WO2021127438A1

WO2021127438A1 - Composition and method for treating dermatological disorders using retinamides

Info

Publication number: WO2021127438A1
Application number: PCT/US2020/066015
Authority: WO
Inventors: Vincent C.O. Njar; Senthilmurugan RAMALINGAM; Lalji K. Gediya; Hannah W. MBATIA; Vidya P. RAMAMURTHY
Original assignee: University Of Maryland, Baltimore
Priority date: 2019-12-19
Filing date: 2020-12-18
Publication date: 2021-06-24
Also published as: IL293872A; US20230114498A1; EP4076668A4; CN115087487A; EP4076668A1; JP2023507119A

Abstract

Novel retinamides with unique properties and biological activities, including inhibition of retinoic acid metabolism and modulation of Mnk1/2-eIF4E and androgen receptor (AR) signaling pathways, are synthesized and developed. The novel retinamides are capable of effecting treatment of a variety of dermatological conditions while limiting adverse side effects.

Description

COMPOSITION AND METHOD FOR TREATING DERMATOLOGICAL DISORDERS USING RETINAMIDES

STATEMENT OF FEDERALLY SPONSORED RESEARCH AND DEVELOPMENT

This invention was made with government support under CA129379 awarded by the National Institutes of Health. The government has certain rights in the invention.

TECHNICAL FIELD

The present disclosure generally relates at least to the fields of medicine, molecular biology, and dermatology therapeutics. In particular, the disclosure relates to the treatment of various dermatological conditions using novel agents.

BACKGROUND

There continues to be the need for highly effective therapeutic agents for treating dermatological disorders, such as acne, eczema, psoriasis, ichthyosis, cold sores, wounds, burns, sunburns (photoaging) and skin cancers, that have no or limited side effects. The present inventors have discovered novel retinamides with unique properties and biological activities, including inhibition of retinoic acid metabolism and modulation of Mnkl/2-eIF4E and androgen receptor (AR) signaling pathways, that are capable of effecting treatment of a variety of dermatological diseases while limiting adverse side effects.

BRIEF SUMMARY OF INVENTION

The present disclosure provides a method of treating a dermatological condition. The method may comprise administering a pharmaceutical composition comprising a therapeutically effective amount of a first compound having the following General Formula 1 A:

In some embodiments, R¹ in General Formula 1 A may be an azole group, a sulfur- containing group, an oxygen-containing group, a nitrogen-containing group, a pyridyl group, an ethinyl group, a cyclopropyl-amine group, an ester group, a cyano group, a heteroaryl ring, or an

1 //-midazole group, or R¹ forms, together with the C-4 carbon atom, an oxime, an oxirane or aziridine group. In some embodiments, R³ in General Formula 1 A may be independent from R¹, and is a halogen group, a cyano group, a thiol group, or an alkyl group substituted with at least one of a halogen group, a cyano group, and a thiol group. In some embodiments, n in General Formula 1 A may be an integer from 0 to 5.

In some embodiments, R¹ in General Formula 1 A may be an azole group.

In some embodiments, the first compound has the following General Formula 1A’:

In some embodiments, R³ in General Formula 1 A’ may be a halogen group, a cyano group, a thiol group, or an alkyl group substituted with at least one of a halogen group, a cyano group, and a thiol group. In some embodiments, n in General Formula 1 A’ may be an integer from 0 to 5.

In some embodiments, R³ in General Formula 1 A’ may be a halogen group, and n may be an integer from 1 to 5.

In some embodiments, the first compound may be Compound VNLG-152 having the following formula:

In some embodiments, the dermatological condition may be one selected from the group consisting of acne, eczema, psoriasis, ichthyosis, cold sores, wounds, burns, sunburns, and skin cancers. In some embodiments, the dermatological condition may be acne.

In some embodiments, the pharmaceutical composition may be administered topically or orally.

In some embodiments, the pharmaceutical composition may further comprise at least one of all-/ra//.s-retinoic acid, 13-cA-retinoic acid, and 9-cA-retinoic acid. In some embodiments, the pharmaceutical composition further comprises a second compound having the following General Formula 6:

In some embodiments, R in General Formula 6 may be a benzyl group or a heterocyclic group that is mono-, di-, or tri-substituted at either at the para, meta, or ortho position with OH, OMe, CN, CO2H, C02Me, SO2NRH; imidazole; or l//-tetrazole. In some embodiments, n in General Formula 6 may be an integer from 1 to 6.

In some embodiments, the second compound may be Compound VNHM-1-73 having the following formula:

The present disclosure also provides a method of treating a dermatological condition, the method comprising administering a pharmaceutical composition comprising a therapeutically effective amount of a compound having the following General Formula 7:

In some embodiments, R in General Formula 7 may be a heteroaryl group. In some embodiments, R’ in General Formula 7 may be a hydrogen, a halide, a hydroxyl group, an alkyl group, an ester group, an ether group, a benzyl group, a thio group, a Weinreb amide group, or a heterocyclic group. In some embodiments, n in General Formula 7 may be an integer from 0 to 6.

In some embodiments, the compound may have the following General Formula 6:

In some embodiments, R may contain at least one -OH group.

In some embodiments, the compound may be Compound VNHM-1-73 having the following formula:

In some embodiments, the pharmaceutical composition may further comprise at least one of all-/ra//.s-retinoic acid, 13-67.v-retinoic acid, and 9-67.v-retinoic acid.

In some embodiments, the pharmaceutical composition may further comprise Compound VNLG-152 having the following formula:

BRIEF DESCRIPTIONS OF DRAWINGS

The subject matter that is regarded as the invention is particularly pointed out and distinctly claimed in the claims at the conclusion of the specification. The objects, features, and advantages of the present disclosure are apparent from the following detailed description taken in conjunction with the accompanying drawings in which:

FIGS. 1A and IB show the growth inhibitory effects of retinamides according to the present disclosure and other retinoids in dermatologic human cell lines in vitro. FIG. 1A shows the growth inhibitory effects in adult normal human keratinocytes (NHAKs). FIG. IB shows the growth inhibitory effects in SEB-1 human primary sebocytes.

FIGS. 2A and 2B show the anti-proliferative effects of all-/ra//.s-retinoic acid (ATRA) or 13-67.s-retinoic acid (13-CRA), alone or in combination with low dose of a retinamide according to the present disclosure (namely, VNLG-152), on adult normal human keratinocytes (NHAKs). FIG. 2A shows the effects as dose-response curves. FIG. 2B shows the effects as fold GEo enhancements.

FIGS. 3A to 3C compare the apoptosis inducing potential of a retinamide according to the present disclosure (namely, VNLG-152) with that of ATRA and 13-CRA in keratinocytes. FIGS. 3A and 3B show acridine orange/ethidium bromide (AO/EB) dual staining images. FIG. 3C shows quantification of the number of apoptotic cells, the data being relative to vehicle treated control.

FIGS. 4A and 4B compare, via TUNEL assay, the apoptosis inducing potential of a retinamide according to the present disclosure (namely, VNLG-152) with that of ATRA and 13- CRA in keratinocytes. FIG. 4A shows images of increased TUNEL positive staining cells of control, 13-CRA, ATRA, and VNLG-152 treatments of adult normal human keratinocytes (NHAKs) at 72 hours. FIG. 4B shows quantification of the number of apoptotic cells, the data being relative to vehicle treated control.

FIGS. 5A to 5E show a morphological comparison of reconstructed human epidermis (RHE) tissues treated topically with formulations containing various retinoids and a retinamide according to the present disclosure (namely, VNLG-152). RHE tissues were untreated (FIG. 5A) or treated with vehicle (ethanol) (FIG. 5B), ATRA 0.02% solution (FIG. 5C), 13-CRA 0.02% (FIG. 5D); and VNLG-152 0.02% (FIG. 5E).

FIG. 6A and 6B show keratin 10 (K10), keratin 19 (K19) and filaggrin expressions in RHE cultures treated topically with various agents. RHE tissues were untreated (FIG. 6A) or treated with vehicle alone and treated with VNLG-152, ATRA or 13-CRA (FIG. 6B). PET ATT, ED DESCRIPTION

Dermatological disorders are characterized by hyperkeratinization and desquamation and include diseases such as acne, eczema, psoriasis, ichthyosis, cold sores, wounds, burns, sunburns (photoaging), and skin cancers,^21,72 all of which are plausible targets for the multitarget novel retinamides therapy according to the present disclosure.

Acne vulgaris , or more commonly, acne, is a skin disorder initiated by sebaceous gland hyperactivity and hyperseborrhea, abnormal hyperproliferation of ductal keratinocytes and keratinization of the acroinfundibular epithelium of the sebaceous follicle and inflammatory signaling giving rise to microcomedones.¹ It is the most prevalent skin disease, affecting 40-50 million individuals of all races and ethnicities in the United States.^2,3 The pathogenesis of acne is multifactorial and originates at the pilosebaceous unit (PSU), which consists of sebaceous glands, an epithelial-lined follicular canal, and a hair.⁴ It involves the interplay of four main factors: excess sebum production, disturbed keratinization within the follicle, colonization of the pilosebaceous duct by the oxygen-tolerant, anaerobic bacterium Propionibacterium acnes (P. acnes ), and the release of inflammatory mediators into the skin. Although individual acne lesions spontaneously regress, persistent cases of acne often require pharmacological intervention.⁴

Psoriasis is a common, chronic inflammatory skin disease that affects 2-3% of the population and is associated with a reduced quality of life and a shortened life expectancy due to the association with the metabolic syndrome and cardiovascular pathologies.^73,74 Although modern biologies targeting different inflammatory mediators show promising therapeutic success, comprehensive knowledge about the molecular events in psoriatic keratinocytes that contribute to the pathogenesis and could serve as therapeutic targets is still scarce.^75,76 However, recent efforts to understand the deregulated signal transduction pathways have led to the development of small molecule inhibitors, including, for example, tofacitinib targeting the Jak/Stat cascade that opens additional therapeutic options. Recently, the PI3-K/Akt/mTOR signaling pathway has emerged as an important player in the control of epidermal homeostasis.⁷⁷

Atopic dermatitis (AD), also called eczema, is a chronically relapsing inflammatory skin disease. It is prevalent in approximately 10.7% and 7.2% of children and adults, respectively, in the United States.^78,79 The onset of AD is usually in early childhood, and it can have an impact on the entire family unit. Additionally, AD is increasingly recognized as a disease that often persists into or begins in adulthood.⁸⁰ Thus, AD can have a detrimental effect on the lives of patients and their families throughout the lifespan.⁸¹ AD requires a manifold approach to therapy. The goal of therapy is to restore the function of the epidermal barrier and to reduce skin inflammation. This can be achieved with skin moisturization and topical anti-inflammatory agents, such as topical corticosteroids and calcineurin inhibitors. Furthermore, proactive therapy with twice weekly use of both topical corticosteroids and calcineurin inhibitors in previously affected areas has been found to reduce the time to the next eczematous flare.⁸² Adjunctive treatment options include wet wrap therapy, anti-histamines, and vitamin D supplementation.⁸²

Ichthyoses comprise a large heterogenous group of inherited skin disorders resulting from abnormality of the keratinization process.^83,84 Lamellar ichthyosis (LI), a member of the nonsyndromic autosomal recessive congenital ichthyosis group of ichthyoses, has an incidence of 1 ~ 250,000 live births.^{84 86} Patients with LI typically have severe generalized hyperkeratosis and dry scaly skin across the entire body, and the disorder is associated with decreased quality of life (QoL).^87,88 Treatment options for LI include mechanical scale removal, hydrating and lubricating creams or ointments and topical keratolytic drugs such as oral retinoids, and most recently, liarozole, a retinoic acid metabolism blocking agent (RAMBA).⁸⁹

Skin Cancers comprise three principal types, including, squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and melanoma.^90,91 These skin cancers are dangerous therapy- resistance cancers, while melanoma and SCC tend to aggressively metastasize. Although a host of therapeutic interventions have been attempted to treat these cancers, none is satisfactory. Thus, there is a pressing need for new strategies. There is compelling evidence that supports the role of human eukaryotic translation initiation factor 4E (eIF4E; and by implication, Mnkl/2, which is the only know in vivo kinases of eIF4E) in skin cancer development, progression and therapy resistance.^{92 94}

Other dermatological diseases, such as cold sores, wounds, burns, and sunburns (photoaging) are commonly driven by inflammations, which are modulated by cellular levels of cytokines, retinoids, and androgens.

Retinoids are a group of natural and synthetic analogues of vitamin A. They comprise a family of polyisoprenoid compounds, and are currently the subject of intense biological interest prompted by the discovery and characterization of retinoid receptor and the realization of these compounds as nonsteroidal small-molecule hormones.⁵ Since retinoids are capable of inhibiting growth, inducing terminal differentiation and apoptosis in cultured cancer cell lines, there is a wide interest in their use in not only cancer therapy, but also in treatments for dermatological diseases.¹⁴

Retinoids have been used to treat hyperproliferative skin disorders, particularly acne.^6,7 When used in pharmacotherapy of acne, retinoids help normalize the disturbed differentiation and hyperproliferation of the follicular epithelium, thereby preventing the formation of microcomedones and decreasing the formation of both inflammatory and non-inflammatory acne lesions. By normalizing differentiation and desquamation, topically administered retinoids also facilitate the entry of other topically applied agents such as antibiotics and benzoyl peroxide (BPO) into the deeper parts of the pilosebaceous unit. Retinoids are also effective for the treatment of post-inflammatory hyperpigmentation which is particularly important for acne patients from darker racial ethnic groups.⁸’^{9 10 11}

All-/ra//.s-retinoic acid (ATRA) is biologically the most active metabolite of vitamin A, and plays a major role in the regulation of gene expression, cellular differentiation, and proliferation of epithelia cells.¹² ATRA has been used in the treatment of dermatological diseases, including acne, psoriasis, and ichthyosis.¹³ Retinoids, and particularly, ATRA and synthetic retinoids, potentiate anti-dermatological effects in dermatologic cells via modulation of sebum production. 9-cA-retinoic acid (9-CRA) and 13-cA-retinoic acid (13-CRA, isotretinoin) are two natural isomers of ATRA. The two isomers have demonstrated efficacy in treating hyperproliferative skin disorders, and in particular, 13-CRA has secured effective treatment of acne.¹⁵ The anti-proliferative effect of isotretinoin on sebocytes is manifested through its isomerization into ATRA and binding to nuclear retinoic acid receptors.^{16 17} The therapeutic effects of these retinoids are, however, limited. It has been suggested that the therapeutic effects of ATRA are undermined by its rapid in vivo metabolism and catabolism by cytochrome P450 enzymes.¹⁸ To prevent in vivo catabolism of ATRA, the inhibition of the P450 enzymes responsible for this process has been proposed. This seems to be an emerging approach that may yield effective agents for chemoprevention and/or treatment of cancers and dermatological diseases.^19,20 A family of compounds known as retinoic acid metabolism blocking agents (RAMBAs) inhibit enzymes responsible for ATRA metabolism.

RAMBAs have demonstrated the ability to enhance the anti-proliferative effects of ATRA in breast and prostate cancer cells in vitro ²¹ In addition, RAMBAs have been shown to induce differentiation and apoptosis in those cancer cell lines. The present inventors have observed that breast cancer cell lines were exquisitely more sensitive to RAMBAs.^21,22 By introduction of nucleophilic ligand at C-4 of ATRA or 13-CRA, and modification of the terminal carboxylic acid group, the present inventors invented a series of novel retinamides that are potent RAMBAs, some of which are by far the most potent retinoic acid metabolism inhibitors known. For example, the present inventors have designed, developed, and synthesized novel C-4 azolyl retinamides based on ATRA scaffold (see, for example, U.S. Patent Nos. 7,265,143 and 9,156,792, the entire content of each of which is hereby incorporated by reference), and novel 13-C/.S-RAMBA retinamides (see, for example, U.S. Patent Publication No. 2019/0002411, the entire content of which is hereby incorporated by reference).

The present inventors have demonstrated that the RAMB As, and in particular, the C-4 azolyl retinamides, inhibit the growth of several breast and prostate cancer cell lines and could exquisitely enhance the ATRA-mediated anti-proliferative activity in vitro and in vivo.^23,24’²⁵ The C-4 azolyl retinamides induced apoptosis, potently inhibited the growth, migration and invasion of a variety of human breast and prostate cancer cell lines. The present inventors have shown that an exemplary C-4 azolyl retinamide — VN/14-1 — binds and activates the RARa,P,y receptors, even though it is significantly less potent than ATRA. Furthermore, none of the RAMB As show significant binding to either cellular retinoic binding proteins (CRABP I or II).²⁵ The present inventors have also demonstrated that some RAMB As inhibit the growth of established breast and prostate tumor xenografts and that their mechanisms of action may in part be due to induction of differentiation, apoptosis, and cell cycle arrest.^23,24’²⁵’²⁶ Some of the present inventors’ proprietary RAMB As appear to be the most potent ATRA metabolism inhibitors known.²¹ Some of these proprietary RAMB As also exhibit retinoidal and cell anti-proliferative activities in a number of human cancer cell lines.

With respect to the breast cancer cell lines, the present inventors have demonstrated that the anti -breast cancer activity of the retinamides was due mainly to degradation of MAPK- interacting kinases 1 and 2 (Mnkl/2) with subsequent suppression of phosphorylated eukaryotic translation initiation factor 4E (peIF4E).²⁷ However, in the prostate cancer cell lines, the present inventors have demonstrated that the anti-tumor activity of the retinamides was due to simultaneous inhibition of the Mnk/eIF4E and androgen receptor (AR) signaling pathways.²⁸

Disruption and/or perturbation of cap-dependent translation is essential for the development of cancers and many fibrotic diseases, the most notable being Alzheimer’s disease.²⁹ Hyper-activation of eIF4E, the mRNA 5' cap-binding protein of cap-dependent translation promotes exquisite transcript-specific translation of key mRNAs that are indispensable in cancer initiation, progression and metastases.³⁰ The oncogenic potential of eIF4E is dependent on serine 209 phosphorylation by Mnkl/2.

The present inventors have demonstrated that the 13-67.s-R.AMBA retinamides cause oxidative down-regulation of mitogen activated protein kinase interacting proteins (MNK1/2), block phosphorylation of eIF4E, induce apoptosis, inhibit cell growth and migration and invasion of triple negative and Her-2 overexpressing human breast cancer cells and tumor xenografts. These novel retinamides are agents for the prevention and treatment of all forms of breast and prostate cancers and other diseases which depend on functional Mnkl/2. These retinamides target Mnkl/2 degradation in both breast cancer and prostate cancer cells and also induce AR degradation in PC cells, which in turn led to induction of apoptosis, cell cycle arrest, inhibition of cell growth, colonization, migration, and invasion.

In most recent studies, the present inventors have demonstrated that the retinamide VNLG-152 inhibits f-AR/AR-V7 and Mnk-eIF4E signaling pathways to suppress EMT and castration-resistant prostate cancer xenograft growth. The also demonstrated that VNLG-152 potently inhibits triple negative breast cancer (TNBC) tumor growth and metastasis.

However, these studies do not address the use of the RAMB A retinamides to treat dermatological diseases. Further, even though the use of retinoids in the treatment of dermatological diseases has met with relatively satisfactory outcomes, side effects limit the chronic use of retinoids.⁴ The need remains for highly effective therapeutic agents for treating dermatological disorders such as psoriasis, acne, atopic dermatitis (eczema), ichthyosis, skin cancers, and skin aging, with no or limited side effects

The present inventors have developed a method of treating dermatological conditions using novel retinamides that work by blocking the intracellular metabolism of ATRA in cells.^21,24,25 The inhibition of ATRA metabolism results in increased intracellular ATRA, providing the same therapeutic benefits of retinoid therapy, but potentially with less risk of adverse side effects. One advantage of the novel retinamides according to the present disclosure over retinoids is believed to be the reduction or absence of birth defects.

The second potential advantage of the novel retinamides according to the present disclosure is their ability to also modulate intracellular androgen transactivation via induction of androgen receptor (AR) degradation.²⁸ Most dermatologic diseases, such as acne, psoriasis and ichthyosis are cause by interaction between hormones, skin oils, and bacteria which cause inflammation of sebaceous glands. Sebaceous glands are stimulated by increased hormone levels, especially, the androgens which are known to cause excessive sebum production and intracellular levels. The novel retinamides according to the present disclosure, by virtue of their ability to degrade AR act on the major cause of dermatological diseases to directly reduce the high levels of AR in the sebaceous glands, with concomitant lowering of sebum secretion.

The third potential advantage of the novel retinamides according to the present disclosure is their ability to induce degradation of MAPK (mitogen activated protein kinase) interacting kinases 1 and 2 (Mnk 1 and 2) with concomitant suppression of phosphorylation of eukaryotic initiation factor 4E (eIF4E).^27,28 These retinamides are agents for the prevention and treatment of all forms of breast and prostate cancers and other diseases that depend on functional Mnkl/2. Phosphorylation of eIF4E is implicated in the pathogenesis of psoriasis and is associated with increased release of pro-inflammatory cytokines from keratinocytes.

The fourth potential advantage of the novel retinamides according to the present disclosure is their ability to inhibit the signaling pathway involved in certain skin cancers. The PI3K/Akt/mTOR (phosphoinositide 3 -kinase/protein kinase B / mechanistic target of rapamycin) pathway is an enzymatic cascade leading to cellular growth, proliferation, and survival. The main signal propagates along the path: PI3K Akt mTOR. Some skin cancers, including several forms of melanomas, have alterations at some point within this pathway. The PI3-K/Akt/mTOR signaling pathway has also emerged as an important player in the control of epidermal homeostasis.⁷⁷ The present inventors discovered that the novel retinamides according to the present disclosure possesses the biological activity of inhibiting mTOR Complexl (mTORCl) signaling. For example, the present inventors discovered that compound VNLG-152 according to the present disclosure potently inhibits mTORCl/4E-BPl/p70SK6 signaling.⁹⁵

The wide-ranging biological activities of the retinamides of the present disclosure make them ideal candidates for the treatment of dermatological conditions, including acne, eczema, psoriasis, ichthyosis, cold sores, wounds, bums, sunburns (photoaging), and skin cancers

C-4 azolyl retinamide

The present inventors designed and synthesized C-4 azolyl retinamides for treating dermatological conditions. The C-4 azolyl retinamides are as described in U.S. Patent Nos. 7,265,143 and 9,156,792, the entire content of each of which is hereby incorporated by reference.

In one embodiment of the present disclosure, the RAMBAs are without the phenolic hydroxyl group as shown in some of the RAMBAs of U.S. Patent No. 7,265,143. Acylation presents a likely avenue for metabolic instability. 4-methoxyphenylretinamide has previously been identified as a major inactive metabolite of the closely related 4-hydroxyphenyl retinamide (4-HPR) in several animal and human studies¹.³¹

In one embodiment of the present disclosure, the strategy for the RAMBAs is to replace the phenol moiety with a more metabolically stable functionality, with a goal of modulating the physical properties of these analogs without affecting the enzyme and anti-proliferative potencies already achieved by the RAMBAs of U.S. Patent No. 7,265,143, for example, VN/66-1.

The RAMBAs for treating dermatological conditions include enantiomers of the novel RAMBAs of the present disclosure (structural formulae 1 A, 2A, 2B, 3B, 3C and 4) and enantiomers of certain RAMBAs of U.S. Patent 7,265,143.

Anilineamide RAMBAs The phenolic hydroxyl moiety may be replaced with its classical isosteres, for example, halogens such as F and Cl, or non-classical bioisosteres, for example, -CF3, -CN, and -SH².³²

General Formula 1 A represents new anilineamide RAMBAs according to an embodiment of the present disclosure:

In General Formula 1A, R¹ is an azole group, a sulfur containing group, an oxygen containing group, a nitrogen containing group, a pyridyl group, an ethinyl group, a cyclopropyl amine group, an ester group, a cyano group, a heteroaryl ring or an lH-midazole group, or R¹ forms, together with the C-4 carbon atom, an oxime, an oxirane or aziridine group.

Each R³ is independent from R¹, and is selected from a halogen group, a cyano group, a thiol group, or an alkyl group substituted with at least one of a halogen group, a cyano group, and a thiol group.

The n is from 0 to 5.

Non-limiting examples of sulfur containing groups include thiirane, thiol and alkylthiol derivatives. Examples of such alkylthiol derivatives include Ci to C10 alkyl thiols.

Non-limiting examples of oxygen containing groups include -OR4, where R4 is hydrogen or an alkyl group (preferably, a 1-10 carbon alkyl, more preferably, methyl or ethyl), cyclopropylether or an oxygen containing group that forms, together with the 4-position carbon, an oxirane group.

Non-limiting examples of nitrogen containing groups include the formula -NR5R6, where R5 and R6 are independently selected from the group consisting of hydrogen and alkyl groups (preferably, a 1-10 carbon alkyl, more preferably, methyl or ethyl), or Rs and R6 may together form a ring. Preferably, the ring formed by Rs and R6 is an imidazolyl ring or a triazole ring.

Azole substituent groups may be imidazoles and triazoles, including attachment through a nitrogen ring atom. The azole substituent groups may be lH-imidazole-l-yl, lH-l,2,4-triazol-l- yl and 4H-l,2,4-triazol-l-yl. R¹ may be cyano, amino, azido, cyclopropylamino, or R¹ may be a nitrogen containing group that forms, together with the 4-position carbon, an aziridine group or an oxime group.

R¹ may also be a pyridyl group or an allylic azole group, preferably methyleneazolyl.

R¹ may also be an ester group. The definitions for R1 of an ester include substituent groups that contain an ester moiety, including substituent groups attached via an ester moiety.

Non-limiting examples of the alkyl group include linear and branched alkyl groups, including primary, secondary and tertiary alkyl groups, and substituted and unsubstituted alkyl groups.

The R³ substituent groups may be F, -CN, -SH and -CF3.

An example of General Formula 1A is General Formula 1A’:

[General Formula 1A’]

In General Formula 1A’, R³ and n are as defined for General Formula 1A.

Exemplary compounds of General Formula 1 A are Compounds VNLG-146, VNLG-153, and Compounds 1 to 30, shown below:

[Compound 3]

[Compound 8]

[Compound 17]

[Compound 20]

[Compound 21]

[Compound 24]

[Compound 30]

Scheme 1 and Scheme 2 below are examples of the syntheses of the anilineamide RAMBAs. The examples involve the coupling of the imidazolyl carboxylic acid (VN/14-1) with various amines (for example, anilines) using 1,3-dicyclohexylcarbodiimide (DCC) and 1- hydroxybenzotriazole (HOBT) in dimethylformamide (DMF) to yield the corresponding amides. This synthesis has been used for synthesis of VNLG-145, VNLG-146, VNLG-147, VNLG-148, VNLG-152, and VNLG-153 and VN-66-1.

Scheme 1

Sulfamoylated and Carbamate RAMBAs

The RAMBAs according to the present disclosure include blocking metabolic conjugation of the phenolic -OH group of the RAMBAs of U.S. Patent No. 7,265,143 by conversion to a corresponding sulfamate and carbamate. This strategy has been successfully used to improve the antiproliferative activity and metabolic stability of 2-methoxyestradiol, ^{33,34,35,36 3-6} as well as several dual aromatase-steroid sulfatase inhibitors, some of which have been tested in phase I clinical trials^7,8.^37,38

The RAMBAs according to the present disclosure include sulfamoylated and carbamate RAMBAs represented by General Formulae 2A and 2B:

[General Formula 2 A]

In General Formula 2A, R¹ has the same definitions as set forth for General Formula 2A above. Each R² is independent and is a hydrogen or an alkyl group. Non-limiting examples of the alkyl group include linear and branched alkyl groups, including primary, secondary and tertiary alkyl groups, and substituted and unsubstituted alkyl groups.

[General Formula 2B]

In General Formula 2B, R¹ and R² have the same definitions as set forth for General Formula 2 A above.

Non-limiting examples of General Formulae 2 A and 2B include General Formulae 2A’, 2B\ 2 A” and 2B” below:

[General Formula 2A’]

[General Formula 2B”]

In General Formulae 2A’, 2B’, 2A” and 2B”, R¹ and R² have the same definitions as set forth for General Formula 2 A above.

Non-limiting examples of General Formulae 2A and 2B include Compounds 31 and 32 below:

Scheme 3 below shows an example of the synthesis of Compounds 31 and 32. VN-66-1 may be sulfamoylated under standard conditions,^34,35 with sulfomoyl chloride in dimethyl acetamide to give Compound 31. The carbamate (Compound 32) may be synthesized in two steps from VN/66-1, first reacted with trichloroacetyl isocyanate to give the N-trichloroacetyl carbamate, followed by hydrolysis with K2CO3 in MeOH/THF/ThO) to give Compound 32. N,N-dialkyl derivatives of Compounds 31 and 32 may be synthesized by reaction with appropriate alkyl halides under basic conditions.³⁵

Scheme 3: Synthesis of Compounds 34 and 35

Heterocyclic Amide RAMBAs

The RAMBAs according to the present disclosure include heterocyclic amine-containing RAMBAs represented by General Formulae 3B and 3C:

In General Formula 3B, R¹ has the same definitions as set forth for General Formula 1 A above. Each R⁵ is independently selected from a hydrogen atom, an alkyl group, and a ring containing a nitrogen atom.

Non-limiting examples of the ring containing a nitrogen atom include monocyclic and multicyclic rings, which consist of carbon atoms and one or more nitrogen atoms. The rings may also include other heterocyclic atoms, such as O, S and Si. The rings may be substituted or unsubstituted. Non-limiting examples of the ring containing a nitrogen atom include an amine group, an azine group, a triazine group, an azirene group, an azete group, an diazetidine group, an azole group, a triazole group, a tetrazole group, an imidazole group, an azocane group, a pyridine group, piperidine group, benzimidazole group, and purine groups. The ring containing a nitrogen atom may be substituted or unsubstituted and may be fused with another ring. The ring containing a nitrogen atom may be attached to the nitrogen atom via a carbon group or via a nitrogen group of the ring.

Non-limiting examples of the ring containing a nitrogen atom include 2,3,4 triazoles, 1,3 imidazoles, and 2, 3, 4, 5 tetrazole.

Non-limiting examples of the alkyl group include linear and branched alkyl groups, including primary, secondary and tertiary alkyl groups, and substituted and unsubstituted alkyl groups. A non-limiting example is a tertiary butyl group.

[General Formula 3C]

In General Formula 3C, R¹ has the same definitions as set forth for General Formula 1 A above. X forms, together with the nitrogen atom, a heterocyclic ring. The heterocyclic ring may be substituted or unsubstituted and may be fused with another ring.

Non-limiting examples of the ring formed by X include monocyclic and multicyclic rings, which consist of carbon atoms and one or more nitrogen atoms. The rings may also include other heterocyclic atoms, such as O, S and Si. The rings may be substituted or unsubstituted. Non limiting examples of the ring formed by X atom include an amine group, an azine group, a triazine group, an azirene group, an azete group, an diazetidine group, an azole group, a triazole group, a tetrazole group, an imidazole group, an azocane group, a pyridine group, piperidine group, benzimidazole group, and purine groups. The fused ring may contain all ring carbon atoms or be heterocyclic.

Non-limiting examples of a fused heterocyclic rings include a purine group.

Non-limiting examples of General Formulae 3B and 3C include General Formulae 3A, 3B’ and 3C’ below:

[General Formula 3A]

In General Formula 3A, R⁵ has the same definitions as set forth for R⁵ in General Formula 3B above.

[General Formula 3B’]

In General Formula 3B’, R⁵ and n have the same definitions as set forth for General

Formula 3B above.

[General Formula 3C’]

In General Formula 3C’, X has the same definitions as set forth for Formula 3C above. Non-limiting exemplary compounds of General Formulae 3B and 3C include

Compounds 33 to 45, VNLG-148, and VNLG-145 shown below:

[Compound 34]

[Compound 36C]

[Compound 38B]

[Compound 38C]

[Compound 40B]

[Compound 40C]

[Compound 42B]

[Compound 42D]

[Compound 43D]

[Compound 43E]

[Compound 44E]

[Compound 45D]

[Compound 45E] VNLG-145

[Compound VNLG-145]

VNLG-148

[Compound VNLG-148]

Synthetic purine derivatives possess great potential to interfere with important cellular functions⁹⁶⁷ and a number of major purine-based drugs exist which find current application for the treatment of cancer^{10 1168,69} and a variety of other diseases.⁷⁰ A further interesting pharmacological property of purine derivatives is that they can be transported across biological membranes by nucleobase active and passive transport systems, which have been characterized in a variety of mammalian cells.⁷¹

The heterocyclic and amide RAMBAs of the present disclosure may be synthesized as outlined in Scheme 4 below. Some reactions will involve the coupling of the imidazolyl carboxylic acid (VN-14-1) with various anilines using 1,3-dicyclohexylcarbodiimide (DCC) and 1-hydroxybenzotriazole (HOBT) in dimethylformamide (DMF) to yield the corresponding amides. While other compounds will involve formation (i.e., reactions with carbonyldiimidazole (CDI)) of imidazolide intermediates followed by coupling with appropriate amino heterocyles.³⁹ For synthesis of Compounds 42, 44, 46 and 48, the primary amino groups will first be protected with di-Zc/V-butyl dicarbonate (Bo O⁴⁰ prior to use for coupling reactions. The Boc groups will then be readily deprotected to give the desired compounds. With the recent availability of simple procedures for the synthesis of large numbers of substituted purines,⁴¹ purine related compounds may be synthesized.

Scheme 4

Non-4-Position-Hvdroxyl RAMBAs

The RAMBAs according to the present disclosure include RAMBA compounds where the hydroxyl group of ring C is not in the 4-position, for example, as represented by General Formula 4:

In General Formula 4, R¹ has the same definitions as set forth for General Formula 1A above.

A non-limiting example of General Formula 4 is VNLG-147 shown below:

VNLG-147 VNLG/147

The compounds of General Formula 4 may be made with synthesis methods similar to those for making VN-66-1.

In the above synthesis methods, the starting retinamide may be a racemate or a (+) or (-) enantiomer to obtain an enantiomer of the retinamides of the present disclosure.

The synthesized compounds (intermediates and final products) may be purified by chromatographic procedures (flash column chromatography, TLC or HPLC) and/or crystallization. The compounds may be fully characterized by spectroscopic methods (IR, UV, NMR and MS) and elemental analyses. The melting points of all compounds may be determined with a Fisher-Johns melting point apparatus.

Enantiomers

Embodiments of the present disclosure also include enantiomers of the RAMBAs according to the present disclosure, including (+)- or (-)- analogs of the RAMBAs. Embodiments of the present disclosure also include certain RAMBAs of U.S. Patent No. 7,265,143, including (+)- or (-)- and (±)-VN-66-l .

VN-66-1 exists as a racemate of two enantiomers as a result of chiral C-4 and studies have been conducted with racemic (±)-VN-66-l. Racemic (±)-VN-12-l (a potent RAMBA and also the methyl ester of (±)-VN-14-l) is considerably (up to 28-fold) more potent than either of the pure (4S)-(+)- or (4R)-(-)- VN-12-1 enantiomers.²⁴ However, the present inventors consider that the enantiomers may exhibit differential anti-neoplastic activities on PCa cell lines. It has been demonstrated from previous studies that the anti -neoplastic activities of the atypical RAMBAs, including (±)-VN-66-l are independent of their RAMBA activity.^{23,24,25,26,42,43,44}

To synthesize VN-66-1 enantiomers, one synthesis of enantiopure (4S)-(+)-VN-66-l and (4R)-(-)- VN-66-1 is outlined in Scheme 5 below, starting from racemic (4S,R)-(±)-4- hydroxymethylretinoate which will be readily synthesized from commercially available ATRA as previously described.^24,45 Next, the racemic allylic alcohol (1) is resolved to give the enantiopure alcohols 2 and 3.⁴⁶ The procedure involves the use of di acetyl -L-tartaric acid anhydride to precipitate the diastereoisomeric precursor (la) of (4S)-(+)-l and diacetyl-D-tartaric acid anhydride to precipitate the diastereoisomeric precursor (lb) of (R)-(-)-l followed by mild hydrolysis to give enantiopure alcohols (Scheme 5). Based on previous studies, it is expected that the terminal methyl ester group will be stable under the mild hydrolysis of the diastereoisomers.^24,45 These two alcohols are expected to have optical purity in the range 92 to 99%, which will be purified to 100% ee either by several recrystallizations or by HPLC using a Chiralcel OJ semipreparative column.⁴⁷ The enantiopure alcohols 2 and 3 will each be used to synthesize enantiopure (4 S)-(+)- VN-66-1 and (4R)-(-)-VN/66-l as previously described,^24,45 and will be characterized by HPLC, ¹H-NMR and optical rotation. It has been previously reported that conversion of the allylic alcohol to the corresponding imidazole via reaction with carbonyl diimidazole proceeds via SNi mechanism with retention of configuration⁴⁸ corroborated by earlier studies.⁴⁹

Scheme 5

Scheme 5: Synthesis of Enantiopure C-4 Alcohols and (4S)-(+)-VN66-1 and (4R)-(-)-VN/66-1

Several alternative procedures to enantiopure VN-66-1 and analogs are described below. There are several other methods to prepare chiral allylic alcohols such as asymmetric reductions^50,51’⁵² and enzymatic⁵³, as well as non-enzymatic⁵⁴ kinetic resolutions. Compounds (s)-2 and (R)-3 may be synthesized via enantioselective reduction of precursor 4-ketone using (R)- or (S)-2-methyl-CBS-oxazaborolidine and BH3.SMe2 as recently reported for closely related retinoids⁵⁰ (Scheme 6A). Another alternative method will be formation of amine salts⁵⁵ of (±)- VN/12-1 to form two diastereoisomers and subsequent separation by crystallization.

Another alternative method will be formation of amine salts⁵⁵ of (±)-VN-66-l to form two diastereoisomers and subsequent separation by crystallization.

The coupling of some amines may be difficult. The present inventors have developed alternative strategies of amide syntheses as outlined in Scheme 6B below. These procedures involve either key pyridylthioester intermediate⁵⁶ or solid phase synthesis that involves reaction of the carboxylic acid with an activating chlorinating reagent.⁵⁷

Schemes 6Aand 6B

Schemes 6A & B: Alternative Synthesis of Enantiopure Alcohols and Retinamides

-_N or (+) or (-)) (HCA = Hexachloroacetone)'

13-cis-RAMBA retinamides

The present inventors designed and synthesized 13-c/.s-RAMBA retinamides for treating dermatological conditions. The 13-67.s-R.AMBA retinamides are as described in U.S. Patent Publication No. 2019/0002411, the entire content of which is hereby incorporated by reference. Amide derivatives (Series A)

The 13-67.S-RAMBA retinamides according to the present disclosure include amide derivatives having the following General Formula 5:

[General Formula 5] In General Formula 5, the R group can be, for example, a benzyl group or a heterocyclic group that is mono-, di-, or tri-substituted at either at the para, meta, or ortho position with OH, OMe, CN, CO2H, C02Me, SO2NH2; imidazole, lH-tetrazole, pyridine and their derivatives. Non-limiting examples of amide derivatives are presented in TABLE 1:

Series B derivatives

The 13-67.s-retinamides according to the present disclosure include derivatives having the following General Formula 6:

[General Formula 6]

In General Formula 6, n can be, for example, any integer between 1 to 6. The R group can be, for example, a benzyl group or a heterocyclic group that is mono-, di-, or tri- substituted at either at the para, meta, or ortho position with OH, OMe, CN, CO2H, C02Me, SO2NRH; imidazole; or l//-tetrazole. Non-limiting examples of Series B derivatives are presented in

TABLE 2:

C4 (R) derivatives

The 13-67.s-retinamides according to the present disclosure include derivatives having the following General Formula 7:

[General Formula 7]

In General Formula 7, n can be, for example, 0 to 5. R can be, for example, an 1H- imidazole group, an azo group, an oxime, a benzoimidazole, an azole group, a sulfur containing group, an oxygen containing group, a nitrogen containing group, a pyridyl containing group, an ethylene group, a cyclopropyl-amine group, an ester, a cyano group, an oxirane, or an aziridine group linked with an amide group, an ester group, or an ether group. R’ can be, for example, an alkyl, an ester, an ether, a benzyl, a thio, a Weinreb amide, a heterocyclic, a halide, or a hydroxyl. Non-limiting examples of C4 (R) derivatives are presented in TABLE 3:

Thioamide derivatives ester and ether (Series D)

The 13-67.s-retinamides according to the present disclosure include amide derivatives having the following General Formula 8:

[General Formula 8]

In General Formula 8, the R group can be, for example, a benzyl group or a heterocyclic group that is mono-, di-, or tri-substituted at either at the para, meta, or ortho position with OH, OMe, CN, CO2H, C02Me, SO2NH2; imidazole, l//-tetrazole, alpha methyl benzyl, pyridine, and their derivatives; Weinreb amide, cyclic amides, and their derivatives. Non-limiting examples of thioamide derivatives, ester, and ether are presented in TABLE 4:

Rationale structural modifications of small molecules allow for their interactions with molecular target(s) in ways that could lead to improved drug-like compounds, and possibly enhanced in vivo pharmacokinetic profiles.^12,13 The present inventors have exploited 13-CRA’s scaffold as a strategy to design novel potent and efficacious retinamides with improved drug-like properties. 13-CRA has long elimination half-life in humans^{14 16} and most animal species.¹⁷ In addition, the inventors have explored rational modification of the terminal amide moiety, C-4 heterocycles and the cyclohexene ring:

Based on the continued success of the C-imidazole retinamides with the ATRA scaffolds as promising anti-cancer agents,⁵⁸ the inventors have designed and synthesized Compounds 16 - 25 as outlined in Scheme 7 below, involving C-4 azoyl/terminal amide modifications.

On the basis of previous findings that structural rigidification that introduces conformational constrains around rotatable bonds contributed to higher specificity and potency, greater metabolic stability, and improved bioavailability,⁵⁹ the inventors designed and synthesized several cyclohexadiene C-4 aryl substituted retinamides, Compounds 33 - 40 as outlined in Scheme 8 below. A potential advantage of this strategy is that the achiral nature of these compounds would not require the tedious characterization of the racemates and pure enantiomers as would be required in advanced preclinical development for the chiral compounds of Scheme 7.⁶⁰

1

2 Scheme 7: Synthesis of C-4 Azoyl/terminal Amide Compounds 17 - 22^a ("Reagents and

3 conditions: (i) (CH3)3SiCHN2, MeOH/benzene; (ii) M11O2, CH2CI2; (iii) NaBH4, MeOH; (iv)

4 CDI, CH3CN; (v) 2M KOH, MeOH, reflux; (vi) EDC, HOBT, DIE A, appropriate anilines, DMF).

5

g 76, n = 2, X =p -OH 79, n = 2, X =p -OH

7 Scheme 8: Synthesis of Cyclohexen Rigidification/C-4 Aryl and Heteroaryl Retinamides^a

8 (^aReagents and conditions: (i) 5-Chloro-2-pyridyl triflimide, NaN(SiMe3)2, THF; (ii) 3- methoxybenzylboronic acid, Pd(PPh3)4, CeCCh, dioxane, reflux; (iii) 2M KOH, MeOH, reflux (iv) EDC, HOBT, DIEA, appropriate benzylamine, DMF).

The synthesis of (2Z,4/',^’,6/',^’,8/',^’)-9-(3-( l//-imidazol- 1 -yl )-2, 6, 6-tri methyl cyclohex-1 -en-1 - yl)-3,7-dimethylnona-2,4,6,8-tetraenoic acid (Compound 54) was carried out in five steps from the commercially available 13-CRA (Compound 49) and the procedure was adopted from our reported procedures of ATRA based retinamides.²⁴

Protection of the carboxylic acid as the methyl ester (Compound 50) was done using trimethylsilyldiazomethane in hexanes followed by allylic oxidation using MnCh to give 4-oxo intermediate (Compound 51). Reduction of Compound 51 using NaBEE gave the (±)-4- hydroxymethylterionate (Compound 52) which was further treated with carbonyldiimidazole (CDI) at ambient temperature to yield (±)-(! T/-i mi dazol-1 -yl)methylterionate (Compound 53). Alkaline hydrolysis of Compound 53 in refluxing methanol gave the desired free acid Compound 54. Coupling of the respective amines with Compound 54 was successfully achieved using ethyl(dimethylaminopropyl) carbodiimide (EDC), hydroxybenzotriazole (HOBt), and diisopropylethylamine (DIEA) to give Compounds 55 - 64 (Scheme 7), respectively.

The synthesis of achiral C-4 aryl retinamides Compounds 72 - 79 (Scheme 8) commenced from the 4-oxo intermediate (Compound 51). Generation of enolate using sodium bis(trimethylsilyl)amide in THF solution and trapping of the enolate with N-(5-chloro-2- pyridyl)bistrifluoromethanesulfonimide furnished the vinyl triflate Compound 65 according to the reported procedure.¹⁸ However, it should be noted that this reaction was carried out at -78°C throughout the reaction time, because, at higher temperatures, decomposition occurred and <

20% of the products were obtained. Regiospecific palladium-catalyzed cross-coupling reaction with boronic acids¹⁹ provided Compounds 66 - 68. Ester hydrolysis using 2M KOH gave the corresponding free acids Compounds 69 - 71. Coupling of these respective acids with appropriate amines was successfully achieved using EDC, HOBt, and DIEA to give Compounds 72 - 79 (Scheme 8), respectively.

Pharmaceutical formulation and treatment method

The retinamides of the present disclosure can be used to prepare formulations for treating dermatological conditions, including, but not limited to, acne, eczema, psoriasis, ichthyosis, cold sores, wounds, burns, sunburns (photoaging), and skin cancer. In some embodiments, the dermatological condition is acne. In some embodiments, the skin cancer is one selected from the group consisting of squamous cell carcinoma, basal cell carcinoma, and melanoma. A method for treating any of the dermatological conditions described herein in a human subject in need thereof includes administering a therapeutically effective amount of at least one retinamide of the present disclosure (or a pharmaceutically acceptable salts, pharmaceutically acceptable N-oxides, pharmaceutically active metabolites, pharmaceutically acceptable prodrugs, and pharmaceutically acceptable solvates thereof). In at least some embodiments, the method includes administering a pharmaceutical composition comprising a therapeutically effective amount of the at least one retinamide.

In some embodiments, the at least one retinamide includes a C-4 azolyl retinamide. In some embodiments, the C-4 azolyl retinamide is an anilineamide RAMBA. In some embodiments, the anilineamide RAMBA is Compound VNLG-152.

In some embodiments, the at least one retinamide includes a 13-cis-RAMBA retinamide. In some embodiments, the 13-cis-RAMBA retinamide is a Series B derivative. In some embodiments, the Series B derivative is Compound B1 (VNHM-1-73, (2Z,4E,6E,8E)-9-(3-(lH- imidazol- 1 -yl )-2, 6, 6-tri methyl cyclohex- 1 -en-1 -yl )-A^f-(4-hydroxybenzyl )-3,7-di methyl nona- 2,4,6, 8-tetraenamide).

The retinamides of the present disclosure can be converted into a pharmaceutically acceptable salt or pharmaceutically acceptable solvate or other physical forms (e.g., polymorphs by way of example only and not limitation) via any appropriate method known to those skilled in the art. The retinamides of the present disclosure can also be administered as a prodrug or as a separate compound.

A “therapeutically effective amount” of a retinamide is the amount that effectively achieves the desired therapeutic result in the subject. Such amounts may be initially determined by knowledge in the art, by conducting in vitro tests, and/or by conducting metabolic studies in healthy experimental animals. Naturally, the dosages of the various retinamides of the present disclosure will vary somewhat depending upon the host treated, the particular mode of administration, among other factors. Those skilled in the art can determine the optimal dosing of the retinamide of the present disclosure selected based on clinical experience and the treatment indication.

In addition to the at least one retinamide of the present disclosure, the pharmaceutical composition may comprise a pharmaceutically acceptable carrier. A “pharmaceutically acceptable carrier” refers to those components in the particular dosage form employed, which are considered inert and are typically employed in the pharmaceutical arts to formulate a dosage form containing a particular active compound. The pharmaceutically acceptable inactive ingredient may be at least one selected from the group consisting of carriers, disintegrating agent, flavoring agent, stabilizers, diluents, dispersing agents, suspending agents, thickening agents, lubricant, dispersant, excipients, and the like.

The composition according to the present disclosure is configured to facilitate administration of a retinamide to a subject. A retinamide of the present disclosure, or a pharmaceutical composition containing the retinamide, can be administered according to any available method and route suitable for drug delivery, including, but not limited to, intranasal, intramuscular, intratracheal, subcutaneous, intradermal, transdermal, sublingual, topical application, intravenous, ocular (e.g., topically to the eye, intravitreal, etc.), rectal, nasal, oral, topical administration, and other enteral and parenteral routes of administration. Methods of administering a retinamide of the present disclosure through the skin or mucosa include, but not limited to, topical application of a suitable pharmaceutical preparation, transdermal transmission, injection and epidermal administration.

In at least some embodiments, a retinamide of the present disclosure is preferably administered topically or orally.

A “topical” administration or application refers to epicutaneous application administration or application, or administration onto skin. A topical composition according to the present disclosure is formulated to be suitable for topical administration. Such a topical composition comprises at least one retinamide of the present disclosure, and a dermatologically acceptable excipient and/or carrier. A component is “dermatologically acceptable” if it is suitable for use in contact with human skin without undue toxicity, incompatibility, instability, allergic response, and the like. Suitable carriers and excipients include, but are not limited to, disintegrating agent, flavoring agent, stabilizers, diluents, dispersing agents, suspending agents, thickening agents, lubricant, dispersant, emollients, humectants, guanidine, glycolic acid and glycolate salts (e.g. ammonium and quaternary alkyl ammonium), lactic acid and lactate salts (e.g. ammonium and quaternary alkyl ammonium), aloe vera in any of its variety of forms (e.g., gel), sugar and starch derivatives (e.g., alkoxylated glucose), hyaluronic acid, lactamide monoethanolamine, acetamide monoethanolamine, and the like.

The topical composition may be provided in the form of gel, lotion, cream, ointment, foam, emulsion, paste, balm, spray, suspension, salve, film, facial/skin peel, and the like. These may be formulated for applying the appropriate dosage topically to the affected area as many times a day as appropriate.

Aerosol formulations for use in this disclosure may include propellants, such as a fluorinated alkane, surfactants and co-solvents and may be filled into aluminum or other conventional aerosol containers which are then closed by a suitable metering valve and pressurized with propellant, producing a metered dose inhaler. Aerosol formulations are typically suitable for nasal or oral inhalation, and may be in powder or solution form, in combination with a compressed gas, typically compressed air. Aerosol formulations may also be useful topically.

Depending upon the particular compositions selected, transdermal delivery may be an option, providing a relatively steady state delivery of the medication which is preferred in some circumstances. Transdermal delivery typically involves the use of a compound in solution, with an alcoholic vehicle, optionally a penetration enhancer, such as a surfactant and other optional ingredients. Matrix and reservoir type transdermal delivery systems are examples of suitable transdermal systems. Transdermal delivery differs from conventional topical treatment in that the dosage form delivers a systemic dose of medication to the patient.

For oral administration, a retinamide of the present disclosure can be formulated, for example, by combining the active compounds with pharmaceutically acceptable carriers or excipients known in the art. Such carriers enable a retinamide of the present disclosure to be formulated as tablets, powders, pills, dragees, capsules, liquids, gels, syrups, elixirs, slurries, suspensions and the like, for oral ingestion by a patient to be treated.

Delivery of a retinamide may be enhanced by promoting a more pharmacologically effective amount of the compound reaching a site of action. The delivery may also be enhanced by promoting a more effective delivery of the compound across a cell membrane or within the cell and across the intra-cellular space.

Non-limiting examples of suitable carriers or excipients include lactose, dextrose, sucrose, sorbitol, mannitol, starches, gum acacia, calcium phosphate, alginates, tragacanth, gelatin, calcium silicate, microcrystalline cellulose, polyvinylpyrrolidone, cellulose, water, syrup, and methyl cellulose. The formulations can additionally include lubricating agents such as talc, magnesium stearate, and mineral oil; wetting agents; emulsifying and suspending agents; preserving agents such as methyl- and propyl-hydroxybenzoates, sweetening agents; and flavoring agents.

A retinamide of the present disclosure may be applied to exert a local or a systemic effect, or both. For example, where systemic delivery is desired, administration may involve invasive or systemically absorbed topical or mucosal administration of pharmaceutical preparation. A pharmaceutical composition containing a retinamide of the present disclosure may be administered in a targeted drug delivery system, for example, in a liposome coated with organ-specific antibody. The liposomes will be targeted to and taken up selectively by the organ. In addition, a pharmaceutical composition containing a retinamide of the present disclosure may be formulated according to suitable procedures known in the art to be a rapid release formulation, an extended release formulation, or an intermediate release formulation.

A retinamide of the present disclosure can be used as a monotherapy or in combination with other therapeutic agents. By way of example only, the therapeutic effectiveness of one of the compounds described herein may be enhanced by administration of an adjuvant (z.e., by itself the adjuvant may only have minimal therapeutic benefit, but in combination with another therapeutic agent, the overall therapeutic benefit to the patient is enhanced). Or, by way of example only, the benefit experienced by a patient may be increased by administering one of the compounds of the present disclosure with another therapeutic agent (which also includes a therapeutic regimen) that also has therapeutic benefit. In any case, regardless of the disease or condition being treated, the overall benefit experienced by the patient may simply be additive of the two therapeutic agents or the patient may experience a synergistic benefit. Where the compounds of the present disclosure are administered in conjunction with other therapies, dosages of the co-administered compounds will of course vary depending on the type of co-drug employed, on the specific drug employed, on the disease or condition being treated and so forth. In addition, when co-administered with one or more biologically active agents, the compound provided herein may be administered either simultaneously with the biologically active agent(s), or sequentially. If administered sequentially, the attending physician will decide on the appropriate sequence of administering protein in combination with the biologically active agent(s).

In at least some embodiments, a retinamide of the present disclosure is used in combination therapy with a retinoid. More particularly, a retinamide of the present disclosure may be used in combination therapy with ATRA, 13-CRA, and/or 9-CRA. In at least some embodiments, a retinamide of the present disclosure is used combination therapy with one or more of the other retinamides described in the present disclosure.

The multiple therapeutic agents (at least one of which is a retinamide of the present disclosure) may be administered in any order or even simultaneously. If simultaneously, the multiple therapeutic agents may be provided in a single, unified form, or in multiple forms (by way of example only, either as a single pill or as two separate pills). One of the therapeutic agents may be given in multiple doses, or both may be given as multiple doses. If not simultaneous, the timing between the multiple doses may vary from more than zero weeks to less than four weeks. In addition, the combination methods, compositions and formulations are not to be limited to the use of only two agents. Multiple therapeutic combinations are envisioned. A retinamide of the present disclosure may also be used in combination with procedures that may provide additional or synergistic benefit to the patient. By way of example only, patients are expected to find therapeutic and/or prophylactic benefit in the methods described herein, wherein pharmaceutical composition of the present disclosure and /or combinations with other therapeutics are combined with genetic testing to determine whether that individual is a carrier of a mutant gene that is known to be correlated with certain diseases or conditions.

A retinamide of the present disclosure, whether as monotherapy or in combination therapy, may be administered before, during or after the occurrence of the dermatological disease or condition, and the timing of administering the composition containing a compound can vary. Thus, for example, a retinamide can be used as a prophylactic and can be administered continuously to subjects with a propensity to conditions in order to prevent the occurrence of the disease or condition. A retinamide may be administered to a subject during or as soon as possible after the onset of the symptoms. A retinamide is preferably administered as soon as is practicable after the onset of the dermatological disease or condition is detected or suspected, and for a length of time necessary for the treatment of the disease. The length of treatment can vary for each subject, and the length can be determined using known criteria. Administration can be acute (for example, of short duration (e.g., single administration, administration for one day to one week)), or chronic (for example, of long duration, (e.g., administration for longer than one week, from about 2 weeks to about one month, from about one month to about 3 months, from about 3 months to about 6 months, from about 6 months to about 1 year, or longer than one year)).

The pharmaceutical composition according to the present disclosure may be in unit dosage forms suitable for single administration of precise dosages. In unit dosage form, the formulation is divided into unit doses containing appropriate quantities of one or more of the retinamides of the present disclosure. The unit dosage may be in the form of a package containing discrete quantities of the formulation. Non-limiting examples are packaged tablets or capsules, and powders in vials or ampoules. Aqueous suspension compositions can be packaged in single-dose non-reclosable containers. In some embodiments, multiple-dose reclosable containers can be used, in which case it is typical to include a preservative in the composition.

By way of example only, formulations for parenteral injection may be presented in unit dosage form, which include, but are not limited to ampoules, or in multi-dose containers, with an added preservative.

As used herein, “treat” and all its forms and tenses (including, for example, treat, treating, treated, and treatment) refer to therapeutic treatment and/or prophylactic or preventative treatment. Those in need of treatment include those already with a pathological condition described in the present disclosure (including, for example, dermatological diseases and cancer) as well as those in which the pathological condition is to be prevented. For example, “treat” means alter, apply, effect, improve, care for or deal with medically or surgically, ameliorate, cure, stop and/or prevent an undesired biological (pathogenic) process. Those of ordinary skill in the art are aware that a treatment may or may not cure.

EXAMPLES Example 1

Effects of structural analogs of ATRA in comparison with other clinically relevant retinoids, including ATRA, 13-CRA, and 9-CRA, on the growth and proliferation of human adult keratinocytes and sebocytes are studied.

Cell culture and treatment

Human adult keratinocytes (pooled) (ZenBio Inc., Research Triangle Park, NC) were cultured in human adult keratinocyte growth medium (KM-2). The SEB-1 human primary sebocytes (ZenBio Inc., Research Triangle Park, NC) were cultured and maintained in sebocyte growth medium. Cells were plated 1 day prior to treatment. Retinamides (VNLG-152 and VNHM-1-73) and other clinically relevant retinoids (13-CRA, 9-CRA, and ATRA) were treated at indicated concentration and time periods and incubated at 37 °C in 5% CO2.

Growth inhibition assays

Assays for normal human adult keratinocytes (NHAKs) and human SEB-1 sebocytes growth inhibition were performed as described previously ²⁰. Adult human keratinocytes or sebocytes were treated with VNLG-152, VNHM-1-73 and other retinoids for 7 days. MTT assay was performed at the end of the experiment. Results represent the mean ± standard deviation of three independent experiments.

Cell apoptosis assay (acridine orange/ethidium bromide (AO/EB) dual staining and in situ cell death detection assay

For acridine orange/ethidium bromide (AO/EB) dual staining assay, keratinocytes were treated with indicated concentrations of the compounds for 24, 48 and 72 h. At the end of incubation period, 100 mΐ of 1:1 ratio of acridine orange (0.1%) and ethidium bromide (0.2%) in PBS were added to the cells and incubated at 37°C and 5% CO2 for 30 min. Cells were then immediately analyzed using Nikon TE2000 fluorescence microscope. Assessment of the apoptotic potential by in situ Cell Death Detection assay was done as per protocol of the manufacturer (Roche Diagnostics). Reconstructed human epidermis (RHE) model

For histological and immunostaining studies, reconstructed human Epidermis (RHE) grown for 12 days at the air medium interface, were purchased from Cell Systems^® GmbH (epiCS). RHE models are three dimensional human epidermis equivalents they are derived from normal human keratinocytes and form a multilayered, highly differentiated model of the human epidermis that mimics biochemical and physiological properties of the epidermis. During cultivation the tissue cultures are lifted to the air-liquid interphase to induce differentiation, epithelial stratification and comification. The cellular structure of RHE closely resembles the human epidermis including a basement membrane, proliferating keratinocytes and a stratum corneum with intact barrier function.⁶¹

As recommended RHE were grown for 1 day in epiCS growth medium before stimulation in the absence and presence of 0.02% VNLG-152, ATRA and 13-CRA for 3 days. The compounds were applied topically to the triplicate RHE tissues and incubated at 37°C. RHE were then fixed in a 10% formalin and embedded in paraffin. 4 mM vertical sections were stained with H and E or stained with K10, K19 and filaggrin anti -bodies (Santa Cruz Biotechnology) and counterstained with haematoxylin as described earlier.⁶²

Results

The retinamides according to the present disclosure inhibit proliferation of adult normal human adult keratinocytes (NHAKs) and human SEB-1 sebocytes. Analysis of the effect of retinamides of the present disclosure [VNLG-152 and VNHM-1-73], 13-CRA, 9-CRA, and ATRA on the growth and proliferation of adult keratinocytes (pooled) by MTT assay revealed that the NRs effectively inhibited the proliferation of adult normal keratinocytes (NHAKs) with GEo values of 0.239 and 1.28 pM, respectively.

In contrast, the clinically relevant retinoids¹⁷ tested, exhibited GEo values in the range between 63.09 - 95.63 pM (FIG. 1A). In similar studies, using human SEB-1 sebocytes, the GEo values of VNLG-152 and VNHM-1-73 were 0.066 and 0.467 pM, respectively. In marked contrast, the clinically relevant retinoids¹⁷ tested, exhibited GEo values in the range between 21.87 - 79.43 pM (FIG. IB).

The retinamides according to the present disclosure are potent anti-proliferative inhibitors of adult human keratinocytes and sebocytes compared to the clinically relevant retinoids. Most notably, VNHM-1-73 and VNLG-152 exhibited 59.3- and 317.4-fold, respectively (for NHAKs), and 85 - 603-fold, respectively (for SEB-1) more potent inhibition of keratinocytes/ sebocytes growth than the U.S. Food and Drug Administration (FDA) approved anti-acne drug, 13-CRA (isotretinoin). Detailed studies on the effect of retinamides of the present disclosure on the biochemical molecules and cellular pathways associated with acne pathogenesis are ongoing to elucidate the molecular mechanisms by which the retinamides of the present disclosure inhibit the growth of adult keratinocytes and sebocytes.

In adult human keratinocytes and sebocytes, retinamides of the present disclosure, and in particular, VNLG-152 and VNHM-1-73, strongly inhibit the growth of the keratinocytes and sebocytes, as compared to other retinoids such as ATRA and 13-CRA. VNLG-152 is also powerful in inducing apoptosis in NHAKs at minimal concentrations compared to ATRA or 13- CRA. Most notably, the effect of VNLG-152 in inhibiting NHAKs and sebocytes as determined by their GEo values (0.066 - 0.239 pmol/L) was remarkably more prevailing than GEo values observed for 13-CRA (isotretinoin) (26.02 - 96.45 pmol/L) that has earned much clinical interest for the treatment of acne vulgaris and other skin disorders. 13-CRA, 9-CRA, and ATRA have been shown to reduce proliferation of immortalized human sebocytes SZ95 by approximately 50% after 9 days.⁶³ 13-CRA have been reported to cause significant dose-dependent and time- dependent decreases in viable SEB-1 sebocytes in a manner far better than 9-CRA or ATRA.⁶⁴ It has also been reported that the ability of 13-CRA to induce apoptosis cannot be recapitulated by 9-cis RA or ATRA, indicating that 13-CRA was better than 9-CRA or ATRA in reducing sebum production and the resolution of acne.⁶⁴

Remarkably, the present inventors have discovered that VNLG-152 inhibits the growth/proliferation and induces apoptosis in normal human adult keratinocytes at concentrations far less than that observed for 13-CRA. Moreover, VNLG-152 is about 35 times more potent than 13-CRA in reducing the growth of SEB-1 sebocytes. Combination studies with 13-CRA and VNLG-152 in NHAKs show that VNLG-152 actually increases the growth inhibiting potencies of 13-CRA. These results together indicate that VNLG-152 exhibits potent antikeratinization and sebosuppressive effects in normal human adult keratinocytes and SEB-1 sebocytes, and in a manner far better than 13-CRA or ATRA.

Reconstructed human epidermis (RHE) is a stratified culture that shares histological features that closely resemble human epidermis in vivo (basal layer and differentiating spinous, granular, and cornified layers). RHE is commonly used to evaluate therapeutic efficacy of compounds for keratinization disorders.⁶¹ VNLG-152 induces in vitro effects in RHE cultures, which are more potent compared to 13-CRA-treated cultures. These effects include degranulation, induction of K19 expression, and reduction of K10 and filaggrin. K19 is a non- epidermal keratin that is absent in normal human epidermis. K10 is an early biomarker of epidermal differentiation and is normally expressed in all suprabasal layers. Filaggrin is a marker of late-stage keratinocyte differentiation that is normally expressed in the stratum granulosum.^62,65,66 Although the immunohistochemistry data are not quantitative, the demonstrated in vitro efficacy of VNLG-152 suggests that the retinamide directly affects differentiating keratinocytes with well-established dekeratinizing effects. The antikeratinizing effects of VNLG-152 in RHE are either similar (as compared to ATRA) or more potent (as compared to 13-CRA) to other available topical retinoids.

Retinamides of the present disclosure, including VNLG-152, exhibit exclusive antikeratinization and sebosuppressive effects in normal adult human keratinocytes, sebocyte cells and RHE cultures. Thus, retinamides of the present disclosure, including VNLG-152, are capable of inducing strong in vitro dekeratinizing and sebosuppressive effects may be effective in treating skin diseases involving abnormal keratinization.

Example 2

To determine whether VNLG-152 potentiates the anti-proliferative effects of ATRA or 13-CRA on NHAK, NHAK cells were continuously incubated with ATRA or 13-CRA (0.1 to 10,000 nM) alone and in combination with low dose (40 nM, dose that exhibited low [< 10%] anti-proliferative effect) of VNLG-152.

ATRA and 13-CRA inhibited NHK cells in dose-dependent fashions with GEo values of 63.09 and 75.85 mM, respectively (FIG. 2A). VNLG-152 in combination with ATRA or 13- CRA significantly enhanced the anti -proliferative activities of ATRA or 13-CRA, by 200- and 123 -fold, respectively (FIGS. 2A and 2B).

Example 3

To further determine whether the observed decrease in growth of keratinocytes was due to induction of cell death, we evaluated apoptosis inducing potential of VNLG-152 compared to ATRA and 13-CRA in keratinocytes by acridine orange/ethidium bromide (AO/EB) dual staining.

AO/EB dual staining established that VNLG-152 (0.2 pM, 48 and 72 h) exhibit strong pro-apoptotic effects compared to that of 13-CRA and ATRA (5 and 10 pM at 24, 48 and 72 h) (FIGS. 3A, 3B, and 3C). In FIGS. 3A and 3B, the plates were analyzed for early apoptotic and viable cells using acridine orange/ ethidium bromide staining. Viable cells (the nucleus evenly circulated in the cell center) and early apoptotic cells displayed yellow green fluorescence in the nucleus. Late apoptotic cells exhibited orange fluorescence in the nucleus. In FIG. 3C, the bars are means of three replicate determinations plus standard deviations. Statistical analysis was performed with ANOVA two factor with replication (*P<0.05, **P<0.01, ***P<0.001).

The apoptosis inducing potential of VNLG-152 was evaluated by TUNEL assay in NHAK. The individual cell lines as indicated were seeded in 8 well chamber slides, and treated with indicated concentrations and times of 13-CRA, ATRA, and VNLG-/152. After 72 hours, the plates were analyzed for TUNEL positive staining. Statistical analysis was performed with ANOVA two factor with replication (*P<0.05, **P<0.01, ***P<0.001).

After 72 hours, even at a low concentration of 0.2 mM VNLG-152 efficiently induced apoptosis (~ 50% versus control), in contrast to ATRA and 13-CRA. Induction of apoptosis increased to -84% with 1 mM VNLG-152. (FIGS. 4A and 4B).

Example 4

Histological analysis of control RHE showed a keratinized, multistratified epithelium resembling human epidermis in vivo containing intact basal (cells were polarized vertically), spinous, granulous and cornified cell layers and numerous keratohyalin granules in the stratum granulosum. RHE tissues were treated with indicated concentration and incubated for 3 days at 37° C. Following treatment tissues were fixed, sectioned and stained with H and E.

Representative images from three independent experiments are shown in FIG. 5 A to 5E. RHE tissues were untreated (FIG. 5A) or treated with vehicle (ethanol) (FIG. 5B), ATRA 0.02% solution (FIG. 5C), 13-CRA 0.02% (FIG. 5D); and VNLG-1520.02% (FIG. 5E). The RHE treated with VNLG-152, ATRA and 13 CRA showed a loss of keratohyalin granules in the upper granular layer. Whereas vehicle treated cultures were similar to untreated controls, indicating that VNLG-152 may have a therapeutic benefit in the local management of keratinization disorders. In the figures, “SC” refers to “stratum corneum”, “SG” to “stratum granulosum”, “SS” to “stratum spinosum”, and “SB” to “stratum basale”.

Example 5

RHE tissues were untreated (FIG. 6A) or treated with vehicle alone and treated with VNLG-152, ATRA or 13-CRA (FIG. 6B). Following incubation for 3 days at 37oC, tissues were fixed, sectioned, and stained for K10, K19 or filaggrin. Representative micrographs from triplicate cultures are shown. The immunolabelling of K10 and filaggrin revealed that in supra a basal (sb) and stratum granulosum (sg) layer was strongly expressed in both vehicle and untreated control groups. Treatment with VNLG-152, and ATRA reduced the expression of these proteins in sb and sg layers. In 13-CRA treated tissues, the expression of these proteins (K10 and filaggrin) was slightly increased compared to VNLG-152 and ATRA treated tissues. The expression of K19 was not present in vehicle and untreated control groups. Treatment with VNLG-152 and ATRA induced significant increase in the expression of K19 in viable cell layers. In 13-CRA treated tissues, the expression of K19 although higher to control, was comparatively lower than VNLG-152 or ATRA treated groups. REFERENCES

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Claims

1. A method of treating a dermatological condition, comprising administering a pharmaceutical composition comprising a therapeutically effective amount of a first compound having the General Formula 1 A:

wherein R¹ is an azole group, a sulfur-containing group, an oxygen-containing group, a nitrogen-containing group, a pyridyl group, an ethinyl group, a cyclopropyl-amine group, an ester group, a cyano group, a heteroaryl ring, or an 1 //-midazole group, or R¹ forms, together with the C-4 carbon atom, an oxime, an oxirane or aziridine group, wherein R³ is independent from R¹, and is a halogen group, a cyano group, a thiol group, or an alkyl group substituted with at least one of a halogen group, a cyano group, and a thiol group, and wherein n is an integer from 0 to 5.

2. The method according to claim 1, wherein R¹ is azole group.

3. The method according to claim 2, wherein the first compound has the General Formula

1A’:

[General Formula 1A’] wherein R³ is a halogen group, a cyano group, a thiol group, or an alkyl group substituted with at least one of a halogen group, a cyano group, and a thiol group, and wherein n is an integer from 0 to 5.

4. The method according to claim 3, wherein R³ is a halogen group, and n is an integer from 1 to 5.

5. The method according to claim 4, wherein the first compound is Compound VNLG- 152 having the following formula:

6. The method according to claim 1, wherein the dermatological condition is one selected from the group consisting of acne, eczema, psoriasis, ichthyosis, cold sores, wounds, burns, sunburns, and skin cancers.

7. The method according to claim 6, wherein the dermatological condition is acne.

8. The method according to claim 1, wherein the pharmaceutical composition is administered topically or orally.

9. The method according to claim 1, wherein the pharmaceutical composition further comprises at least one of all-/ra//.s-retinoic acid, 13-67.v-retinoic acid, and O-c/.s-retinoic acid.

10. The method according to claim 1, wherein the pharmaceutical composition further comprises a second compound having the General Formula 6:

[General Formula 6] wherein R is a benzyl group or a heterocyclic group that is mono-, di-, or tri- substituted at either at the para, meta, or ortho position with OH, OMe, CN, CO2H, C02Me, SO2NRH; imidazole; or liT-tetrazole, and wherein n is an integer from 1 to 6.

11. The method according to claim 10, wherein the second compound is Compound VNHM-1-73 having the following formula:

12. A method of treating a dermatological condition, comprising administering a pharmaceutical composition comprising a therapeutically effective amount of a compound having the General Formula 7:

[General Formula 7] wherein R is a heteroaryl group, wherein R’ is a hydrogen, a halide, a hydroxyl group, an alkyl group, an ester group, an ether group, a benzyl group, a thio group, a Weinreb amide group, or a heterocyclic group, and wherein n is an integer from 0 to 6.

13. The method according to claim 12, wherein the compound has the General Formula

[General Formula 6] wherein R is a benzyl group or a heterocyclic group that is mono-, di-, or tri- substituted at either at the para, meta, or ortho position with OH, OMe, CN, CO2H, C02Me, SO2NRH; imidazole; or l//-tetrazole, and wherein n is an integer from 1 to 6.

14. The method according to claim 13, wherein R contains at least one -OH group.

15. The method according to claim 14, wherein the compound is Compound VNHM-1-73 having the following formula:

16. The method according to claim 12, wherein the dermatological condition is one selected from the group consisting of acne, eczema, psoriasis, ichthyosis, cold sores, wounds, burns, sunburns, and skin cancers.

17. The method according to claim 16, wherein the dermatological condition is acne.

18. The method according to claim 12, wherein the pharmaceutical composition is administered topically or orally.

19. The method according to claim 12, wherein the pharmaceutical composition further comprises at least one of all-/ra//.s-retinoic acid, 13-67.v-retinoic acid, and 9-67.v-retinoic acid.

20. The method according to claim 12, wherein the pharmaceutical composition further comprises Compound VNLG-152 having the following formula: