WO2020191501A1 - Methods and uses of bemithyl and derivatives for treating lung disease, fatty liver disease, and kidney disorders - Google Patents

Methods and uses of bemithyl and derivatives for treating lung disease, fatty liver disease, and kidney disorders Download PDF

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WO2020191501A1
WO2020191501A1 PCT/CA2020/050407 CA2020050407W WO2020191501A1 WO 2020191501 A1 WO2020191501 A1 WO 2020191501A1 CA 2020050407 W CA2020050407 W CA 2020050407W WO 2020191501 A1 WO2020191501 A1 WO 2020191501A1
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alkyl
aryl
heteroaryl
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groups
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Mark Williams
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Algernon Pharmaceuticals Inc.
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    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D413/00—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and oxygen atoms as the only ring hetero atoms
    • C07D413/02—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and oxygen atoms as the only ring hetero atoms containing two hetero rings
    • C07D413/12—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and oxygen atoms as the only ring hetero atoms containing two hetero rings linked by a chain containing hetero atoms as chain links
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/4164—1,3-Diazoles
    • A61K31/4184—1,3-Diazoles condensed with carbocyclic rings, e.g. benzimidazoles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/535—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one oxygen as the ring hetero atoms, e.g. 1,2-oxazines
    • A61K31/5375—1,4-Oxazines, e.g. morpholine
    • A61K31/5377—1,4-Oxazines, e.g. morpholine not condensed and containing further heterocyclic rings, e.g. timolol
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/16—Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00—Drugs for disorders of the respiratory system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00—Drugs for disorders of the urinary system
    • A61P13/12—Drugs for disorders of the urinary system of the kidneys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D235/00—Heterocyclic compounds containing 1,3-diazole or hydrogenated 1,3-diazole rings, condensed with other rings
    • C07D235/02—Heterocyclic compounds containing 1,3-diazole or hydrogenated 1,3-diazole rings, condensed with other rings condensed with carbocyclic rings or ring systems
    • C07D235/04—Benzimidazoles; Hydrogenated benzimidazoles
    • C07D235/18—Benzimidazoles; Hydrogenated benzimidazoles with aryl radicals directly attached in position 2

Definitions

  • the present invention relates to bemithyl and derivatives, methods and uses of bemithyl derivatives for treating fibrotic diseases, and in particular, chronic lung disease, including idiopathic pulmonary fibrosis; non-alcoholic fatty liver disease, and in particular, non-alcoholic fatty liver, and non-alcoholic steatohepatitis; and kidney disorders, and in particular, renal fibrosis and/or chronic kidney disease.
  • chronic lung disease including idiopathic pulmonary fibrosis; non-alcoholic fatty liver disease, and in particular, non-alcoholic fatty liver, and non-alcoholic steatohepatitis; and kidney disorders, and in particular, renal fibrosis and/or chronic kidney disease.
  • Bemithyl 2-ethylsulfanyl-lH-benzoimidazole
  • a synthetic a cto protector antioxidant, and antimutagenic
  • the chemical structure of bemithyl is:
  • Idiopathic pulmonary fibrosis is a form of interstitial lung disease that is characterized by scarring (fibrosis) of the lungs. This results in progressive and irreversible decline in lung operation, including breathing. Symptoms typically include gradual onset of shortness of breath and a dry, chronic cough. Other symptoms include chest pain and fatigue. The causes of IPF is not completely understood. However, factors which increase the risk of IPF include cigarette smoking, acid reflux, and a family history of the condition.
  • BLM bleomycin
  • Intratracheal administration of bleomycin effectively mimics the chronic aspect of pulmonary fibrosis, as well as other characteristics including the presence of hyperplastic alveolar epithelial cells.
  • BLM is initially and directly introduced to the alveolar epithelial cells, to develop neutrophilia and lymphocytes and BLM- induced fibrosis develops after about seven days.
  • BLM-induced fibrosis in mice constitutes an animal model of IPF with high degree of similarity to the histopathological characteristics and distribution of lung fibrosis described in human idiopathic pulmonary fibrosis.
  • Non-alcoholic fatty liver disease covers a range of liver conditions characterized by too much fat stored in liver cells. As its name implies, the causes are generally unrelated to alcohol consumption. This is in contrast to alcoholic liver disease, which is caused by heavy alcohol use.
  • NAFLD non-alcoholic simple fatty liver or non- alcoholic steatohepatitis
  • Nonalcoholic fatty liver is a condition where you have fat in your liver but little or no inflammation or liver cell damage. It typically does not progress to cause liver damage or complications.
  • NASH includes both a fatty liver and liver inflammation. While those with only nonalcoholic fatty liver are generally asymptomatic, the inflammation and liver cell damage with NASH can cause fibrosis, or scarring, of the liver, and in severe cases, may lead to cirrhosis (advanced scarring) or liver cancer. In that regard, common signs and symptoms of NASH and cirrhosis can include abdominal swelling, enlarged blood vessels just beneath the skin's surface, enlarged breasts in men and jaundice.
  • Drugs currently used to treat NAFLD and NASH may help to increase fat loss and/or improve biomedical marker levels, but none have been shown to reverse or reduce NAFLD and NASH once liver scarring has begun.
  • the murine models of NAFLD and NASH are well-characterized experimental models of metabolically-induced hepatic injury that ultimately lead to spontaneous hepatic steatosis - a common characteristic of many chronic hepatitis disorders.
  • the progression towards fatty liver is highly predictable and reproducible, leading to steatosis based on insulin resistance and obesity
  • Ishii et al Female spontaneously diabetic Torii fatty rats develop nonalcoholic steatohepatitis-like hepatic lesions, World J Gastroenterol, 21(30):9067-78 (2015); Kucera 0 and Cervinkova Z, Experimental models of non-alcoholic fatty liver disease in rats, World J Gastroenterol, 20(26) :8364-76 (2014); Takahashi et al, Animal models of nonalcoholic fatty liver diseaselnonalcoholic steatohepatitis, World J
  • NASH-HCC NASH-derived hepatocellular carcinoma
  • STAM IM Stelic Animal Model
  • Chronic kidney disease is a form of kidney disease characterized by damage to the kidneys that worsens over time, often as result of renal fibrosis. This causes gradual loss of kidney functions, so that excess fluid and waste from the blood remain in the body and may cause other health problems.
  • the murine model of UUO surgical intervention is a well- characterized experimental model of renal injury that ultimately leads to tubulointerstitial fibrosis, depending on the duration of obstruction. In this model, the progression of renal fibrosis is highly predictable and
  • lung diseases and in particular, chronic lung disease, including idiopathic pulmonary fibrosis; non alcoholic fatty liver disease, and in particular, non-alcoholic fatty liver disease, non-alcoholic fatty liver, and non-alcoholic steatohepatitis; and kidney disorders, and in particular, renal fibrosis and/or chronic kidney disease.
  • chronic lung disease including idiopathic pulmonary fibrosis; non alcoholic fatty liver disease, and in particular, non-alcoholic fatty liver disease, non-alcoholic fatty liver, and non-alcoholic steatohepatitis; and kidney disorders, and in particular, renal fibrosis and/or chronic kidney disease.
  • A is N or C, subject to the proviso that R 5 is absent when A is N;
  • Q represents a covalent bond; or Q represents— O— ,— S— ,— S(O)-,— S(O) 2 -,— N(R 9 )— ,— C(O)N(R 9 )— , -N(R 9 ) C(O)-, S(O) 2 N(R 9 )- or— N(R 9 )S(O)2— ; or Q represents an optionally substituted straight or branched C 1-6 ;lkylene chain optionally comprising one, two or three heteroatom-containing linkages independently selected from— O— ,— S— ,— S(O)-,— S(O) 2 -,— N(R 9 )— ,— C(O)N(R 9 )— , -N(R 9 )C(O)-,— S(O) 2 -N(R 9 )- and— N(R 9 ) S(O) 2 — ;
  • Z represents hydrogen, halogen or trifluoromethyl; or Z represents C 1-6 alkyl, C 3-7 cycloalkyl, aryl, C 3-7 heterocycloalkyl, C 3- 7 heterocycloalkenyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; or Z represents— Z 1 — Z 2 or— Z 1 — C(O)— Z 2 , either of which moieties may be optionally substituted by one or more substituents;
  • Z 1 represents a divalent radical derived from an aryl, C 3- 7 heterocycloalkyl or heteroaryl group
  • Z 2 represents aryl, C 3-7 heterocycloalkyl, C 3-7 heterocycloalkenyl, (C 4-9 )heterobicycloalkyl, (C 4-9 )spiroheterocycloalkyl or heteroaryl; or
  • Q-Z represents H, halo, loweralkyl, haloloweralkyl
  • cycloalkylalkylamino cycloalkyl, alkylcycloalkyl, hydroxyamino
  • X represents a covalent bond ; or X represents,— S(O) 2 — or— N(R 8 )— ; or X represents an optionally substituted straight or branched C 1- 4 alkylene chain; or X represents,— C(O)— ; or X represents— O— ,—
  • Y represents C 3-7 cycloalkyl, aryl, C 3-7 heterocycloalkyl or heteroaryl;
  • Y represents a linking group such as alkyl (e.g.,— R— where R is C 2- 6 alkyl), alkenyl (e.g.,— R— where R is C 2- 6 alkenyl), cycloalkyl (e.g.,— R— where R is C 3-6 cycloalkyl), alkylcycloalkyl(e.g.,— R— R'— , where R is C 1-4 alkyl and R' is C 3-6 cycloalkyl), cylcoalkylalkyl (e.g.,— R— R'— , where R is C 3- 6 cycloalkyl and R' is C 1-4 alkyl), alkylcycloalkylalkyl (e.g .,— R— R'— R"— , wherein R is C 1-4 alkyl, R' is C 3-6 cycloalkyl, and R" is C 1-4 alkyl), alkyloxyalkyl (e.g.,—
  • alkylheterocyclealkyl heterocycle, aminoalkyl (e.g.,— N(R)R'— , where R is H or C 1-4 alkyl and R' is C 1-4 alkyl), oxyalkyl (e.g.,— O— R— where R is C 2- 6 alkyl), aminoaryl (e.g.,— N(R)R'— , where R is H or C 1-4 alkyl and R' is aryl), and oxyaryl (e.g.,— O— R— , where R is aryl), any of which groups may be optionally substituted by one or more substituents; and
  • R 1 and R 2 are each independently H, loweralkyl, or together form C 2-4 alkylene;
  • E is H
  • E is selected from the group consisting of -B(OR 1 )OR 2 , - CON(R1)0R 2 , and— N(OR 1 )COR 2 or any of the additional alternatives for E described in greater detail below; or
  • X-Y-E represents alkyl, phenyl, substituted phenyl, naphthyl and substituted naphthyl, wherein the substituent in said substituted phenyl and substituted naphthyl is selected from the group consisting of halogen, cyano, alkyl, alkoxy, ester, N-acyl derivatives, N-acyloxy derivatives and amino acid conjugates, when Q of Q-Z is attached to the ring carbon and Q is— S— , then Z is CHR 10 R 11 , where R 10 and R 11 are selected from the group consisting of hydrogen, alkyl, phenyl, and substituted phenyl, wherein the substituent in said substituted phenyl is selected from the group consisting of halogen, cyano, alkyl, alkoxy, ester, N-acyl derivatives, N-acyloxy derivatives and amino acid conjugates; or
  • X-Y-E represents hydrogen or C 1-6 alkyl or C 6-14 aryl when X of X-Y-E is attached to the ring nitrogen and Q-Z represents C 1- 10 alkyl or C 6-14 aryl or oxygen, sulfur, nitrogen containing heteroaryl when attached to the ring carbon;
  • R 4 , R 5 , R 6 , and R 7 are each independently selected from the group consisting of: H, halo, loweralkyl, haloloweralkyl, haloloweralkoxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; arylalkyloxy, cycloalkyloxy, cycloalkylalkoxy, cycloalkylamino, urea, cycloalkylalkylamino, cycloalkyl, alkylcycloalkyl, hydroxyamin
  • R 4 , R 5 , R 6 , and R 7 are each independently represent hydrogen, halogen, cyano, nitro, hydroxy, trifluoromethyl, trifluoromethoxy,— OR a ,— SR a ,— SOR a ,— SO 2 R a ,— OSO 2 R a ,— SF 5 ,— NR b R c ,— NR c COR d , -NR c CO 2 R d , - NHCONR b R c ,— NR c SO 2 R e , -N(SO 2 R e ) 2 ,— NHSO 2 NR b R c , -COR d , -CO 2 R d , - CONR b R c ,— CON(OR a )R b or -SO 2 NR b R c ; or C 1-6 alkyl, C 2-6 alkenyl, C 2-6 alkyn
  • R 4 , R 5 , R 6 , and R 7 are each linear or branched C 1-6 alkyl and linear or branched C 1-6 alkoxy; or
  • R 4 and R 5 are hydrogen or C 1-6 alkyl or C 1-6 alkoxyl or C 6-14 aryl, any of which groups may be optionally substituted by one or more substituents;
  • R 6 ishydrogen or nitro or cyano or carboxyl or acetamidoxime or amidoxime or C 1-6 alkyl or C 1-6 alkoxyl or C 6-14 aryl or oxygen, sulfur, and nitrogen containing heteroaryl, any of which groups may be optionally substituted by one or more substituents;
  • R 7 is hydrogen or C 1-6 alkyl or C 1-6 alkoxyl or C 6-14 aryl or oxygen, sulfur, and nitrogen containing
  • heteroaryl any of which groups may be optionally substituted by one or more substituents;
  • R a , R b and R c independently represent hydrogen or
  • R b and R c when taken together with the nitrogen atom to which they are both attached, represent azetidin-1-yl, pyrrolid in- 1-yl, oxazolidin-3- yl, isoxazolidin-2-yl, thiazolid in-3-yl, isothiazolidin-2-yl, piperidin-1-yl, morpholin-4-yl, thiomorpholin-4-yl, piperazin-1-yl, homopiperidin-1-yl, homomorpholin-4-yl or homopiperazin-1-yl, any of which groups may be optionally substituted by one or more substituents;
  • R d represents hydrogen; or C 1-6 alkyl, C 3-7 cycloalkyl, aryl, C 3- 7 heterocycloalkyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; and [0042] R e represents C 1-6 alkyl, aryl or heteroaryl, any of which groups may be optionally substituted by one or more substituents;
  • R 8 and R 9 independently represent hydrogen or C 1-6 alkyl
  • R 12 is selected from the group consisting of: H, halo, loweralkyl, haloloweralkyl, haloloweralkoxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; arylalkyloxy, cycloalkyloxy, cycloalkylalkoxy, cycloalkylamino, urea, cycloalkylalkylamino, cycloalkyl, alkylcycloalkyl, hydroxyamino,
  • alkoxyacylamino, and arylthio and 5- or 6-membered organic rings containing 0 to 4 heteroatoms selected from the group consisting of N, O and S, which rings may be unsubstituted or substituted from 1 to 4 times with halo, loweralkyl, haloloweralkyl; haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide,
  • chronic lung disease including idiopathic pulmonary fibrosis; non alcoholic fatty liver disease, and in particular, non-alcoholic fatty liver disease, non-alcoholic fatty liver, and non-alcoholic steatohepatitis; and kidney disorders, and in particular, renal fibrosis and/or chronic kidney disease.
  • Fabomitazole or afobazole (5-ethoxy-2-[2- (morpholino)ethylthio]-benzimidazole dihydrochloride) is a derivative of 2- mercaptobenzimidazole with anxiolytic effects.
  • chronic lung disease including idiopathic pulmonary fibrosis; non-alcoholic fatty liver disease, and in particular, non-alcoholic fatty liver disease, non-alcoholic fatty liver, and non-alcoholic steatohepatitis; and kidney disorders, and in particular, renal fibrosis and/or chronic kidney disease
  • fibrotic diseases and in particular, chronic lung disease, including idiopathic pulmonary fibrosis
  • non-alcoholic fatty liver disease and in particular, the use of particular test compounds for treating non-alcoholic fatty liver disease, non-alcoholic fatty liver, and non-alcoholic steatohepatitis
  • kidney disorders and in particular, renal fibrosis and/or chronic kidney disease.
  • A is N or C, subject to the proviso that R 5 is absent when A is N;
  • Q represents a covalent bond; or Q represents— O— ,— S— ,— S(O)-,— S(O) 2 -,— N(R 9 )— ,— C(O)N(R 9 )— , -N(R 9 )C(O)-,— S(O) 2 N(R 9 )- or— N(R 9 )S(O) 2 — ; or Q represents an optionally substituted straight or branched C 1-6 alkylene chain optionally comprising one, two or three heteroatom-containing linkages independently selected from— O— ,— S— ,— S(O)-,— S(O) 2 - ,— N(R 9 )— ,— C(O)N(R 9 )— , -N(R 9 )C(O)-,— S(O) 2 -N(R 9 )- and— N(R 9 )S(O) 2 — ;
  • Z represents hydrogen, halogen or trifluoromethyl; or Z represents C 1-6 alkyl, C 3-7 cycloalkyl, aryl, C 3-7 heterocycloalkyl, C 3- 7 heterocycloalkenyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; or Z represents— Z 1 — Z 2 or— Z 1 — C(O)— Z 2 , either of which moieties may be optionally substituted by one or more substituents;
  • Z 1 represents a divalent radical derived from an aryl, C 3- 7 heterocycloalkyl or heteroaryl group
  • Z 2 represents aryl, C 3-7 heterocycloalkyl, C 3-7 heterocycloalkenyl, (C 4-9 )heterobicycloalkyl, (C 4-9 )spiroheterocycloalkyl or heteroaryl; or
  • Q-Z represents H, halo, loweralkyl, haloloweralkyl
  • cycloalkylalkylamino cycloalkyl, alkylcycloalkyl, hydroxyamino
  • X represents a covalent bond ; or X represents,— S(O)2— or— N(R 8 )— ; or X represents an optionally substituted straight or branched C 1- 4 alkylene chain; or X represents,— C(O)— ; or X represents— O— ,—
  • Y represents C 3-7 cycloalkyl, aryl, C 3-7 heterocycloalkyl or heteroaryl;
  • Y represents a linking group such as alkyl (e.g.,— R— where R is C 2- 6 alkyl), alkenyl (e.g.,— R— where R is C 2- 6 alkenyl), cycloalkyl (e.g.,— R— where R is C 3-6 cycloalkyl), alkylcycloalkyl(e.g.,— R— R'— , where R is C 1-4 alkyl and R' is C 3-6 cycloalkyl), cylcoalkylalkyl (e.g.,— R— R'— , where R is C 3- 6 cycloalkyl and R' is C 1-4 alkyl), a I ky Icy c I oa I ky I a I ky I (e.g .,— R— R'— R"— , wherein R is C 1-4 alkyl, R' is C 3-6 cycloalkyl, and R" is C 1-4 alkyl (e
  • alkylheterocyclealkyl heterocycle, aminoalkyl (e.g.,— N(R)R'— , where R is H or C 1-4 alkyl and R' is C 1-4 alkyl), oxyalkyl (e.g.,— O— R— where R is C 2- 6 alkyl), aminoaryl (e.g.,— N(R)R'— , where R is H or C 1-4 alkyl and R' is aryl), and oxyaryl (e.g.,— O— R— , where R is aryl), any of which groups may be optionally substituted by one or more substituents; and
  • R 1 and R 2 are each independently H, loweralkyl, or together form C 2- 4 alkylene;
  • E is H;
  • E is selected from the group consisting of -B(OR 1 )OR 2 , - CON(R1)0R 2 , and— N(OR 1 )COR 2 or any of the additional alternatives for E described in greater detail below; or
  • X-Y-E represents alkyl, phenyl, substituted phenyl, naphthyl and substituted naphthyl, wherein the substituent in said substituted phenyl and substituted naphthyl is selected from the group consisting of halogen, cyano, alkyl, alkoxy, ester, N-acyl derivatives, N-acyloxy derivatives and amino acid conjugates, when Q of Q-Z is attached to the ring carbon and Q is— S— , then Z is CHR 10 R 11 , where R 10 and R 11 are selected from the group consisting of hydrogen, alkyl, phenyl, and substituted phenyl, wherein the substituent in said substituted phenyl is selected from the group consisting of halogen, cyano, alkyl, alkoxy, ester, N-acyl derivatives, N-acyloxy derivatives and amino acid conjugates; or
  • X-Y-E represents hydrogen or C 1-6 alkyl or C 6-14 aryl when X of X-Y-E is attached to the ring nitrogen and Q-Z represents C 1-10 alkyl or C 6-14 aryl or oxygen, sulfur, nitrogen containing heteroaryl when attached to the ring carbon;
  • R 4 , R 5 , R 6 , and R 7 are each independently selected from the group consisting of: H, halo, loweralkyl, haloloweralkyl, haloloweralkoxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; arylalkyloxy, cycloalkyloxy, cycloalkylalkoxy, cycloalkylamino, urea, cycloalkylalkylamino, cycloalkyl, alkylcycloalkyl, hydroxyamin
  • R 4 , R 5 , R 6 , and R 7 are each independently represent hydrogen, halogen, cyano, nitro, hydroxy, trifluoromethyl, trifluoromethoxy,— OR a ,— SR a ,— SOR a ,— SO 2 R a ,— OSO 2 R a ,— SF 5 ,— NR b R c ,— NR c COR d , -NR c CO 2 R d , - NHCONR b R c ,— NR c SO 2 R e , -N(SO 2 R e ) 2 ,— NHSO 2 NR b R c , -COR d , -CO 2 R d , - CONR b R c ,— CON(OR a )R b or -SO 2 NR b R c ; or C 1-6 alkyl, C 2-6 alkenyl, C 2-6 alkyn
  • R 4 , R 5 , R 6 , and R 7 are each linear or branched C 1-6 alkyl and linear or branched C 1-6 alkoxy; or
  • R 4 and R 5 are hydrogen or C 1-6 alkyl or C 1-6 alkoxyl or C 6-14 aryl, any of which groups may be optionally substituted by one or more substituents;
  • R 6 ishydrogen or nitro or cyano or carboxyl or acetamidoxime or amidoxime or C 1-6 alkyl or C 1-6 alkoxyl or C 6-14 aryl or oxygen, sulfur, and nitrogen containing heteroaryl, any of which groups may be optionally substituted by one or more substituents;
  • R 7 is hydrogen or C 1-6 alkyl or C 1-6 alkoxyl or C 6-14 aryl or oxygen, sulfur, and nitrogen containing
  • heteroaryl any of which groups may be optionally substituted by one or more substituents;
  • R a , R b and R c independently represent hydrogen or
  • R b and R c when taken together with the nitrogen atom to which they are both attached, represent azetidin-1-yl, pyrrolid in- 1-yl, oxazolidin-3- yl, isoxazolidin-2-yl, thiazolid in-3-yl, isothiazolidin-2-yl, piperidin-1-yl, morpholin-4-yl, thiomorpholin-4-yl, piperazin-1-yl, homopiperidin-1-yl, homomorpholin-4-yl or homopiperazin-1-yl, any of which groups may be optionally substituted by one or more substituents;
  • R d represents hydrogen; or C 1-6 alkyl, C 3-7 cycloalkyl, aryl, C 3- 7 heterocycloalkyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; and
  • R e represents C 1-6 alkyl, aryl or heteroaryl, any of which groups may be optionally substituted by one or more substituents;
  • R 8 and R 9 independently represent hydrogen or C 1-6 alkyl
  • R 12 is selected from the group consisting of: H, halo, loweralkyl, haloloweralkyl, haloloweralkoxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; arylalkyloxy, cycloalkyloxy, cycloalkylalkoxy, cycloalkylamino, urea, cycloalkylalkylamino, cycloalkyl, alkylcycloalkyl, hydroxyamino,
  • alkoxyacylamino, and arylthio and 5- or 6-membered organic rings containing 0 to 4 heteroatoms selected from the group consisting of N, O and S, which rings may be unsubstituted or substituted from 1 to 4 times with halo, loweralkyl, haloloweralkyl; haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide,
  • Figure 1 is a line graph comparing the mean percentage change in body weights in grams for the experimental treatment groups of mice, using test compound Bemithyl compared to the Normal (no BLM) control group, the BLM-Vehicle control group, and the Pirfenidone positive control group;
  • Figure 2 is a column graph comparing the mean Trichrome Score data, for the experimental treatment groups of mice, using test compound Bemithyl compared to the Normal (no BLM) control group, the BLM-Vehicle control group, and the Pirfenidone positive control group;
  • Figure 3 is a column graph comparing the percent reduction in fibrosis for the experimental treatment groups of mice, using test compound Bemithyl compared to the BLM-Vehicle control group and the Pirfenidone positive control group;
  • Figure 4 shows an evaluation of liver function and disease progression consisting of the Plasma Alanine Aminotransferases (ALT) in units/L in a study of C57BL/6 mice consisting of the Normal (no NASH) group, the "Vehicle” control group and treatment groups including the positive control treatment group, Telmisartan. Mean is indicated ⁇ SD as determined using the Bonferroni multiple comparison test;
  • Figures 5a, 5b, and 5c show representative photomicrographs of HE-stained liver sections for each of the study groups of C57BL/6 mice consisting of the "Vehicle” control group and the treatment groups including the positive control treatment group, Telmisartan. Upper panels are taken at x50 magnification. Lower panels are x200 magnification. The identity of each study group is listed above the upper panel in each pair of panels;
  • Figure 6 shows the NAFLD activity score for each of the study groups of C57BL/6 mice consisting of the Normal (no NASFI) group, the "Vehicle” control group and treatment groups including the positive control treatment group, Telmisartan. Mean is indicated ⁇ SD as determined using the Bonferroni multiple comparison test;
  • Figure 7 shows the steatosis score for each of the study groups of C57BL/6 mice consisting of the Normal (no NASFI) group, the "Vehicle” control group and the treatment groups including the positive control treatment group, Telmisartan. Mean is indicated ⁇ SD as determined using the Bonferroni multiple comparison test;
  • Figure 8 shows the lobular inflammation score for each of the study groups of C57BL/6 mice consisting of the Normal (no NASFI) group, the "Vehicle” control group and the treatment groups including the positive control treatment group, Telmisartan. Mean is indicated ⁇ SD as determined using the Bonferroni multiple comparison test;
  • Figure 9 shows the hepatocellular ballooning score for each of the study groups of C57BL/6 mice consisting of the Normal (no NASFI) group, the "Vehicle” control group and the treatment groups including the positive control treatment group, Telmisartan. Mean is indicated ⁇ SD as determined using the Bonferroni multiple comparison test;
  • Figures 10a and 10b shows representative photomicrographs of Sirius red-stained liver sections for each of the study groups of C57BL/6 mice consisting of the Normal (no NASH) group, the "Vehicle” control group and the treatment groups including the positive control treatment group, Telmisartan.
  • the panels are taken at x200 magnification. The identity of each study group is listed above the upper panel in each pair of panels;
  • Figure 11 shows an evaluation of liver function and disease progression consisting of the Fibrosis area, i.e. Sirius red-positive area in percentage of the study groups of C57BL/6 mice consisting of the Normal (no NASH) group, the "Vehicle” control group and the treatment groups including the positive control treatment group, Telmisartan. Mean is indicated ⁇ SD as determined using the Bonferroni multiple comparison test;
  • Figure 12 shows a comparison of the change in mean body weight in grams for each of the study groups of C57BL/6 mice a first example consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group “Vehicle (Control)", and the treatment groups including the positive control treatment group,
  • Figure 13 shows an evaluation of renal function consisting of the plasma urea nitrogen (BUN) in mg/dL for each of the study groups of C57BL/6 mice consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group "Vehicle (Control)", and the treatment groups including the positive control treatment group;
  • BUN plasma urea nitrogen
  • Figure 14 shows an evaluation of renal function consisting of the Creatinine in mg/dL for each of the study groups of C57BL/6 mice consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group "Vehicle (Control)", and the treatment groups including the positive control treatment group;
  • Figure 15 shows a comparison of the mean weight difference between the left (ligated UUO) and right (non-ligated) kidneys in grams for each of the study groups of C7BL/6 mice consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group "Vehicle (Control)", and the treatment groups including the positive control treatment group, Telmisartan;
  • Figure 16 shows an evaluation of renal fibrosis and interstitial damage with the level of fibrosis indicated by Histology Scores of 0 (normal), 1 (light), 2 (moderate) or 3(severe) in three randomly selected fields of renal cross-sections stained with Sirius Red at x20 magnification for each of the study groups of C57BL/6 mice consisting of the sham surgery control group, the surgery vehicle control group, and the treatment groups including the positive control treatment group;
  • Figure 17 shows the reduction in renal fibrosis for each the study groups of C57BL/6 mice consisting of the sham surgery control group, the surgery vehicle control group, and the treatment groups including the positive control treatment group;
  • Figure 18 shows a comparison of the change in mean body weight in grams for each of the study groups of C57BL/6 mice from a second example consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group “Vehicle (Control)", and the treatment groups including the positive control treatment group,
  • Figure 19 shows an evaluation of renal function consisting of the plasma urea nitrogen (BUN) in mg/dL for each of the study groups of C57BL/6 mice consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group "Vehicle (Control)", and the treatment groups including the positive control treatment group;
  • BUN plasma urea nitrogen
  • Figure 20 shows an evaluation of renal function consisting of the Creatinine in mg/dL for each of the study groups of C57BL/6 mice consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group "Vehicle (Control)", and the treatment groups including the positive control treatment group;
  • Figure 21 shows the weight of the right kidney in grams for each of the 1 study groups of C57BL/6 mice consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group “Vehicle (Control)", and the treatment groups including the positive control treatment group, Telmisartan;
  • Figure 22 shows the weight of the left kidney in grams for each of the study groups of C57BL/6 mice consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group “Vehicle (Control)", and the treatment groups including the positive control treatment group, Telmisartan;
  • Figure 23 shows an evaluation of renal fibrosis and interstitial damage with the level of fibrosis indicated by Flistology Scores of 0 (normal), 1 (light), 2 (moderate) or 3(severe) in three randomly selected fields of renal cross-sections stained with Sirius Red at x20 magnification for each of the study groups of C57BL/6 mice consisting of the sham surgery control group, the surgery vehicle control group, and the treatment groups including the positive control treatment group; and
  • Figure 24 shows the reduction in renal fibrosis for each the study groups of C57BL/6 mice consisting of the sham surgery control group, the surgery vehicle control group, and the treatment groups including the positive control treatment group;
  • Figure 25 outlines the method of hypoxia induction in FIEK-293 cells and treatment of hypoxia with bemithyl;
  • Figure 26 shows the expression of HIF-1 after PFIT-induced hypoxia with and without treatment with bemithyl at 5 and 10 mM
  • Figure 27 shows the pathway for HIF-1 regulation during normoxia and hypoxia
  • Figure 28 shows the role of HIF-1 in regulating glycolysis during hypoxia
  • Figure 29 shows the role of HIF-1 in metabolic diseases.
  • Figure 30 is an overview of HIF-1a implicated in fibrotic disease.
  • Halo refers to any suitable halogen, including — F,—Cl,— Br, and—I.
  • Cyano refers to a— CN group.
  • Haldroxyl refers to an—OH group.
  • Ni refers to an— NO 2 group.
  • Oxy refers to a— O— group.
  • alkyl refers to a straight or branched chain hydrocarbon containing from 1 to 10 carbon atoms. Representative examples of alkyl include, but are not limited to, methyl, ethyl, n-propyl, iso-propyl, n-butyl, sec-butyl, iso-butyl, tert-butyl, n-pentyl, isopentyl, neopentyl, n-hexyl, 3'-methylhexyl, 2,2-dimethylpentyl,
  • Loweralkyl as used herein, is a subset of alkyl, in some embodiments preferred, and refers to a straight or branched chain hydrocarbon group containing from 1 to 4 carbon atoms.
  • Representative examples of lower alkyl include, but are not limited to, methyl, ethyl, n-propyl, iso-propyl, n-butyl, iso-butyl, tert-butyl, and the like.
  • Alkyl and loweralkyl groups may be unsubstituted or substituted one or more times with halo, alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, cycloalkylalkyl, aryl, arylalkyl, heterocyclo, heterocycloalkyl, hydroxyl, alkoxy, alkenyloxy, alkynyloxy, haloalkoxy, cycloalkoxy, cycloalkylalkyloxy, aryloxy, arylalkyloxy, heterocyclooxy, heterocyclolalkyloxy, mercapto, alkyl-S(O) m , haloalkyl-S(O) m , alkenyl-S(O) m , alkynyl-S(O) m , cycloalkyl-S(O) m , cycloalkylalkyl-S(O) m
  • cycloalkylalkylamino, arylamino, arylalkylamino, heterocycloamino, heterocycloalkylamino, disubstituted-amino, acylamino, acyloxy, ester, amide, sulfonamide, urea, alkoxyacylamino, aminoacyloxy, nitro or cyano where m 0, 1 or 2.
  • Alkenyl as used herein alone or as part of another group, refers to a straight or branched chain hydrocarbon containing from 1 to 10 carbon atoms which include 1 to 4 double bonds in the normal chain.
  • Alkenyl include, but are not limited to, vinyl, 2- propenyl, 3-butenyl, 2-butenyl, 4-pentyl, 3-pentyl, 2-hexenyl, 3-hexenyl,
  • Alkynyl refers to a straight or branched chain hydrocarbon containing from 1 to 10 carbon atoms which include 1 triple bond in the normal chain.
  • Alkynyl include, but are not limited to, 2- propynyl, 3-butynyl, 2-butynyl, 4-pentenyl, 3-pentenyl, and the like These groups may be optionally substituted in like manner as described with alkyl above.
  • alkoxy refers to an alkyl group, as defined herein, appended to the parent molecular moiety through an oxy group, as defined herein.
  • Representative examples of alkoxy include, but are not limited to, methoxy, ethoxy, propoxy, 2-propoxy, butoxy, tert-butoxy, pentyloxy, hexyloxy and the like. These groups may be optionally substituted in like manner as described with alkyl above.
  • Acyl as used herein alone or as part of another group, refers to a— C(O)R radical, where R is any suitable substituent such as alkyl, alkenyl, alkynyl, aryl, alkylaryl, etc. as given herein.
  • Haloalkyl refers to at least one halogen, as defined herein, appended to the parent molecular moiety through am alkyl group, as defined herein.
  • Representative examples of haloalkyl include, but are not limited to, chloromethyl, 2- fluoroethyl, trifluoromethyl, pentafluoroethyl, 2-chloro-3-fluoropentyl, and the like.
  • AlkyIthio refers to an alkyl group, as defined herein, appended to the parent molecular moiety through a thio moiety.
  • Representative examples of alkylthio include, but are not limited, methylthio, ethylthio, tert-butylthio, hexylthio, and the like.
  • Aryl as used herein alone or as part of another group, refers to a monocyclic carbocyclic ring system or a bicyclic carbocyclic fused ring system having one or more aromatic rings.
  • aryl include, azulenyl, indanyl, indenyl, naphthyl, phenyl, tetrahydronaphthyl, and the like. These rings may be optionally substituted with groups selected from halo, alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, cycloalkylalkyl, aryl, arylalkyl, heterocyclo, heterocycloalkyl, hydroxyl, alkoxy, alkenyloxy, alkynyloxy, haloalkoxy, cycloalkoxy, cycloalkylalkyloxy, aryloxy,
  • cycloalkylalkyl-S(O) m cycloalkylalkyl-S(O) m , aryl-S(O) m , arylalkyl-S(O) m , heterocyclo-S(O) m , heterocycloalkyi-S(O) m , amino, alkylamino, alkenylamino, alkynylamino, haloalkylamino, cycloalkylamino, cycloalkylalkylamino, arylamino, arylalkylamino, heterocycloamino, heterocycloalkylamino, disubstituted- amino, acylamino, acyloxy, ester, amide, sulfonamide, urea,
  • alkoxyacylamino, aminoacyloxy, nitro or cyano where m 0, 1 or 2.
  • Arylalkyl refers to an aryl group, as defined herein, appended to the parent molecular moiety through an alkyl group, as defined herein.
  • Representative examples of arylalyl include, but are not limited to, benzyl, 2-phenylethyl, 3- phenylpropyl, 2-naphth-2-ylethyl, and the like.
  • Amino as used herein means the radical— NH 2 .
  • Alkylamino as used herein alone or as part of another group means the radical— NHR, where R is an alkyl group.
  • Arylalkylamino as used herein alone or as part of another group means the radical—NHR, where R is an arylalkyl group.
  • Disubstituted-amino as used herein alone or as part of another group means the radical— NR a R b , where R a and R b are independently selected from the groups alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, cycloalkylalkyl, aryl, arylalkyl, heterocyclo, heterocycloalkyl.
  • Acylamino as used herein alone or as part of another group means the radical— NR a R b , where R a is an acyl group as defined herein and Rb is selected from the hydrogen, alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, cycloalkylalkyl, aryl, arylalkyl, heterocyclo, heterocycloalkyl.
  • Acyloxy as used herein alone or as part of another group means the radical—OR, where R is an acyl group as defined herein.
  • Ester as used herein alone or as part of another group refers to a— C(O)OR radical, where R is any suitable substituent such as alkyl, aryl, alkylaryl, etc.
  • Amide as used herein alone or as part of another group refers to a— C(O)NR a R b radical, where R a and R b are any suitable substituent such as alkyl, aryl, alkylaryl, etc.
  • S(O) 2 NR a R b radical refers to a— S(O) 2 NR a R b radical, where R a and R b are any suitable
  • substituent such as H, alkyl, aryl, alkylaryl, etc.
  • Sulfone as used herein alone or as part of another group refers to a— S(O) 2 R radical, where R is any suitable substituent, such as H, alkyl, aryl, alkylaryl, etc.
  • Aminosulfonyl as used herein alone or as part of another group refers to a—N(R a ) S(O) R 2 b radical, where R a and R b are any suitable substituent, such as H, alkyl, aryl, alkylaryl, etc.
  • Rea as used herein alone or as part of another group refers to an—N(R c )C(O)NR a R b radical, where R a , R b and R c are any suitable substituent such as H, alkyl, aryl, alkylaryl, etc.
  • Alkoxyacylamino as used herein alone or as part of another group refers to an— N(R a )C(O)OR b radical, where R a , R b are any suitable substituent such as H, alkyl, aryl, alkylaryl, etc.
  • aminoacyl as used herein alone or as part of another group refers to an— C(O)NR a R b radical, where R a and R b are any suitable
  • substituent such as H, alkyl, aryl, alkylaryl, etc.
  • aminoacyloxy as used herein alone or as part of another group refers to an— OC(O)NR a R b radical, where R a and R b are any suitable substituent, such as H, alkyl, aryl, alkylaryl, etc.
  • Cycloalkyl refers to a saturated or partially unsaturated cyclic hydrocarbon group containing from 3, 4 or 5 to 6, 7 or 8 carbons (which may be replaced in a heterocyclic group as discussed below).
  • Representative examples of cycloalkyl include, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, and cyclooctyl. These rings may be optionally substituted with halo or loweralkyl.
  • Heterocyclic group or “heterocycle” as used herein alone or as part of another group, refers to a monocyclic- or a bicyclic-ring system.
  • Monocyclic ring systems are exemplified by any 5 or 6 membered ring containing 1, 2, 3, or 4 heteroatoms independently selected from oxygen, nitrogen and sulfur.
  • the 5 membered ring has from 0-2 double bonds and the 6 membered ring has from 0-3 double bonds.
  • monocyclic ring systems include, but are not limited to, azetidine, azepine, aziridine, diazepine, 1,3-dioxolane, dioxane, dithiane, furan, imidazole, imidazoline, imidazolidine, isothiazole, isothiazoline, isothiazolidine, isoxazole, isoxazoline, isoxazolidine, morpholine, oxadiazole, oxadiazoline, oxadiazolidine, oxazole, oxazoline, oxazolidine, piperazine, piperidine, pyran, pyrazine, pyrazole, pyrazoline, pyrazolidine, pyridine, pyrimidine, pyridazine, pyrrole, pyrroline, pyrrolidine, tetrahydrofuran, tetrahydrothiophene, tetrazine,
  • bicyclic ring systems include but are not limited to, for example, benzimidazole, benzothiazole, benzothiadiazole,
  • benzothiophene benzoxadiazole, benzoxazole, benzofuran, benzopyran, benzothiopyran, benzodioxine, 1,3-benzodioxole, cinnoline, indazole, indole, indoline, indolizine, naphthyridine, isobenzofuran, isobenzothiophene, isoindole, isoindoline, isoquinoline, phthalazine, purine, pyranopyridine, quinoline, quinolizine, quinoxaline, quinazoline, tetrahydroisoquinoline, tetrahydroquinoline, thiopyranopyridine, and the like.
  • These rings may be optionally substituted with groups selected from halo, alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, cycloalkylalkyl, aryl, arylalkyl, heterocyclo, heterocycloalkyl, hydroxyl, alkoxy, alkenyloxy, alkynyloxy, haloalkoxy, cycloalkoxy, cycloalkylalkyloxy, aryloxy, arylalkyloxy, heterocyclooxy, heterocyclolalkyloxy, mercapto, alkyl-S(O) m , haloaikyl-S(O) m , aikenyl-S(O) m , aikynyl-S(O) m , cycloaikyl-S(O) m , cycloalkylalkyl-S(O) m , aryl-S(
  • Oxoheterocyclic group refers to a heterocyclic group such as described above, substituted with one or more oxo groups, such as pyridine- N-oxide.
  • Arylthio refers to a group of the formula— S— R, where R is aryl as described above.
  • Haldroxyamino refers to a group of the formula— N(R)OH, where R is any suitable group such as alkyl, aryl, alkylaryl, etc.
  • “Pharmaceutically acceptable” as used herein means that the compound or composition is suitable for administration to a subject to achieve the treatments described herein, without unduly deleterious side effects in light of the severity of the disease and necessity of the treatment.
  • prodrugs refers to those prodrugs of the compounds of the present invention which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of humans and lower animals without undue toxicity, irritation, allergic response and the like, commensurate with a reasonable risk/benefit ratio, and effective for their intended use, as well as the zwitterionic forms, where possible, of the compounds of the invention.
  • prodrug refers to compounds that are rapidly transformed in vivo to yield the parent compound of the above formulae, for example, by hydrolysis in blood. A thorough discussion is provided in T. Higuchi and V. Stella, Prodrugs as Novel delivery Systems, Vol. 14 of the A.C.S.
  • Examples include a prodrug that is metabolized in vivo by a subject to an active drug having an activity of active compounds as described herein, wherein the prodrug is an ester of an alcohol or carboxylic acid group, if such a group is present in the compound; an acetal or ketal of an alcohol group, if such a group is present in the compound; an N-Mannich base or an imine of an amine group, if such a group is present in the compound; or a Schiff base, oxime, acetal, enol ester, oxazolidine, or thiazolidine of a carbonyl group, if such a group is present in the compound.
  • Treat refers to any type of treatment that imparts a benefit to a patient afflicted with a disease, including improvement in the condition of the patient (e.g., in one or more symptoms), delay in the progression of the disease, etc.
  • Suitable alkyl groups which may be present on the compounds of use in the invention include straight-chained and branched C 1-6 alkyl groups, for example C 1-4 alkyl groups. Typical examples include methyl and ethyl groups, and straight-chained or branched propyl, butyl and pentyl groups. Particular alkyl groups include methyl, ethyl, n-propyl, isopropyl, n- butyl, sec-butyl, isobutyl, tert-butyl, 2,2-dimethylpropyl and 3-methylbutyl. Derived expressions such as "C 1-6 alkoxy", “C 1-6 alkylthio", "C 1- 6 alkylsulphonyl” and "C 1-6 alkylamino" are to be construed accordingly.
  • C 1-4 alkylene chain refers to a divalent straight or branched alkylene chain containing 1 to 4 carbon atoms. Typical examples include methylene, ethylene, methylmethylene, ethylmethylene and dimethylmethylene.
  • Suitable C 2- 6 alkenyl groups include vinyl and allyl.
  • Suitable C 2- 6 alkynyl groups include ethynyl and propargyl.
  • Suitable C 3-7 cycloalkyl groups which may comprise benzo- fused analogues thereof, include cyclopropyl, cyclobutyl, benzocyclobutenyl, cyclopentyl, indanyl, cyclohexyl and cycloheptyl.
  • Suitable C 4-7 cycloalkenyl groups include cyclobutenyl, cyclopentenyl, cyclohexenyl and cycloheptenyl.
  • Typical bicycloalkyl groups include bicyclo[3.1.0]hexanyl.
  • Suitable aryl groups include phenyl and naphthyl, preferably phenyl.
  • Suitable aryl(C 1-6 )alkyl groups include benzyl, phenylethyl, phenylpropyl and naphthylmethyl.
  • C 3-7 heterocycloalkyl refers to saturated monocyclic rings containing 3 to 7 carbon atoms and at least one heteroatom selected from oxygen, sulphur and nitrogen, and may comprise benzo-fused analogues thereof.
  • Suitable heterocycloalkyl groups include oxetanyl, azetidinyl, tetrahydrofuranyl, dihydrobenzo-furanyl,
  • dihydrobenzothienyl pyrrolidinyl, indolinyl, isoindolinyl, oxazolidinyl, thiazolidinyl, isothiazolidinyl, imidazolidinyl, tetrahydropyranyl, chromanyl, tetrahydrothiopyranyl, piperidinyl, 1,2,3,4-tetrahydroquinolinyl, 1,2, 3, 4- tetrahydroisoquinolinyl, piperazinyl, 1,2,3,4-tetrahydroquinoxalinyl, homopiperazinyl, morpholinyl, benzoxazinyl, thiomorpholinyl, diazepanyl and azocanyl.
  • C 3-7 heterocycloalkenyl refers to monounsaturated or polyunsaturated monocyclic rings containing 3 to 7 carbon atoms and at least one heteroatom selected from oxygen, sulphur and nitrogen, and may comprise benzo-fused analogues thereof.
  • Suitable heterocycloalkenyl groups include thiazolinyl, imidazolinyl, dihydropyranyl, dihydrothiopyranyl and 1,2,3,6-tetrahydropyridinyl.
  • Typical heterobicycloalkyl groups include quinuclidinyl, 3- azabicyclo[3.1.0]-hexanyl, 5-aza-2-oxabicyclo[2.2.1]heptanyl, 6- azabicyclo[3.2.0]heptanyl, 3-azabicyclo-[4.1.0]heptanyl, 5-aza-2- oxabicyclo[2.2.2]octanyl, 3-azabicyclo[3.2.1]octanyl, 8- azabicyclo[3.2.1]octanyl, 3,8-diazabicyclo[3.2.1]octanyl and 3,9- diazabicyclo[4.2.1]-nonanyl.
  • Suitable spiroheterocycloalkyl groups include 5- azaspiro[2.4]heptanyl, 2-oxa-6-azaspiro[3.3]heptanyl, 2-oxa-6- azaspiro[3.4]octanyl, 2-oxa-6-azaspiro[3.5]nonanyl, 2-oxa-7- azaspiro[3.5]nonanyl and 7-oxa-2-azaspiro[3.5]nonanyl.
  • Suitable heteroaryl groups include furyl, benzofuryl,
  • benzothiazolyl isothiazolyl, imidazolyl, benzimidazolyl, imidazo[2,1- b]thiazolyl, imidazo[1,2-a]pyridinyl, imidazo[4,5-b]pyridinyl, purinyl, imidazo[1,2-a]pyrimidinyl, imidazo[1,2-a]pyrazinyl, oxadiazolyl, thiadiazolyl, triazolyl, [1,2,4]triazolo[1,5-a]pyrimidinyl, benzotriazolyl, tetrazolyl, pyridinyl, quinolinyl, isoquinolinyl, naphthyridinyl, pyridazinyl, cinnolinyl, phthalazinyl, pyrimidinyl, quinazolinyl, pyrazinyl, quinoxalinyl, pteridinyl, triaziny
  • the compounds of formula (I) may accordingly exist as enantiomers. Where the compounds of use in the invention possess two or more asymmetric centres, they may additionally exist as diastereomers.
  • the invention is to be understood to extend to the use of all such enantiomers and diastereomers, and to mixtures thereof in any proportion, including racemates.
  • Formula (I) and the formulae depicted hereinafter are intended to represent all individual stereoisomers and all possible mixtures thereof, unless stated or shown otherwise.
  • Formula (I) and the formulae depicted hereinafter are intended to represent all individual tautomers and all possible mixtures thereof, unless stated or shown otherwise.
  • each individual atom present in formula, or in the formulae depicted hereinafter may in fact be present in the form of any of its naturally occurring isotopes, with the most abundant isotope(s) being preferred.
  • each individual hydrogen atom present in formula, or in the formulae depicted hereinafter may be present as a 1 H, 2 H (deuterium) or 3 H (tritium) atom, preferably
  • each individual carbon atom present in formula (I), or in the formulae depicted hereinafter may be present as a 12 C, 13 C or 14 C atom, preferably 12 C.
  • the present invention provides a compound of formula (I) as depicted above or an N-oxide thereof, or a pharmaceutically acceptable salt or solvate thereof, or a glucuronide derivative thereof, or a co-crystal thereof, wherein :
  • Q represents -O-, -S-, -S(O)-, S(O) 2 -,— N(R 9 )— , - C(O)N(R 5 )— ,— N(R 9 )C(O)— , S(O) 2 N(R 9 )- or -N(R 9 )S(O) 2 -; or Q represents an optionally substituted straight or branched C 1-6 alkylene chain optionally comprising one, two or three heteroatom-containing linkages independently selected from— O— ,— S— ,— S(O)— ,— S(O) 2 — ,— N(R 9 )— ,— C(O)N(R 9 )— ,— N(R 9 )C(O)— , S(O) 2 N(R 5 )- and -N(R 9 )S(O) 2 -.
  • Q represents a covalent bond, whereby the integer Z is attached directly to the benzimidazole nucleus.
  • Q represents— O— ,— S— ,— S(O)— ,— S(O) 2 -,— N(R 5 )— ,— C(O)N(R 5 )— ,— N(R 5 )C(O)— , S(O) 2 N(R 5 )- or - N(R 5 )S(O) 2 — .
  • Q represents— O— .
  • Q represents— S— .
  • Q represents— S(O)— .
  • Q represents— S(O)2— .
  • Q represents— N(R 5 )— .
  • Q represents — C(O)N(R 5 )— .
  • Q represents— N(R 5 )C(O)— .
  • Q represents— S(O)2N(R 5 )— .
  • Q represents—
  • Q represents an optionally substituted straight or branched C 1-6 alkylene chain optionally comprising one, two or three heteroatom-containing linkages independently selected from— O— ,— S— ,— S(O)— , S(O) 2 -,— N(R 5 )— ,— C(O)N(R 5 )— , -N(R 5 )C(O)-, -S(O) 2 N(R 5 )— and— N(R 5 )S(O) 2 — .
  • Q represents an optionally substituted straight or branched C 1-6 alkylene chain.
  • Q represents an optionally substituted straight or branched C 1-6 alkylene chain comprising one heteroatom-containing linkage independently selected from— O— ,— S— ,— S(O)-, S(O) 2 -,— N(R 5 )— ,— C(O)N(R 5 )— , -N(R 5 )C(O)-, S(O) 2 N(R 5 )- and— N(R 5 )S(O) 2 — .
  • Q represents an optionally substituted straight or branched C 1-6 alkylene chain comprising two heteroatom-containing linkages independently selected from— O— ,— S— ,— S(O)-, S(O) 2 -,— N(R 5 )— ,— C(O)N(R 5 )— , -N(R 5 )C(O)-, S(O) 2 N(R 5 )- and— N(R 5 )S(O) 2 — .
  • Q represents an optionally substituted straight or branched C 1-6 alkylene chain comprising three heteroatom-containing linkages independently selected from— O— ,— S— ,— S(O)— , S(O) 2 -,— N(R 5 )— ,— C(O)N(R 5 )— , -N(R 5 )C(O)-, - S(O) 2 N(R 5 )— and— N(R 5 )S(O) 2 — .
  • Q represents an optionally substituted straight or branched C 1-6 alkylene chain comprising one, two or three heteroatom-containing linkages independently selected from— O— ,— S— ,— N(R 5 )— ,— C(O)N(R 5 )— and— N(R 5 )C(O)— .
  • Q represents a covalent bond; or Q represents—
  • Q represents an optionally substituted straight or branched C 1-6 alkylene chain optionally comprising one or two heteroatom- containing linkages selected from— O— ,— S— ,— N(R 5 )— ,— C(O)N(R 5 )— , and— N(R 5 )C(O)— .
  • Selected examples of typical substituents on the linkage represented by Q include halogen, trifluoromethyl, hydroxy, C 1-6 alkoxy and amino.
  • Q represents a covalent bond; or Q represents—
  • CH(CH 3 )— — CH(OH)— ,— CH(0CH 3 )— ,— CH(NH 2 )— , -CH 2 CH 2 -, - CH(0H)CH 2 -, -CH(0H)CF 2 -, -CH(OCH 3 )CH 2 -, -CH 2 O-,— CH(CH 3 )O— ,
  • Additional values include— N(R 5 )— , -CH(CH 2 OH)-,— CH 2 S(O)— ,— CH 2 S(O) 2 — , - CH 2 S(O)CH 2 -, -CH 2 S(O) 2 CH 2 -, and -CH 2 N(R 5 )C(O)-.
  • Q represents— CH 2 — ,— CH 2 O— ,— CH 2 S— , and — CH 2 OCH 2 — .
  • Q represents— CH 2 — .
  • Q represents— CH 2 O— .
  • Q represents — CH 2 S— .
  • Q represents— CH 2 OCH 2 — .
  • Z represents hydrogen .
  • Z is other than hydrogen.
  • Z represents hydrogen; or Z represents C1-6 alkyl, C3-7 cycloalkyl, aryl, C3-7 heterocycloalkyl, C3-7 heterocycloalkenyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; or Z represents— Z1— Z2 or— Z1— C(O)— Z2, either of which moieties may be optionally substituted by one or more substituents.
  • Z represents C 3-7 cycloalkyl, aryl, C 3- 7 heterocycloalkyl, C 3-7 heterocycloalkenyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; or Z represents — Z 1 — Z 2 or— Z 1 — C(O)— Z 2 5 either of which moieties may be optionally substituted by one or more substituents.
  • Z represents C 1-6 alkyl, C 3-7 cycloalkyl, aryl, C 3-7 heterocycloalkyl, C 3-7 heterocycloalkenyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; or Z represents— Z 1 — Z 2 or— Z 1 — C(O)— Z 2 , either of which moieties may be optionally substituted by one or more substituents.
  • Z represents hydrogen, fluoro or trifluoromethyl; or Z represents methyl, ethyl, n-propyl, isopropyl, n-butyl, sec-butyl, isobutyl, tert-butyl, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, phenyl, tetrahydrofuranyl, pyrrolidinyl, indolinyl, tetrahydropyranyl, piperidinyl, 1,2,3,4-tetrahydroquinolinyl, morpholinyl, azocanyl, thiazolinyl, furyl, thienyl, pyrazolyl, 4,5,6,7-tetrahydroindazolyl, benzoxazolyl, isoxazolyl, thiazolyl, benzothiazolyl, imidazolyl, benzimidazolyl,
  • Z may represent dihydrobenzothienyl, dihydroisoindolinyl, 1,2,3,4-tetrahydroisoquinolinyl, pyridazinyl or triazinyl, any of which groups may be optionally substituted by one or more substituents.
  • the moiety Z 1 represents a divalent radical derived from an aryl, C 3-7 heterocycloalkyl or heteroaryl group, any of which groups may be optionally substituted by one or more substituents.
  • the moiety Z 1 represents a divalent radical derived from a phenyl, pyrrolidinyl, piperazinyl, pyrazolyl, thiazolyl, triazolyl, tetrazolyl or pyridinyl group, any of which groups may be optionally substituted by one or more substituents.
  • Typical values of the moiety Z 1 include the groups of formula (Za), (Zb),
  • the moiety Z 2 may represent aryl, C 3-7 heterocycloalkyl, C 3- 7 heterocycloalkenyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents.
  • Z 2 may represent (C 4- 9 )heterobicycloalkyl or (C 4-9 )spiroheterocycloalkyl, either of which groups may be optionally substituted by one or more substituents.
  • Z 2 represents phenyl, pyrrolidinyl, oxazolidinyl, imidazolidinyl, morpholinyl, imidazolinyl, thiazolyl, imidazolyl, tetrazolyl or pyridinyl, any of which groups may be optionally substituted by one or more substituents.
  • Z 2 may represent azetidinyl, isothiazolidinyl, piperidinyl, piperazinyl, 6-azabicyclo[3.2.0]-heptanyl, 2-oxa-6- azaspiro[3.4]octanyl, triazolyl or pyrimidinyl, any of which groups may be optionally substituted by one or more substituents.
  • Examples of optional substituents which may be present on the moiety Z, Z 1 or Z 2 include one, two or three substituents independently selected from halogen, cyano, nitro, C 1-6 alkyl, trifluoromethyl, oxo, hydroxy, hydroxy(C 1-6 )alkyl, C 1-6 a lkoxy, difluoromethoxy, trifluoromethoxy, C 1- 3 alkylenedioxy, C 1- 6 alkylthio, C 1-6 alkylsu Ifinyl, C 1- 6 alkylsulfonyl, amino, C 1- 6 alkylamino, di(C 1-6 )alkylamino, di(C 1-6 )alkylamino(C 1-6 )alkyl, C 2- 6 alkylcarbonyl amino, C 1-6 alkylsu lfonylamino, formyl, C 2- 6 alkylcarbonyl, carboxy, C 2- 6 alkoxycarbonyl, aminocarbonyl
  • Additional examples include thioxo, N— [(C 1-6 )-alkyl]-N— [(C 1-6 )alkylcarbonyl]amino, N - [(C 1-6 )alkyl]-N— [(C 1-6 )alkylsulfonyl]amino, cyano(C 1-6 )alkylaminocarbonyl and (C 3-7 )cycloalkylureido.
  • Typical examples of optional substituents on the moiety Z, Z 1 or Z 2 include halogen, cyano, nitro, C 1-6 alkyl, trifluoromethyl, oxo, hydroxy, hydroxy(C 1-6 )alkyl, C 1-6 alkoxy, difluoromethoxy, trifluoromethoxy, C 1- 3 alkylenedioxy, C 1-6 alkylsulfonyl, amino, di(C 1-6 )alkylamino, di(C 1- 6 )alkylamino(C 1-6 )alkyl, C 2- 6 alkylcarbonylamino, C 1-6 alkylsulfonylamino, formyl, carboxy, C 2 -6 alkoxycarbonyl, aminocarbonyl, C 1-6 alkylaminocarbonyl, di(C 1-6 )alkylaminocarbonyl, aminocarbonylamino and hydrazinocarbonyl.
  • Additional examples include thioxo, C 1-6 alkylthio, N—[(C 1-6 )alkyl]-N—[(C 1- 6 )alkylcarbonyl]amino, N— [(C 1-6 )-alkyl]-N— [(C 1-6 )alkylsulfonyl]amino, cyano(C 1-6 )alkylaminocarbonyl, aminosulfonyl and (C 3-7 )cycloalkylureido.
  • Examples of particular substituents on the moiety Z, Z 1 or Z 2 include fluoro, chloro, bromo, cyano, nitro, methyl, ethyl, isopropyl, trifluoromethyl, oxo, hydroxy, hydroxymethyl, methoxy, difluoromethoxy, trifluoromethoxy, methylenedioxy, methylthio, methylsulfinyl,
  • methylsulfonyl amino, methylamino, tert-butylamino, dimethylamino, dimethylaminomethyl, dimethylaminoethyl, acetylamino,
  • Additional examples include thioxo, ethoxy, N-acetyl-N-methylamino, N- methyl-N-(methylsulfonyl)-amino, cyanomethylaminocarbonyl and cyclopropylureido.
  • Typical examples of particular substituents on the moiety Z, Z 1 or Z 2 include fluoro, chloro, bromo, cyano, nitro, methyl, ethyl,
  • Additional examples include thioxo, methylthio, ethoxy, N-acetyl-N- methylamino, N-methyl-N-(methylsulfonyl)amino,
  • Typical values of Z 2 include phenyl, hydroxyphenyl,
  • Z 2 may represent oxoazetidinyl
  • oxomorpholinyl oxo-6-azabicyclo[3.2.0]-heptanyl, oxo-2-oxa-6- azaspiro[3.4]octanyl, ethoxytriazolyl or pyrimidinyl.
  • Selected values of Z 2 include oxopyrrolidinyl and
  • Z 2 represents oxopyrrolidinyl. In another embodiment, Z 2 represents (oxo)oxazolidinyl.
  • Typical values of Z include hydrogen, fluoro, trifluoromethyl, methyl, ethyl, n-propyl, isopropyl, isobutyl, tert-butyl, cyclopropyl, cyclopentyl, cyclohexyl, oxocyclohexyl, phenyl, bromophenyl, cyanophenyl, nitrophenyl, methoxyphenyl, difluoromethoxyphenyl,
  • Additional values include difluoromethyl, aminocarbonylaminomethyl, difluorophenyl, chlorophenyl, methylphenyl, dimethylphenyl, dimethoxyphenyl, (methylthio)phenyl, methylsulfinyl-phenyl, (bromo)(methylsulfonyl)phenyl,
  • oxodihydroisoindolinyl oxopiperidinyl, 1,2,3,4-tetrahydroisoquinolinyl, aminosulfonyl-pyrazolyl, cyclopropylureidothiazolyl, [1,2,4]triazolo[l,5- c]pyrimidinyl, hydroxypyridinyl, dimethylaminopyridinyl, N-acetyl-N- methylaminopyridinyl, N-methyl-N-(methylsulfonyl)aminopyridinyl, pyridazinyl, oxopyrimidinyl, (amino)(dimethyl)-pyrimidinyl,
  • Particular values of Z include hydrogen, methyl,
  • Z represents hydrogen.
  • Z represents methyl.
  • Z represents methylsulfonylphenyl.
  • Z represents 3-(methylsulfonyl)phenyl.
  • Z represents pyridinyl. In one aspect of that
  • Z represents pyridin-4-yl. In a fifth embodiment, Z represents oxopyrrolidinylphenyl. In one aspect of that embodiment, Z represents 3-(2- oxopyrrolidin-1-yl)phenyl. In a sixth embodiment, Z represents
  • Z represents 3-(3-hydroxy-2-oxopyrrolidin-1-yl)phenyl. In another aspect of that embodiment, Z represents 3-(4-hydroxy-2-oxopyrrolidin-1-yl)phenyl. In a seventh embodiment, Z represents (oxo)oxazolidinylphenyl. In one aspect of that embodiment, Z represents 3-(2-oxo-oxazolidinyl-3-yl)phenyl.
  • Q-Z is not H.
  • Q-Z is preferably a 5- or 6-membered organic ring containing 0 to 4 heteroatoms selected from the group consisting of N, O and S, which ring may be unsubstituted or substituted from 1 to 4 times with halo, cycloalkylalkoxy, loweralkyl, haloloweralkyl, haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide,
  • Q-Z is bonded to the ring nitrogen, in some embodiments it may be less preferred for Q-Z to be halo, azido, mercapto, amino, alkylamino, dialkylamino, acylamino, cyano, and arylalkylamino, and more preferred for R 3 to be alkyl, loweralkyl, and haloloweralkyl, sulfone, amide, and, aryl.
  • X represents a covalent bond ; or X represents— N(R 4 )— ; or X represents an optionally substituted straight or branched C 1- 4 alkylene chain.
  • X represents— N(R 4 )— ; or E represents an optionally substituted straight or branched C 1-4 alkylene chain .
  • E represents an optionally substituted straight or branched C 1-4 alkylene chain.
  • X represents a covalent bond ; or X represents— N(R 4 )— ; or E represents methylene (— CH 2 — ), (methyl)methylene or (ethyl)methylene, any of which groups may be optionally substituted by one or more substituents.
  • Suitable values of X include— N(R 4 )— ,— CH 2 — ,— CH(CH 3 )— and— CH(CH 2 CH 3 )— ; or E may represent a covalent bond.
  • E represents a covalent bond, whereby the integer Y is attached directly to the benzimidazole nucleus.
  • X represents— S(O) 2 — .
  • X represents— N(R 4 )— .
  • X represents— CH 2 — .
  • X represents— CH(CH 3 )— .
  • the— CH(CH 3 )— linkage represented by X is in the (S) stereochemical configuration.
  • X represents— CH(CH 2 CH 3 )— .
  • Y represents C 3-7 cycloalkyl, aryl or heteroaryl, any of which groups may be optionally substituted by one or more substituents. Additionally, Y may represent C 3-7 heterocycloalkyl, which group may be optionally substituted by one or more substituents.
  • Y represents aryl or heteroaryl, either of which groups may be optionally substituted by one or more substituents. Additionally, Y may represent C 3-7 heterocycloalkyl, which group may be optionally substituted by one or more substituents.
  • Y represents optionally substituted C 3- 7 cycloalkyl. In one aspect of that embodiment, Y represents unsubstituted C 3-7 cycloalkyl. In another aspect of that embodiment, Y represents
  • Y represents disubstituted C 3-7 cycloalkyl.
  • Y represents optionally substituted aryl. In one aspect of that embodiment, Y represents unsubstituted aryl. In another aspect of that embodiment, Y represents monosubstituted aryl. In a further aspect of that embodiment, Y represents disubstituted aryl.
  • Y represents optionally substituted C 3- 7 heterocycloalkyl. In one aspect of that embodiment, Y represents
  • Y represents unsubstituted C 3-7 heterocycloalkyl.
  • Y represents monosubstituted C 3-7 heterocycloalkyl.
  • Y represents disubstituted C 3-7 heterocycloalkyl.
  • Y represents optionally substituted heteroaryl.
  • Y represents unsubstituted heteroaryl.
  • Y represents unsubstituted heteroaryl.
  • Y represents disubstituted heteroaryl.
  • Y represents benzocyclobutenyl, phenyl, thiazolyl or pyridinyl, any of which groups may be optionally substituted by one or more substituents.
  • Y may represent pyrrolidinyl, thieno[2,3- c]pyrazolyl, indazolyl, isoxazolyl and imidazo[2,1-b]thiazolyl, any of which groups may be optionally substituted by one or more substituents.
  • Y represents phenyl, which group may be optionally substituted by one or more substituents.
  • Y represents thiazolyl, especially thiazol-4-yl, which group may be optionally substituted by one or more substituents.
  • Examples of optional substituents which may be present on the moiety Y include one, two or three substituents independently selected from halogen, cyano, nitro, C 1-6 alkyl, trifluoromethyl, hydroxy, C 1-6 alkoxy, difluoromethoxy, trifluoromethoxy, C 1-6 a Iky Ithio, C 1-6 a Ikylsu Ifinyl, C 1- 6 alkylsulfonyl, amino, C 1-6 alkylamino, di(C 1-6 )alkylamino, arylamino, C 2- 6 alkylcarbonylamino, C 1-6 alkylsulfonylamino, formyl, C 2- 6 alkylcarbonyl, C 3- 6 cycloalkylcarbonyl, C 3-6 heterocycloalkylcarbonyl, carboxy, C 2- 6 alkoxycarbonyl, aminocarbonyl, C 1-6 alkylaminocarbonyl, di(C 1- 6 )al
  • Typical examples of optional substituents on the moiety Y include halogen, C 1-6 alkyl, trifluoromethyl, C 1-6 alkoxy, difluoromethoxy, trifluoromethoxy and amino. Additional examples include benzyl and methylenedioxy.
  • Examples of particular substituents on the moiety Y include fluoro, chloro, bromo, cyano, nitro, methyl, isopropyl, trifluoromethyl, hydroxy, methoxy, difluoromethoxy, trifluoromethoxy, methylthio, methylsulfinyl, methylsulfonyl, amino, methylamino, tert-butylamino, dimethylamino, phenylamino, acetylamino, methylsulfonylamino, formyl, acetyl, cyclopropylcarbonyl, azetidinylcarbonyl, pyrrolidinylcarbonyl, piperidinyl-carbonyl, piperazinylcarbonyl, morpholinylcarbonyl, carboxy, methoxycarbonyl, aminocarbonyl, methylaminocarbonyl,
  • dimethylaminosulfonyl dimethylaminosulfonyl. Additional examples include benzyl, ethoxy and methylenedioxy.
  • Typical examples of particular substituents on the moiety Y include fluoro, chloro, methyl, trifluoromethyl, methoxy, difluoromethoxy, trifluoromethoxy and amino. Additional examples include bromo, benzyl, ethoxy and methylenedioxy.
  • Suitable values of Y include benzocyclobutenyl, phenyl, fluorophenyl (including 2-fluorophenyl, 3-fluorophenyl and 4-fluorophenyl), chlorophenyl (including 2-chlorophenyl, 3-chlorophenyl and 4-chlorophenyl), difluorophenyl (including 2,6-difluorophenyl), (chloro)(fluoro)phenyl
  • dichlorophenyl including 2,5-dichlorophenyl and 2,6-dichlorophenyl
  • methylphenyl including 4-methylphenyl
  • dimethylphenyl including 2,5- dimethylphenyl and 2,6-dimethylphenyl
  • trifluoromethyl including 2-(trifluoromethyl)phenyl
  • chloro (trifluoromethyl)phenyl [including 5- chloro-2-(trifluoromethyl)phenyl]
  • Y represents 2- (difluoromethoxy)phenyl.
  • R 4 , R 5 , R 6 , and R 7 are each
  • R 4 , R 5 , R 6 , and R 7 are each
  • R 4 , R 5 , R 6 , and R 7 are each
  • R 4 is preferably H . In other words,
  • R 4 is preferably selected from the group consisting of: halo, loweralkyl, haloloweralkyl, haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide,
  • R 4 is selected from the group consisting of: halo, haloloweralkyl, haloloweralkyloxy, loweralkoxy, amino, acylamino, aminoacyl, arylalkyl, aryloxy, acyl, arylamino, cyano, nitro, and heterocycleamino, and still more preferably R 4 is cyano, fluoroalkyl or halo.
  • R 5 is preferably selected from the group consisting of: halo, loweralkyl, haloloweralkyl, haloloweralkyloxy,
  • R 5 is more preferably selected from the group consisting of: halo, haloloweralkyl,
  • R 5 is most preferably cyano, fluoroalkyl or halo.
  • R 6 is H. In other embodiments R 6 is preferably selected from the group consisting of: halo, loweralkyl,
  • R 6 is more preferably selected from the group consisting of: halo, haloloweralkyl, haloloweralkyloxy, loweralkoxy, amino, arylalkyl, aryloxy, acyl, arylamino, cyano, nitro, and heterocycleamino; in such other embodiments R 6 is most preferably cyano,
  • R 4 , R 6 , and R 7 are H. In some preferred embodiments R 6 and R 7 are both H. In some preferred embodiments R 7 is H.
  • typical values thereof include methylene (— CH 2 — ), (methyl)methylene, ethylene (— CH 2 CH 2 — ), (ethyl)methylene, (dimethyl)-methylene,
  • chains may be optionally substituted by one or more substituents.
  • such chains are unsubstituted, monosubstituted or disubstituted.
  • such chains are unsubstituted or monosubstituted .
  • such chains are unsubstituted.
  • such chains are monosubstituted.
  • such chains are disubstituted .
  • Examples of typical substituents on the alkylene chain which may be present in a compound in accordance with the invention include halogen, trifluoromethyl, oxo, hydroxy, C 1-6 alkoxy, trifluoromethoxy, amino, C 1-6 alkylamino, di(C 1-6 )alkylamino, aminocarbonyl, C 1-6 alkylaminocarbonyl and di(C 1-6 )alkylaminocarbonyl.
  • Examples of suitable substituents on the alkylene chain which may be present in a compound in accordance with the invention include halogen, trifluoromethyl, hydroxy, C 1-6 alkoxy and amino.
  • substituents on the alkylene chain which may be present in a compound in accordance with the invention include fluoro, trifluoromethyl, hydroxy, methoxy and amino.
  • integer E is selected from :
  • integer Y-E is selected from:
  • integer X-Y-E is selected from :
  • integer E is selected from :
  • any of the groups in the active compounds above is stated to be optionally substituted, this group may be unsubstituted, or substituted by one or more substituents. Typically, such groups will be unsubstituted, or substituted by one or two substituents.
  • the compounds in accordance with the present invention are beneficial in the treatment and/or prevention of various human ailments.
  • These ailments include lung disease, and in particular, chronic lung disease, including idiopathic pulmonary fibrosis; non-alcoholic fatty liver disease, and in particular, non-alcoholic fatty liver disease, non-alcoholic fatty liver, and non-alcoholic steatohepatitis; and kidney disorders, and in particular, renal fibrosis and/or chronic kidney disease.
  • the present invention includes within its scope solvates of the compounds above.
  • Such solvates may be formed with common organic solvents, e.g. hydrocarbon solvents such as benzene or toluene; chlorinated solvents such as chloroform or dichloromethane; alcoholic solvents such as methanol, ethanol or isopropanol; ethereal solvents such as diethyl ether or tetrahydrofuran; or ester solvents such as ethyl acetate.
  • the solvates of the above compounds may be formed with water, in which case they will be hydrates.
  • the present invention also includes co-crystals within its scope.
  • co-crystal is used to describe the situation where neutral molecular components are present within a crystalline compound in a definite stoichiometric ratio.
  • the preparation of pharmaceutical co-crystals enables modifications to be made to the crystalline form of an active pharmaceutical ingredient, which in turn can alter its physicochemical properties without compromising its intended biological activity (see
  • co-crystal formers which may be present in the co-crystal alongside the active pharmaceutical ingredient, include L-ascorbic acid, citric acid, glutaric acid, urea and nicotinamide.
  • active compounds disclosed herein can, as noted above, be prepared in the form of their pharmaceutically acceptable salts.
  • salts are salts that retain the desired biological activity of the parent compound and do not impart undesired toxicological effects.
  • examples of such salts are (a) acid addition salts formed with inorganic acids, for example hydrochloric acid, hydrobromic acid, sulfuric acid, phosphoric acid, nitric acid and the like; and salts formed with organic acids such as, for example, acetic acid, oxalic acid, tartaric acid, succinic acid, maleic acid, fumaric acid, gluconic acid, citric acid, malic acid, ascorbic acid, benzoic acid, tannic acid, palmitic acid, alginic acid, polyglutamic acid, naphthalenesulfonic acid, methanesulfonic acid, p-toluenesulfonic acid, naphthalenedisulfonic acid, polygalacturonic acid, and the like; (b) salts formed from elemental anions such as chlorine, bromine, and iodine, and
  • the pharmaceutically acceptable salt is selected from the group consisting of Na, K, Li, Ca and Mg salts.
  • a pharmaceutically acceptable prodrug is selected from the group consisting of esters, carbonates, thiocarbonates, N- acyl derivatives, N-acyloxy derivatives and amino acid conjugates.
  • the active compounds described above may be formulated for administration in a pharmaceutical carrier in accordance with known techniques. See, e.g., Remington, The Science And Practice of
  • the active compound (including the physiologically acceptable salts thereof) is typically admixed with, inter alia, an acceptable carrier.
  • the carrier must, of course, be acceptable in the sense of being compatible with any other ingredients in the formulation and must not be deleterious to the patient.
  • the carrier may be a solid or a liquid, or both, and is preferably formulated with the compound as a unit-dose formulation, for example, a tablet, which may contain from 0.01 or 0.5% to 95% or 99% by weight of the active compound.
  • One or more active compounds may be incorporated in the formulations of the invention, which may be prepared by any of the well known techniques of pharmacy consisting essentially of admixing the components, optionally including one or more accessory ingredients.
  • compositions of the invention include those suitable for oral, rectal, topical, buccal (e.g., sub-lingual), vaginal, parenteral (e.g., subcutaneous, intramuscular, intradermal, or intravenous), topical (i.e., both skin and mucosal surfaces, including airway surfaces) and transdermal administration, although the most suitable route in any given case will depend on the nature and severity of the condition being treated and on the nature of the particular active compound which is being used.
  • Formulations suitable for oral administration may be presented in discrete units, such as capsules, cachets, lozenges, or tablets, each containing a predetermined amount of the active compound; as a powder or granules; as a solution or a suspension in an aqueous or non-aqueous liquid; or as an oil-in-water or water-in-oil emulsion.
  • Such formulations may be prepared by any suitable method of pharmacy which includes the step of bringing into association the active compound and a suitable carrier (which may contain one or more accessory ingredients as noted above).
  • the formulations of the invention are prepared by uniformly and intimately admixing the active compound with a liquid or finely divided solid carrier, or both, and then, if necessary, shaping the resulting mixture.
  • a tablet may be prepared by compressing or molding a powder or granules containing the active compound, optionally with one or more accessory ingredients.
  • Compressed tablets may be prepared by compressing, in a suitable machine, the compound in a free-flowing form, such as a powder or granules optionally mixed with a binder, lubricant, inert diluent, and/or surface active/dispersing agent(s). Molded tablets may be made by molding, in a suitable machine, the powdered compound moistened with an inert liquid binder.
  • Formulations suitable for buccal (sub-lingual) administration include lozenges comprising the active compound in a flavoured base, usually sucrose and acacia or tragacanth; and pastilles comprising the compound in an inert base such as gelatin and glycerin or sucrose and acacia.
  • the pharmaceutical composition of this invention may comprise conventional excipients such as binders, fillers, thinners, tableting agents, lubricants, disintegrants, coloring agents, flavoring agents and wetting agents. Tablets can be coated when necessary.
  • Suitable fillers comprise cellulose, mannitol, lactose, and other similar fillers.
  • Suitable disintegrants comprise starch, polyvinylpyrrolidone and starch derivatives such as sodium starch glycolate.
  • Suitable lubricants comprise magnesium stearate.
  • Suitable pharmaceutically acceptable wetting agents comprise sodium lauryl sulfate.
  • compositions in solid form can be prepared by conventional methods comprising mixing, filling, tableting, etc. Repeated mixing can distribute the active substances throughout those compositions that use large amounts of fillers.
  • the orally administered liquid forms can be in the form of aqueous or oily suspensions, solutions, emulsions, syrups or elixirs, or can be a dried product to be reconstituted with water or other suitable carriers before administration.
  • the liquid forms can contain conventional additives, such as suspending agents like sorbitol, syrup, methyl cellulose, gelatin, hydroxyethyl cellulose, carboxymethyl cellulose, aluminum stearate gel, or hydrogenated edible fat; emulsifiers like lecithin, sorbitan monooleate or acacia; non-aqueous carriers (which may include edible oils) like almond oil, fractionated coconut oil; oil esters such as esters of glycerol, propylene glycol or ethanol; preservatives such as methyl p-hydroxybenzoate, propyl p-hydroxybenzoate or sorbic acid, and if necessary, may contain
  • Formulations of the present invention suitable for parenteral administration comprise sterile aqueous and non-aqueous injection solutions of the active compound, which preparations are preferably isotonic with the blood of the intended recipient. These preparations may contain anti oxidants, buffers, bacteriostats and solutes which render the formulation isotonic with the blood of the intended recipient.
  • Aqueous and non-aqueous sterile suspensions may include suspending agents and thickening agents.
  • the formulations may be presented in unit ⁇ dose or multi-dose containers, for example sealed ampoules and vials, and may be stored in a freeze-dried (lyophilized) condition requiring only the addition of the sterile liquid carrier, for example, saline or water-for-injection immediately prior to use.
  • sterile liquid carrier for example, saline or water-for-injection immediately prior to use.
  • an injectable, stable, sterile composition comprising a compound of Formula (I), or a salt thereof, in a unit dosage form in a sealed container.
  • the compound or salt is provided in the form of a lyophilizate which is capable of being reconstituted with a suitable pharmaceutically acceptable carrier to form a liquid composition suitable for injection thereof into a subject.
  • the unit dosage form typically comprises from about 10 mg to about 10 grams of the compound or salt.
  • a sufficient amount of emulsifying agent which is physiologically acceptable may be employed in sufficient quantity to emulsify the compound or salt in an aqueous carrier.
  • One such useful emulsifying agent is
  • Formulations suitable for rectal administration are preferably presented as unit dose suppositories. These may be prepared by admixing the active compound with one or more conventional solid carriers, for example, cocoa butter, and then shaping the resulting mixture.
  • one or more conventional solid carriers for example, cocoa butter
  • Formulations suitable for topical application to the skin preferably take the form of an ointment, cream, lotion, paste, gel, spray, aerosol, or oil.
  • Carriers which may be used include petroleum jelly, lanoline, polyethylene glycols, alcohols, transdermal enhancers, and combinations of two or more thereof.
  • Formulations suitable for transdermal administration may be presented as discrete patches adapted to remain in intimate contact with the epidermis of the recipient for a prolonged period of time. Formulations suitable for transdermal administration may also be delivered by
  • iontophoresis typically take the form of an optionally buffered aqueous solution of the active compound.
  • Suitable formulations comprise citrate or bis ⁇ tris buffer (pH 6) or ethanol/water and contain from 0.1 to 0.2M active ingredient.
  • the present invention provides liposomal formulations of the compounds disclosed herein and salts thereof.
  • the technology for forming liposomal suspensions is well known in the art.
  • the compound or salt thereof is an aqueous-soluble salt, using conventional liposome technology, the same may be incorporated into lipid vesicles. In such an instance, due to the water solubility of the compound or salt, the compound or salt will be substantially entrained within the hydrophilic center or core of the liposomes.
  • the lipid layer employed may be of any conventional composition and may either contain cholesterol or may be cholesterol-free.
  • the salt may be substantially entrained within the hydrophobic lipid bilayer which forms the structure of the liposome.
  • the liposomes which are produced may be reduced in size, as through the use of standard sonication and
  • Liposomal formulations containing the compounds disclosed herein or salts thereof may be lyophilized to produce a lyophilizate which may be reconstituted with a pharmaceutically acceptable carrier, such as water, to regenerate a liposomal suspension.
  • a pharmaceutically acceptable carrier such as water
  • compositions may be prepared from the water-insoluble compounds disclosed herein, or salts thereof, such as aqueous base emulsions.
  • the composition will contain a sufficient amount of pharmaceutically acceptable emulsifying agent to emulsify the desired amount of the compound or salt thereof.
  • Particularly useful emulsifying agents include phosphatidyl cholines, and lecithin.
  • the pharmaceutical compositions may contain other additives, such as pH-adjusting additives.
  • useful pH-adjusting agents include acids, such as hydrochloric acid, bases or buffers, such as sodium lactate, sodium acetate, sodium phosphate, sodium citrate, sodium borate, or sodium gluconate.
  • the compositions may contain microbial preservatives. Useful microbial preservatives include methylparaben, propylparaben, and benzyl alcohol.
  • the microbial preservative is typically employed when the formulation is placed in a vial designed for multidose use.
  • the pharmaceutical compositions of the present invention may be lyophilized using techniques well known in the art.
  • compound of formula (I) or a pharmaceutically acceptable salt or prodrug thereof act as an a cto protector, has antihypoxic effects, and downregulates HIF1 alpha .
  • HIF-1 hypoxia-inducible factor 1
  • HIF- 1 is regulated mainly by oxygen tension through the oxygen-dependent degradation of it's A subunit. Oxygen deprivation initiates a wide range of responses to restore oxygen homeostasis in the affected tissues. These adaptive responses are aimed to increase oxygen supply and compensate for the loss of energy.
  • the transcription factor HIF- 1 helps to restore oxygen homeostasis at a cellular, local, and systemic level. HIF-1 functions by regulating many of the genes involved in angiogenesis, erythropoiesis, glycolysis, iron metabolism, and cell survival. In addition to its role in oxygen homeostasis, HIF- 1 has been implicated as a critical factor in the
  • HIF-1a is degraded.
  • HIF-1a protein is stabilized and initiates a multistep pathway of activation (Stroka et al., The FASEB Journal, Vol 15, Nov 2001, 2445-2453) ( Figure 27).
  • HIF- 1 is a heterodimer consisting of HIF-1a and HIF-1b [also known as the aryl hydrocarbon nuclear translocator (ARNT)] subunits.
  • the amino-terminal half of each subunit contains basic helix-loop-helix (bHLH) and PER-ARNT-SIM homology (PAS) domains.
  • the bHLH domain defines a large superfamily of dimeric eukaryotic transcription factors in which the H LH domain mediates dimerization and the basic domain contacts DNA.
  • the carboxy-terminal half of HIF-1a contains two
  • CBP CREB binding protein
  • p300 p300
  • HIF-1 The biological activity of HIF-1 is determined by the expression and activity of the HIF-1a subunit.
  • the regulation of HIF-1a expression and activity in vivo occurs at multiple levels, including mRNA expression, protein expression, nuclear localization, and transactivation. Among these, the most intensively studied has been the regulation of steady-state HIF-1a protein levels.
  • HIF prolyl-hydroxylases The alpha subunits of HIF are hydroxylated at conserved proline residues by HIF prolyl-hydroxylases, allowing their recognition and ubiquitination by the VHL E3 ubiquitin ligase, which labels them for rapid degradation by the proteasome. This occurs only in normoxic conditions. In hypoxic conditions, HIF prolyl-hydroxylase is inhibited, since it utilizes oxygen as a cosubstrate (Figure 27).
  • HIF- 1 when stabilized by hypoxic conditions, upregulates several genes to promote survival in low-oxygen conditions. These include glycolysis enzymes, which allow ATP synthesis in an oxygen-independent manner, and vascular endothelial growth factor (VEGF), which promotes angiogenesis. HIF- 1 is known to induce transcription of more than 60 genes, including VEGF and erythropoietin that are involved in biological processes such as angiogenesis and erythropoiesis, which assist in promoting and increasing oxygen delivery to hypoxic regions, as well as LDH-A and Aldolase A (Figure 27).
  • VEGF vascular endothelial growth factor
  • HIF- la dimerizes with HIF- 1 b and the heterodimer binds to DNA at sites represented by the consensus sequence 5'-RCGTG-3'.
  • the HIF- 1 binding site is present within a hypoxia response element, a c/s-acting transcriptional regulatory sequence that can be located within 5'-flanking, 3'-flanking, or intervening sequences of target genes.
  • Semenza GL, HIF- 1 mediator of physiological and pathophysiological responses to hypoxia, Journal of Applied Physiology, Volume 88, Issue 4, April 2000. Pages 1474-1480 and Semenza GL, Flydroxylation of HIF-1 : Oxygen Sensing at the Molecular Level, Journal of Applied Physiology, Volume 19, Issue 4, August 2004, Pages 176-182.
  • HIF-1 also regulates glycolysis which is a vital pathway for energy production. It regulates the uptake of glucose through glucose transporters, i.e. glucose transporter 1 (GLUT1) and sodium-glucose transporters (SGLT).
  • glucose transporters i.e. glucose transporter 1 (GLUT1) and sodium-glucose transporters (SGLT).
  • SGLT sodium-glucose transporters
  • metabolic pathways shift from more productive oxidative phosphorylation to less efficient anaerobic metabolism for maintenance of ATP production (Warburg effect). This shift is done through up-regulation of hexokinase, aldolase, pyruvate kinase and down-regulation of pyruvate dehydrogenase which promotes the conversion of pyruvate to acetyl CoA to enter the citric acid cycle (Figure 28).
  • HIF-1 not only promotes glucose uptake by activating the transcription of transporters GLUT1 and GLUT3, but also enhances anaerobic energy production, as it upregulates most of the glycolytic enzymes
  • HIF-1 stimulates the expression of pyruvate dehydrogenase kinase (PDK1).
  • PDK inhibits the pyruvate dehydrogenase complex and blocks the conversion of pyruvate, the glycolytic end product, to acetyl-CoA, which normally feeds into TCA cycle by producing citrate. Therefore, the flow of pyruvate into the mitochondria is decreased, fueling the production of lactate by LDH in the cytoplasm ( Figure 28).
  • Obesity triggers hypoxia in adipose tissue and the small intestine, which stabilizes and activates hypoxia-inducible factor (HIF) la and FIIF2a (of which expression is limited to specific tissues such as the vasculature, liver, kidney and intestines) signalling, resulting in adverse metabolic effects, including insulin resistance and non-alcoholic fatty liver disease (Figure 29).
  • HIF hypoxia-inducible factor
  • FIIF2a of which expression is limited to specific tissues such as the vasculature, liver, kidney and intestines
  • HIF- la may also play a key role in vascular remodeling under hypoxic conditions.
  • Vascular remodeling is primarily composed of
  • ECs endothelial cells
  • ASMC arterial smooth muscle cells
  • Fibrosis is typically characterized by prolonged and/or exaggerated activation of fibroblasts and excessive deposition of ECM in organs or tissues including different kinds of collagens, hyaluronic acid, fibronectin, and proteoglycans.
  • HIF-1a may be helpful in repairing injury and correcting hypoxia via multiple mechanisms, however, prolonged exposure to HIF-1a is harmful and contributes to persistent pathofibrogenesis in fibrotic disease (Figure 30). See Xiong A and Liu Y, Targeting Hypoxia Inducible Factors-la As a Novel Therapy in Fibrosis, Front. Pharmacol., 30 May 2017.
  • the amount of compound of formula (I) or a pharmaceutically acceptable salt or prodrug thereof, used is between 0.5 to 200 mg per kg of the subject per day. In a preferred embodiment, the amount of formula (I) or a pharmaceutically acceptable salt or prodrug thereof, used is between 1 to 30 mg per kg of the subject per day. In a further preferred embodiment, the amount of formula (I) or a
  • the amount of formula (I) or a pharmaceutically acceptable salt or prodrug thereof, used is between 4 to 25 mg per kg of the subject per day. In a yet further preferred embodiment, the amount of formula (I) or a pharmaceutically acceptable salt or prodrug thereof, used is between 8 to 17 mg per kg of the subject per day. In a still further preferred embodiment, the amount of formula (I) or a
  • pharmaceutically acceptable salt or prodrug thereof, used is about 17 mg per kg of the subject per day.
  • Example 1 - fibrotic lung disease
  • mice The mouse species or strain is Mouse/C57BL/6, the mice being 8-10 week old males.
  • Bleomycin (BLM) was obtained from Euroasias.
  • mice will be maintained in a controlled environment with a temperature of 70-72° F, humidity 30-70%, with a photocycle of 12 hours of light and 12 hours of dark. They will be provided with TEKLAD 2018-Global 18% diet and Arrowhead drinking water ad libitium.
  • mice will be anesthetized with isoflurane/O2 mixture.
  • Bleomycin (BLM) will then be administered to the mice intratracheally (PennCentury) - single bolus, at 2.5U/kg body weight in 50mI sterile saline.
  • mice Seven days after the bleomycin is administered, and fibroblasts have generally proliferated, groups of IT bleomycin challenged mice will be dosed orally (p.o.) once a day with the active compounds at specified amounts per kg of body weight (mg/kg) daily for 14 consecutive days.
  • the vehicle to used is 0.5% carboxymethyl cellulose (CMC). Vehicle and no-BLM control groups will receive 0.5% CMC orally for 14 consecutive days.
  • mice On day 21 of the study, 4 hours after the last dose, the mice will be sacrificed and plasma was collected and frozen for cytokine analysis (testing for IL-6, IL-12, TGFb, IL-13 proteins, or fibrosis markers).
  • Brochoalveolar lavage fluid (BALF) was collected and frozen for optional cytokine analyses and cell counts pending the initial data.
  • the lungs will be excised, weighed and fixed in formalin.
  • Gomori's Trichrome stain a histological stain, will be used to determine collagen content.
  • the dose selected for the animal studies will be determined by taking the maximum known human daily dose, dividing by the average weight of an adult ( ⁇ 60 kg) to get a human mg/kg dose. Then that number was multiplied by 12 to convert to a mouse dose based on conventional dosing tables. See Nair and Jacob, J Basic Clin Pharm March 2016-May 2016, 7(2) :27-31.
  • Body Weight The body weights will be measured over 21 days using a laboratory balance.
  • Trichrome Score A trichrome score measures the level of scarring to the lungs caused by the disease. The greater the trichrome score, the greater the scarring.
  • Formalin fixed lung samples will be submitted to affiliated histopathology laboratory for histopathological analysis subjected Gomori's Trichrome stain, a histological stain, which will be used to determine collagen content.
  • Each lung will be divided into ten sections. All ten sections were stained and evaluated. A board certified veterinarian pathologist will assess the presence of lung fibrosis and severity score - The expression of collagen (associated with fibrosis) is determined from the ratio of the stained area versus the total area of the lung section.
  • Mortality Rate the mortality rate in each group was also observed over 21 days.
  • Example 2 non-alcoholic steatohepatitis
  • mice Male newborn C57BL/6 mice will be used. All mice will be born from pathogen-free 14 day-pregnant mice obtained from Japan SLC, Inc. (Hamamatsu, Japan) prior to the start of the study.
  • the murine STAMTM model of NASH-HCC will be performed according to previously described methods known in the art (Takakura et al, Characterization of non-alcoholic steatohepatitis, Anticancer Res,
  • NASH will be induced in male mice by a single subcutaneous injection of 200 mg of streptozotocin (STZ, Sigma, MO, USA) at 2 days after birth and continuous feeding after 4 weeks of age (day 28 ⁇ 2) with a high fat diet (CLEA Japan Inc, Tokyo, Japan) given ad libitum.
  • mice Following induction of NASH, the mice will be randomized study groups of 8 mice each at 6 weeks of age (day 42 ⁇ 2) based on body weight, the day before the start of treatment.
  • mice One day following randomization, the mice will be administered a once-daily oral treatment from 6 weeks of age plus one day (day 43 ⁇ 2, treatment Day 1) to 9 weeks of age (hereinafter known as the "treatment period") ⁇ Telmisartan will be used as the positive control.
  • treatment period 6 weeks of age plus one day (day 43 ⁇ 2, treatment Day 1) to 9 weeks of age (hereinafter known as the "treatment period") ⁇ Telmisartan will be used as the positive control.
  • mice in all groups were 0.5% carboxymethyl cellulose (CMC).
  • CMC carboxymethyl cellulose
  • the mice in the remaining study group (hereafter known as the "vehicle control group") will be treated individually with the same pharmaceutically acceptable vehicle with no active ingredient. Individual body weight will be measured daily during the treatment period. Survival, clinical signs and behavior of mice will be also monitored daily.
  • a volume of 10 mL/kg of 0.5% CMC will be administered orally with (or without) the active ingredient as noted in Table 3 from 6 to 9 weeks of age. All mice will then be sacrificed at 9 weeks of age. Blood samples were collected from all mice and the liver from each mouse will be removed for analysis.
  • the dose selected for the animal studies will be determined by taking the maximum known human daily dose, dividing by the average weight of an adult ( ⁇ 60-70 kg) to get a human mg/kg dose. Then that number was multiplied by 12 to convert to a mouse dose based on conventional dosing tables. See Nair and Jacob, J Basic Clin Pharm March 2016-May 2016, 7(2) : 27-31.
  • Blood Sample Collection and Biochemical Analysis Blood will be collected from all sacrificed mice and frozen for further analyses or shipping.
  • Plasma Alanine Aminotransferase ALT
  • the plasma from each blood sample will be analyzed by FUJI DRI CHEM (Fujifilm, Japan) for alanine aminotransferase (ALT) as an indicator of liver function and disease progression.
  • liver Sample Collection, Biochemical Analysis, and Histological Analysis The liver will be removed from all sacrificed mice and frozen for further analyses or shipping.
  • liver Weight Following removal, the livers from all sacrificed mice will be weighed in grams.
  • liver Flistopathology The removed livers will be fixed in formalin and embedded in paraffin, and cross sections ( 4mm) were then prepa red.
  • NAFLD Activity Scores of: 0 (normal), 1-2 (NAFLD), 3-4 (borderline) or at least 5 (NASFI) in 3 randomly selected fields of H &E-stained liver cross-sections of 4mm thickness at x50 magnification for evaluation of steatosis and x200 magnification each for evaluation of inflammation and evaluation of ballooning.
  • the NAFLD Activity Score is the unweighted sum of the following : 1) hepatic steatosis score (0-3); 2) lobular inflammation score (0-2); 3) hepatocellular ballooning score (0-2).
  • liver cross-sections of the Vehicle group, and the treated groups will also be subjected to Sirius-red staining using standard techniques for histological estimation of the percentage of fibrosis area.
  • Sirius-red staining For quantitative analysis of fibrosis area, bright field images of Sirius red-stained sections were captured around the central vein using a digital camera (DFC295;
  • mice Male 9-12 week old C57BL/6 mice of 23-25 grams body weight were used. All mice (Sirius red-positive area) acclimated for a minimum of 5 days prior to the start of the study and housed individually in microisolators throughout the study in a 12: 12 light-dark cycle on a standard maintenance mouse chow diet (Harlan Teklad 2018) with food and water given ad libitum. Prior to surgery, all mice (Sirius red-positive area) weighed for baseline body weight.
  • mice will be first anesthetized by intraperitoneal injection with a rodent cocktail (ketamine lOmg/mL and Xyaline lmg/mL) in normal saline (10mL/g body weight). Pedal reflex and movement of the vibrissae will be used to determine the state of unconsciousness. A state of
  • mice will then be shaved on the left side of the abdomen.
  • the shaved area will be first swabbed with iodine and then swabbed with alcohol.
  • a vertical incision will be made through the skin with a #22 scalpel and the skin will then be retracted.
  • a further incision of about 2.5cm was then made through the peritoneum avoiding any major blood vessels. The peritoneum will be then retracted and the left kidney was exposed.
  • the left kidney will be then brought to the surface by hooking the ureter directly beneath the kidney with sterile forceps and gently manipulating the kidney upward.
  • the ureter will be ligated at two points directly below the kidney with 5-0 surgical silk with excess suture cut away and discarded post-ligation.
  • the kidney will be then gently placed back to its correct anatomical position and the abdomen was lavaged with lmL sterile saline to replenish fluid loss.
  • the peritoneum and then skin will be sutured with 5-0 Mersilene, and the incision site was gently wiped with iodine. All mice will then be placed individually in clean cages that were set on top of a thermal blanket until recovery at about 30-60 minutes later.
  • sham surgery will be performed as a control by following all steps of the UUO surgical intervention procedure except ligation.
  • mice Following surgery, the mice will be divided into study groups of 8 mice each and, following post-surgical recovery, administered a once-daily oral treatment for 14 days.
  • the mice in the study groups (hereafter known as "treatment groups") will all receive the UUO surgical ligation and will be treated individually with active compound.
  • the pharmaceutically acceptable vehicle in all groups was 0.5% carboxymethyl cellulose (CMC). All mice will be sacrificed with CO2 on post-surgical day 15.
  • the dose selected for the animal studies will be determined by taking the maximum known human daily dose, dividing by the average weight of an adult ( ⁇ 60-70 kg) to get a human mg/kg dose. Then that number was multiplied by 12 to convert to a mouse dose based on conventional dosing tables. See Nair and Jacob, J Basic Clin Pharm March 2016-May 2016, 7(2) : 27-31.
  • Body weight The body weights will be measured on days 1, 2, 5, 8, 10 and 14 using a laboratory balance.
  • Serum collection A blood sample will be collected from all mice and plasma analyzed for urea nitrogen and creatinine. Plasma was stored at -80 °C for possible future analysis.
  • Kidney weight The UUO will be examined in situ to ensure that the surgical ligation ties remained patent. Both the ligated (UUO) and non- ligated kidneys were removed for analysis. Weights of both kidneys will be measured using a laboratory balance.
  • Trichrome score data are presented in Figure 2, Table 4 and Appendix B.
  • the dose selected for the animal studies was determined by taking the maximum known human daily dose, dividing by the average weight of an adult ( ⁇ 60-70 kg) to get a human mg/kg dose. Then that number was multiplied by 12 to convert to a mouse dose based on conventional dosing tables. See Nair and Jacob, J Basic Clin Pharm March 2016-May 2016, 7(2) : 27-31.
  • Body weight The body weight of all mice were measured daily throughout the treatment period.
  • Blood Sample Collection and Biochemical Analysis Blood was collected from all sacrificed mice and frozen for further analyses or shipping.
  • Plasma Alanine Aminotransferase (ALT) The plasma from each blood sample was analyzed by FUJI DRI CHEM (Fujifilm, Japan) for alanine aminotransferase (ALT) as an indicator of liver function and disease progression.
  • liver Sample Collection, Biochemical Analysis, and Histological Analysis The liver was removed from all sacrificed mice and frozen for further analyses or shipping. Following removal, the livers from all sacrificed mice were weighed in grams.
  • liver Flistopathology The removed livers were fixed in formalin and embedded in paraffin, and cross sections (4mm) were then prepared.
  • the level of steatohepatitis severity in each liver cross-section was indicated by NAFLD Activity Scores of: 0 (normal), 1-2 (NAFLD), 3-4 (borderline) or at least 5 (NASH) in 3 randomly selected fields of Fi8iE-stained liver cross-sections of 4mm thickness at x50 magnification for evaluation of steatosis and x200 magnification each for evaluation of inflammation and evaluation of ballooning.
  • the NAFLD Activity Score is the unweighted sum of the following : 1) hepatic steatosis score (0-3); 2) lobular inflammation score (0-2); 3) hepatocellular ballooning score (0-2).
  • liver cross-sections of the treated groups were also subjected to Sirius-red staining using standard techniques for histological estimation of the percentage of fibrosis area.
  • Sirius-red staining For quantitative analysis of fibrosis area, bright field images of Sirius red-stained sections were captured around the central vein using a digital camera (DFC295; Leica, Germany) at 200-fold magnification, and the positive areas in 5 fields/section were measured using ImageJ software (National Institute of Health, USA).
  • Steatohepatitis Evaluation Steatohepatitis and disease progression was evaluated by H&E-staining of liver cross-sections as previously described. Representative photomicrographs of HE-stained liver sections for each of the study groups are shown in Figures 5a, 5b, and 5c.
  • the NAFLD Activity Score of each study group consisted of the NAFLD Activity Score average of all mice in each study group. Scores were determined based on the steatosis score, lobular inflammation score and hepatocellular ballooning score for each animal. Results are shown in Figures 6-9 and Appendix E. Statistically significant reductions in NAFLD activity score relative to Vehicle control were observed.
  • Bemithyl showed statistically significant decreases in the fibrosis area (Sirius red-positive area) compared with the Vehicle group.
  • the Bemithyl group showed particularly statistically significant decrease in fibrosis area.
  • the fibrosis area in the Telmisartan group also tended to decrease compared with the Vehicle group. Results are shown in FIGS 10a and 10b, and 11.
  • inflammation and hepatocellular ballooning may be useful in the prophylaxis and/or treatment of NASFI.
  • the dose selected for the animal studies was determined by taking the maximum known human daily dose, dividing by the average weight of an adult ( ⁇ 60-70 kg) to get a human mg/kg dose. Then that number was multiplied by 12 to convert to a mouse dose based on conventional dosing tables. See Nair and Jacob, J Basic Clin Pharm March 2016-May 2016, 7(2) : 27-31.
  • Body weight The body weights were measured on days 1, 2, 5, 8, 10 and 14 using a laboratory balance.
  • Serum collection A blood sample was then collected from all mice and plasma analyzed for urea nitrogen and creatinine. Plasma was stored at -80 °C for possible future analysis.
  • Kidney weight The UUO was then examined in situ to ensure that the surgical ligation ties remained patent. Both the ligated (UUO) and non-ligated kidneys were removed for analysis. Weights of both kidneys were measured using a laboratory balance.
  • Body Weight Evaluation Results of the evaluation of mean body weight change are shown in Figure 12 and Table 8. Body weights were measured on post-surgical days 1, 2, 5, 8, 10 and 14 as previously described. The mean body weight change of each study group was calculated using the body weight average of all mice in each study group.
  • Bemithyl treatment showed an initial decrease in mean body weight change followed by an increase in mean body weight change until sacrifice.
  • the mean body weight change on post-surgical day 14 with bemithyl treatment showed a more positive value than the positive control treatment group (Telmisartan).
  • the mean body weight change on post- surgical day 14 with bemithyl treatment was even greater than that of the sham surgery control group. See FIG 12.
  • Renal Function Evaluation Renal function and disease progression was evaluated by BUN (blood urea nitrogen) as previously described.
  • BUN blood urea nitrogen
  • the BUN of each study group consisted of the BUN average of all mice in each study group. Results are shown in Figures 13 and 14. and Table 9.
  • the BUN was decreased in comparison to the surgery vehicle control group and the positive control treatment group. This indicated that bemithyl had less renal dysfunction and disease progression than the positive control treatment with Telmisartan, the current gold standard for treatment of renal fibrosis.
  • Kidney Weight Evaluation Kidney weight indicating, which indicates functional and pathological changes in the kidney, was evaluated by measuring the weight of both the ligated (UUO) and non-ligated kidneys as previously described. The ligated and non-ligated kidney weights of each study group consisted of the respective kidney weight averages of all mice in each study group. Results are shown in Table 10 and Figure 15.
  • the ligated kidney weights for the bemithyl treatment and surgery vehicle control group were increased in comparison to the sham surgery control group.
  • the increase in weight of the ligated kidney in comparison to the non-ligated kidney was greater as compared to the positive control treatment group.
  • the positive control was greater as compared to the positive control treatment group.
  • Renal Fibrosis Evaluation Renal fibrosis and interstitial damage was evaluated by histochemical staining of renal cross-sections with Sirius Red as previously described.
  • the Flistology Score of each study group consisted of the histology score average of all mice in each study group. Results are shown in Table 11 and Figures 16 and 17.
  • mice healthy young female C57BL/6 mice were used for the study. At the commencement of the study, mice were between 9-12 weeks of age, weighing 23-25g. All the mice were obtained from Charles River Laboratories. [00400] The mice were maintained in a controlled environment with a temp 70-72° F, humidity 30-70 %, with a photo cycle of 12 hours of light and 12 hours of dark. They were provided with Harlan Teklad 2018 standard maintenance mouse chow diet and drinking water ad libitium.
  • mice After five days of acclimatization, the mice were grouped according to their body weight. There were ten groups of ten mice each.
  • mice Nine groups of ten mice each underwent UUO as described above and the other group of ten mice underwent a sham procedure to serve as a no- surgery control.
  • mice were divided into 10 individual study groups of 10 mice each and, following post-surgical recovery, administered a once-daily oral treatment for 14 days.
  • the mice in the study groups had all received the UUO surgical ligation and were treated individually with a distinct pharmacologic compound as set out in Table 12.
  • the mice in 2 of the study groups were treated individually with a pharmaceutically acceptable vehicle with no active ingredient.
  • the pharmaceutically acceptable vehicle in all groups was 0.5% carboxymethyl cellulose (CMC). All mice were sacrificed with CO2 on post-surgical day 15.
  • CMC carboxymethyl cellulose
  • the dose selected for the animal studies was determined by taking the maximum known human daily dose, dividing by the average weight of an adult ( ⁇ 60-70 kg) to get a human mg/kg dose. That number was multiplied by 12 to convert to a mouse dose based on conventional dosing tables. See Nair and Jacob, J Basic Clin Pharm March 2016-May 2016, 7(2) :27-31.
  • Body weight The body weights were measured on days 1, 4, 7, 10 and 14 using a laboratory balance.
  • Serum collection A blood sample was then collected from all mice and plasma analyzed for urea nitrogen and creatinine. Plasma was stored at -80 °C for possible future analysis.
  • Kidney weight The UUO was then examined in situ to ensure that the surgical ligation ties remained patent. Both the ligated (UUO) and non-ligated kidneys were removed for analysis. Weights of both kidneys were measured using a laboratory balance.
  • Body Weight Evaluation Results of the evaluation of mean body weight change are shown in Figure 18 and Table 13. Body weights were measured on post-surgical days 1, 4, 7, 10 and 14 as previously described. The mean body weight change of each study group was calculated using the body weight average of all mice in each study group.
  • Renal Function Evaluation Renal function and disease progression was evaluated by BUN (blood urea nitrogen) as previously described.
  • BUN blood urea nitrogen
  • the BUN of each study group consisted of the BUN average of all mice in each study group. Results are shown in Figures 19 and 20 and Table 14.
  • BUN urea nitrogen
  • creatinine data are presented in Figures 19 & 20 and Table 14, respectively.
  • Administration of Bemithyl 200 mg/kg led to significant reductions in the level of BUN compared to vehicle.
  • the positive control Telmisartan did not reduce levels of BUN, and when combined with Bemithyl appeared to mitigate the ability of these agents to reduce BUN levels.
  • Kidney Weight Evaluation Kidney weight, which indicates functional and pathological changes in the kidney, was evaluated by measuring the weight of both the ligated (UUO) and non-ligated kidneys as previously described. The ligated and non-ligated kidney weights of each study group consisted of the respective kidney weight averages of all mice in each study group. Results are shown in Table 15 and Figures 21 and 22.
  • the weight of the left (ligated) kidney in the vehicle group was greatly increased. All of the compounds effected numerical reductions in the weight of the left kidney. Significant reductions were achieved by the administration of Telmisartan (3 mg/kg) combined with Bemithyl (200 mg/kg). Bemithyl (200 mg/kg) was also able to significantly reduce the weight of the drained left kidney compared to the vehicle group. During the experiment, the vehicle group also saw a significant increase in the weight of the right (unligated) kidney. All of the treatments tested were able to significantly reduce the weight of this organ.
  • Renal Fibrosis Evaluation Renal fibrosis and interstitial damage was evaluated by histochemical staining of renal cross-sections with Sirius Red as previously described. The Histology Score of each study group consisted of the histology score average of all mice in each study group. Results are shown in Table 16 and Figures 23 and 24.
  • Bemithyl (200 mg/kg), Telmisartan (3 mg/kg) in combination with either Bemithyl (200 mg/kg) were able to significantly reduce the level of kidney fibrosis compared to vehicle.
  • Oral administration of Bemithyl (200 mg/kg) showed significant improvement in kidney fibrosis and reduction in BUN compared to vehicle, and appeared to reverse the negative effects of UUO on body weight gain.
  • Example 4 Bemithyl effect on anti-hypoxic activity in vitro
  • hypoxia was induced by 10 mM PHT (lane 2), and HIF1-alpha was stabilized, showing a 100% band.
  • Addition of bemithyl at 5 or 10 pM to PHT samples normalized (reduced) hypoxia as demonstrated by the level of HIF1-alpha.

Abstract

Methods and uses of bemithyl and derivatives of the formula (I) for treating fibrotic diseases are taught, and in particular, chronic lung disease, including idiopathic pulmonary fibrosis; non-alcoholic fatty liver disease, and in particular, non-alcoholic fatty liver, and non-alcoholic steatohepatitis; and kidney disorders, and in particular, renal fibrosis and/or chronic kidney disease.

Description

METHODS AND USES OF BEMITHYL AND DERIVATIVES FOR TREATING LUNG DISEASE, FATTY LIVER DISEASE, AND KIDNEY
DISORDERS
CROSS-REFERENCE TO RELATED APPLICATION
This application claims the benefits of priority to United States Provisional Patent Application No. 62/824,738, filed March 27, 2019, titled METHODS AND USES OF BEMITHYL AND DERIVATIVES FOR TREATING LUNG DISEASE, FATTY LIVER DISEASE, AND KIDNEY DISORDERS, and United States Provisional Patent Application No. 62/940,566, filed November 26, 2019 titled METHODS AND USES OF BEMITHYL AND DERIVATIVES FOR TREATING LUNG DISEASE, FATTY LIVER DISEASE, AND KIDNEY DISORDERS, the contents of which are hereby expressly incorporated into the present application by reference in their entirety.
TECHNICAL FIELD
[0001] The present invention relates to bemithyl and derivatives, methods and uses of bemithyl derivatives for treating fibrotic diseases, and in particular, chronic lung disease, including idiopathic pulmonary fibrosis; non-alcoholic fatty liver disease, and in particular, non-alcoholic fatty liver, and non-alcoholic steatohepatitis; and kidney disorders, and in particular, renal fibrosis and/or chronic kidney disease.
BACKGROUND
[0002] Bemithyl, 2-ethylsulfanyl-lH-benzoimidazole, is known as a synthetic a cto protector, antioxidant, and antimutagenic, and is often used to increase physical performance. The chemical structure of bemithyl is:
Figure imgf000003_0001
[0003] Idiopathic pulmonary fibrosis (IPF) is a form of interstitial lung disease that is characterized by scarring (fibrosis) of the lungs. This results in progressive and irreversible decline in lung operation, including breathing. Symptoms typically include gradual onset of shortness of breath and a dry, chronic cough. Other symptoms include chest pain and fatigue. The causes of IPF is not completely understood. However, factors which increase the risk of IPF include cigarette smoking, acid reflux, and a family history of the condition.
[0004] There is currently no cure for IPF and no procedures or medications that can remove the scarring from the lungs. Conventional treatment of IPF tends to focus on slowing the progression of the lung scarring. Such treatment includes pulmonary rehabilitation, supplemental oxygen, and/or use of medications like pirfenidone or nintedanib. Lung transplantation is also an option in severe cases.
[0005] The bleomycin (BLM) murine models is probably the most accepted model of pulmonary fibrosis. Intratracheal administration of bleomycin effectively mimics the chronic aspect of pulmonary fibrosis, as well as other characteristics including the presence of hyperplastic alveolar epithelial cells. (Mouratis et al., Modeling pulmonary fibrosis with bleomycin, Current Opinion in Pulmonary Medicine: September 2011, Vol 17(5): 355- 361). In one such model, BLM is initially and directly introduced to the alveolar epithelial cells, to develop neutrophilia and lymphocytes and BLM- induced fibrosis develops after about seven days. In this model, only a single instillation is needed, the disease develops in a short time frame and it has high reproducibility. BLM-induced fibrosis in mice constitutes an animal model of IPF with high degree of similarity to the histopathological characteristics and distribution of lung fibrosis described in human idiopathic pulmonary fibrosis.
[0006] Non-alcoholic fatty liver disease (NAFLD) covers a range of liver conditions characterized by too much fat stored in liver cells. As its name implies, the causes are generally unrelated to alcohol consumption. This is in contrast to alcoholic liver disease, which is caused by heavy alcohol use.
Most commonly, NAFLD is either non-alcoholic simple fatty liver or non- alcoholic steatohepatitis (NASH).
[0007] Nonalcoholic fatty liver is a condition where you have fat in your liver but little or no inflammation or liver cell damage. It typically does not progress to cause liver damage or complications.
[0008] NASH includes both a fatty liver and liver inflammation. While those with only nonalcoholic fatty liver are generally asymptomatic, the inflammation and liver cell damage with NASH can cause fibrosis, or scarring, of the liver, and in severe cases, may lead to cirrhosis (advanced scarring) or liver cancer. In that regard, common signs and symptoms of NASH and cirrhosis can include abdominal swelling, enlarged blood vessels just beneath the skin's surface, enlarged breasts in men and jaundice.
[0009] Factors which increase one's risk of NASH
include diabetes, obesity, a high fructose diet, genetics and advanced age. While improving one's diet and exercise are an efficient way to manage NAFLD and reduce insulin resistance, there is currently no cure for NAFLD or NASH, and there is no single treatment that works for every individual.
Drugs currently used to treat NAFLD and NASH may help to increase fat loss and/or improve biomedical marker levels, but none have been shown to reverse or reduce NAFLD and NASH once liver scarring has begun.
[0010] The murine models of NAFLD and NASH are well-characterized experimental models of metabolically-induced hepatic injury that ultimately lead to spontaneous hepatic steatosis - a common characteristic of many chronic hepatitis disorders. In the dietary models, the progression towards fatty liver is highly predictable and reproducible, leading to steatosis based on insulin resistance and obesity (Ishii et al, Female spontaneously diabetic Torii fatty rats develop nonalcoholic steatohepatitis-like hepatic lesions, World J Gastroenterol, 21(30):9067-78 (2015); Kucera 0 and Cervinkova Z, Experimental models of non-alcoholic fatty liver disease in rats, World J Gastroenterol, 20(26) :8364-76 (2014); Takahashi et al, Animal models of nonalcoholic fatty liver diseaselnonalcoholic steatohepatitis, World J
Gastroenterol, 18(19);2300-08 (2012)).
[0011] In one such model (known as the Stelic Animal Model or STAMIM) of NASH-derived hepatocellular carcinoma ("NASH-HCC") in mice, subcutaneous streptozotocin ("STZ") exposure followed by a continuous high-fat diet leads to diabetes, significant steatosis, chronic lobular inflammation, pericellular fibrosis, liver cirrhosis and HCC resembling the entire cascade of human NASH-HCC in a relatively short period of 6 to 16 weeks, including moderate increases of transaminases and plasma lipids - major hallmarks of human NASH (Fujii M et al, A murine model for non- alcoholic steatohepatitis showing evidence of association between diabetes and hepatocellular carcinoma, Med Mol Morphol, 46(3) : 141-52 (2013)).
[0012] Chronic kidney disease (CKD) is a form of kidney disease characterized by damage to the kidneys that worsens over time, often as result of renal fibrosis. This causes gradual loss of kidney functions, so that excess fluid and waste from the blood remain in the body and may cause other health problems.
[0013] Early on, an individual with CKD is generally asymptomatic. As the disease progresses, however, symptoms can include muscle cramps, nausea and vomiting, loss of appetite, swelling in your feet and ankles, and tiredness. Symptoms of acute kidney failure include abdominal and back pain, diarrhea, vomiting, and fever. [0014] Factors which increase the risk of CKD include diabetes, high blood pressure, heart disease, advanced age and a family history of the condition. Blood tests checking for glomerular filtration rate and urine tests to check for albumin (albumin being a protein that can pass into the urine when the kidneys are damaged) can be used to diagnose CKD.
[0015] There is currently no cure for renal fibrosis or CKD. Treatment of CKD generally focus on controlling the risk factors, the goal of therapy is simply to slow down or halt the progression of CKD.
[0016] The murine model of UUO surgical intervention is a well- characterized experimental model of renal injury that ultimately leads to tubulointerstitial fibrosis, depending on the duration of obstruction. In this model, the progression of renal fibrosis is highly predictable and
reproducible, leading to significant fibrosis and nephron loss in a relatively short period of 7 to 14 days (Eddy et al., Investigating mechanisms of chronic kidney disease in mouse models, Pediatr Nephrol. 2012 August; 27(8) : 1233-47; Grande M T and Lopez-Novoa J M, Fibroblast activation and myofibroblast generation in obstructive nephropathy, Nat Rev Nephrol.,
2009 June; 5(6): 319-28).
[0017] There is a need for compounds, compositions, methods and/or use of bemithyl and derivatives thereof, for treating lung diseases, and in particular, chronic lung disease, including idiopathic pulmonary fibrosis; non alcoholic fatty liver disease, and in particular, non-alcoholic fatty liver disease, non-alcoholic fatty liver, and non-alcoholic steatohepatitis; and kidney disorders, and in particular, renal fibrosis and/or chronic kidney disease.
SUMMARY OF THE INVENTION :
[0018] It is an embodiment of the present invention to provide uses of compound of formula (I) : [0019]
Figure imgf000007_0001
[0020] A is N or C, subject to the proviso that R5 is absent when A is N;
[0021] Q represents a covalent bond; or Q represents— O— ,— S— ,— S(O)-,— S(O) 2-,— N(R9)— ,— C(O)N(R9)— , -N(R9) C(O)-, S(O) 2N(R9)- or— N(R9)S(O)2— ; or Q represents an optionally substituted straight or branched C1-6 ;lkylene chain optionally comprising one, two or three heteroatom-containing linkages independently selected from— O— ,— S— ,— S(O)-,— S(O) 2-,— N(R9)— ,— C(O)N(R9)— , -N(R9)C(O)-,— S(O) 2-N(R9)- and— N(R9) S(O)2— ;
[0022] Z represents hydrogen, halogen or trifluoromethyl; or Z represents C1-6 alkyl, C3-7 cycloalkyl, aryl, C3-7 heterocycloalkyl, C3- 7 heterocycloalkenyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; or Z represents— Z1— Z2 or— Z1— C(O)— Z2, either of which moieties may be optionally substituted by one or more substituents;
[0023] Z1 represents a divalent radical derived from an aryl, C3- 7 heterocycloalkyl or heteroaryl group;
[0024] Z2 represents aryl, C3-7 heterocycloalkyl, C3-7 heterocycloalkenyl, (C4-9)heterobicycloalkyl, (C4-9)spiroheterocycloalkyl or heteroaryl; or
[0025] Q-Z represents H, halo, loweralkyl, haloloweralkyl,
haloloweralkoxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acy, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; arylalkyloxy, cycloalkyloxy, cyclo alkyl alkoxy, cyclo alkyl amino, urea,
cycloalkylalkylamino, cycloalkyl, alkylcycloalkyl, hydroxyamino,
alkoxyacylamino, and arylthio;and 5- or 6- membered organic rings containing 0 to 4 heteroatoms selected from the group consisting of N, 0 and S, which rings may be unsubstituted or substituted from 1 to 4 times with halo, loweralkyl, haloloweralkyl, haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide,
aminosulfonyl, sulfone, nitro; and oxoheterocyclic groups;
[0026] X represents a covalent bond ; or X represents,— S(O)2— or— N(R8)— ; or X represents an optionally substituted straight or branched C1- 4 alkylene chain; or X represents,— C(O)— ; or X represents— O— ,—
N(R12)— , or— S— ;
[0027] Y represents C3-7 cycloalkyl, aryl, C3-7 heterocycloalkyl or heteroaryl; or
[0028] Y represents a linking group such as alkyl (e.g.,— R— where R is C2- 6 alkyl), alkenyl (e.g.,— R— where R is C2- 6 alkenyl), cycloalkyl (e.g.,— R— where R is C3-6 cycloalkyl), alkylcycloalkyl(e.g.,— R— R'— , where R is C1-4 alkyl and R' is C3-6 cycloalkyl), cylcoalkylalkyl (e.g.,— R— R'— , where R is C3- 6 cycloalkyl and R' is C1-4 alkyl), alkylcycloalkylalkyl (e.g .,— R— R'— R"— , wherein R is C1-4 alkyl, R' is C3-6 cycloalkyl, and R" is C1-4 alkyl), alkyloxyalkyl (e.g.,— R— O— R'— , wherein R and R' are C1-4alkyl); aryl (e.g.,— R— where R is aryl), alkylaryl (e.g.,— R— R'— where R is C1-4 alkyl and R' is aryl), alkylarylalkyl (e.g.,— R— R'— R"— where R is C1-4 a lkyl, R' is aryl, and R" is C1-4 alkyl), or arylalkyl (e.g.,— R— R'— where R is aryl alkyl and R' is C1-4 alkyl); cycloalkylalkyl (e.g.— R— R'— , where R is C3-6 cycloalkyl and R' is C1-4 alkyl), alkylheterocycle (e.g.,— R— R', where R is C1-4 alkyl and R' is a heterocyclic group as described herein), heterocyclealkyl,
alkylheterocyclealkyl, heterocycle, aminoalkyl (e.g.,— N(R)R'— , where R is H or C1-4 alkyl and R' is C1-4 alkyl), oxyalkyl (e.g.,— O— R— where R is C2- 6 alkyl), aminoaryl (e.g.,— N(R)R'— , where R is H or C1-4 alkyl and R' is aryl), and oxyaryl (e.g.,— O— R— , where R is aryl), any of which groups may be optionally substituted by one or more substituents; and
[0029] R1 and R2 are each independently H, loweralkyl, or together form C2-4 alkylene;
[0030] E is H; or
[0031] E is -N=C=S; or
[0032] E is selected from the group consisting of -B(OR1)OR2, - CON(R1)0R2, and— N(OR1)COR2 or any of the additional alternatives for E described in greater detail below; or
[0033] X-Y-E represents alkyl, phenyl, substituted phenyl, naphthyl and substituted naphthyl, wherein the substituent in said substituted phenyl and substituted naphthyl is selected from the group consisting of halogen, cyano, alkyl, alkoxy, ester, N-acyl derivatives, N-acyloxy derivatives and amino acid conjugates, when Q of Q-Z is attached to the ring carbon and Q is— S— , then Z is CHR10R11, where R10 and R11 are selected from the group consisting of hydrogen, alkyl, phenyl, and substituted phenyl, wherein the substituent in said substituted phenyl is selected from the group consisting of halogen, cyano, alkyl, alkoxy, ester, N-acyl derivatives, N-acyloxy derivatives and amino acid conjugates; or
[0034] X-Y-E represents hydrogen or C1-6 alkyl or C6-14 aryl when X of X-Y-E is attached to the ring nitrogen and Q-Z represents C1- 10 alkyl or C6-14 aryl or oxygen, sulfur, nitrogen containing heteroaryl when attached to the ring carbon;
[0035] R4, R5, R6, and R7 are each independently selected from the group consisting of: H, halo, loweralkyl, haloloweralkyl, haloloweralkoxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; arylalkyloxy, cycloalkyloxy, cycloalkylalkoxy, cycloalkylamino, urea, cycloalkylalkylamino, cycloalkyl, alkylcycloalkyl, hydroxyamino, alkoxyacylamino, and arylthio; and 5- or 6- membered organic rings containing 0 to 4 heteroatoms selected from the group consisting of N, O and S, which rings may be unsubstituted or substituted from 1 to 4 times with halo, loweralkyl, haloloweralkyl;
haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; and
oxoheterocyclic groups; or
[0036] R4, R5, R6, and R7 are each independently represent hydrogen, halogen, cyano, nitro, hydroxy, trifluoromethyl, trifluoromethoxy,— ORa,— SRa,— SORa,— SO2Ra,— OSO2Ra,— SF5,— NRbRc,— NRcCORd, -NRcCO2Rd, - NHCONRbRc,— NRcSO2Re, -N(SO2Re)2,— NHSO2NRbRc, -CORd, -CO2Rd, - CONRbRc,— CON(ORa)Rb or -SO2NRbRc; or C1-6alkyl, C2-6 alkenyl, C2-6 alkynyl, C3-7 cycloalkyl, C4- 7 cycloalkenyl, C3-7 cycloalkyl(C1-6)alkyl, aryl, aryl(C1-6)alkyl, C3-7 heterocycloalkyl, C3-7 heterocycloalkyl( C1-6)alkyl, C3-7 heterocycloalkenyl, C4-9 heterobicycloalkyl, heteroaryl, heteroaryl(C1-6)alkyl, (C3- 7)heterocycloalkyl-aryl-, (C3-7)heterocycloalkyl(C1-6)alkyl-aryl-, heteroaryl- (C3-7)heterocycloalkyl-, (C3-7)cycloalkyl-heteroaryl-, (C3-7)cycloalkyl-(C1- 6)alkyl-heteroaryl-, (C4-7)cycloalkenyl-heteroaryl-, (C4-9)bicycloalkyl- heteroaryl-, (C3-7)heterocycloalkyl-heteroaryl-, (C3-7)hetero cyclo alkyl(C1- 6)alkyl-hetero aryl-, (C3-7)heterocycloalkenyl-heteroaryl-, (C4- 9)heterobicycloalkyl-heteroaryl-, (C4-9)spiroheterocycloalkyl-heteroaryl- or (C3-7)heterocycloalkyl-heteroaryl(C1-6)alkyl-, any of which groups may be optionally substituted by one or more substituents; or
[0037] R4, R5, R6, and R7 are each linear or branched C1-6 alkyl and linear or branched C1-6 alkoxy; or
[0038] R4 and R5 are hydrogen or C1-6 alkyl or C1-6 alkoxyl or C6-14 aryl, any of which groups may be optionally substituted by one or more substituents; R6 ishydrogen or nitro or cyano or carboxyl or acetamidoxime or amidoxime or C1-6 alkyl or C1-6 alkoxyl or C6-14 aryl or oxygen, sulfur, and nitrogen containing heteroaryl, any of which groups may be optionally substituted by one or more substituents; and R7 is hydrogen or C1-6 alkyl or C1-6 alkoxyl or C6-14 aryl or oxygen, sulfur, and nitrogen containing
heteroaryl, any of which groups may be optionally substituted by one or more substituents;
[0039] Ra, Rb and Rc independently represent hydrogen or
trifluoromethyl; or C1-6 alkyl, C3-7cycloalkyl, C3-7 cycloalkyl(C1-6)alkyl, aryl, aryl(C1-6)alkyl, C3-7 heterocycloalkyl, C3-7heterocycloalkyl(C1-6)alkyl, heteroaryl or heteroaryl(C1-6)alkyl, any of which groups may be optionally substituted by one or more substituents; or
[0040] Rb and Rc, when taken together with the nitrogen atom to which they are both attached, represent azetidin-1-yl, pyrrolid in- 1-yl, oxazolidin-3- yl, isoxazolidin-2-yl, thiazolid in-3-yl, isothiazolidin-2-yl, piperidin-1-yl, morpholin-4-yl, thiomorpholin-4-yl, piperazin-1-yl, homopiperidin-1-yl, homomorpholin-4-yl or homopiperazin-1-yl, any of which groups may be optionally substituted by one or more substituents;
[0041] Rd represents hydrogen; or C1-6 alkyl, C3-7 cycloalkyl, aryl, C3- 7 heterocycloalkyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; and [0042] Re represents C1-6 alkyl, aryl or heteroaryl, any of which groups may be optionally substituted by one or more substituents;
[0043] R8 and R9 independently represent hydrogen or C1-6 alkyl;
[0044] R12 is selected from the group consisting of: H, halo, loweralkyl, haloloweralkyl, haloloweralkoxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; arylalkyloxy, cycloalkyloxy, cycloalkylalkoxy, cycloalkylamino, urea, cycloalkylalkylamino, cycloalkyl, alkylcycloalkyl, hydroxyamino,
alkoxyacylamino, and arylthio; and 5- or 6-membered organic rings containing 0 to 4 heteroatoms selected from the group consisting of N, O and S, which rings may be unsubstituted or substituted from 1 to 4 times with halo, loweralkyl, haloloweralkyl; haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide,
aminosulfonyl, sulfone, nitro; and oxoheterocyclic groups;
[0045] or a pharmaceutically acceptable salt or prodrug thereof.
[0046] It is an embodiment of the present invention to provide a use of a compound of formula (I) wherein XYE is hydrogen and is connected to the ring nitrogen, R4, R5, R6, and R7 are each hydrogen, Q is— S— , and Z is— CH2-CH3.
[0047] It is an embodiment of the present invention to provide a use of a compound of formula (I) wherein X is connected to the ring carbon and is — O— ,— N(R12)— , or— S— , Y is C1-6 alkyl, and E is -N=C=S. In another embodiment, X is connected to the ring carbon and is— O— ,— N(R12)— , or -S-, R12 is H, Y is -CH2-CH2-, E is -N=C=S, and QZ is H. [0048] It is an embodiment of the present invention to provide a use of
a compound of
Figure imgf000013_0001
(fabomitazole) or a derivative thereof for treating one or more of fibrotic diseases, and in particular, chronic lung disease, including idiopathic pulmonary fibrosis; non alcoholic fatty liver disease, and in particular, non-alcoholic fatty liver disease, non-alcoholic fatty liver, and non-alcoholic steatohepatitis; and kidney disorders, and in particular, renal fibrosis and/or chronic kidney disease.
[0049] Fabomitazole or afobazole (5-ethoxy-2-[2- (morpholino)ethylthio]-benzimidazole dihydrochloride) is a derivative of 2- mercaptobenzimidazole with anxiolytic effects.
[0050] It is an embodiment of the present invention to provide a method of treating one or more of fibrotic diseases, and in particular, chronic lung disease, including idiopathic pulmonary fibrosis; non-alcoholic fatty liver disease, and in particular, non-alcoholic fatty liver disease, non-alcoholic fatty liver, and non-alcoholic steatohepatitis; and kidney disorders, and in particular, renal fibrosis and/or chronic kidney disease, the method comprising administering a compound of formula (I), or a pharmaceutically acceptable salt or prodrug thereof to a subject in need thereof.
[0051] It is an embodiment of the present invention to provide a use of a compound of formula (I), or a pharmaceutically acceptable salt or prodrug thereof, to treat one or more of fibrotic diseases, and in particular, chronic lung disease, including idiopathic pulmonary fibrosis; non-alcoholic fatty liver disease, and in particular, the use of particular test compounds for treating non-alcoholic fatty liver disease, non-alcoholic fatty liver, and non-alcoholic steatohepatitis; and kidney disorders, and in particular, renal fibrosis and/or chronic kidney disease.
[0052] It is an embodiment of the present invention to provide a compound of formula (I) :
[0053]
Figure imgf000014_0001
[0054] A is N or C, subject to the proviso that R5 is absent when A is N;
[0055] Q represents a covalent bond; or Q represents— O— ,— S— ,— S(O)-,— S(O) 2-,— N(R9)— ,— C(O)N(R9)— , -N(R9)C(O)-,— S(O) 2N(R9)- or— N(R9)S(O)2— ; or Q represents an optionally substituted straight or branched C1-6 alkylene chain optionally comprising one, two or three heteroatom-containing linkages independently selected from— O— ,— S— ,— S(O)-,— S(O) 2- ,— N(R9)— ,— C(O)N(R9)— , -N(R9)C(O)-,— S(O) 2-N(R9)- and— N(R9)S(O)2— ;
[0056] Z represents hydrogen, halogen or trifluoromethyl; or Z represents C1-6 alkyl, C3-7 cycloalkyl, aryl, C3-7 heterocycloalkyl, C3- 7 heterocycloalkenyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; or Z represents— Z1— Z2 or— Z1— C(O)— Z2, either of which moieties may be optionally substituted by one or more substituents;
[0057] Z1 represents a divalent radical derived from an aryl, C3- 7 heterocycloalkyl or heteroaryl group; [0058] Z2 represents aryl, C3-7 heterocycloalkyl, C3-7 heterocycloalkenyl, (C4-9)heterobicycloalkyl, (C4-9)spiroheterocycloalkyl or heteroaryl; or
[0059] Q-Z represents H, halo, loweralkyl, haloloweralkyl,
haloloweralkoxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; arylalkyloxy, cycloalkyloxy, cyclo alkyl alkoxy, cyclo alkyl amino, urea,
cycloalkylalkylamino, cycloalkyl, alkylcycloalkyl, hydroxyamino,
alkoxyacylamino, and arylthio;and 5- or 6- membered organic rings containing 0 to 4 heteroatoms selected from the group consisting of N, 0 and S, which rings may be unsubstituted or substituted from 1 to 4 times with halo, loweralkyl, haloloweralkyl, haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide,
aminosulfonyl, sulfone, nitro; and oxoheterocyclic groups;
[0060] X represents a covalent bond ; or X represents,— S(O)2— or— N(R8)— ; or X represents an optionally substituted straight or branched C1- 4 alkylene chain; or X represents,— C(O)— ; or X represents— O— ,—
N(R12)— , or— S— ;
[0061] Y represents C3-7 cycloalkyl, aryl, C3-7 heterocycloalkyl or heteroaryl; or
[0062] Y represents a linking group such as alkyl (e.g.,— R— where R is C2- 6 alkyl), alkenyl (e.g.,— R— where R is C2- 6 alkenyl), cycloalkyl (e.g.,— R— where R is C3-6 cycloalkyl), alkylcycloalkyl(e.g.,— R— R'— , where R is C1-4 alkyl and R' is C3-6 cycloalkyl), cylcoalkylalkyl (e.g.,— R— R'— , where R is C3- 6 cycloalkyl and R' is C1-4 alkyl), a I ky Icy c I oa I ky I a I ky I (e.g .,— R— R'— R"— , wherein R is C1-4 alkyl, R' is C3-6 cycloalkyl, and R" is C1-4 alkyl), alkyloxyalkyl (e.g.,— R— O— R'— , wherein R and R' are C1-4alkyl); aryl (e.g.,— R— where R is aryl), alkylaryl (e.g.,— R— R'— where R is C1-4 alkyl and R' is aryl), alkylarylalkyl (e.g.,— R— R'— R"— where R is C1-4 alkyl, R' is aryl, and R" is C1-4 alkyl), or arylalkyl (e.g.,— R— R'— where R is aryl alkyl and R' is C1-4 alkyl); cycloalkylalkyl (e.g.— R— R'— , where R is C3-6 cycloalkyl and R' is C1-4 alkyl), alkylheterocycle (e.g.,— R— R', where R is C1-4 alkyl and R' is a heterocyclic group as described herein), heterocyclealkyl,
alkylheterocyclealkyl, heterocycle, aminoalkyl (e.g.,— N(R)R'— , where R is H or C1-4 alkyl and R' is C1-4 alkyl), oxyalkyl (e.g.,— O— R— where R is C2- 6 alkyl), aminoaryl (e.g.,— N(R)R'— , where R is H or C1-4 alkyl and R' is aryl), and oxyaryl (e.g.,— O— R— , where R is aryl), any of which groups may be optionally substituted by one or more substituents; and
[0063] R1 and R2 are each independently H, loweralkyl, or together form C2-4 alkylene;
[0064] E is H; or
[0065] E is -N=C=S; or
[0066] E is selected from the group consisting of -B(OR1)OR2, - CON(R1)0R2, and— N(OR1)COR2 or any of the additional alternatives for E described in greater detail below; or
[0067] X-Y-E represents alkyl, phenyl, substituted phenyl, naphthyl and substituted naphthyl, wherein the substituent in said substituted phenyl and substituted naphthyl is selected from the group consisting of halogen, cyano, alkyl, alkoxy, ester, N-acyl derivatives, N-acyloxy derivatives and amino acid conjugates, when Q of Q-Z is attached to the ring carbon and Q is— S— , then Z is CHR10R11, where R10 and R11 are selected from the group consisting of hydrogen, alkyl, phenyl, and substituted phenyl, wherein the substituent in said substituted phenyl is selected from the group consisting of halogen, cyano, alkyl, alkoxy, ester, N-acyl derivatives, N-acyloxy derivatives and amino acid conjugates; or
[0068] X-Y-E represents hydrogen or C1-6 alkyl or C6-14 aryl when X of X-Y-E is attached to the ring nitrogen and Q-Z represents C1-10 alkyl or C6-14 aryl or oxygen, sulfur, nitrogen containing heteroaryl when attached to the ring carbon;
[0069] R4, R5, R6, and R7 are each independently selected from the group consisting of: H, halo, loweralkyl, haloloweralkyl, haloloweralkoxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; arylalkyloxy, cycloalkyloxy, cycloalkylalkoxy, cycloalkylamino, urea, cycloalkylalkylamino, cycloalkyl, alkylcycloalkyl, hydroxyamino, alkoxyacylamino, and arylthio; and 5- or 6- membered organic rings containing 0 to 4 heteroatoms selected from the group consisting of N, O and S, which rings may be unsubstituted or substituted from 1 to 4 times with halo, loweralkyl, haloloweralkyl;
haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; and
oxoheterocyclic groups; or
[0070] R4, R5, R6, and R7 are each independently represent hydrogen, halogen, cyano, nitro, hydroxy, trifluoromethyl, trifluoromethoxy,— ORa,— SRa,— SORa,— SO2Ra,— OSO2Ra,— SF5,— NRbRc,— NRcCORd, -NRcCO2Rd, - NHCONRbRc,— NRcSO2Re, -N(SO2Re)2,— NHSO2NRbRc, -CORd, -CO2Rd, - CONRbRc,— CON(ORa)Rb or -SO2NRbRc; or C1-6alkyl, C2-6 alkenyl, C2-6 alkynyl, C3-7 cycloalkyl, C4- 7 cycloalkenyl, C3-7 cycloalkyl(C1-6)alkyl, aryl, aryl(C1-6)alkyl, C3-7 heterocycloalkyl, C3-7 heterocycloalkyl(C1-6)alkyl, C3-7 heterocycloalkenyl, C4-9 heterobicycloalkyl, heteroaryl, heteroaryl(C1-6)alkyl, (C3- 7)heterocycloalkyl-aryl-, (C3-7)heterocycloalkyl(C1-6)alkyl-aryl-, heteroaryl- (C3-7)heterocycloalkyl-, (C3-7)cycloalkyl-heteroaryl-, (C3-7)cycloalkyl-(C1- 6)alkyl-heteroaryl-, (C4-7)cycloalkenyl-heteroaryl-, (C4-9)bicycloalkyl- heteroaryl-, (C3-7)heterocycloalkyl-heteroaryl-, (C3-7)hetero cyclo alkyl(C1- 6)alkyl-hetero aryl-, (C3-7)heterocycloalkenyl-heteroaryl-, (C4- 9)heterobicycloalkyl-heteroaryl-, (C4-9)spiroheterocycloalkyl-heteroaryl- or (C3-7)heterocycloalkyl-heteroaryl(C1-6)alkyl-, any of which groups may be optionally substituted by one or more substituents; or
[0071] R4, R5, R6, and R7 are each linear or branched C1-6 alkyl and linear or branched C1-6 alkoxy; or
[0072] R4 and R5 are hydrogen or C1-6 alkyl or C1-6 alkoxyl or C6-14 aryl, any of which groups may be optionally substituted by one or more substituents; R6 ishydrogen or nitro or cyano or carboxyl or acetamidoxime or amidoxime or C1-6 alkyl or C1-6 alkoxyl or C6-14 aryl or oxygen, sulfur, and nitrogen containing heteroaryl, any of which groups may be optionally substituted by one or more substituents; and R7 is hydrogen or C1-6 alkyl or C1-6 alkoxyl or C6-14 aryl or oxygen, sulfur, and nitrogen containing
heteroaryl, any of which groups may be optionally substituted by one or more substituents;
[0073] Ra, Rb and Rc independently represent hydrogen or
trifluoromethyl; or C1-6 alkyl, C3-7cycloalkyl, C3-7 cycloalkyl(C1-6)alkyl, aryl, aryl(C1-6)alkyl, C3-7 heterocycloalkyl, C3-7heterocycloalkyl(C1-6)alkyl, heteroaryl or heteroaryl(C1-6)alkyl, any of which groups may be optionally substituted by one or more substituents; or
[0074] Rb and Rc, when taken together with the nitrogen atom to which they are both attached, represent azetidin-1-yl, pyrrolid in- 1-yl, oxazolidin-3- yl, isoxazolidin-2-yl, thiazolid in-3-yl, isothiazolidin-2-yl, piperidin-1-yl, morpholin-4-yl, thiomorpholin-4-yl, piperazin-1-yl, homopiperidin-1-yl, homomorpholin-4-yl or homopiperazin-1-yl, any of which groups may be optionally substituted by one or more substituents;
[0075] Rd represents hydrogen; or C1-6 alkyl, C3-7 cycloalkyl, aryl, C3- 7 heterocycloalkyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; and
[0076] Re represents C1-6 alkyl, aryl or heteroaryl, any of which groups may be optionally substituted by one or more substituents;
[0077] R8 and R9 independently represent hydrogen or C1-6 alkyl;
[0078] R12 is selected from the group consisting of: H, halo, loweralkyl, haloloweralkyl, haloloweralkoxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; arylalkyloxy, cycloalkyloxy, cycloalkylalkoxy, cycloalkylamino, urea, cycloalkylalkylamino, cycloalkyl, alkylcycloalkyl, hydroxyamino,
alkoxyacylamino, and arylthio; and 5- or 6-membered organic rings containing 0 to 4 heteroatoms selected from the group consisting of N, O and S, which rings may be unsubstituted or substituted from 1 to 4 times with halo, loweralkyl, haloloweralkyl; haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide,
aminosulfonyl, sulfone, nitro; and oxoheterocyclic groups;
[0079] or a pharmaceutically acceptable salt or prodrug thereof.
[0080] It is an embodiment of the present invention to provide a compound of formula (I) wherein XYE is hydrogen and is connected to the ring nitrogen, R4, R5, R6, and R7 are each hydrogen, Q is— S— , and Z is— CH2-CH3.
[0081] It is an embodiment of the present invention to provide a compound of formula (I) wherein X is connected to the ring carbon and is— O— ,— N(R12)— , or— S— , Y is C1-6 alkyl, and E is -N=C=S. In another embodiment, X is connected to the ring carbon and is— O— ,— N(R12)— , or -S-, R12 is H, Y is -CH2-CH2-, E is -N=C=S, and QZ is H.
BRIEF DESCRIPTION OF TH E FIGURES
[0082] Figure 1 is a line graph comparing the mean percentage change in body weights in grams for the experimental treatment groups of mice, using test compound Bemithyl compared to the Normal (no BLM) control group, the BLM-Vehicle control group, and the Pirfenidone positive control group;
[0083] Figure 2 is a column graph comparing the mean Trichrome Score data, for the experimental treatment groups of mice, using test compound Bemithyl compared to the Normal (no BLM) control group, the BLM-Vehicle control group, and the Pirfenidone positive control group;
[0084] Figure 3 is a column graph comparing the percent reduction in fibrosis for the experimental treatment groups of mice, using test compound Bemithyl compared to the BLM-Vehicle control group and the Pirfenidone positive control group;
[0085] Figure 4 shows an evaluation of liver function and disease progression consisting of the Plasma Alanine Aminotransferases (ALT) in units/L in a study of C57BL/6 mice consisting of the Normal (no NASH) group, the "Vehicle" control group and treatment groups including the positive control treatment group, Telmisartan. Mean is indicated ± SD as determined using the Bonferroni multiple comparison test; [0086] Figures 5a, 5b, and 5c show representative photomicrographs of HE-stained liver sections for each of the study groups of C57BL/6 mice consisting of the "Vehicle" control group and the treatment groups including the positive control treatment group, Telmisartan. Upper panels are taken at x50 magnification. Lower panels are x200 magnification. The identity of each study group is listed above the upper panel in each pair of panels;
[0087] Figure 6 shows the NAFLD activity score for each of the study groups of C57BL/6 mice consisting of the Normal (no NASFI) group, the "Vehicle" control group and treatment groups including the positive control treatment group, Telmisartan. Mean is indicated ± SD as determined using the Bonferroni multiple comparison test;
[0088] Figure 7 shows the steatosis score for each of the study groups of C57BL/6 mice consisting of the Normal (no NASFI) group, the "Vehicle" control group and the treatment groups including the positive control treatment group, Telmisartan. Mean is indicated ± SD as determined using the Bonferroni multiple comparison test;
[0089] Figure 8 shows the lobular inflammation score for each of the study groups of C57BL/6 mice consisting of the Normal (no NASFI) group, the "Vehicle" control group and the treatment groups including the positive control treatment group, Telmisartan. Mean is indicated ± SD as determined using the Bonferroni multiple comparison test;
[0090] Figure 9 shows the hepatocellular ballooning score for each of the study groups of C57BL/6 mice consisting of the Normal (no NASFI) group, the "Vehicle" control group and the treatment groups including the positive control treatment group, Telmisartan. Mean is indicated ± SD as determined using the Bonferroni multiple comparison test;
[0091] Figures 10a and 10b shows representative photomicrographs of Sirius red-stained liver sections for each of the study groups of C57BL/6 mice consisting of the Normal (no NASH) group, the "Vehicle" control group and the treatment groups including the positive control treatment group, Telmisartan. The panels are taken at x200 magnification. The identity of each study group is listed above the upper panel in each pair of panels;
[0092] Figure 11 shows an evaluation of liver function and disease progression consisting of the Fibrosis area, i.e. Sirius red-positive area in percentage of the study groups of C57BL/6 mice consisting of the Normal (no NASH) group, the "Vehicle" control group and the treatment groups including the positive control treatment group, Telmisartan. Mean is indicated ± SD as determined using the Bonferroni multiple comparison test;
[0093] Figure 12 shows a comparison of the change in mean body weight in grams for each of the study groups of C57BL/6 mice a first example consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group "Vehicle (Control)", and the treatment groups including the positive control treatment group,
Telmisartan;
[0094] Figure 13 shows an evaluation of renal function consisting of the plasma urea nitrogen (BUN) in mg/dL for each of the study groups of C57BL/6 mice consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group "Vehicle (Control)", and the treatment groups including the positive control treatment group;
[0095] Figure 14 shows an evaluation of renal function consisting of the Creatinine in mg/dL for each of the study groups of C57BL/6 mice consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group "Vehicle (Control)", and the treatment groups including the positive control treatment group;
[0096] Figure 15 shows a comparison of the mean weight difference between the left (ligated UUO) and right (non-ligated) kidneys in grams for each of the study groups of C7BL/6 mice consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group "Vehicle (Control)", and the treatment groups including the positive control treatment group, Telmisartan;
[0097] Figure 16 shows an evaluation of renal fibrosis and interstitial damage with the level of fibrosis indicated by Histology Scores of 0 (normal), 1 (light), 2 (moderate) or 3(severe) in three randomly selected fields of renal cross-sections stained with Sirius Red at x20 magnification for each of the study groups of C57BL/6 mice consisting of the sham surgery control group, the surgery vehicle control group, and the treatment groups including the positive control treatment group;
[0098] Figure 17 shows the reduction in renal fibrosis for each the study groups of C57BL/6 mice consisting of the sham surgery control group, the surgery vehicle control group, and the treatment groups including the positive control treatment group;
[0099] Figure 18 shows a comparison of the change in mean body weight in grams for each of the study groups of C57BL/6 mice from a second example consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group "Vehicle (Control)", and the treatment groups including the positive control treatment group,
Telmisartan;
[00100] Figure 19 shows an evaluation of renal function consisting of the plasma urea nitrogen (BUN) in mg/dL for each of the study groups of C57BL/6 mice consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group "Vehicle (Control)", and the treatment groups including the positive control treatment group;
[00101] Figure 20 shows an evaluation of renal function consisting of the Creatinine in mg/dL for each of the study groups of C57BL/6 mice consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group "Vehicle (Control)", and the treatment groups including the positive control treatment group;
[00102] Figure 21 shows the weight of the right kidney in grams for each of the 1 study groups of C57BL/6 mice consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group "Vehicle (Control)", and the treatment groups including the positive control treatment group, Telmisartan;
[00103] Figure 22 shows the weight of the left kidney in grams for each of the study groups of C57BL/6 mice consisting of the sham surgery control group "Sham + Vehicle (Control)", the surgery vehicle control group "Vehicle (Control)", and the treatment groups including the positive control treatment group, Telmisartan;
[00104] Figure 23 shows an evaluation of renal fibrosis and interstitial damage with the level of fibrosis indicated by Flistology Scores of 0 (normal), 1 (light), 2 (moderate) or 3(severe) in three randomly selected fields of renal cross-sections stained with Sirius Red at x20 magnification for each of the study groups of C57BL/6 mice consisting of the sham surgery control group, the surgery vehicle control group, and the treatment groups including the positive control treatment group; and
[00105] Figure 24 shows the reduction in renal fibrosis for each the study groups of C57BL/6 mice consisting of the sham surgery control group, the surgery vehicle control group, and the treatment groups including the positive control treatment group;
[00106] Figure 25 outlines the method of hypoxia induction in FIEK-293 cells and treatment of hypoxia with bemithyl; [00107] Figure 26 shows the expression of HIF-1 after PFIT-induced hypoxia with and without treatment with bemithyl at 5 and 10 mM
concentrations;
[00108] Figure 27 shows the pathway for HIF-1 regulation during normoxia and hypoxia;
[00109] Figure 28 shows the role of HIF-1 in regulating glycolysis during hypoxia;
[00110] Figure 29 shows the role of HIF-1 in metabolic diseases; and
[00111] Figure 30 is an overview of HIF-1a implicated in fibrotic disease.
DETAILED DESCRIPTION
[00112] "Halo" as used herein refers to any suitable halogen, including — F,—Cl,— Br, and—I.
[00113] "Mercapto" as used herein refers to an— SH group.
[00114] "Azido" as used herein refers to an— N3 group.
[00115] "Cyano" as used herein refers to a— CN group.
[00116] "Hydroxyl" as used herein refers to an—OH group.
[00117] "Nitro" as used herein refers to an— NO2 group.
[00118] "Oxy" as used herein refers to a— O— group.
[00119] "Oxo" as used herein refers to a =0 group. [00120] "Alkyl" as used herein alone or as part of another group, refers to a straight or branched chain hydrocarbon containing from 1 to 10 carbon atoms. Representative examples of alkyl include, but are not limited to, methyl, ethyl, n-propyl, iso-propyl, n-butyl, sec-butyl, iso-butyl, tert-butyl, n-pentyl, isopentyl, neopentyl, n-hexyl, 3'-methylhexyl, 2,2-dimethylpentyl,
2.3-dimethylpentyl, n-heptyl, n-octyl, n-nonyl, n-decyl, and the like.
"Loweralkyl" as used herein, is a subset of alkyl, in some embodiments preferred, and refers to a straight or branched chain hydrocarbon group containing from 1 to 4 carbon atoms. Representative examples of lower alkyl include, but are not limited to, methyl, ethyl, n-propyl, iso-propyl, n-butyl, iso-butyl, tert-butyl, and the like. Alkyl and loweralkyl groups may be unsubstituted or substituted one or more times with halo, alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, cycloalkylalkyl, aryl, arylalkyl, heterocyclo, heterocycloalkyl, hydroxyl, alkoxy, alkenyloxy, alkynyloxy, haloalkoxy, cycloalkoxy, cycloalkylalkyloxy, aryloxy, arylalkyloxy, heterocyclooxy, heterocyclolalkyloxy, mercapto, alkyl-S(O)m, haloalkyl-S(O)m, alkenyl-S(O)m, alkynyl-S(O)m, cycloalkyl-S(O)m, cycloalkylalkyl-S(O)m, aryl-S(O)m, arylalkyl-S(O)m, heterocyclo-S(O)m, heterocycloalkyi-S(O)m, amino, alkyl-amino, alkenylamino, alkynylamino, haloalkylamino, cycloalkylamino,
cycloalkylalkylamino, arylamino, arylalkylamino, heterocycloamino, heterocycloalkylamino, disubstituted-amino, acylamino, acyloxy, ester, amide, sulfonamide, urea, alkoxyacylamino, aminoacyloxy, nitro or cyano where m=0, 1 or 2.
[00121] "Alkenyl" as used herein alone or as part of another group, refers to a straight or branched chain hydrocarbon containing from 1 to 10 carbon atoms which include 1 to 4 double bonds in the normal chain.
Representative examples of Alkenyl include, but are not limited to, vinyl, 2- propenyl, 3-butenyl, 2-butenyl, 4-pentyl, 3-pentyl, 2-hexenyl, 3-hexenyl,
2.4-heptadiene, and the like. These groups may be optionally substituted in like manner as described with alkyl above. [00122] "Alkynyl" as used herein alone or as part of another group, refers to a straight or branched chain hydrocarbon containing from 1 to 10 carbon atoms which include 1 triple bond in the normal chain.
Representative examples of Alkynyl include, but are not limited to, 2- propynyl, 3-butynyl, 2-butynyl, 4-pentenyl, 3-pentenyl, and the like These groups may be optionally substituted in like manner as described with alkyl above.
[00123] "Alkoxy," as used herein alone or as part of another group, refers to an alkyl group, as defined herein, appended to the parent molecular moiety through an oxy group, as defined herein. Representative examples of alkoxy include, but are not limited to, methoxy, ethoxy, propoxy, 2-propoxy, butoxy, tert-butoxy, pentyloxy, hexyloxy and the like. These groups may be optionally substituted in like manner as described with alkyl above.
[00124] "Acyl" as used herein alone or as part of another group, refers to a— C(O)R radical, where R is any suitable substituent such as alkyl, alkenyl, alkynyl, aryl, alkylaryl, etc. as given herein.
[00125] "Haloalkyl," as used herein alone or as part of another group, refers to at least one halogen, as defined herein, appended to the parent molecular moiety through am alkyl group, as defined herein. Representative examples of haloalkyl include, but are not limited to, chloromethyl, 2- fluoroethyl, trifluoromethyl, pentafluoroethyl, 2-chloro-3-fluoropentyl, and the like.
[00126] "AlkyIthio," as used herein alone or as part of another group, refers to an alkyl group, as defined herein, appended to the parent molecular moiety through a thio moiety. Representative examples of alkylthio include, but are not limited, methylthio, ethylthio, tert-butylthio, hexylthio, and the like. [00127] "Aryl," as used herein alone or as part of another group, refers to a monocyclic carbocyclic ring system or a bicyclic carbocyclic fused ring system having one or more aromatic rings. Representative examples of aryl include, azulenyl, indanyl, indenyl, naphthyl, phenyl, tetrahydronaphthyl, and the like. These rings may be optionally substituted with groups selected from halo, alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, cycloalkylalkyl, aryl, arylalkyl, heterocyclo, heterocycloalkyl, hydroxyl, alkoxy, alkenyloxy, alkynyloxy, haloalkoxy, cycloalkoxy, cycloalkylalkyloxy, aryloxy,
arylalkyloxy, heterocyclooxy, heterocyclolalkyloxy, mercapto, alkyl-S(O)m, haloalkyl-S(O)m, alkenyl-S(O)m, alkynyl-S(O)m, cycloalkyl-S(O)m,
cycloalkylalkyl-S(O)m, aryl-S(O)m, arylalkyl-S(O)m, heterocyclo-S(O)m, heterocycloalkyi-S(O)m, amino, alkylamino, alkenylamino, alkynylamino, haloalkylamino, cycloalkylamino, cycloalkylalkylamino, arylamino, arylalkylamino, heterocycloamino, heterocycloalkylamino, disubstituted- amino, acylamino, acyloxy, ester, amide, sulfonamide, urea,
alkoxyacylamino, aminoacyloxy, nitro or cyano where m=0, 1 or 2.
[00128] "Arylalkyl," as used herein alone or as part of another group, refers to an aryl group, as defined herein, appended to the parent molecular moiety through an alkyl group, as defined herein. Representative examples of arylalyl include, but are not limited to, benzyl, 2-phenylethyl, 3- phenylpropyl, 2-naphth-2-ylethyl, and the like.
[00129] "Amino" as used herein means the radical— NH2.
[00130] "Alkylamino" as used herein alone or as part of another group means the radical— NHR, where R is an alkyl group.
[00131] "Arylalkylamino" as used herein alone or as part of another group means the radical—NHR, where R is an arylalkyl group.
[00132] "Disubstituted-amino" as used herein alone or as part of another group means the radical— NRaRb, where Ra and Rb are independently selected from the groups alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, cycloalkylalkyl, aryl, arylalkyl, heterocyclo, heterocycloalkyl.
[00133] "Acylamino" as used herein alone or as part of another group means the radical— NRaRb, where Ra is an acyl group as defined herein and Rb is selected from the hydrogen, alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, cycloalkylalkyl, aryl, arylalkyl, heterocyclo, heterocycloalkyl.
[00134] "Acyloxy" as used herein alone or as part of another group means the radical—OR, where R is an acyl group as defined herein.
[00135] "Ester" as used herein alone or as part of another group refers to a— C(O)OR radical, where R is any suitable substituent such as alkyl, aryl, alkylaryl, etc.
[00136] "Amide" as used herein alone or as part of another group refers to a— C(O)NRaRb radical, where Ra and Rb are any suitable substituent such as alkyl, aryl, alkylaryl, etc.
[00137] "Sulfonamide" as used herein alone or as part of another group refers to a— S(O) 2NRaRb radical, where Ra and Rb are any suitable
substituent, such as H, alkyl, aryl, alkylaryl, etc.
[00138] "Sulfone" as used herein alone or as part of another group refers to a— S(O) 2R radical, where R is any suitable substituent, such as H, alkyl, aryl, alkylaryl, etc.
[00139] "Aminosulfonyl" as used herein alone or as part of another group refers to a—N(Ra) S(O) R2b radical, where Ra and Rb are any suitable substituent, such as H, alkyl, aryl, alkylaryl, etc. [00140] "Urea" as used herein alone or as part of another group refers to an—N(Rc)C(O)NRaRb radical, where Ra, Rb and Rc are any suitable substituent such as H, alkyl, aryl, alkylaryl, etc.
[00141] "Alkoxyacylamino" as used herein alone or as part of another group refers to an— N(Ra)C(O)ORb radical, where Ra, Rb are any suitable substituent such as H, alkyl, aryl, alkylaryl, etc.
[00142] "Aminoacyl" as used herein alone or as part of another group refers to an— C(O)NRaRb radical, where Ra and Rb are any suitable
substituent, such as H, alkyl, aryl, alkylaryl, etc.
[00143] "Aminoacyloxy" as used herein alone or as part of another group refers to an— OC(O)NRaRb radical, where Ra and Rb are any suitable substituent, such as H, alkyl, aryl, alkylaryl, etc.
[00144] "Cycloalkyl," as used herein alone or as part of another group, refers to a saturated or partially unsaturated cyclic hydrocarbon group containing from 3, 4 or 5 to 6, 7 or 8 carbons (which may be replaced in a heterocyclic group as discussed below). Representative examples of cycloalkyl include, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, and cyclooctyl. These rings may be optionally substituted with halo or loweralkyl.
[00145] "Heterocyclic group" or "heterocycle" as used herein alone or as part of another group, refers to a monocyclic- or a bicyclic-ring system. Monocyclic ring systems are exemplified by any 5 or 6 membered ring containing 1, 2, 3, or 4 heteroatoms independently selected from oxygen, nitrogen and sulfur. The 5 membered ring has from 0-2 double bonds and the 6 membered ring has from 0-3 double bonds. Representative examples of monocyclic ring systems include, but are not limited to, azetidine, azepine, aziridine, diazepine, 1,3-dioxolane, dioxane, dithiane, furan, imidazole, imidazoline, imidazolidine, isothiazole, isothiazoline, isothiazolidine, isoxazole, isoxazoline, isoxazolidine, morpholine, oxadiazole, oxadiazoline, oxadiazolidine, oxazole, oxazoline, oxazolidine, piperazine, piperidine, pyran, pyrazine, pyrazole, pyrazoline, pyrazolidine, pyridine, pyrimidine, pyridazine, pyrrole, pyrroline, pyrrolidine, tetrahydrofuran, tetrahydrothiophene, tetrazine, tetrazole, thiadiazole, thiadiazoline, thiadiazolidine, thiazole, thiazoline, thiazolidine, thiophene, thiomorpholine, thiomorpholine sulfone, thiopyran, triazine, triazole, trithiane, and the like. Bicyclic ring systems are exemplified by any of the above monocyclic ring systems fused to an aryl group as defined herein, a cycloalkyl group as defined herein, or another monocyclic ring system as defined herein.
Representative examples of bicyclic ring systems include but are not limited to, for example, benzimidazole, benzothiazole, benzothiadiazole,
benzothiophene, benzoxadiazole, benzoxazole, benzofuran, benzopyran, benzothiopyran, benzodioxine, 1,3-benzodioxole, cinnoline, indazole, indole, indoline, indolizine, naphthyridine, isobenzofuran, isobenzothiophene, isoindole, isoindoline, isoquinoline, phthalazine, purine, pyranopyridine, quinoline, quinolizine, quinoxaline, quinazoline, tetrahydroisoquinoline, tetrahydroquinoline, thiopyranopyridine, and the like. These rings may be optionally substituted with groups selected from halo, alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, cycloalkylalkyl, aryl, arylalkyl, heterocyclo, heterocycloalkyl, hydroxyl, alkoxy, alkenyloxy, alkynyloxy, haloalkoxy, cycloalkoxy, cycloalkylalkyloxy, aryloxy, arylalkyloxy, heterocyclooxy, heterocyclolalkyloxy, mercapto, alkyl-S(O)m, haloaikyl-S(O)m, aikenyl-S(O)m, aikynyl-S(O)m, cycloaikyl-S(O)m, cycloalkylalkyl-S(O)m, aryl-S(O)m, arylalkyl-S(O)m, heterocycio-S(O)m, heterocycloaikyl-S(O)m, amino, alkylamino, alkenylamino, alkynylamino, haloalkylamino, cycloalkylamino,
cycloalkylalkylamino, arylamino, arylalkylamino, heterocycloamino, heterocycloalkylamino, disubstituted-amino, acylamino, acyloxy, ester, amide, sulfonamide, urea, alkoxyacylamino, aminoacyloxy, nitro or cyano where m=0, 1 or 2. [00146] "Oxoheterocyclic group" refers to a heterocyclic group such as described above, substituted with one or more oxo groups, such as pyridine- N-oxide.
[00147] "Arylthio" as used herein refers to a group of the formula— S— R, where R is aryl as described above.
[00148] "Hydroxyamino" as used herein refers to a group of the formula— N(R)OH, where R is any suitable group such as alkyl, aryl, alkylaryl, etc.
[00149] "Pharmaceutically acceptable" as used herein means that the compound or composition is suitable for administration to a subject to achieve the treatments described herein, without unduly deleterious side effects in light of the severity of the disease and necessity of the treatment.
[00150] "Pharmaceutically acceptable prodrugs" as used herein refers to those prodrugs of the compounds of the present invention which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of humans and lower animals without undue toxicity, irritation, allergic response and the like, commensurate with a reasonable risk/benefit ratio, and effective for their intended use, as well as the zwitterionic forms, where possible, of the compounds of the invention. The term "prodrug" refers to compounds that are rapidly transformed in vivo to yield the parent compound of the above formulae, for example, by hydrolysis in blood. A thorough discussion is provided in T. Higuchi and V. Stella, Prodrugs as Novel delivery Systems, Vol. 14 of the A.C.S. Symposium Series and in Edward B. Roche, ed., Bioreversible Carriers in Drug Design, American Pharmaceutical Association and Pergamon Press, 1987, both of which are incorporated by reference herein. Examples include a prodrug that is metabolized in vivo by a subject to an active drug having an activity of active compounds as described herein, wherein the prodrug is an ester of an alcohol or carboxylic acid group, if such a group is present in the compound; an acetal or ketal of an alcohol group, if such a group is present in the compound; an N-Mannich base or an imine of an amine group, if such a group is present in the compound; or a Schiff base, oxime, acetal, enol ester, oxazolidine, or thiazolidine of a carbonyl group, if such a group is present in the compound.
[00151] "Treat" as used herein refers to any type of treatment that imparts a benefit to a patient afflicted with a disease, including improvement in the condition of the patient (e.g., in one or more symptoms), delay in the progression of the disease, etc.
[00152] Suitable alkyl groups which may be present on the compounds of use in the invention include straight-chained and branched C1-6 alkyl groups, for example C1-4 alkyl groups. Typical examples include methyl and ethyl groups, and straight-chained or branched propyl, butyl and pentyl groups. Particular alkyl groups include methyl, ethyl, n-propyl, isopropyl, n- butyl, sec-butyl, isobutyl, tert-butyl, 2,2-dimethylpropyl and 3-methylbutyl. Derived expressions such as "C1-6 alkoxy", "C1-6 alkylthio", "C1- 6 alkylsulphonyl" and "C1-6 alkylamino" are to be construed accordingly.
[00153] The expression "C1-4 alkylene chain" refers to a divalent straight or branched alkylene chain containing 1 to 4 carbon atoms. Typical examples include methylene, ethylene, methylmethylene, ethylmethylene and dimethylmethylene.
[00154] Suitable C2- 6 alkenyl groups include vinyl and allyl.
[00155] Suitable C2- 6 alkynyl groups include ethynyl and propargyl.
[00156] Suitable C3-7 cycloalkyl groups, which may comprise benzo- fused analogues thereof, include cyclopropyl, cyclobutyl, benzocyclobutenyl, cyclopentyl, indanyl, cyclohexyl and cycloheptyl. [00157] Suitable C4-7 cycloalkenyl groups include cyclobutenyl, cyclopentenyl, cyclohexenyl and cycloheptenyl.
[00158] Typical bicycloalkyl groups include bicyclo[3.1.0]hexanyl.
[00159] Suitable aryl groups include phenyl and naphthyl, preferably phenyl.
[00160] Suitable aryl(C1-6)alkyl groups include benzyl, phenylethyl, phenylpropyl and naphthylmethyl.
[00161] The term "C3-7 heterocycloalkyl" as used herein refers to saturated monocyclic rings containing 3 to 7 carbon atoms and at least one heteroatom selected from oxygen, sulphur and nitrogen, and may comprise benzo-fused analogues thereof. Suitable heterocycloalkyl groups include oxetanyl, azetidinyl, tetrahydrofuranyl, dihydrobenzo-furanyl,
dihydrobenzothienyl, pyrrolidinyl, indolinyl, isoindolinyl, oxazolidinyl, thiazolidinyl, isothiazolidinyl, imidazolidinyl, tetrahydropyranyl, chromanyl, tetrahydrothiopyranyl, piperidinyl, 1,2,3,4-tetrahydroquinolinyl, 1,2, 3, 4- tetrahydroisoquinolinyl, piperazinyl, 1,2,3,4-tetrahydroquinoxalinyl, homopiperazinyl, morpholinyl, benzoxazinyl, thiomorpholinyl, diazepanyl and azocanyl.
[00162] The term "C3-7 heterocycloalkenyl" as used herein refers to monounsaturated or polyunsaturated monocyclic rings containing 3 to 7 carbon atoms and at least one heteroatom selected from oxygen, sulphur and nitrogen, and may comprise benzo-fused analogues thereof. Suitable heterocycloalkenyl groups include thiazolinyl, imidazolinyl, dihydropyranyl, dihydrothiopyranyl and 1,2,3,6-tetrahydropyridinyl.
[00163] Typical heterobicycloalkyl groups include quinuclidinyl, 3- azabicyclo[3.1.0]-hexanyl, 5-aza-2-oxabicyclo[2.2.1]heptanyl, 6- azabicyclo[3.2.0]heptanyl, 3-azabicyclo-[4.1.0]heptanyl, 5-aza-2- oxabicyclo[2.2.2]octanyl, 3-azabicyclo[3.2.1]octanyl, 8- azabicyclo[3.2.1]octanyl, 3,8-diazabicyclo[3.2.1]octanyl and 3,9- diazabicyclo[4.2.1]-nonanyl.
[00164] Suitable spiroheterocycloalkyl groups include 5- azaspiro[2.4]heptanyl, 2-oxa-6-azaspiro[3.3]heptanyl, 2-oxa-6- azaspiro[3.4]octanyl, 2-oxa-6-azaspiro[3.5]nonanyl, 2-oxa-7- azaspiro[3.5]nonanyl and 7-oxa-2-azaspiro[3.5]nonanyl.
[00165] Suitable heteroaryl groups include furyl, benzofuryl,
dibenzofuryl, thienyl, thieno[2,3-c]pyrazolyl, thieno[3,4-b][1,4]dioxinyl, benzothienyl, dibenzothienyl, pyrrolyl, indolyl, pyrrolo[2,3-b]pyridinyl, pyrrolo[3,4-b]pyridinyl, pyrrolo[3,2-c]pyridinyl, pyrazolyl, pyrazolo[l,5- a]pyridinyl, pyrazolo[3,4-c]pyrimidinyl, indazolyl, 4, 5,6,7- tetrahydroindazolyl, oxazolyl, benzoxazolyl, isoxazolyl, thiazolyl,
benzothiazolyl, isothiazolyl, imidazolyl, benzimidazolyl, imidazo[2,1- b]thiazolyl, imidazo[1,2-a]pyridinyl, imidazo[4,5-b]pyridinyl, purinyl, imidazo[1,2-a]pyrimidinyl, imidazo[1,2-a]pyrazinyl, oxadiazolyl, thiadiazolyl, triazolyl, [1,2,4]triazolo[1,5-a]pyrimidinyl, benzotriazolyl, tetrazolyl, pyridinyl, quinolinyl, isoquinolinyl, naphthyridinyl, pyridazinyl, cinnolinyl, phthalazinyl, pyrimidinyl, quinazolinyl, pyrazinyl, quinoxalinyl, pteridinyl, triazinyl and chromenyl groups.
[00166] Where the compounds of formula (I) have one or more asymmetric centres, they may accordingly exist as enantiomers. Where the compounds of use in the invention possess two or more asymmetric centres, they may additionally exist as diastereomers. The invention is to be understood to extend to the use of all such enantiomers and diastereomers, and to mixtures thereof in any proportion, including racemates. Formula (I) and the formulae depicted hereinafter are intended to represent all individual stereoisomers and all possible mixtures thereof, unless stated or shown otherwise. In addition, compounds of formula (I) may exist as tautomers, for example keto (CH2C=O)
Figure imgf000035_0001
enol (CH=CHOH) tautomers or amide (NHC=O)
Figure imgf000036_0002
hydroxyimine (N=COH) tautomers. Formula (I) and the formulae depicted hereinafter are intended to represent all individual tautomers and all possible mixtures thereof, unless stated or shown otherwise.
[00167] It is to be understood that each individual atom present in formula, or in the formulae depicted hereinafter, may in fact be present in the form of any of its naturally occurring isotopes, with the most abundant isotope(s) being preferred. Thus, by way of example, each individual hydrogen atom present in formula, or in the formulae depicted hereinafter, may be present as a 1H, 2H (deuterium) or 3H (tritium) atom, preferably
Figure imgf000036_0001
Similarly, by way of example, each individual carbon atom present in formula (I), or in the formulae depicted hereinafter, may be present as a 12C, 13C or 14C atom, preferably 12C.
[00168] In one aspect, the present invention provides a compound of formula (I) as depicted above or an N-oxide thereof, or a pharmaceutically acceptable salt or solvate thereof, or a glucuronide derivative thereof, or a co-crystal thereof, wherein :
[00169] Q represents -O-, -S-, -S(O)-, S(O) 2-,— N(R9)— , - C(O)N(R5)— ,— N(R9)C(O)— , S(O) 2N(R9)- or -N(R9)S(O)2-; or Q represents an optionally substituted straight or branched C1-6alkylene chain optionally comprising one, two or three heteroatom-containing linkages independently selected from— O— ,— S— ,— S(O)— ,— S(O)2— ,— N(R9)— ,— C(O)N(R9)— ,— N(R9)C(O)— , S(O) 2N(R5)- and -N(R9)S(O)2-.
[00170] In another embodiment, Q represents a covalent bond, whereby the integer Z is attached directly to the benzimidazole nucleus.
[00171] In another embodiment, Q represents— O— ,— S— ,— S(O)— ,— S(O)2-,— N(R5)— ,— C(O)N(R5)— ,— N(R5)C(O)— , S(O) 2N(R5)- or - N(R5)S(O)2— . In a first aspect of that embodiment, Q represents— O— . In a second aspect of that embodiment, Q represents— S— . In a third aspect of that embodiment, Q represents— S(O)— . In a fourth aspect of that embodiment, Q represents— S(O)2— . In a fifth aspect of that embodiment, Q represents— N(R5)— . In a sixth aspect of that embodiment, Q represents — C(O)N(R5)— . In a seventh aspect of that embodiment, Q represents— N(R5)C(O)— . In an eighth aspect of that embodiment, Q represents— S(O)2N(R5)— . In a ninth aspect of that embodiment, Q represents—
N(R5)S(O)2-.
[00172] In another embodiment, Q represents an optionally substituted straight or branched C1-6 alkylene chain optionally comprising one, two or three heteroatom-containing linkages independently selected from— O— ,— S— ,— S(O)— , S(O) 2-,— N(R5)— ,— C(O)N(R5)— , -N(R5)C(O)-, -S(O)2N(R5)— and— N(R5)S(O)2— . In a first aspect of that embodiment, Q represents an optionally substituted straight or branched C1-6alkylene chain. In a second aspect of that embodiment, Q represents an optionally substituted straight or branched C1-6 alkylene chain comprising one heteroatom-containing linkage independently selected from— O— ,— S— ,— S(O)-, S(O) 2-,— N(R5)— ,— C(O)N(R5)— , -N(R5)C(O)-, S(O) 2N(R5)- and— N(R5)S(O)2— . In a third aspect of that embodiment, Q represents an optionally substituted straight or branched C1-6 alkylene chain comprising two heteroatom-containing linkages independently selected from— O— ,— S— ,— S(O)-, S(O) 2-,— N(R5)— ,— C(O)N(R5)— , -N(R5)C(O)-, S(O) 2N(R5)- and— N(R5)S(O)2— . In a fourth aspect of that embodiment, Q represents an optionally substituted straight or branched C1-6alkylene chain comprising three heteroatom-containing linkages independently selected from— O— ,— S— ,— S(O)— , S(O) 2-,— N(R5)— ,— C(O)N(R5)— , -N(R5)C(O)-, - S(O)2N(R5)— and— N(R5)S(O)2— . In a fifth aspect of that embodiment, Q represents an optionally substituted straight or branched C1-6alkylene chain comprising one, two or three heteroatom-containing linkages independently selected from— O— ,— S— ,— N(R5)— ,— C(O)N(R5)— and— N(R5)C(O)— .
[00173] Typically, Q represents a covalent bond; or Q represents—
S(O)— or— S(O)2— ; or Q represents an optionally substituted straight or branched C1-6alkylene chain optionally comprising one or two heteroatom- containing linkages selected from— O— ,— S— ,— N(R5)— ,— C(O)N(R5)— , and— N(R5)C(O)— .
[00174] Selected examples of typical substituents on the linkage represented by Q include halogen, trifluoromethyl, hydroxy, C1-6alkoxy and amino.
[00175] Specific examples of typical substituents on the linkage represented by Q include fluoro, trifluoromethyl, hydroxy, methoxy and amino.
[00176] Suitably, Q represents a covalent bond; or Q represents—
S(O)— or— S(O)2— ; or Q represents— CH2— ,— CH(F)— ,— CF2— ,—
CH(CH3)— ,— CH(OH)— ,— CH(0CH3)— ,— CH(NH2)— , -CH2CH2-, - CH(0H)CH2-, -CH(0H)CF2-, -CH(OCH3)CH2-, -CH2O-,— CH(CH3)O— ,
— C(CH3)2O— , -CH(CH2CH3)O— ,— CH(CF3)O— , -CH2S-, -CH2N(R5)-, - CH2CH2CH2-, -CH(OH)CH2CH2-, -CH(OCH3)CH2CH2-, -CH2CH2O-, - CH2OCH2-, -CH2OCH(F)-, -CH2OCF2-, -CH2OCH(CH3)-, - CH(CH3)0CH2-, -CH2OC(CH3)2-, -C(CH3)2OCH2-, -CH2SCH2-, - CH2CH2N(R5)-, -CH2N(R5)CH2-, -CH2CH2OCH2-, -CH2CH2N(R5)C(O)-, - CH2OCH2CH2-, -CH2OCH2CF2-, -CH20CH2CH(CH3)-, - CH2OCH(CH3)CH2-, -CH20C(CH3)2CH2-, -CH20CH2CH(CH3)CH2-, - CH2OCH2CH2O-, -CH20CH2C(O)N(R5)- or -CH2OCH2CH2OCH2-. Additional values include— N(R5)— , -CH(CH2OH)-,— CH2S(O)— ,— CH2S(O)2— , - CH2S(O)CH2-, -CH2S(O)2CH2-, and -CH2N(R5)C(O)-.
[00177] Particular values of Q include— CH2— ,— CH2 O— ,— CH2 S— , and — CH2OCH2 — . In a first embodiment, Q represents— CH2— . In a second embodiment, Q represents— CH2 O— . In a third embodiment, Q represents — CH2 S— . In a fourth embodiment, Q represents— CH2 OCH2— .
[00178] In one embodiment, Z represents hydrogen . [00179] In another embodiment, Z is other than hydrogen.
[00180] In a selected embodiment, Z represents hydrogen; or Z represents C1-6 alkyl, C3-7 cycloalkyl, aryl, C3-7 heterocycloalkyl, C3-7 heterocycloalkenyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; or Z represents— Z1— Z2 or— Z1— C(O)— Z2, either of which moieties may be optionally substituted by one or more substituents.
[00181] In one embodiment, Z represents C3-7 cycloalkyl, aryl, C3- 7 heterocycloalkyl, C3-7heterocycloalkenyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; or Z represents — Z1— Z2 or— Z1— C(O)— Z2 5 either of which moieties may be optionally substituted by one or more substituents.
[00182] In a further embodiment, Z represents C1-6 alkyl, C3-7 cycloalkyl, aryl, C3-7heterocycloalkyl, C3-7 heterocycloalkenyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; or Z represents— Z1— Z2 or— Z1— C(O)— Z2, either of which moieties may be optionally substituted by one or more substituents.
[00183] Typically, Z represents hydrogen, fluoro or trifluoromethyl; or Z represents methyl, ethyl, n-propyl, isopropyl, n-butyl, sec-butyl, isobutyl, tert-butyl, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, phenyl, tetrahydrofuranyl, pyrrolidinyl, indolinyl, tetrahydropyranyl, piperidinyl, 1,2,3,4-tetrahydroquinolinyl, morpholinyl, azocanyl, thiazolinyl, furyl, thienyl, pyrazolyl, 4,5,6,7-tetrahydroindazolyl, benzoxazolyl, isoxazolyl, thiazolyl, benzothiazolyl, imidazolyl, benzimidazolyl, [1,2,4]triazolo[1,5-c]- pyrimidinyl, tetrazolyl, pyridinyl, quinolinyl, isoquinolinyl, phthalazinyl, pyrimidinyl or pyrazinyl, any of which groups may be optionally substituted by one or more substituents; or Z represents— Z1— Z2 or— Z1— C(O)— Z2, either of which moieties may be optionally substituted by one or more substituents. Additionally, Z may represent dihydrobenzothienyl, dihydroisoindolinyl, 1,2,3,4-tetrahydroisoquinolinyl, pyridazinyl or triazinyl, any of which groups may be optionally substituted by one or more substituents.
[00184] The moiety Z1 represents a divalent radical derived from an aryl, C3-7heterocycloalkyl or heteroaryl group, any of which groups may be optionally substituted by one or more substituents. Typically, the moiety Z1 represents a divalent radical derived from a phenyl, pyrrolidinyl, piperazinyl, pyrazolyl, thiazolyl, triazolyl, tetrazolyl or pyridinyl group, any of which groups may be optionally substituted by one or more substituents. Typical values of the moiety Z1 include the groups of formula (Za), (Zb),
(Zc), (Zd), (Ze), (Zf), (Zg), (Zh) and (Zj) :
[00185]
Figure imgf000041_0001
[00186] Wherein the symbols # represent the points of attachment of the moiety Z1 to the remainder of the molecule; and the asterisks (*) represent the site of attachment of optional substituents. [00187] Additional values of the moiety Z1 include the group of formula (Zk) :
[00188]
Figure imgf000042_0001
[00189] The moiety Z2 may represent aryl, C3-7 heterocycloalkyl, C3- 7 heterocycloalkenyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents. In addition, Z2 may represent (C4- 9)heterobicycloalkyl or (C4-9)spiroheterocycloalkyl, either of which groups may be optionally substituted by one or more substituents.
[00190] Typically, Z2 represents phenyl, pyrrolidinyl, oxazolidinyl, imidazolidinyl, morpholinyl, imidazolinyl, thiazolyl, imidazolyl, tetrazolyl or pyridinyl, any of which groups may be optionally substituted by one or more substituents. Additionally, Z2 may represent azetidinyl, isothiazolidinyl, piperidinyl, piperazinyl, 6-azabicyclo[3.2.0]-heptanyl, 2-oxa-6- azaspiro[3.4]octanyl, triazolyl or pyrimidinyl, any of which groups may be optionally substituted by one or more substituents.
[00191] Examples of optional substituents which may be present on the moiety Z, Z1 or Z2 include one, two or three substituents independently selected from halogen, cyano, nitro, C1-6 alkyl, trifluoromethyl, oxo, hydroxy, hydroxy(C1-6)alkyl, C1-6a lkoxy, difluoromethoxy, trifluoromethoxy, C1- 3 alkylenedioxy, C1-6 alkylthio, C1-6alkylsu Ifinyl, C1-6 alkylsulfonyl, amino, C1- 6 alkylamino, di(C1-6)alkylamino, di(C1-6)alkylamino(C1-6)alkyl, C2- 6 alkylcarbonyl amino, C1-6 alkylsu lfonylamino, formyl, C2- 6 alkylcarbonyl, carboxy, C2- 6 alkoxycarbonyl, aminocarbonyl, C1-6alkylaminocarbonyl, di(C1- 6)alkylaminocarbonyl, aminosulfonyl, C1-6alkylaminosulfonyl, di(C1- 6)alkylaminosulfonyl, aminocarbonylamino and hydrazinocarbonyl. Additional examples include thioxo, N— [(C1-6)-alkyl]-N— [(C1-6)alkylcarbonyl]amino, N - [(C1-6)alkyl]-N— [(C1-6)alkylsulfonyl]amino, cyano(C1-6)alkylaminocarbonyl and (C3-7)cycloalkylureido.
[00192] Typical examples of optional substituents on the moiety Z, Z1 or Z2 include halogen, cyano, nitro, C1-6 alkyl, trifluoromethyl, oxo, hydroxy, hydroxy(C1-6)alkyl, C1-6alkoxy, difluoromethoxy, trifluoromethoxy, C1- 3 alkylenedioxy, C1-6 alkylsulfonyl, amino, di(C1-6)alkylamino, di(C1- 6)alkylamino(C1-6)alkyl, C2- 6 alkylcarbonylamino, C1-6 alkylsulfonylamino, formyl, carboxy, C2-6 alkoxycarbonyl, aminocarbonyl, C1-6alkylaminocarbonyl, di(C1-6)alkylaminocarbonyl, aminocarbonylamino and hydrazinocarbonyl. Additional examples include thioxo, C1-6 alkylthio, N—[(C1-6)alkyl]-N—[(C1- 6)alkylcarbonyl]amino, N— [(C1-6)-alkyl]-N— [(C1-6)alkylsulfonyl]amino, cyano(C1-6)alkylaminocarbonyl, aminosulfonyl and (C3-7)cycloalkylureido.
[00193] Examples of particular substituents on the moiety Z, Z1 or Z2 include fluoro, chloro, bromo, cyano, nitro, methyl, ethyl, isopropyl, trifluoromethyl, oxo, hydroxy, hydroxymethyl, methoxy, difluoromethoxy, trifluoromethoxy, methylenedioxy, methylthio, methylsulfinyl,
methylsulfonyl, amino, methylamino, tert-butylamino, dimethylamino, dimethylaminomethyl, dimethylaminoethyl, acetylamino,
methylsulfonylamino, formyl, acetyl, carboxy, methoxycarbonyl, tert- butoxycarbonyl, aminocarbonyl, methylaminocarbonyl,
dimethylaminocarbonyl, aminosulfonyl, methylaminosulfonyl,
dimethylaminosulfonyl, aminocarbonylamino and hydrazinocarbonyl.
Additional examples include thioxo, ethoxy, N-acetyl-N-methylamino, N- methyl-N-(methylsulfonyl)-amino, cyanomethylaminocarbonyl and cyclopropylureido.
[00194] Typical examples of particular substituents on the moiety Z, Z1 or Z2 include fluoro, chloro, bromo, cyano, nitro, methyl, ethyl,
trifluoromethyl, oxo, hydroxy, hydroxymethyl, methoxy, difluoromethoxy, trifluoromethoxy, methylenedioxy, methylsulfonyl, amino, dimethylamino, dimethylaminomethyl, dimethylaminoethyl, acetylamino, methylsulfonylamino, formyl, carboxy, methoxycarbonyl, tert- butoxycarbonyl, aminocarbonyl, methylaminocarbonyl,
dimethylaminocarbonyl, aminocarbonylamino and hydrazinocarbonyl.
Additional examples include thioxo, methylthio, ethoxy, N-acetyl-N- methylamino, N-methyl-N-(methylsulfonyl)amino,
cyanomethylaminocarbonyl, aminosulfonyl and cyclopropylureido.
[00195] Typical values of Z2 include phenyl, hydroxyphenyl,
oxopyrrolidinyl, dioxo-pyrrolidinyl, (hydroxy)(oxo)pyrrolidinyl,
(amino)(oxo)pyrrolidinyl, (oxo)oxazolidinyl, oxoimidazolidinyl, morpholinyl, imidazolinyl, methylthiazolyl, formylthiazolyl, imidazolyl, tetrazolyl and pyridinyl. Additionally, Z2 may represent oxoazetidinyl,
(methyl)(oxo)pyrrolidinyl, (hydroxymethyl)(oxo)pyrrolidinyl,
dioxoisothiazolidinyl, oxopiperidinyl, (methyl)(oxo)piperazinyl,
oxomorpholinyl, oxo-6-azabicyclo[3.2.0]-heptanyl, oxo-2-oxa-6- azaspiro[3.4]octanyl, ethoxytriazolyl or pyrimidinyl.
[00196] Selected values of Z2 include oxopyrrolidinyl and
(oxo)oxazolidinyl. In one embodiment, Z2 represents oxopyrrolidinyl. In another embodiment, Z2 represents (oxo)oxazolidinyl.
[00197] Typical values of Z include hydrogen, fluoro, trifluoromethyl, methyl, ethyl, n-propyl, isopropyl, isobutyl, tert-butyl, cyclopropyl, cyclopentyl, cyclohexyl, oxocyclohexyl, phenyl, bromophenyl, cyanophenyl, nitrophenyl, methoxyphenyl, difluoromethoxyphenyl,
trifluoromethoxyphenyl, methylenedioxyphenyl, methylsulfonylphenyl, dimethylaminophenyl, acetylaminophenyl, methylsulfonylaminophenyl, carboxyphenyl, aminocarbonylphenyl, methylaminocarbonylphenyl, dimethylaminocarbonylphenyl, aminocarbonylaminophenyl,
tetrahydrofuranyl, oxopyrrolidinyl, dimethylamino-pyrrolidinyl, tert- butoxycarbonylpyrrolidinyl, indolinyl, tetrahydropyranyl, piperidinyl, ethy Ipiperid iny I, tert-butoxycarbonylpiperidinyl, aminocarbonylpiperidinyl, 2- oxo-3, 4-dihydroquinolinyl, morpholinyl, azocanyl, oxothiazolinyl, furyl, hydroxymethylfuryl, thienyl, methylpyrazolyl, dimethylpyrazolyl, 4, 5,6,7- tetrahydroindazolyl, benzoxazolyl, methylisoxazolyl, dimethylisoxazolyl, methylthiazolyl, aminothiazolyl, benzothiazolyl, methylbenzothiazolyl, aminobenzothiazolyl, imidazolyl, methylimidazolyl, methyl-benzimidazolyl, dimethyl[l,2,4]triazolo[l,5-c]pyrimidinyl, dimethylaminoethyltetrazolyl, pyridinyl, fluoropyridinyl, chloropyridinyl, cyanopyridinyl, methylpyridinyl, (cyano)-(methyl)pyridinyl, trifluoromethylpyridinyl, oxopyridinyl, methoxypyridinyl, dimethylaminomethylpyridinyl, acetylaminopyridinyl, carboxypyridinyl, methoxycarbonyl-pyridinyl, aminocarbonylpyridinyl, (aminocarbonyl)(fluoro)pyridinyl, methylaminocarbonylpyridinyl, dimethylaminocarbonylpyridinyl, hydrazinocarbonylpyridinyl, quinolinyl, isoquinolinyl, (methyl)(oxo)phthalazinyl, pyrimidinyl, pyrazinyl,
oxopyrrolidinylphenyl, dioxopyrrolidinylphenyl,
(hydroxy)(oxo)pyrrolidinylphenyl, (amino)(oxo)pyrrolidinylphenyl,
(oxo)oxazolidinylphenyl, oxoimidazolidinylphenyl, imidazolinylphenyl, methylthiazolylphenyl, formylthiazolylphenyl, imidazolylphenyl,
tetrazolylphenyl, phenylpyrrolidinyl, hydroxyphenylpiperazinyl,
(methyl)(phenyl)-pyrazolyl, oxoimidazolidinylthiazolyl,
hydroxyphenyltriazolyl, morpholinyltetrazolyl, oxopyrrolidinylpyridinyl, (oxo)oxazolidinylpyridinyl, oxoimidazolidinylpyridinyl, pyridinylth iazolyl, pyridinyltetrazolyl and morpholinylcarbonylphenyl. Additional values include difluoromethyl, aminocarbonylaminomethyl, difluorophenyl, chlorophenyl, methylphenyl, dimethylphenyl, dimethoxyphenyl, (methylthio)phenyl, methylsulfinyl-phenyl, (bromo)(methylsulfonyl)phenyl,
(methyl)(methylsulfonyl)phenyl, cyanomethyl-aminocarbonylphenyl, trioxodihydrobenzothienyl, pyrrolidinyl, methylpyrrolidinyl,
oxodihydroisoindolinyl, oxopiperidinyl, 1,2,3,4-tetrahydroisoquinolinyl, aminosulfonyl-pyrazolyl, cyclopropylureidothiazolyl, [1,2,4]triazolo[l,5- c]pyrimidinyl, hydroxypyridinyl, dimethylaminopyridinyl, N-acetyl-N- methylaminopyridinyl, N-methyl-N-(methylsulfonyl)aminopyridinyl, pyridazinyl, oxopyrimidinyl, (amino)(dimethyl)-pyrimidinyl,
(oxo)(thioxo)triazinyl, pyridinylpiperazinyl, pyrimidinylpiperazinyl, oxopyrrolidinylth iazolyl, oxoazetidinylpyridinyl, (methyl)(oxo)pyrrolidinylpyridinyl, (hydroxy)(oxo)pyrrolidinylpyridinyl, (hydroxymethyl)(oxo)pyrrolidinylpyridinyl, (amino)(oxo)pyrrolidinylpyridinyl, dioxoisothiazolidinylpyridinyl, oxopiperidinyl-pyridinyl,
(methyl)(oxo)piperazinylpyridinyl, oxomorpholinylpyridinyl, oxo-6- azabicyclo[3.2.0]heptanylpyridinyl, oxo-2-oxa-6- azaspiro[3.4]octanylpyridinyl and ethoxytriazolylpyridinyl.
[00198] Particular values of Z include hydrogen, methyl,
methylsulfonylphenyl, pyridinyl, oxopyrrolidinylphenyl,
(hydroxy)(oxo)pyrrolidinylphenyl and (oxo)oxazolidinylphenyl. In a first embodiment, Z represents hydrogen. In a second embodiment, Z represents methyl. In a third embodiment, Z represents methylsulfonylphenyl. In one aspect of that embodiment, Z represents 3-(methylsulfonyl)phenyl. In a fourth embodiment, Z represents pyridinyl. In one aspect of that
embodiment, Z represents pyridin-4-yl. In a fifth embodiment, Z represents oxopyrrolidinylphenyl. In one aspect of that embodiment, Z represents 3-(2- oxopyrrolidin-1-yl)phenyl. In a sixth embodiment, Z represents
(hydroxy)(oxo)pyrrolidinylphenyl. In one aspect of that embodiment, Z represents 3-(3-hydroxy-2-oxopyrrolidin-1-yl)phenyl. In another aspect of that embodiment, Z represents 3-(4-hydroxy-2-oxopyrrolidin-1-yl)phenyl. In a seventh embodiment, Z represents (oxo)oxazolidinylphenyl. In one aspect of that embodiment, Z represents 3-(2-oxo-oxazolidinyl-3-yl)phenyl.
[00199] In some embodiments, Q-Z is not H. Thus in some
embodiments Q-Z is preferably a 5- or 6-membered organic ring containing 0 to 4 heteroatoms selected from the group consisting of N, O and S, which ring may be unsubstituted or substituted from 1 to 4 times with halo, cycloalkylalkoxy, loweralkyl, haloloweralkyl, haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide,
aminosulfonyl, sulfone, nitro; and oxoheterocyclic groups. [00200] It will be understood that where Q-Z is bonded to the ring nitrogen, in some embodiments it may be less preferred for Q-Z to be halo, azido, mercapto, amino, alkylamino, dialkylamino, acylamino, cyano, and arylalkylamino, and more preferred for R3 to be alkyl, loweralkyl, and haloloweralkyl, sulfone, amide, and, aryl.
[00201] Generally, X represents a covalent bond ; or X represents— N(R4)— ; or X represents an optionally substituted straight or branched C1- 4 alkylene chain.
[00202] Typically, X represents— N(R4)— ; or E represents an optionally substituted straight or branched C1-4 alkylene chain .
[00203] In a selected aspect, E represents an optionally substituted straight or branched C1-4 alkylene chain.
[00204] Suitably, X represents a covalent bond ; or X represents— N(R4)— ; or E represents methylene (— CH2— ), (methyl)methylene or (ethyl)methylene, any of which groups may be optionally substituted by one or more substituents.
[00205] Suitable values of X include— N(R4)— ,— CH2— ,— CH(CH3)— and— CH(CH2CH3)— ; or E may represent a covalent bond.
[00206] In a first embodiment, E represents a covalent bond, whereby the integer Y is attached directly to the benzimidazole nucleus.
[00207] In a second embodiment, X represents— S(O)2— .
[00208] In a th ird embodiment, X represents— N(R4)— .
[00209] In a fourth embodiment, X represents— CH2— . [00210] In a fifth embodiment, X represents— CH(CH3)— . In a particular aspect of that embodiment, the— CH(CH3)— linkage represented by X is in the (S) stereochemical configuration.
[00211] In a sixth embodiment, X represents— CH(CH2CH3)— .
[00212] Generally, Y represents C3-7 cycloalkyl, aryl or heteroaryl, any of which groups may be optionally substituted by one or more substituents. Additionally, Y may represent C3-7 heterocycloalkyl, which group may be optionally substituted by one or more substituents.
[00213] Typically, Y represents aryl or heteroaryl, either of which groups may be optionally substituted by one or more substituents. Additionally, Y may represent C3-7 heterocycloalkyl, which group may be optionally substituted by one or more substituents.
[00214] In a first embodiment, Y represents optionally substituted C3- 7 cycloalkyl. In one aspect of that embodiment, Y represents unsubstituted C3-7cycloalkyl. In another aspect of that embodiment, Y represents
monosubstituted C3-7 cycloalkyl. In a further aspect of that embodiment, Y represents disubstituted C3-7 cycloalkyl.
[00215] In a second embodiment, Y represents optionally substituted aryl. In one aspect of that embodiment, Y represents unsubstituted aryl. In another aspect of that embodiment, Y represents monosubstituted aryl. In a further aspect of that embodiment, Y represents disubstituted aryl.
[00216] In a third embodiment, Y represents optionally substituted C3- 7heterocycloalkyl. In one aspect of that embodiment, Y represents
unsubstituted C3-7 heterocycloalkyl. In another aspect of that embodiment, Y represents monosubstituted C3-7 heterocycloalkyl. In a further aspect of that embodiment, Y represents disubstituted C3-7heterocycloalkyl. [00217] In a fourth embodiment, Y represents optionally substituted heteroaryl. In one aspect of that embodiment, Y represents unsubstituted heteroaryl. In another aspect of that embodiment, Y represents
monosubstituted heteroaryl. In a further aspect of that embodiment, Y represents disubstituted heteroaryl.
[00218] Suitably, Y represents benzocyclobutenyl, phenyl, thiazolyl or pyridinyl, any of which groups may be optionally substituted by one or more substituents. Additionally, Y may represent pyrrolidinyl, thieno[2,3- c]pyrazolyl, indazolyl, isoxazolyl and imidazo[2,1-b]thiazolyl, any of which groups may be optionally substituted by one or more substituents.
[00219] In a selected embodiment, Y represents phenyl, which group may be optionally substituted by one or more substituents.
[00220] In a selected embodiment, Y represents thiazolyl, especially thiazol-4-yl, which group may be optionally substituted by one or more substituents.
[00221] Examples of optional substituents which may be present on the moiety Y include one, two or three substituents independently selected from halogen, cyano, nitro, C1-6 alkyl, trifluoromethyl, hydroxy, C1-6alkoxy, difluoromethoxy, trifluoromethoxy, C1-6 a Iky Ithio, C1-6 a Ikylsu Ifinyl, C1- 6alkylsulfonyl, amino, C1-6 alkylamino, di(C1-6)alkylamino, arylamino, C2- 6alkylcarbonylamino, C1-6 alkylsulfonylamino, formyl, C2- 6 alkylcarbonyl, C3- 6 cycloalkylcarbonyl, C3-6 heterocycloalkylcarbonyl, carboxy, C2- 6alkoxycarbonyl, aminocarbonyl, C1-6 alkylaminocarbonyl, di(C1- 6)alkylaminocarbonyl, aminosulfonyl, C1-6 alkylaminosulfonyl and di(C1- 6)alkylaminosulfonyl. Additional examples include benzyl and
methylenedioxy.
[00222] Typical examples of optional substituents on the moiety Y include halogen, C1-6 alkyl, trifluoromethyl, C1-6alkoxy, difluoromethoxy, trifluoromethoxy and amino. Additional examples include benzyl and methylenedioxy.
[00223] Examples of particular substituents on the moiety Y include fluoro, chloro, bromo, cyano, nitro, methyl, isopropyl, trifluoromethyl, hydroxy, methoxy, difluoromethoxy, trifluoromethoxy, methylthio, methylsulfinyl, methylsulfonyl, amino, methylamino, tert-butylamino, dimethylamino, phenylamino, acetylamino, methylsulfonylamino, formyl, acetyl, cyclopropylcarbonyl, azetidinylcarbonyl, pyrrolidinylcarbonyl, piperidinyl-carbonyl, piperazinylcarbonyl, morpholinylcarbonyl, carboxy, methoxycarbonyl, aminocarbonyl, methylaminocarbonyl,
dimethylaminocarbonyl, aminosulfonyl, methylaminosulfonyl and
dimethylaminosulfonyl. Additional examples include benzyl, ethoxy and methylenedioxy.
[00224] Typical examples of particular substituents on the moiety Y include fluoro, chloro, methyl, trifluoromethyl, methoxy, difluoromethoxy, trifluoromethoxy and amino. Additional examples include bromo, benzyl, ethoxy and methylenedioxy.
[00225] Suitable values of Y include benzocyclobutenyl, phenyl, fluorophenyl (including 2-fluorophenyl, 3-fluorophenyl and 4-fluorophenyl), chlorophenyl (including 2-chlorophenyl, 3-chlorophenyl and 4-chlorophenyl), difluorophenyl (including 2,6-difluorophenyl), (chloro)(fluoro)phenyl
(including 5-chloro-2-fluorophenyl and 2-chloro-5-fluorophenyl),
dichlorophenyl (including 2,5-dichlorophenyl and 2,6-dichlorophenyl), methylphenyl (including 4-methylphenyl), dimethylphenyl (including 2,5- dimethylphenyl and 2,6-dimethylphenyl), (trifluoromethyl)phenyl [including 2-(trifluoromethyl)phenyl], (chloro)(trifluoromethyl)phenyl [including 5- chloro-2-(trifluoromethyl)phenyl], (methyl)-(trifluoromethyl)phenyl
[including 2-methyl-5-(trifluoromethyl)phenyl], bis(trifluoromethyl)phenyl [including 2,5-bis(trifluoromethyl)phenyl], methoxyphenyl (including 2- methoxyphenyl), (difluoromethoxy)phenyl [including 2- (difluoromethoxy)phenyl and 3-(difluoromethoxy)phenyl], (difluoromethoxy)(fluoro)phenyl [including 2-(difluoromethoxy)-5- fluorophenyl and 5-(difluoromethoxy)-2-fluorophenyl], (chloro)- (difluoromethoxy)phenyl [including 5-chloro-2-(difluoromethoxy)phenyl and 6-chloro-2-(difluoromethoxy)phenyl], (trifluoromethoxy)phenyl [including 2- (trifluoromethoxy)-phenyl], (amino)(chloro)phenyl (including 5-amino-2- chlorophenyl), methylthiazolyl (including 2-methyl-1,3-thiazol-4-yl),
(chloro)(methyl)thiazolyl (including 5-chloro-2-methyl-1,3-thiazol-4-yl) and pyridinyl (including pyrid in-3-yl and pyridin-4-yl). Additional values include (fluoro)(methoxy)phenyl, (difluoro)(difluoromethoxy)phenyl,
(dichloro)(difluoromethoxy)phenyl, (bromo)(difluoromethoxy)phenyl, (difluoromethoxy)(methyl)phenyl, (difluoromethoxy)(methoxy)phenyl, bis(difluoromethoxy)-phenyl, (difluoromethoxy)(methylenedioxyoxy)phenyl, (chloro)(trifluoromethoxy)phenyl, benzylpyrrolidinyl,
(methyl)(trifluoromethyl)thieno[2,3-c]pyrazolyl, methylindazolyl,
methylisoxazolyl, dimethylthiazolyl, (methyl)(trifluoromethyl)thiazolyl, (ethoxy)-(methyl)thiazolyl and chloroimidazo[2,1-b]thiazolyl.
[00226] In a particular embodiment, Y represents 2- (difluoromethoxy)phenyl.
[00227] In some embodiments, R4, R5, R6, and R7 are each
independently halogen or cyano; or C1-6 alkyl, C2- 6 alkenyl, C2- 6 alkynyl, C3- 7cycloalkyl, C4- 7 cycloalkenyl, C3-7 cycloalkyl(C1-6)alkyl, aryl, aryl(C1-6)alkyl, C3- 7 heterocycloalkyl, C3-7 heterocycloalkyl(C1-6)alkyl, C3-7heterocycloalkenyl, C4- 9 heterobicycloalkyl, heteroaryl, heteroaryl(C1-6)alkyl, (C3-7)heterocycloalkyl- aryl-, (C3-7)heterocycloalkyl(C1-6)alkyl-aryl-, heteroaryl(C3-7)heterocycloalkyl- , (C3-7)cycloalkyl-heteroaryl-, (C3-7)cyclo alkyl(C1-6)alkyl-hetero aryl-, ( C4- 7)cycloalkenyl-heteroaryl-, (C4-9)bicycloalkyl-heteroaryl-, (C3- 7)heterocycloalkyl-heteroaryl-, (C3-7)hetero cyclo alkyl(C1-6)alkyl-hetero aryl-, (C3-7)hetero cyclo alkenyl-hetero aryl-, (C4-9)heterobicycloalkyl-heteroaryl-, (C4-9)spiroheterocycloalkyl-heteroaryl- or (C3-7)heterocycloalkyl- heteroaryl(C1-6)alkyl-, any of which groups may be optionally substituted by one or more substituents;
[00228] In some embodiments, R4, R5, R6, and R7 are each
independently halogen or cyano; or C1-6 alkyl, C2- 6 alkenyl, C2- 6 alkynyl, C3- 7cycloalkyl, C4-7 cycloalkenyl, C3-7 cycloalkyl(C1-6)alkyl, aryl, aryl(C1-6)alkyl, C3- 7 heterocycloalkyl, C3-7 heterocycloalkyl(C1-6)alkyl, C3-7heterocycloalkenyl, C4- 9 heterobicycloalkyl, heteroaryl, heteroaryl(C1-6)alkyl, (C3- 7)heterocycloalkyl(C1-6)alkyl-aryl-, heteroaryl(C3-7)heterocycloalkyl-, (C3- 7)cycloalkyl-heteroaryl-, (C3-7)cycloalkyl-(C1-6)alkyl-hetero aryl-, ( C4-7)cyclo alkenyl-hetero aryl-, (C3-7)hetero cyclo alkyl-hetero aryl-, (C3-7)hetero cyclo alkyl(C1-6)alkyl-hetero aryl-, (C3-7)hetero cyclo alkenyl-hetero aryl-, (C4- 9)heterobicycloalkyl-heteroaryl- or (C4-9)spiroheterocycloalkyl-heteroaryl-, any of which groups may be optionally substituted by one or more
substituents;
[00229] In some embodiments, R4, R5, R6, and R7 are each
independently halogen or cyano; or C1-6 alkyl, C2- 6 alkenyl, C2- 6 alkynyl, C3- 7cycloalkyl, C4-7 cycloalkenyl, C3-7 cycloalkyl(C1-6)alkyl, aryl, aryl(C1-6)alkyl, C3- 7 heterocycloalkyl, C3-7 heterocycloalkyl(C1-6)alkyl, C3-7heterocycloalkenyl, C4- 9 heterobicycloalkyl, heteroaryl, heteroaryl(C1-6)alkyl, (C3- 7)heterocycloalkyl(C1-6)alkyl-aryl-, heteroaryl(C3-7)heterocycloalkyl-, (C4- 7)cycloalkenyl-heteroaryl-, (C3-7)hetero cyclo alkyl-heteroaryl-, (C3-7)hetero cyclo alkyl(C1-6)alkyl-hetero aryl-, (C3-7)heterocycloalkenyl-heteroaryl-, (C4- 9)heterobicycloalkyl-heteroaryl- or (C4-9)spiroheterocycloalkyl-heteroaryl-, any of which groups may be optionally substituted by one or more
substituents.
[00230] In some embodiments, R4 is preferably H . In other
embodiments R4 is preferably selected from the group consisting of: halo, loweralkyl, haloloweralkyl, haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide,
aminosulfonyl, sulfone, and nitro; more preferably R4 is selected from the group consisting of: halo, haloloweralkyl, haloloweralkyloxy, loweralkoxy, amino, acylamino, aminoacyl, arylalkyl, aryloxy, acyl, arylamino, cyano, nitro, and heterocycleamino, and still more preferably R4 is cyano, fluoroalkyl or halo.
[00231] In some embodiments, R5 is preferably selected from the group consisting of: halo, loweralkyl, haloloweralkyl, haloloweralkyloxy,
loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, and nitro. R5 is more preferably selected from the group consisting of: halo, haloloweralkyl,
haloloweralkyloxy, loweralkoxy, amino, acylamino, aminoacyl, arylalkyl, aryloxy, acyl, arylamino, cyano, nitro, and heterocycleamino. R5 is most preferably cyano, fluoroalkyl or halo.
[00232] In some embodiments R6 is H. In other embodiments R6 is preferably selected from the group consisting of: halo, loweralkyl,
haloloweralkyl, haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, and nitro, in such other embodiments R6 is more preferably selected from the group consisting of: halo, haloloweralkyl, haloloweralkyloxy, loweralkoxy, amino, acylamino, aminoacyl, arylalkyl, aryloxy, acyl, arylamino, cyano, nitro, and heterocycleamino; in such other embodiments R6 is most preferably cyano, fluoroalkyl or halo.
[00233] In some embodiments, at least two of R4, R6, and R7 are H. In some preferred embodiments R6 and R7 are both H. In some preferred embodiments R7 is H. [00234] Where the compounds in accordance with the invention comprise an optionally substituted straight or branched alkylene chain, typical values thereof include methylene (— CH2— ), (methyl)methylene, ethylene (— CH2CH2— ), (ethyl)methylene, (dimethyl)-methylene,
(methyl)ethylene, propylene (— CH2CH2CH2— ), (propyl)methylene and (dimethyl)ethylene, any of which chains may be optionally substituted by one or more substituents. Suitably, such chains are unsubstituted, monosubstituted or disubstituted. Typically, such chains are unsubstituted or monosubstituted . In one embodiment, such chains are unsubstituted. In another embodiment, such chains are monosubstituted. In a further embodiment, such chains are disubstituted .
[00235] Examples of typical substituents on the alkylene chain which may be present in a compound in accordance with the invention include halogen, trifluoromethyl, oxo, hydroxy, C1-6alkoxy, trifluoromethoxy, amino, C1-6alkylamino, di(C1-6)alkylamino, aminocarbonyl, C1-6 alkylaminocarbonyl and di(C1-6)alkylaminocarbonyl.
[00236] Examples of suitable substituents on the alkylene chain which may be present in a compound in accordance with the invention include halogen, trifluoromethyl, hydroxy, C1-6alkoxy and amino.
[00237] Specific examples of suitable substituents on the alkylene chain which may be present in a compound in accordance with the invention include fluoro, trifluoromethyl, hydroxy, methoxy and amino.
[00238] In some embodiments, integer E is selected from :
[00239]
Figure imgf000055_0001
[00240] In some embodiments, integer Y-E is selected from:
[00241]
Figure imgf000056_0001
[00242] In some embodiments, integer X-Y-E is selected from :
[00243]
Figure imgf000057_0001
Figure imgf000058_0001
[00244]
Figure imgf000058_0002
[00245]
Figure imgf000059_0001
[00246] In some embodiments, integer E is selected from :
Figure imgf000060_0001
Amidoximes
Figure imgf000060_0002
N-Hydroxyform amides
Figure imgf000060_0003
Oxyguanidmes, cyclic oxyguanidmes
[00247]
Figure imgf000060_0004
[00248]
[00249]
Figure imgf000061_0001
[00250] Additional derivatives can be found in US 2018/0317484, US 2009/0005344, US 2015/0152065, and US 2018/0297959, which are incorporated by reference in their entirety.
[00251] Where any of the groups in the active compounds above is stated to be optionally substituted, this group may be unsubstituted, or substituted by one or more substituents. Typically, such groups will be unsubstituted, or substituted by one or two substituents.
[00252] The compounds in accordance with the present invention are beneficial in the treatment and/or prevention of various human ailments. These ailments include lung disease, and in particular, chronic lung disease, including idiopathic pulmonary fibrosis; non-alcoholic fatty liver disease, and in particular, non-alcoholic fatty liver disease, non-alcoholic fatty liver, and non-alcoholic steatohepatitis; and kidney disorders, and in particular, renal fibrosis and/or chronic kidney disease.
[00253] The present invention includes within its scope solvates of the compounds above. Such solvates may be formed with common organic solvents, e.g. hydrocarbon solvents such as benzene or toluene; chlorinated solvents such as chloroform or dichloromethane; alcoholic solvents such as methanol, ethanol or isopropanol; ethereal solvents such as diethyl ether or tetrahydrofuran; or ester solvents such as ethyl acetate. Alternatively, the solvates of the above compounds may be formed with water, in which case they will be hydrates.
[00254] The present invention also includes co-crystals within its scope. The technical term "co-crystal" is used to describe the situation where neutral molecular components are present within a crystalline compound in a definite stoichiometric ratio. The preparation of pharmaceutical co-crystals enables modifications to be made to the crystalline form of an active pharmaceutical ingredient, which in turn can alter its physicochemical properties without compromising its intended biological activity (see
Pharmaceutical Salts and Co-crystals, ed. J. Wouters & L. Quere, RSC Publishing, 2012). Typical examples of co-crystal formers, which may be present in the co-crystal alongside the active pharmaceutical ingredient, include L-ascorbic acid, citric acid, glutaric acid, urea and nicotinamide.
[00255] The active compounds disclosed herein can, as noted above, be prepared in the form of their pharmaceutically acceptable salts.
Pharmaceutically acceptable salts are salts that retain the desired biological activity of the parent compound and do not impart undesired toxicological effects. Examples of such salts are (a) acid addition salts formed with inorganic acids, for example hydrochloric acid, hydrobromic acid, sulfuric acid, phosphoric acid, nitric acid and the like; and salts formed with organic acids such as, for example, acetic acid, oxalic acid, tartaric acid, succinic acid, maleic acid, fumaric acid, gluconic acid, citric acid, malic acid, ascorbic acid, benzoic acid, tannic acid, palmitic acid, alginic acid, polyglutamic acid, naphthalenesulfonic acid, methanesulfonic acid, p-toluenesulfonic acid, naphthalenedisulfonic acid, polygalacturonic acid, and the like; (b) salts formed from elemental anions such as chlorine, bromine, and iodine, and (c) salts derived from bases, such as ammonium salts, alkali metal salts such as those of sodium and potassium, alkaline earth metal salts such as those of calcium and magnesium, and salts with organic bases such as
dicyclohexylamine and N-methyl-D-glucamine.
[00256] In one embodiment, the pharmaceutically acceptable salt is selected from the group consisting of Na, K, Li, Ca and Mg salts.
[00257] In one embodiment, a pharmaceutically acceptable prodrug is selected from the group consisting of esters, carbonates, thiocarbonates, N- acyl derivatives, N-acyloxy derivatives and amino acid conjugates.
[00258] The active compounds described above may be formulated for administration in a pharmaceutical carrier in accordance with known techniques. See, e.g., Remington, The Science And Practice of
Pharmacy (9th Ed. 1995). In the manufacture of a pharmaceutical
formulation according to the invention, the active compound (including the physiologically acceptable salts thereof) is typically admixed with, inter alia, an acceptable carrier. The carrier must, of course, be acceptable in the sense of being compatible with any other ingredients in the formulation and must not be deleterious to the patient. The carrier may be a solid or a liquid, or both, and is preferably formulated with the compound as a unit-dose formulation, for example, a tablet, which may contain from 0.01 or 0.5% to 95% or 99% by weight of the active compound. One or more active compounds may be incorporated in the formulations of the invention, which may be prepared by any of the well known techniques of pharmacy consisting essentially of admixing the components, optionally including one or more accessory ingredients. [00259] The formulations of the invention include those suitable for oral, rectal, topical, buccal (e.g., sub-lingual), vaginal, parenteral (e.g., subcutaneous, intramuscular, intradermal, or intravenous), topical (i.e., both skin and mucosal surfaces, including airway surfaces) and transdermal administration, although the most suitable route in any given case will depend on the nature and severity of the condition being treated and on the nature of the particular active compound which is being used.
[00260] Formulations suitable for oral administration may be presented in discrete units, such as capsules, cachets, lozenges, or tablets, each containing a predetermined amount of the active compound; as a powder or granules; as a solution or a suspension in an aqueous or non-aqueous liquid; or as an oil-in-water or water-in-oil emulsion. Such formulations may be prepared by any suitable method of pharmacy which includes the step of bringing into association the active compound and a suitable carrier (which may contain one or more accessory ingredients as noted above). In general, the formulations of the invention are prepared by uniformly and intimately admixing the active compound with a liquid or finely divided solid carrier, or both, and then, if necessary, shaping the resulting mixture. For example, a tablet may be prepared by compressing or molding a powder or granules containing the active compound, optionally with one or more accessory ingredients. Compressed tablets may be prepared by compressing, in a suitable machine, the compound in a free-flowing form, such as a powder or granules optionally mixed with a binder, lubricant, inert diluent, and/or surface active/dispersing agent(s). Molded tablets may be made by molding, in a suitable machine, the powdered compound moistened with an inert liquid binder.
[00261] Formulations suitable for buccal (sub-lingual) administration include lozenges comprising the active compound in a flavoured base, usually sucrose and acacia or tragacanth; and pastilles comprising the compound in an inert base such as gelatin and glycerin or sucrose and acacia. [00262] When in an orally administered form, the pharmaceutical composition of this invention may comprise conventional excipients such as binders, fillers, thinners, tableting agents, lubricants, disintegrants, coloring agents, flavoring agents and wetting agents. Tablets can be coated when necessary.
[00263] Suitable fillers comprise cellulose, mannitol, lactose, and other similar fillers. Suitable disintegrants comprise starch, polyvinylpyrrolidone and starch derivatives such as sodium starch glycolate. Suitable lubricants comprise magnesium stearate. Suitable pharmaceutically acceptable wetting agents comprise sodium lauryl sulfate.
[00264] Orally administered compositions in solid form can be prepared by conventional methods comprising mixing, filling, tableting, etc. Repeated mixing can distribute the active substances throughout those compositions that use large amounts of fillers.
[00265] The orally administered liquid forms can be in the form of aqueous or oily suspensions, solutions, emulsions, syrups or elixirs, or can be a dried product to be reconstituted with water or other suitable carriers before administration. The liquid forms can contain conventional additives, such as suspending agents like sorbitol, syrup, methyl cellulose, gelatin, hydroxyethyl cellulose, carboxymethyl cellulose, aluminum stearate gel, or hydrogenated edible fat; emulsifiers like lecithin, sorbitan monooleate or acacia; non-aqueous carriers (which may include edible oils) like almond oil, fractionated coconut oil; oil esters such as esters of glycerol, propylene glycol or ethanol; preservatives such as methyl p-hydroxybenzoate, propyl p-hydroxybenzoate or sorbic acid, and if necessary, may contain
conventional flavoring or coloring agents.
[00266] Formulations of the present invention suitable for parenteral administration comprise sterile aqueous and non-aqueous injection solutions of the active compound, which preparations are preferably isotonic with the blood of the intended recipient. These preparations may contain anti oxidants, buffers, bacteriostats and solutes which render the formulation isotonic with the blood of the intended recipient. Aqueous and non-aqueous sterile suspensions may include suspending agents and thickening agents. The formulations may be presented in unit\dose or multi-dose containers, for example sealed ampoules and vials, and may be stored in a freeze-dried (lyophilized) condition requiring only the addition of the sterile liquid carrier, for example, saline or water-for-injection immediately prior to use.
Extemporaneous injection solutions and suspensions may be prepared from sterile powders, granules and tablets of the kind previously described. For example, in one aspect of the present invention, there is provided an injectable, stable, sterile composition comprising a compound of Formula (I), or a salt thereof, in a unit dosage form in a sealed container. The compound or salt is provided in the form of a lyophilizate which is capable of being reconstituted with a suitable pharmaceutically acceptable carrier to form a liquid composition suitable for injection thereof into a subject. The unit dosage form typically comprises from about 10 mg to about 10 grams of the compound or salt. When the compound or salt is substantially water- insoluble, a sufficient amount of emulsifying agent which is physiologically acceptable may be employed in sufficient quantity to emulsify the compound or salt in an aqueous carrier. One such useful emulsifying agent is
phosphatidyl choline.
[00267] Formulations suitable for rectal administration are preferably presented as unit dose suppositories. These may be prepared by admixing the active compound with one or more conventional solid carriers, for example, cocoa butter, and then shaping the resulting mixture.
[00268] Formulations suitable for topical application to the skin preferably take the form of an ointment, cream, lotion, paste, gel, spray, aerosol, or oil. Carriers which may be used include petroleum jelly, lanoline, polyethylene glycols, alcohols, transdermal enhancers, and combinations of two or more thereof. [00269] Formulations suitable for transdermal administration may be presented as discrete patches adapted to remain in intimate contact with the epidermis of the recipient for a prolonged period of time. Formulations suitable for transdermal administration may also be delivered by
iontophoresis (see, for example, Pharmaceutical Research 3 (6) : 318 (1986)) and typically take the form of an optionally buffered aqueous solution of the active compound. Suitable formulations comprise citrate or bis\tris buffer (pH 6) or ethanol/water and contain from 0.1 to 0.2M active ingredient.
[00270] Further, the present invention provides liposomal formulations of the compounds disclosed herein and salts thereof. The technology for forming liposomal suspensions is well known in the art. When the compound or salt thereof is an aqueous-soluble salt, using conventional liposome technology, the same may be incorporated into lipid vesicles. In such an instance, due to the water solubility of the compound or salt, the compound or salt will be substantially entrained within the hydrophilic center or core of the liposomes. The lipid layer employed may be of any conventional composition and may either contain cholesterol or may be cholesterol-free. When the compound or salt of interest is water-insoluble, again employing conventional liposome formation technology, the salt may be substantially entrained within the hydrophobic lipid bilayer which forms the structure of the liposome. In either instance, the liposomes which are produced may be reduced in size, as through the use of standard sonication and
homogenization techniques. Liposomal formulations containing the compounds disclosed herein or salts thereof, may be lyophilized to produce a lyophilizate which may be reconstituted with a pharmaceutically acceptable carrier, such as water, to regenerate a liposomal suspension.
[00271] Other pharmaceutical compositions may be prepared from the water-insoluble compounds disclosed herein, or salts thereof, such as aqueous base emulsions. In such an instance, the composition will contain a sufficient amount of pharmaceutically acceptable emulsifying agent to emulsify the desired amount of the compound or salt thereof. Particularly useful emulsifying agents include phosphatidyl cholines, and lecithin.
[00272] In addition to the active compounds, the pharmaceutical compositions may contain other additives, such as pH-adjusting additives. In particular, useful pH-adjusting agents include acids, such as hydrochloric acid, bases or buffers, such as sodium lactate, sodium acetate, sodium phosphate, sodium citrate, sodium borate, or sodium gluconate. Further, the compositions may contain microbial preservatives. Useful microbial preservatives include methylparaben, propylparaben, and benzyl alcohol.
The microbial preservative is typically employed when the formulation is placed in a vial designed for multidose use. Of course, as indicated, the pharmaceutical compositions of the present invention may be lyophilized using techniques well known in the art.
[00273] Without being limited to any particular theory, the inventors believe that compound of formula (I) or a pharmaceutically acceptable salt or prodrug thereof act as an a cto protector, has antihypoxic effects, and downregulates HIF1 alpha .
[00274] Adaptation to hypoxia is regulated by hypoxia-inducible factor 1 (HIF-1), a heterodimeric transcription factor consisting of an oxygen- regulated alpha subunit and a constitutively expressed beta subunit. HIF- 1 is regulated mainly by oxygen tension through the oxygen-dependent degradation of it's A subunit. Oxygen deprivation initiates a wide range of responses to restore oxygen homeostasis in the affected tissues. These adaptive responses are aimed to increase oxygen supply and compensate for the loss of energy. The transcription factor HIF- 1 helps to restore oxygen homeostasis at a cellular, local, and systemic level. HIF-1 functions by regulating many of the genes involved in angiogenesis, erythropoiesis, glycolysis, iron metabolism, and cell survival. In addition to its role in oxygen homeostasis, HIF- 1 has been implicated as a critical factor in the
pathogenesis of tumor vascularization, and ischemia . Under normoxic conditions, HIF-1a is degraded. Under hypoxic conditions, HIF-1a protein is stabilized and initiates a multistep pathway of activation (Stroka et al., The FASEB Journal, Vol 15, Nov 2001, 2445-2453) (Figure 27).
[00275] More specifically, HIF- 1 is a heterodimer consisting of HIF-1a and HIF-1b [also known as the aryl hydrocarbon nuclear translocator (ARNT)] subunits. The amino-terminal half of each subunit contains basic helix-loop-helix (bHLH) and PER-ARNT-SIM homology (PAS) domains. The bHLH domain defines a large superfamily of dimeric eukaryotic transcription factors in which the H LH domain mediates dimerization and the basic domain contacts DNA. The carboxy-terminal half of HIF-1a contains two
transactivation domains that mediate interactions with coactivators such as CREB binding protein (CBP) and p300 (Figure 27).
[00276] The biological activity of HIF-1 is determined by the expression and activity of the HIF-1a subunit. The regulation of HIF-1a expression and activity in vivo occurs at multiple levels, including mRNA expression, protein expression, nuclear localization, and transactivation. Among these, the most intensively studied has been the regulation of steady-state HIF-1a protein levels.
[00277] The alpha subunits of HIF are hydroxylated at conserved proline residues by HIF prolyl-hydroxylases, allowing their recognition and ubiquitination by the VHL E3 ubiquitin ligase, which labels them for rapid degradation by the proteasome. This occurs only in normoxic conditions. In hypoxic conditions, HIF prolyl-hydroxylase is inhibited, since it utilizes oxygen as a cosubstrate (Figure 27).
[00278] HIF- 1, when stabilized by hypoxic conditions, upregulates several genes to promote survival in low-oxygen conditions. These include glycolysis enzymes, which allow ATP synthesis in an oxygen-independent manner, and vascular endothelial growth factor (VEGF), which promotes angiogenesis. HIF- 1 is known to induce transcription of more than 60 genes, including VEGF and erythropoietin that are involved in biological processes such as angiogenesis and erythropoiesis, which assist in promoting and increasing oxygen delivery to hypoxic regions, as well as LDH-A and Aldolase A (Figure 27).
[00279] To activate transcription of target genes, HIF- la dimerizes with HIF- 1 b and the heterodimer binds to DNA at sites represented by the consensus sequence 5'-RCGTG-3'. The HIF- 1 binding site is present within a hypoxia response element, a c/s-acting transcriptional regulatory sequence that can be located within 5'-flanking, 3'-flanking, or intervening sequences of target genes. See, for example, Semenza GL, HIF- 1 : mediator of physiological and pathophysiological responses to hypoxia, Journal of Applied Physiology, Volume 88, Issue 4, April 2000. Pages 1474-1480 and Semenza GL, Flydroxylation of HIF-1 : Oxygen Sensing at the Molecular Level, Journal of Applied Physiology, Volume 19, Issue 4, August 2004, Pages 176-182.
[00280] HIF-1 also regulates glycolysis which is a vital pathway for energy production. It regulates the uptake of glucose through glucose transporters, i.e. glucose transporter 1 (GLUT1) and sodium-glucose transporters (SGLT). In absence of oxygen, metabolic pathways shift from more productive oxidative phosphorylation to less efficient anaerobic metabolism for maintenance of ATP production (Warburg effect). This shift is done through up-regulation of hexokinase, aldolase, pyruvate kinase and down-regulation of pyruvate dehydrogenase which promotes the conversion of pyruvate to acetyl CoA to enter the citric acid cycle (Figure 28).
[00281] When oxygen is sparse, cells adapt to hypoxia by
reprogramming the expression of a number of genes involved in energy metabolism. HIF-1 not only promotes glucose uptake by activating the transcription of transporters GLUT1 and GLUT3, but also enhances anaerobic energy production, as it upregulates most of the glycolytic enzymes
(including HK1/2, ENOl, PGK1 and PKM2) and proteins that facilitate the synthesis and excretion of lactate (LDH and MCT4). Moreover, in order to reduce mitochondrial function for decreasing consumption of oxygen and ROS production, HIF-1 stimulates the expression of pyruvate dehydrogenase kinase (PDK1). PDK inhibits the pyruvate dehydrogenase complex and blocks the conversion of pyruvate, the glycolytic end product, to acetyl-CoA, which normally feeds into TCA cycle by producing citrate. Therefore, the flow of pyruvate into the mitochondria is decreased, fueling the production of lactate by LDH in the cytoplasm (Figure 28). See Mylonis I et al, Flypoxia-Inducible Factors and the Regulation of Lipid Metabolism, Cells 2019, 8(3), 214. Also, FIIF-induced ectoenzyme CA (carbonic anhydrase) IX or XII converts diffused carbon dioxide into carbonic acid (Figure 28). See Singh D et al,
Overexpression of hypoxia-inducible factor and metabolic pathways: possible targets of cancer, Cell & Bioscience, 2017, 7: 62.
[00282] Obesity triggers hypoxia in adipose tissue and the small intestine, which stabilizes and activates hypoxia-inducible factor (HIF) la and FIIF2a (of which expression is limited to specific tissues such as the vasculature, liver, kidney and intestines) signalling, resulting in adverse metabolic effects, including insulin resistance and non-alcoholic fatty liver disease (Figure 29). See Gonzalez FJ et al, The role of hypoxia-inducible factors in metabolic diseases, Nature Reviews Endocrinology,
volume 15, pages21-32 (2019).
[00283] HIF- la may also play a key role in vascular remodeling under hypoxic conditions. Vascular remodeling is primarily composed of
dysregulated proliferation of endothelial cells (ECs) and an increase in the number (hyperplasia) and volume (hypertrophy) of arterial smooth muscle cells (ASMC) resulting in progressive vascular occlusion and chronic hypoxia.
[00284] The extensive and cumulative vascular remodeling in arterioles that accompanies chronic hypoxia results in multiple internal organ fibrosis and pulmonary hypertension (PH). Fibrosis is typically characterized by prolonged and/or exaggerated activation of fibroblasts and excessive deposition of ECM in organs or tissues including different kinds of collagens, hyaluronic acid, fibronectin, and proteoglycans.
[00285] While HIF-1a may be helpful in repairing injury and correcting hypoxia via multiple mechanisms, however, prolonged exposure to HIF-1a is harmful and contributes to persistent pathofibrogenesis in fibrotic disease (Figure 30). See Xiong A and Liu Y, Targeting Hypoxia Inducible Factors-la As a Novel Therapy in Fibrosis, Front. Pharmacol., 30 May 2017.
[00286] In an embodiment, the amount of compound of formula (I) or a pharmaceutically acceptable salt or prodrug thereof, used is between 0.5 to 200 mg per kg of the subject per day. In a preferred embodiment, the amount of formula (I) or a pharmaceutically acceptable salt or prodrug thereof, used is between 1 to 30 mg per kg of the subject per day. In a further preferred embodiment, the amount of formula (I) or a
pharmaceutically acceptable salt or prodrug thereof, used is between 4 to 25 mg per kg of the subject per day. In a yet further preferred embodiment, the amount of formula (I) or a pharmaceutically acceptable salt or prodrug thereof, used is between 8 to 17 mg per kg of the subject per day. In a still further preferred embodiment, the amount of formula (I) or a
pharmaceutically acceptable salt or prodrug thereof, used is about 17 mg per kg of the subject per day.
[00287] Throughout the following description, specific details are set forth in order to provide a more thorough understanding to persons skilled in the art. However, well known elements may not have been shown or described in detail to avoid unnecessarily obscuring the disclosure.
Accordingly, the description and drawings are to be regarded in an
illustrative, rather than a restrictive, sense.
[00288] While a number of exemplary aspects and embodiments have been discussed above, those of skill in the art will recognize certain modifications, permutations, additions and sub-combinations thereof. It is therefore intended that the following appended claims and claims hereafter introduced are interpreted to include all such modifications, permutations, additions and sub-combinations as are consistent with the broadest interpretation of the specification as a whole.
[00289] The embodiments of the present application described above are intended to be examples only. Those of skill in the art may effect alterations, modifications and variations to the particular embodiments without departing from the intended scope of the present application. In particular, features from one or more of the above-described embodiments may be selected to create alternate embodiments comprised of a
subcombination of features which may not be explicitly described above. In addition, features from one or more of the above-described embodiments may be selected and combined to create alternate embodiments comprised of a combination of features which may not be explicitly described above. Features suitable for such combinations and subcombinations would be readily apparent to persons skilled in the art upon review of the present application as a whole. Any dimensions provided in the drawings are provided for illustrative purposes only and are not intended to be limiting on the scope of the invention. The subject matter described herein and in the recited claims intends to cover and embrace all suitable changes in technology.
[00290] Example 1 - fibrotic lung disease
[00291] The mouse species or strain is Mouse/C57BL/6, the mice being 8-10 week old males. Nine groups of 10 mice each will be obtained from Charles River Laboratories. Each group will be randomized based on body weight. Bleomycin (BLM) was obtained from Euroasias.
[00292] The mice will be maintained in a controlled environment with a temperature of 70-72° F, humidity 30-70%, with a photocycle of 12 hours of light and 12 hours of dark. They will be provided with TEKLAD 2018-Global 18% diet and Arrowhead drinking water ad libitium.
[00293] The mice will be anesthetized with isoflurane/O2 mixture.
Bleomycin (BLM) will then be administered to the mice intratracheally (PennCentury) - single bolus, at 2.5U/kg body weight in 50mI sterile saline.
[00294] Seven days after the bleomycin is administered, and fibroblasts have generally proliferated, groups of IT bleomycin challenged mice will be dosed orally (p.o.) once a day with the active compounds at specified amounts per kg of body weight (mg/kg) daily for 14 consecutive days. The vehicle to used is 0.5% carboxymethyl cellulose (CMC). Vehicle and no-BLM control groups will receive 0.5% CMC orally for 14 consecutive days.
[00295] On day 21 of the study, 4 hours after the last dose, the mice will be sacrificed and plasma was collected and frozen for cytokine analysis (testing for IL-6, IL-12, TGFb, IL-13 proteins, or fibrosis markers).
Brochoalveolar lavage fluid (BALF) was collected and frozen for optional cytokine analyses and cell counts pending the initial data. The lungs will be excised, weighed and fixed in formalin. Gomori's Trichrome stain, a histological stain, will be used to determine collagen content.
[00296] The dose selected for the animal studies will be determined by taking the maximum known human daily dose, dividing by the average weight of an adult (~60 kg) to get a human mg/kg dose. Then that number was multiplied by 12 to convert to a mouse dose based on conventional dosing tables. See Nair and Jacob, J Basic Clin Pharm March 2016-May 2016, 7(2) :27-31.
[00297] The following measurements and assessments will be taken for each mouse. [00298] Body Weight: The body weights will be measured over 21 days using a laboratory balance.
[00299] Trichrome Score: A trichrome score measures the level of scarring to the lungs caused by the disease. The greater the trichrome score, the greater the scarring.
[00300] Formalin fixed lung samples will be submitted to affiliated histopathology laboratory for histopathological analysis subjected Gomori's Trichrome stain, a histological stain, which will be used to determine collagen content.
[00301] Each lung will be divided into ten sections. All ten sections were stained and evaluated. A board certified veterinarian pathologist will assess the presence of lung fibrosis and severity score - The expression of collagen (associated with fibrosis) is determined from the ratio of the stained area versus the total area of the lung section.
[00302] Mortality Rate: the mortality rate in each group was also observed over 21 days.
[00303] Example 2 - non-alcoholic steatohepatitis
[00304] Male newborn C57BL/6 mice will be used. All mice will be born from pathogen-free 14 day-pregnant mice obtained from Japan SLC, Inc. (Hamamatsu, Japan) prior to the start of the study.
[00305] The murine STAM™ model of NASH-HCC will be performed according to previously described methods known in the art (Takakura et al, Characterization of non-alcoholic steatohepatitis, Anticancer Res,
34(9) :4849-55 (2014); Fujii et al, (2013)). NASH will be induced in male mice by a single subcutaneous injection of 200 mg of streptozotocin (STZ, Sigma, MO, USA) at 2 days after birth and continuous feeding after 4 weeks of age (day 28 ± 2) with a high fat diet (CLEA Japan Inc, Tokyo, Japan) given ad libitum.
[00306] Following induction of NASH, the mice will be randomized study groups of 8 mice each at 6 weeks of age (day 42 ± 2) based on body weight, the day before the start of treatment.
[00307] One day following randomization, the mice will be administered a once-daily oral treatment from 6 weeks of age plus one day (day 43 ± 2, treatment Day 1) to 9 weeks of age (hereinafter known as the "treatment period")· Telmisartan will be used as the positive control. The
pharmaceutically acceptable vehicle in all groups was 0.5% carboxymethyl cellulose (CMC). The mice in the remaining study group (hereafter known as the "vehicle control group") will be treated individually with the same pharmaceutically acceptable vehicle with no active ingredient. Individual body weight will be measured daily during the treatment period. Survival, clinical signs and behavior of mice will be also monitored daily.
[00308] In each case, a volume of 10 mL/kg of 0.5% CMC will be administered orally with (or without) the active ingredient as noted in Table 3 from 6 to 9 weeks of age. All mice will then be sacrificed at 9 weeks of age. Blood samples were collected from all mice and the liver from each mouse will be removed for analysis.
[00309] The dose selected for the animal studies will be determined by taking the maximum known human daily dose, dividing by the average weight of an adult (~60-70 kg) to get a human mg/kg dose. Then that number was multiplied by 12 to convert to a mouse dose based on conventional dosing tables. See Nair and Jacob, J Basic Clin Pharm March 2016-May 2016, 7(2) : 27-31.
[00310] The following measurements and assessments will be taken for each mouse. [00311] Body weight: The body weight of all mice will be measured daily throughout the treatment period.
[00312] Blood Sample Collection and Biochemical Analysis: Blood will be collected from all sacrificed mice and frozen for further analyses or shipping.
[00313] Plasma Alanine Aminotransferase (ALT) : The plasma from each blood sample will be analyzed by FUJI DRI CHEM (Fujifilm, Japan) for alanine aminotransferase (ALT) as an indicator of liver function and disease progression.
[00314] Liver Sample Collection, Biochemical Analysis, and Histological Analysis: The liver will be removed from all sacrificed mice and frozen for further analyses or shipping.
[00315] Liver Weight: Following removal, the livers from all sacrificed mice will be weighed in grams.
[00316] Liver Flistopathology: The removed livers will be fixed in formalin and embedded in paraffin, and cross sections ( 4mm) were then prepa red.
[00317] Assessment of Steatohepatitis: Liver cross-sections will be subjected to hematoxylin and eosin (H&E) staining using standard
techniques for histological assessment of hepatic steatosis, lobular inflammation and hepatocellular ballooning. The level of steatohepatitis severity in each liver cross-section will be indicated by NAFLD Activity Scores of: 0 (normal), 1-2 (NAFLD), 3-4 (borderline) or at least 5 (NASFI) in 3 randomly selected fields of H &E-stained liver cross-sections of 4mm thickness at x50 magnification for evaluation of steatosis and x200 magnification each for evaluation of inflammation and evaluation of ballooning. The NAFLD Activity Score is the unweighted sum of the following : 1) hepatic steatosis score (0-3); 2) lobular inflammation score (0-2); 3) hepatocellular ballooning score (0-2).
[00318] The liver cross-sections of the Vehicle group, and the treated groups will also be subjected to Sirius-red staining using standard techniques for histological estimation of the percentage of fibrosis area. For quantitative analysis of fibrosis area, bright field images of Sirius red-stained sections were captured around the central vein using a digital camera (DFC295;
Leica, Germany) at 200-fold magnification, and the positive areas in 5 fields/section will be measured using ImageJ software (National Institute of Health, USA).
[00319] Statistically significant decreases in the fibrosis area compared with the Vehicle group will be determined by Sirius red-positive areas.
[00320] Example 3 - fibrotic kidney disease
[00321] Male 9-12 week old C57BL/6 mice of 23-25 grams body weight were used. All mice (Sirius red-positive area) acclimated for a minimum of 5 days prior to the start of the study and housed individually in microisolators throughout the study in a 12: 12 light-dark cycle on a standard maintenance mouse chow diet (Harlan Teklad 2018) with food and water given ad libitum. Prior to surgery, all mice (Sirius red-positive area) weighed for baseline body weight.
[00322] The UUO surgical intervention (Sirius red-positive area) performed according to previously described methods known in the art (Le Meur Y et al., Macrophage accumulation at a site of renal inflammation is dependent on the M-CSF/c-fms pathway, J Leukocyte Biol., 72: 530-537; 2002).
[00323] All mice will be first anesthetized by intraperitoneal injection with a rodent cocktail (ketamine lOmg/mL and Xyaline lmg/mL) in normal saline (10mL/g body weight). Pedal reflex and movement of the vibrissae will be used to determine the state of unconsciousness. A state of
unconsciousness was confirmed after a period of about 5 minutes in all animals. All mice will then be shaved on the left side of the abdomen. The shaved area will be first swabbed with iodine and then swabbed with alcohol. A vertical incision will be made through the skin with a #22 scalpel and the skin will then be retracted. A further incision of about 2.5cm was then made through the peritoneum avoiding any major blood vessels. The peritoneum will be then retracted and the left kidney was exposed.
[00324] The left kidney will be then brought to the surface by hooking the ureter directly beneath the kidney with sterile forceps and gently manipulating the kidney upward. The ureter will be ligated at two points directly below the kidney with 5-0 surgical silk with excess suture cut away and discarded post-ligation. The kidney will be then gently placed back to its correct anatomical position and the abdomen was lavaged with lmL sterile saline to replenish fluid loss. The peritoneum and then skin will be sutured with 5-0 Mersilene, and the incision site was gently wiped with iodine. All mice will then be placed individually in clean cages that were set on top of a thermal blanket until recovery at about 30-60 minutes later. In some examples, sham surgery will be performed as a control by following all steps of the UUO surgical intervention procedure except ligation.
[00325] Following surgery, the mice will be divided into study groups of 8 mice each and, following post-surgical recovery, administered a once-daily oral treatment for 14 days. The mice in the study groups (hereafter known as "treatment groups") will all receive the UUO surgical ligation and will be treated individually with active compound. The pharmaceutically acceptable vehicle in all groups was 0.5% carboxymethyl cellulose (CMC). All mice will be sacrificed with CO2 on post-surgical day 15.
[00326] The dose selected for the animal studies will be determined by taking the maximum known human daily dose, dividing by the average weight of an adult (~60-70 kg) to get a human mg/kg dose. Then that number was multiplied by 12 to convert to a mouse dose based on conventional dosing tables. See Nair and Jacob, J Basic Clin Pharm March 2016-May 2016, 7(2) : 27-31.
[00327] The following measurements and assessments will be taken for each mouse.
[00328] Body weight: The body weights will be measured on days 1, 2, 5, 8, 10 and 14 using a laboratory balance.
[00329] Serum collection : A blood sample will be collected from all mice and plasma analyzed for urea nitrogen and creatinine. Plasma was stored at -80 °C for possible future analysis.
[00330] Kidney weight: The UUO will be examined in situ to ensure that the surgical ligation ties remained patent. Both the ligated (UUO) and non- ligated kidneys were removed for analysis. Weights of both kidneys will be measured using a laboratory balance.
[00331] Histopathology: Formalin-fixed kidney cross-section samples will be subjected histopathological scoring with Sirius Red staining, and imaged at a magnification of x20, using standard techniques. All three sections were stained and evaluated. The analysis was performed by a board -certified veterinarian pathologist. The presence of interstitial damage and severity score was assessed according to the following criteria : 0= normal, 1= light, 2= moderate, 3= severe.
[00332] Results - Bimethyl treatment and fibrotic lung disease
[00333] Dosing [00334] Table 1
Figure imgf000081_0001
[00335] Body Weight
[00336] The changes in body weights are presented in Figure 1, Tables 2 and 3 and Appendix A. The decrease in body weight (grams) were observed from day 1 till day 5 and then started recovering. They showed improvement beginning on Day 5 as compared to the BLM-vehicle group.
[00337] Table 2 Body Weight (g)
Figure imgf000081_0002
[00338] Table 3 Percent Change in Body Weight
Figure imgf000082_0001
[00339] Trichrome Score
[00340] The Trichrome score data are presented in Figure 2, Table 4 and Appendix B.
[00341] Table 4: Trichrome Score Average
Figure imgf000082_0002
An example of how reduction in fibrosis for Pirfenidone was calculated is as follows: % reduction = 100 - (trichrome score Pirfenidone - trichrome score normal) divided by (trichrome score vehicle - trichrome score normal)
[00342] Percent Survival
[00343] Mortality is an important endpoint for IPF patients. The percent survival data is presented in Table 5.
[00344] Table 5 : Survival Data
Figure imgf000083_0001
[00345] Overall
[00346] The fibrosis percent reduction analysis is presented in Figure 3 and Appendix C.
[00347] In conclusion, oral administration of Bemithyl showed improvement in lung fibrosis as well as in the loss of body weight, Trichrome score and mortality as compared to BLM-vehicle.
[00348] Oral administration of Pirfenidone at 300 mg/kg showed minimal improvement in the loss of body weight and trichrome index as compared to BLM-vehicle. [00349] Results - Bimethyl treatment and non-alcoholic
steatoheDatitis
[00350] Dosing
[00351] Table 6
Figure imgf000084_0001
[00352] In each case, a volume of 10 mL/kg of 0.5% CMC was administered orally with (or without) the active ingredient as noted in Table 6 from 6 to 9 weeks of age. All mice were then sacrificed at 9 weeks of age. Blood samples were collected from all mice and the liver from each mouse was removed for analysis.
[00353] The dose selected for the animal studies was determined by taking the maximum known human daily dose, dividing by the average weight of an adult (~60-70 kg) to get a human mg/kg dose. Then that number was multiplied by 12 to convert to a mouse dose based on conventional dosing tables. See Nair and Jacob, J Basic Clin Pharm March 2016-May 2016, 7(2) : 27-31.
[00354] The following measurements and assessments were taken for each mouse.
[00355] Body weight: The body weight of all mice were measured daily throughout the treatment period. [00356] Blood Sample Collection and Biochemical Analysis: Blood was collected from all sacrificed mice and frozen for further analyses or shipping.
[00357] Plasma Alanine Aminotransferase (ALT) : The plasma from each blood sample was analyzed by FUJI DRI CHEM (Fujifilm, Japan) for alanine aminotransferase (ALT) as an indicator of liver function and disease progression.
[00358] Liver Sample Collection, Biochemical Analysis, and Histological Analysis: The liver was removed from all sacrificed mice and frozen for further analyses or shipping. Following removal, the livers from all sacrificed mice were weighed in grams.
[00359] Liver Flistopathology: The removed livers were fixed in formalin and embedded in paraffin, and cross sections (4mm) were then prepared.
[00360] Assessment of Steatohepatitis: Liver cross-sections were subjected to hematoxylin and eosin (H&E) staining using standard
techniques for histological assessment of hepatic steatosis, lobular inflammation and hepatocellular ballooning. The level of steatohepatitis severity in each liver cross-section was indicated by NAFLD Activity Scores of: 0 (normal), 1-2 (NAFLD), 3-4 (borderline) or at least 5 (NASH) in 3 randomly selected fields of Fi8iE-stained liver cross-sections of 4mm thickness at x50 magnification for evaluation of steatosis and x200 magnification each for evaluation of inflammation and evaluation of ballooning. The NAFLD Activity Score is the unweighted sum of the following : 1) hepatic steatosis score (0-3); 2) lobular inflammation score (0-2); 3) hepatocellular ballooning score (0-2).
[00361] The liver cross-sections of the treated groups were also subjected to Sirius-red staining using standard techniques for histological estimation of the percentage of fibrosis area. For quantitative analysis of fibrosis area, bright field images of Sirius red-stained sections were captured around the central vein using a digital camera (DFC295; Leica, Germany) at 200-fold magnification, and the positive areas in 5 fields/section were measured using ImageJ software (National Institute of Health, USA).
[00362] Statistical Analysis
[00363] Values are arithmetic means. Comparison between the study group and positive control group was performed using a two-tailed, heteroscedastic (two-sample unequal variance) Student's T-Test. A P-value of < 0.05 was considered statistically significant following a Bonferroni post- hoc statistical correction analysis for multiple groups (Bonferroni Multiple Comparison Test).
[00364] Results
[00365] Liver Function Evaluation : Liver function and disease
progression was evaluated by Plasma ALT as previously described. Results are shown in Figures 4 and Appendix D.
[00366] Steatohepatitis Evaluation : Steatohepatitis and disease progression was evaluated by H&E-staining of liver cross-sections as previously described. Representative photomicrographs of HE-stained liver sections for each of the study groups are shown in Figures 5a, 5b, and 5c.
[00367] The NAFLD Activity Score of each study group consisted of the NAFLD Activity Score average of all mice in each study group. Scores were determined based on the steatosis score, lobular inflammation score and hepatocellular ballooning score for each animal. Results are shown in Figures 6-9 and Appendix E. Statistically significant reductions in NAFLD activity score relative to Vehicle control were observed.
[00368] Bemithyl showed statistically significant decreases in the fibrosis area (Sirius red-positive area) compared with the Vehicle group. The Bemithyl group showed particularly statistically significant decrease in fibrosis area. The fibrosis area in the Telmisartan group also tended to decrease compared with the Vehicle group. Results are shown in FIGS 10a and 10b, and 11.
[00369] The statistically significant and clinically relevant composite reduction in NAFLD Activity Scores suggest these compounds could be useful in preventing and/or treating NASH and its sequelae.
[00370] In conclusion, administration of bemithyl showed improvement in reducing the NAFLD Activity Scores, hepatic steatosis, lobular
inflammation and hepatocellular ballooning and may be useful in the prophylaxis and/or treatment of NASFI.
[00371] Results - Bimethyl treatment and fibrotic kidney disease
[00372] Dosing
[00373] Table 7
Figure imgf000087_0001
[00374] The dose selected for the animal studies was determined by taking the maximum known human daily dose, dividing by the average weight of an adult (~60-70 kg) to get a human mg/kg dose. Then that number was multiplied by 12 to convert to a mouse dose based on conventional dosing tables. See Nair and Jacob, J Basic Clin Pharm March 2016-May 2016, 7(2) : 27-31.
[00375] The following measurements and assessments were taken for each mouse.
[00376] Body weight: The body weights were measured on days 1, 2, 5, 8, 10 and 14 using a laboratory balance.
[00377] Serum collection : A blood sample was then collected from all mice and plasma analyzed for urea nitrogen and creatinine. Plasma was stored at -80 °C for possible future analysis.
[00378] Kidney weight: The UUO was then examined in situ to ensure that the surgical ligation ties remained patent. Both the ligated (UUO) and non-ligated kidneys were removed for analysis. Weights of both kidneys were measured using a laboratory balance.
[00379] Histopathology: Formalin-fixed kidney cross-section samples were subjected histopathological scoring with Sirius Red staining, and imaged at a magnification of x20, using standard techniques. All three sections were stained and evaluated. The analysis was performed by a board -certified veterinarian pathologist. The presence of interstitial damage and severity score was assessed according to the following criteria : 0= normal, 1= light, 2= moderate, 3= severe.
[00380] Values are arithmetic means. Comparison between the study group and positive control group was performed using a two-tailed, heteroscedastic (two-sample unequal variance) Student's T-Test. A p-value of <0.05 was considered statistically significant. [00381] Results
[00382] Body Weight Evaluation: Results of the evaluation of mean body weight change are shown in Figure 12 and Table 8. Body weights were measured on post-surgical days 1, 2, 5, 8, 10 and 14 as previously described. The mean body weight change of each study group was calculated using the body weight average of all mice in each study group.
[00383] Table 8. Mean Body Weight Change Following Surgery (g)
Figure imgf000089_0001
[00384] Bemithyl treatment showed an initial decrease in mean body weight change followed by an increase in mean body weight change until sacrifice. The mean body weight change on post-surgical day 14 with bemithyl treatment showed a more positive value than the positive control treatment group (Telmisartan). The mean body weight change on post- surgical day 14 with bemithyl treatment was even greater than that of the sham surgery control group. See FIG 12.
[00385] Renal Function Evaluation: Renal function and disease progression was evaluated by BUN (blood urea nitrogen) as previously described. The BUN of each study group consisted of the BUN average of all mice in each study group. Results are shown in Figures 13 and 14. and Table 9.
[00386] Table 9
Figure imgf000090_0001
[00387] The BUN was decreased in comparison to the surgery vehicle control group and the positive control treatment group. This indicated that bemithyl had less renal dysfunction and disease progression than the positive control treatment with Telmisartan, the current gold standard for treatment of renal fibrosis.
[00388] The BUN for treatment bemithyl was decreased in comparison to the sham surgery control group. This indicated that treatment resulted in an improved renal function as compared to the study group that did not receive any surgical ligation (UUO). In particular, bemithyl (200 mg/kg) showed significant reductions in the levels of BUN compared to vehicle (p < 0.05, Tamhane post-test). The positive control, Telmisartan (5 mg/kg), did not show a significant reduction compared to the vehicle. See FIG 13. [00389] Serum creatinine was also reduced by bemithyl treatment as compared to vehicle. See FIG 14.
[00390] Kidney Weight Evaluation: Kidney weight indicating, which indicates functional and pathological changes in the kidney, was evaluated by measuring the weight of both the ligated (UUO) and non-ligated kidneys as previously described. The ligated and non-ligated kidney weights of each study group consisted of the respective kidney weight averages of all mice in each study group. Results are shown in Table 10 and Figure 15.
[00391] Table 10
Figure imgf000091_0001
[00392] The ligated kidney weights for the bemithyl treatment and surgery vehicle control group were increased in comparison to the sham surgery control group. The increase in weight of the ligated kidney in comparison to the non-ligated kidney was greater as compared to the positive control treatment group. In particular, the positive control
Telmisartan (5 mg/kg) showed the greatest numerical reduction in the disparity between the two kidneys.
[00393] Renal Fibrosis Evaluation: Renal fibrosis and interstitial damage was evaluated by histochemical staining of renal cross-sections with Sirius Red as previously described. The Flistology Score of each study group consisted of the histology score average of all mice in each study group. Results are shown in Table 11 and Figures 16 and 17.
[00394] Table 11
Figure imgf000092_0001
[00395] The p-values of all treatment groups were statistically significant.
[00396] The Histology Scores for the Bemithyl (200 mg/kg) treatment group was significantly decreased in comparison to the positive control treatment group Telmisartan.
[00397] Oral administration of Bemithyl (200 mg/kg) showed significant improvement in kidney fibrosis and reduction in BUN compared to vehicle, and appeared to reverse the negative effects of UUO on body weight gain.
[00398] Results - Combination Bimethyl and Telmisartan treatment and fibrotic kidney disease
[00399] In this example, healthy young female C57BL/6 mice were used for the study. At the commencement of the study, mice were between 9-12 weeks of age, weighing 23-25g. All the mice were obtained from Charles River Laboratories. [00400] The mice were maintained in a controlled environment with a temp 70-72° F, humidity 30-70 %, with a photo cycle of 12 hours of light and 12 hours of dark. They were provided with Harlan Teklad 2018 standard maintenance mouse chow diet and drinking water ad libitium.
[00401] After five days of acclimatization, the mice were grouped according to their body weight. There were ten groups of ten mice each.
Nine groups of ten mice each underwent UUO as described above and the other group of ten mice underwent a sham procedure to serve as a no- surgery control.
[00402] Following surgery, the mice were divided into 10 individual study groups of 10 mice each and, following post-surgical recovery, administered a once-daily oral treatment for 14 days. The mice in the study groups had all received the UUO surgical ligation and were treated individually with a distinct pharmacologic compound as set out in Table 12. The mice in 2 of the study groups were treated individually with a pharmaceutically acceptable vehicle with no active ingredient. The pharmaceutically acceptable vehicle in all groups was 0.5% carboxymethyl cellulose (CMC). All mice were sacrificed with CO2 on post-surgical day 15.
[00403] Dosing
[00404] Table 12
Figure imgf000093_0001
Figure imgf000094_0001
[00405] The dose selected for the animal studies was determined by taking the maximum known human daily dose, dividing by the average weight of an adult (~60-70 kg) to get a human mg/kg dose. That number was multiplied by 12 to convert to a mouse dose based on conventional dosing tables. See Nair and Jacob, J Basic Clin Pharm March 2016-May 2016, 7(2) :27-31.
[00406] Measurements
[00407] The following measurements and assessments were taken for each mouse.
[00408] Body weight: The body weights were measured on days 1, 4, 7, 10 and 14 using a laboratory balance.
[00409] Serum collection : A blood sample was then collected from all mice and plasma analyzed for urea nitrogen and creatinine. Plasma was stored at -80 °C for possible future analysis.
[00410] Kidney weight: The UUO was then examined in situ to ensure that the surgical ligation ties remained patent. Both the ligated (UUO) and non-ligated kidneys were removed for analysis. Weights of both kidneys were measured using a laboratory balance.
[00411] Histopathology: Formalin-fixed kidney cross-section samples were subjected histopathological scoring with Sirius Red staining, and imaged at a magnification of x20, using standard techniques. All three sections were stained and evaluated. The analysis was performed by a board -certified veterinarian pathologist. The presence of interstitial damage and severity score was assessed according to the following criteria : 0= normal; 1= light; 2= moderate; 3= severe.
[00412] The data are presented as the mean obtained from Microsoft Excel or GraphPad Prism version 5.00 for Windows (GraphPad Software, San Diego California USA). Data were analyzed using two-way ANOVA using Bonferroni and Tamhane post-tests. Differences between groups were considered significant at p < 0.05.
[00413] Results
[00414] Body Weight Evaluation: Results of the evaluation of mean body weight change are shown in Figure 18 and Table 13. Body weights were measured on post-surgical days 1, 4, 7, 10 and 14 as previously described. The mean body weight change of each study group was calculated using the body weight average of all mice in each study group.
[00415] Table 13. Mean Body Weight Change Following Surgery (g)
Figure imgf000095_0001
[00416] A decrease in body weight gains was observed for the first 4 days in the vehicle group, after which these gains began to recover. In the Bemithyl (200 mg/kg) and Telmisartan + Bemithyl (3 mg/kg + 200 mg/kg), there was no initial decrease in body weight, and weight gain continued for the duration of the experiment. The mean body weight change on post- surgical day 14 for the Bemithyl treatment group was even greater than that of the sham surgery control group.
[00417] Renal Function Evaluation: Renal function and disease progression was evaluated by BUN (blood urea nitrogen) as previously described. The BUN of each study group consisted of the BUN average of all mice in each study group. Results are shown in Figures 19 and 20 and Table 14.
[00418] Table 14. Results of Renal Function Evaluation.
Figure imgf000096_0001
[00419] For Table 14: * - significantly different from vehicle following a Bonferroni post-hoc test
[00420] The urea nitrogen (BUN) and creatinine data are presented in Figures 19 & 20 and Table 14, respectively. Administration of Bemithyl (200 mg/kg) led to significant reductions in the level of BUN compared to vehicle. The positive control Telmisartan did not reduce levels of BUN, and when combined with Bemithyl appeared to mitigate the ability of these agents to reduce BUN levels. There were no differences in the levels of serum creatinine in any of the groups tested.
[00421] Kidney Weight Evaluation: Kidney weight, which indicates functional and pathological changes in the kidney, was evaluated by measuring the weight of both the ligated (UUO) and non-ligated kidneys as previously described. The ligated and non-ligated kidney weights of each study group consisted of the respective kidney weight averages of all mice in each study group. Results are shown in Table 15 and Figures 21 and 22.
[00422] Table 15. Kidney Weights for Study Groups.
Figure imgf000097_0001
[00423] For Table 15 : * - significantly different from vehicle following a Bonferroni post-hoc test; # - following a Tamhane post-hoc test (p < 0.05)
[00424] The weight of the left (ligated) kidney in the vehicle group was greatly increased. All of the compounds effected numerical reductions in the weight of the left kidney. Significant reductions were achieved by the administration of Telmisartan (3 mg/kg) combined with Bemithyl (200 mg/kg). Bemithyl (200 mg/kg) was also able to significantly reduce the weight of the drained left kidney compared to the vehicle group. During the experiment, the vehicle group also saw a significant increase in the weight of the right (unligated) kidney. All of the treatments tested were able to significantly reduce the weight of this organ.
[00425] Renal Fibrosis Evaluation: Renal fibrosis and interstitial damage was evaluated by histochemical staining of renal cross-sections with Sirius Red as previously described. The Histology Score of each study group consisted of the histology score average of all mice in each study group. Results are shown in Table 16 and Figures 23 and 24.
[00426] Table 16. Histology
Figure imgf000098_0001
[00427] Bemithyl (200 mg/kg), Telmisartan (3 mg/kg) in combination with either Bemithyl (200 mg/kg) were able to significantly reduce the level of kidney fibrosis compared to vehicle. [00428] Oral administration of Bemithyl (200 mg/kg) showed significant improvement in kidney fibrosis and reduction in BUN compared to vehicle, and appeared to reverse the negative effects of UUO on body weight gain.
[00429] Telmisartan in combination with Bemithyl (200 mg/kg) significantly reduced the size of the ligated kidney in the UUO-model.
[00430] Example 4 - Bemithyl effect on anti-hypoxic activity in vitro
[00431] An experiment was conducted to examine the effects of bemithyl on HIF-1alpha expression. HEK293 cells were seeded at 300,000 cells/well and allowed to incubate for 24 hours. Bemithyl at 5 or 10 mM and/or 10 mM PHT (phenanthroline, PHT) were added for 24 hours (see figure 25). A western blot was run and expression of HIF 1 alpha is normalized to the house keeping gene beta-actin by analyzing band intensity.
[00432] As shown in figure 26, hypoxia was induced by 10 mM PHT (lane 2), and HIF1-alpha was stabilized, showing a 100% band. Addition of bemithyl at 5 or 10 pM to PHT samples normalized (reduced) hypoxia as demonstrated by the level of HIF1-alpha. In conclusion, there was a reduction in normalized HIF1-alpha band intensity when bemithyl was added to the PHT samples.

Claims

1. A use of a compound for treating one or more of lung disease; non- alcoholic fatty liver disease; and kidney disorder, said compound of formula (I) :
Figure imgf000100_0001
A is N or C, subject to the proviso that R5 is absent when A is N;
Q represents a covalent bond; or Q represents— O— ,— S— ,— S(O)— , S(O) 2-,— N(R9)— ,— C(O)N(R9)— ,— N(R9)C(O)— , S(O) 2N(R9)- or - N(R9)S(O)2— ; or Q represents an optionally substituted straight or branched C1-6alkylene chain optionally comprising one, two or three heteroatom- containing linkages independently selected from— O— ,— S— ,— S(O)— ,— S(O)2-,— N(R9)— ,— C(O)N(R9)— ,— N(R9)C(O)— , S(O) 2N(R9)- and - N(R9)S(O)2— ;
Z represents hydrogen, halogen or trifluoromethyl; or Z represents C1-
6 alkyl, C3-7 cycloalkyl, aryl, C3-7 heterocycloalkyl, C3-7 heterocycloalkenyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; or Z represents— Z1— Z2 or— Z1— C(O)— Z2, either of which moieties may be optionally substituted by one or more substituents;
Z1 represents a divalent radical derived from an aryl, C3-
7 heterocycloalkyl or heteroaryl group; Z2 represents aryl, C3-7 heterocycloalkyl, C3-7 heterocycloalkenyl, (C4- 9)heterobicycloalkyl, (C4-9)spiroheterocycloalkyl or heteroaryl; or
Q-Z represents H, halo, loweralkyl, haloloweralkyl, haloloweralkoxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; arylalkyloxy, cycloalkyloxy, cyclo alkyl alkoxy, cyclo alkyl amino, urea, cycloalkylalkylamino, cycloalkyl, alkylcycloalkyl, hydroxyamino, alkoxyacylamino, and arylthio;and 5- or 6- membered organic rings containing 0 to 4 heteroatoms selected from the group consisting of N, 0 and S, which rings may be unsubstituted or substituted from 1 to 4 times with halo, loweralkyl, haloloweralkyl, haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; and
oxoheterocyclic groups; or a pharmaceutically acceptable salt or prodrug thereof.
X represents a covalent bond ; or X represents,— S(O)2— or— N(R8)— ; or X represents an optionally substituted straight or branched C1-4 alkylene chain; or X represents,— C(O)— ; or X represents O, N, or S;
Y represents C3-7 cycloalkyl, aryl, C3-7 heterocycloalkyl or heteroaryl; or
Y represents a linking group such as alkyl (e.g.,— R— where R is C2- 6 alkyl), alkenyl (e.g.,— R— where R is C2- 6 alkenyl), cycloalkyl (e.g.,— R— where R is C3-6 cycloalkyl), alkylcycloalkyl(e.g.,— R— R'— , where R is C1-4 alkyl and R' is C3-6 cycloalkyl), cylcoalkylalkyl (e.g.,— R— R'— , where R is C3- 6 cycloalkyl and R' is C1-4 alkyl), a I ky Icy c I oa I ky I a I ky I (e.g .,— R— R'— R"— , wherein R is C1-4 alkyl, R' is C3-6 cycloalkyl, and R" is C1-4 alkyl), alkyloxyalkyl (e.g.,— R— O— R'— , wherein R and R' are C1-4alkyl); aryl (e.g.,— R— where R is aryl), alkylaryl (e.g.,— R— R'— where R is C1-4 alkyl and R' is aryl), alkylarylalkyl (e.g.,— R— R'— R"— where R is C1-4 alkyl, R' is aryl, and R" is C1-4 alkyl), or arylalkyl (e.g.,— R— R'— where R is aryl alkyl and R' is C1-4 alkyl); cycloalkylalkyl (e.g.— R— R'— , where R is C3-6 cycloalkyl and R' is C1-4 alkyl), alkylheterocycle (e.g.,— R— R', where R is C1-4 alkyl and R' is a heterocyclic group as described herein), heterocyclealkyl,
alkylheterocyclealkyl, heterocycle, aminoalkyl (e.g.,— N(R)R'— , where R is H or C1-4 alkyl and R' is C1-4 alkyl), oxyalkyl (e.g.,— O— R— where R is C2- 6 alkyl), aminoaryl (e.g.,— N(R)R'— , where R is H or C1-4 alkyl and R' is aryl), and oxyaryl (e.g.,— O— R— , where R is aryl), any of which groups may be optionally substituted by one or more substituents; and
R1 and R2 are each independently H, loweralkyl, or together form C2-4 alkylene;
E is H; or
E is -N = C=S; or
E is selected from the group consisting of -B(OR1)OR2, -CON(R1)0R,2 and - N(OR1)COR2 or
E is selected from :
Figure imgf000103_0001
Figure imgf000104_0001
N-Hydroxyform amides
Figure imgf000104_0003
Oxyguanidines, cyclic oxyguanidmes
Figure imgf000104_0002
Figure imgf000105_0001
; or
X-Y-E represents alkyl, phenyl, substituted phenyl, naphthyl and substituted naphthyl, wherein the substituent in said substituted phenyl and substituted naphthyl is selected from the group consisting of halogen, cyano, alkyl, alkoxy, ester, N-acyl derivatives, N-acyloxy derivatives and amino acid conjugates, when Q of Q-Z is attached to the ring carbon and Q is— S— , then Z is CHR10R11, where R10 and R11 are selected from the group consisting of hydrogen, alkyl, phenyl, and substituted phenyl, wherein the substituent in said substituted phenyl is selected from the group consisting of halogen, cyano, alkyl, alkoxy, ester, N-acyl derivatives, N-acyloxy derivatives and amino acid conjugates; or
X-Y-E represents hydrogen or C1-6 alkyl or C6-14 aryl when X of X-Y-E is attached to the ring nitrogen and Q-Z represents C1- 10 alkyl or C6-14 aryl or oxygen, sulfur, nitrogen containing heteroaryl when attached to the ring carbon; or
X-Y-E is selected from :
Figure imgf000107_0001
Figure imgf000108_0001
Figure imgf000109_0001
Y-E is selected from :
Figure imgf000109_0002
R4, R5, R6, and R7 are each independently selected from the group consisting of: H, halo, loweralkyl, haloloweralkyl, haloloweralkoxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; arylalkyloxy, cycloalkyloxy, cycloalkylalkoxy, cycloalkylamino, urea, cycloalkylalkylamino, cycloalkyl, alkylcycloalkyl, hydroxyamino, alkoxyacylamino, and arylthio; and 5- or 6- membered organic rings containing 0 to 4 heteroatoms selected from the group consisting of N, O and S, which rings may be unsubstituted or substituted from 1 to 4 times with halo, loweralkyl, haloloweralkyl;
haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; and
oxoheterocyclic groups; or
R4, R5, R6, and R7 are each independently represent hydrogen, halogen, cyano, nitro, hydroxy, trifluoromethyl, trifluoromethoxy,— ORa,— SRa,— SORa,— SO2Ra,— OSO2Ra,— SFs,— NRbRc,— NRcCORd, -NRcCO2Rd, - NHCONRbRc,— NRcSO2Re, -N(SO2Re)2,— NHSO2NRbRc, -CORd, -CO2Rd, - CONRbRc,— CON(ORa)Rb or -SO2NRbRc; or C1-6alkyl, C2-6 alkenyl, C2-6 alkynyl, C3-7 cycloalkyl, C4-7 cycloalkenyl, C3-7 cycloalkyl(C1-6)alkyl, aryl, aryl(C1-6)alkyl, C3-7 heterocycloalkyl, C3-7 heterocycloalkyl(C1-6)alkyl, C3-7 heterocycloalkenyl, C4-9 heterobicycloalkyl, heteroaryl, heteroaryl(C1-6)alkyl, (C3- 7)heterocycloalkyl-aryl-, (C3-7)heterocycloalkyl(C1-6)alkyl-aryl-, heteroaryl- (C3-7)heterocycloalkyl-, (C3-7)cycloalkyl-heteroaryl-, (C3-7)cycloalkyl-(C1- 6)alkyl-heteroaryl-, (C4-7)cycloalkenyl-heteroaryl-, (C4-9)bicycloalkyl- heteroaryl-, (C3-7)heterocycloalkyl-heteroaryl-, (C3-7)hetero cyclo alkyl(C1- 6)alkyl-hetero aryl-, (C3-7)heterocycloalkenyl-heteroaryl-, (C4- 9)heterobicycloalkyl-heteroaryl-, (C4-9)spiroheterocycloalkyl-heteroaryl- or (C3-7)heterocycloalkyl-heteroaryl(C1-6)alkyl-, any of which groups may be optionally substituted by one or more substituents; or
R4, R5, R6, and R7 are each linear or branched C1-6 alkyl and linear or branched C1-6 alkoxy; or
R4 and R5 are hydrogen or C1-6 alkyl or C1-6alkoxyl or C6-14 aryl, any of which groups may be optionally substituted by one or more substituents; R6 ishydrogen or nitro or cyano or carboxyl or acetamidoxime or amidoxime or C1-6 alkyl or C1-6alkoxyl or C6-14 aryl or oxygen, sulfur, and nitrogen containing heteroaryl, any of which groups may be optionally substituted by one or more substituents; and R7 is hydrogen or C1-6 alkyl or C1-6alkoxyl or C6-14 aryl or oxygen, sulfur, and nitrogen containing heteroaryl, any of which groups may be optionally substituted by one or more substituents;
Ra, Rb and Rc independently represent hydrogen or trifluoromethyl; or C1-6 alkyl, C3-7cycloalkyl, C3-7 cycloalkyl(C1-6)alkyl, aryl, aryl(C1-6)alkyl, C3- 7 heterocycloalkyl, C3-7heterocycloalkyl(C1-6)alkyl, heteroaryl or heteroaryl(C1- 6)alkyl, any of which groups may be optionally substituted by one or more substituents; or
Rb and Rc, when taken together with the nitrogen atom to which they are both attached, represent azetidin-1-yl, pyrrolid in- 1-yl, oxazolidin-3-yl, isoxazolidin-2-yl, thiazolidin-3-yl, isoth iazolid in-2-yl, piperidin- 1-yl, morpholin-4-yl, thiomorpholin-4-yl, piperazin-1-yl, homopiperidin-1-yl, homomorpholin-4-yl or homopiperazin-1-yl, any of which groups may be optionally substituted by one or more substituents;
Rd represents hydrogen; or C1-6 alkyl, C3-7 cycloalkyl, aryl, C3- 7 heterocycloalkyl or heteroaryl, any of which groups may be optionally substituted by one or more substituents; and
Re represents C1-6 alkyl, aryl or heteroaryl, any of which groups may be optionally substituted by one or more substituents;
R8 and R9 independently represent hydrogen or C1-6 alkyl;
R12 is selected from the group consisting of: H, halo, loweralkyl, haloloweralkyl, haloloweralkoxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; arylalkyloxy, cycloalkyloxy, cycloalkylalkoxy, cycloalkylamino, urea, cycloalkylalkylamino, cycloalkyl, alkylcycloalkyl, hydroxyamino,
alkoxyacylamino, and arylthio; and 5- or 6-membered organic rings containing 0 to 4 heteroatoms selected from the group consisting of N, O and S, which rings may be unsubstituted or substituted from 1 to 4 times with halo, loweralkyl, haloloweralkyl; haloloweralkyloxy, loweralkoxy, hydroxy, loweralkoxycarbo, carboxylic acid, acyl, azido, mercapto, alkylthio, amino, heterocycleamino, alkylamino, dialkylamino, acylamino, aminoacyl, arylamino, arylalkyl, arylalkylamino, aryloxy, cyano, sulfonamide, aminosulfonyl, sulfone, nitro; and oxoheterocyclic groups; or a pharmaceutically acceptable salt or prodrug thereof.
2. The use of the compound of claim 1 wherein i) XYE is hydrogen and is connected to the ring nitrogen, Q is— S— , and Z is— CH2-CH3; or ii) X is connected to the ring carbon and is— O— ,— N(R12)— , or— S— , Y is C1-6 alkyl, and E is -N=C=S, and preferably R12 is H, Y is -CH2-CH2-, and QZ is H; and preferably, A is C and R4, R5, R6, and R7 are each hydrogen.
3. The use of the compound of claim 1 wherein the compound is
Figure imgf000112_0001
4. The use of the compound of any one of claims 1 to 3 further comprising one or more pharmaceutical carriers.
5. A method of treating one or more of lung disease; non-alcoholic fatty liver disease; and kidney disorder, the method comprising administering a therapeutically effective amount of the compound of any one of claims 1 to 3 to a subject in need thereof.
6. The method of claim 5 wherein the lung disease is chronic lung disease, and preferably idiopathic pulmonary fibrosis; the non-alcoholic fatty liver disease is non-alcoholic fatty liver disease, non-alcoholic fatty liver, or non-alcoholic steatohepatitis; and the kidney disorder is renal fibrosis and/or chronic kidney disease.
7. The method of claim 6, wherein the amount is between 0.5 to 200 mg per kg of the subject.
8. The method of claim 7, wherein the amount is between 5 to 50 mg per kg of the subject.
9. The method of claim 8, wherein the amount is between 5 to 30 mg per kg of the subject.
10. The method of claim 9, wherein the amount is between 8 to 17 mg per kg of the subject.
11. The method of claim 10, wherein the amount is about 17 mg per kg of the subject.
12. Use of the compound of any one claims 1 to 3 in the preparation of a medicament to treat one or more of lung disease; non-alcoholic fatty liver disease; and kidney disorder.
13. The use of claim 12, wherein the use is between 0.5 to 200 mg per kg of the subject.
14. The use of claim 13, wherein the use is between 5 to 50 mg per kg of the subject.
15. The use of claim 14, wherein the use is between 5 to 30 mg per kg of the subject.
16. The use of claim 15, wherein the use is between 8 to 17 mg per kg of the subject.
17. The method of claim 16, wherein the use is about 17 mg per kg of the subject.
18. The use of any one of claims 12 to 17 wherein the lung disease is chronic lung disease, and preferably idiopathic pulmonary fibrosis; the non alcoholic fatty liver disease is non-alcoholic fatty liver disease, non-alcoholic fatty liver, or non-alcoholic steatohepatitis; and the kidney disorder is renal fibrosis and/or chronic kidney disease.
19. The use of claim 18, wherein the non-alcoholic fatty liver disease is non-alcoholic steatohepatitis.
20. The use of claim 19, wherein the non-alcoholic fatty liver disease is non-alcoholic steatohepatitis-derived hepatocellular carcinoma.
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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022253884A1 (en) * 2021-06-02 2022-12-08 Axichem Ab Capsaicin derivatives in the treatment of idiopathic pulmonary fibrosis
US11827627B2 (en) 2021-06-04 2023-11-28 Vertex Pharmaceuticals Incorporated N-(hydroxyalkyl (hetero)aryl) tetrahydrofuran carboxamides as modulators of sodium channels
US11834441B2 (en) 2019-12-06 2023-12-05 Vertex Pharmaceuticals Incorporated Substituted tetrahydrofurans as modulators of sodium channels

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU1674847A1 (en) * 1989-04-26 1991-09-07 Всесоюзный научно-исследовательский институт пульмонологии Method for treatment of inflammatory bronchopulmonary diseases
RU2306137C1 (en) * 2005-12-28 2007-09-20 Денис Вячеславович Лисицын Preparation for preventing and treating influenza
WO2009005344A2 (en) * 2007-06-07 2009-01-08 Nederlandse Organisatie Voor Toegepast-Natuurwetenschappelijk Onderzoek Tno Ventilation system
RU2354371C1 (en) * 2007-11-26 2009-05-10 Государственное образовательное учреждение высшего профессионального образования "Омская государственная Медицинская академия" Method of correction of psychovegetative dysfunctions and prophylaxis of neuro- and cardiotoxic responses to polychemical therapy in patients with tuberculosis
WO2015152065A1 (en) * 2014-04-02 2015-10-08 寿秀 松井 Freezing tool and freezer
WO2020000092A1 (en) * 2018-06-27 2020-01-02 Algernon Pharmaceuticals Inc. The use of actarit in the prophylaxis or treatment of renal fibrosis or kidney disease
WO2020006631A1 (en) * 2018-07-06 2020-01-09 Algernon Pharmaceuticals Inc. Compositions and methods for treating non-alcoholic steatohepatitis

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU1674847A1 (en) * 1989-04-26 1991-09-07 Всесоюзный научно-исследовательский институт пульмонологии Method for treatment of inflammatory bronchopulmonary diseases
RU2306137C1 (en) * 2005-12-28 2007-09-20 Денис Вячеславович Лисицын Preparation for preventing and treating influenza
WO2009005344A2 (en) * 2007-06-07 2009-01-08 Nederlandse Organisatie Voor Toegepast-Natuurwetenschappelijk Onderzoek Tno Ventilation system
RU2354371C1 (en) * 2007-11-26 2009-05-10 Государственное образовательное учреждение высшего профессионального образования "Омская государственная Медицинская академия" Method of correction of psychovegetative dysfunctions and prophylaxis of neuro- and cardiotoxic responses to polychemical therapy in patients with tuberculosis
WO2015152065A1 (en) * 2014-04-02 2015-10-08 寿秀 松井 Freezing tool and freezer
WO2020000092A1 (en) * 2018-06-27 2020-01-02 Algernon Pharmaceuticals Inc. The use of actarit in the prophylaxis or treatment of renal fibrosis or kidney disease
WO2020006631A1 (en) * 2018-07-06 2020-01-09 Algernon Pharmaceuticals Inc. Compositions and methods for treating non-alcoholic steatohepatitis

Non-Patent Citations (8)

* Cited by examiner, † Cited by third party
Title
ALGERNON PHARMACEUTICALS: "NASH Pharmaceuticals announces 84% reduction in fibrosis by additional lead compound in second pre-clinical study for non-alcoholic fatty liver disease", - GLOBE NEWSWIRE, 21 January 2019 (2019-01-21), XP055743474, Retrieved from the Internet <URL:https://www.globenewswire.com/news-release/2019/01/21/1702820/0/en/Nash-Pharmaceuticals-Announces-84-Reduction-of-Fibrosis-by-Additional-Lead-Compound-In-Second-Pre-Clinical-Studv-For-Non-Alcoholic-Fattv-Liver-Disease.html#:~:text=Nash%20Pharmaceuticals%20Announces%2084%25%20Reduction%20of%20Fibrosis%20bv%20Additional%20Lead.Non%2DAlcoholic%20Fatty%20Liver%20Disease> *
ALGERNON PHARMACEUTICALS: "NASH Pharmaceuticals announces positive pre-clinical results from a second study for chronic kidney disease as well as 2 additional lead targets", GLOBE NEWSWIRE, 14 January 2019 (2019-01-14), XP055743475, Retrieved from the Internet <URL:https://www.globenewswire.com/news-release/2019/01/14/1690918/0/en/Nash-Pharmaceuticals-Announces-Positive-Pre-Clinical-Results-From-a-Second-Study-for-Chronic-Kidney-Disease-as-well-as-2-Additional-Lead-Targets.html> *
KOBYLYANSKIY: "The stimulation of pulmonary epithelial regeneration and of the clearance function of the mucociliary apparatus by using bemetil", TSITOLOGIIA., vol. 37, no. 3, 1995, pages 213 - 215 *
NABOKA ET AL.: "Effect of various chemotherapeutic regimens on E. coli persistence factors in experimental pyelonephritis", IZVESTIYA VYSSHIKH UCHEBNYKH ZAVEDENII, 2004, pages 73 - 79 *
OKOVITYL ET AL.: "Studying the hepatoprotector effect of bemithyl on a model of chronic toxic liver damage", EKSP KLIN FARMAKOL., vol. 69, no. 2, 2006, pages 52 - 54 *
SOLOV'EV ET AL.: "The effect of bemithyl in rats with experimental pneumonia", EKSP KLIN FARMAKOL., vol. 65, no. 4, 2002, pages 28 - 29 *
WILLIAMS: "Repurposed compounds NP-135 and NP-160 reduce fibrosis in a NASH pre- clinical mouse model", ALGERNON PHARMACEUTICALS, 25 February 2019 (2019-02-25), Vancouver, Canada, XP055743469, Retrieved from the Internet <URL:https://algernonpharmaceuticals.com/wp-content/uploads/2018/01/Algernon-NASH-Congress-2019.pdf> *
ZARUBINA ET AL.: "Antioxidant effect of polyoxidonium and metaprot during bronchopulmonary inflammation in rats", BULLETIN OF EXPERIMENTAL BIOLOGY AND MEDICINE, vol. 160, no. 2, 2015, pages 234 - 237, XP035900895, DOI: 10.1007/s10517-015-3137-9 *

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11834441B2 (en) 2019-12-06 2023-12-05 Vertex Pharmaceuticals Incorporated Substituted tetrahydrofurans as modulators of sodium channels
US11919887B2 (en) 2019-12-06 2024-03-05 Vertex Pharmaceuticals Incorporated Substituted tetrahydrofurans as modulators of sodium channels
WO2022253884A1 (en) * 2021-06-02 2022-12-08 Axichem Ab Capsaicin derivatives in the treatment of idiopathic pulmonary fibrosis
US11827627B2 (en) 2021-06-04 2023-11-28 Vertex Pharmaceuticals Incorporated N-(hydroxyalkyl (hetero)aryl) tetrahydrofuran carboxamides as modulators of sodium channels

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