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Core 2 glcnac-t inhibitors

Core 2 glcnac-t inhibitors description/claims

The present invention relates to the use of known and novel compounds as inhibitors of UDP-GlcNAc:Galβ1,3GalNAc-R (GlcNAc to GalNAc) β-1,6-N-acetylglucosaminyl transferase (core 2 β-1,6 N-acetylaminotransferase, core 2 GlcNAc-T-EC 2.4.1.102). The present invention relates to the use of known and novel compounds as pharmaceutical actives against diseases susceptible to treatment by modulation, eg. inhibition, of Core 2 GlcNAc-T.

Inhibitors of Core 2 GlcNAc-T, and the present compounds in particular, have application in therapy for diseases in which core 2 GlcNAc-T is implicated and especially those in which the enzyme activity is raised relative to the normal level in the tissue type concerned, or those conditions in which it is advantageous to lower the activity of core 2 GlcNAc-T for example to its normal level or below. Examples of such conditions are inflammatory diseases such as atherosclerosis and multiple sclerosis, diabetes, cancer including treatment or prevention of metastasis.

Inhibitors of Core 2 GlcNAc-T are known but none are in clinical development as isolated actives for pharmaceutical use. Examples of known compounds are disclosed in WO0187548, Kuhns et al., Glycoconjugate Journal 10 381-394 (1993), Hindsgaul et al., J Biol Chem. 266(27):17858-62 (1991), and Toki et al, Biochem Biophys Res Commun. 198(2):417-23 (1994).

Applicant's co-pending application WO05/060977 (incorporated herein by reference) discloses known and novel steroidal glycosides that have therapeutic use as Core GlcNAc-T inhibitors, discusses the basis for use of such inhibitors in therapy and discloses published documents detailing the basis for Core 2 GlcNAc-T involvement in a number of diseases. Compounds of the formula IIb are not disclosed therein. The present application discloses further steroidal glycoside compounds that are inhibitors of core 2 GlcNAc-T and additional conditions in which these compounds have a therapeutic use.

The present inventors have determined that the compounds herein described can inhibit glucose-induced activity of core 2 GlcNAc-T and glucose induced binding of human leukocytes to cultured bovine retinal capillary endothelial cells as measured in assays described herein. The administration of these compounds, hereinafter referred to as Core 2 GlcNAc-T inhibitors to patients can prevent or treat the abnormal formation of core 2 O-glycans and sialyl Lewisx by inhibiting raised activity of core 2 GlcNAc-T in the aforementioned disease states.

Following initiation of glycosylation by the attachment of an N-acetylglucosamine (GalNAc) to either a serine or threonine residue in a protein to be glycosylated, processing proceeds by elongation, branching and then terminal modification of the O-glycans.

Essential steps in O-glycan elongation and branching are catalysed by multiple glycosyl transferase isoforms from families of homologous glycosyltransferases. Depending on which saccharide groups are subsequently attached to this first GalNAc residue, O-glycans are divided into four major subtypes (FIG. 1). The core 1 structure is formed by addition of galactose to form Galβ1-3GalNAc-αSer/Thr. The core 2 structure requires the core 1 structure as substrate and is formed by addition of GlcNAc to form Galβ1-3(GlcNAcβ1-6)GalNAc-αSer/Thr. The core 3 structure is formed by the addition of GlcNAc to form GlcNAcβ1-3GalNAc-αSer/Thr. The core 4 structure requires the core 3 structure as substrate and is formed by addition of GlcNAc to form GlcNAcβ1-3(GlcNAcβ1-6)GalNAc-αSer/Thr. Other modifications to the core GalNAc structure have also been found, but appear to be uncommon. All these core structures are further modified by galactosylation, sialylation, fucosylation, sulfation or elongation to eventually form the O-glycan.

Three forms of Core 2 GlcNAc-T are known. Core 2 GlcNAc-T I identified in from leukemic cells, core 2 GlcNAc-T II identified in mucin secreting tissue, and a third thymus associated type designated core 2 GlcNAc-T III.

Cell surface O-glycans are known to play a crucial role in mediating cell-cell interactions in development and certain disease states. The patterns of protein glycosylation are determined largely by the activity and specificity of the glycotransferase enzymes, such as core 2 GlcNAc-T which is expressed in the Golgi apparatus (Colley K. J. Glycobiology 7, 1-13 (1997) Varki A. Glycobiology 3, 97-130 (1993)) Core 2 GlcNAc-T plays a crucial role in the biosynthesis of O-linked glycans (3-4) and represents an important regulatory step for the extension of O-linked sugars with polylactosamine (i.e. repeating Galβ1-4GlcNAcβ1-3), a structure associated with malignant transformation (Leferte S. Cancer Res. 48, 4743-4748 (1988) Ellies L. G. Immunity 9, 881-890 (1998)).

Changes in the activity of core 2 GlcNAc-T have been associated with various disease states, such as T-cell activation, cancers, metastasis, myeloblastic leukaemia, myocardial dysfunction and inflammation (Brockhausen I. et al. Cancer Res. 51, 1257-1263 (1991) Renkonen J., APMIS 109, 500-506 (2001) Machida E. et al., Cancer Res. 61, 2226-2231 (2001) Dalziel M. Biol. Chem. 276, 11007-11105 (2001) Perandio M., Blood 97, 3812-3819 (2001) Yousefi S., J. Biol. Chem. 266, 1772-1782 (1991) Higgins E. A., J. Biol. Chem. 266, 6280-6290 (1991) Piller F. J. Biol. Chem. 263, 15146-15150 (1988). Koya D. et al., FASEB J. 13, 2329-2337 (1999) Nishio Y. J. Clin. Invest. 96, 1759-1767 (1995) Tsuboi S., Bioassays 23, 46-53 (2001) Tsuboi S., EMBO J. 16, 6364-6373 (1997)). Regulation of core 2 GlcNAc-T is thought to be particularly important, because addition of lactosamine structures to the basic core oligosaccharides formed by this enzyme and subsequent modification with fucose and sialic acid, results in the formation of the Lewisx, sialyl-sialyl Lewisa, and Lewisx sugar groups that constitute the ligands of selectins which are cell adhesion proteins. This selectin-ligand interaction plays an important role in many processes.

Inflammation is how the body generally responds to infection or to some other form of trauma. One of the major events during inflammation is the movement of cells of the immune system from the blood stream to the infected or injured area. Once at the site of injury, these cells are responsible for the isolation, destruction and removal of the offending agent.

Acute inflammation, characterised by short duration (minutes to days), is essential for health, but sometimes the inflammatory process does not end when appropriate, and it is this that causes problems. Chronic inflammation is characterised by long duration (days, weeks, months and even years), lymphocytes and macrophages, tissue destruction and repair, and vascular proliferation and fibrosis. Inflammation can also be triggered inappropriately by the body's normal constituents and plays a role in common diseases, such as asthma, rheumatoid arthritis and inflammatory bowel disease.

Many cell adhesion molecules are known to be involved in the process of inflammation. At the site of inflammation, leukocytes first adhere to the vascular endothelial cells prior to the extravasation process. It is postulated that selectins play a crucial role in the initial adhesion of leukocytes to endothelial cells. Cell adhesion mediated by selectins and their carbohydrate ligands leads to the tethering and rolling of leukocytes on endothelial linings. This then leads to the secondary firm adhesion. Within hours of the initial stimulus, neutrophils begin to enter the tissue and may continue transmigration for many days. In some inflammatory conditions, tissue damage is caused by direct injury of the vessels and amplified by the subsequent recruitment of neutrophils into the tissue.

The expression of O-glycans reduces cell-cell interactions because of the bulkiness of these adducts. The expression of core 2 O-glycans is regulated by the transcriptional levels of core 2 GlcNAc-T in all of these cases. Antigen-mediated activation of peripheral T and B-cells is characterised by increased activity of core 2 GlcNAc-T and branched O-glycans on CD43 (leukosialin) (Tsuboi S., Bioassays 23, 46-53 (2001) Piller F. et al., J. Biol. Chem. 263, 15146-15150 (1988)).

Leukocyte extravasation, lymphocyte trafficking and other processes involve O-glycan synthesised by core 2 GlcNAc-T. Specifically, cell-surface O-glycan structures terminating in sialyl Lewisx are involved in the recruitment of leukocytes to the site of inflammation. Core 2 GlcNAc-T is not important for T-cell development, but over expression of this enzyme has been shown to completely block the development of myeloid lineages. Over expression of core 2 O-glycans has also been reported to affect the interaction between T-cells and B-cells (TB interaction). This T-B interaction is crucial for humoral immune response and is mediated through binding of the CD40 ligand (CD40L) on T-cells with CD40 on B-cells (CD40L-CD40 interaction). This interaction induces the proliferation of B-cells. Over expression of core 2 O-glycans has been shown to cause significant reduction in CD40L-CD40 interaction (Tsuboi S., J. Biol. Chem. 273(46), 30680-30687 (1998)).

It is possible to effectively block the initial step of leukocyte invasion from taking place, by blocking the synthesis of sialyl Lewisx on the cell surface of activated leukocytes and thereby halting their interactions with selectins. Therefore, inhibitors of core 2 GlcNAc-T that can reduce the activity of core 2 GlcNAc-T have utility in modulating inflammation.

Atherosclerosis is a progressive inflammatory disease of unknown mechanism. Recruitment and adhesion of circulating leukocytes to the endothelium particularly at arterial branches and bifurcations is one of the earliest events known to occur in atherogenesis. Integrins on the leukocytes then cause a stronger attachment between the cells. Leukocytes transmigrate through into the sub-endothelial space where they begin to accumulate in the intima. Monocytes become converted to activated macrophages with the presence of oxidised low density lipoprotein (LDL-oxLDL), these activated macrophages take up the modified types of lipoprotein via their scavenger receptors and differentiate to become foam cells. Histological analysis of atherosclerotic coronary arteries from patients who died of acute coronary syndromes demonstrate foam cells, macrophages, lymphocytes and mast cells were present in unstable or ruptured plaques (Mulvihill N. T. Heart. 87(3):201-4. (2002)).

At least three leukocyte adhesion molecules, E-selectin, ICAM-1, and VCAM-1, have been identified in human atherosclerosis (Guray U. et al. Int J Cardiol. 2004 96(2):235-40. O'Brien K D Circulation. 15; 93(4):672-82. (1996).). Further, in contrast to normal vessels, P selectin is overly expressed by epithelial cells in atherosclerotic lesions and expression of E-selectin and ICAM-1 (Davies M J. J Pathol. 171(3):223-9 (1993).) at the arterial lumen, has been found to be increased in arterial segments with mononuclear leukocyte accumulation. A third adhesion molecule, VCAM-1, has been detected in animal models of atherosclerosis, and also has been shown to be more prevalent in the intima of atherosclerotic plaques than in non atherosclerotic segments of human coronary arteries.

Chibber et al (Chibber R; Diabetes; 49(10):1724-30 (2000).) evaluated the importance of core 2 GlcNAc-T in increased leukocyte-endothelial cell adhesion and found significant increases in the activity of this enzyme in leukocytes of diabetic patients. However, until now there has been no evidence that core 2 GlcNAc-T activity is raised in circulating leukocytes of patients suffering from atherosclerosis. The applicants have now demonstrated that activity of the enzyme Core 2 GlcNAc-T is indeed raised in circulating leukocytes from patients with atherosclerosis, suggesting that compounds capable of lowering the activity of core 2 GlcNAc-T would be useful in the treatment or prevention of atherosclerosis or in preventing reoccurrence of atherosclerotic plaques in patients following interventions.

Although the clinical symptoms of diabetic cardiomyopathy have been identified, its pathogenesis is uncertain. The definition of diabetic cardiomyopathy describes both specific defects in the diabetic's myocytes, such as fibrosis leading to myocardial hypertrophy and diastolic dysfunction, and associated changes in the heart which have developed during the course of diabetes.

There is now strong evidence suggesting that raised activity of core 2 GlcNAc-T is directly responsible for elevated glycoconjugates, commonly observed in the heart tissue of diabetic animals and patients. In support of this, it has recently been shown that increased core 2 GlcNAc-T activity causes pathology similar to that observed in the heart of diabetic patients after years with the condition, in the heart of diabetic experimental animal models. Studies were carried out using a transgenic mouse with core 2 GlcNAc-T expression driven by a cardiac myosin promoter. At 4 months, a marked hypertrophy of the left ventricle and general hypertrophy of the heart was observed (Nishio Y., J. Clin. Invest. 96, 1759-1767 (1995) Tsuboi S, Bioassays 23, 46-53 (2001)).

Marked changes in core 2 branching and core 2 GlcNAc-T activities are associated with malignant transformation, leukaemia and carcinomas (Tsuboi S. J. Biol. Chem. 273(46), 30680-30687 (1998) Saitoh O., Cancer Res. 51(11), 2854-2862 (1991) Brockhausen I., Cancer Res. 51, 1257-1263 (1991) Renkonen J., APMIS 109, 500-506 (2001) Shimodaira K., Cancer Res. 1; 57(23), 5201-5216 (1997)). Rat fibroblasts and mammary carcinoma cells transfected with T24H-ras express core 2 O-glycans as they become metastatic tumours.

There is a great deal of evidence pointing to the involvement of core 2 GlcNAc-T in cancer and cancer metastasis. For example, highly metastatic colonic carcinoma cells both express more sialyl Lewisx than their low metastatic counterparts and adhere more strongly to E-selectin than poorly metastatic cells. There is a strong correlation between the expression of sialyl Lewisx in tumour cells and tumour progression (Brockhausen I, ibid). Moreover, a good correlation exists between the expression of sialyl Lewisx in core 2 O-glycans and lymphatic and venous invasion.

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