Title of Invention

NOVEL DIAMINE COMPOUNDS FOR THE DIAGNOSIS AND TREATMENT OF INFECTIOUS DISEASE

Abstract A compound selected from the group consisting of:
Full Text METHODS OF USE AND COMPOSITIONS FOR THE DIAGNOSIS AND
TREATMENT OF INFECTIOUS DISEASE
FIELD OF INVENTION
The present invention relates to methods and compositions for treating disease
caused by microorganisms, particularly tuberculosis. The present invention also relates to
methods and compositions having improved anti-mycobacterial activity, namely
compositions comprising novel substituted ethylene diamine compounds.
BACKGROUND OF THE INVENTION
Mycobacterial infections often manifest as diseases such as tuberculosis. Human
infections caused by mycobacteria have been widespread since ancient times, and
tuberculosis remains a leading cause of death today. Although the incidence of the disease
declined, in parallel with advancing standards of living, since the mid-nineteenth century,
mycobacterial diseases still constitute a leading cause of morbidity and mortality in
countries with limited medical resources. Additionally, mycobacterial diseases can cause
overwhelming, disseminated disease in immunocompromised patients. In spite of the
efforts of numerous health organizations worldwide, the eradication of mycobacterial
diseases has never been achieved, nor is eradication imminent. Nearly one third of the
world's population is infected with mycobacterium tuberculosis complex, commonly
referred to as tuberculosis (TB), with approximately 8 million new cases, and two to three
million deaths attributable to TB yearly. Tuberculosis (TB) is the cause of the largest
number of human deaths attributable to a single etiologic agent (see Dye et al., J. Am. Med.
Association, 282, 677-686, (1999); and 2000 WHO/OMS Press Release).
After decades of decline, TB is now on the rise. In the United States, up to 10
million individuals are believed to be infected. Almost 28,000 new cases were reported in
1990, constituting a 9.4 percent increase over 1989. A sixteen percent increase in TB cases
was observed from 19S5 to 1990. Overcrowded living conditions and shared air spaces are
especially conducive to the spread of TB, contributing to the increase in instances that have
been observed among prison inmates, and among the homeless in larger U.S. cities.
Approximately half of all patients with "Acquired Immune Deficiency Syndrome" (AIDS)
will acquire a mycobacterial infection, with TB "being an especially devastating
complication. AIDS patients are at higher risks of developing clinical TB, and anti-TB
treatment seems to be less effective than in non-AIDS patients. Consequently, the
infection often progresses to a fatal disseminated disease.
Mycobacteria other than M. tuberculosis are increasingly found in opportunistic
infections that plague the AIDS patient. Organisms from the M. avium-intracellulare
complex (MAC), especially serotypes four and eight, account for 68% of the mycobacteria!
isolates from AIDS patients. Enormous numbers of MAC are found (up to 10 acid-fast
bacilli per gram of tissue), and consequently, the prognosis for the infected AIDS patient is
poor.
The World Health Organization (WHO) continues to encourage the battle against
TB, recommending prevention initiatives such as the "Expanded Program on
Immunization" (EPI), and therapeutic compliance initiatives such as "Directly Observed
Treatment Short-Course" (DOTS). For the eradication of TB, diagnosis, treatment, and
prevention are equally important. Rapid detection of active TB patients will lead to early
treatment by which about 90% cure is expected. Therefore, early diagnosis is critical for
the battle against TB. In addition, therapeutic compliance will ensure not only elimination
of infection, but also reduction in the emergence of drug-resistance strains.
The emergence of drug-resistant M. tuberculosis is an extremely disturbing
phenomenon. The rate of new TB cases proven resistant to at least one standard drug
increased from 10 percent in the early 19S0's to 23 percent in 1991. Compliance with
therapeutic regimens, therefore, is also a crucial component in efforts to eliminate TB and
prevent the emergence of drug resistant strains. Equally important is the development of
new therapeutic agents that are effective as vaccines, and as treatments, for disease caused
by drug resistant strains of mycobacteria.
Although over 37 species of mycobacteria have been identified, more than 95% of
all human infections are caused by six species of mycobacteria: M. tuberculosis, M. avium
intracellulare, M. kansasii, M. fortuitum, M. chelonae, and M. leprae. The most prevalent
mycobacterial disease in humans is tuberculosis (TB) winch is predominantly caused by
mycobacterial species comprising M. tuberculosis, M. bovis, or M. africamum (Merck
Manual 1992). Infection is typically initiated by the inhalation of infectious particles
which are able to reach the terminal pathways in lungs. Following engulfment by alveolar
macrophages, the bacilli are able to replicate freely, with eventual destruction of the
phagocytic cells. A cascade effect ensues wherein destruction of the phagocytic cells
causes additional macrophages and lymphocytes to migrate to the site of infection, where
they too are ultimately eliminated. The disease is further disseminated during the initial
stages by the infected macrophages which travel to local lymph nodes, as well as into the
blood stream and other tissues such as the bone marrow, spleen, kidneys, bone and central
nervous system. (See Murray et al. Medical Microbiology, The C.V. Mosby Company
219-230(1990)).
There is still no clear understanding of the factors which contribute to the virulence
of mycobacteria. Many investigators have implicated lipids of the cell wall and bacterial
surface as contributors to colony morphology and virulence. Evidence suggests that C-
mycosides, on the surface of certain mycobacterial cells, are important in facilitating
survival of the organism within macrophages. Trehalose 6,6' dimycolate, a cord factor, has
been implicated for other mycobacteria.
The interrelationship of colony morphology and virulence is particularly
pronounced in M. avium. M. avium bacilli occur in several distinct colony forms. Bacilli
which grow as transparent, or rough, colonies on conventional laboratory media are
multiplicable within macrophages in tissue culture, are virulent when injected into
susceptible mice, and are resistant to antibiotics. Rough or transparent bacilli, which are
maintained on laboratory culture media, often spontaneously assume an opaque R colony
morphology, at which time they are not multiplicable in macrophages, are avirulent in
mice, and are highly susceptible to antibiotics. The differences in colony morphology
between the transparent, rough and opaque strains of M. avium are almost certainly due to
the presence of a glycolipid coating on the surface of transparent and rough organisms
which acts as a protective capsule. This capsule, or coating, is composed primarily of C-
mycosides which apparently shield the virulent M. avium organisms from lysosomal
enzymes and antibiotics. By contrast, the non-virulent opaque forms ofM. avium have
very little C-mycoside on their surface. Both the resistance to antibiotics and the resistance
to killing by macrophages have been attributed to the glycolipid barrier on the surface of
M. avium.
Diagnosis of mycobacterial infection is confirmed by the isolation and
identification of the pathogen, although conventional diagnosis is based on sputum smears,
chest X-ray examination (CXR), and clinical symptoms. Isolation of mycobacteria on a
medium takes as long as four to eight weeks. Species identification takes a further two
weeks. There are several other techniques for detecting mycobacteria such as the
polymerase chain reaction (PCR), mycobacterium tuberculosis direct test, or amplified
mycobacterium tuberculosis 'direct test (MTD), and detection assays that utilize
radioactive labels.
One diagnostic test that is widely used for detecting infections caused by M.
tuberculosis is the tuberculin skin test. Although numerous versions of the skin test are
available, typically one of two preparations of tuberculin antigens are used: old tuberculin
(OT), or purified protein derivative (PPD). The antigen preparation is either injected into
the skin intradermally, or is topically applied and is then invasively transported into the
skin with the use of a multiprong inoculator (Tine test). Several problems exist with the
skin test diagnosis method. For example, the Tine test is not generally recommended
because the amount of antigen injected into the intradermal layer cannot be accurately
controlled. (See Murray et al. Medical Microbiology, The C.V. Mosby Company 219-230
(1990)).
Although the tuberculin skin tests are widely used, they typically require two to
three days to generate results, and many times, the results are inaccurate since false
positives are sometimes seen in subjects who have been exposed to mycobacteria, but are
healthy. In addition, instances of mis-diagnosis are frequent since a positive result is
observed not only in active TB patients, but also in persons vaccinated with Bacille
Calmette-Guerm (BCG), and those who had been infected with mycobacteria, but have not
developed the disease. It is hard therefore, to distinguish active TB patients from the
others, such as household TB contacts, by the tuberculin skin test. Additionally, the
tuberculin test often produces a cross-reaction in those individuals who were infected with
mycobacteria other than M. tuberculosis (MOTT). Therefore, diagnosis using the skin tests
currently available is frequently subject to error and inaccuracies.
The standard treatment for tuberculosis caused by drug-sensitive organisms is a six-
month regimen consisting of four drugs given for two months, followed by two drugs given
for four months. The two most important drugs, given throughout the six-month course of
therapy, are isomazid and rifampin. Although the regimen is relatively simple, its
administration is quite complicated. Daily ingestion of eight or nine pills is often required
during the first phase of therapy; a daunting and confusing prospect. Even severely ill
patients are often symptom free within a few weeks, and nearly all appear to be cured
within a few months. If the treatment is not continued to completion, however, the patient
may experience a relapse, and the relapse rate for patients who do not continue treatment to
completion is high. A variety of forms of patient-centered care are used to promote
adherence with therapy. The most effective way of ensuring that patients are talcing their
medication is to use directly observed therapy, which involves having a member of the
health care team observe the patient take each dose of each drug. Directly observed
therapy can be provided in the clinic, the patient's residence, or any mutually agreed upon
site. Nearly all patients who have tuberculosis caused by drug-sensitive organisms, and
who complete therapy will be cured, and the risk of relapse is very low ("Ending Neglect:
The Elimination of Tuberculosis in the United States" ed. L. Geiter Committee on the
Elimination of Tuberculosis in the United States Division of Health Promotion and Disease
Prevention, Institute of Medicine. Unpublished.)
What is needed are effective therapeutic regimens that include improved
vaccination and treatment protocols. Currently available therapeutics are no longer
consistently effective as a result of the problems with treatment compliance, and these
compliance problems contribute to the development of drug resistant mycobacterial strains.
Ethambutol (EMB) is a widely used antibiotic for the treatment of TB, with over
300 million doses delivered for tuberculosis therapy in 1988.
Ethambutol, developed by Lederle Laboratories in the 1950s, has low toxicity and
is a good pharmacokinetic. However, ethambutol has a relatively high Minimum
Inhibition Concentration (MIC) of about 5 µg/ml, and can cause optic neuritis. Thus, there
is an increasing need foT new, and more effective, therapeutic compositions (See for
example, U.S. Pat. No. 3,176,040, U.S. Pat. No. 4,262,122; U.S. Pat. No. 4,006,234; U.S.
Pat. No. 3,931,157; U.S. Pat. No. 3, 931,152; U.S. Re. 29,358; and Hausleref a/.,
Bioorganic & Medicinal Chemistry Letters 11 (2001) 1679-1681). In the decoder years
since the discovery of the beneficial effects of ethambutol, few pharmacological advances
in TB treatment have been developed. Moreover, with the combined emergence of drug
resistant strains, and the more prevalent spread of mycobacterial disease, it is becoming
seriously apparent that new therapeutic compositions are crucial in the fight against
tuberculosis.
Clearly effective therapeutic regimens that include improved vaccination and
treatment protocols are needed. A therapeutic vaccine that would prevent the onset of
tuberculosis, and therefore eliminate the need for therapy is desirable. Although currently
available therapeutics such as ethambutol are effective, the emergence of drug resistant
strains has necessitated new formulations and compositions that are more versatile than
ethambutol. Currently available therapeutics are no longer consistently effective as a result
of the problems with treatment compliance, lending to the development of drug resistant
mycobacterial strains. What is needed are new anti-tubercular drugs that provide highly
effective treatment, and shorten or simplify tuberculosis chemotherapy.
SUMMARY OF THE INVENTION
The present invention comprises methods and compositions comprising ethylene
diamine compounds effective for the treatment of infectious disease. The present invention
also provides methods and compositions comprising substituted ethylene diamines having
improved anti-mycobacterial activity, including substituted ethylene diamines having
improved anti-tuberculosis activity.
The present invention contemplates substituted ethylene diamines, which can derive .
from a variety of amine compounds. In the present invention, the substituted ethylene
diamines are based on the following structure.

The substituted ethylene diamine compounds described herein are synthesized and
screened for activity as follows. A chemical library of substituted ethylene diamines is
prepared on a solid polystyrene support using split and pool technologies. This technique
allows for the synthesis of a diverse set of substituted ethylene diamines. These diamines
are screened for anti-TB activity using in vitro, biological assays, including a High-
Throughput Screening (HTS) assay, based on the recently completed genomic sequence of
M. tuberculosis, and a Minimum Inhibition Concentration (MIC) assay.
The methods and compositions described herein comprise substituted ethylene
diamines that are effective against disease caused by infectious organisms, including, but
not limited to, bacteria and viruses.
One embodiment of the invention provides methods and compositions comprising
substituted ethylene diamines that are effective against mycobacterial disease.
Another embodiment of the invention provides methods and compositions
comprising substituted ethylene diamines that have MIC of 50uM or lower for
mycobacterial disease.
Another embodiment of the present invention comprises substituted ethylene
diamines that have an MTC of 25 uM or lower for mycobacterial disease. Yet another
embodiment of the present invention comprises substituted ethylene diamines that have an
MIC of 12.5 µM or lower for mycobacterial disease. Another embodiment of the
present invention comprises substituted ethylene diamines that have an MIC of 5 uM or
lower for mycobacterial disease. In another embodiment of the present invention, the
methods and compositions comprise substituted ethylene diamines with HTS Luc activity
of 10% or greater.
In yet another embodiment of the present invention, the methods and compositions
comprise substituted ethylene diamines, wherein one amine group is derived from a
primary amine, and wherein the other amine group is derived from a primary or secondary
amine.
The present invention contemplates various salt complexes and other substituted
derivatives of the substituted ethylene diamines. The present invention also contemplates
enantiomers and other stereoisomers of the substituted ethylene diamines and their
substituted derivatives. The present invention further contemplates treatment for animals,
including, but not limited to, humans.
Accordingly, it is an object of the present invention to provide methods and
compositions for the treatment and prevention of diseases caused by infectious agents.
Accordingly, it is an object of the present invention to provide methods and
compositions for the treatment and prevention of infectious diseases.
Another object of the present invention is to provide methods and compositions for
the treatment and prevention of mycobacterial disease, including but not limited to.
tuberculosis.
Yet another object of the present invention is to provide methods and compositions
for the treatment and prevention of infectious diseases using compositions comprising
substituted ethylene diamines.
Another object of the present invention is to provide methods and compositions for
the treatment and prevention of mycobacterial disease using compositions comprising
substituted ethylene diamines.
Still another object of the present invention is to provide methods and compositions
for the treatment and prevention of tuberculosis using compositions comprising substituted
ethylene diamines.
Another object of the present invention is to provide methods and compositions for
the treatment and prevention of tuberculosis using compositions comprising substituted
ethylene diamines, wherein the diamine has an MIC of 50 uM, or less.
Another object of the present invention is to provide methods and compositions for
the treatment and prevention of tuberculosis using compositions comprising substituted
ethylene diamines, wherein the diamine has an MIC of 25 uM, or less.
Another object of the present invention is to provide methods and compositions for
the treatment and prevention of tuberculosis using compositions comprising substituted
ethylene diamines, wherein the diamine has an MIC of 12.5µM, or less.
Yet another object of the present invention is to provide methods and compositions
for the treatment and prevention of tuberculosis using compositions comprising substituted
ethylene diamines, wherein the diamine has an MIC of 5µM,or less.
Yet another object of the present invention is to provide methods and compositions
for the treatment and prevention of tuberculosis using compositions comprising substituted
ethylene diamines, wherein the diamine has HTS/Luc activity of 10% or greater.
Yet another object of the present invention is to provide composition for the
therapeutic formulation for the treatment and prevention of mycobacterial disease.
Another object of the present invention is to provide compositions for therapeutic
fomrulations for the treatment and prevention of mycobacterial disease caused by
mycobacterial species comprising M. tuberculosis complex, M. avium intracellulare, M.
kansavii, M. fortuitum, M. chelonoe, M. leprae, M. africanum, M. microti, M. avium
par atuber miosis, or M. hovis.
These and other objects, features and advantages of the present invention will
become apparent after a review of tire following detailed description of the disclosed
embodiments and the appended claims.
BRIEF DESCRIPTION OF THE.FIGURES
Figure 1 provides representative examples of diamine products synthesized from
amino alcohol pre-loaded resins.
Figure 2 provides commercially available amino alcohol pre-loaded resins.
Figure 3 provides Table 1 which shows the prepared library of targeted 21,120
ethambutol analogs.
Figure 4 provides Scheme 1, a schematic showing the Synthesis of the original
100,000 compound library of Ethambutol analogs.
Figure 5 provides Scheme 2, a schematic showing the use of ammo alcohol pre-
loaded resins and amino acids as linker.
Figure 6 provides Scheme 3, a schematic showing further modification of the
linker: working with amino alcohol pre-loaded resins.
Figure 7 provides Table 2 which lists the Amino acids used in the library
preparation.
Figure 8 provides representative carbonyl compounds used as reagents in the
syntheses.
Figure 9 provides representative examples of MIC and Lux data.
Figure 10 shows the occurrence of alkylating monomers in the active molecules
Figure 11 provides a list of hit compounds and their structures.
Figure 12 provides Table 3 which shows the layout for deconvolutions.
DETAILED DESCRIPTION
The present invention may be understood more readily by reference to the
following detailed description of the specific embodiments included herein. However,
although the present invention has been described with reference to specific details of
certain embodiments thereof, it is not intended that such details should be regarded as
limitations upon the scope of the invention. The entire text of the references mentioned
herein are hereby incorporated in their entireties by reference including United States
Provisional Patent Application Serial No. 60/381,244 filed May 17, 2002 and United States
Patent Application Serial No. 10/147,587 filed May 17, 2002.
Mycobacterial infections, such as those causing tuberculosis, once thought to be
declining in occurrence, have rebounded, and again constitute a serious health threat.
Tuberculosis (TB) is the cause of the largest number of human deaths attributed to a single
etiologic agent with two to three million people infected with tuberculosis dying each year.
Areas where humans are crowded together, or living in substandard housing, are
increasingly found to have persons affected with mycobacteria. Individuals who are
immunocompromised are at great risk of being infected with mycobacteria and dying from
such infection. In addition, the emergence of drug-resistant strains of mycobacteria has led
to treatment problems of such infected persons.
Many people who are infected with mycobacteria are poor, or live in areas with
inadequate healthcare facilities. As a result of various obstacles (economical, education
levels, etc.), many of these individuals are unable to comply with the prescribed therapeutic
regimens. Ultimately, persistent non-compliance by these and other individuals results in
the prevalence of disease. This noncompliance is frequently compounded by the
emergence of drug-resistant strains of mycobacteria. Effective compositions and vaccines
that target various strains of mycobacteria are necessary to bring the increasing number of
tuberculosis cases under control.
Chemotherapy is a standard treatment for tuberculosis. Some current chemotherapy
treatments require the use of three or four drugs, in combination, administered daily for
two months, or administered biweekly for four to twelve months. Table 1 lists several
treatment schedules for standard tuberculosis drug regimens.

Decades of misuse of existing antibiotics and poor compliance with prolong and
complex therapeutic regimens has led to mutations of the mycobacterium tuberculosis and
has created an epidemic of drug resistance that threatens tuberculosis control world wide.
The vast majority of currently prescribed drugs, including the front line drugs, such as
isoniazid, rifampin, pyrazinamide, ethambutol and streptomycin were developed from the
1950s to the 1970s. Thus, this earlier development of tuberculosis chemotherapy did not
have at its disposal the implications of the genome sequence of Mycobacterium
tuberculosis, the revolution in pharmaceutical drug discovery of the last decades, and the
use of national drug testing and combinational chemistry.
Consequently, the treatments of drug-resistant M. tuberculosis strains, and latent
tuberculosis infections, require new anti-tuberculosis drugs that provide highly effective
treatments, and shortened and simplified tuberculosis chemotherapies. Moreover, it is
desirable that these drugs be prepared by a low-cost synthesis, since the demographics of
the disease dictate that cost is a significant factor.
The present invention provides methods and compositions comprising a class of
substituted ethylene diamine compounds effective in treatment and prevention of disease
caused by microorganisms including, but not limited to, bacteria. In particular, the
methods and compositions of the present invention are effective in inhibiting the growth of
the microorganism, M. tuberculosis. The methods and compositions, of the present
invention are intended for the treatment of mycobacteria infections in human, as well as
other animals. For example, the present invention may be particularly useful for the
treatment of cows infected by M. bovis.
As used herein, the term "tuberculosis" comprises disease states usually associated
with infections caused by mycobacteria species comprising M. tuberculosis complex. The
term "tuberculosis" is also associated with mycobacterial infections caused by
mycobacteria other thanM tuberculosis (MOTT). Other mycobacterial species include M.
avium-intracellulare, M. kansarii, M. fortuitum, M. chelonae, M. leprae, M. africanum,
and M. microti, M. avium pcratuberculosis, M. intracellulare, M. scrofulaceum,M. xenopi,
M. murinum, M. ulcerans.
The present invention further comprises methods and compositions effective for the
treatment of infectious disease, including but not limited to those caused by bacterial,
mycological, parasitic, and viral agents. Examples of such infectious agents include the
following: staphylococcus, streptococcaceae, neisseriaaceae, cocci, enterobacteriaceae,
pseudomonadaceae, vibronaceae, Campylobacter, pasteurellaceae, bordetella, francisella,
brucella, legionellaceae, bacteroidaceae, gram-negative bacilli, Clostridium,
corynebacterium, propionibacterium, gram-positive bacilli, anthrax, actinomyces, nocardia,
mycobacterium, treponema, borrefia, leptospira, mycoplasma, ureaplasma, rickettsia,
chlamydiae, systemic mycoses, opportunistic mycoses, protozoa, nematodes, trematodes,
cestodes, adenoviruses, herpesviruses, poxviruses, papovaviruses, hepatitis viruses,
orthomyxoviruses, paramyxoviruses, corona viruses, picomaviruses, reoviruses,
togaviruses, flaviviruses, bunyaviridae, rhabdoviruses, human immunodeficiency virus and
retroviruses.
The present invention further provides methods and compositions useful for the
treatment of infectious disease, including hy not limited to, tuberculosis, leprosy, Crohn's
Disease, aqnired immunodeficiency syndrome, lyme disease, cat-scratch disease, Rocky-
Mountain Spotted Fever and influenza.
Second Generation Antibiotics from Ethambutol
The present invention is particularly directed to a novel library of diamine
compounds of Ethambutol family comprising a modified ethylene linker starting from
commercially available amino alcohol pre-loaded resins.

In an effort to enhance the structural diversity of our library of Ethambutol analogs
and to assess the influence of a modified linker on the activity of structurally diverse
diamines against M.taberculosis, the synthetic scheme to incorporate amino acids into the
bridging linker between the two amine components was modified. Use of amino acids was
of a special interest since it allowed introduction of another diversity element into the
linker (as R4), as well as chirality.
It was crucial for the project to synthesize a sub-library of diamines closely related
to Ethambutol by having amino alcohol moiety in the molecule, and yet quite different due
to presence an elaborate linker between the two amine atoms (see Figure 1 for
representative examples). Also, the fact that the 2-Chlorotrityl resins with pre-loaded
amino alcohols are commercially available (Figure 2) and suit well proposed chemistry was
very attractive.
The compounds in the library were prepared on mmol scale in 96-well format in
pools of 10 compounds per well (for the vast majority of the plates). Table 1 (Figure 3)
summarizes data for the synthesized plates.
Solid phase syntheses using amino alcohol pre-loaded resins. Twenty 96-well
plates have been prepared. Four- and five-steps synthetic routes starting from
commercially available amino alcohol pre-loaded resins similar to what had been used to
create our first 100,000 compound library (Scheme 1, Figure 4), were applied to make
targeted diamines (Schemes 2 and 3, Figures 5 and 6 respectivety). There are some
differences in the syntheses: (1) two first steps of the Scheme 1 are abandoned in Schemes
2 and 3; (2) in the Scheme 1, the second amine is introduced into the molecule as a whole
synthon via nucleophilic displacement of C1 function of the linker, while in the Schemes 2
and 3, it proceeds through modification of the existing amino moiety by carbonyl
compounds.
Scheme 2. Acylation of the purchased amino alcohol pre-loaded 2-Chlorotrityl
resins was accomplished via peptide coupling with FMOC protected amino acids in
presence of HATU (0-(7-Azabenzotriazol-!-yl)-N,N,N,N-tetramethyluronium
hexafluorophosphate) and EtN(iso-Pr)2 in DCM/DMF mixture at RT. The reaction was
done twice to improve product yields. The list of the amino acids used to create this library
is shown in the Table 2 (Figure 7).
Deprotection (removal of the FMOC group) was carried out by reaction with
piperidine at RT. Derivatization of the amino group was achieved by reductive alkylation
with 96 various carbonyl compounds, such as aldehydes, ketones, and carboxylic acids, in
the presence of NaBCNH3 at RT for 72-96 h. The selection of the carbonyl compounds was
made so, that the final diamine products would carry the same or similar types of
substituents that had been observed in the hit compounds generated from the previous
library of ethambutol analogs, as well as structural diversity (Figure 8). A complete list of
the carbonyl compounds used is shown in Table 3 (Figure 8).
Reduction of the aminoethyleneamides into corresponding diamines was carried out
using the soluble reducing reagent 65+w% Red-Al at room temperature. Cleavage of the
products from the resin was achieved with a 10% solution of trifluoroacetic acid in
dichloromethane resulting in the formation of TFA salts of the diamines.
For library production the acylation step of the synthetic scheme was carried out
using a Quest 210 Synthesizer on scale of 0.1-0.15 g of resin per tube. Following the
reaction, formed resins were thoroughly washed, dried, and then groups of ten resins were
pooled together. A small amount of each resin (~0.05g) was archived prior to pooling to
facilitate re-synthesis and deconvoration of actives.
Deprotection of the FMOC group, addition of the carbonyl component, reduction,
and cleavage were carried out in 96-well reaction blocks using the Combic lamps system by
Whatman Polyfiltronics or the FlexChem system by Robbins Scientific. A suspension of
the pooled resins in 2:1 mixture of DCM/THF was evenly distributed into one reaction
plate resulting in approximately 10 mg of the resin per well. The 96 diverse carbonyl
compounds were arrayed in one 96-well plate template and added, one carbonyl compound
per well, to each individual pool of ten resins, resulting in an anticipated 960 diamines
produced per plate. Reduction was carried out in the same format and cleavage and
filtering into storage plates was followed by evaporation of the TFA prior to biological
assay.
Quality assessment of the prepared library of diamines was done by Electrospray
Ionization mass spectrometry using two randomly selected rows (16 samples) per plate,
17% of the total number. Successful production of a compound was based on an
appearance of a molecular ion of the calculated mass. Depending on the amino acid that
had been used for tire synthesis, the percentage of the predicted ions were observed and
therefore the predicted compounds were formed, varied from 31-96% (Table 1, Figure 3).
Based on MS analysis, out of targeted 15,360 compounds, 7,500 diamines were actually
formed. Amino acids such as aminomethylcylcohexyl carboxylic acid, thienylalanine, or
phenylalanine produced desirable compounds with good yields (88-96%). At the same
time, some amino acids, such as arginine, tetrahydroisoquinoline carboxylic acid, and
thiazolidine carboxylic acid did not lead to the corresponding products.
Scheme 3. Success in preparation of ethambutol analogs with modified linker
encouraged us to attempt synthesis of another sub-library of diamines using commercially
available ammo-alcohol pre-loaded resins (Scheme 3, Figure 6). This route yields diamine
compounds that are similar to those produced by the (Scheme 2, Figure 5) but that also
possess desirable substiruents at the first nitrogen atom.
We have illustrated this method by starting from commercially available 1,4-
aminobutanol pre-loaded resin. We prepared five plates using five amino acids Phe, Amc,
Cha, Trp, and Inp (Table 1) that gave the best preliminary results in the screening assays
(see number of hits in the Table 1). The very first step was derivatization of the amino
group via reductive alkylation by 10 carbonyl compounds (cyclooctanone, 4-
benzyloxybenzaldehyde, (S)-citronellal, myrtenal, tetrahydro-4H-pyran-4-one,
norcamphor, 4-(4-hydroxyphenyl)2-butanone, geranylacetone, 2-decalone, 2-
adamantanone) in presence of NaBCNH3 at RT. The following steps were carried out in a
similar fashion as we reported earlier for the Scheme 2.
Screening the library against M. tuberculosis and deconvolution of the active
mixtures. A high-throughput assay with recombinant mycobacteria containing a promoter
fusion of luciferase to Rv0341, as well as the MICs, has been used to screen this new
compound library of ethambutol analogs, Figure 9.
198 compound mixtures have shown to exhibit anti-TB activity, Table 1 (activity at
deconvolutions. Deconvolutions of all 198 compound mixtures were performed by the
discrete re-synthesis of the diamine compounds in 96-well format using stored archive
resins (prior pooling them together) and the same synthetic Schemes 2 and 3. The same
screening tests were used for every deconvoluted plate. Few carbonyl compounds have
been identified as potent synthons contributing to the anti-TB activity (Figure 5).
Performed deconvolutions revealed 118 hits of novel structures as potent anti-TB
compounds (Table 4), 38 of those compounds were proven to be active in both assays.
Figure 11 provides a list of hit compounds and their structures.
Formulations
Therapeutics, including compositions containing the substituted ethylene diamine
compounds of the present invention, can be prepared in physiologically acceptable
formulations, such as in pharmaceutic ally acceptable carriers, using known techniques. For
example, a substituted ethylene diamine compound is combined with a pharmaceutically
acceptable excipient to form a therapeutic composition.
The compositions of the present inventionrriay. be administered in the form of a
solid, liquid or aerosol. Examples of solid compositions include pills, creams, soaps and
implantable dosage units. Pills may be administered orally. Therapeutic creams and anti-
mycobacteria soaps may be administered topically. Implantable dosage units may be
administered locally, for example, in the lungs, or may be implanted for systematic release
of the therapeutic composition, for example, subcutaneously. Examples of liquid
compositions include formulations adapted for injection intramuscularly, subcutaneously,
intravenously, intraarterially, and formulations for topical and intraocular administration.
Examples of aerosol formulations include inhale'r formulations for administration to the
lungs.
A sustained release matrix, as used herein, is a matrix made of materials, usually
polymers, which are degradable by enzymatic or acid/base hydrolysis, or by dissolution.
Once inserted into the body, the matrix is acted upon by enzymes and body fluids. The
sustained release matrix is chosen desirably from biocompatible materials, including, but
not limited to, liposomes, polylactides, polyglycolide (polymer of glycolic acid),
polylactide co-glycolide (coplymers of lactic acid and glycolic acid), polyanhydrides,
poly(ortho)esters, polypeptides, hyaluronic acid, collagen, chondroitin sulfate, carboxylic
acids, fatty acids, phospholipds, polysaccharides, nucleic acids, polyamino acids, amino
acids such as phenylalanine, tyrosine, isoleucine, polynucleotides, polyvinyl propylene,
polyvinylpyrrolidone and silicone. A preferred biodegradable matrix is a matrix of one of
either polylactide, polyglycolide,.or polylactide co-glycolide.
The dosage of the composition will depend on the condition being treated, the
particular composition used, and other clinical factors, such as weight and condition of the
patient, and the route of administration. A suitable dosage may range from 100 to 0.1
mg/kg. A more preferred dosage may range from 50 to 0.2 mg/kg. A more preferred
dosage may range from 25 to 0.5 mg/kg. Tablets or other forms of media may contain
from 1 to 1000 mg of the substituted ethylene diamine. Dosage ranges and schedules of
administration similar to ethambutol or other anti-tuberculosis drugs may be used.
The composition may be administered in combination with other compositions and
procedures for the treatment of other disorders occurring in combination with
mycobacterial disease. For example, tuberculosis frequently occurs as a secondary
complication associated with acquired immunodeficiency syndrome (AIDS). Patients
undergoing AIDS treatment, which includes procedures such as surgery, radiation or
chemotherapy, may benefit from the therapeutic methods and compositions described
herein.
The following specific examples will illustrate the invention as it applies to the
particular synthesis of the substituted ethylene diamine compounds, and the in vitro and in
vivo suppression of the growth of colonies of M tuberculosis. In additiona, the teachings
of R. Lee et al. J. Comb. Chem 2003, 5, 172-1S7 are hereby incorporated by reference in
their entirety. It will be appreciated that other examples, including minor variations in
chemical procedures, will be apparent to those skilled in the art, and that the invention is
not limited to these specific illustrated examples.
EXAMPLE I
Generating the Diamine Library from
commercially available amino alcohol pre-loaded resins.
General Methods: All reagents were purchased from Sigma-Aldrich. Amino
alcohol pre-loaded resins were purchased from NovaBiochem. Solvents acetonitrile,
dichloromethane, dimethylformamide, ethylene dichloride, methanol, and tetrahydrofuran
were purchased from Aldrich and used as received. Solid phase syntheses were performed
on Quest 210 Synthesizer (Argonaut Technologies) and combinatorial chemistry
equipment (Whatman Polyfiltronics and Robbins Scientific). Evaporation of the solvents
was done using SpeedVac AES (Savant). Mass spectra data were obtained by Electrospray
Ionization technique on Perkin Elmer/Sciex, API-300, TQMS with an autosampler.
Scheme 2. Description of the Process.
The acylation step was carried out in 5 ml tubes using the Quest 210 Synthesizer.
Removal of the FMOC group, reductive alleviation reaction with carbonyl compounds, the
reduction with Red-Al, and the cleavage from the solid support were carried out in 96-deep
(2ml) well, chemically resistant plates.
Step 1. deviation of amino alcohol pre-loaded resins with amino acids.
Each tube was loaded 0.150 g of corresponding resin (coverage of 0.3-1.0 tnmol/g),
and all resins were pre-swollen in DCM for 1.5 h and filtered. If Fmoc protected resin was
used: the resin was stirred with 2.5 ml of 20% solution of piperidine in DMF for 10 min,
filtered, and washed with 2.5 ml of DMF. The procedure was repeated, but the stirring time
was 20 min. After that all resins were filtered, washed with DMF (1x2.5 ml) and DCM
(2x3ml). Each tube was charged with 1 ml of dichloromethane. Amino acids, 0.38mmol in
1 ml of DMF (2,5 mol excess to loaded resin) were mixed with HATU. 0.3 mmol, 011 g in
0.5 ml of DMF (2 mol excess to loaded resin) and allowed to stay for 1520 min. Then 1.5
ml of mixture acid-HATU were added to each tube following by the addition of solution of
1.5 mmol, 0.26 ml (10 mol excess to loaded resin) of EtNPr2 in 0.5 ml of dichloromethane.
Reaction carried out 8 h at 45 C and 6-8 h at room temperature. After the reaction was
complete, the resins were filtered, washed with 1:1 mixture of DMF and dichloromethane
(1x3ml), dichloromethane (1x3ml), and acylation was repeated with the same amount of
reagents. At the end, the resins were filtered, washed wife 1:1 mixture of DMF and
dichloromethane (1x3ml), methanol (3x3ml), sucked dry (on Quest) for 30 min and
transferred into vials (one resin per vial), and dried in a desiccator under vacuum for Ih.
After this step all resins were subjected for quality control using MS spectra.
Step 2. Alkylation of the amino group.
Deprotection. Ten prepared resins from the first three steps were pooled together,
leaving approximately 0.03 g of each in the individual vials for all necessary
deconvolutions. A suspension of the resin mixture (0.08- 1.0 g) in 100 ml of a 2:1
mixture of dichloromethane and THF was distributed into two 96-well filterplates and
filtered using a filtration manifold. The reaction plates were transferred into combiclamps,
and 0.2 ml of 20% solution of piperidine in DMF was added to remove Fmoc protecting
group and allowed to stay for 10 min. After 10 min plate was fdtered, washed with 0.2 ml
of DMF, and deprotection was repeated with 0.2 ml of 20% solution of piperidine in DMF
and allowed to stay for 20 min. After that plate was filtered, washed with DMF (0.2 ml per
well) and dichloromethane (2x0.5 ml per well).
Reaction with the carbonyl compounds. Each well in row A on the reaction plate
was charged with 0.1 ml of dichloromethane, 0.08ml of ~1.0M solution of appropriate acid
in DMF from master plate, 0.05 ml DMF solution of PyBrop, (0.012 g, 0.025 mmol, 2.5
mol excess to loaded resin) and 0.05 ml of EfNi'Pr2 in dichloromethane (0.017 ml, 0.10
mmol, 10 mol excess to loaded resin). Each well in rows B through H was charged with
0.1 ml of THF, 0.160 ml of~1.0 M solution of appropriate aldehyde or ketone in DMF
from master plate and allowed to react for 30 min. After 30 min 0.075 ml (0.075 mmol) of
1.0 M solution of NaBCNH3 in THF were added. The reaction plates were sealed and kept
at RT for 72h. At the end, the resins were filtered, washed with THF, DCM (1x1m1),
methanol (2xlml) and dried in desiccator under vacuum for 3h.
Step 3. Reduction with Red-Al.
The reaction plates were placed into combiclamps. A 1:6 mixture of Red-Al (65+
w% in toluene) and THF was added, 0.6 ml per well (0.28mmol of Red-Al per well), and
allowed to react for 4 h. After the reaction completion the resins were filtered, washed
with THF (2x1 ml), methanol (3x1 ml) and dried in tire filtration manifold.
Step 4. Cleavage.
This step was carried out using a cleavage manifold. The reaction plates (placed on
the top of the collection plates in this manifold) were charged with a 10:88:2 mixture of
TFA, dichloromethane, and triisopropylsilane, 0.5 ml per well. After 15 min, the solutions
were filtered and collected into proper wells of the collection plates. The procedure was
repeated. Solvents were evaporated on a speedvac, and the residual samples were ready for
testing.
Scheme 3. Description of the Process.
The reductive alkylation step of 4-aminobutan-l ol resin and the acylation stop were
carried out in 5 ml tubes using the Quest 210 Synthesizer. Removal of the FMOC group,
reductive alkylation reaction with carbonyl compounds, the reduction with Red-Al, and the
cleavage from the solid support were carried out in 96-deep (2ml) well, chemically
resistant plates.
Step 1. Reductive alkylation of 4-Aminobutan-l-ol resin.
A suspension of the resin (coverage of 0.3-1.0 mmol/g), 1.0 g (up to 1.0 mmol), in
30 ml of 2:1 mixture of dichloromethane and THF was disitrubuted into 10 tubes, 3 ml per
tube and filtered, than each tube was charged with 0.10 g of resin. Resin was pre swollen in
DCM for 1.5 h and filtered. Each tube were loaded with 1.5 ml 1,2-dichloroethane, 0.3
mmol (3 mol excess) of corresponded aldehyde or ketone (alkylating reagent) and allowed
to react for 30 min. After that 0.3 mmol (0.3 ml) of 1 M solution of NaBCNH3 in THF
were added and reaction was carried out at RT for 48 h. When reaction was completed, all
tubes were filtered, washed with THF (2x3ml), MeOH (3x3ml) and sucked dry (on Quest
for ~30min).
Step 2. Acylation with amino acids.
All tubes were pre washed with DCM twice. Each tube was charged with 1 ml of
dichloromethane. Amino acids, 0.25 mmol in 1 ml of DMF (2,5 mol excess to loaded
resm) were mixed with HATU, 0.2 mmol, 0.076 g in 0.5 ml of DMF (2 mol excess to
loaded resin) and allowed to stay for 15-20 min. Then 1.5 ml of mixture acid-HATU were
added to each tube following by the addition of solution of 1.0 mmol, 0.17 ml (10 mol
excess to loaded resin) of EtNiPr2 in 0.5 ml of dichloromethane. Reaction carried out 8 h at
45 C and 6-S h at room temperature. After 16 h the resins were filtered, washed with 1:1
mixture of DMF and dichloromethane (1x3ml), dichloromethane (1x3ml) and acylation
was repeated with the same amount of reagents. At the end, the resins were filtered, washed
with 1:1 mixture of DMF and dichloromethane (1x3ml), methanol (3x3ml), sucked dry (on
Quest) for 30 min and transferred into vials (one resin per vial), and dried in a desiccator
under vacuum for 1h. After this step all resins were subjected for quality control using MS
spectra.
All following reaction steps, - alkylation of the amino group (Step 3), reduction with Red-Al
(Step 4), and Cleavage (Step 5), - were carried as they were described for the Scheme 2 of
this Application.
Deconvolution
Deconvolution of the active wells was performed by re-synthesis of discrete
compounds, from the archived FMOC-protected -aminoacetamide resins (10 resins, 0.05-
0.10g each), which were set aside at the end of the acylation step before the pooling. Each
resin was assigned a discrete'Column (1, or 2, or 3, etc.) in a 96-well filterplate, and was
divided between X rows (A, B, C, etc), where X is the number of hits discovered in the
original screening plate. To each well, in a row, a selected carbonyl compound (present in
the hit) was added along with other required reagents: the first selected carbonyl compound
was added to the resins in the row "A", the second carbonyl compound- to the resins in
the row "B", the third carbonyl compound- to the resins in the row "C", etc. A lay-out of
a representative 96-well deconvolution plate is shown in Table3, Figure 12.
The reaction plates were sealed and kept at RT for 72h. At the end, the resins were
filtered, washed with THF, DCM (1x1ml), methanol (2x1 ml) and dried in desiccator under
vacuum for 2h. Reduction and cleavage were performed according to steps 5 and 6 of the
synthetic protocol. The product wells from the cleavage were analyzed by ESI-MS
(Electrospray Ionization Mass Spectroscopy) to ensure the identity of the actives, and were
tested in the MIC assay.
Solid Phase Synthesis of Selected Substituted Ethylenediamines
Using the Quest 210 Synthesizer.
The solid phase protocol described above for generating a library of diamine
compounds was applied to the scale-up synthesis of the selected substituted
ethylenediamine compounds. Here, all reaction steps, from the acylation of the
commercially available amino alcohol pre-loaded resins to the cleavage of the final
product, were carried out using Quest instrument only, which allowed for up to twenty
parallel reactions. Purification of all crude samples was done by Flash Chromatography on
CombiFlash (Isco, Inc.) to yield desirable products in purity greater than 90%. Here, the
synthesis of one of the active compounds, l-(2-{[3-(4-cmorophenoxy)benzyl]aminoj-3-
phenylpropyl)piperidin-4-ol, is described below as an example.
The preparation of l-(2-{[3-(4-chlorophenoxy)benzyl]amino}-3-
phenylpropyl)piperidin-4-ol, compound 588.

Representative synthesis of active compounds.
Removal of FMOC protective group. Commercially available resin (N-FMOC-
piperidinyl-4-oxy)-(4-methoxyphenyl)methyl polystyrene, coverage (linker) 0.88 mmol/g
(0.4 g, 0.35 mmol), was placed into one of the 10 ml tubes of Quest 210 Synthesizer. A
solution of piperidine (1.5 ml) in DMF (6 ml) was added and stin'ed for 30 min, filtered,
washed with DMF (1x6 ml), and the addition of piperidine was repeated. The resin was
washed with DMF (1x8 ml) and DCM (2x8ml).
Acylation with FMOC protected L-Phenylalanine . The resin was pre-washed with
5 ml of DCM for 20 min. FMOC L-Phenylalanine, (.0341 g, 0.88 mmol) in 1 ml of DMF
(2,5 mol excess to loaded resin) were mixed with HATU (0.33 g, 0.88 mmol) in 3 ml of
DMF, and added to the tube following by the addition of solution of 0.6 ml of EtN/Pr2.
Reaction was carried at RT for 20 h. After the reaction was complete, the resin was
filtered, washed with 1:1 mixture of DMF and dichloromethane (1x6ml), dichloromethane
(Tx6ml), and acylation was repeated with the same amount of reagents. At the end, the
resins were filtered, washed with 1:1 mixture of DMF and dichloromethane (2x6ml).
Removal of FMOCprotective group. A solution of piperidine (1.5 ml) in DMF (6
ml) was added to the resin and formed suspension was stirred for 30 min, filtered, washed
with DMF (1x6 ml), and the addition of piperidine was repeated. The resin was washed
with DMF (lxS ml) and methanol (2x8ml), and sucked dry inder Ar for 20 min.
Reaction with a carbonyl compound. The resin was pre-washed with THF for 30
min, filtered, and charged wjth 6 ml of THF. 3-(4-Chlorophenoxy)-benzaldehyde (0.280
ml, 1.00 mmol) was added followed by addition of 1.0 M solution of NaBCNH3 in THF (1
ml, 1 mmol) after 30 min. The reaction was allowed to proceed at RT for 72h. At the end,
the resin was filtered, washed with THF (1x6ml) and MeOH (2x6ml), and dried under Ar
for 30 min.
Reduction with Red-Al. The resulted resin in a tube was pre-washed with
anhydrous THF (2x6ml) and filtered. The rube was charged with 5 ml of anhydrous THF
followed by addition upon stirring commercially available Red-Al as 65+% in toluene (1
ml, 3.2 mmol). After 4 h the resin was filtered, washed with THF (2xlml) and MeOH
(3xlml) (addition of MeOH should proceed with caution!), and dried under Ar for 10 min.
Cleavage. For this last step of the synthesis the tube with the resin was charged with
DCM (S ml) and TFA (1 ml) and formed bright red suspension was allowed to stir for 30
min. The resin was filtered and the filtrate was collected into a collection tube. The
procedure was repeated. DCM and excess of TFA were evaporated on a speedvac. Crude
l-(2-{[3-(4-chIorophenoxy)benzyl]ammo}-3-phenylpropyl)piperidin-4-ol (in a form of
trufluoroacetate salt) was purified by Flash Chromatography on CombiFlash (Isco) using
following conditions: pre-loaded silica gel column, 12 g, flow 15 ml/'min, 25 min run,
gradient starting with DCM finishing up with DCM/MeOH/NH4OH (600/400/10).
Obtained: 0.128 mg of l-(2-{[3-(4-chlorophenoxy)benzyI]amino}-3-
phenyIpropyl)piperidin-4-ol ditrifluoroacetate, 53% yield, of at least 95% purity. Mass
spectrum (ESI) m/z (MH)+451.2, 453.2.
WE CLAIM:
1. A compound selected from the group consisting of:
ft


A compound selected from the group consisting of:


Documents:

1908-KOLNP-2004-ABSTRACT 1.1.pdf

1908-kolnp-2004-abstract.pdf

1908-KOLNP-2004-CANCELLED PAGES 1.1.pdf

1908-KOLNP-2004-CLAIMS 1.1.pdf

1908-kolnp-2004-claims.pdf

1908-KOLNP-2004-CORRESPONDENCE 1.1.pdf

1908-KOLNP-2004-CORRESPONDENCE 1.3.pdf

1908-KOLNP-2004-CORRESPONDENCE-1.1.pdf

1908-KOLNP-2004-CORRESPONDENCE-1.2.pdf

1908-kolnp-2004-correspondence.pdf

1908-KOLNP-2004-DESCRIPTION (COMPLETE) 1.1.pdf

1908-kolnp-2004-description (complete).pdf

1908-KOLNP-2004-DRAWINGS 1.1.pdf

1908-kolnp-2004-drawings.pdf

1908-kolnp-2004-examination report.pdf

1908-KOLNP-2004-FORM 1 1.1.pdf

1908-KOLNP-2004-FORM 1 1.2.pdf

1908-kolnp-2004-form 1.pdf

1908-KOLNP-2004-FORM 18 1.1.pdf

1908-kolnp-2004-form 18.pdf

1908-KOLNP-2004-FORM 2 1.1.pdf

1908-kolnp-2004-form 2.pdf

1908-KOLNP-2004-FORM 26 1.1.pdf

1908-kolnp-2004-form 26.pdf

1908-KOLNP-2004-FORM 3 1.2.pdf

1908-KOLNP-2004-FORM 3-1.1.pdf

1908-kolnp-2004-form 3.pdf

1908-KOLNP-2004-FORM 5 1.1.pdf

1908-kolnp-2004-form 5.pdf

1908-KOLNP-2004-FORM-27.pdf

1908-KOLNP-2004-GRANTED-ABSTRACT.pdf

1908-KOLNP-2004-GRANTED-CLAIMS.pdf

1908-KOLNP-2004-GRANTED-DESCRIPTION (COMPLETE).pdf

1908-KOLNP-2004-GRANTED-DRAWINGS.pdf

1908-KOLNP-2004-GRANTED-FORM 1.pdf

1908-KOLNP-2004-GRANTED-FORM 2.pdf

1908-KOLNP-2004-GRANTED-SPECIFICATION.pdf

1908-KOLNP-2004-OTHERS.pdf

1908-KOLNP-2004-PCT SEARCH REPORT.pdf

1908-KOLNP-2004-REPLY TO EXAMINATION REPORT 1.1 .pdf

1908-kolnp-2004-reply to examination report.pdf

1908-kolnp-2004-specification.pdf


Patent Number 250595
Indian Patent Application Number 1908/KOLNP/2004
PG Journal Number 02/2012
Publication Date 13-Jan-2012
Grant Date 11-Jan-2012
Date of Filing 13-Dec-2004
Name of Patentee SEQUELLA INC.
Applicant Address 9610 MEDICAL CENTER DRIVE, SUITE 200, ROCKVILLE, MD
Inventors:
# Inventor's Name Inventor's Address
1 PROTOPOPOVA, MARINA, NIKOLAEVNA 1425 CREDSTRIDGE DRIVE, SILVER SPRING, MD 20910 M.P.
2 BOGATCHEVA, ELENA 5301 WEST E.BARD CIRCLE, APT. 110, BETHESDA, MD 20816
PCT International Classification Number A61K
PCT International Application Number PCT/US2003/15925
PCT International Filing date 2003-05-19
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 60/381, 244 2002-05-17 U.S.A.
2 10/147, 587 2002-05-17 U.S.A.