as any of those described above.
  • condition associated with altered TCA cycle metabolism may be an inherited disorder, such as 2-oxoglutaric aciduria, fumarase deficiency, or succinyl-CoA synthetase deficiency.
  • the condition associated with altered TCA cycle metabolism may be a
  • the condition associated with altered TCA cycle metabolism may be a cancer, such as pancreatic cancer, kidney cancer, cervical cancer, prostate cancer, muscle cancer, gastric cancer, colon cancer, glioblastoma, glioma, paraganglioma, leukemia, liver cancer, breast cancer, carcinoma, neuroblastoma.
  • a cancer such as pancreatic cancer, kidney cancer, cervical cancer, prostate cancer, muscle cancer, gastric cancer, colon cancer, glioblastoma, glioma, paraganglioma, leukemia, liver cancer, breast cancer, carcinoma, neuroblastoma.
  • the condition associated with altered TCA cycle metabolism may be an energetic disorder, refractory epilepsy, propionic acidemia (PA), methylmalonic acidemia (MMA), a long chain fatty acid oxidation disorder, succinyl CoA lyase deficiency, pymvate carboxylase deficiency, mitochondrial respiratory chain deficiency, glutaric acidemia type 1 or type 2 a neurologic disease, disorder or condition, a pain or fatigue disease, muscular dystrophy (e.g., Duchenne’s muscular dystrophy and Becker’s muscular dystrophy), mitochondrial myopathy, mitochondrial encephalomyopathy lactic acidosis and stroke-like syndrome (MELAS), myoclonic epilepsy and ragged-red fibers (MERRF), a mitochondrial associated disease, or a disorder related to POLG mutation.
  • PA propionic acidemia
  • MMA methylmalonic acidemia
  • a long chain fatty acid oxidation disorder succinyl CoA lyase defic
  • the condition may be an inherited disorder, a neurodegenerative disorder, a cancer, an energetic disorder, refractory epilepsy, propionic acidemia (PA), methylmalonic acidemia (MMA), a long chain fatty acid oxidation disorder, succinyl CoA lyase deficiency, pyruvate carboxylase deficiency, mitochondrial respiratory chain deficiency, glutaric acidemia type 1 or type 2 a neurologic disease, disorder or condition, a pain or fatigue disease, muscular dystrophy, mitochondrial myopathy, mitochondrial encephalomyopathy lactic acidosis and stroke-like syndrome (MELAS), myoclonic epilepsy and ragged-red fibers (MERRF), a mitochondrial associated disease, or a disorder related to POLG mutation.
  • PA propionic acidemia
  • MMA methylmalonic acidemia
  • a long chain fatty acid oxidation disorder succinyl CoA lyase deficiency
  • pyruvate carboxylase deficiency
  • the invention provides compositions that allow efficient delivery of TCA cycle intermediates for treatment of conditions associated with abnormal TCA cycle metabolism.
  • Such intermediates are conjugated to amino acids in compounds that are highly soluble in water to facilitate system absorption and circulation.
  • the compounds can be cleaved in the body to release the intermediates in a form that enter the cycle either directly or by conversion through intermediary metabolic pathways.
  • TCA cycle metabolism is associated with a variety of conditions.
  • hereditary metabolic disorders of the TCA cycle such as 2-oxoglutaric aciduria, fumarase deficiency, and succinyl-CoA synthetase deficiency
  • genetic mutations affect enzymes of the TCA cycle or enzymes that catalyze related reactions. Consequently, individual reactions of the TCA cycle are impaired, leading to the depletion of intermediates required for the cycle to proceed.
  • Such diseases typically present early with severe symptoms, such as mental retardation, microcephaly, deafness, and hypotonia and are often fatal in early childhood.
  • TCA cycle metabolism is also observed in other diseases that do not have direct genetic links to this metabolic pathway.
  • altered TCA metabolism is observed in neurodegenerative disorders, such as Amyotrophic Lateral Sclerosis, Alzheimer's
  • the compounds provided herein overcome the limited bioavailability of previously described compositions for delivery of TCA cycle intermediates. Because the compounds of the invention are highly water soluble, they are absorbed and circulate readily in the body. In addition, the compounds can be cleaved to efficiently deliver TCA cycle intermediates to target tissues. Due to their superior bioavailability, the compounds of the invention can be provided in doses suitable for oral administration to treat abnormal TCA metabolism associated with a wide range of conditions.
  • TCA cycle intermediates Compound that include (1) one or more TCA cycle intermediates, metabolites that feed into the TCA cycle, such as pyruvate or ketone bodies, or prodrugs of TCA cycle intermediates or metabolites that feed into the TCA cycle and (2) one or more amino acids are described in International Publication No. WO 2019/023231, the contents of which are incorporated herein by reference.
  • the compounds provided herein include (1) one or more TCA cycle intermediates, metabolites that feed into the TCA cycle, such as pyruvate or ketone bodies, or prodrugs of TCA cycle intermediates or metabolites that feed into the TCA cycle and (2) N-acetylcysteine (NAC).
  • TCA cycle intermediates described in the TCA cycle above may be used in compositions of the invention.
  • any of the compounds described in PCT/US2017/019000 may be TCA cycle intermediates within the context of the invention.
  • a prodrug is a medication or compound that, after administration, is metabolized (i.e., converted within the body) into a pharmacologically active drug.
  • the prodrug itself may be pharmacologically inactive.
  • Prodrugs may be used to improve how a medicine is absorbed, distributed, metabolized, and excreted.
  • the prodrug may improve the bioavailability of the active drug when the active drug is poorly absorbed from the gastrointestinal tract.
  • the prodrug may improve how selectively the drug interacts with cells or processes that are not its intended target, thereby reducing unintended and undesirable side effects.
  • the prodrug may be converted into a biologically active form (bioactivated) inside cells (a Type I prodrug) or outside cells (a Type II prodrug).
  • the prodrug may bioactivated in the gastrointestinal tract, in systemic circulation, in metabolic tissue other than the target tissue, or in the target tissue.
  • the compounds of the invention can be metabolized in the body to yield an intermediate of the TCA cycle, such as citrate, cis-aconitate, D-isocitrate, a-ketoglutarate, succinate, fumarate, malate, or oxaloacetate, or a molecule that can be metabolized to enter the TCA cycle, such as pymvate or a ketone body.
  • an intermediate of the TCA cycle such as citrate, cis-aconitate, D-isocitrate, a-ketoglutarate, succinate, fumarate, malate, or oxaloacetate
  • a molecule that can be metabolized to enter the TCA cycle such as pymvate or a ketone body.
  • ketone bodies include acetone, acetoacetate, b-hydroxybutyrate, b-ketopentanoate, or b-hydroxypentanoate.
  • any prodrugs of the TCA cycle intermediates described in the TCA cycle above may be used in compositions of the invention.
  • Any of the prodrugs or prodrugs of the compounds described in PCT/US2017/019000 may be TCA cycle intermediate prodrugs within the context of the invention.
  • the TCA cycle intermediate or prodrug thereof may include one or more substituents.
  • the one or more substituents may be linked via, via any suitable chemical linkage, such as an alkoxyl linkage, to one or more carboxyl groups on the intermediate or prodrug thereof.
  • the substituent may be a short-chain fatty acid, such as formate, acetate, propionate, butyrate, isobutyrate, valerate, or isovalerate.
  • the TCA cycle intermediate or prodrug may include succinate diserine, glycerol trisuccinate triserine, or glycerol trisuccinate trityrosine.
  • the TCA cycle intermediate or prodrug may include a structure represented by one of formulas (I), (II) and (III):
  • the TCA cycle intermediate or prodrug may include a structure represented by formula
  • A is serine, and B is succinate.
  • the TCA cycle intermediate or prodrug may include a structure represented by formula
  • V C - D - E (V), in which C is a first TCA cycle intermediate, D is a second TCA cycle intermediate, and E is an amino acid.
  • C is malate
  • D is succinate
  • E is serine.
  • each R° may be substituted as defined below and is independently hydrogen, Ci 6 aliphatic, -CH 2 Ph, -O(CH 2 )o iPh, -CH 2 -(5-6 membered heteroaryl ring), or a 5-6-membered saturated, partially unsaturated, or aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or,
  • Suitable monovalent substituents on R ⁇ are independently halogen, -(CH 2 )o 2 R ⁇ , -(haloR ⁇ ), -(CH 2 )0-20H, -(CH 2 ) 0-2 O R ⁇ -(CH 2 ) 0-2 CH(O R ⁇ ) 2 ; - O(haloR ⁇ ), -CN, -N3, -(CH 2 ) 0-2 C(O)R ⁇ , -(CH 2 ) 0-2 C(O)OH, -(CH 2 ) 0-2 C(O)OR ⁇ , -(CH 2 ) 0-2 SR ⁇ , -(CH 2 ) 0-2 SH, -(CH 2 ) 0-2 NH 2 , -(CH 2 ) 0-2 NHR ⁇ , -(CH 2 ) 0-2 NR ⁇ 2 .
  • each R ⁇ is unsubstituted or where preceded by “halo” is substituted only with one or more halogens, and is independently selected from C 1-4 aliphatic, -CH 2 Ph, -O(CH 2 ) 0-1 Ph, or a 5-6-membered saturated, partially unsaturated, or aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur.
  • Suitable divalent substituents that are bound to vicinal substitutable carbons of an “optionally substituted” group include: -O(CR* 2 ) 2-3 O-, wherein each independent occurrence of R* is selected from hydrogen, C 1-6 aliphatic which may be substituted as defined below, or an unsubstituted 5-6-membered saturated, partially unsaturated, or aryl ring having 0-4
  • heteroatoms independently selected from nitrogen, oxygen, or sulfur.
  • Suitable substituents on the aliphatic group of R* include halogen, -R ⁇ , -(haloR ⁇ ), - OH, -OR ⁇ , -O(haloR ⁇ ), -CN, -C(O)OH, -C(O)OR ⁇ , -NH 2 , -NHR ⁇ , -NR ⁇ , or -N02, wherein each R ⁇ is unsubstituted or where preceded by“halo” is substituted only with one or more halogens, and is independently C 1-4 aliphatic, -CH 2 Ph, -O(CH 2 )o
  • Suitable substituents on a substitutable nitrogen include -R ⁇ , - NR ⁇ 2, -C(O)R ⁇ , - C(O)OR ⁇ , -C(O)C(O)R ⁇ , -C(O)CH 2 C(O)R ⁇ , -S(O)2R ⁇ , -S(O)2NR ⁇ 2 , - C(S)NR ⁇ 2 , - C(NH)NR ⁇ 2 , or -N(R ⁇ )S(O) 2 R ⁇ ; wherein each R ⁇ is independently hydrogen, ci 6 aliphatic which may be substituted as defined below, unsubstituted -OPh, or an unsubstituted 5- 6- membered saturated, partially unsaturated, oraryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or, notwithstanding the definition above, two independent occurrences of R ⁇ , taken together with their intervening atom(s) form an unsubstituted 3-12-membered saturated, partially
  • Suitable substituents on the aliphatic group of R ⁇ are independently halogen, -R ⁇ , -(R ⁇ ), -OH, -OR ⁇ , -O(haloR ⁇ , ), -CN, -C(O)OH, -C(O)OR ⁇ , -NH 2 , -NHR ⁇ , -NR ⁇ , or -N0 2 , wherein each R ⁇ is unsubstituted or where preceded by“halo” is substituted only with one or more halogens, and is independently C 1-4 aliphatic, -CH 2 Ph, -O(CH 2 ) 0-1 Ph. or a 5-6- membered saturated, partially unsaturated, or aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur.
  • N-acetylcysteine which has the following structure:
  • N-acetylcysteine may be linked to a TCA cycle intermediate via any bond that provides adequate stability but can be broken in vivo to release the TCA cycle intermediate.
  • N-acetylcysteine is linked via the sulfur atom in its side chain to form a thioether or thioester bond with the TCA cycle intermediate. N-acetylcysteine may also linked via an oxygen atom in the carboxyl group.
  • N-acetylcysteine may be linked to any portion of the TCA cycle intermediate.
  • N-acetylcysteine is linked to a carboxy group of the TCA cycle intermediate, such as one or both of the terminal carboxyl groups in succinate, to form a thioester bond.
  • N-acetylcysteine may form a thioether bond by substituting for one or more hydroxyl group in a TCA cycle intermediate.
  • the compound may contain multiple copies of N-acetylcysteine.
  • the compound may have N-acetylcysteine linked to two or more positions on the TCA cycle intermediate, such as a N-acetylcysteine linked to each terminal carbon in succinate via thioester bonds.
  • the compound may contain another amino acid, i.e., an amino acid in addition to the N- acetylcysteine.
  • the other amino acid may be any naturally-occurring or non-naturally-occurring amino acid.
  • Naturally-occurring amino acids include the following twenty amino acids that are encoded by the genetic code and incorporated into polypeptides by the translational machinery: alanine, arginine, asparagine, aspartic acid, cysteine, glutamine, glutamic acid, glycine, histidine, isoleucine, leucine, lysine, methionine, phenylalanine, proline, serine, threonine, tryptophan, tyrosine, or valine.
  • Non-naturally-occurring amino acids include amino acids that are not found in proteins or produced by cellular metabolic machinery, such as those described in Young and Schultz, Beyond the Canonical 20 Amino Acids: Expanding the Genetic Lexicon, J. Biol. Chem. 285(15):11039-11044 (2010); US Patent No. 7,566,555; and US Patent No. 9,488,660, each of which is incorporated herein by reference.
  • the compounds may include two or more TCA intermediates or prodrugs thereof attached via one or more linkers or backbone moieties.
  • the backbone moiety may be a C2-20 hydrocarbon moiety substituted with two or more groups selected from one or more of hydroxyl, amino groups, and carboxyl groups.
  • the backbone moiety may be a polyol, such as a C2-C20 polyol, e.g., glycerol, erythritol, or xylitol.
  • the two or more TCA intermediates or prodrugs thereof may be attached to each other directly.
  • the compounds may be represented by formula (VI):
  • R 1 , R 2 , and R’ are TCA cycle intermediates or prodrugs thereof, and R 4 , R 5 , and R 6 are amino acids.
  • R 1 , R 2 , and R 3 may be the same or different, and R 4 , R 5 , and R 6 may be the same or different.
  • R 1 , R 2 , and R 3 may be succinate.
  • R 4 , R 5 , and R 6 may be serine, threonine, or tyrosine.
  • R 4 , R 5 , and R 6 are serine, threonine, or tyrosine, they may be linked via the oxygen atom on their side chains, and the carboxyl group and amino group may be free and thus able to form COO and N3 ⁇ 4 + ions in aqueous solutions.
  • the compounds may include one or more atoms that are enriched for an isotope.
  • the compounds may have one or more hydrogen atoms replaced with deuterium or tritium. Isotopic substitution or enrichment may occur at carbon, sulfur, or phosphorus atoms as well.
  • the compounds may be isotopically substituted or enriched for a given atom at one or more positions within the compound, or the compounds may be isotopically substituted or enriched at all instances of a given atom within the compound.
  • the compounds may have an octanol: water partition coefficient of less than 0.1, less than 0.01, less than 0.001, less than 0.0001, less than 0.0001, less than 0.00001, or less than 0.000001.
  • TCA cycle intermediates can be increased by covalently linking capping moieties to such molecules.
  • capping moieties as substituents on the hydroxyl groups of TCA cycle intermediates.
  • Such capped- alcohol molecules have improved solubility and do not have offensive odors.
  • the invention provides compounds that include a TCA cycle intermediate or prodrug thereof and covalently linked to two or more capping moieties.
  • the compounds may include a TCA cycle intermediate linked to two, three, four, five, or six capping moieties.
  • the TCA cycle intermediate or prodrug thereof may be citrate, cis-aconitate, D-isocitrate, a-ketoglutarate, succinate, fumarate, malate, oxaloacetate, acetone, acetoacetate, b- hydroxybutyrate, b-ketopentanoate, or b-hydroxypentanoate.
  • the TCA cycle intermediate is succinate.
  • the TCA cycle intermediate may have L or R chirality. Compositions including such compounds may include only L-forms, only R-forms, or racemic mixtures of L- and R-forms of the TCA cycle intermediate.
  • the two or more capping moieties may be the same, or they may be different.
  • the capping moieties may be polyols, such as C2-C20 polyols, amino acids, or other TCA cycle intermediates or prodrugs thereof.
  • the compound may have two capping moieties, both of which are glycerol.
  • the compound may have two capping moieties, with one being malate and the other being serine.
  • the capping moieties may be linked by any atoms on the TCA cycle intermediate or prodrug thereof.
  • capping moieties are substituted onto hydroxyl groups and attached via alkoxy linkages.
  • a capping moiety is substituted onto the hydroxyl group of each of the terminal carbon atoms in the carbon skeleton of the TCA cycle intermediate or prodrug thereof.
  • the TCA cycle intermediate or prodrug thereof may be represented by one of formulas (VII), (VIII), (IX), (X), (XI), and (XII):
  • the compounds include a polyol, a TCA cycle intermediate or prodrug thereof covalently linked to the polyol, and an amino acid covalently linked to the TCA cycle intermediate or prodrug thereof.
  • the polyol is glycerol
  • the TCA intermediates or prodrugs thereof is succinate
  • the amino acid is serine.
  • the polyol may be linked via a terminal hydroxy group or an internal hydroxy group.
  • glycerol may linked to the TCA cycle intermediate or prodrug thereof via a hydroxy group on its first, second, or third carbon.
  • the compound may be represented by one of formulas (XIII) and (XIV):
  • the TCA cycle intermediate is a-ketoglutarate.
  • the amino acid is serine.
  • the polyol is glycerol.
  • the compound is represented formula (XV):
  • the TCA cycle intermediate is b-hydroxybutyrate.
  • the amino acid is serine.
  • the polyol is glycerol.
  • the compound is represented formula (XVI):
  • the invention provides compounds including citrate or citric acid, prodrugs, analogs, derivatives, or salts thereof, and one or more amino acids.
  • the compound includes a plurality of amino acids, e.g., at least two or three amino acids.
  • the compound includes three amino acids. Numerous different types of amino acids can be conjugated to the citrate.
  • the amino acids may be any naturally- occurring or non-naturally-occurring amino acids or combinations thereof (e.g., all naturally occurring, all non-naturally occurring, or a combination of naturally and non-naturally occurring amino acids).
  • amino acids may be alanine, arginine, asparagine, aspartic acid, cysteine, glutamine, glutamic acid, glycine, histidine, isoleucine, leucine, lysine, methionine,
  • the amino acid may be serine and tyrosine. In certain embodiments, the amino acid is serine and the compound includes three serines.
  • An exemplary compound is represented formula (XVII):
  • the composition is formulated for oral administration. In certain embodiments, the composition is formulated as a single unit dose.
  • the TCA cycle intermediate or prodrug thereof is selected from the group consisting of citrate, cis-aconitate, D-isocitrate, a-ketoglutarate, succinate, fumarate, malate, oxaloacetate, pyruvate, acetone, acetoacetate, b-hydroxybutyrate, b-ketopentanoate, and b-hydroxypentanoate.
  • the TCA cycle intermediate or prodrug thereof is citrate.
  • the polyol is glycerol.
  • the composition comprises a plurality of citrate molecules covalently bound to one or more glycerol molecules.
  • the composition comprises a plurality of citrate molecules, at least one of which is covalently bound to a plurality of glycerol molecules.
  • a preferred compound is a compound of Formula XVIII:
  • the condition associated with altered TCA cycle metabolism may be an inherited disorder, a neurodegenerative disorder, a cancer, an energetic disorder, refractory epilepsy, propionic acidemia (PA), methylmalonic acidemia (MMA), a long chain fatty acid oxidation disorder, succinyl CoA lyase deficiency, pymvate carboxylase deficiency, mitochondrial respiratory chain deficiency, glutaric acidemia type 1 or type 2 a neurologic disease, disorder or condition, a pain or fatigue disease, muscular dystrophy, mitochondrial myopathy, mitochondrial encephalomyopathy lactic acidosis and stroke-like syndrome (MELAS), myoclonic epilepsy and ragged-red fibers (MERRF), a mitochondrial associated disease, and a disorder related to POLG
  • compositions comprising a TCA cycle intermediate anhydride or polymer or pharmaceutically acceptable salt or prodrug thereof in a therapeutically effective amount to treat a condition associated with altered TCA cycle metabolism in a subject.
  • the TCA cycle intermediate or pharmaceutically acceptable salt or polymer or prodrug thereof may be selected from the group consisting of citrate, cis-aconitate, D-isocitrate, a-ketoglutarate, succinate, fumarate, malate, oxaloacetate, pyruvate, acetone, acetoacetate, b-hydroxybutyrate, b-ketopentanoate, and b-hydroxypentanoate.
  • the prodrug comprises one or more polyols. In other embodiments, the prodrug comprises one or more amino acids. In certain embodiments, the prodrug comprises one or more polyols and one or more amino acids. In certain embodiments, the composition is a polymer of a TCA cycle intermediate, e.g., one or more repeating units of a TCA cycle intermediate monomer.
  • the composition is formulated for oral or gastric administration. In certain embodiments, the composition is formulated as a single unit dose.
  • the condition associated with altered TCA cycle metabolism may be an inherited disorder, a neurodegenerative disorder, a cancer, an energetic disorder, refractory epilepsy, propionic acidemia (PA), methylmalonic acidemia (MMA), a long chain fatty acid oxidation disorder, succinyl CoA lyase deficiency, pymvate carboxylase deficiency, mitochondrial respiratory chain deficiency, glutaric acidemia type 1 or type 2 a neurologic disease, disorder or condition, a pain or fatigue disease, muscular dystrophy, mitochondrial myopathy, mitochondrial encephalomyopathy lactic acidosis and stroke-like syndrome (MELAS), myoclonic epilepsy and ragged-red fibers (MERRF), a mitochondrial associated disease, and a disorder related to POLG
  • compositions containing one or more of the compounds described above may be in a form suitable for oral use, for example, as tablets, troches, lozenges, fast-melts, aqueous or oily suspensions, dispersible powders or granules, emulsions, hard or soft capsules, syrups or elixirs.
  • Compositions intended for oral use may be prepared according to any method known in the art for the manufacture of pharmaceutical compositions and such compositions may contain one or more agents selected from sweetening agents, flavoring agents, coloring agents and preserving agents, in order to provide pharmaceutically elegant and palatable preparations.
  • Tablets contain the compounds in admixture with non-toxic pharmaceutically acceptable excipients which are suitable for the manufacture of tablets.
  • excipients may be for example, inert diluents, such as calcium carbonate, sodium carbonate, lactose, calcium phosphate or sodium phosphate; granulating and disintegrating agents, for example corn starch, or alginic acid; binding agents, for example starch, gelatin or acacia, and lubricating agents, for example magnesium stearate, stearic acid or talc.
  • the tablets may be uncoated or they may be coated by known techniques to delay disintegration in the stomach and absorption lower down in the gastrointestinal tract and thereby provide a sustained action over a longer period.
  • a time delay material such as glyceryl monostearate or glyceryl distearate may be employed. They may also be coated by the techniques described in U.S. Patents 4,256,108, 4,166,452 and 4,265,874, to form osmotic therapeutic tablets for control release. Preparation and administration of compounds is discussed in U.S. Pat. 6,214,841 and U.S. Pub. 2003/0232877, incorporated by reference herein in their entirety.
  • Formulations for oral use may also be presented as hard gelatin capsules in which the compounds are mixed with an inert solid diluent, for example calcium carbonate, calcium phosphate or kaolin, or as soft gelatin capsules in which the compounds are mixed with water or an oil medium, for example peanut oil, liquid paraffin or olive oil.
  • an inert solid diluent for example calcium carbonate, calcium phosphate or kaolin
  • an oil medium for example peanut oil, liquid paraffin or olive oil.
  • An alternative oral formulation where control of gastrointestinal tract hydrolysis of the compound is sought, can be achieved using a controlled-release formulation, where a compound of the invention is encapsulated in an enteric coating.
  • Aqueous suspensions may contain the compounds in admixture with excipients suitable for the manufacture of aqueous suspensions.
  • excipients are suspending agents, for example sodium carboxymethylcellulose, methylcellulose, hydroxypropylmethylcellulose, sodium alginate, polyvinylpyrrolidone, gum tragacanth and gum acacia; dispersing or wetting agents such as a naturally occurring phosphatide, for example lecithin, or condensation products of an alkylene oxide with fatty acids, for example, polyoxyethylene stearate, or condensation products of ethylene oxide with long chain aliphatic alcohols, for example heptadecaethyleneoxycetanol, or condensation products of ethylene oxide with partial esters derived from fatty acids and a hexitol such a polyoxyethylene with partial esters derived from fatty acids and hexitol anhydrides, for example polyoxyethylene sorbitan monooleate.
  • dispersing or wetting agents such as a naturally occurring phosphatide, for example lecithin, or condensation products of an alkylene oxide with fatty acids, for example, polyoxyethylene stea
  • the aqueous suspensions may also contain one or more preservatives, for example ethyl, or n-propyl p-hydroxybenzoate, one or more coloring agents, one or more flavoring agents, and one or more sweetening agents, such as sucrose or saccharin.
  • preservatives for example ethyl, or n-propyl p-hydroxybenzoate
  • coloring agents for example ethyl, or n-propyl p-hydroxybenzoate
  • flavoring agents for example ethyl, or n-propyl p-hydroxybenzoate
  • sweetening agents such as sucrose or saccharin.
  • Oily suspensions may be formulated by suspending the compounds in a vegetable oil, for example, arachis oil, olive oil, sesame oil or coconut oil, or in a mineral oil such as liquid paraffin.
  • the oily suspensions may contain a thickening agent, for example beeswax, hard paraffin or cetyl alcohol. Sweetening agents such as those set forth above, and flavoring agents may be added to provide a palatable oral preparation. These compositions may be preserved by the addition of an anti-oxidant such as ascorbic acid.
  • Dispersible powders and granules suitable for preparation of an aqueous suspension by the addition of water provide the compounds in admixture with a dispersing or wetting agent, suspending agent and one or more preservatives.
  • a dispersing or wetting agent, suspending agent and one or more preservatives Suitable dispersing or wetting agents and suspending agents are exemplified, for example sweetening, flavoring and coloring agents, may also be present.
  • the pharmaceutical compositions of the invention may also be in the form of oil-in-water emulsions.
  • the oily phase may be a vegetable oil, for example olive oil or arachis oil, or a mineral oil, for example liquid paraffin or mixtures of these.
  • Suitable emulsifying agents may be naturally-occurring gums, for example gum acacia or gum tragacanth, naturally occurring phosphatides, for example soya bean, lecithin, and esters or partial esters derived from fatty acids and hexitol anhydrides, for example sorbitan monooleate and condensation products of the said partial esters with ethylene oxide, for example polyoxyethylene sorbitan monooleate.
  • the emulsions may also contain sweetening and flavoring agents.
  • Syrups and elixirs may be formulated with sweetening agents, such as glycerol, propylene glycol, sorbitol or sucrose. Such formulations may also contain a demulcent, a preservative, and agents for flavoring and/or coloring.
  • the pharmaceutical compositions may be in the form of a sterile injectable aqueous or oleaginous suspension. This suspension may be formulated according to the known art using those suitable dispersing or wetting agents and suspending agents which have been mentioned above.
  • the sterile injectable preparation may also be in a sterile injectable solution or suspension in a non-toxic parenterally acceptable diluent or solvent, for example as a solution in 1,3-butanediol.
  • Suitable vehicles and solvents that may be employed are water, Ringer's solution and isotonic sodium chloride solution.
  • sterile, fixed oils are conventionally employed as a solvent or suspending medium.
  • any bland fixed oil may be employed including synthetic mono- or di-glycerides.
  • fatty acids such as oleic acid find use in the preparation of injectables.
  • compositions of the invention may include other pharmaceutically acceptable carriers, such as sugars, such as lactose, glucose and sucrose; starches, such as com starch and potato starch; cellulose, and its derivatives, such as sodium carboxymethyl cellulose, ethyl cellulose and cellulose acetate; powdered tragacanth; malt; gelatin; talc; excipients, such as cocoa butter and suppository waxes; oils, such as peanut oil, cottonseed oil, safflower oil, sesame oil, olive oil, com oil and soybean oil; glycols, such as propylene glycol; polyols, such as glycerin (glycerol), erythritol, xylitol.
  • sugars such as lactose, glucose and sucrose
  • starches such as com starch and potato starch
  • cellulose, and its derivatives such as sodium carboxymethyl cellulose, ethyl cellulose and cellulose acetate
  • sorbitol mannitol and polyethylene glycol
  • esters such asethyl oleate and ethyllaurate
  • agar buffering agents, such as magnesium hydroxide and aluminum hydroxide; alginic acid; pyrogen-free water; isotonic saline; Ringer’s solution; ethyl alcohol; pH buffered solutions; polyesters, polycarbonates and/or poly anhydrides; and other non-toxic compatible substances employed in pharmaceutical formulations.
  • compositions of the invention may be provided as pharmaceutically acceptable salts, such as nontoxic acid addition salts, which are salts of an amino group formed with inorganic acids such as hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid and perchloric acid or with organic acids such as acetic acid, maleic acid, tartaric acid, citric acid, succinic acid or malonic acid or by using other methods used in the art such as ion exchange.
  • nontoxic acid addition salts which are salts of an amino group formed with inorganic acids such as hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid and perchloric acid or with organic acids such as acetic acid, maleic acid, tartaric acid, citric acid, succinic acid or malonic acid or by using other methods used in the art such as ion exchange.
  • pharmaceutically acceptable salts include, but are not limited to, adipate, alginate, ascorbate, aspartate, benzenesulfonate, benzoate, bisulfate, borate, butyrate, camphorate, camphor sulfonate, citrate, cyclopentanepropionate, digluconate, dodecylsulfate, ethanesulfonate, formate, fumarate, glucoheptonate, glycerophosphate, gluconate, hemisulfate, heptanoate, hexanoate, hydroiodide, 2-hydroxy-ethanesulfonate, lactobionate, lactate, laurate, lauryl sulfate, malate, maleate, malonate, methanesulfonate, 2-naphthalenesulfonate, nicotinate, nitrate, oleate, oxalate, palm
  • alkali or alkaline earth metal salts include sodium, lithium, potassium, calcium, magnesium, and the like.
  • a pharmaceutically acceptable salt is an alkali salt.
  • a pharmaceutically acceptable salt is a sodium salt.
  • a pharmaceutically acceptable salt is an alkaline earth metal salt.
  • pharmaceutically acceptable salts include, when appropriate, nontoxic ammonium, quaternary ammonium, and amine cations formed using counter ions such as halide, hydroxide, carboxylate, sulfate, phosphate, nitrate, alkyl having from 1 to 6 carbon atoms, sulfonate and aryl sulfonate.
  • the compounds of the invention allow for delivery of TCA cycle intermediates or prodrugs thereof to tissues that have abnormal TCA cycle metabolism.
  • the invention also provides methods of treating conditions associated with altered TCA cycle metabolism in a subject by providing compositions of the invention.
  • the methods include providing a composition of the invention, as described above, to the subject.
  • Providing may include administering the composition to the subject.
  • the composition may be administered by any suitable means, such as orally, intravenously, enterally, parenterally, dermally, buccally, topically (including transdermally), by injection, intravenously, nasally, pulmonarily, and with or on an implantable medical device (e.g., stent or drug-eluting stent or balloon equivalents).
  • an implantable medical device e.g., stent or drug-eluting stent or balloon equivalents.
  • the condition may be any disease or disorder associated with altered TCA cycle metabolism or that can be ameliorated by providing an intermediate of the TCA cycle.
  • the condition may be an inherited disorder, such as 2-oxoglutaric aciduria, fumarase deficiency, or succinyl-CoA synthetase deficiency.
  • the condition may be a neurodegenerative disorder, such as Amyotrophic Lateral Sclerosis, Alzheimer's disease, Parkinson's disease, or Huntington's disease.
  • the condition may be a cancer, such as pancreatic cancer, kidney cancer, cervical cancer, prostate cancer, muscle cancer, gastric cancer, colon cancer, glioblastoma, glioma, paraganglioma, leukemia, liver cancer, breast cancer, carcinoma, neuroblastoma.
  • a cancer such as pancreatic cancer, kidney cancer, cervical cancer, prostate cancer, muscle cancer, gastric cancer, colon cancer, glioblastoma, glioma, paraganglioma, leukemia, liver cancer, breast cancer, carcinoma, neuroblastoma.
  • the condition may be an energetic disorder, refractory epilepsy, propionic acidemia (PA), methylmalonic acidemia (MMA), a long chain fatty acid oxidation disorder, succinyl CoA lyase deficiency, pyruvate carboxylase deficiency, mitochondrial respiratory chain deficiency, glutaric acidemia type 1 or type 2 a neurologic disease, disorder or condition, a pain or fatigue disease, muscular dystrophy (e.g., Duchenne’s muscular dystrophy and Becker’s muscular dystrophy), mitochondrial myopathy, mitochondrial encephalomyopathy lactic acidosis and stroke-like syndrome (MELAS), myoclonic epilepsy and ragged-red fibers (MERRF), a mitochondrial associated disease, or a disorder related to a POLG mutation.
  • PA propionic acidemia
  • MMA methylmalonic acidemia
  • a long chain fatty acid oxidation disorder e.g., succinyl CoA lyase defic
  • Example 1 The compound of formula (XIII) was made and analyzed. The compound of formula (XIII) was found to have a solubility in water of 1.2 g/mL and to taste slightly sweet but not bitter.

Landscapes

  • Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)

Abstract

L'invention concerne des compositions et des procédés pour traiter des états associés à un métabolisme de cycle TCA modifié. L'invention surmonte les défis d'administration de grandes quantités d'intermédiaires de TCA par incorporation de tels intermédiaires dans des molécules de solubilité plus élevée qui peuvent être métabolisées pour libérer les intermédiaires dans le corps.
PCT/US2020/016311 2019-02-08 2020-02-03 Compositions contenant de la n-acétylcystéine conjuguée à un intermédiaire de cycle tca WO2020163188A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201962803019P 2019-02-08 2019-02-08
US62/803,019 2019-02-08

Publications (1)

Publication Number Publication Date
WO2020163188A1 true WO2020163188A1 (fr) 2020-08-13

Family

ID=71948039

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2020/016311 WO2020163188A1 (fr) 2019-02-08 2020-02-03 Compositions contenant de la n-acétylcystéine conjuguée à un intermédiaire de cycle tca

Country Status (1)

Country Link
WO (1) WO2020163188A1 (fr)

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2010033871A2 (fr) * 2008-09-18 2010-03-25 The Johns Hopkins University Compositions et procédés de ciblage de glutaminase
US9233090B2 (en) * 2010-10-21 2016-01-12 Nestec S.A. Cysteine and food intake
WO2017147220A1 (fr) * 2016-02-23 2017-08-31 Carnot, Llc Traitement combiné
US10137103B2 (en) * 2015-11-06 2018-11-27 The Children's Hospital Of Philadelphia Compositions and methods for the treatment of fatty acid metabolism disorders
WO2019023231A1 (fr) * 2017-07-24 2019-01-31 Carnot, Llc Compositions et méthodes pour le traitement d'états associés à un métabolisme de cycle de tca modifié

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2010033871A2 (fr) * 2008-09-18 2010-03-25 The Johns Hopkins University Compositions et procédés de ciblage de glutaminase
US9233090B2 (en) * 2010-10-21 2016-01-12 Nestec S.A. Cysteine and food intake
US10137103B2 (en) * 2015-11-06 2018-11-27 The Children's Hospital Of Philadelphia Compositions and methods for the treatment of fatty acid metabolism disorders
WO2017147220A1 (fr) * 2016-02-23 2017-08-31 Carnot, Llc Traitement combiné
WO2019023231A1 (fr) * 2017-07-24 2019-01-31 Carnot, Llc Compositions et méthodes pour le traitement d'états associés à un métabolisme de cycle de tca modifié

Similar Documents

Publication Publication Date Title
TW592691B (en) Solid compositions containing 4-amino-3-substituted butanoic acid derivatives and process for preparing the same
JP6177787B2 (ja) 治療薬のポリマーコンジュゲートの皮下送達
US20100297262A1 (en) Pharmaceutically active compositions comprising oxidative stress modulators (osm), new chemical entities, compositions and uses
CA2785834A1 (fr) Derives d'acides gras et analogues de medicaments
TWI564291B (zh) 一氧化氮生成調節劑
EP3658135A1 (fr) Compositions et méthodes pour le traitement d'états associés à un métabolisme de cycle de tca modifié
EP3509578B1 (fr) Composés d'acide hydroxycitrique bimétalliques monomères et leurs procédés de fabrication et utilisation
WO2020163188A1 (fr) Compositions contenant de la n-acétylcystéine conjuguée à un intermédiaire de cycle tca
CA3113290A1 (fr) Compositions et procedes de traitement et de prevention de la neuropathie optique hereditaire de leber
EP3928835A1 (fr) Dérivé polymère soluble dans l'eau de vénétoclax
EP3143032B1 (fr) Nouveaux dérivés de oxazaphosphorines et leurs utilisations thérapeutiques
WO2011143590A1 (fr) Compositions et méthodes de polythérapie utilisant dérivés d'acide lipoïque et agent antiprolifératif
CN113710323A (zh) 偶联物及癌治疗剂
EP3071238B1 (fr) Conjugué comprenant de l'indole-3-carbinol à usage médical
WO2021229832A1 (fr) Dérivé polymère soluble dans l'eau de vénétoclax
US6245815B1 (en) Method of treating alcoholism and complications resulting therefrom
US20220133657A1 (en) Compounds for prevention and treatment of obesity and related disorders
ITRM980445A1 (it) Composizioni solide atte alla somministrazione orale comprendenti sali non igroscopici della l-carnitina e delle alcanoil l-carnitine
ITMI20111452A1 (it) Soluzione basica di acido alfa-lipoico e suoi usi
JP2022551528A (ja) カンナビノイドを含む経口医薬組成物およびその製造方法
KR20230063061A (ko) Her2-발현 암에 대한 신규 항체-약물 접합체 및 이의 용도
CN116731305A (zh) 一种抗肿瘤大环内酯聚合物及其制备方法和应用
PT88309B (pt) Processo para a preparacao de esteres de butilo terciario de drogas anticancerigenas e sua utilizacao para melhorar a administracao das drogas ao cerebro
CA2507848A1 (fr) Compositions a base d'ifosfamide pour l'administration parenterale et leur procede de preparation

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 20752852

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

32PN Ep: public notification in the ep bulletin as address of the adressee cannot be established

Free format text: NOTING OF LOSS OF RIGHTS PURSUANT TO RULE 112(1) EPC (EPO FORM 1205A DATED 16.11.2021)

122 Ep: pct application non-entry in european phase

Ref document number: 20752852

Country of ref document: EP

Kind code of ref document: A1