U.S. patent application number 11/030632 was filed with the patent office on 2005-07-21 for fitness assay and associated methods.
This patent application is currently assigned to THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS. Invention is credited to Erickson, John W., Ghosh, Arun K., Gulnik, Sergei V., Mitsuya, Hiroaki.
Application Number | 20050158713 11/030632 |
Document ID | / |
Family ID | 22222591 |
Filed Date | 2005-07-21 |
United States Patent
Application |
20050158713 |
Kind Code |
A1 |
Erickson, John W. ; et
al. |
July 21, 2005 |
Fitness assay and associated methods
Abstract
The present invention provides an assay for determining the
biochemical fitness of a biochemical species in a mutant
replicating biological entity relative to its predecessor. The
present invention further provides a continuous fluorogenic assay
for measuring the anti-HIV protease activity of a protease
inhibitor. The present invention also provides a method of
administering a therapeutic compound that reduces the chances of
the emergence of drug resistance in therapy. The present invention
also provides a compound of the formula: 1 or a pharmaceutically
acceptable salt, a prodrug, a composition, or an ester thereof,
wherein A is a group of the formula: 2 R.sup.1, R.sup.2, R.sup.3,
R.sup.5, or R.sup.6 is H, or an optionally substituted and/or
heteroatom-bearing alkyl, alkenyl, alkynyl, or cyclic group; Y
and/or Z are CH.sub.2, O, S, SO, SO.sub.2, amino, amides,
carbamates, ureas, or thiocarbonyl derivatives thereof, optionally
substituted with an alkyl, alkenyl, or alkynyl group; n is from 1
to 5; X is a bond, an optionally substituted methylene or ethylene,
an amino, 0 or S; Q is C(O), C(S), or SO.sub.2; m is from 0 to 6;
R.sup.4 is OH, .dbd.O (keto), NH.sub.2, or alkylamino, including
esters, amides, and salts thereof; and W is C(O), C(S), S(O), or
SO.sub.2. Optionally, R.sup.5 and R.sup.6, together with the N--W
bond of formula (I), comprise a macrocyclic ring.
Inventors: |
Erickson, John W.;
(Frederick, MD) ; Gulnik, Sergei V.; (Frederick,
MD) ; Mitsuya, Hiroaki; (Chevy Chase, MD) ;
Ghosh, Arun K.; (River Forest, IL) |
Correspondence
Address: |
MARSHALL, GERSTEIN & BORUN LLP
233 S. WACKER DRIVE, SUITE 6300
SEARS TOWER
CHICAGO
IL
60606
US
|
Assignee: |
THE BOARD OF TRUSTEES OF THE
UNIVERSITY OF ILLINOIS
Urbana
IL
|
Family ID: |
22222591 |
Appl. No.: |
11/030632 |
Filed: |
January 6, 2005 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11030632 |
Jan 6, 2005 |
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09720276 |
Mar 7, 2001 |
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09720276 |
Mar 7, 2001 |
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PCT/US99/14119 |
Jun 23, 1999 |
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60090393 |
Jun 23, 1998 |
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Current U.S.
Class: |
435/5 |
Current CPC
Class: |
G01N 2333/16 20130101;
A61K 31/4523 20130101; G01N 2333/8142 20130101; A61K 31/426
20130101; A61P 37/04 20180101; A61P 43/00 20180101; C12Q 1/37
20130101; Y02A 50/30 20180101; A61K 31/35 20130101; Y02A 50/411
20180101; A61P 31/12 20180101; A61K 31/341 20130101; A61K 31/4525
20130101; A61P 31/04 20180101; A61P 35/00 20180101; A61K 31/4725
20130101; C12Q 1/025 20130101; A61P 31/00 20180101; A61P 33/06
20180101; A61K 31/427 20130101; A61P 31/14 20180101; A61P 31/18
20180101; A61K 31/34 20130101; A61K 31/47 20130101; A61K 31/343
20130101; A61K 31/496 20130101 |
Class at
Publication: |
435/005 |
International
Class: |
C12Q 001/70 |
Claims
1-62. (canceled)
63. A compound represented by a formula: 37or a pharmaceutically
acceptable salt, prodrug, or ester thereof, wherein: A is a group
having a formula: 38R.sup.1 is H, alkyl, alkenyl, alkynyl,
cycloalkyl, cycloalkylalkyl, aryl, aralkyl, heterocycloalkyl,
heterocycloalkylalkyl, heteroaryl, or heteroaralkyl, wherein at
least one hydrogen atom is optionally substituted with a
substituent selected from the group consisting of OR.sup.7,
SR.sup.7, CN, NO.sub.2, N.sub.3, and a halogen, and wherein R.sup.7
is H, unsubstituted alkyl, unsubstituted alkenyl, or unsubstituted
alkynyl; Y and Z, the same or different, are independently selected
from the group consisting of CH.sub.2, O, S, SO, SO.sub.2,
NR.sup.8, R.sup.8C(O)N, R.sup.8C(S)N, R.sup.8OC(O)N,
R.sup.8OC--(S)N, R.sup.8SC(O)N, R.sup.8R.sup.9NC(O)N, and
R.sup.8R.sup.9NC(S)N, wherein R.sup.8 and R.sup.9 each are selected
from the group consisting of H, unsubstituted alkyl, unsubstituted
alkenyl, and unsubstituted alkynyl; n is an integer from 1 to 5; X
is a covalent bond, CHR.sup.10, CHR.sup.10CH.sub.2,
CH.sub.2CHR.sup.10, O, NR.sup.10, or S, wherein R.sup.10 is H,
unsubstituted alkyl, unsubstituted alkenyl, or unsubstituted
alkynyl; Q is C(O), C(S), or SO.sub.2; R.sup.2 is H,
C.sub.1-C.sub.6 alkyl, C.sub.2-C.sub.6 alkenyl, or C.sub.2-C.sub.6
alkynyl; m is an integer from 0 to 6; R.sup.3 is cycloalkyl,
heterocycloalkyl, aryl, or heteroaryl wherein at least one hydrogen
atom is optionally substituted with a substituent selected from the
group consisting of alkyl, (CH.sub.2).sub.pR.sup.11, OR.sup.12,
SR.sup.12, CN, N.sub.3, NO.sub.2, NR.sup.12R.sup.13, C(O)R.sup.12,
C(S)R.sup.12, CO.sub.2R.sup.12, C(O)SR.sup.12,
C(O)NR.sup.12R.sup.13, C(S)NR.sup.12R.sup.13,
NR.sup.12C(O)R.sup.13, NR.sup.12C--(S)R.sup.13,
NR.sup.12CO.sub.2R.sup.13, NR.sup.12C(O)SR.sup.13, and halogen, and
wherein p is an integer from 0 to 5; R.sup.11 is cycloalkyl,
heterocycloalkyl, aryl, or heteroaryl wherein at least one hydrogen
atom is optionally substituted with a substituent selected from the
group consisting of a halogen, OH, OCH.sub.3, NH.sub.2, NO.sub.2,
SH, and CN; and R.sup.12 and R.sup.13 are independently selected
from the group consisting of H, unsubstituted alkyl, unsubstituted
alkenyl, and unsubstituted alkynyl; R.sup.4 is OH, .dbd.O (keto),
NH.sub.2, or NHCH.sub.3; R.sup.5 is H, C.sub.1-C.sub.6 alkyl
radical, C.sub.2-C.sub.6 alkenyl radical, or
(CH.sub.2).sub.qR.sup.14, wherein q is an integer from 0 to 5,
R.sup.14 is cycloalkyl, heterocycloalkyl, aryl, or heteroaryl
radical wherein at least one hydrogen atom is optionally
substituted with a substituent selected from the group consisting
of a halogen, OH, OCH.sub.3, NH.sub.2, NO.sub.2, SH, and CN; W is
C(O), C(S), or SO.sub.2; and R.sup.6 is cycloalkyl,
heterocycloalkyl, aryl, or heteroaryl radical wherein at least one
hydrogen atom is optionally substituted with a substituent selected
from the group consisting of halogen, OR.sup.15, SR.sup.15,
S(O)R.sup.15, SO.sub.2NR.sup.15, SO.sub.2N.sup.15R.sup.16,
SO.sub.2N(OH)R.sup.15, CN, CR.sup.15.dbd.NR.sup.16,
CR.sup.15.dbd.N(OR.sup.16), N.sub.3, NO.sub.2, NR.sup.15R.sup.16,
N(OH)R.sup.15, C(O)R.sup.15, C(S)R.sup.15, CO.sub.2R.sup.15,
C(O)SR.sup.15, C(O)NR.sup.15R.sup.16, C(S)--NR.sup.15R.sup.16,
C(O)N(OH)R.sup.15, C(S)N(OH)R.sup.15, NR.sup.15C(O)R.sup.16,
NR.sup.15C--(S)R.sup.16, N(OH)C(O)R.sup.15, N(OH)C(S)R.sup.15,
NR.sup.15CO.sub.2R.sup.16, N(OH)--CO.sub.2R.sup.15,
NR.sup.15C(O)SR.sup.16, NR.sup.15C(O)NR.sup.16R.sup.17,
NR.sup.15C(S)NR.sup.16R.sup.17, N(OH)C(O)NR.sup.15R.sup.16,
N(OH)C(S)NR.sup.15R.sup.16, NR.sup.15C(O)N(OH)R.sup.16,
NR.sup.15C(S)N(OH)R.sup.16, NR.sup.15SO.sub.2R.sup.16,
NHSO.sub.2NR.sup.15R.sup.16, NR.sup.15SO.sub.2NHR.sup.16, P(O)
(OR.sup.15) (OR.sup.16), alkyl, alkoxy, alkylthio, alkylamino,
cycloalkyl, cycloalkylalkyl, heterocycloalkyl,
heterocycloalkylalkyl, aryl, aryloxy, arylamino, arylthio, aralkyl,
aryloxyalkyl, arylaminoalkyl, aralkoxy, (aryloxy)alkoxy,
(arylamino)alkoxy, (arylthio)alkoxy, aralkylamino,
(aryloxy)alkylamino, (arylamino)alkylamino, (arylthio)alkylamino,
aralkylthio, (aryloxy)alkylthio, (arylamino)alkylthio,
(arylthio)alkylthio, heteroaryl, heteroaryloxy, heteroarylamino,
heteroarylthio, heteroaralkyl, heteroaralkoxy, heteroaralkylamino,
and heteroaralkylthio, and wherein R.sup.15, R.sup.16, and R.sup.17
are H, unsubstituted alkyl, or unsubstituted alkenyl, wherein, when
at least one hydrogen atom of R.sup.6 is substituted with a
substituent other than halogen, OR.sup.15, SR.sup.15, CN, N.sub.3,
NO.sub.2, NR.sup.15R.sup.16, C(O)R.sup.15, C(S)R.sup.15,
CO.sub.2R.sup.15, C(O)SR.sup.15, C(O)NR.sup.15R.sup.16,
C(S)NR.sup.15R.sup.16, NR.sup.15C(O)R.sup.16,
NR.sup.15C(S)R.sup.16, NR.sup.15CO.sub.2R.sup.16,
NR.sup.15C(O)SR.sup.16, NR.sup.15C--(O)NR.sup.16R.sup.17, or
NR.sup.15C(S)NR.sup..noteq.R.sup.17, at least one hydrogen atom on
said substituent is optionally substituted with halogen, OR.sup.15,
SR.sup.15, CN, N.sub.3, NO.sub.2, NR.sup.15R.sup.16, C(O)R.sup.15,
C(S)R.sup.15, CO.sub.2R.sup.15, C(O)SR.sup.15, C(O,
NR.sup.15R.sup.16, C(S)NR.sup.15R.sup.16, NR.sup.15C(O)R.sup.15,
NR.sup.15C(S)R.sup.16, NR.sup.15 CO.sub.2R.sup.16,
NR.sup.15C(O)SR.sup.16, NR.sup.15C--(O)NR.sup.16R.sup.17, or
NR.sup.15C(S)NR.sup.16R.sup.17; or R.sup.5 and R.sup.6 together
comprise a 12- to 18-membered ring comprising at least one
additional heteroatom in the ring skeleton which includes the N--W
bond of formula (I); and wherein said compound inhibits a
multidrug-resistant retroviral protease.
64. The compound of claim 63 wherein A has the formula: 39
65. The compound of claim 63 or 64 wherein: when R.sup.1 is alkyl,
it is a C.sub.1-C.sub.6 alkyl; when R.sup.1 is alkenyl, it is a
C.sub.2-C.sub.6 alkenyl; when R.sup.1 is cycloalkyl,
heterocycloalkyl, aryl, or heteroaryl, R.sup.1 is a 4- to
7-membered ring; when R.sup.7, R.sup.8, or R.sup.9 is unsubstituted
alkyl, it is a C.sub.1-C.sub.6 unsubstituted alkyl; when R.sup.7,
R.sup.8, or R.sup.9 is unsubstituted alkenyl, it is a
C.sub.1-C.sub.6 unsubstituted alkenyl; R.sup.3 is a 4- to
7-membered ring; R.sup.11 is a 4- to 7-membered ring; when R.sup.12
or R.sup.13 is unsubstituted alkyl, it is a C.sub.1-C.sub.6
unsubstituted alkyl; when R.sup.12 or R.sup.13 is unsubstituted
alkenyl, it is a C.sub.2-C.sub.6 unsubstituted alkenyl; when
R.sup.14 is cycloalkyl, heterocycloalkyl, aryl, or heteroaryl,
R.sup.14 is a 4- to 7-membered ring; when R.sup.6 is cycloalkyl,
heterocycloalkyl, aryl, or heteroaryl, R.sup.6 is a 4- to
7-membered ring; when R.sup.6 is substituted with a substituent
that is alkyl, alkylthio, or alkylamino, the substituent comprises
from one to six carbon atoms; and when R.sup.6 is substituted with
a substituent that is cycloalkyl, heterocycloalkyl, aryl, or
heteroaryl, the substituent is a 4- to 7-membered ring; or a
pharmaceutically acceptable salt, a prodrug, or an ester
thereof.
66. The compound of claim 63 or 64 wherein Q is C(O), R.sup.2 is H,
and W is SO.sub.2, or a pharmaceutically acceptable salt, prodrug,
or ester thereof.
67. The compound of claim 64 represented by a formula: 40
68. The compound of claim 67 represented by a formula: 41wherein Ar
is phenyl, optionally substituted with a substituent selected from
the group consisting of methyl, amino, hydroxy, methoxy,
methylthio, hydroxymethyl, aminomethyl, and methoxymethyl.
69. The compound of claim 68 represented by a formula: 42
70. The compound of claim 68 or 69 wherein X is oxygen.
71. The compound of claim 68 or 69 wherein R.sup.5 is isobutyl.
72. The compound of claim 68 or 69 wherein Ar is phenyl substituted
at the para position.
73. The compound of claim 68 or 69 wherein Ar is phenyl substituted
at the meta position.
74. The compound of claim 68 or 69 wherein Ar is phenyl substituted
at the ortho position.
75. The compound of claim 68 or 69 wherein Ar is selected from the
group consisting of para-aminophenyl, para-toluyl,
para-methoxyphenyl, meta-methoxyphenyl, and
meta-hydroxymethylphenyl.
76. The compound of claim 69 represented by a formula 43
77. A pharmaceutical composition comprising (a) compound of claim
63, 64, 67, 68, or 69 and (b) a pharmaceutically acceptable
carrier.
Description
TECHNICAL FIELD OF THE INVENTION
[0001] The present invention relates to a biochemical fitness assay
and related methods.
BACKGROUND OF THE INVENTION
[0002] The development of drug resistance is one of the most
perplexing challenges in the field of medicine. One of the most
common causes of drug failure in the treatment of diseases
involving replicating biological entities, for example, cancer and
infectious diseases, is the emergence of drug resistance. One of
the most dramatic and tragic examples of drug resistance can be
found in connection with the antiviral therapy of acquired immune
deficiency syndrome (AIDS).
[0003] AIDS is a fatal disease, reported cases of which have
increased dramatically within the past several years. Estimates of
reported cases in the very near future also continue to rise
dramatically.
[0004] The AIDS virus was first identified in 1983. It has been
known by several names and acronyms. It is the third known
T-lymphocyte virus (HTLV-III), and it has the capacity to replicate
within cells of the immune system, causing profound cell
destruction. The AIDS virus is a retrovirus, a virus that uses
reverse transcriptase during replication. This particular
retrovirus is also known as lymphadenopathy-associated virus (LAV),
AIDS-related virus (ARV) and, most recently, as human
immunodeficiency virus (HIV). Two distinct families of HIV have
been described to date, namely HIV-1 and HIV-2. The acronym HIV
will be used herein to refer to HIV viruses generically.
[0005] Specifically, HIV is known to exert a profound cytopathic
effect on the CD4+ helper/inducer T-cells, thereby severely
compromising the immune system. HIV infection also results in
neurological deterioration and, ultimately, in the death of the
infected individual.
[0006] The field of viral chemotherapeutics has developed in
response to the need for agents effective against retroviruses, in
particular HIV. For example antiretroviral agents, such as
3'-azido-2',3'-dideoxythymidin- e (AZT), 2'3'-dideoxycytidine
(ddC), and 2'3'-dideoxyinosine (ddI) are known to inhibit reverse
transcriptase. There also exist antiviral agents that inhibit
transactivator protein. Nucleoside analogs, such as AZT, are
currently available for antiviral therapy. Although very useful,
the utility of AZT and related compounds is limited by toxicity and
insufficient therapeutic indices for fully adequate therapy.
[0007] Retroviral protease inhibitors also have been identified as
a class of anti-retroviral agents. Retroviral protease processes
polyprotein precursors into viral structural proteins and
replicative enzymes. This processing is essential for the assembly
and maturation of fully infectious virions. Accordingly, the design
of protease inhibitors remains an important therapeutic goal in the
treatment of AIDS.
[0008] The use of HIV protease inhibitors, in combination with
agents that have different antiretroviral mechanisms (e.g., AZT,
ddI and ddT), also has been described. For example, synergism
against HIV-1 has been observed between certain C.sub.2 symmetric
HIV inhibitors and AZT (Kageyama et al., Antimicrob. Agents
Chemother., 36, 926-933 (1992)).
[0009] Numerous classes of potent peptidic inhibitors of protease
have been designed using the natural cleavage site of the precursor
polyproteins as a starting point. These inhibitors typically are
peptide substrate analogs in which the scissile P.sub.1-P.sub.1'
amide bond has been replaced by a non-hydrolyzable isostere with
tetrahedral geometry (Moore et al, Perspect. Drug Dis. Design, 1,
85 (1993); Tomasselli et al., Int. J. Chem. Biotechnology, 6
(1991); Huff, J. Med. Chem., 34, 2305 (1991); Norbeck et al., Ann.
Reports Med. Chem., 26, 141 (1991); and Meek, J. Enzyme Inhibition,
6, 65 (1992)). Although these inhibitors are effective in
preventing the retroviral protease from functioning, the inhibitors
suffer from some distinct disadvantages. Generally, peptidomimetics
often make poor drugs, due to their potential adverse
pharmacological properties, i.e., poor oral absorption, poor
stability and rapid metabolism (Plattner et al, Drug Discovery
Technologies, Clark et al., eds., Ellish Horwood, Chichester,
England (1990)).
[0010] The design of the HIV-1 protease inhibitors based on the
transition state mimetic concept has led to the generation of a
variety of peptide analogs highly active against viral replication
in vitro (Erickson et al, Science, 249, 527-533 (1990); Kramer et
al., Science, 231, 1580-1584 (1986); McQuade et al., Science, 247,
454-456 (1990); Meek et al., Nature (London), 343, 90-92 (1990);
and Roberts et al., Science, 248, 358-361 (1990)). These active
agents contain a non-hydrolyzable, dipeptidic isostere, such as
hydroxyethylene (McQuade et al., supra; Meek et al., Nature
(London), 343, 90-92 (1990); and Vacca et al., J. Med. Chew., 34,
1225-1228 (1991)) or hydroxyethylamine (Ghosh et al., Bioorg. Med.
Chem. Lett., 8, 687-690 (1998); Ghosh et al., J. Med. Chem., 36,
292-295 (1993)); Rich et al., J. Med. Chem., 33, 1285-1288 (1990);
and Roberts et al., Science, 248, 358-361 (1990)) as an active
moiety that mimics the putative transition state of the aspartic
protease-catalyzed reaction.
[0011] Two-fold (C.sub.2) symmetric inhibitors of HIV protease
represent another class of potent HIV protease inhibitors, which
were created by Erickson et al., on the basis of the
three-dimensional symmetry of the enzyme active site (Erickson et
al. (1990), supra). Typically, however, the usefulness of currently
available HIV protease inhibitors in the treatment of AIDS has been
limited by relatively short plasma half-life, poor oral
bioavailability, and the technical difficulty of scale-up synthesis
(Meek et al. (1992), supra).
[0012] In a continuing effort to address the problem of short
plasma half-life and poor bioavailability, new HIV protease
inhibitors have been identified. For example, HIV protease
inhibitors incorporating the
2,5-diamino-3,4-disubstituted-1,6-diphenylhexane isostere are
described in Ghosh et al., Bioorg. Med. Chem. Lett., 8, 687-690
(1998) and U.S. Pat. No. 5,728,718 (Randad et al.). HIV protease
inhibitors, which incorporate the hydroxyethylamine isostere, are
described in U.S. Pat. No. 5,502,060 (Thompson et al.), U.S. Pat.
No. 5,703,076 (Talley et al.), and U.S. Pat. No. 5,475,027 (Talley
et al.).
[0013] Recent studies, however, have revealed the emergence of
mutant strains of HIV, in which the protease is resistant to the
C.sub.2 symmetric inhibitors (Otto et al., PNAS USA, 90, 7543
(1993); Ho et al., J. Virology, 68, 2016-2020 (1994); and Kaplan et
al., PNAS USA, 91, 5597-5601 (1994)). In one study, the most
abundant mutation found in response to a C.sub.2 symmetry based
inhibitor was Arg to Gln at position 8 (R8Q), which strongly
affects the S.sub.3/S.sub.3, subsite of the protease binding
domain. In this study, the shortening of the P.sub.3/P.sub.3,
residues resulted in inhibitors that were equipotent towards both
wild-type and R8Q mutant proteases (Majer et al., 13th American
Peptide Symposium, Edmonton, Canada (1993)). Inhibitors have been
truncated to P.sub.2/P.sub.2, without significant loss of activity
(Lyle et al., J. Med. Chem., 34, 1230 (1991); and Bone et al., J.
Am. Chem. Soc., 113, 9382 (1991)). These results suggest that
inhibitors can be truncated and yet maintain the crucial
interactions necessary for strong binding. The benefits of such an
approach include the elimination of two or more peptide bonds, the
reduction of molecular weight, and the diminishment of the
potential for recognition by degradative enzymes.
[0014] More recently, new mutant strains of HIV have emerged that
are resistant to multiple, structurally diverse, experimental and
chemotherapeutic retroviral protease inhibitors. Such
multidrug-resistant HIV strains are typically found in infected
patients, who had undergone treatment with a combination of HIV
protease inhibitors or a series of different HIV protease
inhibitors. The number of reported cases of patients infected with
multidrug-resistant HIV is rising dramatically. Tragically for
these patients, the available options for AIDS chemotherapy and/or
HIV management is severely limited or is, otherwise, completely
nonexistent.
[0015] Drug resistance is unfortunately the most common reason for
drug failures generally. One of the most dramatic examples of drug
failure due to resistance is in HIV therapy. Once HIV resistance is
obtained to first-line therapy, the chances of future success are
greatly diminished because of the development of multidrug cross
resistance. Other diseases involving infectious agents (e.g.,
viruses, bacteria, protozoa, and prions) or other disease-causing
cells (e.g., tumor cells) present similar challenges in that drug
resistance is a primary cause of drug failure.
[0016] In view of the foregoing problems, there exists a need to
determine whether a mutant will be capable of replicating in the
presence of a drug. There also exists a need for a method of
predicting whether drug resistance is likely to emerge in a disease
involving a replicating biological entity. There is also a need for
a method of devising a long-term therapeutic regimen that minimizes
the likelihood that resistance will occur in a disease involving a
replicating biological entity. Moreover, there is a need for a
method of preventing or inhibiting the development of drug
resistance in such diseases.
[0017] The present invention provides such methods. These and other
advantages of the present invention, as well as additional
inventive features, will be apparent from the description of the
invention provided herein.
BRIEF SUMMARY OF THE INVENTION
[0018] The present invention is predicated on the surprising and
unexpected discovery that biochemical "vitality," as described
below, can be used to determine the biological fitness of a mutant
replicating biological entity relative to its predecessor under the
selection pressure of an inhibitor. The present invention provides
an assay for determining the biochemical fitness of a biochemical
target (i.e., a biomolecule having a biochemical function), of a
mutant replicating biological entity relative to its predecessor's
biochemical target, in the presence of a compound that acts upon
the biochemical target. The assay method of the present invention
includes obtaining the predecessor, determining the biochemical
vitality of the biochemical target of both the predecessor and the
mutant in the presence of a compound that acts upon the biochemical
target of the predecessor, and comparing the vitality of the
mutant's biochemical target relative to the vitality of the
predecessor's biochemical target. Where the biochemical vitality of
the mutant is greater than the biochemical fitness of the
predecessor, the mutant is predicted to be more biologically fit in
the presence of the compound. The assay method can thus be used to
predict the emergence of drug resistance for a particular
replicating biological-entity (e.g., a disease-causing cell) in the
presence a drug (e.g., an inhibitor). Utilization of the assay in
accordance with the present invention permits the administrations
of an inhibitor or combination of inhibitors to treat a disease in
a way that decreases the likelihood that drug resistance will
develop.
[0019] The present invention further provides a continuous
fluorogenic assay for measuring the anti-HIV protease activity of a
protease inhibitor. The continuous fluorogenic assay of the present
invention utilizes a substrate of the formula
Ala-Arg-Val-Tyr-Phe(NO.sub.2)-Glu-Ala- -Nle-NH.sub.2. The
continuous fluorogenic assay of the present invention is highly
sensitive and particularly useful for the prediction of the
antiviral inhibitory activity of a compound against mutant HIV.
[0020] The present invention further provides a method of
administering a therapeutic compound that inhibits a biochemical
target of a disease-causing replicating biological entity. The
therapeutic compound, when administered in accordance with the
method of the present invention, minimizes the chances that the
disease-causing entity will develop drug resistance. As such, the
method of administering a therapeutic compound in accordance with
the present invention improves the chances of long-term success in
therapy.
[0021] The present method of administering a therapeutic compound
involves the identification of at least one mutant replicating
biological entity (the mutant) capable of evolving from the
disease-causing replicating biological entity (the predecessor).
Biochemical fitness is determined by comparing the biochemical
vitality of the mutant's biochemical target with the biochemical
vitality of the predecessor's biochemical target. Biochemical
fitness is determined in the presence of a drug (e.g, an
inhibitor). The biochemical vitality of the mutant's biochemical
target is compared to biochemical vitality of the predecessor's
biochemical target in the presence of the drug. When there are two
or more drugs available for treatment, biochemical fitness can be
determined for each drug in accordance with the present invention.
A therapeutic compound is then administered from among one of the
compounds that produces a lower value for biochemical fitness with
respect to one or more mutants. Administration of a therapeutic
compound producing a lower fitness value for a particular mutant
indicates that the predecessor is less likely to develop resistance
in the presence of that compound.
[0022] The present invention also provides a method of preventing
the development of drug resistance of HIV in an HIV-infected mammal
by the administration of a drug resistance-inhibiting effective
amount of a compound of the formula: 3
[0023] or a pharmaceutically acceptable salt, a prodrug, or an
ester thereof, or a pharmaceutical composition thereof,
wherein:
[0024] A is a group of the formula: 4
[0025] R.sup.1 is H or an alkyl, an alkenyl, an alkynyl, a
cycloalkyl, a cycloalkylalkyl, an aryl, an aralkyl, a
heterocycloalkyl, a heterocycloalkylalkyl, a heteroaryl, or a
heteroaralkyl radical, which unsubstituted or substituted;
[0026] Y and Z are the same or different and are each selected from
the group consisting of CH.sub.2, O, S, SO, SO.sub.2, NR.sup.8,
R.sup.8C(O)N, R.sup.8C(S)N, R.sup.8OC(O)N, R.sup.8OC(S)N,
R.sup.8SC(O)N, R.sup.8R.sup.9NC(O)N, and R.sup.8R.sup.9NC(S)N,
wherein R.sup.8 and R.sup.9 are each H, an alkyl, an alkenyl, or an
alkynyl;
[0027] n is an integer from 1 to 5;
[0028] X is a covalent bond, CHR.sup.10, CHR.sup.10CH.sub.2.
CH.sub.2CHR.sup.10, O, NR.sup.10, or S, wherein R.sup.10 is H, an
alkyl, an alkenyl, or an alkynyl;
[0029] Q is C(O), C(S), or SO.sub.2;
[0030] R.sup.2 is H, an alkyl, an alkenyl, or an alkynyl;
[0031] m is an integer from 0 to 6;
[0032] R.sup.3 is a cycloalkyl, a heterocycloalkyl, an aryl, or a
heteroaryl which is unsubstituted or substituted;
[0033] R.sup.4 is OH, .dbd.O (keto), N or a derivative thereof;
[0034] R.sup.5 is H, a C.sub.1-C.sub.6 alkyl radical, a
C.sub.2-C.sub.6 alkenyl radical, or (CH.sub.2).sub.qR.sup.14,
wherein q is an integer form 0 to 5, and R.sup.14 is a cycloalkyl,
a heterocycloalkyl, an aryl, or a heteroaryl which is unsubstituted
or substituted;
[0035] W is C(O), C(S), S(O), or SO.sub.2; and
[0036] R.sup.6 is a cycloalkyl, heterocycloalkyl, aryl, or
heteroaryl which is unsubstituted or substituted. Optionally,
R.sup.5 and R.sup.6, together with the N--W bond of formula (I),
comprise a macrocyclic ring which can contain at least one
additional heteroatom in the ring skeleton.
BRIEF DESCRIPTION OF THE DRAWINGS
[0037] FIG. 1 illustrates the synthesis of a particular sulfonamide
isostere core of a compound of the present invention.
[0038] FIG. 2 illustrates the synthesis of a bis-tetrahydrofuran
ligand and the optical resolution thereof.
[0039] FIG. 3A illustrates the synthesis of a compound of the
present invention via coupling of a bis-tetrahydrofuran ligand to a
sulfonamide isostere of the present invention.
[0040] FIG. 3B illustrates the synthesis of a compound of the
present invention via coupling of a bis-tetrahydrofuran ligand to a
sulfonamide isostere of the present invention.
[0041] FIG. 4 illustrates generally the present method of
synthesizing a compound of the present invention.
[0042] FIGS. 5A-5D illustrate the structures of particular
compounds that were tested against various drug resistant HIV
mutants.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0043] The present invention is predicated on the surprising and
unexpected discovery to that the "vitality" of a biochemical target
of a mutant replicating biological entity relative to that of its
predecessor's biochemical target can be used to predict the
biological fitness of the mutant under the selection pressure of an
inhibitor of the biochemical target. The "vitality" of a
biochemical target of a mutant replicating biological entity
relative to the "vitality" of its predecessor's biochemical target
is defined herein as the "biochemical fitness."
[0044] "Vitality" as utilized-herein describes the ability of a
particular biomolecular "target" (i.e., a biochemical species
intended to be inhibited by a particular inhibitor) to perform its
biochemical function in the presence of the inhibitor. Biochemical
vitality is a function of at least two variables: the ability of a
particular inhibitor to inhibit a biochemical target of the
replicating biological entity in question, and the ability of the
cell's biochemical target to inherently perform its biochemical
function (irrespective of an inhibitor). Biochemical vitality also
can include other factors that effect the ability of a biochemical
target to perform its biochemical function in the presence of the
inhibitor.
[0045] The biochemical target in question can include, for example,
a biochemical species with one or more known or unknown biological
functions. The biochemical target can be, for example, a
biochemical species having one or more specific biochemical
function, or it can be a biochemical species that effects or
influences a biochemical function directly or indirectly. Suitable
biochemical targets include, for example, enzymes, proteins,
oligomers, receptors, and the like. Suitable enzymes include, for
example, reverse transcriptases, proteases (e.g., retroviral
proteases, plasmepsins, and the like), methylases, oxidases,
esterases, acyl transferases, and the like. Suitable enzymes also
include, for example, viral and non-viral helicases,
topoisomerases, DNA gyrases, DNA and RNA polymerases,
parasite-encoded proteases, and the like.
[0046] Suitable proteins include, for example, proteins that
incorporate a conformational change as a major functional
requirement, and the like. Examples of such proteins include HIV
gp41 and other fusogenic viral proteins and peptides,
topoisomerases, and all DNA enzymes, and the like.
[0047] Suitable oligomers include, for example, oligomers that
require oligomerization in order to perform their biochemical
function. Examples of such oligomers include HIV protease,
retroviral fusion proteins, peptides, HIV gp 41, viral and
non-viral membrane fusion proteins, tumor suppressor proteins
(e.g., p53, and the like) prions, ribosomes, and the like.
[0048] The ability of a particular inhibitor to inhibit a
biochemical target of a particular replicating biological entity
can be determined by any suitable method and/or can be obtained
from any suitable source. The ability of a particular inhibitor to
inhibit a biochemical function of a replicating biological entity
can be determined, for example, on the basis of a measurable
property, or a measurable relationship of properties, that
correlate with the ability of the inhibitor to inhibit the target.
Suitable methods for determining the ability of the inhibitor to
inhibit the target include, for example, assays, and the like. In
some instances, the ability of the inhibitor to inhibit the target
can be obtained from one or more suitable sources, for example,
assay data from a database, a textbook, or the literature.
[0049] When the biochemical target is a protein, the ability of an
inhibitor to inhibit the protein can be determined, for example, by
obtaining the equilibrium dissociation constant (K.sub.d) of drug
binding to the target where drug binding interferes with the
function of the protein.
[0050] When the biochemical target is an enzyme, the ability of an
inhibitor to inhibit the enzyme can be determined, for example, by
obtaining the inhibition constant (K.sub.inh), or the like. The
inhibition constant can be in terms of drug inhibition constant for
the effect of the drug on substrate catalysis (e.g., K.sub.i) or
dissociation constant for drug binding (e.g., K.sub.d) where drug
binding correlates with inhibition of enzyme function.
[0051] When the biochemical target is an oligomer, the ability of
an inhibitor to inhibit the oligomer can be determined, for
example, by obtaining the equilibrium dissociation constant
(K.sub.d) for drug binding where drug binding interferes with
oligomerization of the target.
[0052] Where the biochemical target is a protein that requires a
conformational change for its function, the ability of an inhibitor
to inhibit the conformational change can be determined, for
example, by obtaining the equilibrium dissociation constant
(K.sup.d) for drug binding where drug binding interferes with the
conformational change of the target.
[0053] When the biochemical target is a protein that is required to
bind to a ligand, macromolecule, or macromolecular complex to
perform its biochemical function, the ability of an inhibitor to
inhibit the protein function can be determined by obtaining the
equilibrium dissociation constant (K.sub.d) for drug binding where
drug binding interferes with ligand binding, macromolecule binding,
or macromolecular complex binding.
[0054] When the biochemical target is a nucleic acid binding
protein, the ability of an inhibitor to inhibit the nucleic acid
binding protein's function can be determined by obtaining the
equilibrium dissociation constant (K.sub.d) for drug binding where
drug binding interferes with nucleic acid binding.
[0055] Vitality also is a function of the biochemical target's
ability to inherently perform its biochemical function
(irrespective of an inhibitor). The biochemical target's ability to
inherently perform its biochemical function can be determined by
any suitable method and/or can be obtained from any suitable
source. The biochemical target's ability to inherently perform its
biochemical function can be determined, for example, on the basis
of a measurable property, or measurable relationship of properties,
that correlate with the ability of the biochemical target's ability
to inherently perform its biochemical function. Suitable methods
for determining the biochemical target's ability to inherently
perform its biochemical function include, for example, biochemical
assays, and the like. In some instances, the ability of a cell's
biochemical target to inherently perform its biochemical function
can be obtained from one or more suitable sources, for example,
assay data from a database, a textbook, or the literature.
[0056] When the biochemical target is an enzyme, the ability of the
enzyme to inherently perform its biochemical function can be
determined, for example, by determining the catalytic efficiency of
the enzyme. For example, the catalytic efficiency for enzymes that
exhibit Michaelis-Menten kinetics can be determined by obtaining
the k.sub.cat/K.sub.M ratio, or by a similar method, wherein
k.sub.cat is the catalytic rate and K.sub.M is the Michaelis
constant.
[0057] When the biochemical target is a protein, the ability of the
protein to inherently perform its biochemical function can be
determined, for example, by obtaining the equilibrium constant
(K.sub.eq) for the biochemical function of the protein, or the
like.
[0058] When the biochemical target is an oligomer, the ability of
an inhibitor to perform its biological function can be determined,
for example, by obtaining the equilibrium constant (K.sub.eq) that
is associated with oligomerization.
[0059] Where the biochemical target is a protein that requires a
conformational change for its function, the ability of the target
to perform its function can be determined, for example, by
obtaining the equilibrium constant (K.sub.eq) associated with
conformational change.
[0060] When the biochemical target is a protein that is required to
bind to a ligand to perform its function, the ability of the target
to perform its function can be determined, for example, by
obtaining the equilibrium dissociation constant (K.sub.d) for
ligand binding.
[0061] When the biochemical target is a nucleic acid binding
protein, the ability of an inhibitor to perform its function can be
determined by obtaining the equilibrium dissociation constant
(K.sub.d) for nucleic acid binding.
[0062] It will be appreciated that vitality also can be a function
of other factors that effect the ability of a biochemical target to
perform its biochemical function in the presence of the inhibitor.
If the biochemical target is a dimeric species, for example, other
factors that influence biochemical vitality might include the
ability of the species to dimerize in the presence and/or in the
absence of the inhibitor. If, by way of example, a mutation causes
the dimerization rate to become a factor in the biochemical
function of the biochemical target of the mutant relative to its
predecessor's, then dimerization rate can be included in the
vitality determination.
[0063] The biochemical vitalities of a mutant replicating
biological entity and its predecessor, when compared, describes the
biochemical fitness of the target of the mutant cell. In keeping
with the invention, it has been found that the biochemical fitness
relates to the biological fitness of the mutant in the presence of
the inhibitor. When the value for the biochemical vitality of the
target of the mutant exceeds the value for the biochemical vitality
of the target of a predecessor of the mutant, the target of the
mutant has greater biochemical fitness in the presence of the
inhibitor. In such cases, the mutant replicating biological entity
is favored over the predecessor and resistance to the inhibitor
that is used to treat the predecessor is likely to develop.
[0064] Biochemical vitality can be determined in many different
ways that suitably relate the various factors relating to the
biochemical vitality of the target. For example, a mathematical
function may be used to relate the various factors. By way of
illustration, when the biochemical target is an enzyme, the
vitality can be determined as a function of K.sub.inh (e.g.,
K.sub.i or K.sub.d) and enzymatic or catalytic efficiency (e.g.,
K.sub.cat/K.sub.M). Vitality can be determined as the product of
K.sub.inh and enzymatic efficiency, for example,
(K.sub.inh).times.(catal- ytic efficiency), or
(K.sub.i).times.(catalytic efficiency) or (K.sub.d)(catalytic
efficiency). Alternatively, vitality can be determined, for
example, as the log of the product of K.sub.inh and enzymatic
efficiency, for example, log[(K.sub.inh).times.(catalytic
efficiency)], or log[(K.sub.i).times.(catalytic efficiency)] or
log[(K.sub.d).times.(catalytic efficiency)]. Similarly, for enzymes
that exhibit Michaelis-Menten kinetics, vitality can be determined
as a function of K.sub.inh (e.g., K.sub.i or K.sub.d) and the
K.sub.cat/K.sub.M ratio. For example, vitality can be determined as
the product of K.sub.inh and k.sub.cat/K.sub.M, e.g.,
(K.sub.inh).times.(k.su- b.cat/K.sub.M), wherein K.sub.inh is
K.sub.i or K.sub.d. Alternatively, vitality can be determined, for
example, as the log of the product of K.sub.inh and
k.sub.cat/K.sub.M, e.g., log[(K.sub.inh).times.(k.sub.cat/K-
.sub.M)], wherein K.sub.inh is K.sub.i or K.sub.d. In a preferred
embodiment, the biochemical target is an enzyme and the vitality is
(K.sub.i).times.(k.sub.cat/K.sub.M), or
log[(K.sub.i).times.(k.sub.cat/K.- sub.M)].
[0065] "Fitness," unless otherwise indicated, means biochemical
fitness. "Biochemical fitness" as utilized herein is a value that
represents the vitality of a biochemical target of a mutant
replicating biological entity relative to the vitality the
biochemical target of its predecessor. Biochemical fitness is
determined by comparing the vitality of a biochemical target of a
mutant replicating biological entity relative to that of its
predecessor. Any suitable comparison of the vitality of a
biochemical target of a mutant replicating biological entity
relative to that of its predecessor can be used in the
determination of fitness. For example, biochemical fitness can be
determined as the difference between the biochemical vitality of a
biochemical target of a predecessor (biochemical vitality.sub.pred)
and the biochemical vitality of the biochemical target of a
particular mutant replicating biological entity that can evolve
from the predecessor (biochemical vitality.sub.mut), e.g.,
(biochemical vitality.sub.mut)-(biochemical vitality.sub.pred). If
biochemical fitness is determined on the basis of this difference,
then a positive value indicates that the mutant has a higher
fitness relative to its predecessor in the presence of the
inhibitor, whereas a negative value indicates that the mutant is
less fit relative to its predecessor. A value of zero indicates
that the fitness of the mutant and the predecessor are equal. A
higher positive value indicates a greater chance that resistance to
the inhibitor will emerge, whereas a higher negative value
indicates a lower chance that resistance to the inhibitor will
emerge.
[0066] Alternatively, and preferably, fitness can be determined as
the quotient of two biochemical vitalities, for example, as the
quotient of a biochemical target of a particular mutant replicating
biological entity and the biochemical vitality of the biochemical
target of a predecessor, e.g., 1 fitness = vitality mut vitality
pred .
[0067] If fitness is determined on the basis of this quotient, then
a value greater than one indicates that the mutant has a higher
fitness relative to its predecessor, in the presence of the
inhibitor. A value of one indicates that the fitness of the mutant
and the predecessor are equal. A value less than one indicates that
the mutant is less fit relative to its predecessor. A higher value
indicates a greater chance that resistance to the inhibitor/drug
will emerge, whereas a lower value indicates a lower chance that
resistance to the inhibitor/drug will emerge. A value less than one
indicates that the mutant will not emerge in the presence of the
inhibitor/drug.
[0068] Alternatively, fitness can be determined as the log of the
quotient of two biochemical vitalities, for example, as the log of
the quotient of a biochemical target of a particular mutant
replicating biological entity and the biochemical vitality of the
biochemical target of a predecessor, e.g., 2 fitness = log [
vitality mut vitality pred ] .
[0069] If fitness is determined on the basis of this log, then a
value greater than zero indicates that the mutant has a higher
fitness relative to its predecessor, in the presence of the
inhibitor. A negative value indicates that the mutant is less fit
relative to its predecessor. A value of zero indicates that the
fitness of the mutant and the predecessor are equal. A higher
positive value indicates a greater chance that resistance to the
inhibitor/drug will emerge, whereas a lower positive value
indicates a lower chance that resistance to the inhibitor/drug will
emerge. A negative value indicates that the mutant will not emerge
in the presence of the inhibitor/drug.
[0070] Fitness can be determined in the presence of any suitable
compound that inhibits a biochemical target from performing its
biological function. The inhibitor, for example, can be a compound
that inhibits an enzyme. Suitable enzyme inhibitors include, for
example, protease inhibitors, reverse transcriptase inhibitors, DNA
polymerase inhibitors, methylase inhibitors, oxidase inhibitors,
esterase inhibitors, acyl transferase inhibitors, and the like.
[0071] Suitable protease inhibitors include, for example, viral
protease inhibitors, plasmepsin inhibitors, and cathepsin D
inhibitors. In a preferred embodiment, the inhibitor is a viral
protease inhibitor, more preferably a retroviral protease
inhibitor, still more preferably an HIV-1 or an HIV-2 protease
inhibitor, and most preferably and HIV-1 protease inhibitor.
Exemplary HIV-1 protease inhibitors include, for example,
saquinavir, ritonavir, indinavir, nelfinavir, amprenavir, and HIV-1
protease inhibitors that are undergoing clinical trials, e.g.,
tipranavir (PNU-140690).
[0072] Suitable plasmepsin inhibitors include, for example,
inhibitors of plasmepsin I or II, including inhibitors of
plasmepsin I or II that have antimalarial activity. Suitable
inhibitors of cathepsin D include, for example, cathepsin D
inhibitors that inhibit cathepsin D in primary breast cancer
tissues, including cathepsin D inhibitors that inhibit cathepsin D
in primary breast cancer tissues and would be expected to lower the
risk of metastasis and/or shorter relapse-free survival in breast
cancer patients. See, e.g., Gulnik et al., J. Mol. Biol., 227,
265-270 (1992).
[0073] Suitable reverse transcriptase inhibitors include, for
example, retroviral reverse transcriptase inhibitors, e.g., AZT,
3TC, ddI, ddC, D4T, and the like.
[0074] Suitable protein inhibitors include, for example, compounds
that inhibit a conformational change in a protein, and the like.
Suitable oligomerization inhibitors include, for example, T-20
peptide inhibitor of HIV-1 fusion and other compounds that inhibit
oligomers from oligomerizing on a cell surface or within a cell
membrane.
[0075] In accordance with the present invention, fitness in the
presence of an inhibitor can be determined for a biological entity
that produces or includes a biological target of the inhibitor. The
biological entity is preferably a replicating biological entity,
for example, a virus, a parasite, or a cell, preferably a
disease-causing cell. Disease-causing replicating biological
entities include, for example, tumor cells, cancer cells, and
infectious organisms (e.g., fungi, protozoa, bacteria, and the
like) and prions.
[0076] Cancer cells include, for example, cells associated with
breast cancer, colon cancer, lung cancer, and the like. Fitness can
be determined for a rapidly growing tumor cell.
[0077] Fungi include, for example, candida albicans, and the like.
Protozoa include, for example, trypanosome species, schistosomial
species, malarial protozoa, e.g., Plasmodium species. Plasmodium
species include, for example, Plasmodium Falciparum, Plasmodium
ovale, Plasmodium vivax, Plasmodium malariae, and the like.
Bacteria include, for example, Helicobacter pylori, Escherichia
coli, Salmonella, Streptococcus pyogenes, Staphylococcus aureas,
Bacillus anthrax, Mycobacterium tuberculosis, Hemophilus influenza,
and the like. Viruses include, for example, retroviruses (e.g.,
HIV-1 and HIV-2), herpes viruses, cytomegaloviruses, influenza
viruses, epstein-barr virus (EBV), Kaposi's sarcoma herpes virus
(KSHV), varicella-zoster virus (VZV), human papillomavirus (HPV),
echovirus, picornaviruses, rhinoviruses, poliovirus, coxsackie
virus, measles, mumps, human T-cell leukemia virus (HTLV-1),
rubella, rotaviruses, yellow fever virus, ebola virus, and other
pathogenic viruses, and the like.
[0078] Replicating biological entities also include multicellular
organisms, for example, infectious microorganisms, e.g., helminths.
Helminths include, for example, hookworms (e.g., ancylostoma
duodenale) strongyloides stercoralis, fasciola hepatica, trichuris
trichiura, trichinella spiralis, taenia solium, taenia saginata,
and the like.
[0079] It is believed that drug resistance is the evolutionary
result of fitness-based selection of mutant cells/microorganisms in
the presence of a drug (or any compound that has biological
activity). In accordance with the present invention, the emergence
(or non-emergence) of drug resistance in a disease caused by a
disease-causing replicating biological entity can be predicted by
determining the fitness of a biochemical target of a mutant in the
presence of the drug. Thus, the emergence (or non-emergence) of
drug resistance can be predicted on the basis of biochemical
fitness. While resistance profiles may, in some instances, reflect
fitness, it cannot be assumed that the emergence of drug resistance
for a particular mutant can be directly predicted on the basis of
its resistance profile alone.
[0080] The present invention thus provides an assay that can be
used to predict the biological fitness of a replicating biological
entity in the presence of a particular inhibitor. In a preferred
embodiment, an assay is provided for determining the biochemical
fitness of a biochemical target of a mutant replicating biological
entity relative to its predecessor. In accordance with the assay of
the present invention, a predecessor to the mutant is obtained, the
biochemical vitality of the biochemical target of the predecessor
in the presence of a compound capable of inhibiting the biochemical
target of the predecessor is determined, the biochemical vitality
of the biochemical target of the mutant in the presence of the
compound is determined, and the biochemical vitality of the
biochemical target of the mutant relative to the biochemical
vitality of the biochemical target of the predecessor are
compared.
[0081] The assay can be used with a wide variety of infectious
microorganisms, as described above, including, for example, a
virus, a fungus, a protozoa, or bacterium, a retrovirus, including
HIV-1 or HIV-2, and cancer cells. When the infectious microorganism
is a protozoa, it is preferably a malarial parasite, which is more
preferably a plasmodium species.
[0082] In another embodiment, the predecessor is a cancer cell,
which is preferably a rapidly growing tumor cell, for example, a
rapidly growing cancer cell found in breast cancer, colon cancer,
lung cancer, a tumor cell of a lymphoid origin, a tumor-derived
cell with a high metastatic potential, or the like.
[0083] The assay of the present invention can be applied to any
suitable biochemical target, preferably a biochemical target whose
biochemical vitality can be determined using measurable properties
that can be obtained by assay. Desirably, the biochemical target is
one that plays an important role in the replication and growth of
the entity. By way of example, the biochemical target of the
predecessor (and the mutant) can be an enzyme and the compound can
be an inhibitor of the enzyme of the predecessor.
[0084] The enzyme can be a viral enzyme. Illustrative of viral
enzymes are a viral protease enzyme, a viral reverse transcriptase,
a viral integrase, a viral polymerase, a viral protein with
enzymatic activity, or a retroviral enzyme, including an HIV-1 or
an HIV-2 enzyme. Viral protease enzymes, include a retroviral
protease, such as an HIV-1 protease or an HIV-2 protease. Viral
integrase enzymes include, for example, HIV-1 integrate, HIV-2
integrase, and the like. Viral polymerase can be a retroviral
polymerase, including an HIV-1 polymerase or an HIV-2 polymerase. A
viral protein with enzymatic activity can be a retroviral protein,
such as an HIV-1 protein or an HIV-2 protein.
[0085] The enzyme also can be a protozoal enzyme, including a
protozoal protease enzyme. The protozoal protease can be a malarial
protease. The malarial protease can be a plasmepsin, including
plasmepsin I or plasmepsin II. The malarial enzyme can also be a
plasmodial enzyme or a protein with enzymatic activity.
[0086] In yet another embodiment, the biochemical target of the
predecessor is an oligomer and the compound inhibits the
oligomerization of the oligomer of the predecessor. In yet another
embodiment, the biochemical target of the predecessor is a protein
and the compound inhibits a conformational change in the protein of
the predecessor.
[0087] The biochemical vitality determination can also take into
account other factors, preferably measurable factors, that effect
the ability of a biochemical target to perform its biochemical
function in the presence of the inhibitor. When the biochemical
target is an enzyme and the compound is an enzyme inhibitor, the
biochemical vitality of the enzyme of the mutant replicating
biological entity preferably corresponds to K.sub.inh-mut,
K.sub.cat-mut, K.sub.M-mut, and the biochemical vitality of the
enzyme of the predecessor preferably corresponds to K.sub.inh-pred,
K.sub.cat-pred, and K.sub.M-pred. K.sub.inh is an inhibition
constant of the compound, k.sub.cat is the biochemical catalytic
rate, and K.sub.M is the Michaelis constant. More preferably, the
vitality of the enzyme corresponds to K.sub.inh, k.sub.cat and
K.sub.M, and the biochemical vitality of the enzyme of the mutant
replicating biological entity is defined by the relationship
K.sub.inh-mut(K.sub.cat-mut/K.sub.M-mut) (i.e.,
(K.sub.inh-mut).times.(K.- sub.cat-mut/K.sub.M-mut)) and the
biochemical vitality of the enzyme of the predecessor is defined by
the relationship K.sub.inh-pred(k.sub.cat-p- red/K.sub.M-pred). The
variables K.sub.inh-mut, K.sub.inh-pred, k.sub.cat-mut,
k.sub.cat-pred, K.sub.M-mut, and KM-pred can be obtained by any
suitable means, and are preferably obtained by measurement (e.g.,
from an assay). When vitality is determined on the basis of these
relationships, biochemical fitness in the presence of a given
inhibitor/drug preferably is defined by the equation: 3 K inh - mut
( k cat - mut / K M - mut ) K inh - pred ( k cat - pred / K M -
pred ) , or log [ K inh - mut ( k cat - mut / K M - mut ) K inh -
pred ( k cat - pred / K M - pred ) ] .
[0088] K.sub.inh can be determined by any suitable means, but
typically is determined on the basis of K.sub.i or K.sub.d.
[0089] The present invention also provides a method of
administering a therapeutic compound, which method increases the
chances of successful long-term therapy. In a preferred embodiment,
the present invention provides a method of administering a
therapeutic compound that inhibits a biochemical target of a
replicating disease-causing replicating biological entity (disease
causing predecessor), including identifying at least one mutant
capable of evolving from the disease-causing predecessor. A first
biochemical vitality of the biochemical target of the
disease-causing predecessor in the presence of a first compound
capable of inhibiting the biochemical target of the disease-causing
predecessor, and a first biochemical vitality of the biochemical
target of the mutant in the presence of the first compound, are
determined.
[0090] Additional biochemical vitalities of the biochemical target
of the disease-causing replicating biological entity in the
presence of additional compounds capable of inhibiting the
biochemical target of the disease-causing cell, and additional
biochemical vitalities of the biochemical target of the mutant in
the presence of the additional compounds, are also determined.
[0091] Fitnesses in the presence of different inhibitors/drugs can
be compared and a therapeutic compound administered on the basis of
the comparison. A first biochemical fitness of the biochemical
target of the mutant relative to the disease-causing predecessor is
determined by comparing the first biochemical vitality of the
biochemical target of the mutant with the first biochemical
vitality of the biochemical target of the disease-causing
predecessor, and a second biochemical fitness of the biochemical
target of the mutant relative to the disease-causing replicating
biological entity is determined by comparing the second biochemical
vitality of the biochemical target of the mutant with the second
biochemical vitality of the biochemical target of the
disease-causing replicating biological entity. Additional
biochemical fitness determinations can be made in the presence of
additional compounds. The biochemical fitness values for one or
more mutants in the presence of each compound are compared. A
therapeutic compound is then administered from among the first and
the additional compound(s), which therapeutic compound produces the
lowest biochemical fitness values.
[0092] In accordance with the method of the present invention, the
replicating disease-causing replicating biological entity is less
likely to develop resistance in the presence of the therapeutic
compound. The therapeutic compound can be administered from among
any particular set of compounds, which can have the same
biochemical target or different biochemical targets with respect to
each other. The method of administering a compound in accordance
with the present invention is, therefore, not limited to comparing
fitness in the presence of compounds that act on the same
biochemical target.
[0093] In one embodiment, the disease-causing replicating
biological entity is an infectious microorganism, for example, a
virus, a fungus, a protozoa, or a bacterium, more preferably a
virus or a protozoa. When the infectious microorganism is a virus,
it is preferably a retrovirus, which is more preferably HIV-1 or
HIV-2, and most preferably HIV-1. When the infectious microorganism
is a protozoa, it is preferably a malarial parasite, which is more
preferably a plasmodium species.
[0094] In another embodiment, the disease-causing replicating
biological entity is a cancer cell, which is preferably a rapidly
growing tumor cell, for example, a rapidly growing cancer cell
found in breast cancer, colon cancer, lung cancer, or the like.
[0095] The method of administering a compound in accordance with
the present invention can be applied to any suitable biochemical
target, preferably a biochemical target whose biochemical vitality
can be determined using measurable properties that can be obtained
by assay. In one embodiment, the biochemical target of the
predecessor (and the mutant) is an enzyme and the compound inhibits
an enzyme of the predecessor. The enzyme can be any enzyme whose
biochemical vitality can be measured including, for example, an
enzyme described herein in connection with the fitness assay of the
present invention.
[0096] In another embodiment, the biochemical target of the
disease-causing replicating biological entity is an oligomer and
the compound inhibits the oligomerization of the oligomer of the
predecessor. In yet another embodiment, the biochemical target of
the disease-causing replicating biological entity is a protein and
the compound inhibits a conformational change in the protein of the
predecessor.
[0097] The biochemical vitality can be determined in any suitable
manner. For example, vitality can be determined as described
herein, e.g., as described in connection with the assay of the
present invention.
[0098] When an infectious microorganism is tested in accordance
with the assay of the present invention, the predecessor can be a
wild-type species, or the predecessor can itself be a mutant
species. In a particularly preferred embodiment, the predecessor is
a retrovirus, which is more preferably a wild-type HIV-1 or HIV-2
strain, most preferably HIV-1. When the predecessor is a wild-type
HIV strain, the mutant replicating biological entity preferably has
at least one mutation in the biochemical target thereof. When the
predecessor has at least one mutation in the biochemical target
thereof, the mutant preferably has at least two mutations in the
biochemical target thereof.
[0099] Similarly, when the method of administering a therapeutic
compound in accordance with the present invention is used in
connection with an infectious microorganism, the disease-causing
replicating biological entity can be a wild-type species, or the
disease-causing entity can itself be a mutant species. In a
particularly preferred embodiment, the disease-causing replicating
biological entity is a retrovirus, which is more preferably a
wild-type HIV-1 or HIV-2 strain, most preferably HIV-1. When the
disease-causing replicating biological entity is a wild-type HIV
strain, the mutant preferably has at least one mutation in the
biochemical target thereof. When the disease-causing replicating
biological entity has at least one mutation in the biochemical
target thereof, the mutant preferably has at least two mutations in
the biochemical target thereof.
[0100] When the predecessor or the disease-causing replicating
biological entity in the assay of the present invention, or in the
method of administering a compound in accordance with the present
invention, is a wild-type HIV strain, the biochemical target of the
mutant preferably has at least one active site mutation. When the
predecessor in the assay of the present invention has at least one
mutation, and the mutant replicating biological entity has at least
two mutations, the biochemical target of the predecessor or of the
mutant preferably has at least one active site mutation. When the
disease-causing replicating biological entity in the method of the
present invention has at least one mutation in the biochemical
target thereof, and the mutant has at least two mutations in the
biochemical target thereof, the biochemical target of the
disease-causing entity or of the mutant preferably has at least one
active site mutation.
[0101] The present invention further provides a continuous
fluorogenic assay for measuring the anti-HIV protease activity of a
protease inhibitor, which method comprises adding a solution of HIV
protease to a substrate stock solution, in which the substrate has
the formula Ala-Arg-Val-Tyr-Phe(NO.sub.2)-Glu-Ala-Nle-NH.sub.2, to
provide a substrate reaction solution. The fluorescence of the
substrate reaction solution is then measured at specified time
intervals. The solution of HIV protease is then added to a solution
of the protease inhibitor and the substrate stock solution, to
provide an inhibitor-substrate reaction solution. The fluorescence
of the inhibitor-substrate reaction solution is then measured at
specified time intervals. The initial velocity of the
inhibitor-substrate reaction solution is then calculated by
applying the equation:
V=V.sub.0/2E.sub.t({[K.sub.i(1+S/K.sub.m)+I.sub.t-E.sub.t].sup.-
2+4K.sub.i(1+S/K.sub.m)E.sub.t)}.sup.1/2-[K.sub.i((1+S/K.sub.m)+I.sub.t-E.-
sub.t]), wherein V is the initial velocity of the inhibitor
reaction solution, V.sub.0 is the initial velocity of the substrate
reaction solution, K.sub.m is the Michaelis-Menten constant, S is
the substrate concentration, E.sub.t is the protease concentration,
and I.sub.t is the inhibitor concentration.
[0102] The assay method described herein is highly sensitive and
particularly useful for the prediction of the antiviral inhibitory
activity of a compound against mutant HIV, more particularly
multiple mutant HIV, specifically multidrug-resistant human
immunodeficiency viruses. The continuous flourogenic assay of the
present invention is distinctly advantageous in that it is more
sensitive than standard assays in determining the activity of
protease inhibitors against multidrug-resistant HIV. The continuous
flourogenic assay of the present invention is disclosed in more
detail in the examples that follow. The inhibitory data obtained in
accordance with this continuous fluorogenic assay can be used to
determine vitality and fitness for HIV-1 protease in the presence
of a protease inhibitor, in accordance with the present
invention.
[0103] The present invention also provides a method of preventing
the emergence of drug resistance in an HIV-infected mammal that
includes the administration of a drug resistance-inhibiting
effective amount of a compound represented by the formula: 5
[0104] or a pharmaceutically acceptable salt, a prodrug, or an
ester thereof, or a pharmaceutical-composition thereof,
wherein:
[0105] A is a group of the formula: 6
[0106] R.sup.1 is H or an alkyl, an alkenyl, an alkynyl, a
cycloalkyl, a cycloalkylalkyl, an aryl, an aralkyl, a
heterocycloalkyl, a heterocycloalkylalkyl, a heteroaryl, or a
heteroaralkyl radical, in which at least one hydrogen atom is
optionally substituted with a substituent independently selected
from the group consisting of OR.sup.7, SR.sup.7, CN, NO.sub.2,
N.sub.3, and a halogen, wherein R.sup.7 is H, an alkyl, an alkenyl,
or an alkynyl;
[0107] Y and Z are the same or different and are independently
selected from the group consisting of C O, S, SO, SO.sub.2,
NR.sup.8, R.sup.8C(O)N, R.sup.8C(S)N, R.sup.8OC(O)N, R.sup.8OC(S)N,
R.sup.8SC(O)N, R.sup.8R.sup.9NC(O)N, and R.sup.8R.sup.9NC(S)N,
wherein R.sup.8 and R.sup.9 are independently selected from the
group consisting of H, an alkyl, an alkenyl, and an alkynyl;
[0108] n is an integer from 1 to 5;
[0109] X is a covalent bond, CHR.sup.10, CHR.sup.10CH.sub.2,
CH.sub.2CHR.sup.10, O, NR.sup.10, or S, wherein R.sup.10 is H, an
alkyl, an alkenyl, or an alkynyl;
[0110] Q is C(O), C(S), or SO.sub.2;
[0111] R.sup.2 is H, an alkyl, an alkenyl, or an alkynyl;
[0112] m is an integer from 0 to 6;
[0113] R.sup.3 is a cycloalkyl, a heterocycloalkyl, an aryl, or a
heteroaryl in which at least one hydrogen atom is optionally
substituted with a substituent independently selected from the
group consisting of H, alkyl, (CH.sub.2).sub.pR.sup.11, OR.sup.12,
SR.sup.12, CN, N.sub.3, NO.sub.2, NR.sup.12R.sup.13, C(O)R.sup.12,
C(S)R.sup.12, CO.sub.2R.sup.12, C(O)SR.sup.12,
C(O)NR.sup.12R.sup.13, C(S)NR.sup.12R.sup.13,
NR.sup.12C(O)R.sup.13, NR.sup.12C(S)R.sup.13,
NR.sup.12CO.sub.2R.sup.13, NR.sup.12C(O)SR.sup.13, and a halogen,
wherein:
[0114] p is an integer from 0 to 5;
[0115] R.sup.11 is a cycloalkyl, a heterocycloalkyl, an aryl, or a
heteroaryl in which at least one hydrogen atom is optionally
substituted with a substituent independently selected from the
group consisting of a halogen, OH, OCH.sub.3, NH.sub.2, NO.sub.2,
SH, and CN; and
[0116] R.sup.12 and R.sup.13 are independently selected from the
group consisting of H, an alkyl, an alkenyl, and an alkynyl;
[0117] R.sup.4 is OH, .dbd.O (keto), or NH.sub.2, wherein, when
R.sup.4 is OH, it is optionally in the form of a pharmaceutically
acceptable ester or prodrug, and when R.sup.4 is NH.sub.2, it is
optionally an amide, a hydroxylamino, a carbamate, a urea, an
alkylamino, a dialkylamino, a protic salt, or a tetraalkylammonium
salt;
[0118] R.sup.5 is H, a C.sub.1-C.sub.6 alkyl radical, a
C.sub.2-C.sub.6 alkenyl radical, or (CH.sub.2).sub.qR.sup.14,
wherein q is an integer form 0 to 5, and R.sup.14 is a cycloalkyl,
a heterocycloalkyl, an aryl, or a heteroaryl radical in which at
least one hydrogen atom is optionally substituted with a
substituent independently selected from the group consisting of a
halogen, OH, OCH.sub.3, NH.sub.2, NO.sub.2, SH, and CN;
[0119] W is C(O), C(S), S(O), or SO.sub.2; and
[0120] R.sup.6 is a cycloalkyl, heterocycloalkyl, aryl, or
heteroaryl radical in which at least one hydrogen atom is
optionally substituted with a substituent independently selected
from the group consisting of a halogen, OR.sup.15, SR.sup.15,
S(O)R.sup.15, SO.sub.2R.sup.15, SO.sub.2NR.sup.15R.sup.16,
SO.sub.2N(OH)R.sup.15, CN, CR.sup.15.dbd.NR.sup.16,
CR.sup.15.dbd.N(OR.sup.16), N.sub.3, NO.sub.2, NR.sup.15R.sup.16,
N(OH)R.sup.15, C(O)R.sup.15, C(S)R.sup.15, CO.sub.2R.sup.15,
C(O)SR.sup.15, C(O)NR.sup.15R.sup.16, C(S)NR.sup.15R.sup.16,
C(O)N(OH)R.sup.15, C(S)N(OH)R.sup.15, NR.sup.15C(O)R.sup.16,
NR.sup.15C(S)R.sup.16, N(OH)C(O)R.sup.15, N(OH)C(S)R.sup.15,
NR.sup.15CO.sub.2R.sup.16, N(OH)CO.sub.2R.sup.15,
NR.sup.15C(O)SR.sup.16, NR.sup.15C(O)NR.sup.15R.sup.17,
NR.sup.15C(S)NR.sup.16R.sup.17, N(OH)C(O)NR.sup.15R.sup.16,
N(OH)C(S)NR.sup.15R.sup.16, NR.sup.15C(O)N(OH)R.sup.16,
NR.sup.15C(S)N(OH)R.sup.16, NR.sup.15SO.sub.2R.sup.16,
NHSO.sub.2NR.sup.15R.sup.16, NR.sup.15SO.sub.2NHR.sup.16, P(O)
(OR.sup.15) (OR.sup.16), an alkyl, an alkoxy, an alkylthio, an
alkylamino, a cycloalkyl, a cycloalkylalkyl, a heterocycloalkyl, a
heterocycloalkylalkyl, an aryl, an aryloxy, an arylamino, an
arylthio, an aralkyl, an aryloxyalkyl, an arylaminoalkyl, an
aralkoxy, an (aryloxy)alkoxy, an (arylamino)alkoxy, an
(arylthio)alkoxy, an aralkylamino, an (aryloxy)alkylamino, an
(arylamino)alkylamino, an (arylthio)alkylamino, an aralkylthio, an
(aryloxy)alkylthio, an (arylamino)alkylthio, an
(arylthio)alkylthio, a heteroaryl, a heteroaryloxy, a
heteroarylamino, a heteroarylthio, a heteroaralkyl, a
heteroaralkoxy, a heteroaralkylamino, and a heteroaralkylthio,
[0121] wherein R.sup.15, R.sup.16, and R.sup.17 are H, an
unsubstituted alkyl, and an unsubstituted alkenyl,
[0122] wherein, when at least one hydrogen atom of R.sup.6 is
optionally substituted with a substituent other than a halogen,
OR.sup.15, SR.sup.15, S(O)R.sup.15, SO.sub.2R.sup.15,
SO.sub.2NR.sup.15R.sup.16, SO.sub.2N(OH)R.sup.15, CN,
CR.sup.15.dbd.NR.sup.16, CR.sup.15.dbd.N(OR.sup.16), N.sub.3,
NO.sub.2, NR.sup.15R.sup.16, N(OH)R.sup.15, C(O)R.sup.15,
C(S)R.sup.15, CO.sub.2R.sup.15, C(O)SR.sup.15,
C(O)NR.sup.15R.sup.16, C(S)NR.sup.15R.sup.16, C(O)N(OH)R.sup.15,
C(S)N(OH)R.sup.15, NR.sup.15C(O)R.sup.16, NR.sup.15C(S)R.sup.16,
N(OH)C(O)R.sup.15, N(OH)C(S)R.sup.15, NR.sup.15CO.sub.2R.sup.16,
N(OH)CO.sub.2R.sup.15, NR.sup.15C(O)SR.sup.16,
NR.sup.15C(O)NR.sup.16R.sup.17, NR.sup.15C(S)NR.sup.16R.sup.17,
N(OH)C(O)NR.sup.15R.sup.16, N(OH)C(S)NR.sup.15R.sup.16,
NR.sup.15C(O)N(OH)R.sup.16, NR.sup.15C(S)N(OH)R.sup.16,
NR.sup.15SO.sub.2R.sup.16, NHSO.sub.2NR.sup.15R.sup.16,
NR.sup.15SO.sup.2NHR.sup.16, or P(O) (OR.sup.15) (OR.sup.16), then
at least one hydrogen atom on said substituent is optionally
substituted with a halogen, OR.sup.15, SR.sup.15, S(O)R.sup.15,
SO.sub.2R.sup.15, SO.sub.2NR.sup.15R.sup.16, SO.sub.2N(OH)R.sup.15,
CN, CR.sup.15.dbd.NR.sup.16, CR.sup.15.dbd.N(OR.sup.16), N.sub.3,
NO.sub.2, NR.sup.15R.sup.16, N(OH)R.sup.15, C(O)R.sup.15,
C(S)R.sup.15, CO.sub.2R.sup.15, C(O)SR.sup.15,
C(O)NR.sup.15R.sup.16, C(S)NR.sup.15R.sup.16, C(O)N(OH)R.sup.15,
C(S)N(OH)R.sup.15, NR.sup.15C(O)R.sup.16, NR.sup.15C(S)R.sup.16,
N(OH)C(O)R.sup.15, N(OH)C(S)R.sup.15, NR.sup.15CO.sub.2R.sup.16,
N(OH)CO.sub.2R.sup.15, NR.sup.15C(O)SR.sup.16,
NR.sup.15C(O)NR.sup.16R.sup.17, NR.sup.15C(S)NR.sup.16R.sup.17,
N(OH)C(O)NR.sup.15R.sup.16, N(OH)C(S)NR.sup.15R.sup.16,
NR.sup.15C(O)N(OH)R.sup.16, NR.sup.15C(S)N(OH)R.sup.16,
NR.sup.15SO.sub.2R.sup.16, NHSO.sub.2NR.sup.15R.sup.16,
NR.sup.15SO.sub.2NHR.sup.16, or P(O) (OR.sup.15) (OR.sup.16)
[0123] Optionally, R.sup.5 and R.sup.6 are covalently bonded such
that R.sup.5 and R.sup.6, together with the N--W bond of formula
(I), comprise a 12 to 18 membered ring. The 12 to 18 membered ring
can comprise at least one additional heteroatom in the ring
skeleton other than the nitrogen of the N--W bond (e.g., N, O, or
S) within the ring. In the practice of the method of preventing the
emergence of drug resistance in an HIV-infected mammal, it is
preferable that a mutant virus that is capable of evolving from the
infection has low fitness, relative to the infecting virus, in the
presence of the compound or combination of compounds that are
administered.
[0124] As utilized herein, the term "alkyl" means a straight-chain
or branched alkyl radical containing from about 1 to about 20
carbon atoms chain, preferably from about 1 to about 10 carbon
atoms, more preferably from about 1 to about 8-carbon atoms, still
more preferably from about 1 to about 6 carbon atoms. Examples of
such substituents include methyl, ethyl, propyl, isopropyl,
n-butyl, sec-butyl, isobutyl, tert-butyl, pentyl, isoamyl, hexyl,
octyl, dodecanyl, and the like.
[0125] The term "alkenyl" means a straight-chain or branched-chain
alkenyl radical having one or more double bonds and containing from
about 2 to about 20 carbon atoms chain, preferably from about 2 to
about 10 carbon atoms, more preferably from about 2 to about 0.8
carbon atoms, still more preferably from about 2 to about 6 carbon
atoms. Examples of such substituents include vinyl, allyl,
1,4-butadienyl, isopropenyl, and the like.
[0126] The term "alkynyl" means a straight-chain or branched-chain
alkynyl radical having one or more triple bonds and containing from
about 2 to about 20 carbon atoms chain, preferably from about 2 to
about 10 carbon atoms, more preferably from about 2 to about 8
carbon atoms, still more preferably from about 2 to about 6 carbon
atoms. Examples of such radicals include ethynyl, propynyl
(propargyl), butynyl, and the like.
[0127] The term "alkoxy" means an alkyl ether radical, wherein the
term "alkyl" is defined as above. Examples of alkoxy radicals
include methoxy, ethoxy, n-propoxy, isopropoxy, n-butoxy,
isobutoxy, sec-butoxy, tert-butoxy, hexanoxy, and the like.
[0128] The term "alkylthio" means an alkyl thioether radical,
wherein the term "alkyl" is defined as above. Examples of alkylthio
radicals include methylthio (SCH.sub.3), ethylthio
(SCH.sub.2CH.sub.3), n-propylthio, isopropylthio, n-butylthio,
isobutylthio, sec-butylthio, tert-butylthio, n-hexylthio, and the
like.
[0129] The term "alkylamino" means an alkyl amine radical, wherein
the term "alkyl" is defined as above. Examples of alkylamino
radicals include methylamino (NHCH.sub.3), ethylamino
(NHCH.sub.2CH.sub.3), n-propylamino, isopropylamino, n-butylamino,
isobutylamino, sec-butylamino, tert-butylamino, n-hexylamino, and
the like.
[0130] The term "cycloalkyl" means a monocyclic or a polycyclic
alkyl radical defined by one or more alkyl carbocyclic rings, which
can be the same or different when the cycloalkyl is a polycyclic
radical having 3 to about 10 carbon atoms in the carbocyclic
skeleton in each ring, preferably about 4 to about 7 carbon atoms,
more preferably 5 to 6 carbons atoms. Examples of monocyclic
cycloalkyl radicals include cyclopropyl, cyclobutyl, cyclopentyl,
cyclohexyl, cycloheptyl, cyclodecyl, and the like. Examples of
polycyclic cycloalkyl radicals include decahydronaphthyl,
bicyclo[5.4.0]undecyl, adamantyl, and the like.
[0131] The term "cycloalkylalkyl" means an alkyl radical as defined
herein, in which at least one hydrogen atom on the alkyl radical is
replaced by a cycloalkyl radical as defined herein. Examples of
cycloalkylalkyl radicals include cyclohexylmethyl,
3-cyclopentylbutyl, and the like.
[0132] The term "heterocycloalkyl" means a cycloalkyl radical as
defined herein (including polycyclics), wherein at least one carbon
which defines the carbocyclic skeleton is substituted with a
heteroatom such as, for example, O, N, or S, optionally comprising
one or more double-bond within the ring, provided the ring is not
heteroaryl as defined herein. The heterocycloalkyl preferably has 3
to about 10 atoms (members) in the carbocyclic skeleton of each
ring, preferably about 4 to about 7 atoms, more preferably 5 to 6
atoms. Examples of heterocycloalkyl radicals include epoxy,
aziridyl, oxetanyl, tetrahydrofuranyl, dihydrofuranyl, piperadyl,
piperidinyl, pyperazyl, piperazinyl, pyranyl, morpholinyl, and the
like.
[0133] The term "heterocycloalkylalkyl" means an alkyl radical as
defined herein, in which at least one hydrogen atom on the alkyl
radical is replace by a heterocycloalkyl radical as defined herein.
Examples of heterocycloalkylalkyl radicals include
2-morpholinomethyl, 3-(4-morpholino)-propyl,
4-(2-tetrahydrofuranyl)-butyl, and the like.
[0134] The term "aryl" refers to an aromatic carbocyclic radical,
as commonly understood in the art, and includes monocyclic and
polycyclic aromatics such as, for example, phenyl and naphthyl
radicals, optionally substituted with one or more substituents
selected from the group consisting of a halogen, an alkyl, alkoxy,
amino, cyano, nitro, and the like.
[0135] The term "aryloxy" means aryl as defined herein, wherein a
hydrogen atom is replaced by an oxygen. Examples of aryloxy
radicals include phenoxy, naphthoxy, 4-flourophenoxy, and the
like.
[0136] The term "arylamino" means aryl as defined herein, wherein a
hydrogen atom is replaced by an amine. Examples of arylamino
radicals include phenylamino, naphthylamino, 3-nitrophenylamino,
4-aminophenylamino, and the like.
[0137] The term "arylthio" means aryl as defined herein, wherein a
hydrogen atom is replaced by a sulfur atom. Examples of arylthio
radicals include phenylthio, naphthylthio, 3-nitrophenylthio,
4-thiophenylthio, and the like.
[0138] The term "aralkyl" means alkyl as defined herein, wherein an
alkyl hydrogen atom is replaced by an aryl as defined herein.
Examples of aralkyl radicals include benzyl, phenethyl,
3-(2-naphthyl)-butyl, and the like.
[0139] The term "aryloxyalkyl" means alkyl as defined herein,
wherein an alkyl hydrogen atom is replaced by an aryloxy as defined
herein. Examples of aryloxyalkyl radicals include phenoxyethyl,
4-(3-aminophenoxy)-1-butyl- , and the like.
[0140] The term "arylaminoalkyl" means alkyl as defined herein,
wherein an alkyl hydrogen atom is replaced by an arylamino as
defined herein. Examples of arylaminoalkyl radicals include
phenylaminoethyl, 4-(3-methoxyphenylamino)-1-butyl, and the
like.
[0141] The term "aralkoxy" means alkoxy as defined herein, wherein
an alkyl hydrogen atom is replaced by an aryl as defined herein.
Examples of aralkoxy radicals include 2-phenylethoxy,
2-phenyl-1-propoxy, and the like.
[0142] The term "(aryloxy)alkoxy" means alkoxy as defined herein,
wherein an alkyl hydrogen atom is replaced by an aryloxy as defined
herein. Examples of (aryloxy)alkoxy radicals include
2-phenoxyethoxy, 4-(3-aminophenoxy)-1-butoxy, and the like.
[0143] The term "(arylamino)alkoxy" means alkoxy as defined herein,
wherein an alkyl hydrogen atom is replaced by an arylamino as
defined herein. Examples of (arylamino)alkoxy radicals include
2-(phenylamino)-ethoxy, 2-(2-naphthylamino)-1-butoxy, and the
like.
[0144] The term "(arylthio)alkoxy" means alkoxy as defined herein,
wherein an alkyl hydrogen atom is replaced by an arylthio as
defined herein. Examples of (arylthio)alkoxy radicals include
2-(phenylthio)-ethoxy, and the like.
[0145] The term "aralkylamino" means alkylamino as defined herein,
wherein an alkyl hydrogen atom is replaced by an aryl as defined
herein. Examples of aralkylamino radicals include 2-phenethylamino,
4-phenyl-n-butylamino, and the like.
[0146] The term "(aryloxy)alkylamino" means alkylamino as defined
herein, wherein an alkyl hydrogen atom is replaced by an aryloxy as
defined herein. Examples of (aryloxy)alkylamino radicals include
3-phenoxy-n-propylamino, 4-phenoxybutylamino, and the like.
[0147] The term "(arylamino)alkylamino" means alkylamino as defined
herein, wherein an alkyl hydrogen atom is replaced by an arylamino
as defined herein. Examples of (arylamino)alkylamino radicals
include 3-(naphthylamino)-1-propylamino,
4-(phenylamino)-1-butylamino, and the like.
[0148] The term "(arylthio)alkylamino" means alkylamino as defined
herein, wherein an alkyl hydrogen atom is replaced by an arylthio
as defined herein. Examples of (arylthio)alkylamino radicals
include 2-(phenylthio)-ethylamino, and the like.
[0149] The term "aralkylthio" means alkylthio as defined herein,
wherein an alkyl hydrogen atom is replaced by an aryl as defined
herein. Examples of aralkylthio radicals include
3-phenyl-2-propylthio, 2-(2-naphthyl)-ethylthio, and the like.
[0150] The term "(aryloxy)alkylthio" means alkylthio as defined
herein, wherein an alkyl hydrogen atom is replaced by an aryloxy as
defined herein. Examples of (aryloxy)alkylthio radicals include
3-phenoxypropylthio, 4-(2-fluorophenoxy)-butylthio, and the
like.
[0151] The term "(arylamino)alkylthio" means alkylthio as defined
herein, wherein an alkyl hydrogen atom is replaced by an arylamino
as defined herein. Examples of (arylamino)alkylthio radicals
include 2-(phenylamino)-ethylthio,
3-(2-naphthylamino)-n-propylthio, and the like.
[0152] The term "(arylthio)alkylthio" means alkylthio as defined
herein, wherein an alkyl hydrogen atom is replaced by an arylthio
as defined herein. Examples of (arylthio)alkylthio radicals include
2-(naphthylthio)-ethylthio, 3-(phenylthio)-propylthio, and the
like.
[0153] The term "heteroaryl" means a radical defined by an aromatic
heterocyclic ring as commonly understood in the art, including
monocyclic radicals such as, for example, imidazole, thiazole,
pyrazole, pyrrole, furane, pyrazoline, thiophene, oxazole,
isoxazol, pyridine, pyridone, pyrimidine, pyrazine, and triazine
radicals, and also including polycyclics such as, for example,
quinoline, isoquinoline, indole, and benzothiazole radicals, which
heteroaryl radicals are optionally substituted with one or more
substituents selected from the group consisting of a halogen, an
alkyl, alkoxy, amino, cyano, nitro, and the like. It will be
appreciated that the heterocycloalkyl and heteroaryl substituents
can be coupled to the compounds of the present invention via a
heteroatom, such as nitrogen (e.g., 1-imidazolyl).
[0154] The term "heteroaryloxy" means heteroaryl as defined herein,
wherein a hydrogen atom on the heteroaryl ring is replaced by an
oxygen. Heteroaryloxy radicals include, for example, 4-pyridyloxy,
5-quinolyloxy, and the like.
[0155] The term "heteroarylamino" means heteroaryl as defined
herein, wherein a hydrogen atom on the heteroaryl ring is replaced
by an nitrogen. Heteroarylamino radicals include, for example,
4-thiazolylamino, 2-pyridylamino, and the like.
[0156] The term "heteroarylthio" means heteroaryl as defined
herein, wherein a hydrogen atom on the heteroaryl ring is replaced
by a sulfur. Heteroarylthio radicals include, for example,
3-pyridylthio, 3-quinolylthio, 4-imidazolylthio, and the like.
[0157] The term "heteroaralkyl" means alkyl as defined herein,
wherein an alkyl hydrogen atom is replaced by a heteroaryl as
defined herein. Examples of heteroaralkyl radicals include
2-pyridylmethyl, 3-(4-thiazolyl)-propyl, and the like.
[0158] The term "heteroaralkoxy" means alkoxy as defined herein,
wherein an alkyl hydrogen atom is replaced by a heteroaryl as
defined herein. Examples of heteroaralkoxy radicals include
2-pyridylmethoxy, 4-(1-imidazolyl)-butoxy, and the like.
[0159] The term "heteroaralkylamino" means alkylamino as defined
herein, wherein an alkyl hydrogen atom is replaced by a heteroaryl
as defined herein. Examples of heteroaralkylamino radicals include
4-pyridylmethylamino, 3-(2-furanyl)-propylamino, and the like.
[0160] The term "heteroaralkylthio" means alkylthio as defined
herein, wherein an alkyl hydrogen atom is replaced by a heteroaryl
as defined herein. Examples of heteroaralkylthio radicals include
3-pyridylmethylthio, 3-(4-thiazolyl)-propylthio, and the like.
[0161] In the compound of Formula I, A is preferably a group of the
formula: 7
[0162] R.sup.1 is H or an alkyl, an alkenyl, a cycloalkyl, a
cycloalkylalkyl, an aryl, an aralkyl, a heterocycloalkyl, a
heterocycloalkylalkyl, a heteroaryl, or a heteroaralkyl radical, in
which at least one hydrogen atom is optionally substituted with a
substituent independently selected from the group consisting of
OR.sup.7, SR.sup.7, CN, NO.sub.2, N.sub.3, and a halogen, wherein
R.sup.7 is H, an unsubstituted alkyl, or an unsubstituted alkenyl;
Y and Z are the same or different and are independently selected
from the group consisting of CH.sub.2, O, S, SO, SO.sub.2,
NR.sup.8, R.sup.8C(O)N, R.sup.8C(S)N, R.sup.8OC(O)N, R.sup.8SC(S)N,
R.sup.8SC(O)N, R.sup.8R.sup.9NC(O)N, and R.sup.8R.sup.9NC(S)N,
wherein R.sup.8 and R.sup.9 are independently selected from the
group consisting of H, an unsubstituted alkyl, and an unsubstituted
alkenyl; X is a covalent bond, CHR.sup.10, CHR.sup.10CH.sub.2,
CH.sub.2CHR.sup.10, O, NR.sup.10, or S, wherein R.sup.10 is H, an
unsubstituted alkyl, or an unsubstituted alkenyl; R.sup.2 is H, a
C.sub.1-C.sub.6 alkyl radical, or a C.sub.2-C.sub.6 alkenyl
radical; R.sup.12 and R.sup.13, as defined with respect to R.sup.3,
are independently selected from the group consisting of H, an
unsubstituted alkyl, and an unsubstituted alkenyl radical; R.sup.4
is 40H, NH.sub.2, or NHCH.sub.3; W is C(O), C(S), or SO.sub.2; and
R.sup.6 is a cycloalkyl, heterocycloalkyl, aryl, or heteroaryl
radical in which at least one hydrogen atom is optionally
substituted with a substituent independently selected from the
group consisting of a halogen, OR.sup.15, SR.sup.15, CN, N.sub.3,
NO.sub.2, NR.sup.15R.sup.16, C(O)R.sup.15, C(S)R.sup.15,
CO.sub.2R.sup.15, C(O)SR.sup.15, C(O)NR.sup.15R.sup.16,
C(S)NR.sup.15R.sup.16, NR.sup.15C(O)R.sup.16,
NR.sup.15C(S)R.sup.16, NR.sup.15CO.sub.2R.sup.16,
NR.sup.15C(O)SR.sup.16, NR.sup.15C(O)NR.sup.16R.sup.17, and
NR.sup.15C(S)NR.sup.16R.sup.17, an alkyl, an alkoxy, an alkylthio,
an alkylamino, a cycloalkyl, a cycloalkylalkyl, a heterocycloalkyl,
a heterocycloalkylalkyl, an aryl, an aryloxy, an arylamino, an
arylthio, an aralkyl, an aryloxyalkyl, an arylaminoalkyl, an
aralkoxy, an (aryloxy)alkoxy, an (arylamino)alkoxy, an
(arylthio)alkoxy, an aralkylamino, an (aryloxy)alkylamino, an
(arylamino)alkylamino, an (arylthio)alkylamino, an aralkylthio, an
(aryloxy)alkylthio, an (arylamino)alkylthio, an
(arylthio)alkylthio, a heteroaryl, a heteroaryloxy, a
heteroarylamino, a heteroarylthio, a heteroaralkyl, a
heteroaralkoxy, a heteroaralkylamino, and a heteroaralkylthio,
wherein R.sup.15, R.sup.16, and R.sup.17 are H, an unsubstituted
alkyl, and an unsubstituted alkenyl, such that when at least one
hydrogen atom of R.sup.6 is optionally substituted with a
substituent other than a halogen, OR.sup.15, SR.sup.15, CN,
N.sub.3, NO.sub.2, NR.sup.15R.sup.16, C(O)R.sup.15, C(S)R.sup.15,
CO.sub.2R.sup.15, C(O)SR.sup.15, C(O)NR.sup.15R.sup.16,
C(S)NR.sup.15R.sup.16, NR.sup.15C(O)R.sup.16,
NR.sup.15C(S)R.sup.16, NR.sup.15CO.sub.2R.sup.16,
NR.sup.15C(O)SR.sup.16, NR.sup.15C(O)NR.sup.16R.sup.17, or
NR.sup.15C(S)NR.sup.16R.sup.17, at least one hydrogen atom on said
substituent attached to R.sup.6 is optionally substituted with a
halogen, OR.sup.15, SR.sup.15, CN, N.sub.3, NO.sub.2,
NR.sup.15R.sup.16, C(O)R.sup.15, C(S)R.sup.15, CO.sub.2R.sup.15,
C(O)SR.sup.15, C(O)NR.sup.15R.sup.16, C(S)NR.sup.15R.sup.16,
NR.sup.15C(O)R.sup.15, NR.sup.15C(S)R.sup.16,
NR.sup.15CO.sub.2R.sup.16, NR.sup.15C(O)SR.sup.16,
NR.sup.15C(O)NR.sup.16R.sup.17, or
NR.sup.15C(S)NR.sup.16R.sup.17.
[0163] It is further preferred that when R.sup.1 is an alkyl or an
alkenyl radical (i.e., an alkyl or an alkenyl substituent), then it
is a C.sub.1-C.sub.6 alkyl or, in the case when R.sup.1 is an
alkenyl, it is a C.sub.2-C.sub.6 alkenyl. When R.sup.1 is a
monocyclic substituent such as, for example, a cycloalkyl, a
heterocycloalkyl, an aryl, or a heteroaryl, it preferably comprises
4-7 members in the ring that defines the monocyclic skeleton. When
R.sup.7, R.sup.8 or R.sup.9 is an unsubstituted alkyl, it is
preferably a C.sub.1-C.sub.6 unsubstituted alkyl; and when R.sup.7,
R.sup.8 or R.sup.9 is an unsubstituted alkenyl, it is preferably a
C.sub.2-C.sub.6 unsubstituted alkenyl. The ring defined by R.sup.3
preferably comprises 4-7 members or, in the case of polycyclics,
each ring comprises 4-7 members. When R.sup.3 is
(CH.sub.2).sub.pR.sup.11, the ring defined by R.sup.11 preferably
comprises 4-7 members, or, in the case of polycyclics, each
ring-comprises 4-7 members. When either of R.sup.12 or R.sup.13 is
an unsubstituted alkyl, it is preferably a C.sub.1-C.sub.6
unsubstituted alkyl, and when either of R.sup.12 or R.sup.13 is an
unsubstituted alkenyl, it is a C.sub.2-C.sub.6 unsubstituted alkyl.
When R.sup.14 is a cycloalkyl, a heterocycloalkyl, an aryl, or a
heteroaryl, the ring defined by R.sup.14 preferably comprises 4-7
members, or, in the case of polycyclics, each ring comprises 4-7
members. When R.sup.6 is a cycloalkyl, a heterocycloalkyl, aryl, or
a heteroaryl, the ring defined by R.sup.6 preferably comprises 4-7
members, or, in the case of polycyclics, each ring comprises 4-7
members, and when R.sup.6 is substituted with a substituent that is
an alkyl, an alkylthio, or an alkylamino, it is preferred that the
substituent comprises from one to six carbon atoms, and when
R.sup.6 is substituted with a substituent that is a cycloalkyl, a
heterocycloalkyl, an aryl, or a heteroaryl, the ring defined by the
substituent preferably comprises 4-7 members or, in the case of
polycyclics, each ring comprises 4-7 members.
[0164] In a preferred embodiment, the method of preventing the
emergence of resistance in accordance with the present invention
includes administering a compound of Formula (I), wherein Q is
C(O), R.sup.2 is H, and W is C(O) or SO.sub.2. In a further
preferred embodiment, Q is C(O), R.sup.2 is H, R.sup.4 is OH, W is
SO.sub.2, and the stereochemical orientation of the asymmetric
centers is represented by formula (IA) or (IB) below: 8
[0165] It is further preferred that R.sup.6 is a monocyclic
substituent, preferably an aromatic ring, which is preferably a
substituted benzene ring, as illustrated by the formula: 9
[0166] wherein Ar is a phenyl which is optionally substituted with
a substituent selected from the group consisting of methyl, amino,
hydroxy, methoxy, methylthio, hydroxymethyl, aminomethyl, and
methoxymethyl.
[0167] In a preferred series, Y and Z are oxygen atoms, n is 2, the
resulting bis-tetrahydrofuranyl ring system has the stereochemical
orientations illustrated in Formulae (1C) and (ID) above, m is 1,
and R.sup.3 is phenyl, in which case the compound is represented by
the formula: 10
[0168] wherein Ar is a phenyl which is optionally substituted with
a substituent selected from the group consisting of methyl, amino,
hydroxy, methoxy, methylthio, hydroxymethyl, aminomethyl, and
methoxymethyl. When the compound is a compound of Formula (IE) or
(IF), wherein at least one hydrogen atom on Ar substituted with a
substituent selected from the group consisting of methyl, amino,
hydroxy, methoxy, methylthio, hydroxymethyl, and methoxymethyl, it
is further preferred that X is an oxygen. Still more preferably, X
is an oxygen and R.sup.5 is isobutyl. Suitable Ar substituents
include phenyl groups that are substituted at the para position,
the meta position, and/or the ortho position. Examples of suitable
Ar substituents are shown in Table 4, and in FIGS. 3 and 5A-5D.
[0169] A resistance-inhibiting effective amount is an amount
sufficient to produce an in vivo drug concentration or level in
which the biochemical vitality of a mutant HIV is lower than the
biochemical vitality of the HIV (predecessor) infecting the
HIV-infected mammal. For example, a resistance-inhibiting effective
amount is an amount sufficient to produce an in vivo drug
concentration or level where the value for biochemical fitness is
less than one, when determined by the ratio of the biochemical
vitality of the mutant to the biochemical vitality of the
predecessor. The compound can be administered to a wild-type
HIV-infected mammal to prevent the emergence of first line
resistance, or it can be administered to a mammal infected with a
mutant-HIV to prevent the emergence of drug resistance due to
further mutations.
[0170] The compound is preferably administered in the form of a
pharmaceutical composition. The pharmaceutical composition
preferably includes a pharmaceutically acceptable carrier and a
resistance-inhibiting effective amount of at least one of the
aforesaid compound, alone or in combination with another
antiretroviral compound such as, for example, a wild-type HIV
protease inhibitor, a mutant HIV retroviral protease inhibitor, or
a reverse transcriptase inhibitor. Generally, the pharmaceutical
composition of the present invention comprises a
resistance-inhibiting effective amount of at least one compound of
Formula (I), as disclosed herein, and a pharmaceutically acceptable
carrier.
[0171] In a preferred embodiment, a pharmaceutical composition is
administered that comprises a resistance-inhibiting effective
amount of at least one compound of Formula (IA) or Formula (IB), or
a pharmaceutically acceptable salt, prodrug, or ester thereof, and
a pharmaceutically acceptable carrier. In a further preferred
embodiment, the pharmaceutical composition comprises a
resistance-inhibiting effective amount of at least one compound of
Formula (IC) or Formula (ID), or a pharmaceutically acceptable
salt, prodrug, or ester thereof, and a pharmaceutically acceptable
carrier. In a highly preferred embodiment, the pharmaceutical
composition comprises a resistance-inhibiting effective amount of
at least one compound of Formula TIE), and pharmaceutically
acceptable salts, prodrugs, and esters thereof, and a
pharmaceutically acceptable carrier.
[0172] Pharmaceutically acceptable carriers are well-known to those
of skill in the art. The choice of a carrier will be determined in
part by the particular composition, as well as by the particular
mode of administration. Accordingly, there are a wide variety of
suitable formulations for administration in accordance the present
invention.
[0173] The pharmaceutical composition may be administered in a form
suitable for oral use such as, for example, tablets, troches,
lozenges, aqueous or oily suspensions or solutions, dispersible
powders or granules, emulsions, hard or soft capsules, syrups or
elixirs. Compositions intended for oral use may be prepared
according to any method known in the art form the manufacture of
pharmaceutical compositions, and such compositions can contain one
or more agents such as, for example, sweetening agents, flavoring
agents, coloring agents, and preserving agents in order to provide
a pharmaceutically elegant and/or palatable preparation. Tablets
can contain the active ingredient in admixture with non-toxic
pharmaceutically acceptable excipients which are suitable for
manufacture of tablets. Such excipients can be, for example, inert
diluents such as, for example, calcium carbonate, lactose, calcium
phosphate or sodium phosphate; granulating and disintegrating
agents such as, for example, maize starch or alginic acid; binding
agents such as, for example, starch, gelatine or acacia, and
lubricating agents such as, for example, stearic acid or talc. The
tablets may be uncoated or they may be coated by known techniques
to delay disintegration and absorption in the gastrointestinal
tract and thereby provide a sustained action over a longer period.
For example, a time delay material such as glyceryl monostearate or
glyceryl distearate alone or with a wax may be employed.
[0174] Formulations for oral use also can be presented as hard
gelatin capsules wherein the active ingredient is mixed with an
inert solid diluent, for example calcium carbonate, calcium
phosphate or kaolin, or as soft gelatin capsules wherein the active
ingredient is mixed with water or an oil medium, for example
arachis oil, peanut oil, liquid paraffin or olive oil.
[0175] Aqueous suspensions typically contain the active materials
in admixture with excipients suitable for the manufacture of
aqueous suspensions. Such excipients are suspending agents, for
example, sodium carboxymethyl cellulose, methylcellulose,
hydroxypropylmethylcellulose, sodium alginate,
polyvinylpyrrolidone, gum-tragacanth and gam acacia; dispersing or
wetting agents may be a natural-occurring phosphatide, for example,
lecithin, or condensation products of an alkylene oxide with fatty
acids, for example polyoxyethylene stearate, or condensation
products of ethylene oxide with long chain aliphatic alcohols, for
example heptadecaethyleneoxycetanol, or condensation products of
ethylene oxide with partial esters derived from fatty acids and a
hexitol such as polyoxyethylene sorbitol monooleate, or
condensation product-s of ethylene oxide with partial esters
derived from fatty acids and hexitol anhydrides, for example
polyoxyethylene sorbitan mono-oleate. The aqueous suspensions also
can contain one or more preservatives, for example, ethyl or
n-propyl p-hydroxy benzoate, one or more coloring agents, one or
more flavoring agents and one or more sweetening agents such as,
for example, sucrose or saccharin.
[0176] Oily suspensions may be formulated by suspending the active
ingredient in a vegetable oil, for example arachis oil, olive oil,
sesame oil or coconut oil, or in a mineral oil such as liquid
paraffin. The oil suspensions may contain a thickening agent, for
example beeswax, hard paraffin or cetyl alcohol. Sweetening agents,
such as those set forth above, and flavoring agents may be added to
provide a palatable oral preparation. These compositions can be
preserved by the addition of an antioxidant such as, for example,
ascorbic acid.
[0177] Dispersible powders and granules suitable for preparation of
an aqueous suspension by the addition of water provide the active
ingredient in admixture with a dispersing or wetting agent,
suspending agent and one or more preservatives. Suitable dispersing
or wetting agents and suspending agents are exemplified by those
already mentioned above. Additional excipients, for example
sweetening, flavoring and coloring agents, also may be present.
[0178] The pharmaceutical composition also can be administered in
the form of oil-in-water emulsions. The oily phase can be a
vegetable oil, for example, olive oil or arachis oils, or a mineral
oil, for example liquid paraffin or mixtures of these. Suitable
emulsifying agents may be naturally-occurring gums, for example gum
acacia or gum tragacantn, naturally-occurring phosphatides, for
example soya bean lecithin, and esters or partial esters derived
from fatty acids and hexitol anhydrides, for example sorbitan
mono-oleate, and condensation products of the said partial esters
and ethylene oxide, for example polyoxyethylene sorbitan
mono-oleate. The emulsions also can contain sweetening and
flavoring agents.
[0179] The pharmaceutical composition also can be administered in
the form of syrups and elixirs, which are typically formulated with
sweetening agents such as, for example, glycerol, sorbitol or
sucrose. "Such formulations also can contain a demulcent, a
preservative and flavoring and coloring agents.
[0180] Further, the pharmaceutical composition can be administered
in the form of a sterile injectable preparation, for example, as a
sterile injectable aqueous or oleagenous suspension. Suitable
suspensions for parenteral administration can be formulated
according to the known art using those suitable dispersing or
wetting agents and suspending agents which have been mentioned
above. Formulations suitable for parenteral administration include,
for example, aqueous and non-aqueous, isotonic sterile injection
solutions, which can contain anti-oxidants, buffers,
bacteriostates, and solutes that render the formulation isotonic
with the blood of the intended recipient, and aqueous and
non-aqueous sterile suspensions that can include suspending agents,
solubilizers, thickening agents, stabilizers, and preservatives.
The sterile injectable preparation can be a solution or a
suspension in a non-toxic parenterally-acceptable diluent or
solvent, for example, as a solution in water or 1,3-butanediol.
Among the acceptable vehicles and solvents that can be employed,
for example, are water, Ringer's solution and isotonic
sodium-chloride solution. In addition, sterile, fixed oils are
conventionally employed as a solvent or suspending medium. For this
purpose any bland fixed oil can be employed including synthetic
mono- or diglycerides. In addition, fatty acids such as, for
example, oleic acid find use in the preparation of injectables.
[0181] Further, the compound can be administered in the form of
suppositories for rectal administration of the drug. These
compositions can be prepared by mixing the drug with a suitable
non-irritating excipient which is solid at ordinary temperatures
but liquid at the rectal temperature and will therefore melt in the
rectum to release the drug. Such materials include, for example,
cocoa butter and polyethylene glycols. Formulations suitable for
vaginal administration can be presented as pessaries, tampons,
creams, gels, pastes, and foams.
[0182] Formulations suitable for topical administration may be
presented as creams, gels, pastes, or foams, containing, in
addition to the active ingredient, such carriers as are known in
the art to be appropriate.
[0183] The composition can be made into an aerosol formulation to
be administered via inhalation. Such aerosol formulations can be
placed into pressurized acceptable propellants, such as
dichlorodifluoromethane, propane, nitrogen, and the like. They also
can be formulated as pharmaceuticals for non-pressured preparations
such as in a nebulizer or an atomizer.
[0184] The formulations can be presented in unit-dose or multi-dose
sealed containers, such as ampules and vials, and can be stored in
a freeze-dried (lyophilized) condition requiring only the addition
of the sterile liquid excipient, for example, water, for
injections, immediately prior to use. Extemporaneous injection
solutions and suspensions can be prepared from sterile powders,
granules, and tablets of the kind previously described.
[0185] Any suitable dosage level can be employed in the
pharmaceutical compositions of the present invention. The dose
administered to an animal, particularly a human, in the context of
the present invention should be sufficient to effect a prophylactic
or therapeutic response in the animal over a reasonable time frame.
The amount of active ingredient that can be combined with the
carrier materials to produce a single dosage form will vary
depending upon the host treated and the particular mode of
administration. The size of the dose also will be determined by the
existence, nature, and extent of any adverse side-effects that
might accompany the administration of a particular composition.
Suitable doses and dosage regimens for the prevention of drug
resistance can be determined by comparisons to antiretroviral
chemotherapeutic agents that are known to inhibit the proliferation
of a retrovirus in an infected individual. The preferred dosage is
the amount that results in the inhibition of the emergence of
mutant drug-resistant retroviruses, particularly the emergence of
multidrug-resistant retroviral HIV, without significant side
effects. In proper doses and with suitable administration of
certain compounds, a wide range of antiretroviral chemotherapeutic
compositions are possible. A suitable dose includes a dose or
dosage which would be insufficient to completely suppress the
growth of a wild-type or predecessor virus, but would be sufficient
to inhibit or effectively suppress the growth of a mutant.
[0186] In accordance with the present invention, the compound or
composition can be administered in combination with other
antiretroviral compounds such as, for example, ritonavir,
amprenavir, saquinavir, indinavir, AZT, ddI, ddC, D4T, lamivudine,
3TC, and the like, as well as admixtures and combinations thereof,
in a pharmaceutically acceptable carrier. The individual daily
dosages for these combinations can range from about one-fifth of
the minimally recommended clinical dosages to the maximum
recommended levels for the entities when they are given singly.
[0187] The present invention also provides a method of preventing
the emergence of multidrug-resistant retroviruses in an
HIV-infected mammal, which method comprises administering to the
mammal a multidrug resistance-inhibiting effective amount of a
compound of the present invention, so as to inhibit the emergence
of a multidrug-resistant retrovirus in the mammal. The dose
administered to an animal, particularly a human in the context of
the present invention, should be sufficient to effect a therapeutic
response in the animal over a reasonable time frame. The dose will
be determined by the strength of the particular composition
employed and the condition of the animal, as well as the body
weight of the animal to be treated. The size of the dose will also
be determined by the existence, nature, and extent of any adverse
side-effects that might accompany the administration of a
particular compound. Other factors which effect the specific dosage
include, for example, bioavailability, metabolic profile, and the
pharmacodynamics associated with the particular compound to be
administered in a particular patient. One skilled in the art will
recognize that the specific dosage level for any particular patient
will depend upon a variety of factors including, for example, the
activity of the specific compound employed, the age, body weight,
general health, sex, diet, time of administration, route of
administration, rate of excretion, drug combination, CD4 count, the
potency of the active compound with respect to the particular
mutant retroviral strain to be inhibited, and the severity of the
symptoms presented prior to or during the course of therapy. What
constitutes a resistance-inhibiting effective amount can be
determined, in part, by use of one or more of the assays described
herein, particularly the fitness assay of the present
invention.
[0188] One skilled in the art will appreciate that suitable methods
of administering compounds and pharmaceutical compositions are
available, and, although more than one route can be used to
administer a particular composition, a particular route can provide
a more immediate and/or more effective reaction than another
route.
[0189] Numerous compounds have been identified that exhibit potent
antiretroviral activity, in particular retroviral protease
activity, against wild-type HIV. However, among the fifteen
currently FDA-approved antiretroviral agents which are all known
potent inhibitors of wild-type HIV, five of which are potent
inhibitors of wild-type HIV protease, none of these compounds have
the ability to prevent the emergence of drug-resistance mutations
that are associated with high level cross resistance. Thus, these
inhibitors do not have the ability to suppress the sufficiently fit
mutant retroviruses that can (and almost certainly will) emerge
under the selection pressure of these inhibitors.
[0190] Surprisingly, it has been discovered that compound 32 (shown
in FIG. 3A), which is a potent wild-type HIV inhibitor, possesses
remarkably potent and unprecedented broad-spectrum inhibitory
activity against a panel of recombinant mutant HIV protease
targets. These enzymes represent the key or primary resistance
mutations, most of which occur in the active site region. Based on
this finding, the compound was tested against a panel of drug
resistant mutant patient isolates of HIV and was found to possess
broad spectrum antiviral activity against a wide range of
clinically isolated, multiply drug-resistant, human
immunodeficiency viruses. Other compounds described herein showed
similar activity. The mutant viruses were obtained from infected
humans who had received several antiviral drugs. Although
applicants do not wish to abound by any one particular theory, it
is believed that the combination of the bicyclic ligand (vii) with
isostere (vi) gives the antiretroviral compounds of the present
invention the unique ability to bind to the active site of the
mutant proteases of multiply drug-resistant human immunodeficiency
viruses generally, which trait has heretofore not been reported
with respect to any known chemotherapeutic and/or experimental HIV
protease inhibitor. A wild-type preliminary screen was utilized to
determine the antiretroviral activity of analogs against wild-type
HIV. It is predicted that compounds of Formula (I), which have
potent antiretroviral or protease-inhibitory activity against
wild-type HIV, also will be potent inhibitors of drug-resistance,
even multiple drug-resistance, in wild-type HIV, or even a mutant
thereof.
[0191] The resistance-inhibiting compounds of the present invention
can be synthesized by any suitable method known in the art. The
preferred synthesis method is generally illustrated in FIG. 4,
which is an representation of the synthetic approach to preparing a
preferred series of compounds, wherein a compound of Formula (I) is
synthesized in several steps starting from azidoepoxide (i),
wherein R.sup.1-R.sup.17, m, n, p, Q, W, X, y, and z are defined as
above. Referring to FIG. 4, amine (ii) is nucleophilically added to
azidoepoxide (i), providing aminoalcohol (iii). The amine
functional group of aminoalcohol (iii) is then reacted with
intermediate (iv), wherein L represents a leaving group (e.g.,
halogen, N-oxysuccinimide), which can be displaced by the amine of
aminoalcohol (iii), to provide azide (v). Reduction of azide (v),
or, when R.sup.5 is not hydrogen, reductive amination with aldehyde
R.sup.5CH.dbd.O, provides intermediate (vi), which is subsequently
coupled with activated bicyclic ligand (vii), to provide compounds
of Formula I. Of course, it will be appreciated by a person of
ordinary skill in the art that there are combinations of
substituents, functional groups, R-groups, and the like, which are
reactive under particular reaction conditions, and require the
utilization of an appropriate protecting group or groups, which are
known in the art, to ensure that the desired synthetic
transformation will take place without the occurrence of undesired
side reactions. For example, possible substituents at R.sup.5
(e.g., NH.sub.2) can be competitive nucleophiles requiring the
attachment of an appropriate protecting group thereon (e.g.,
benzyloxycarbonyl, tert-butoxycarbonyl) in order obtain proper
selectivity in the ring opening of epoxide (i) with amine (ii).
[0192] FIGS. 1-3B illustrate the synthesis of a preferred series of
compounds for use in the method of preventing the emergence of
resistance in accordance with the present invention. FIG. 1, which
is a synthetic scheme for the synthesis of a particular
sulfonamide, illustrates the synthesis of a preferred isosteric
core, particularly, the sulfonamide isosteric core represented by
aminosulfonamide 15. With reference to FIG. 1, aminosulfonamide
core 15 can be synthesized by initially providing azidoepoxide 11
and subjecting it to nucleophilic addition with amine 12 to give
aminoalcohol 13, which is subsequently converted to sulfonamide 14
by reaction with 4-methoxybenzenesulfonyl chloride. The azide group
of 14 is then reduced to provide aminosulfonamide 15, which can be
used as a core for synthesizing numerous multidrug-resistant
retroviral protease inhibitors of the present invention.
[0193] FIG. 2, which is a reaction scheme detailing the preparation
of bicyclic alcohols, illustrates the synthesis of a preferred
series of bicyclic ligands, particularly bis-tetrahydrofurans 25
and 26. With reference to FIG. 2, dihydrofuran 21 is treated with
N-iodosuccinimide in the presence of propargyl alcohol to give
iodoether 22, which is cyclized to methylene-substituted
bis-tetrahydrofuran 23. Ozonolysis of the exo-methylene residue of
23, followed by reduction, provides bicyclic racemic alcohol 24,
which is resolved to give, separately, bicyclic alcohol 25 and its
enantiomeric acetate ester 26, which ester group of 26 is
subsequently hydrolyzed to afford enantiomer 27.
[0194] FIGS. 3A and 3B, which are reaction schemes describing the
preparation of two protease inhibitors, illustrate the preparation
of two preferred multidrug-resistant HIV protease inhibitors of the
present invention. With reference to FIG. 3A, compound 32 was
synthesized by coupling succinimidocarbonate 31 with
aminosulfonamide 15. Succinimidocarbonate 31 was prepared by
reacting optically pure bicyclic alcohol 25 with disuccinimidyl
carbonate in the presence of triethylamine. Inhibitor 34, which
possesses the enantiomeric bis-tetrahydrofuranyl ligand (relative
to inhibitor 32), was prepared in the same fashion, except that the
enantiomeric bicyclic alcohol 27 was used instead of alcohol 25, as
illustrated in FIG. 3B.
[0195] The following examples further illustrate the present
invention but, of course, should not be construed as in any way
limiting its scope.
EXAMPLE 1
[0196] This example describes the synthesis of exemplary epoxide 11
(FIG. 1), which is used as an intermediate in the synthesis of a
particular series of compounds within the scope of the present
invention.
[0197] Anhydrous CuCN (4.86 g, 54 mmol) was added to a solution of
butadiene monooxide (38 g, 540 mmol) in anhydrous tetrahydrofuran
(1.2 L) and the resulting mixture was stirred at -78.degree. C.
Commercial phenyl magnesium bromide solution (Aldrich) in ether (65
mmol) was added dropwise over a period of 10 min. The resulting
reaction mixture was then allowed to warm to 0.degree. C. and it
was continued to stir until the reaction mixture was homogeneous.
After this period, the reaction mixture was cooled to -78.degree.
C. and 0.58 mole of phenylmagnesium bromide solution in ether was
added dropwise for 30 min. The reaction mixture was allowed to warm
to 23.degree. C. for 1 h. The reaction was quenched by slow
addition of saturated aqueous NH.sub.4Cl (120 mL) followed by
NH.sub.4OH (70 mL), saturated NH.sub.4Cl (500 ML) and then H.sub.2O
(300 mL). The aqueous layer was thoroughly extracted with ethyl
acetate (2.times.300 mL). The combined organic layers were dried
over anhydrous Na.sub.2SO.sub.41 filtered, and concentrated under
reduced pressure. The residue was distilled under vacuum (0.12
torr) at 95.degree. C. to give trans-4-phenyl-2-butene-1-ol (75.6
g).
[0198] To a suspension of powdered 4 .ANG. molecular sieves (6.6 g)
in anhydrous methylene chloride (750 mL), titanium
tetraisopropoxide (Aldrich, 3.2 mL) and then diethyl D-tartrate
(2.3 mL) were added. The resulting mixture was cooled to
-22.degree. C. and tert-butylhydroperoxide solution in isooctane
(Aldrich, 430 mmol) was added over a period of 10 min. The mixture
was stirred an additional 30 min and then a solution of
trans-4-phenyl-2-butene-1-ol (32.6 g, 213 mmol), in anhydrous
methylene chloride (120 mL), was added dropwise over a period of 40
min at -22.degree. C. The reaction mixture was then aged in a
freezer at -22.degree. C. for 24 h. After this period, water (100
mL) was added to the reaction mixture at -22.degree. C. and the
mixture was allowed to warm to 0.degree. C. After stirring at
0.degree. C. for 45 min, 20% NaOH in brine (20 mL) was added. The
resulting mixture was then allowed to warm to 23.degree. C. and was
stirred at that temperature for 1 h. After this period, the layers
were separated and the aqueous layer was extracted with methylene
chloride (2.times.200 mL). The combined organic layers were dried
over anhydrous Na.sub.2SO.sub.4 and concentrated under reduced
pressure. The residue was diluted with toluene (800 mL) and then
evaporated under reduced pressure. The residue was chromatographed
over silica gel (35% ethyl acetate in hexane as eluent) to provide
(2R, 3R)-epoxy-4-phenylbutan-1-ol (21.8 g).
[0199] To a solution of titanium ispropoxide (12 mL) in anhydrous
benzene (250 mL) was added azidotrimethylsilane (11 mL) and the
resulting mixture was refluxed for 6 h. A solution of
(2R,3R)-epoxy-4-phenylbutan-1-ol (5.32 g) in anhydrous benzene (25
mL) was added to the above refluxing mixture. The resulting mixture
was refluxed for addition 25 min. After this period, the reaction
mixture was cooled to 23.degree. C. and the reaction was quenched
with aqueous 5% H.sub.2SO.sub.4 (400 mL). The resulting mixture was
stirred for 1 h and the layers were separated and the aqueous layer
was extracted with ethyl acetate (2.times.300 mL). The combined
organic layers were washed with saturated NaHCO.sub.3 (200 mL),
dried over Na.sub.2SO.sub.4 and concentrated under reduced pressure
to afford the (2S,3S)-2-hydroxy-3-azido-4-phenyl-butan-12-ol (5.1
g) as a white solid (mp 81-82.degree. C.).
[0200] To a stirred solution of the azidodiol (5.1 g) in chloroform
(100 mL) at 23.degree. C., 2-acetoxyisobutyryl chloride (Aldrich, 5
mL) was added. The resulting reaction mixture was stirred at
23.degree. C. for 8 h. The reaction was quenched by addition of
saturated sodium bicarbonate (100 mL) and the resulting mixture was
stirred 30 min. The layers were separated and the aqueous layer was
extracted with chloroform (2.times.200 mL). The combined organic
layer was extracted with chloroform (2.times.200 mL). The combined
organic layers were dried over Na.sub.2SO.sub.4 and evaporated
under reduced pressure. The resulting residue was dissolved in
anhydrous THF (50 mL) and solid NaOMe (2.1 g) was added. The
mixture was stirred for 4 h at 23.degree. C. and after this period,
the reaction was quenched with saturated NH.sub.4Cl (50 mL). The
resulting mixture was extracted with ethyl acetate (2.times.200
ML). The combined organic layers were dried over anhydrous
Na.sub.2SO.sub.4 and concentrated under reduced pressure to give a
residue, which was chromatographed over silica gel (10%
ethyl-acetate in hexanes) to afford the
3(S)-azido-(1,2R)-epoxy-4-phenylbutane 11 (3.3 g) as an oil:
[0201] .sup.1H NMR (300 MHz): CDCl.sub.3; .delta. 7.4-7.2 (m, 5H,),
3.6 (m, 1H), 3.1 (m, 1H), 2.95 (dd, 1H, J=4.6, 13.9 Hz), 2.8 (m,
3H).
EXAMPLE 2
[0202] This example illustrates the synthesis of azidoalcohol 13
(FIG. 1), which can be used as an intermediate in the synthesis of
a preferred series of the compounds of the present invention.
[0203] To a stirred solution of above azidoepoxide 11 (700 mg, 3.7
mmol) in ispropanol (70 mL) was added isobutyl amine (Aldrich, 0.74
mL 7.4 mmol) and the resulting mixture was heated at 80.degree. C.
for 12 h. After this period, the reaction mixture was concentrated
under reduced pressure and the residue was chromatographed over
silica gel to provide azidoalcohol 13 (800 mg) as an oil.
EXAMPLE 3
[0204] This example illustrates the synthesis of azidosulfonamide
14, the structure of which is shown in FIG. 1.
[0205] To a stirred solution of 13 (600 mg, 2.28 mmol) in
CH.sub.2Cl.sub.2 (20 mL) was added 4-methoxybenzenesulfonyl
chloride (Aldrich, 530 mg, 2.52 mmol) and saturated aqueous
NaHCO.sub.3 (6 mL). The resulting heterogeneous mixture was stirred
at 23.degree. C. for 12 h. The reaction was diluted with
CH.sub.2Cl.sub.2 and the layers were separated. The organic layer
was washed with brine, dried over anhydrous magnesium sulfate and
concentrated to dryness. The residue was chromatographed over
silica gel (25% ethyl acetate/hexane) to provide 900 mg of
azidosulfonamide 14.
EXAMPLE 4
[0206] This example illustrates the preparation of aminosulfonamide
15 via reduction of azidosulfonamide 14, as shown in FIG. 1.
[0207] A solution of 14 (1.53 g) in THF (45 mL), MeOH (10 mL) and
acetic acid (0.5 mL), was shaken with 10% palladium on carbon
catalyst (200 mg) at 50 psi hydrogen pressure for 2 h. Removal of
the catalyst by filtration over celite and concentration under
reduced pressure gave a crude residue, which was diluted with
CH.sub.2Cl.sub.2 (100 mL), and was washed successively with
saturated aqueous NaHCO.sub.3 and brine. The organic layer was
dried over MgSO.sub.4 and concentrated to give the corresponding
aminosulfonamide 15 (1.2 g).
EXAMPLE 5
[0208] This example demonstrates the synthesis of
trans-2-(propargyloxy)-3- -iodotetrahydrofuran 22 (FIG. 2).
[0209] To a stirred, ice-cold suspension of 15 g (66.6 mmol) of
N-iodosuccinimide in 150 mL of CH.sub.2Cl.sub.2 was added a mixture
of dihydrofuran 21 (66.6 mmol, 4.67 g, 5.1 mL) and propargyl
alcohol (100 mmol, 5.0 g, 5.2 mL) of in 50 mL of CH.sub.2Cl.sub.2
over 20 min. After warming to 24.degree. C. with stirring over 2 h,
200 mL of water were added and the stirring continued for 1 h. The
layers were separated and the aqueous layer was extracted with
2.times.100 mL of CH.sub.2Cl.sub.2. The combined organic extracts
were washed with brine solution containing small amount of
Na.sub.2S.sub.2O.sub.3 (70 mg), dried over anhydrous
Na.sub.2SO.sub.4, filtered, and concentrated. Chromatography over
silica gel using 30% ethyl acetate in hexane afforded (15.4 g, 92%)
the title iodoether 22 as an oil.
EXAMPLE 6
[0210] This example illustrates the synthesis of (.+-.)-(3aR, 6aS)
and (3aS, 6aR)-3-methylene-4H-hexahydrofuro-[2,3-b]furan 23, as
shown in FIG. 2.
[0211] To a refluxing solution of (20.7 mL, 77 mmol) tributyltin
hydride containing AIBN (100 mg) in toluene (200 mL) was added
dropwise a solution of 15.4 g (61 mmol) of iodotetrahydrofuran 22
in toluene (50 mL) over a period of 1 h. The resulting mixture was
stirred at reflux for an additional 4 h (monitored by TLC). The
mixture was then cooled to 23.degree. C. and concentrated under
reduced pressure. The residue was partitioned between petroleum
ether and acetonitrile (200 mL of each) and the acetonitrile
(lower) layer was concentrated. The residue was purified by
chromatography on silica gel, using 10% ethyl acetate in hexane as
the eluent to provide the title product 23 (5.84 g, 76%) as an
oil.
EXAMPLE 7
[0212] This example demonstrates the synthesis of (.+-.)-(3SR,
3aRS, 6aS) and (3R, 3aS,
6aR)-3-hydroxy-4H-hexahydrofuro[2,3-b]furan 24, as shown in FIG.
2.
[0213] A stream of ozone was dispersed into a solution of 15 (5.84
g, 46.4 mmol) at -78.degree. C. in 150 mL of methanol and 150 mL of
CH.sub.2Cl.sub.2 for 30 min. The resulting blue solution was purged
with nitrogen until colorless, then quenched with 20 mL of dimethyl
sulfide and the resulting mixture was allowed to warm to 23+ C. The
mixture was concentrated under reduced pressure to afford the crude
ketone. The resulting crude ketone was dissolved in ethanol (50 mL)
and the solution was cooled to 0.degree. C. and sodium borohydride
(2.1 g, 55.6 mmol) was added. The reaction mixture was stirred for
an additional 2 h at 0.degree. C. and then quenched with 10%
aqueous citric acid (10 mL). The resulting mixture was concentrated
under reduced pressure and the reside was partitioned between ethyl
acetate and brine. The layers were separated and the aqueous layer
was extracted with ethyl acetate (2.times.100 mL). The combined
organic layers were dried over anhydrous-Na.sub.2SO.sub.4 and
concentrated carefully under reduced pressure. The resulting
residue was chromatographed over silica gel using 30% ethyl acetate
in hexane as the eluent to furnish (4.52 g, 75%) the title racemic
alcohol 24 as an oil.
EXAMPLE 8
[0214] This example illustrates the preparation of immobilized
Amano Lipase 30, which was used to resolve racemic aminoalcohol 24
(FIG. 2).
[0215] Commercially available 4 g of Celite" 521 (Aldrich) was
loaded on a buchner funnel and washed successively with 50 mL of
deionized water and 50 mL of 0.05 N phosphate buffer (pH=7.0;
Fisher Scientific). The washed celite was then added to a
suspension of 1 g of Amano lipase 30 in 20 mL of 0.05 N phosphate
buffer. The resulting slurry was spread on a glass dish and allowed
to dry in the air at 23.degree. C. for 48 h (weight 5.4 g; water
content about 2% by Fisher method).
EXAMPLE 9
[0216] This example demonstrates the synthesis of 13R,3aS, 6aR)
3-hydroxyhexahydrofuro[2,3-b]furan 25 by immobilized lipase
catalyzed acylation, as illustrated in FIG. 2.
[0217] To a stirred solution of reacemic alcohol 24 (2 g, 15.4
mmol) and acetic anhydride (4 g, 42.4 mmol) in 100 mL of DME was
added 2.7 g (about 25% by weight of lipae PS30) of immobilized
Amano lipase and the resulting suspension was stirred at 23.degree.
C. The reaction was monitored by TLC and .sup.1H NMR analysis until
50% conversion was reached. The reaction mixture was filtered and
the filter cake was washed repeatedly with ehtyl acetate. The
combined filtrate was carefully concentrated in a rotary
evaporator, keeping the bath temperature below 15.degree. C. The
residue was chromatographed over silica gel to provide 843 mg (42%)
of 25 (95% ee; a.sub.D.sup.23.cndot.-11.9.degree., MeOH);
[0218] .sup.1H-NMR (CDCl.sub.3) d 1.85 (m, 2H), 2.3 (m, 1H), 2.9
(m, 1H), 3.65 (dd, J=7.0, 9.1, 1H), 3.85-4.0 (m, 3H), 4.45 (dd,
J=6.8, 14.6, 1H), 5.7 (d, J=5.1, 1H); also, 1.21 g of 26 after
washing with 5% aqueous sodium carbonate (45%,
a.sub.D.sup.23.cndot.+31.8.degree., MeOH); .sup.1H-NMR
(CDCl.sub.3)d 1.85-2.1 (m, 2H), 2.1 (s, 3H), 3.1 (m, 1H), 3.75 (dd,
J=6.6, 9.2, 1H), 3.8-4.1 (m, 3H), 5.2 (dd, J=6.4, 14.5, 1H), 5.7
(d, J=5.2, 1H). Acetate 26 was dissolved in THF (SmL) and 1 M
aqueous LiOH solution (20 mL) was added to it. The resulting
mixture was stirred at 23.degree. C. for 3 h and the reaction was
extracted with chloroform (3.times.25 mL). The combined organic
layers were dried over anhydrous Na.sub.2SO.sub.4 and evaporated
under reduced pressure. The residue was chromatographed over silica
gel to provide 733 mg of 27 (97% ee;
.alpha..sub.D.sup.23.cndot.-12.50, MeOH).
EXAMPLE 10
[0219] This example demonstrates the synthesis of activated
carbonates 31 and 33, as illustrated in FIGS. 3A and 3B.
[0220] To a stirred solution of [3R,3aS,
6aS]-3-hydroxyhexahydrofuro[2,3-b- ]furan 25 (65 mg, 0.5 mmol) in
dry CH.sub.3CN (5 mL) at 23.degree. C. were added disuccinimidyl
carbonate (192 mg, 0.75 mmol) and triethylamine (0.25 mL). The
resulting mixture was stirred at 23.degree. C. for 12 h. The
reaction was quenched with saturated aqueous NaHCO.sub.3 (10 mL)
and the mixture was concentrated under reduced pressure. The
residue was extracted with CH.sub.2Cl.sub.2 (2.times.25 mL) and the
combined organic layers were washed with brine (10 mL) and dried
over anhydrous Na.sub.2SO.sub.4. Evaporation of the solvent under
reduced pressure gave a residue, which was chromatographed over
silica gel (50% ethyl acetate/hexane) to furnish (3R, 3aS, 6aR)
3-hydroxyhexahydrofuro[2,3-b]fu- ranyl-succinimidyl carbonate 31
(70 mg) as a brown oil. Carbonate 33 (65 mg) was prepared from 60
mg of alcohol 27 by following a similar procedure.
EXAMPLE 11
[0221] This example illustrates the preparation of
multidrug-resistant HIV inhibitor 32, as illustrated in FIG.
3A.
[0222] To a stirred solution of amine 15 (82 mg, 0.2 mmol) in dry
CH.sub.2Cl.sub.2 (5 mL) was added succinimidyl carbonate 31 (55 mg,
0.18 mmol). The resulting solution was stirred at 23.degree. C. for
12 h. After this period, the reaction was quenched with saturated
aqueous NaHCO.sub.3 (10 mL) and diluted with CH.sub.2Cl.sub.2 (25
mL). The layers were separated and the organic layer was washed
with brine (15 mL) and dried over anhydrous Na.sub.2SO.sub.4.
Evaporation of the solvent under reduced pressure afforded a
residue, which was purified by silica gel chromatography (75% ethyl
acetate/hexane) to furnish compound 32 (85 mg) as a white solid
(m.p 55-58.degree. C.). .sup.1H-NMR (CDCl.sub.3, 400 MHz); .delta.
7.71 (d, 2H, J=8.8 Hz), 7.29-7.20 (m, 5H), 6.99 (d,2H,J=7.0 Hz),
5.65 (d,1H,J=5.19), 5.01 (m, 2H), 3.95-3.82 (m, 7H), 3.69 (m,2H),
3.0-2.7 (m, 6H), 1.85 (m, 1H), 1.64-1.45 (m, 3H), 0.90 (two d, 6H,
J=6.5 Hz, 6.6 Hz).
EXAMPLE 12
[0223] This example illustrates the preparation of
multidrug-resistant HIV inhibitor 33, as illustrated in FIG.
3B.
[0224] Carbonate 33 (55 mg) was reacted with amine 15 (82 mg, 0.2
mmol) according to the procedure mentioned above to provide
compound 34 (81 mg). .sup.1H-NMR (CDCl.sub.3, 300 MHz); .delta.
7.69 (d, 2H, J=8.8 Hz), 7.28-7.21 (m,5H), 6.87 (d,2H,J=5.84 Hz),
5.67 (d,1H,J=5.46 Hz), 5.0 (m, 2H), 3.86-3.81 (m, 7H), 3.58 (dd,
2H, J=6.6 Hz, 3.6 Hz, 3.17-2.73 (m, 6H), 2.17-1.83 (m, 4H), 0.90
(two d, 6H, J=6.5 Hz, 6.6 Hz).
EXAMPLE 13
[0225] This example describes the protocol for the sensitive
continuous fluorogenic assay for HIV protease of the present
invention and its application. Using this assay, the inhibitory
activity of compound 32 (FIG. 3A) was tested against the proteases
of wild-type HIV-1<WT) and various mutant enzynes: D30N, V32I,
I84V, V32I/I84V, M46F/V82A, G48V/L90M, V82F/I84V, V82T/I84V,
V32I/K45I/F53L/A71V/I84V/L89M, V32I/L33F/K45I/F53L/A71V/I84V, and
20R/36I/54V/71V/82T, which protease enzymes are available from Dr.
John W. Erickson, Structural Biochemistry Program, SAIC Frederick,
P.O. Box B, Frederick, Md. 21702-1201, upon written request. The
inhibition constant for wild-type HIV-1K.sub.imnt/K.sub.iwt ratio,
and vitality were-measured. (See Gulnik-et al., Biochemistry, 34,
9282-9287 (1995). Protease activity was measured using the
fluorgenic substrate Lys-Ala-Arg-Val-Tyr-Phe
(NO.sub.2)-Glu-Ala-Nle-NH.sub.2 (Bachem Bioscience, Inc.). (See
Peranteau et al., D. H. (1995) Anal. Biochem.).
[0226] Typically, 490 .mu.l of 0.125 M ACES-NaOH buffer, pH 6.2,
containing 1.25 M (NH.sub.4).sub.2SO.sub.4, 6.25 mM DTT and 0.1%
PEG-8000 was mixed with 5 .mu.l of titrated protease (final
concentration 1-5 nM) and incubated 3 min at 37.degree. C. The
reaction was initiated by the addition of 5 .mu.l of substrate
stock solution in water. Increase in fluorescence intensity at the
emission maximum of 306 nm (excitation wavelength was 277 nm) was
monitored as a function of time using Aminco Bowman-2 luminescence
spectrometer (SLM Instruments, Inc.). The initial rate of
hydrolysis was calculated by second degree polynomial fit using SLM
AB2 2.0 operating software. Kinetic parameters were determined by
nonlinear regression-fitting of initial rate versus substrate
concentration data to the Michaelis-Menten equation using-program
Enzfiter version 1.05.
[0227] For inhibition studies, inhibitors were prepared as stock
solutions at different concentrations in dimethylsulfoxide. In a
typical experiment 485 .mu.l of 0.125 M ACES-NaOH buffer, pH 6.2,
containing 1.25 M (NH.sub.4).sub.2SO.sub.4, 6.25 mM DTT AND 0.1%
PEG-8000, was mixed with 5 .mu.l of inhibitor stock solution and 5
.mu.l of titrated protease (final concentration of 1-5 nM) and
preincubated 3 min at 37.degree. C. The reaction was initiated by
the addition of 5 .mu.l of substrate stock solution in water. For
data analysis, the mathematical model for tight-binding inhibitors
was used. (See Williams and Morrison (1979), In: Methods of
Enzymol. 63, (ed. D. L. Purich), 437-467, Academic Press, NY,
London). The data were fitted by nonlinear regression analysis to
the equation:
V=V.sub.0/2E.sub.t({[K.sub.i(1+S/K.sub.m)+I.sub.t-E.sub.t].sup.-
2+4K.sub.i(1+S/K.sub.m)E.sub.t}.sup.1/2-[K.sub.i((1+S/K.sub.m)+I.sub.t-E.s-
ub.t]) with the program Enzfiter (version 1.05), where V and
V.sub.0 are initial velocities with and without inhibitor,
respectively, K.sub.m is a Michaelis-Menten constant, and S,
E.sub.t and I.sub.t are the concentrations of substrate, active
enzyme, and inhibitor, respectively. Biochemical fitness for each
mutant was determined by comparing the biochemical vitality of each
mutant (vitality.sub.mut) with the biochemical vitality of the
wild-type reference (vitality.sub.wt), according to the formula
(vitality.sub.mut)/(vitality.sub.wt),
[0228] wherein vitality is (K.sub.i)(k.sub.cat/K.sub.M). The
results are shown below in Table 1.
1TABLE 1 Compound 32 Biochemical Enzyme K.sub.i (pM)
K.sub.I-mut/K.sub.I-wt Fitness WT 14 1 1 D30N <5 0.33 0.3 V32I 8
0.57 0.5 I84V 40 2.85 1 V32I/I84V 70 5 0.7 M46F/V82A <5 0.33 0.1
G48V/L90M <5 0.33 0.1 V82F/I84V 7 0.5 0.1 V82T/I84V 22 1.57 0.1
V32I/K45I/F53L/A 31 2.2 0.1 71V/I84V/L89M V32I/L33F/K45I/F 46 3.3
0.1 53L/A71V/I84V 20R/36I/54V/71V/ 31 2.2 0.1 82T
[0229] The above results demonstrate that compound 32 is a potent
inhibitor of multiple HIV protease mutants that contain the primary
or key drug resistance mutations. These data predict that compound
32 will have potent and broad-spectrum multidrug-resistant
antiretroviral activity. Moreover, the biochemical fitness of each
mutant relative to wild type is equal to or less than one in the
presence of compound 32. Based on this fitness profile, it is
believed that drug resistant viruses containing the characteristic
mutations assayed herein will not emerge from the wild-type in the
presence of compound 32.
EXAMPLE 14
[0230] This example illustrates the potent and broad-spectrum
multidrug-resistant antiretroviral activity of an exemplary
compound of the present invention.
[0231] Compound 32, shown in FIG. 3A, was tested side-by-side with
four other known HIV-1 protease inhibitors against various
wild-type HIV-1 strains (HIV-1.sub.LRS104pre, HIV-1.sub.LAI, and
HIV-1.sub.BAL), and mutant multidrug-resistant HIV-1 strains
clinically isolated from eight different patients who had received
numerous antiviral drugs, either singly or in combination. The
patients from which the mutant strains were isolated had a history
of anti-HIV therapy with a variety of different drugs such as, for
example, ritonavir, saquinavir, indinavir, amprenavir, AZT, ddI,
ddC, d4T, 3TC, ABV (abacavir), DLV (delaviridine), and PFA
(foscarnet). The patient profiles are shown below in Table 2.
2TABLE 2 HIV-1 RNA Patient/ level Months on Isolate CD4.sup.+
(copies/ Antiviral Prior and Present Anti- Code (/mm.sup.3) mL)
Therapy HIV Therapy 1 361 246,700 64 AZT, ddI, ddC, d4T, 3TC, ABV,
IDV, RTV, SQV, AMV, DLV 2 3 553,700 46 AZT, ddI, ddC, d4T, 3TC,
ABV, IDV, SQV, AMV 3 108 42,610 39 AZT, ddI, ddC, d4T, 3TC, ABV,
IDV, SQV, AMV 4 560 60,000 81 AZT, ddI, ddC, U90, d4T, 3TC, ABV,
IDV, SQV, AMV 5 -- -- 32 AZT, ddI, ddC, d4T, 3TC, ABV, IDV, SQV,
AMV 6 -- -- 34 AZT, ddI, ddC, d4T, 3TC, ABV, IDV, SQV, AMV 7 -- --
83 AZT, ddI, ddC, d4T, 3TC, ABV, IDV, SQV, RTV, AMV 8 -- -- 69 AZT,
ddI, ddC, d4T, 3TC, PFA, ABV, IDV, SQV, AMV
[0232] The four known chemotherapeutic HIV protease inhibitors used
for comparative purposes in this example have been utilized in
actual human HIV chemotherapy, and are: Ritonavir ("RTV," Abbott
Laboratories); indinavir ("IDV," Merck Research Laboratories);
Amprenavir (AMV, See Ghosh et al., Bioorg. Med. Chem. Lett., 8,
687-690 (1998)); and Saquinavir ("SAQ", Roche Research Centre). The
IC.sub.50 values (.mu.M) for all five compounds were determined
with respect to wild-type and multidrug-resistant HIV-1.
[0233] To determine protease inhibitory activity against multidrug
resistant HIV, the IC.sub.50's were measured against a panel of
clinically isolated mutant HIV isolates. The IC.sub.50's were
determined by utilizing the PHA-PBMC exposed to HIV-1 (50
TCID.sub.50 dose/1.times.10.sup.6 PBMC) as target cells and using
the inhibition of p24 Gag protein production as an endpoint.
[0234] The IC.sub.50's were determined by utilizing the PHA-PBMC
assay in which target cells are exposed to HIV-1 (50 TCID.sub.50
dose/1.times.10.sup.5 PBMC) and inhibition of p24 Gag protein
production is used as an endpoint. All drug sensitivities were
performed in triplicate. In order to determine whether the HIV
isolates were syncitium inducing (SI) or non-syncitium inducing
(NSI), an aliquot of viral stock supernatant, containing 100
TCID.sub.50, was cultured with 1.times.10.sup.5 MT-2 cells in a
12-well plate. Cultures were maintained for four weeks and were
examined for syncytium formation twice a week. The results are
shown below in Table 3.
3TABLE 3 IC.sub.50 (.mu.M) Patient/ Com- Isolate code pound
Phenotype (See Table 2) RTV IDV AMV SAQ 32 SI HIV-1.sub.KRS104pre
0.055 0.013 0.021 0.01 <0.001 SI HIV-1.sub.LAI 0.0047 0.019
0.019 0.0054 0.0004 NSI HIV-1.sub.BAL 0.018 0.0056 0.014 0.0037
0.0004 1 >1 >1 0.29 0.29 0.002 2 >1 0.24 0.24 0.035
<0.001 3 >1 0.46 0.33 0.036 <0.001 4 >1 0.24 0.4 0.033
0.001 NS1 5 >1 0.8 0.28 0.24 0.002 6 >1 0.37 0.11 0.19
<0.001 7 >1 >1 0.42 0.12 0.004 8 >1 >1 0.22 0.009
0.001
[0235] The above IC.sub.50's clearly demonstrate the broad-spectrum
and extraordinarily potent activity of compound 32 against
wild-type HIV-1 and the eight different multidrug-resistant
clinical isolates tested as was predicted from the biochemical
fitness profiles in Example 13. For example, compound 32 exhibits
nanomolar and sub-nanomolar potency against all the
multidrug-resistant strains tested, whereas Ritonavir, a reasonably
potent wild-type inhibitor, is virtually inactive toward the
resistant viruses. Moreover, compound 32 is about -9 to about 150
times more potent against the multidrug-resistant viruses than
Saquinavir, one of the most potent known compounds against known
multidrug-resistant strains of HIV-1. Patients with viral plasma
loads greater than 10,000 RNA copies/mm.sup.3 are at risk for
developing fatal AIDS complications. There are no effective
therapeutic options currently available for these patients infected
with these multidrug resistant viruses. Compound 32 and analogs
thereof are predicted to be potent in preventing the selection of
these viral strains in vivo.
EXAMPLE 15
[0236] This example demonstrates the wild-type antiretroviral
activity of the compounds of the present invention.
[0237] It is predicted that the activity of the present inventive
compounds against wild-type HIV protease correlates with of
antiretroviral activity against multidrug-resistant HIV. Numerous
compounds of the present invention were tested against wild-type
HIV (See, Ghosh et al., J. Bioorg. Med. Chem. Lett., 8, 6870690
(1998)). Exemplary compounds, which demonstrate potent wild-type
HIV protease activity, are shown below in Table 4.
4TABLE 4 11 ID.sub.50 A R.sup.3 R.sup.5 R.sup.6 Ki (nM) (nM)
Comments 12 Ph 13 14 2.1 4.5 Compound 32 (FIG. 3A) Compound 34
(FIG. 3B) 15 Ph 16 17 1.1 1.4 18 Ph 19 20 21 Ph 22 23 24 Ph 25 26
1.2 3.5 27 Ph 28 29 2.2 4.5 30 31 32 33 34 Ph 35 36
[0238] It is believed that the above compounds in Table 4 will
prevent the emergence of resistance in an HIV-infected human.
EXAMPLE 16
[0239] This example demonstrates the oral absorption of compound 32
in an in vivo experimental model.
[0240] Compound 32 was orally administered to a rat at a dose of
about 40 mg per kg body mass, using a PEG 300 vehicle as a carrier.
The plasma blood levels of compound 32 were measured over a 24 h
period after oral administration. The results are shown in Table 5
below.
5 TABLE 5 Time After Plasma Administration Concentration Hours
Minutes (nM) (ng/mL) 0.28 17 1598 898 1.00 60 878 493 2.07 124 626
352 4.01 240 670 377 6.01 360 594 334 8.05 483 1115 627 12.04 722
246 138 14.08 845 102 57 24.00 1440 82 46
[0241] These results demonstrate that compound 32 maintains high
blood levels (e.g., nearly 0.6 uM after 6 hours) long after oral
administration. Although applicants do not wish to abound by any
one particular theory, it is believed that the non-peptide
structure of the compounds of the present invention make them less
prone to biological (e.g., enzymatic) degradation, and thereby
contribute to their prolonged blood levels after oral
administration. From these data, the compounds of the present
invention are predicted to have excellent oral bioavailability in
humans, and maintain therapeutically significant blood levels over
prolonged periods after oral administration.
EXAMPLE 17
[0242] This example demonstrates the influence of human protein
binding on the antiviral activity of compound 32. Several potent
and orally bioavailable HIV protease inhibitors failed to have in
vivo antiviral efficacy. These failures have been ascribed, but not
definitively proven, to be due to excessive binding to human plasma
proteins, particularly serum albumin and AAG. The protein binding
against human alpha acid glycoprotein (AAG, 10 .mu.M) and against
human serum albumin (HAS, 300 .mu.M) were compared for compound 32
and amprenavir, a structurally related analog that is an FDA
approved drug. The results are shown in Table 6.
6 TABLE 6 IC.sub.50 (.mu.M) Compound (-) AAG Alb 32 0.0015(1X)
0.0022(1.5X) 0.003(2X) amprenavir 0.029(1X) 0.18(6X) 0.021(1X)
[0243] These data demonstrate that the presence of AAG and HAS in
physiologically excessive amounts does not adversely affect the
antiviral activity of compound 32. From these data, the affinity of
compound 32 for human AAG and HSA is predicted to be actually lower
than that for amprenavir, a known drug. From these data, the
compounds of the present invention are expected to have excellent
in vivo efficacy in humans, and maintain therapeutically
significant levels over prolonged periods of time.
EXAMPLE 18
[0244] This example describes the inhibitory activity of compounds
35 (FIG. 5A), 36 (FIG. 5B), 37 (FIG. 5C) and 38 (FIG. 5D). In
accordance with the technique disclosed in Example 13 above, the
inhibitory activity of these compounds was tested against proteases
of the wild-type HIV-1. Compound 36, 37 and 38 were also tested
against proteases containing the deleterious drug resistance
associated mutations V82F/I84V and G48V/V82A. Fitness was
determined in accordance with Example 13. The results of these
experiments are shown below in Table 7.
7TABLE 7 COMPOUND ENZYME K.sub.i (pM) K.sub.I-wt/K.sub.I-muwt
Fitness 35 WT 81 1 36 WT 5< V82F/I84V 24.4 >4.9 >0.8
G48V/V82A 15.3 >3.0 >0.8 37 WT 12 1 V82F/I84V 25.7 2.1 0.3
G48V/V82A 64 5.3 1.4 38 WT >5 V82F/I84V 66.8 >13 >2.1
G84V/V82A 34 >6.8 >1.8
[0245] These results further demonstrate compounds of the present
invention that are potent inhibitors against mutant proteases.
Based on the fitness profile, it is believed that drug resistant
viruses containing the characteristic mutations assayed herein will
not emerge from the wild-type in the presence of compound 37.
EXAMPLE 19
[0246] This example further demonstrates the broad-spectrum and
potent activity of exemplary compounds of the present invention
against multidrug-resistant clinical isolates.
[0247] The IC.sub.50 values (AIM) for all compounds 32, 35, 36, 37,
and 38 were determined with respect to wild type clinical isolates
HIV-1.sub.LAI, and HIV-1.sub.SaL. The latter is a monocytotropic
strain of HIV.
[0248] The IC.sub.50's for isolates HIV-1.sub.LAI and
HIV-1.sub.Ba-L were determined by exposing the PHA-simulated PBMC
to HIV-1 (50 TCID.sub.50 dose/1.times.10.sup.6 PBMC), in the
precence of various concentrations of compounds 32, 35, 36, 37 and
38, and using the inhibition of p24 Gag protein production as an
endpoint on day 7 of culture ("p24 assay"). All drug sensitivities
were performed in triplicate. The IC.sub.50's for isolate
HIV-1.sub.LAI were also determined by exposing MT-2 cells
(2.times.10.sup.3) to 100 TCID.sub.50s of HIV-1.sub.LAI cultured in
the presence of various concentrations of compounds 32, 35, 36, 37
and 38. The IC.sub.50's were determined using the MTT assay on day
7 of culture. All sensitivities were determined in duplicate. The
results are shown below in Table 8.
8TABLE 8 Cell Type/ Comp. 32 Comp. 35 Comp. 36 Comp. 37 Comp. 38
Virus Assay IC.sub.50 (.mu.M) IC.sub.50 (.mu.M) IC.sub.50 (.mu.M)
IC.sub.50 (.mu.M) IC.sub.50 (.mu.M) HIV-1.sub.LAI MT-2/MTT 0.00022
0.028 0.017 0.0053 0.028 HIV-1.sub.LAI PBMC/p24 0.00022 0.020 0.034
0.0027 0.0080 HIV-1.sub.Ba-L PBMC/p24 0.00033 0.013 0.038 0.0030
0.0093
[0249] These results demonstrate the potent antiretroviral activity
of particular compounds of the present invention.
EXAMPLE 20
[0250] This example further illustrates the potent and
broad-spectrum multidrug-resistant antiretroviral activity of an
exemplary compound of the present invention.
[0251] Compound 32, shown in FIG. 3A, was tested against various
mutant multidrug-resistant HIV-1 strains clinically isolated from
patients. These isolates were all taken from patients who failed
therapy on one or more HIV protease inhibitors due to high level
clinical resistance. All of these isolates exhibit high level
phenotypic resistance in antiviral assays against many of the
commonly use HIV protease inhibitor drugs. Compound 32 was tested
against these multidrug-resistant clinical isolates side-by-side
with known drugs that are commonly used in HIV antiviral therapy,
including reverse transcriptase inhibitors such as AZT, 3TC, DDI,
DDC, and D4T, and protease inhibitors such as Indinavir (Ind.),
Nelfinavir (Nel.), Ritonavir (Rit.), and Saquinavir (Saq.). The
IC.sub.50's for compound 32 and the comparative drugs against the
multidrug-resistant HIV-1 clinical isolates, and against wild-type
HIV-1 (WT), are shown in Table 9a.
[0252] The mutant multidrug-resistant HIV-1 strains corresponding
to each patient, numbered 9-35, were genetically analyzed in terms
of the nucleic acid sequences of the protease (PR) and a portion of
the reverse transcriptase (RT) genes from which mutations in these
enzymes were determined. The mutations in the protease and reverse
transcriptase of the multidrug-resistant viruses isolated from each
patient are shown below in Table 9b.
9TABLE 9a IC.sub.50 (.mu.M) Patient Isolate AZT 3TC DDI DDC D4T
Ind. Nel. Rit. Saq. Comp. 32 9 0.01 0.39 0.7 0.15 0.91 1.087 0.98
0.53 >0.3125 0.0003 10 0.02 1.35 1.7 0.37 1.29 >1.25 >1.25
2.03 >0.3125 0.0017 11 0.11 23.61 2.4 0.18 3.10 0.012 0.03 0.01
0.001 0.0004 12 0.07 0.78 0.9 0.20 1.23 >1.25 >1.25 2.47
>0.3125 0.0010 13 0.17 1.04 0.5 <0.1221 0.78 >1.25 0.47
1.64 >0.3125 0.0004 14 0.64 2.4 <0.1221 1.10 0.089 0.01 0.04
0.040 0.0003 15 0.20 >31.25 2.2 0.32 1.10 0.265 0.47 1.14
>0.3125 0.0011 16 0.97 27.98 3.5 0.57 1.81 0.384 0.86 1.34
>0.3125 0.0031 17 >1.25 28.05 0.63 4.28 0.502 0.52 0.87 0.107
0.0022 18 0.55 >31.25 2.2 0.48 2.08 0.369 0.60 3.02 0.039 0.0019
19 >1.25 >31.25 36.6 6.80 35.63 0.784 0.50 2.94 0.055 0.0005
20 1.25 3.21 7.1 0.57 22.54 0.591 0.58 1.90 0.032 21 >1.25 1.69
1 0.38 3.28 1.250 >1.25 2.18 0.21 0.0023 22 1.02 >31.25 3.7
0.63 4.68 0.173 0.10 0.56 0.003 23 0.19 >31.25 1.8 0.28 1.00
0.461 0.28 1.82 0.008 0.0004 24 0.0004 25 0.0019 26 0.0019 27 0.03
1.72 2.6 0.41 4.00 >1.25 >1.25 2.97 >0.3125 0.0009 28
>1.25 2.08 2.8 0.36 5.44 1.040 >1.25 2.66 >0.3125 29
>1.25 2.24 3.8 0.34 5.29 0.569 0.67 0.36 0.050 0.0009 30 0.16
>31.25 2.8 0.24 2.52 0.270 0.52 1.03 0.191 0.0019 31 >31.25
2.6 <0.1221 3.11 0.251 0.24 0.85 0.074 0.0010 32 0.32 >31.25
8.4 0.91 2.41 0.223 0.22 0.37 >0.3125 33 0.51 >31.25 2.0 0.28
2.73 0.133 0.35 0.18 0.059 0.0005 34 >1.25 >31.25 9.1 1.13
7.71 0.595 0.26 3.38 0.063 0.0024 35 0.88 >31.25 17.0 2.46 18.13
0.509 0.48 2.60 0.0616 0.0012 (WT) 0.022 0.264 0.895 0.243 1.059
0.02 0.031 0.019 0.007 0.0007
[0253]
10TABLE 9b Isolate Mutations 9 PR V003I L010I S037N R041K G048V
I054S I062V RT P004S V0601 V0901 E122K I135V Q174K Y181C E297R
L301L/I 10 PR V003I L010I S037N R041K G048V I054S I062V RT P004S
V0601 V0901 E122K I135V T165A/T Q174K V245M R277K 11 PR V003I L010I
1015V M036I S037N R041K L063T RT K020R/K M041L K043Q E044D V060I
D067N T069D L210W R211K 12 PR V003I L010I 1015V K020R M036I S037N
R041K 1093L RT M041L K043Q E044D V060I D067N T069D L074L/I L201W
R211K 13 PR V0031 L010I 1015V K020R/K M036I S037N R041K 1072T/I
T074A/T V082A I093L RT M041L K043Q E044D V060I D067N T069D L074L/I
L210W R211K 14 PR V003I L010I K020R E035D M036I S037D R041K RT
M041L T069T/N L074L/V E122K D123E Y181C Q207E R277K E297K 15 PR
V003I L010I E035D R041K L063P A071A/V I072V/I RT D067N T069D I142V
E169D Y181C M184V Q207B L283I I293V 16 PR V003I L010I 1013V E035D
S037A R041K L063P RT K020R M041L K043N D067N D123N D177E I178M/I
R277K G333E 17 PR V003I L01OI 1013V E035D S037A R041K L063P RT
K020R M041L K043N D067N D123N D177E I178M/I G333E A360T 18 PR V003I
L010V S037N K043T I054V L063P A071V RT K020R V035M K064H D067G
T069N K070R K102R/K D128E K219Q 19 PR V003I L010I L0191 S037Q M046L
I054V R057K RT K020R T058N A062V S068G T069T/I V075I F077L Y181C
M184V 20 PR V003I L010I T012P K014R I015V/I G016E S037N V077I V082A
I085V L090M RT K020R V0351 T039A M041L K043E E044A D067N L210W
R211K 21 PR V003I L010I 1015V K020R E035D M036I S037K T074S V082F
N088E L084M L090M I093L RT K020R V035T T039R M041L K043E E044D
V060I I135T/I I142V 22 PR V003I L010I E034E/Q S037H M046I I054V
I062V RT K020R/K T039A/T M041L K043E E044D D067N V118I L214F T215Y
23 PR V003I L010I 1015V K020I L024I M036I S037N RT K011R D067N
K070R I135T Y181V/D M184V D218E/D M357T/M G359G/S 24 PR V003I I015V
D030N E035D S037D L063P V077I RT K064R E122K D123E D177E M184V
G196R R211G N348I R358K 25 PR V003I K020I T026T/I S037N M046I L063P
A071V RT V035M D067N T069D K070R E122P D177E M184V E224K R277K 26
PR V003I L010I S037N R041K G048V I054S I062V RT P004S V060I V090I
E122K I135Y T135A/T Q174K V245M R277K 27 PR V003I L010I I015V K020R
M036I S037N R041K I093L RT M041L K043Q E044D V060I D067N T069D
L074L/I H208Y L210W 28 PR V003I L010I I015V M036I S037D G048V I054V
L090M I093L RT P004S M041L D067N T069D K070R V090I K103N L214F
T215F 29 PR V003I L010I K020I S037N M046M/I L063P I072I/K RT V035I
T039A/E M041L E044D L074L/V R083K K102Q L214F T215Y 30 PR V003I
L010I E035D R041K L063P A071A/V I072V/I RT D067N T069D I142V E169D
Y181C M184V Q207E L283I I293V 31 PR V003I L010L/I E035D M036M/I
S037N M046X I054V RT K032R/K K064R D067N K070R K103N/K E122K
Y181F/C T286A I293V 32 PR V003I L010I S037N G048V I054V I062V/I
L063P RT K020R M041L D123N I178L M184V T200A/T E203D Q334L/Q
T338S/T 33 PR V003I L010I E035D M036I S037D D060E L063P RT M041L/M
D067N T063T/N K070R D177D/E M184V I202V V245T P272A 34 PR V003I
L010V S037N K043T I054V L063P A071V RT K020R V035M K064H D067G
T069N K070R K102R/K D218E K219Q 35 PR V003I L010I L019I S037Q M046L
I054V R057K RT K020R T058N A062V S068G T069T/I V075I F077L Y181C
M184V Isolate Mutations 9 L063S 1064L 1064L A071V V082A 1093L
E194E/K G196E R211K L214F V245M R227K 10 L063S 1064L 1064L A071V
V082A 1093L Y181C E194K G196E R211K L214F H221H/Y 11 I093L E122E/K
D123E Y181C/Y M184V G196E H208Y 12 G048V I054T/I L063T A071V T074A
V082A/V K103N D123E I135T Y181C G196E H208Y 13 G048V/G I054T/I
Q058E/Q Q061R/Q L063T A071A/V K103N D123E I135T/I Y181C G196E H208Y
14 G048V L063C A071V 1072T V082A/V 1093L L210W R211K L214F T215Y
L228R E248D 15 G073R/C V077I 1084V L090M 1093L R211K L214F T215Y
D250E P272A Q278E 16 A071V G073S I084V L090M M184V G196E E203D
L214F T215Y K219Q 17 A071V G073G/S I084V L090M M184V G196E E203D
L214F T215Y R277K 18 V082A L090M V1118I E122K I135T S162A M184V
T215S 19 L063P A071V V082A L090M A098S K103N F116Y I135T I142M
Q151M 20 M046I I054V K055R I062V L063N A071T V075A K103N V118I
I135M Y181C H208Y 21 R041N K043T/K M401I L063P H069K A071V I063M/I
D067N T069D A098G V118I D121H 22 L063S V082A L089L/M M184V E203E/K
Q207E H208Y L210W R211K 23 I054V R057K L063P A071V V082A K219Q
P272A R277K R284R/K I293V E297V 24 N088D L214F V245T/M E297A I326V
I329L T338S 25 G073S V077I I084V L090M I093L I202V Q207E R211K
L214F T215F K219Q 26 L063S I064L A071V V082A I093L Y181C E194K
G196E R211K L214F H221H/Y 27 G048V I054T/I L063T A071A/V T074A
V082A K103N F116F/L D123R I135T Y181C G196E 28 D060E Q061E I062V
I064V A071V V082A I135T S162A V179I Y181C G196E Q207E 29 G073C
V077I L090M S162C I178L E203K H208Y L210W R211K 30 G073G/S V077I
I084V/I L090M I093L R211K L214F T215Y D250E P272A Q278E 31 L063P
I066F A071V V082A/T I084V/I M184V R211K L214F D218E K219Q E248D 32
A071A/T V077I V082A I093L Q207E L210L/W L214F T215Y R277K T286A 33
I064V I084V L090M Q207E L210W R211K L214F T215Y K219Q 34 V082A
L090M V1181I E122K I135T S162A M184V T215S 35 L063P A071V V082A
L090M A098S K103N F116Y I135T I142M Q151M
[0254] The results of this experiment further show the
effectiveness of an exemplary compound of the present invention
against a wide range of viral mutants compared to other well-known
inhibitors. These mutant viruses represent a panel of the most
broadly cross resistant clinical isolates known to date based on
their resistance to therapeutically used HIV protease inhibitors.
Compound 32 was consistently potent against all of the clinically
isolated mutant viruses tested, and was significantly more potent
against these multidrug resistant viruses than the comparative
drugs which are currently used in human HIV-1 therapy. Compound 32
was ten to one-thousand times more potent against these viruses
than even saquinavir, one of the most potent-known compounds
against multidrug-resistant HIV-1. Based on the high potency, it is
believed that these mutants will not only be inhibited, but also
that these mutants would not be able to emerge if the compound is
administered to a patient infected with a predecessor virus.
[0255] All of the references cited herein, including patents,
patent applications, and publications, are hereby incorporated in
their entireties by reference.
[0256] While this invention has been described with an emphasis
upon preferred embodiments, it will be obvious to those of ordinary
skill in the art that variations of the preferred embodiments may
be used and that it is intended that the invention may be practiced
otherwise than as specifically described herein. Accordingly, this
invention includes all modifications encompassed within the spirit
and scope of the invention as defined by the following claims.
* * * * *