U.S. patent application number 10/315445 was filed with the patent office on 2003-10-02 for therapeutic methods and compositions for the treatment of impaired interpersonal and behavioral disorders.
Invention is credited to Marcel, Tony, Rougeon, Francois, Rougeot, Catherine.
Application Number | 20030186870 10/315445 |
Document ID | / |
Family ID | 22491816 |
Filed Date | 2003-10-02 |
United States Patent
Application |
20030186870 |
Kind Code |
A1 |
Marcel, Tony ; et
al. |
October 2, 2003 |
Therapeutic methods and compositions for the treatment of impaired
interpersonal and behavioral disorders
Abstract
The invention relates to the field of psychopharmacology. More
particularly, the invention relates to the treatment of DSM-III
disorders, such as impaired interpersonal and behavioral disorders,
including sexual disorders such as M.E.D. and H.S.D.D. The
invention provides new therapeutic compositions and methods for
treating DSM-III disorders, including M.E.D. and H.S.D.D. The
compositions and methods according to the invention provide
improved awareness and alertness to environment, improved
adaptation to environment and ability to sustain attention, and
increased interest in environment and capacity for arousal, without
increased aggressiveness.
Inventors: |
Marcel, Tony; (Paris,
FR) ; Rougeon, Francois; (Sevres, FR) ;
Rougeot, Catherine; (Chevreuse, FR) |
Correspondence
Address: |
HALE AND DORR, LLP
60 STATE STREET
BOSTON
MA
02109
|
Family ID: |
22491816 |
Appl. No.: |
10/315445 |
Filed: |
December 10, 2002 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10315445 |
Dec 10, 2002 |
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09599927 |
Jun 22, 2000 |
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60140563 |
Jun 23, 1999 |
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Current U.S.
Class: |
514/17.6 ;
514/17.5; 514/17.7 |
Current CPC
Class: |
A61K 38/08 20130101;
A61P 15/00 20180101; A61P 25/24 20180101; A61P 25/00 20180101; A61P
25/28 20180101; A61P 25/18 20180101; A61P 43/00 20180101; A61K
38/07 20130101; A61P 15/10 20180101 |
Class at
Publication: |
514/12 |
International
Class: |
A61K 038/17 |
Claims
What is claimed is:
1. A method for treating a DSM-III disorder comprising
administering to a mammal having a DSM-III disorder an amount of a
peptide comprising an amino acid sequence selected from the amino
acid sequences shown in SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3
and SEQ ID NO: 4, or a peptidomimetic thereof, that is sufficient
to reduce or eliminate symptoms of the DSM-III disorder.
2. The method according to claim 1, wherein the DSM-III disorder is
an avoidance disorder.
3. The method according to claim 1, wherein the DSM-III disorder is
a decreased awareness disorder.
4. The method according to claim 3, wherein the disorder includes
elements of an autistic disorder.
5. The method according to claim 1, wherein the DSM-III disorder is
an attention deficit disorder.
6. The method according to claim 1, wherein the DSM-III disorder is
an arousal disorder.
7. The method according to claim 6, wherein the disorder is
hospitalism.
8. The method according to claim 1, wherein the DSM-III disorder is
impaired interpersonal functioning and relationship to the external
world.
9. The method according to claim 8, wherein the DSM-III disorder is
schizoid personality disorder.
10. The method according to claim 8, wherein the DSM-III disorder
is schizophrenia or a depressive disorder.
11. The method according to claim 1, wherein the DSM-III disorder
is decreased interest in environment.
12. The method according to claim 1, wherein the DSM-III disorder
is impaired social activity linked to sexuality.
13. The method according to claim 1, wherein the DSM-III disorder
is impaired sexual behavior including untimely ejaculation.
14. The method according to claim 13, wherein the impaired sexual
behavior is hypoactive sexual desire disorder.
15. The method according to claim 1, wherein the DSM-III disorder
comprises symptoms of more than one DSM-III disorder.
16. The method according to any of claims 1-15, wherein the peptide
or peptidomimetic is administered, together with a second
pharmaceutical agent, wherein the second pharmaceutical agent is
present in an amount insufficient to reduce or eliminate symptoms
of the DSM-III disorder, and wherein the peptide or peptidomimetic
according to the invention and the second pharmaceutical agent act
synergistically to reduce or eliminate symptoms of the DSM-III
disorder.
17. The method of any of claims 1-16, wherein the route of
administration is selected from parenteral, intranasal, oral,
sublingual, transmucosal, intrarespiratory, or through an inert or
iontophoretic patch.
18. A therapeutic composition comprising a peptide comprising an
amino acid sequence selected from the amino acid sequences shown in
SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3 and SEQ ID NO: 4, or a
peptidomimetic thereof, in an amount sufficient to reduce or
eliminate symptoms of a DSM-III disorder in a mammal having the
DSM-III disorder, and further comprising a pharmaceutically
acceptable diluent and/or buffer and/or excipient.
19. The therapeutic composition according to claim 18, wherein the
therapeutic composition is useful in preparing a medicament for the
treatment of an avoidance disorder.
20. The therapeutic composition according to claim 18, wherein the
therapeutic composition is useful in preparing a medicament for the
treatment of a decreased awareness disorder.
21. The therapeutic composition according to claim 18, wherein the
therapeutic composition is useful in preparing a medicament for the
treatment of an attention deficit disorder.
22. The therapeutic composition according to claim 18, wherein the
therapeutic composition is useful in preparing a medicament for the
treatment of an arousal disorder.
23. The therapeutic composition according to claim 18, wherein the
therapeutic composition is useful in preparing a medicament for the
treatment of impaired interpersonal functioning and relationship to
the external world.
24. The therapeutic composition according to claim 18, wherein the
therapeutic composition is useful in preparing a medicament for the
treatment of impaired social activity linked to sexuality.
25. The therapeutic composition according to claim 18, wherein the
therapeutic composition is useful in preparing a medicament for the
treatment of impaired sexual behavior.
26. The therapeutic composition according to claim 18, wherein the
therapeutic composition is useful in preparing a medicament for the
treatment of symptoms of more than one DSM-III disorder.
27. The therapeutic composition according to any of claims 18-26,
wherein the peptide or peptidomimetic is present in the therapeutic
composition, together with a second pharmaceutical agent, wherein
the second pharmaceutical agent is present in an amount
insufficient to reduce or eliminate symptoms of the DSM-III
disorder, and wherein the peptide or peptidomimetic according to
the invention and the second pharmaceutical agent act
synergistically to reduce or eliminate symptoms of the DSM-III
disorder.
28. The therapeutic composition of any of claims 18-27, wherein the
therapeutic composition is in the form of a solid, a liquid, a gel,
an aerosol, or a sustained release formulation.
Description
BACKGROUND OF THE INVENTION
[0001] 1. Field of the Invention
[0002] The invention relates to the field of psychopharmacology.
More particularly, the invention relates to the treatment of
DSM-III disorders, such as impaired interpersonal and behavioral
disorders.
[0003] 2. Summary of the Related Art
[0004] The field of psychopharmacology has produced numerous
breakthroughs in behavioral modification since the 1950's, when
phenothiazines were first introduced. Unfortunately, certain types
of mental disorders have proven refractory to pharmacotherapy.
Among these refractory disorders are disorders designated DSM-III
(see Diagnostic and Statistical Manual of Mental Disorders,
American Psychiatric Assoc., 1992), which are characterized by
impaired interpersonal interactions and other behavioral defects.
These defects include impairment in communication, impairment of
interpersonal activities, restricted reprotoire of interest, fear
of partners, decreased awareness of partners similar to that seen
in autism, attention deficit disorder, impairment in social
functioning, solitary conduct disorders, decreased ability to
relate to others, avoidance disorders, unassertive states, reactive
attachment disorders, lack of social interest, impaired
interpersonal functioning and relationship to the external world,
impairment of self-care, decreased interest in environment,
hypersomnia, and adjustment disorders with impairment in
occupational functioning.
[0005] Also included in these disorders are sexual defects,
including arousal disorders, impaired sexual behavior in the form
of a lack of affective attention, and impaired social activity
linked to sexuality. These latter disorders can manifest in part as
a condition known as male erectile dysfunction (M.E.D.), a serious
condition believed to affect some 8% of males worldwide. In
addition, hypoactive sexual desire disorder (H.S.D.D.) is believed
to affect 20% of the population worldwide, with no available
therapy. Most efforts to treat M.E.D. have vasodilators to induce
erection, rather than utilizing behavior modifiers. For example,
PDE5 inhibitors, such as sildenafil, alpha blocking agents, such as
moxysylate or phentolamine, and prostaglandins have been used.
Unfortunately, these treatments suffer from certain deficiencies.
The PDE5 inhibitors, for example, are subject to degradation via
the cytochrome P450 degradation pathway. Prostaglandins require
unpleasant intracavernous or intra-urethral administration. In
addition, none of these treatments directly affects the emotional,
affectionate aspects of the sexual relationship.
[0006] There is, therefore, a need for new therapeutic compositions
and methods for treating DSM-III disorders, including M.E.D. and
H.S.D.D. Ideally, such compositions and methods should provide
improved awareness and alertness to environment, improved
adaptation to environment and ability to sustain attention, and
increased interest in environment and capacity for arousal, without
increased aggressiveness.
[0007] Many central peptides, known as neuropeptides, have effects
on behavior. For example, Mondal et al., B.B.R.C. 256:495-499
(1999) teaches that the neuropeptide orexin can be used to treat
eating disorders. Insel et al., Reviews of Reproduction 2:28-37
(1997) discloses that oxytocin, a neurohypohyseal peptide can
influence reproductive behavior. Unfortunately, oxytocin can
produce unwanted side effects in male subjects. For example,
Uvnaes-Moberg et al., Pharmacology, Biochemnistry and Behavior
49:101-106 (1994) teaches that high doses of oxytocin decrease
locomotion and low doses of oxytocin cause an anxiolytic-like
effect in male rats. Thus, neuropeptides have shown limitations as
therapeutics for DSM-III disorders, particularly for sexual
disorders.
[0008] Rosinski-Chupin et al. U.S. Pat. No. 5,859,189 (1999)
discloses a purified pentapeptide or tetrapeptide expressed in the
submaxillary gland of the rat, and suggests that it may fulfil an
important function specific for the male. However, Rougeot et al,
Amer. J. Physiol. 273:R1309-R1320 (1997) discloses biodistribution
for this peptide with autoradiographs which suggest that the
peptide does not cross the blood brain barrier. Thus, this peptide
would not be expected to be a promising candidate for behavior
modification.
BRIEF SUMMARY OF THE INVENTION
[0009] The invention provides new therapeutic compositions and
methods for treating DSM-III disorders, including M.E.D. The
compositions and methods according to the invention provide
improved awareness and alertness to environment, improved
adaptation to environment and ability to sustain attention, and
increased interest in environment and capacity for arousal, without
increased aggressiveness.
[0010] The present inventor has surprisingly discovered that
peptides of the type disclosed in U.S. Pat. No. 5,859,189 are
effective as therapeutics for DSM-III disorders including, without
limitation, sexual disorders.
[0011] In a first aspect, the invention provides methods for
treating DSM-III disorders. The methods according to the invention
comprise administering to a mammal having a DSM-III disorder an
amount of a peptide or a peptidomimetic according to the invention
that is sufficient to reduce or eliminate symptoms of the DSM-III
disorder.
[0012] In certain preferred embodiments, the DSM-III disorder is an
avoidance disorder. In certain preferred embodiments, the DSM-III
disorder is a decreased awareness disorder. In certain preferred
embodiments, the DSM-III disorder is an attention deficit disorder.
In certain preferred embodiments, the DSM-III disorder is an
arousal disorder. In certain preferred embodiments, the DSM-III
disorder is impaired interpersonal functioning and relationship to
the external world. In certain preferred embodiments, the DSM-III
disorder is impaired social activity linked to sexuality. In
certain preferred embodiments, the DSM-III disorder is impaired
sexual behavior. In certain preferred embodiments, the DSM-III
disorder comprises symptoms of more than one of these
disorders.
[0013] In certain preferred embodiments, the peptide or
peptidomimetic according to the invention is administered, together
with a second pharmaceutical, wherein the second pharmaceutical
agent is present in an amount insufficient to reduce or eliminate
symptoms of the DSM-III disorder, and wherein the peptide or
peptidomimetic according to the invention and the second
pharmaceutical agent act synergistically to reduce or eliminate
symptoms of the DSM-III disorder.
[0014] In a second aspect, the invention provides therapeutic
compositions comprising a peptide or peptidomimetic according to
the invention in an amount sufficient to reduce or eliminate
symptoms of a DSM-III disorder in a mammal having the DSM-III
disorder, and further comprising a pharmaceutically acceptable
diluent and/or buffer and/or excipient.
[0015] In certain preferred embodiments, the therapeutic
composition is useful in preparing a medicament for the treatment
of an avoidance disorder. In certain preferred embodiments, the
therapeutic composition is useful in preparing a medicament for the
treatment of a decreased awareness disorder. In certain preferred
embodiments, the therapeutic composition is useful in preparing a
medicament for the treatment of an attention deficit disorder. In
certain preferred embodiments, the therapeutic composition is
useful in preparing a medicament for the treatment of an arousal
disorder. In certain preferred embodiments, the therapeutic
composition is useful in preparing a medicament for the treatment
of impaired interpersonal functioning and relationship to the
external world. In certain preferred embodiments, the therapeutic
composition is useful in preparing a medicament for the treatment
of impaired social activity linked to sexuality. In certain
preferred embodiments, the therapeutic composition is useful in
preparing a medicament for the treatment of impaired sexual
behavior. In certain preferred embodiments, the therapeutic
composition is useful in preparing a medicament for the treatment
of symptoms of more than one of these disorders.
[0016] In certain preferred embodiments, the peptide or
peptidomimetic, according to the invention, is present in the
therapeutic composition, according to the invention, together with
a second pharmaceutical, wherein the second pharmaceutical agent is
present in an amount insufficient to reduce or eliminate symptoms
of the DSM-III disorder, and wherein the peptide or peptidomimetic
according to the invention and the second pharmaceutical agent act
synergistically to reduce or eliminate symptoms of the DSM-III
disorder.
BRIEF DESCRIPTION OF THE DRAWINGS
[0017] FIG. 1 shows sleep results in an Irwin test on rats
administered escalating doses of a preferred embodiment of a
peptide according to the invention.
[0018] FIG. 2 shows results of a startle response test on rats
administered escalating doses of a preferred embodiment of a
peptide according to the invention.
[0019] FIG. 3 shows results of an abdominal tone test on rats
administered escalating doses of a preferred embodiment of a
peptide according to the invention.
[0020] FIG. 4 shows results of a tail pinch test at 15 minutes on
rats administered escalating doses of a preferred embodiment of a
peptide according to the invention.
[0021] FIG. 5 shows results of a tail pinch test at 30 minutes on
rats administered escalating doses of a preferred embodiment of a
peptide according to the invention.
[0022] FIG. 6 shows results of a tail pinch test at 60 minutes on
rats administered escalating doses of a preferred embodiment of a
peptide according to the invention.
[0023] FIG. 7 shows results of a tail pinch test at 120 minutes on
rats administered escalating doses of a preferred embodiment of a
peptide according to the invention.
[0024] FIG. 8 shows results of a latency of the first mount test on
rats administered escalating doses of a preferred embodiment of a
peptide according to the invention.
[0025] FIG. 9 shows results of a number of ejaculations test on
rats administered escalating doses of a preferred embodiment of a
peptide according to the invention.
[0026] FIG. 10 shows results of a test of the refractory period
between the second ejaculation and the next mount for rats
administered escalating doses of a preferred embodiment of a
peptide according to the invention.
[0027] FIG. 11 is a graphic representation of the effect of
increasing concentrations of FG-005 peptide (QHNPK) on the number
of mounts.
[0028] FIG. 12 is a graphic representation of the effect of
increasing concentrations of FG-005 peptide (QHNPR) on the number
of mounts with intromission.
[0029] FIG. 13 is a graphic representation of the effect of
increasing concentrations of FG-005 peptide (QHNPR) on the number
of mounts before the first ejaculation.
[0030] FIG. 14 is a graphic representation of the effect of
increasing concentrations of FG-005 peptide (QHNPR) on the number
of mounts before the third ejaculation.
[0031] FIG. 15 is a graphic representation of the effect of
increasing concentrations of FG-005 peptide on the number of mounts
before the fourth ejaculation.
[0032] FIG. 16 is a graphic representation of the effect of
increasing concentrations of FG-005 peptide on the mean number of
mounts per ejaculation.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0033] The invention relates to the field of psychopharmacology.
More particularly, the invention relates to the treatment of
DSM-III disorders, such as impaired interpersonal and behavioral
disorders, including sexual disorders such as M.E.D. The patents
and publications cited in this specification evidence the knowledge
in this field and are hereby incorporated by reference in their
entirety. In the case of conflict between any teaching of a
reference cited in this specification and any teaching specifically
disclosed in this specification, the teaching specifically
disclosed in this specification shall prevail.
[0034] The invention provides new therapeutic compositions and
methods for treating DSM-III disorders, including M.E.D. The
compositions and methods according to the invention provide
improved awareness and alertness to environment, improved
adaptation to environment and ability to sustain attention, and
increased interest in environment and capacity for arousal, without
increased aggressiveness. The present inventor has surprisingly
discovered that peptides of the type disclosed in U.S. Pat. No.
5,859,189 are effective as therapeutics for DSM-III disorders
including, without limitation, sexual disorders.
[0035] In a first aspect, the invention provides methods for
treating DSM-III disorders. The methods according to the invention
comprise administering to a mammal having a DSM-III disorder an
amount of a peptide or a peptidomimetic according to the invention
that is sufficient to reduce or eliminate symptoms of the DSM-III
disorder.
[0036] For purposes of the invention, the term "mammal" is used in
its usual taxonomic sense and specifically includes humans.
[0037] For purposes of the invention, a "peptide" is a molecule
comprised of a linear array of amino acid residues connected to
each other in the linear array by peptide bonds. Such linear array
may optionally be cyclic, i.e., the ends of the linear peptide or
the side chains of amino acids within the peptide may be joined,
e.g., by a chemical bond. Such peptides, according to the
invention, may include from about three to about 500 amino acids,
and may further include secondary, tertiary or quaternary
structures, as well as intermolecular associations with other
peptides or other non-peptide molecules. Such intermolecular
associations may be through, without limitation, covalent bonding
(e.g., through disulfide linkages), or through chelation,
electrostatic interactions, hydrophobic interactions, hydrogen
bonding, ion-dipole interactions, dipole-dipole interactions, or
any combination of the above.
[0038] Preferred peptides according to the invention comprise an
amino acid sequence selected from the group consisting of:
1 Glp-His-Asn-Pro-Arg [SEQ ID NO: 1] Gln-His-Asn-Pro-Arg [SEQ ID
NO: 2] Glp-His-Asn-Pro [SEQ ID NO: 3] Gln-His-Asn-Pro, [SEQ ID NO:
4]
[0039] wherein the sequences are shown in N to C configuration, and
wherein Glp is pyroglutamate, Gln is glutamine, His is histidine,
Asn is asparagine and Pro is proline.
[0040] Certain particularly preferred peptides according to the
invention consist essentially of an amino acid sequence selected
from the group consisting of:
2 Glp-His-Asn-Pro-Arg [SEQ ID NO: 1] Gln-His-Asn-Pro-Arg [SEQ ID
NO: 2] Glp-His-Asn-Pro [SEQ ID NO: 3] Gln-His-Asn-Pro, [SEQ ID NO:
4]
[0041] wherein the sequences are shown in N to C configuration, and
wherein Glp is pyroglutamate, Gln is glutamine, His is histidine,
Asn is asparagine and Pro is proline.
[0042] Certain most preferred peptides according to the invention
consist of an amino acid sequence selected from the group
consisting of:
3 Glp-His-Asn-Pro-Arg [SEQ ID NO: 1] Gln-His-Asn-Pro-Arg [SEQ ID
NO: 2] Glp-His-Asn-Pro [SEQ ID NO: 3] Gln-His-Asn-Pro, [SEQ ID NO:
4]
[0043] wherein the sequences are shown in N to C configuration, and
wherein Glp is pyroglutamate, Gln is glutamine, His is histidine,
Asn is asparagine and Pro is proline. In these peptides, by
cyclization/decyclization, Glp and Gln interconvert.
[0044] In addition, certain preferred peptides according to the
invention comprise, consist essentially of, or consist of an
allelic variant of a peptide shown in any of SEQ ID NO: 1-4. As
used herein, an "allelic variant" is a peptide having from one to
two amino acid substitutions from a parent peptide, but retaining
the binding specificity and/or physiological activity of the parent
peptide. As used herein, "retaining the binding specificity of the
parent peptide" means being able to bind to a monoclonal antibody
that binds to one of the peptides shown in SEQ ID NOS:1-4 with an
affinity that is at least one-tenth, more preferably at least
one-half, and most preferably at least as great as that of one of
the actual peptides shown in SEQ ID NOS: 1-4. Determination of such
affinity is preferably conducted under standard competitive binding
immunoassay conditions. "Retaining the physiological activity of
the parent peptide" means retaining the ability of any one of the
peptides shown in SEQ ID NOS: 1-4 to reduce or eliminate symptoms
of a DSM-III disorder. Determining whether such symptoms are
reduced or eliminated is further described later in this
specification. The term "allelic variants" is specifically intended
to include any human analogs of the peptides set forth in SEQ ID
NOS: 1-4 which do not have the identical amino acid sequence
thereof.
[0045] Peptides according to the invention can be conveniently
synthesized using art recognized techniques (see e.g., Merrifield,
J. Am. Chem. Soc. 85:2149-2154).
[0046] Preferred peptidomimetics retain the binding specificity
and/or physiological activity of the parent peptide, as described
above. As used herein, a "peptidomimetic" is an organic molecule
that mimics some properties of peptides, preferably their binding
specificity and physiological activity. Preferred peptidomimetics
are obtained by structural modification of peptides according to
the invention, preferably using unnatural amino acids,
conformational restraints, isosteric replacement, cyclization, or
other modifications. Other preferred modifications include, without
limitation, those in which one or more amide bond is replaced by a
non-amide bond, and/or one or more amino add side chain is replaced
by a different chemical moiety, or any one of more of the
N-terminus, the C-terminus or one or more side chain is protected
by a protecting group, and/or double bonds and/or cyclization
and/or stereospecificity is introduced into the amino acid chain to
increase rigidity and/or binding affinity. All of these variations
are well known in the art. Thus, given the peptide sequences
disclosed herein, those skilled in the art are enabled to design
and produce peptidomimetics having binding characteristics similar
to or superior to such peptides (see e.g., Horwell et al., Bioorg.
Med. Chem. 4:1573 (1996); Liskamp et al., Recl. Trav. Chim.
Pays-Bas 1:113 (1994); Gante et al., Angew. Chem. Int. Ed. Engl.
33:1699 (1994); Seebach et al., Helv. Chim. Acta 79:913
(1996)).
[0047] As used herein, "having a DSM-III disorder" means
manifesting at least one clinically observable behavior or physical
characteristic that is generally recognized as a symptom of a
DSM-III disorder. The term "to reduce or eliminate symptoms of a
DSM-III disorder" means to obtain a clinically observable
beneficial change in one or more behavior or physical
characteristic that is generally recognized as a symptom of a
DSM-III disorder. DSM-III disorders are diagnostic categories for
which criteria are provided by a manual written by working groups
of psychiatrists. This manual is published by the American
Psychiatric Association, "Diagnostic and Statistical Manual of
Mental Disorders," 1992, which is hereby incorporated by reference.
Each of the disorders discussed below are well known, as evidenced
by their treatment in this manual. Thus, only brief definitions are
provided herein for the disorders discussed below.
[0048] In certain preferred embodiments, the DSM-III disorder is an
avoidance disorder. As used herein, an "avoidance disorder" means a
disorder having as an essential feature a pervasive pattern of
social discomfort, fear of negative evaluation, and timidity. It
includes excessive shrinking from contact with unfamiliar
people.
[0049] In certain preferred embodiments, the DSM-III disorder is a
decreased awareness disorder. As used herein, a "decreased
awareness disorder" means a disorder marked by lack of awareness of
the existence or feelings of others (e.g. treats a person like if
he or she were a piece of furniture; does not notice another
person's distress). These disorders can be elements of an autistic
disorder.
[0050] In certain preferred embodiments, the DSM-III disorder is an
attention deficit disorder. As used herein, an "attention deficit
disorder" means a disturbance in which the predominant feature is
the persistence of developmentally inappropriate and marked
inattention.
[0051] In certain preferred embodiments, the DSM-III disorder is an
arousal disorder. As used herein, an "arousal disorder" means a
reactive attachment disorder such as persistent failure to initiate
or respond to most social interactions. This can lead to severe
forms in children that have been called "failure to thrive" or
"hospitalism." Decreased interest in environment is another element
of reactive attachment disorders, commonly manifested as
insufficient visual tracking of eyes, faces or voices, absence of
reaching out to objects.
[0052] In certain preferred embodiments, the DSM-III disorder is
impaired interpersonal functioning and relationship to the external
world. As used herein, "impaired interpersonal functioning and
relationship to the external world" means other interpersonal
problems, examples of which are difficulties with co-workers or
with romantic partners. These disorders include schizoid
personality disorder, which is a pervasive pattern of indifference
to social relationships and a restricted range of emotional
experience and expression, and also include schizophrenia or
depressive disorder.
[0053] In certain preferred embodiments, the DSM-III disorder is
impaired social activity linked to sexuality. As used herein,
"impaired social activity linked to sexuality" is impairment of
social relationship to a sexual partner, which can lead to
impairment of occupational functioning.
[0054] In certain preferred embodiments, the DSM-III disorder is
impaired sexual behavior. As used herein, "impaired sexual
behavior" includes hypoactive sexual desire disorder (H.S.D.D.),
defined as persistently or recurrently deficient or absent sexual
fantasies and desire for sexual activity, and further includes
feelings of inadequacy concerning sexual performance such as
untimely ejaculation.
[0055] In certain preferred embodiments, the DSM-III disorder
comprises symptoms of more than one of these disorders.
[0056] In the methods according to the invention, the peptides or
peptidomimetics according to the invention may be administered by
any of a variety of means. In certain preferred embodiments,
administration may be parenteral, most preferably intravenous. In
other preferred embodiments, administration may be intranasal,
oral, sublingual, transmucosal, intrarespiratory, or through an
inert or iontophoretic patch.
[0057] Dosages of the peptide or peptidomimetic to be administered
will depend on the particular patient, the condition, and the route
of administration, and can be determined empirically by observing
the reduction or elimination of symptoms of a DSM-III disorder in
response to an elevating dosage regimen. Preferred dosages are from
about 0.1 .mu.g/kg to about 1 mg/kg, more preferably from about 1
.mu.g/kg to about 100 kg/kg, and most preferably from about 1
.mu.g/kg to about 50 .mu.g/kg.
[0058] In certain preferred embodiments, the peptide or
peptidomimetic according to the invention is administered, together
with a second pharmaceutical agent, wherein the second
pharmaceutical agent is present in an amount insufficient to reduce
or eliminate symptoms of the DSM-III disorder, and wherein the
peptide or peptidomimetic according to the invention and the second
pharmaceutical agent act synergistically to reduce or eliminate
symptoms of the DSM-III disorder. Administration of the peptide or
peptidomimetic according to the invention and the second
pharmaceutical agent can be simultaneous, sequential, or
alternating. As used herein, a "pharmaceutical agent" is a
substance other than food, water or air that mediates a beneficial
physiological response at a sublethal concentration when
administered to a mammal. Preferred second pharmaceutical agents
include those currently used to treat DSM-III disorders, including
M.E.D. "Synergistically" means that the peptide or the
peptidomimetic and the second pharmaceutical agent together are
more effective in reducing or eliminating symptoms of a DSM-III
disorder than either one alone would be at the same
concentration.
[0059] The methods, according to the invention, are useful for
animal model studies of DSM-III disorders. The methods of the
invention are also useful in treating mammals, including humans,
for sexual disorders and other DSM-III disorders.
[0060] In a second aspect, the invention provides therapeutic
compositions comprising a peptide or peptidomimetic according to
the invention in an amount sufficient to reduce or eliminate
symptoms of a DSM-III disorder in a mammal having the DSM-III
disorder, and further comprising a pharmaceutically acceptable
diluent and/or buffer and/or excipient.
[0061] According to this aspect of the invention, the terms
"peptide," "peptidomimetic," and "to reduce or eliminate symptoms
of the DSM-III disorder" are used as described for the first aspect
of the invention. The terms "pharmaceutically acceptable,"
"diluent," "buffer" and "excipient" are used in their usual sense
within the industry. The therapeutic composition may preferably be
in the form of a solid, a liquid, a gel, an aerosol, or a sustained
release formulation.
[0062] In certain preferred embodiments, the therapeutic
composition is useful in preparing a medicament for the treatment
of an avoidance disorder. In certain preferred embodiments, the
therapeutic composition is useful in preparing a medicament for the
treatment of a decreased awareness disorder. In certain preferred
embodiments, the therapeutic composition is useful in preparing a
medicament for the treatment of an attention deficit disorder. In
certain preferred embodiments, the therapeutic composition is
useful in preparing a medicament for the treatment of an arousal
disorder. In certain preferred embodiments, the therapeutic
composition is useful in preparing a medicament for the treatment
of impaired interpersonal functioning and relationship to the
external world. In certain preferred embodiments, the therapeutic
composition is useful in preparing a medicament for the treatment
of impaired social activity linked to sexuality. In certain
preferred embodiments, the therapeutic composition is useful in
preparing a medicament for the treatment of impaired sexual
behavior. Each of these disorders are as defined for the first
aspect of the invention. In certain preferred embodiments, the
therapeutic composition is useful in preparing a medicament for the
treatment of symptoms of more than one of these disorders.
[0063] In certain preferred embodiments, the peptide or
peptidomimetic according to the invention is present in the
therapeutic composition according to the invention, together with a
second pharmaceutical agent, wherein the second pharmaceutical
agent is present in an amount insufficient to reduce or eliminate
symptoms of the DSM-III disorder, and wherein the peptide or
peptidomimetic according to the invention and the second
pharmaceutical agent act synergistically to reduce or eliminate
symptoms of the DSM-III disorder.
[0064] The therapeutic compositions according to the invention are
useful for the preparation of medicaments, and are useful in the
methods according to the invention.
[0065] The following examples are provided to further illustrate
certain preferred embodiments of the invention and are not intended
in any way to limit the scope of the invention.
EXAMPLE 1
[0066] Synthesis of FG-005
[0067] The FG-005 peptide (QHNPR) was synthesized, for FGene by
Bachem AG. The pentapeptide has a Glutamine at its N-terminal end
which tends to transform (cyclization) into a pyroglutamate when in
an aqueous phase but the peptide retains its biological properties.
The synthesized peptide had a purity of more than 91% of its
non-cydic structure and 5% of its cyclic structure. It was
conditioned under a neutral gas atmosphere (Argon) in vials of 500
.mu.g to be opened just prior to each experiment. Purity and
structure were checked by HPLC and Mass Spectroscopy. Prior to
injection, FG-005 was resuspended in a solution of acetic acid 0.01
N and PBS. Several concentrations were tested: 0, 3, 15 and 30
.mu.g/kg.
EXAMPLE 2
Irwin Test
[0068] An Irwin test was performed on 12 male Wistar rats (Iffa
Credo, L'Arbresles, France), weighing 260-280 g. They were housed
in groups of 4 in a climate controlled room with a 12h light:dark
cycle (light 8:00 PM-8:00 AM) and had access to food and water ad
libitum. After a seven day acclimatization period, the rats were
weighed, identified and randomly assigned to one of the four
treatment groups. The drug was injected to the tail vein of the
rats according to the group dose.
[0069] Observations were performed 15, 30, 60 and 120 minutes after
administration. Among the most noticeable results are the results
concerning the awareness state of the rats. As shown in FIG. 1,
rats are much more aware and alert to the environment and are much
less likely to fall asleep after 2 hours of tests when injected
with FG-005. Significant response to the wire maneuver test
demonstrates improved adaptation to environment and ability to
sustain attention. Their increased interest in environment and
capacity for arousal is demonstrated by increased interest in the
finger approach test, and increased vocalization when third parties
approach. This increased alertness and vigilance is not associated
with an increase of aggressiveness Rats injected FG-005 are less
stressed as shown by startle response test (FIG. 2), and by the
abdominal tone (FIG. 3). They demonstrate less reactivity to
nociceptive stimuli as shown by the tail pinch test (FIGS. 4, 5, 6,
7).
EXAMPLE 3
Behavior of Male Rats in the Presence of Females
[0070] Behavior tests were performed on 12 male Wistar rats (Iffa
Credo, L'Arbresles, France), weighing 260-280 g. They were housed
in groups of 4 in a climate controlled room with a 12-h light:dark
cycle and had access to food and water ad libitum. After seven days
acclimatization period, the rats were weighed, identified and
randomly assigned to one of the four treatment groups. The rats
were familiarized once with female rats which had been brought to
sexual receptivity by injecting estradiol benzoate for 4 days (5
.mu.g/0.5 ml oil, s.c. once daily). Behavioral testing was
performed under blind conditions in a dimlight environment 2 hours
after the onset of the dark phase of the light/dark cycle. Behavior
was assessed by placing the male rat in a plexiglass cage
(50.times.30.times.20 cm) five minutes before a receptive female
was presented. All of the tests on rats were recorded on a
VHS-videotape. The recorded parameters were: number of
ejaculations, latency of first mount, latency of first ejaculation,
number of mounts, postejaculatory interval, avoidance behavior
patterns, awareness of other rats presence, initiation or response
to social interaction, interest in other rat, self-care,
willingness to enter into relationship. All of the quantitative
results were analyzed using the Kruskal-Wallis test followed by the
Mann-Whitney U-Test to compare each treated group with the control
group. The statistical analyzes were carried out using the Statview
4.1 statistical package.
EXAMPLE 4
Latency of the First Mount
[0071] The VHS-video recorded study of the behavior of the rats
showed that rats at a dose of 3 .mu.g/kg exhibited a significantly
increased latency of first mounts (see Table I and FIG. 8). Treated
rats are more aware of their partner's presence and considerably
increase their signs of interest in the other rat. Social
interaction and interpersonal activities before sexual intercourse
are significantly increased.
4 TABLE I Number Mean (sec.) Std. Deviation Std. Error r Control 3
8.333 2.887 1.667 3 .mu.g/kg 3 93.333 73.711 42.557 0.0238 15
.mu.g/kg 3 23.000 10.440 6.028 0.6439 30 .mu.g/kg 3 13.667 6.658
3.844 0.8657
EXAMPLE 5
Ejaculations, Self-Care and Interest in Other Rat
[0072] The number of episodes of intercourse (as measured by number
of ejaculations in 45 minutes) are significantly increased (see
Table II and FIG. 9). After each penetration, rat's self-care, and
attention to personal toilet is increased. After ejaculation
non-treated rats lose interest in the other rat and stay at a
distance in a self defeating attitude (digging into litter). In
treated rats interest is maintained, with enhanced proximity of
animals, decrease of fear of partner and improved ability to relate
as shown by signs of tenderness and attention (muzzle to muzzle
approach, licking), completely absent in non-treated animals.
5 TABLE II Number Mean Std. deviation Std. Error r Control 3 3.000
1.000 0.577 3 .mu.g/kg 3 5.333 0.577 0.333 0.0175 15 .mu.g/kg 3
4.000 1.000 0.577 0.2367 30 .mu.g/kg 3 4.667 1.155 0.677 0.0656
EXAMPLE 6
Behavior During Refractory Periods
[0073] There was a loss of avoidance symptoms and enhanced
willingness to enter into relationship during refractory periods,
the duration of which is shortened (see Table III and FIG. 10).
Treated rats show a clear-cut improvement in willingness to enter
into relationship with the other rat, increasingly respond to
attempts of social interaction, completely loose the avoidance
pattern behavior seen in control rats.
6 TABLE III Number Mean (sec.) Std. deviation Std. Error r Control
3 467.333 87.763 50.670 3 .mu.g/kg 3 311.333 66.516 38.403 0.0476
15 .mu.g/kg 3 412.000 87.430 50.478 0.4311 30 .mu.g/kg 3 373.667
83.393 48.147 0.1981
EXAMPLE 7
Dose-Response Relationship of FG-005 Peptide on the Male Rat Sexual
Behavior
[0074] Effect of increasing concentrations of FG-005 peptide
(QHNPR) given i.v. on the number of sexual intercourse episodes of
male rats with sexually receptive female, was assessed. All of the
qualitative parameters were analyzed using one-way analysis of
variance (ANOVA) for the differences between treated groups and
followed by the multiple comparison test of Fisher (PLSD Fisher) to
compare each group of FG-005-injected rats with the control group
(vehicle-injected rats). Nine to ten rats were used for each group
and P value of less than 0.005 was considered as significant for
both tests.
[0075] At the doses of 0.03 .mu.g-1 .mu.g and 3 .mu.g/Kg, FG-005
peptide induced improvement on the male rat sexual behavior, during
the 45-min-period of observation. This is appreciated by the
significant dose-dependent increase of sexual interactions (mounts,
mounts with intromission and mounts per ejaculation) during (first
ejaculation latency and interejaculatory latency) episodes of
sexual intercourse.
[0076] FG-005-treated rats exhibit a significant increase with a
dose-dependent relationship of the total number of mounts with or
without intromission, p=0.0003 by ANOVA of 9-10 rats per dose (FIG.
11 and Table IV); of the number of mounts with intromission,
p=0.0006 by ANOVA of 9-10 rats per dose (FIG. 12 and Table V); of
the number of mounts before the first ejaculation, p=0.019 by ANOVA
of 9-10 rats per dose (FIG. 13 and Table VI); of the number of
mounts during interejaculatory intervals, p=0.017 by ANOVA of 9-10
rats per dose (FIG. 14 and Table VII) and p=0.025 by ANOVA of 6-10
rats per dose (FIG. 15 and Table VIII); and of the number of mount
per ejaculation, p=0.011 by ANOVA of 9-10 rats per dose (FIG. 16
and Table IX).
[0077] As the number of sexual intercourse (mounts) increased
before and during the ejaculatory intervals, parallely the first
ejaculation latency of FG-005-treated rats increased significantly
compared to vehicle-injected rats at the dose of 3 .mu.g/Kg
(p=0.03, n=10 rats versus vehicle-injected rats, n=10). And this is
particularly appreciated by the significant dose-related
prolongation of the second ejaculation latency, with a P value of
0.048 by ANOVA for 9-10 rats per dose and a pronounced effect at 1
and 3 .mu.g/Kg. In the same way, the third ejaculation latency
tended also to increase in a dose-related manner.
[0078] In this set of experiments, during the 45 minute observation
period, as the moments of social intercourse signs displayed by the
male towards the female (sniffing, grooming, ano-genital
exploration and mount) and of attention signs to personal toilet
displayed by the male, are prolongated, and the total number of
ejaculations of FG-005-treated rats tended to be diminished, and
was lower than that of vehicle-treated rats at the dose of 3
.mu.g/Kg (p=0.04, n=10 rats per group).
[0079] In general, there was in FG-005-treated rats a loss of
aggressive impulse behavior seen in control rats.
7TABLE IV Male Rat Sexual Behavior With Sexually Receptive Female
Dose Response Relationship of Fg-005 Peptide (OHNPR) (FIG. 11)
ANOVA Table for a number of mounts during the 45 min. observation
period DDL Sum Square Square Mean F Value p Value TT 3 13126.855
4375.618 8.076 .0003 Count 34 18421.356 541.805 Model II estimation
of variance: 403.932 Table of Means for Number of Total Mounts
Effect: TT Number Mean Std. Der. Std. Err. Control 10 61.100 15.892
5.025 FG-0.3 9 81.778 26.729 8.910 Pg-1 9 96.667 24.027 8.910 FG-3
10 110.100 25.265 7.990 PLSD for Number of Mounts Effect: TT
Standard Difference Mean Critical Different p Value Control, FG-0.3
-20.678 21.735 .0615 Control, Fg-1 -35.567 21.735 .0021 Control,
FG-3 -49.000 21.155 <.0001 FG-0.3, Fg-1 -14.889 22.299 .1838
FG-0.3, FG-3 -28.322 21.735 .0122 Fg-1, FG-3 -13.433 21.735
.2177
[0080]
8TABLE V Male Rat Sexual Behavior With Sexually Receptive Female
Dose-Response Relationship of FG-005 Peptide (ONRP) (FIG. 12) ANOVA
Table for Number of Total Mounts with Penetration DDL Sum Square
Square Mean F Value p Value TT 3 10914.442 3638.147 7.379 .0006
Residus 34 16764.111 493.062 Model II estimation of variance:
331.368 Table of Mounts for Number of Total Mounts with Penetration
Effect: TT Number Mean Std. Dev. Std. Err Control 10 54.100 14.955
4.729 FG-0.3 9 77.111 23.945 7.982 Fg-1 9 90.556 26.735 8.912 FG-3
10 97.700 22.226 7.029 Fisher PLSD for Number of Total Mounts with
Penetration Effect: TT Standard Difference Critical Difference p
Value Control, FG-0.3 -23.011 20.734 .0307 Control, Fg-1 -36.456
20.734 .0011 Control, FG-3 -43.600 20.181 .0001 FG-0.3, Fg-1
-13.444 21.273 .2077 FG-0.3, FG-3 -20.589 20.734 .0515 Fg-1, FG-3
-7.144 20.734 .4885
[0081]
9TABLE VI Male Rat Sexual Behavior With Sexually Receptive Female
Dose-Response Relationship of FG-005 Peptide (OHNPR) (FIG. 13)
ANOVA Table for Number of Mounts Before the First Ejaculation
Standard DDL Difference Critical Difference F Value p Value TT 3
3249.105 1083.035 3.789 .0190 Count 34 9717.211 285.800 Model II
estimation of variance: 83.997 Table of Means for Number of Mounts
Before the First Ejaculation Effets: TT Number Mean Std Der. Std.
Err. Control 10 13.800 8.080 2.555 FG-0.3 9 31.111 20.368 6.789
Fg-1 9 33.444 16.356 5.452 FG-3 10 37.500 20.195 6.386 Fisher PLSD
for Number of Mounts Before the First Ejaculation Effect: TT
Standard Difference Critical Difference p Value Control, FG-0.3
-17.311 15.786 .0326 Control, Fg-1 -19.644 15.786 .0162 Control,
FG-3 -23.700 15.365 .0035 FG-0.3, Fg-1 -2.333 16.196 .7715 FG-0.3,
FG-3 -6.389 15.786 .4165 Fg-1, FG-3 -4.056 15.786 .6050
[0082]
10TABLE VII Male Rat Sexual Behavior With Sexually Receptive Female
Dose Response Relationship of FG-005 Peptide (OHNPR) (FIG. 14)
ANOVA Table for number of mounts before the third ejaculation
Standard DDL Difference Critical Difference F Value p Value TT 3
894.889 298.296 3.939 .0166 Counts 33 2499.111 75.731 Model II
estimation of variance: 24.079 Missing Value: 1 Table of Means for
Number of Mounts Before the Third Ejaculation Effect: TT Number
Mean Std. Dev. Std. Err Control 10 10.000 5.578 1.764 FG-0.3 9
13.444 5.918 1.973 Fg-1 9 18.333 9.849 3.283 FG-3 9 22.889 12.057
4.019 Missing Value: 1 Fisher PLSD for Number of Mounts Before the
Third Ejaculation Effect: TT Standard Difference Critical
Difference p Value Control, PG-0.3 -3.444 8.135 .3952 Control, Pg-1
-8.333 8.135 .0450 Control, FG-3 -12.889 8.135 .0029 FG-0.3, Pg-1
-4.889 8.346 .2419 FG-0.3, FG-3 -9.444 8.346 .0278 Fg-1, FG-3
-4.556 8.346 .2748 Missing Value
[0083]
11TABLE VIII Male Rat Sexual Behavior With Sexually Receptive
Female Dose-Response Relationship of FG-005 Peptide (OHNPR) (FIG.
15) ANOVA Table for Number of Mounts Before the Fourth Ejaculation
DDL Sum Square Square Mean F Value p Value TT 3 865.087 288.362
3665 .0246 Count 27 2124.590 78.689 Model II estimation of
variance: 27.387 Missing Value: 7 Table of Means for Number of
Mounts Before the Fourth Ejaculation Effect: TT Number Mean Std.
Dev. Std. Err. Control 10 11.100 4.483 1.418 FG-0.3 8 11.500 3.338
1.180 Fg-1 7 19.143 6.256 2.365 FG-3 6 24.167 18.060 7.373 Missing
Value: 7 Fisher PLSD For Number of Mounts Before the Fourth
Ejaculation Effect: TT Standard Difference Critical Difference p
Value Control, FG-0.3 -.400 8.634 .9250 Control, Fg-1 -8.043 8.970
.0768 Control, FG-3 -13.067 9.399 .0082 FG-0.3, Fg-1 -7.643 9.430
.1075 FG-0.3, FG-3 -12.667 9.830 .0135 Fg-1, FG-3 -5.024 10.126
.3177 Missing Value: 7
[0084]
12TABLE IX Male Rat Sexual Behavior With Sexually Receptive Female
Dose-Response Relationship of FG-005 Peptide (OHNPR) (FIG. 16)
ANOVA Table for Number of Mounts for Ejaculation DDL Sum Square
Square Mean F Value p Value TT 3 3149.935 1049.978 4.345 .0107
Count 34 8216.206 241.653 Model II estimation of variance: 27.387
Table of Means for Number of Mounts per Ejaculation Effect: TT
Number Mean Std. Dev. Std. Err. Control 10 11.733 3.413 1.079
FG-0.3 9 20.220 12.976 4.325 Fg-1 9 26.911 18.092 6.031 FG-3 10
36.013 21.462 6.787 Fisher PLSD for Number of Mounts per
Ejaculation Effect: TT Standard Difference Critical Difference p
Value Control, FG-0.3 -8.487 14.515 .2430 Control, Fg-1 -15.178
14.515 .0409 Control, FG-3 -24.280 14.128 .0013 FG-0.3, Fg-1 -6.691
14.892 .3677 FG-0.3, FG-3 -15.793 14.515 .0339 Fg-1, FG-3 -9.102
14.515 .2112
[0085] Equivalents
[0086] Those skilled in the art will recognize, or be able to
ascertain, using no more than routine experimentation, many
equivalents to the specific embodiments of the invention described
specifically herein. Such equivalents are intended to be
encompassed in the scope of the following claims.
* * * * *