Drug – bio-affecting and body treating compositions – Designated organic active ingredient containing – Having -c- – wherein x is chalcogen – bonded directly to...
Reexamination Certificate
2001-05-11
2002-10-01
Owens, Amelia (Department: 1625)
Drug, bio-affecting and body treating compositions
Designated organic active ingredient containing
Having -c-, wherein x is chalcogen, bonded directly to...
C514S315000, C514S422000, C514S432000, C549S373000, C548S517000, C516S201000
Reexamination Certificate
active
06458829
ABSTRACT:
TECHNICAL FIELD
This invention is directed towards &Dgr;-lactone compounds and analogs thereof such as lactams, and in particular to &ggr;-phenyl-substituted &Dgr;-lactone and analogs thereof, and therapeutic uses related thereto.
BACKGROUND OF THE INVENTION
The Inflammatory Response (Inflammation)
Inflammation is an essential localized host response to invading microorganisms or tissue injury which involves cells of the immune system. The classic signs of inflammation include redness (erythema), swelling (edema), pain and increased heat production (pyrema) at the site of injury. The inflammatory response allows the body to specifically recognize and eliminate an invading organism and/or repair tissue injury. Many of the acute changes at the site of inflammation are either directly or indirectly attributable to the massive influx of leukocytes (e.g., neutrophils, eosinophils, lymphocytes, monocytes) which is intrinsic to this response. Leukocytic infiltration and accumulation in tissue results in their activation and subsequent release of inflammatory mediators such as LTB
4
, prostaglandins, TNF-&agr;, IL-1&bgr;, IL-8, IL-5, IL-6, histamine, proteases and reactive oxygen species for example.
Normal inflammation is a highly regulated process that is tightly controlled at several levels for each of the cell types involved in the response. For example, expression of the pro-inflammatory cytokine TNF-&agr; is controlled at the level of gene expression, translation, post-translational modification and release of the mature form from the cell membrane. Many of the proteins up-regulated during inflammation are controlled by the transcription factor, NF-&kgr;B. Pro-inflammatory responses are normally countered by endogenous anti-inflammatory mechanisms such as generation of IL-10 or IL-4. A characteristic of a normal inflammatory response is that it is temporary in nature and is followed by a resolution phase which brings the state of the tissue back to its prior condition. The resolution phase is thought to involve up-regulation of anti-inflammatory mechanisms, such as IL-10, as well as down-regulation of the pro-inflammatory processes.
Inflammatory Disease
Inflammatory disease occurs when an inflammatory response is initiated that is inappropriate and/or does not resolve in the normal manner but rather persists and results in a chronic inflammatory state. Inflammatory disease may be systemic (e.g. lupus) or localized to particular tissues or organs and exerts an enormous personal and economic burden on society. Examples of some of the most common and problematic inflammatory diseases are rheumatoid arthritis, inflammatory bowel disease, psoriasis, asthma, emphysema, colitis and ischemia-reperfusion injury.
A common underlying theme in inflammatory disease is a perturbation of the cellular immune response that results in recognition of host proteins (antigens) as foreign. Thus the inflammatory response becomes misdirected at host tissues with effector cells targeting specific organs or tissues often resulting in irreversible damage. The self-recognition aspect of auto-immune disease is often reflected by the clonal expansion of T-cell subsets characterized by a particular T-cell receptor (TCR) subtype in the disease state. Often inflammatory disease is also characterized by an imbalance in the levels of T-helper (Th) subsets (i.e., Th1 cells vs. Th2 cells).
Therapeutic strategies aimed at curing inflammatory diseases usually fall into one of two categories: (a) down-modulation of processes that are up-regulated in the disease state or (b) up-regulation of anti-inflammatory pathways in the affected cells or tissues. Most regimes currently employed in the clinic fall into the first category. Some examples of which are corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs).
Many of the tissue, cellular and biochemical processes which are perturbed in inflammatory disease have been elucidated and this has allowed the development of experimental models or assays to mimic the disease state. These in-vitro assays enable selection and screening of compounds with a high probability of therapeutic efficacy in the relevant inflammatory disease. Thus, currently employed assays used to model the importance of the activated leukocytes in the development of acute inflammation and maintenance of the chronic inflammatory state are assays monitoring leukocyte chemotaxis and cellular degranulation and cytokine synthesis and reactive oxygen species (ROS) production assays in vitro. Since a result of acute or chronic neutrophil activation is release of ROS with resultant tissue damage, an assay for scavengers of ROS allows detection of compounds with potential therapeutic efficacy. Cellular assays to detect inhibitors of TNF-&agr; release from stimulated macrophage or monocytic cells are an important component of an in vitro model for inflammation as this cytokine is upregulated and has been shown to contribute to the pathology in many inflammatory diseases. Since elevated cAMP in affected cells has been shown to modulate or dampen the inflammatory response, monitoring cellular cyclic AMP (cAMP) levels, and the activity of pathways controlling cAMP levels allows for the detection of potential anti-inflammatory compounds. Assays may include monitoring the level of cAMP itself, phosphodiesterase activity, or changes in cAMP response element (CRE)-luciferase activity.
Rheumatoid Arthritis
Rheumatoid arthritis (RA), the most common form of inflammatory arthritis, is an auto-immune disorder of unknown etiology which affects 1% of the adult population and is characterized by symmetric, chronic, erosive synovitis (inflammation of the joint synovial lining) and frequent multisystem involvement. Interestingly, it is 3-6 times more prevalent in women than men. Most patients exhibit a chronic fluctuating course of disease that, if left untreated, results in progressive joint destruction, deformity, disability, and premature death. Symptoms indicative of RA include pain and swelling of the joints (usually symmetrical), morning stiffness of joints and muscles, general weakness/fatigue and fever and weight loss. RA results in more than 9 million physician visits and more than 250,000 hospitalizations per year in the U.S. each year. It frequently affects patients in their most productive years, and thus, disability results in major economic loss.
Recent insights have established that the genetic background, especially the structure of the class II major histocompatibilty (MHC) genes, plays a critical role in an individual's susceptibility and the severity of the disease. The current understanding of cytokine networks, chemokines, growth factors and adhesion molecules have led to the appreciation that T cell-dependent and T cell-independent pathways contribute to the initiation and perpetuation of rheumatoid arthritis. Furthermore, much has been learned about the specific cellular and biochemical events responsible for the bone and cartilage destruction that characterizes this disorder. At the tissue level, RA is characterized by synovial hyperplasia, hypertrophy, angiogenesis and attachment and invasion of synovial fibroblasts into adjacent cartilage and bone. In active RA there are increased levels of the pro-inflammatory cytokines TNF-&agr;, IL-1 and IL-6 relative to the anti-inflammatory cytokines in affected joints.
Current Treatments for Rheumatoid Arthritis and Other Inflammatory Diseases
At present there is no cure or prevention (prophylactic) available for rheumatoid arthritis, only regimes that address symptoms such as pain and stiffness. The five major treatment modalities for this disease include medication (pharmacological), physical (exercise), joint protection and lifestyle changes and surgery.
Therapeutics for rheumatoid arthritis can be divided into three groups: nonsteroidal anti-inflammatory drugs (NSAIDs), disease modifying anti-rheumatic drugs (DMARDs) also known as second line agents and corticosteroids.
NSAIDs reduce pain at low doses and relieve some of the inflammatory symptom
Abraham Samuel D. M.
Burgoyne David L.
Lauener Ronald W.
Rebstein Patrick J.
Shen Yaping
Inflazyme Pharmaceuticals Ltd.
Owens Amelia
Seed Intellectual Property Law Group PLLC
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