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• • 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
  • A61K31/658—Medicinal preparations containing organic active ingredients o-phenolic cannabinoids, e.g. cannabidiol, cannabigerolic acid, cannabichromene or tetrahydrocannabinol
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
  • A61K36/18—Magnoliophyta (angiosperms)
  • A61K36/185—Magnoliopsida (dicotyledons)
  • A61K36/348—Cannabaceae
  • A61K36/3482—Cannabis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/08—Antiepileptics; Anticonvulsants
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
  • C07C37/00—Preparation of compounds having hydroxy or O-metal groups bound to a carbon atom of a six-membered aromatic ring
  • C07C37/68—Purification; separation; Use of additives, e.g. for stabilisation
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
  • C07C39/00—Compounds having at least one hydroxy or O-metal group bound to a carbon atom of a six-membered aromatic ring
  • C07C39/23—Compounds having at least one hydroxy or O-metal group bound to a carbon atom of a six-membered aromatic ring polycyclic, containing six-membered aromatic rings and other rings, with unsaturation outside the aromatic rings

Definitions

• the present invention relates to a cannabidiol (CBD) type cannabinoid compound for use as a medicament.
• CBD cannabidiol
• CBD-type cannabinoid cannabidiol-C1 (CBD-C1)
• CBD-C1 cannabidiol-C1
• CBD-C1 cannabidiol-C1
• CBD-C1 Disclosed herein are data which demonstrate the efficacy of CBD-C1 in models of disease. In addition, a method for the production of CBD-C1 is described.
• Cannabinoids are natural and synthetic compounds structurally or pharmacologically related to the constituents of the cannabis plant or to the endogenous agonists (endocannabinoids) of the cannabinoid receptors CB1 or CB2.
• the only way in nature in which these compounds are produced is by the cannabis plant.
• Cannabis is a genus of flowering plants in the family Cannabaceae, comprising the species Cannabis sativa, Cannabis indica, and Cannabis ruderalis (sometimes considered as part of Cannabis sativa).
• Cannabis plants comprise a highly complex mixture of compounds. At least 568 unique molecules have been identified. Among these compounds are cannabinoids, terpenoids, sugars, fatty acids, flavonoids, other hydrocarbons, nitrogenous compounds, and amino acids.
• Cannabinoids exert their physiological effects through a variety of receptors including, but not limited to, adrenergic receptors, cannabinoid receptors (CB1 and CB2), GPR55, GPR3, or GPR5.
• the principle cannabinoids present in cannabis plants are cannabinoid acids A9-tetrahydrocannabinolic acid (A9-THCA) and cannabidiolic acid (CBDA) with small amounts of their respective neutral (decarboxylated) cannabinoids.
• cannabis may contain lower levels of other minor cannabinoids. “Chemical composition, pharmacological profiling, and complete physiological effects of these medicinal plants, and more importantly the extracts from cannabis, remain to be fully understood.” Lewis, M. M. et al., ACS Omega, 2, 6091-6103 (2017).
• CBD-C1 cannabidiol-C1
• CBD-C1 cannabidiol-C1
• cannabinoids are a class of compounds which may be derived naturally from the cannabis plant or produced synthetically via chemical synthesis.
• cannabinoids produced by cannabis can be split into different groups as follows: phytocannabinoids; endocannabinoids and synthetic cannabinoids (which may be novel cannabinoids or synthetically produced versions of phytocannabinoids or endocannabinoids).
• Phytocannabinoids are cannabinoids that originate from nature and can be found in the cannabis plant. Phytocannabinoids can be isolated from plants to produce a highly purified extract. Phytocannabinoids may be obtained as either the neutral (decarboxylated form) or the carboxylic acid form depending on the method used to extract the cannabinoids from plant material. For example, it is known that heating the carboxylic acid form will cause most of the carboxylic acid form to decarboxylate into the neutral form. Phytocannabinoids can only be produced from plants, however versions of phytocannabinoids may be produced synthetically via chemical synthesis.
• Endocannabinoids are endogenous lipid-based retrograde neurotransmitters that bind to cannabinoid receptors, and cannabinoid receptor proteins that are expressed throughout the mammalian central nervous system (including the brain) and peripheral nervous system.
• the endocannabinoid system is involved in regulating a variety of physiological and cognitive processes including fertility, pregnancy, during pre- and postnatal development, appetite, pain- sensation, mood, and memory, and in mediating the pharmacological effects of cannabis.
• Synthetic cannabinoids are compounds that have a cannabinoid-like structure and are manufactured using chemical means rather than by the plant.
• Cannabidiol is a major cannabinoid constituent of Cannabis species, such as the hemp plant ( Cannabis sativa). Unlike other cannabinoids, such as THC, cannabidiol does not bind CB1 or CB2, or its binding to the receptors is negligible in terms of inducing a pharmacological effect. Thus, cannabidiol does not cause the central or peripheral nervous system effects mediated by the CB1 or CB2 receptors. CBD has little or no psychotropic (cannabimimetic) activity and its molecular structure and properties are substantially different from those of other cannabinoids.
• Cannabidiol administration has been the subject of research in an attempt to provide an alternative treatment for various diseases and disorders which may respond to such treatment.
• THC Tetrahydrocannabinol
• CB1 and CB2 receptors Tetrahydrocannabinol
• Synthetic THC or dronabinol is approved for the treatment of loss of appetite in AIDS patients and nausea and vomiting caused by cancer chemotherapy.
• CBD-type compounds Of the over 100 natural cannabinoids identified in Cannabis sativa, seven have been classified as CBD-type compounds, these cannabinoids have the same absolute configuration as CBD. These are: CBD, Cannabidiolic acid (CBDA), Cannabidivarin (CBDV), Cannabidivarin acid (CBDVA), Cannabidiol-C1 (CBD-C1), Cannabidiol-C4 (CBD-C4) and Cannabidiol monomethyl ether (CBDM).
• CBD Cannabidiolic acid
• CBDDV Cannabidivarin
• CBDVA Cannabidivarin acid
• CBD-C1 Cannabidiol-C1
• CBD-C4 Cannabidiol-C4
• CBDDM Cannabidiol monomethyl ether
• CBD Cannabidiolic acid
• CBDV Cannabidivarin
• CBD-C1 cannabidiorcol
• CBD-C1 also known as cannabidiorcol is a homolog of CBD, with the side-chain shortened by four methylene bridges. CBD-C1 occurs naturally in plants producing CBD but has not been shown to have any therapeutic effects.
• CBD-C4 also known as nor-cannabidiol is a homolog of CBD, with the side-chain shortened by one methylene bridge. CBD-C4 occurs naturally in plants producing CBD and prior to the present invention has not been shown to have any therapeutic effects.
• the present invention demonstrates data for the first time to indicate that the compound cannabidiol-C1 may have therapeutic benefit.
• CBD-C1 cannabidiol-C1 for use as a medicament.
• the CBD-C1 is in the form of a plant extract. More preferably the CBD-C1 is in the form of a highly purified extract of cannabis.
• the highly purified extract comprises at least 80% (w/w) CBD-C1 , more preferably the highly purified extract comprises at least 85% (w/w) CBD-C1, more preferably the highly purified extract comprises at least 90% (w/w), more preferably the highly purified extract comprises at least 95% (w/w) CBD-C1, more preferably still the highly purified extract comprises at least 98% (w/w) CBD-C1.
• the CBD-C1 is present as a synthetic compound.
• the dose of CBD-C1 is greater than 100 mg/kg/day. More preferably the dose of CBD-C1 is greater than 250 mg/kg/day. More preferably the dose of CBD-C1 is greater than 500 mg/kg/day. More preferably the dose of CBD-C1 is greater than 750 mg/kg/day. More preferably the dose of CBD-C1 is greater than 1000 mg/kg/day. More preferably the dose of CBD-C1 is greater than 1500 mg/kg/day.
• the dose of CBD-C1 is less than 100 mg/kg/day. More preferably the dose of CBD-C1 is less than 50 mg/kg/day. More preferably the dose of CBD-C1 is less than 20 mg/kg/day. More preferably the dose of CBD-C1 is less than 10 mg/kg/day. More preferably the dose of CBD-C1 is less than 5 mg/kg/day. More preferably the dose of CBD-C1 is less than 1 mg/kg/day. More preferably the dose of CBD-C1 is less than 0.5 mg/kg/day.
• composition for use as a medicament comprising cannabidiol-C1 (CBD-C1), and one or more pharmaceutically acceptable excipients.
• a cannabidiol-C1 for use in the treatment of epilepsy.
• the epilepsy is treated in a mammal. More preferably the mammal is a human. Alternatively, the mammal is a dog.
• Figure 1 shows the evaluation of CBD-C1 in the MEST test in the mouse as described in Example 2.
• FIG. 1 shows the effect of CBD-C1 on the electroshock-induced generalised seizure threshold (MEST) in the mouse as described in Example 3.
• EXAMPLE 1 SYNTHETIC PRODUCTION METHOD FOR CANNABIDIOL-C1 (CBD-C1)
• CBD-C1 is produced as a minor cannabinoid in the cannabis plant.
• the amount of CBD-C1 which remains in the extract is not more than 0.15% (w/w).
• the synthetic pathway described below details a methodology that can be used in order to produce the cannabinoid CBD-C1 in larger quantities.
• EXAMPLE 2 EVALUATION OF CANNABIDIOL-C1 (CBD-C1) FOR ANTICONVULSANT ACTIVITY USING THE MAXIMAL ELECTROSHOCK SEIZURE THRESHOLD (MEST) TEST IN THE MOUSE
• the efficacy of CBD-C1 was tested in a mouse model of seizure, the maximal electroshock seizure threshold (MEST) test.
• MEST maximal electroshock seizure threshold
• the maximal electroshock seizure threshold (MEST) test is widely utilized preclinically to evaluate pro- and anti-convulsant properties of molecules (Loscher et al., 1991).
• mice were acclimatised to the procedure room in their home cages, with food and water available ad libitum.
• the vehicle (10ml/kg i.p. 60 min pre-treatment time) was 1:1:18 vehicle 5% ethanol, 5% kolliphor EL, 90% saline.
• the test compound, CBD-C1 was administered at doses of 20, 100 and 200mg/kg given at 10ml/kg i.p. 60min pre-treatment time.
• the positive control diazepam was used at 2.5mg/kg (10ml/kg i.p. 30min pre treatment time)
• mice were individually assessed for the production of a tonic hind limb extensor seizure using a Hugo Sachs Electronik stimulator, which delivered an adjustable constant current (1-300 mA) of 0.1 s duration via corneal electrodes.
• the stimulus intensity was varied by an ‘up and down’ method of shock titration.
• the first mouse within a treatment group was given a shock at the expected or estimated seizure threshold (CC5 0 ) current, that is, the current producing tonic hind limb extensor seizure in 50% of animals.
• the stimulus intensity was lowered or raised in 2mA intervals if the preceding mouse did or did not show tonic hind limb extension, respectively.
• Induction of seizure is measured as an all-or-nothing effect scored as either present (+) or absent (0) for each animal.
• the CC5 0 value was 33.5mA. This result was statistically significant (p ⁇ 0.01) compared to the vehicle control.
• the lower dose of 20 mg/kg CBD-C1 produced a statistically significant CC50 value compared to vehicle.
• mice treated with the higher doses of CBD-C1 there was a very large (>225%) difference from vehicle and as such the significance value could not be calculated. However, the effect seen should be considered to be of therapeutic benefit.
• EXAMPLE 3 EVALUATION OF CANNABIDIOL-C1 (CBD-C1) FOR ANTICONVULSANT ACTIVITY USING THE MAXIMAL ELECTROSHOCK SEIZURE THRESHOLD (MEST) TEST IN THE MOUSE
• mice were acclimatised to the procedure room in their home cages for up to 7 days, with food and water available ad libitum.
• All animals were weighed at the beginning of the study and randomly assigned to treatment groups based on a mean distribution of body weight across groups. All animals were dosed at 10 mL/kg via intraperitoneal (i.p) injection, with either vehicle, CBD-C1 at 50, 100 or 150 mg/kg, diazepam at 2.5 mg/kg or sodium valproate at 250 mg/kg.
• i.p intraperitoneal
• the first animal within a treatment group was given a shock at the expected or estimated CC50 current.
• the current was lowered or raised depending on the convulsions outcome from the preceding animal.
• Vehicle (5% ethanol, 5% solutol, 90% Saline) was prepared as follows: 2 ml_ of ethanol, 2 ml_ of solutol were warmed to 60°C, in 36 L of saline (1:1:18).
• the test compound, CBD-C1 was prepared according to the method described in Example 1. CBD-C1 was administered at 50, 100 and 150 mg/kg (i.p.) in a 1:1:18 ethanol:solutol:0.9% saline formulation.
• Each animal was humanely killed immediately after production of a convulsion by destruction of the brain from striking the cranium, followed by the confirmation of permanent cessation of the circulation from decapitation under The Humane Killing of Animals under Schedule 1 to the Animals (Scientific Procedures) Act 1986. Terminal blood and brain collection were performed following decapitation.
• CBD-C1 effects were also calculated as percentage change in CC50 from the vehicle control group.
• the CC50 value was calculated to be 22.3mA.
• CBD-C1 treatment groups administered i.p. 15 minutes before the test, the doses of 50 and 100 mg/kg CBD-C1 produced a statistically significant CC50 value compared to vehicle.
• CBD-C1 tested at 150 mg/kg produced a CCso > 255; an exact value was not calculated as a “+” tonic hindlimb convulsion was not seen within the 12 animals tested.
• CCso was not determined and statistical significance was not achieved, 150 mg/kg showed a clear increase in seizure threshold in the MEST.
• CBD-C1 produced a dose-related increase in MEST, which provides evidence that this compound exhibits anticonvulsive properties. Significant effects were observed at 50 and 100 g/kg, when compared to vehicle.

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