U.S. patent number RE39,055 [Application Number 10/145,040] was granted by the patent office on 2006-04-04 for hepatoselective pharmaceutical actives.
This patent grant is currently assigned to BTG International Limited. Invention is credited to Dietrich Brandenburg, Heike Eckey, Richard Henry Jones, Achim Schuttler, Fariba Shojaee-Moradi, Peter Henri Sonksen.
United States Patent |
RE39,055 |
Jones , et al. |
April 4, 2006 |
Hepatoselective pharmaceutical actives
Abstract
The invention provides an analogue of a pharmaceutical active
whose molecular weight is less than 25,000 Daltons, the analogue
comprising a pharmaceutical active whose molecular weight is less
than 25,000 Daltons covalently linked to a pendant molecular group
wherein as a result of the administration of the composition to the
human or animal body an active complex having a molecular weight of
25,000 Daltons or greater is present in the human or animal
circulatory system. The analogue is hepatoselective when
administered to the circulatory system. Preferably the analogue is
an insulin analogue comprising an insulin or functional equivalent
thereof covalently linked to the pendant molecular group wherein
the active complex is an insulin complex. Such an insulin analogue
may be used in a method of insulin replacement therapy.
Inventors: |
Jones; Richard Henry (London,
GB), Shojaee-Moradi; Fariba (London, GB),
Sonksen; Peter Henri (London, GB), Brandenburg;
Dietrich (Reichelsheim, DE), Schuttler; Achim
(Aachen, DE), Eckey; Heike (Darmstadt,
DE) |
Assignee: |
BTG International Limited
(London, GB)
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Family
ID: |
10740471 |
Appl.
No.: |
10/145,040 |
Filed: |
May 15, 2002 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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08596285 |
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5854208 |
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PCT/GB94/01784 |
Aug 15, 1994 |
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Reissue of: |
09097535 |
Jun 15, 1998 |
06063761 |
May 16, 2000 |
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Foreign Application Priority Data
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Aug 13, 1993 [GB] |
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9316895 |
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Current U.S.
Class: |
514/1.2; 514/866;
514/484; 514/5.9 |
Current CPC
Class: |
C07K
14/62 (20130101); A61P 3/10 (20180101); A61K
38/28 (20130101); A61K 38/1709 (20130101); A61P
3/08 (20180101); Y10S 514/866 (20130101) |
Current International
Class: |
A61K
31/27 (20060101); A61K 38/28 (20060101) |
Field of
Search: |
;514/3,484,866 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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0242416 |
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Oct 1987 |
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EP |
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0 678 522 |
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Oct 1995 |
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EP |
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0 383 472 |
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Feb 1996 |
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EP |
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0 709 395 |
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May 1996 |
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EP |
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0 712 861 |
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May 1996 |
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EP |
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0 712 862 |
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May 1996 |
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EP |
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0 747 390 |
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Dec 1996 |
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EP |
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0 747 391 |
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Dec 1996 |
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EP |
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01254699 |
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Nov 1989 |
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JP |
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9012814 |
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Nov 1990 |
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WO |
|
9112817 |
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Sep 1991 |
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WO |
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9200322 |
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Jan 1992 |
|
WO |
|
9215611 |
|
Sep 1992 |
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WO |
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9507931 |
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Mar 1995 |
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WO |
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WO 99/65941 |
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Dec 1999 |
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WO |
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WO 02/04515 |
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Jan 2002 |
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WO |
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Other References
Windholz et al., The Merck Index, Tenth Edition (1983), pp. 723 and
724, abstract No. 4866. cited by examiner .
Shojaee-Moradie et al., "Novel Hepatoselective Insulin Analogues:
Studies with Covalently Linked Thyroxyl-insulin Complexes,"
Diabetic Medicine, vol. 15, (1998), pp. 928-936. cited by other
.
Shojaee-Moradie et al., "Effects of a hepatoselective insulin
analogue in normal subjects," Diabetic Medicine, vol. 15, (1998),
(Suppl. 2), 53, A1. cited by other .
Telfer et al, "The effects of thyroid hormone binding proteins on
insulin receptor binding of thyroxyl-insulin analogues in vitro,"
Diabetic Medicine, vol. 15, (1998), (Suppl 2), S5, A10. cited by
other .
Shojaee-Moradie et al., "Novel Hepatoselective Insulin Analog:
Studies with a covalently linked thyroxyl-insulin complex in
humans," Diabetes Care, vol. 23, No. 8, (Aug. 2000), pp. 1124-1129.
cited by other .
Kurtzhals et al., "Albumin binding of insulins acylated with fatty
acids: characterization of the ligand-protein interaction and
correlation between binding affinity and timing of the insulin
effect in vivo," Biochem J., (1995), vol. 312, pp. 725-731. cited
by other .
Myers et al., "Acylation of Human Insulin With Palmitic Acid
Extends the Time Action of Human Insulin in Diabetic Dogs,"
Diabetics, vol. 46, (Apr. 1997), 637-642. cited by other .
Asada et al., "Absorption Characteritics of Chemically
Modified-Insulin Derivatives with Various Fatty Acids in the Small
and Large Intestine," J. Pharm. Sci., vol. 84, No. 6, (Jun. 1995),
pp. 682-687. cited by other .
Polzer, et al, "Inhibition of benzol[a]pyrene metabolism by
insulin, FITC-insulin and an FITC-insulin-antibody conjugate in the
human hepatoma cell line HepG2," Chemico-Biological Interactions,
vol. 97, (1995), pp. 307-318. cited by other .
Schaffer, "A model for insulin binding to the insulin receptor,"
Eur. J. Biochem., (1994), vol. 221, pp. 1127-1132. cited by other
.
Ziegler et al., "Insulin Binding to Human Cultured Lymphocytes
Measured by Flow Cytometry Using Three Ligands," Cytometry, (1994),
vol. 16, pp. 339-345. cited by other .
Matkhanov et al., "Cytotoxic Effect of Free Bleomycin A.sub.5-Iron
(II) Complex and its Conjugates with Concanavalin, A, Insulin and
Colcitonin on Mouse thymocytes," Biochem. Biophys. Res. Comm.,
(Nov. 1993), vol. 197, No. 1, pp. 85-91. cited by other .
Fabry et al., "Design and Synthesis of a Novel Biotinylated
Photoreactive Insulin for Receptor Analysis," Biological Chemistry
Hoppe-Seyler, (Mar. 1992), vol. 373, No. 3, pp. 143-150. cited by
other .
Ikeda et al., "Effect of Diabetes on Triiodothyronine and Reverse
Triiodothyronine Production in the Perfused Rat Liver and Kidney,"
Diabetes, (Jul. 1985), vol. 34, pp. 647-652. cited by other .
Chemical Abstracts (99:116795m) Kaliman ct al. (1983). J. cited by
examiner .
J. Brange et al., Diabetes Care, vol. 13, No. 9 "Monomeric Insulins
and Their Experimental and Clinical Implications" Sep. 9, 1990, pp.
923-925. cited by examiner .
Ronald S. Spangler, "Selective insulinization of liver in conscious
diabetic dogs", Am. J. Physiol. 249 (Endocrinal. Metab. 12) pp.
E152-159 (1985). cited by examiner .
J. Morkussen et al., Soluble, fatty acid acylated insulins bind to
albumin and show protracted action in pigs, No. 262, pp. 002-009.
cited by examiner .
Journal of Controlled Release, (1992), pp. 179-188, Trials of Lipid
modification of piptide hormones for intestinal delivery. cited by
examiner .
Pharmaceutical Research, vol. 6, No. 2, (1989), Synthesis of
Palmitoyl Derivatives of Insulin and Their Biological Activities.
cited by examiner .
Proceedings of the Second International Insulin Symposium Aachen,
Germany, Sep. 4-7, 1979, Insulin Chemistry, Structure and Function
of Insulin and Related Hormones. cited by examiner .
F. Shojaee-Maradi, et al., "Convalent Insulin Dimers Are
Hepatoselective", Abstract, Medical and Scientific Section, Apr.
13-15, 1989. cited by examiner .
Snyder, S. M. et al. "The Binding of Thyroid Hormone Analogues to
to Thyrozine-Binding Globulin (TBG)", in Thyroid Research (Robbin
J. and Braveman L. E. eds.) (1976) pp. 297 to 299. cited by
examiner .
Snyder, S. M. et al. (1976) Binding of Thyroid Hormones and their
Analogues to Thyroxin-Binding Globulin in Human Serum, J. Biol.
Chem. 251 (21), 6489 to 6494. cited by examiner .
Robbins, J. et al. "Plasma Transport of Thyroid Hormones" from
Thyroid Hormone Metabolism (Hennemann, G. ed) 1986, 3 to 38. cited
by examiner.
|
Primary Examiner: Weddington; Kevin E.
Attorney, Agent or Firm: Sughrue Mion, PLLC
Parent Case Text
This application is a .Iadd.REI of Ser. No. 09/097,535 filed Jun.
15, 1998; U.S. Pat. No. 6,063,761 which is a .Iaddend.divisional of
Ser. No. 08/596,285 filed Feb. 13, 1996; U.S. Pat. No. 5,854,208
which is a 371 of PCT/GB94/01784 filed Aug. 15, 1994.
Claims
We claim:
1. A method of treating diabetes in a human or an animal,
comprising the step of: administering a conjugate compound having a
molecular weight of less than 25 kD comprised of a pharmaceutically
active compound and a pendant molecular moiety which is a naturally
occurring hormone or an analogue thereof, wherein the pendant
molecular moiety has an affinity for one or more binding proteins
naturally present in the circulatory system of a human or an animal
whereby the conjugate reaches the systemic circulation of the human
or the animal and in the circulation forms a complex having a
molecular weight of more than 25 kD with the one or more binding
proteins.
2. A treatment method according to claim 1, wherein the
pharmaceutically active compound is insulin or a functional
equivalent of insulin.
3. A treatment method according to claim 1, wherein the pendant
molecular moiety is a thyroid hormone.
4. A treatment method according to claim 3, wherein the thyroid
hormone is thyroxine.
5. A treatment method according to claim 1, wherein the pendant
molecular moiety if IGF1.
6. A treatment method according to claim 2, wherein the pendant
molecular moiety is a thyroid hormone.
7. A treatment method according to claim 6, wherein the thyroid
hormone is thyroxine.
8. A treatment method according to claim 1, wherein the pendant
molecular moiety is linked to the pharmaceutically active compound
by a spacer.
9. A treatment method according to claim 8, wherein the spacer is a
linear chain of from 3 to 10 carbon atoms in length.
10. A treatment method according to claim 1, wherein the binding
protein is selected from the group consisting of albumin,
thyroxine-binding pre-albumin, thyroxine-binding globulin, and
combinations of those proteins.
11. A treatment method according to claim 2, wherein the binding
protein is selected from the group consisting of albumin,
thyroxine-binding pre-albumin, thyroxine-binding globulin, and
combinations of those proteins.
12. A method according to claim 7, wherein the binding protein is
selected from the group consisting of albumin, thyroxine-binding
pre-albumin, thyroxine-binding globulin, and combinations of those
proteins.
13. A method of delivering a pharmaceutically active compound to a
human or an animal comprising: a) covalently bonding to the
pharmaceutically active compound a pendant molecular moiety which
is a naturally occurring hormone or an analogue thereof to form a
conjugate compound which has a molecular weight of less than 25 kD;
and b) administering the said conjugate compound to a human or an
animal whereby the conjugate compound is delivered to the
circulatory system of the said human or animal and forms a complex
therein with one or more binding proteins naturally present in the
said circulatory system, said complex having a molecular weight of
more than 25 kD.
14. A method of directing a pharmaceutically active compound
selectively to the liver of a human or animal comprising the steps:
a) covalently bonding to the pharmaceutically active compound a
pendant molecular moiety which is a naturally occurring hormone or
an analogue thereof to form a conjugate compound which has a
molecular weight of less than 25 kD; and b) administering the said
conjugate compound to a human or an animal whereby the conjugate
compound is delivered to the circulatory system of the said human
or animal and forms a complex therein with one or more binding
proteins naturally present in the said circulatory system, said
complex having a molecular weight of more than 25 kD.
15. A method of forming a complex in the systemic circulation of a
human or animal comprising the Steps of: a) covalently bonding to
the pharmaceutically active compound a pendant molecular moiety
which is a naturally occurring hormone or an analogue thereof to
form a conjugate compound which has a molecular weight of less than
25 kD; and b) administering the said conjugate compound to a human
or an animal whereby the conjugate compound is delivered to the
circulatory system of the said human or animal and forms a complex
therein with one or more binding proteins naturally present in the
said circulatory system, said complex having a molecular weight of
more than 25 kD.
16. A method according to claim 2 in which the pendant molecular
moiety is conjugated at the alpha amino group of the B1 residue of
the insulin molecule.
17. A method according to claim 6 wherein the pendant molecular
moiety is conjugated at the alpha amino group of the B1 residue of
the insulin molecule.
.Iadd.18. A method of treating diabetes in a human or animal with
insulin, or a functional equivalent thereof, comprising the step of
administering a conjugate compound having a molecular weight of
less than 25 kD comprised of insulin, or a functional equivalent of
insulin, covalently bound to a molecule having an affinity for one
or more binding proteins naturally present in blood plasma of a
human or animal, whereby the conjugate reaches the systemic
circulation of the human or the animal and in the circulation forms
a complex having a molecular weight of more than 25 kD with the one
or more binding proteins..Iaddend.
.Iadd.19. A method of selectively delivering a pharmaceutically
active compound to hepatocytes in a human or animal comprising (a)
covalently bonding to the pharmaceutically active compound a
pendant molecular moiety to form a conjugate compound which has a
molecular weight of less than 25 kD and (b) administering said
conjugate compound to a human or an animal whereby said conjugate
compound is delivered to the circulatory system of the said human
or animal and forms a complex therein with one or more binding
proteins naturally present in said circulatory system, said complex
having a molecular weight of more than 25 kD..Iaddend.
.Iadd.20. A method as claimed in claim 19 wherein the
pharmaceutically active compound is insulin or a functional
equivalent thereof..Iaddend.
Description
The present invention relates to novel hepatoselective
pharmaceutical actives. In particular it relates to novel
hepatoselective insulin analogues suitable for use in an improved
treatment of diabetes mellitus.
When drugs and other pharmaceutical actives are administered to the
human or animal body it may be required that the active is needed
to be present primarily in the liver or to act primarily on the
tissues of the liver. That is, the active is required to be
hepatoselective. Achieving hepatoselectivity can be difficult, in
particular where the active is administered by injection into the
skin. One case in which achievement of hepatoselectivity would be
especially desirable is the administration of insulin.
The hormone insulin, secreted by the pancreas, has various
important roles to play in glucose metabolism. In the liver, after
binding to cell surface receptors, insulin promotes the conversion
of glucose to glycogen (glycogenesis), promotes protein synthesis
and inhibits fat breakdown. Insulin deficiency results in breakdown
of glycogen (glycogenolysis), protein and conversion of products of
fat and protein breakdown to glucose (gluconeogenesis) leading to a
raised plasma glucose level (hyperglycaemia). In subjects who
produce adequate amounts of insulin the blood glucose level remains
within a certain range. Any excess of glucose is stored in the
liver and muscles as glycogen.
Insulin also acts on cell membrane receptors in other tissues to
enhance the entry of glucose into cells, thereby diminishing the
plasma glucose concentration.
Thus insulin acts to reduce the plasma glucose level by reducing
the production of glucose by the liver and by increasing uptake and
metabolism of glucose by the liver and by increasing uptake and
metabolism of glucose by peripheral tissues.
Deficiency of insulin due to disease of the islets of Langerhans
and/or deficiency of insulin action results in diabetes mellitus, a
condition in which the blood glucose concentration is high.
In subjects who are not diabetic insulin is produced in the
pancreas and transported directly to the hepatic circulation and
hence is transported to the liver before any other organs or
regions of the body. Thus the liver experiences a very high
exposure to the insulin produced. Usually at least 50% of the
insulin produced is bound to receptors in the liver, and hence acts
in the liver. Insulin bound to receptors in the liver is removed
from the circulation and degraded by the liver cells. The insulin
which is not bound in the liver and hence passes to the peripheral
circulation is therefore at a much lover concentration. Thus the
peripheral tissues (eg fat and muscle) which are also targets of
the insulin experience a smaller exposure to the insulin
secreted.
In diabetic subjects treatment is often carried out by
insulin-replacement therapy. In general an insulin preparation is
injected subcutaneously. The most common subcutaneous insulin
regimen involves twice-daily injection of mixtures of short- and
intermediate-acting insulin preparations. Insulin is absorbed from
the subcutis into the peripheral circulation and thence to the
entire body, including the liver. With such a system the liver and
the peripheral tissues tend to experience approximately equal
exposure to insulin.
There are various disadvantages and negative side-effects with the
use of this system.
First, if sufficient insulin is injected to enable a high enough
concentration to be present in the hepatic circulation then too
high a concentration will be present in the peripheral circulation.
Similarly if a suitable concentration is present in the peripheral
circulation the concentration of insulin in the hepatic circulation
will be inadequate.
There is believed to be a danger associated with high
concentrations of insulin in the peripheral circulation
(hyperinsulinaemia) of cardiovascular disease.
Second, there is a serious risk of hypoglycaeaia in diabetic
subjects receiving insulin replacement therapy by subcutaneous
injection. A concentration of insulin in the peripheral circulation
which is too high can lead to a blood sugar level which is too low
and subsequent collapse.
It would therefore be desirable to be able to direct a large
concentration of insulin directly to the hepatic insulin receptors
with a lower concentration of insulin being directed to the
peripheral insulin receptors. It would also be desirable to achieve
such hepatoselectivity for other active molecules.
Some attempts have been made to obtain the desired
hepatoselectivity of insulin. Intravenous injection directly into
the hepatic portal circulation could allow injected insulin to pass
directly to the liver before reaching the peripheral circulation.
Such a system is unsuitable for general use due to the difficulty
and complicated nature of its operation; in particular it is not
suitable for use by diabetic patients themselves except under
exceptional circumstances.
An attempt has been made to render insulin hepatoselective by
injecting it subcutaneously whilst encapsulated in lipid vesicles.
(Spangler, Ronald S., "Selective Insulinisation of Liver in
Conscious Diabetic Dogs", Am. J. Physiol. 249 (Endocrinol. Metab.
12): E152-E159, 1985). Insulin encapsulated in lipid vesicles
(designated vesicle encapsulated insulin VEI) was targeted to
hepatocytes by means of a digalactosyl diglyceride moiety
incorporated on the outside of the lipid vesicles. Using this
approach it was possible to alter the distribution of an
administered glucose load to favour hepatic deposition.
The present inventors have found (British Diabetic Association
Medical and Scientific section Conference, Manchester, Apr. 13-15,
1989) that covalent dimers of insulin (molecular weight .+-.12,000
Daltons rather than .+-.6,000 for insulin monomer) have a greater
effect on hepatic glucose output than on peripheral uptake and
utilisation. That is, the covalent insulin dimers appear to act
preferentially on hepatocytes rather than on cells of the
peripheral tissues. It has also been found that proinsulin shows
this hepatoslectivity to a smaller degree.; Proinsulin is the
zymogen which is cleaved to form the active hormone insulin. The
proinsulin molecule is larger than the active insulin molecule.
The cells of the peripheral tissues, for instance fat and muscle,
are separated from the blood vessels by the capillary endothelium.
In the liver however there is no such barrier between blood vessels
and hepatocytes.
It is thought that transport across the capillary endothelium is
mainly by diffusion i.e. active transport of insulin across the
capillary endothelium does not occur to any significant extent.
Therefore the present inventors believe that the absorption of
insulin into the peripheral tissues is determined by factors
influencing diffusive transport, in particular by steric hindrance
or size of molecules. This is believed to be a reason for the
relative hepatoselectivity of covalent insulin dimers and
proinsulin when compared with insulin monomers; both have free
access to hepatocytes but the larger covalent insulin dimer or
proinsulin is absorbed into the peripheral tissues from the
bloodstream more slowly than is the insulin monomer. Thus the
larger molecules spend a longer time in the bloodstream before
being absorbed into the peripheral tissues and are thus are more
likely to reach the liver, where they may be active more
easily.
According to the present invention there is provided the use of an
analogue of a pharmaceutical active whose molecular weight is less
than 25,000 Daltons in the manufacture of a composition for use in
a method of treatment of the human or animal body, the analogue
comprising a pharmaceutical active whose molecular weight is less
than 25,000 Daltons covalently linked to a pendant molecular group
wherein as a result of the administration of the composition to the
human or animal body an active complex having a molecular weight of
25,000 Daltons or greater is present in the human or animal
circulatory system.
The invention is of particular usefulness when the analogue is an
insulin analogue which comprises an insulin or functional
equivalent thereof covalently linked to a pendant molecular group,
so that as a result of the administration of the composition to the
human or animal body an insulin complex having a molecular weight
of 25,000 Daltons or greater is present in the human or animal
circulatory system. This invention is also applicable to other
pharmaceutical actives of molecular weight below 25,000 Daltons
which are administered so as to enter the circulatory system and
which are required to be hepatoselective and for which similar
problems as those encountered with the administration of insulin
therefore also apply. In this specification the invention is
discussed primarily in terms of its use for giving
hepatoselectivity to insulin or a functional equivalent thereof,
but it will be understood that the disclosures made are equally
applicable to other pharmaceutical actives of molecular weight less
than 25,000 Daltons.
According to a first, particularly preferred, embodiment of the
invention the pendant molecular group has an affinity for one or
more binding proteins present in the human or animal circulatory
system wherein the total molecular weight of the insulin or
functional equivalent thereof (or other pharmaceutical active) and
the additional molecular group and the one or more binding proteins
is 25,000 Daltons or greater.
Binding proteins "in the human or animal circulatory system" are
those which are present in the blood plasma.
Thus when the analogue is introduced into the bloodstream the one
or more binding proteins will become non-covalently linked to the
additional molecular group, forming a complex which has a molecular
weight of 25,000 Daltons or greater.
According to a second embodiment of the invention an insulin
analogue (or analogue of another pharmaceutical active) is used
which additionally comprises one or more binding proteins
non-covalently attached to the pendant molecular group wherein the
total molecular weight of the insulin or functional equivalent
thereof (or other pharmaceutical active) and the pendant molecular
group and the one or more binding proteins is 25,000 or
greater.
In this second embodiment the analogue is a complex having a
molecular weight of 25,000 or greater and may be administered into
the circulatory system as such, for instance intravenously.
According to a third embodiment of the invention an insulin
analogue (or analogue of other pharmaceutical active) is used in
which the total molecular weight of the insulin or functional
equivalent thereof (or other pharmaceutical active) and the
covalently linked pendant molecular group is 25,000 Daltons or
greater.
As with the second embodiment, the analogue is a complex having a
molecular weight of 25,000 or greater and may be administered into
the circulatory system as such, for instance intravenously.
For use in the first aspect of the present invention there is
provided an analogue of a pharmaceutical active whose molecular
weight is less than 25,000 Daltons comprising a pharmaceutical
active whose molecular weight is less than 25,000 Daltons
covalently linked to a pendant molecular group, said pendant
molecular group having an affinity for one or more binding proteins
present in the human or animal circulatory system.
As explained above, the invention is especially useful when the
compound is an insulin analogue comprising an insulin or functional
equivalent thereof covalently linked to a pendant molecular group
which has an affinity for one or more binding proteins present in
the human or animal circulatory system.
Such an insulin analogue (or analogue of other pharmaceutical
active) may be injected subcutaneously and absorbed into the
bloodstream through the capillary endothelium without difficulty.
When in the bloodstream the insulin analogue will come into contact
with the binding protein for which the covalently-linked pendant
molecular group has an affinity. Thus at least some molecules of
the insulin analogue will become bound to the said binding protein,
forming an insulin complex. Binding proteins tend to be bulky
molecules of high molecular weight. They therefore tend not to
diffuse out through the capillary endothelium easily and remain in
the bloodstream. Thus the effective size of molecule and hence the
molecular weight of the bound insulin analogue is increased
dramatically. Absorption from the blood vessels into the peripheral
tissues, for instance fat and muscle, through the capillary
endothelium is now greatly inhibited due to the attachment of the
insulin analogue to the high molecular weight binding protein. In
the liver however there is no such barrier therefore the insulin
analogue even with the associated binding protein may have access
to the hepatocyte insulin receptors essentially to the same degree
as would conventional insulin.
In the same way an analogue of another pharmaceutical active may be
induced not to diffuse out through the capillary endothelium and to
remain in the bloodstream until it is carried to the liver where it
may act or be taken up as required.
Binding of the pendant molecular group and the binding protein is
not covalent. Binding forces may be for instance electrostatic (eg
attraction of opposite charges, hydrogen bonding) or hydrophobic.
Thus binding is not permanent. The insulin analogue (or analogue of
other pharmaceutical active) may be absorbed onto the hepatic
tissues in its bound form. Molecules of the insulin analogue which
have not been bound by the binding protein or which have become
bound and subsequently unbound are capable of passing through the
capillary endothelium into the peripheral tissues.
The covalently-linked molecular group is attached in such a way
that the active site (or sites) of the insulin equivalent or other
pharmaceutical active remains available to carry out its prescribed
functions.
Attachment of a suitable molecular group to the insulin equivalent
(or other active) may be carried out by conventional chemical
methods known to those skilled in the art.
According to this aspect of the invention there is also provided a
method of insulin replacement therapy comprising subcutaneous
injection of a preparation comprising an insulin analogue as
described above.
Preferred features of the first embodiment of the invention will
now be described in detail.
The insulin or functional equivalent thereof, when, insulin is the
active used, may be any of the insulins conventionally used in
insulin replacement therapy.
J. Brange et al ("Monomeric Insulins and their Experimental and
Clinical Implications", Diabetes Care, vol. 13, no. 9, September
1990) and others have studied the possibility of developing
insulins with reduced tendencies to self-association. These
insulins are absorbed from the subcutis into the bloodstream more
rapidly than is the form in which insulin is usually found in
pharmaceutical formulations. Insulin assumes an associated state in
pharmaceutical formulation. Six monomers of insulin associate to
form hexamers. The association is non-covalent. With the use of DNA
technology Brange et al and others have prepared insulins which
remain dimeric or even monomeric at high (pharmaceutical)
concentration by the introduction of one or a few amino acid
substitutions into human insulin. Insulins with reduced association
capacity as described by Brange et al and others are preferred for
use as the insulin equivalent to which the additional molecular
group is attached. When the pharmaceutical active is an insulin
equivalent such insulins are preferred, because their reduced
tendency to self-associate means that they are more rapidly
absorbed into the bloodstream from the subcutis than are
conventional insulins which tend to be injected in hexameric
form.
Insulins of this type have also been developed by Eli Lilly. These
are described in Protein Engineering, Vol 5, 519-525 and 527-533
(1992) (both D. N. Brems et al). Studies of amino acid modified
monomeric insulins have also been described in Diabetes 40 Suppl. 1
(1991), 423A (Howey et al) and 464A (Shaw et al).
The pendant molecular group covalently linked to the insulin
equivalent or other active may be any molecular group which has an
affinity for a binding protein present in the circulatory system
and which will not itself act in the body to give detrimental
effects. The molecular group chosen should usually be of a
molecular weight similar to or less than that of the insulin
equivalent or other active. Preferably the total molecular weight
of the insulin or functional equivalent thereof or other active and
the additional molecular group is less than 25,000, more preferably
less than 20,000 or 15,000, and may be less than 12,000. This is in
order that attachment of the pendant molecular group to the insulin
equivalent or other active to form the analogue should not hinder
the passage by diffusion of the injected analogue from the subcutis
through the capillary endothelium into the bloodstream. Preferred
molecular groups are molecular structures which possess an affinity
for one or more proteins which are naturally present in the
circulation. They may be based on naturally-occurring hormones or
on functional equivalents of such hormones which also possess
affinity to their binding proteins or they may be based on other
substances for which such binding proteins exist. The pendant
molecular group should be harmless when injected into the body;
this may be achieved for instance by ensuring that the
concentration of insulin analogue or analogue of other active in
the bloodstream is high enough to allow the beneficial effects of
insulin or other therapy to be felt, but low enough to prevent any
effects which might be due to the pendant molecular group being
felt, or by ensuring that the insulin analogue or analogue of other
active is not present in parts of the body where the pendant
molecular group might be active, or by rendering the pendant
molecular group inactive by structural modification which
nevertheless preserves its ability to bind to its binding
protein.
The pendant molecular group may be itself an insulin equivalent,
for instance insulin-like growth factor 1 (IGF1). This polypeptide
has an affinity for IGF1 binding proteins, which circulate
naturally in the human bloodstream.
The pendant molecular group may be a native or modified thyroxyl
group, derived from the human thyroid hormone thyroxine
3,5,3',5'-L-tetraiodothyronine (T4). There are several binding
proteins present in the human circulatory system which have an
affinity for the T4 group, for instance thyroxine binding globulin
(TBG), thyroxine binding prealbumin (TBPA) and albumin. These
proteins are known collectively as thyroxine binding proteins
(TBP).
Other suitable groups derived from hormones or their functional
equivalents may be used. Suitable groups may be ascertained by a
skilled person using methods known in the pharmaceutical field.
The pendant molecular group with an affinity for a binding protein
may be covalently attached directly to the insulin equivalent (or
other active), as explained above in a place chosen so that the
additional molecular group does not inhibit the action of the
insulin equivalent. The structure of insulin and the locations of
its active sites are well known, therefore when insulin is used
those skilled in the art will be able to establish appropriate
positions at which to attach the said molecular group so as not to
interfere significantly with the action of the insulin or
equivalent.
Alternatively a short molecular chain (or "spacer arm") may be used
to link the insulin equivalent (or other active) and the said
molecular group. The spacer arm is linked covalently both to the
insulin equivalent and to the pendant molecular group. Such a
spacer arm ensures that the insulin equivalent and binding protein
are distanced from one another thus preventing substantial
interference with insulin activity by the (usually bulky) high
molecular weight binding protein. The spacer arm is usually a
linear chain, preferably of from 3-10 carbon atoms in length. Such
a spacer arm may be for instance an aminohexanoyl (AH) group, which
is a six-carbon chain. Other groups may of course be used as a
spacer arm. For example aminoacids either singly or linked as small
peptide sequences could be used.
It should be ensured that the binding protein which has an affinity
for the pendant molecular group is present in the blood plasma in
sufficiently large amounts that the trapping of the binding protein
by the insulin analogue (or analogue of other active) with the
covalently linked molecular group will not deplete the levels of
binding protein in the blood to detrimental effect. For instance
the level of binding protein should not be depleted so that
insufficient binding protein is available to carry out its usual
function in the body, if any.
The insulin analogue (or analogue of other active) of the invention
may be produced by various methods, for instance: chemical reaction
of the insulin or insulin equivalent or other active with a
substance or substances which include the pendant molecular group;
protein synthesis of the complete analogue; production by a
genetically engineered micro organism.
The insulin analogue of the invention may be used in a method of
insulin replacement therapy.
An insulin analogue according to the invention or a mixture of two
or more different insulin analogues according to the invention form
part of an insulin preparation. This insulin preparation is
suitable for use in a method of treatment of the human or animal
body, preferably suitable for subcutaneous injection, and may
comprise a treatment for diabetes. Additional ingredients may be
added which modify the rate of absorption from the subcutaneous
depot into the circulation. The insulin-based preparation
preferably is suitable for subcutaneous injection, in which case it
is therefore suitable for use by sufferers from diabetes on
themselves.
The insulin preparation may comprise the hepatoselective insulin
analogue of the invention and a conventional non-hepatoselective
insulin. On subcutaneous injection and passing into the bloodstream
the conventional insulin will act in the peripheral tissues whilst
the insulin analogue of the invention provides a controlled,
hepatoselective action.
The analogues of other pharmaceutical actives of the invention may
also be used in methods of treatment or therapy by subcutaneous
injection of a preparation comprising the analogue of the
active.
According to the second embodiment of the invention an insulin
analogue (or analogue of other active) with a covalently attached
pendant molecular group is used with a binding protein already
non-covalently linked to the pendant molecular group. A composition
comprising such an insulin analogue would be more suitable for
intravenous administration than for subcutaneous administration due
to the very high molecular weight of the insulin analogue in the
composition (as compared with the insulin analogue of the first
embodiment, which forms an insulin complex of molecular weight
greater than 25,000 only after administration into the circulatory
system). It may be desirable in some cases however to provide such
an insulin analogue or analogue of other active for use in the
manufacture of a composition suitable for intravenous
administration.
The pendant molecular group and binding proteins may be any of
those described above as suitable for the first embodiment of the
invention. In addition the binding proteins may be proteins which
do not occur naturally in the human or animal circulatory system
(and which are harmless when introduced into the circulatory
system) and the pendant molecular group may be any group with an
affinity to such a protein.
According to a third embodiment of the invention an insulin
analogue (or analogue of other active) is used which comprises an
insulin or functional equivalent thereof (or other active) with a
large group covalently attached. Such a group should be large
enough that the entire insulin analogue has a molecular weight of
at least 25,000. It should also, like the pendant molecular group
of the first embodiment of the invention, be harmless when
introduced into the body. This may be achieved as described above
for the pendant molecular group. The large molecular group of the
third embodiment of the invention may for instance be based on a
polypeptide structure or on other suitable polymeric
structures.
The analogues of the second and third embodiments of the invention
may be produced by the methods mentioned above as suitable for the
production of the analogue of the first embodiment of the
invention. For instance suitable methods in the case of the
analogue of the third embodiment include chemical reaction of the
insulin or equivalent or other active with a substance of
substances which include the covalently linked molecular group,
protein synthesis of the complete analogue and production by a
genetically engineered micro organism. In the case of the second
embodiment the section of the analogue comprising the insulin or
equivalent or other active and the additional molecular group may
be synthesized in the same way as may be the insulin of the first
embodiment. The binding protein may be synthesized for instance by
protein synthesis, production by a genetically engineered micro
organism, extraction from a naturally-occurring organism.
Non-covalent attachment of the binding protein or proteins to the
pendant molecular group may be achieved by methods known in the
art.
The analogues of the second and third aspects of the invention are
suitable for incorporation in compositions which are to be
administered intravenously. Where the active is insulin or a
functional equivalent thereof, such compositions may be used in a
method of insulin replacement therapy. Such compositions comprise
one or more insulin analogues of the second and third embodiments
of the invention. The composition may also comprise additional
ingredients which may be chosen by those skilled in the art.
EXAMPLES
The present inventors have undertaken a study to explore the
possibility that insulin analogues with restricted access to
peripheral tissues may display relative hepatoselectivity in
vivo.
Analogues of insulin which include a thyroxyl moiety which binds to
thyroid hormone binding protein (TBP) have been designed and
tested. N.sup..alpha.B1-thyroxyl-insulin (T4-Ins) and
N.sup..alpha.B1-thyroxyl-aminohexanoyl insulin (T4-AH-Ins) were
synthesized using methods of chemical synthesis given below.
Preparation of thyroxyl insulins
Abbreviations:
Msc=methylsulphonylethyloxycarbonyl
Boc=tert.butyloxycarbonyl
DMF=dimethylformamide
DMSO=dimethylsulfoxide
mp=melting point
ONSU=N-oxysuccinimide ester
Example 1
B1-thyroxyl-insulin (porcine) (T4-Ins)
Protected thyroxine derivatives:
Msc-L-thyroxine (I)
776 mg (1 mmol) L-thyroxine in 2 ml dimethylsulfoxide was reacted
with 530 mg (2 mmol) Msc-ONSu in the presence of 139 .mu.l (1 mmol)
triethylamine at room temperature for 18 hours. After concentration
in vacuo the oily residue was taken up in ethyl acetate, the
organic layer washed with water, dried over Na.sub.2SO.sub.4, and
the solvent removed in vacuo. The solid residue was crystallised
from hexane.
Yield: 651 mg (70.2% of theory),
mp: 200.degree. C.
Msc-L-thyroxine-N-oxysuccinimide ester (II)
To a cooled (0.degree. C.) solution of 371 mg (0.4 mmol) of
Msc-thyroxine and 40 mg (0.4 mmol) N-hydroxysuccinimide in 1 ml
tetrahydrofurane a precooled solution of 82.5 mg
N,N'-dicyclohexycarbodiimide in 0.5 ml tetrahydrofurane was added
under stirring. After further stirring for 3 hours the precipitate
was removed by filtration, and the filtrate concentrated in vacuo.
Crystallisation of the solid residue from
methylenechloride/petroleum ether.
Yield: 295 mg (71%, based on I)
mp: 180.degree. C.
B1-thyroxyl-insulin (porcine) (III)
To a solution of 100 mg (approx 0.016 mmol)
A1,B29-Msc.sub.2-insulin (prepared according to Schuttler and
Brandenburg, Hoppe-Seyler's Z. Physiol, Chem. 360, 1721-1725
(1979)) and 18 .mu.l (0.160 mmol) N-methylmorpholine in 2 ml of
DMSO 116.4 ml (0.160 mmol) of II in 0.2 ml DMSO were added. After
stirring for 6 h at room temperature the insulin derivative was
precipitated with ether/methanol (9:1, v/v), isolated by
centrifugation, washed 3 times with ether/methanol, and dried in
vacuo.
Msc groups were removed by treatment with NaOH/dioxane/methanol at
0.degree. C., and III was purified by gel filtration on Sephadex G
50 fine as described (Geiger et al, Chem. Ber. 108, 2758-2763
(1975)). Lyophilization gave 78.4 mg B1-thyroxyl-insulin (75%,
based on Msc.sub.2-insulin).
Example 2
B1-thyroxyl-aminohexanol-insulin (porcine) (IV) (T4-AH-Ins)
1. BOC-.epsilon.-aminohexanoic acid was prepared by reacting 1.32 g
(10 mmol) .epsilon.-aminohexanoic acid with 2.4 g (11 mmol)
di-tert.butyldicarbonate in dioxane/water at pH 9 and was obtained
in 87% yield (2.2 g). Mp after recrystallization from ethyl
acetate: 75.degree. C.
2. 22.8 mg (0.096 mmol) Boc-aminohexanoic acid was preactivated
with 13 mg 1-hydroxybenzotriazole and 17.8 mg (0.09 mmol)
dicyclohexyl carbodiimide in 0.7 ml dimethylformamide for 1 h at
0.degree. C. and 1 further hour at room temperature.
3. Then, a solution of 100 mg (approx. 0.016 mol)
A1,B29-Msc.sub.2-insulin and 18 .mu.l (0.160 mmol)
N-methylmorpholine in 1 ml of DMF was added. After stirring for 70
minutes at room temperature the mixtures was filtered, and the
insulin derivative was precipitated with ethyl ether/methanol (9:1,
v/v), isolated by centrifugation, washed 3 times with
ether/methanol, and dried in vacuo.
4. The Boc protecting group was cleaved by treatment of the product
with 3 ml trifluoro acetic acid for 1 hour at room temperature. The
solution was concentrated in vacuo, the insulin derivative
precipitated with ether, isolated, washed with ester, and dried.
Yield: 77.8 mg of B1-aminohexyl-A1,B29-Msc.sub.2-insulin.
5. 102 mg (0.016 mmol) of this derivative was dissolved in 2 ml
dimethylformamide and 18 .mu.l (0.16 mmol) N-methylmorpholine.
After addition of 116 mg (0.16 mmol) Msc-thyroxine-N-oxysuccinimide
ester in 0.2 ml dimethylformamide the mixture was stirred for 3
hours at room temperature. The protected insulin was isolated by
precipitation with methanol/ether and isolated as described
above.
6. Msc groups were removed by treatment with NaOH/dioxane/methanol
at 0.degree. C., and IV was purified by gel filtration on Sephadex
G 50 fine as described (Geiger et al, op. cit.). Lyophilization
gave 39.1 mg B1-thyroxylaminohexanoyl-insulin (37%, based on
aminohexyl-Msc.sub.2-insulin).
T4-Ins, T4-AH-Ins and insulin (Ins) were infused into four
anaesthetized beagles with D-.sup.3H-3-glucose for measurement of
the rates of glucose production (Ra) and glucose disposal (Rd).
Euglycaemia and glucose specific activity were maintained by
variable infusion of D-glucose with D-.sup.3H-3-glucose.
With all three materials glucose Rd was increased and glucose Ra
decreased from basal level 2.70.+-.0.19 mg. kg.sup.-1 min.sup.-1,
(p<0.05). In each experiment insulin-like activity for Ra and Rd
was calculated as the area between the basal values of each of
these variables and subsequent values plotted graphically against
time (AUC). For Ins, T4-Ins and T4-AH-Ins respectively, AUC for Ra
values were -431.+-.121, -226.+-.154 and -357.+-.50 (mean.+-.SEM,
mg/kg), (no significant differences) and AUC for Rd values were
1142.+-.160, 629.+-.125 and 830.+-.178 mg/kg, both analogues
different from Ins p<0.05.
These results indicate that insulin analogues of the invention act
to a greater extent on the tissues of the liver than on those of
the peripheral regions of the body, such as fat and muscle.
* * * * *