Cyclosporine analogue mixtures and their use as immunomodulating agents

Abstract

The invention is directed to isomeric mixtures of cyclosporine analogues that are structurally similar to cyclosporine A. The mixtures possess enhanced efficacy and reduced toxicity over the individual isomers and over naturally occurring and other presently known cyclosporines and cyclosporine derivatives. Embodiments of the present invention are directed toward cis and trans-isomers of cyclosporin A analogs referred to as ISA TX 247, and derivatives thereof. Mixtures of ISA TX 247 isomers exhibit a combination of enhanced potency and reduced toxicity over the naturally occurring and presently known cyclosporins. ISA TX 247 isomers and alkylated, arylated, and deuterated derivatives are synthesized by stereoselective pathways where the particular conditions of a reaction determine the degree of stereo selectivity. The ratio of isomers in a mixture comprises greater than about 80 percent by weight of the E-isomer and less than about 20 percent by weight of the Z-isomer, based on the total weight of the mixture.

What is claimed: 
     
         1 . A composition comprising an isomeric mixture of a cyclosporine analogues modified at the 1-amino acid residue with a 1,3-diene substituent, wherein the isomeric mixture comprises greater than about 80% of the E-isomer and less than about 20% of the Z-isomer, wherein the isomers are the E- and Z-isomers as specified below: 
       
         
           
           
               
               
           
         
       
     
     
         2 . A pharmaceutical composition comprising an isomeric cyclosporine analogue mixture according to  claim 1  and a pharmaceutically acceptable excipient. 
     
     
         3 . The pharmaceutical composition of  claim 2 , which comprises a gelatin capsule containing the isomeric analogue mixture, a liquid solution containing a surfactant, ethanol, a lipophilic and/or an amphiphilic solvent. 
     
     
         4 . The pharmaceutical composition of  claim 2 , which comprises a liquid solution containing a surfactant, ethanol, a lipophilic and/or an amphiphilic solvent. 
     
     
         5 . The pharmaceutical composition of  claim 2 , which comprises d-alpha Tocopheryl polyethylene glycol 1000 succinate (vitamin E TPGS), medium chain triglyceride (MCT) oil, Tween 40, and ethanol. 
     
     
         6 . The pharmaceutical composition of  claim 5 , which is in unit dosage form. 
     
     
         7 . The pharmaceutical composition of  claim 6 , which contains from about 5 mg to about 500 mg of active ingredient. 
     
     
         8 . The pharmaceutical composition of  claim 7 , which contains about 50 mg isomeric mixture. 
     
     
         9 . The pharmaceutical composition of  claim 4 , wherein the solution contains about 50 mg/mL isomeric mixture. 
     
     
         10 . The pharmaceutical composition of  claim 3 , which is adapted for oral administration. 
     
     
         11 . A method of producing immunosuppression, the method comprising administering to a patient in need thereof a therapeutically effective amount of an isomeric cyclosporine analogue mixture according to  claim 1 . 
     
     
         12 . The method of  claim 11  wherein the isomeric cyclosporine analogue mixture is administered in an amount selected from the group consisting of: about 0.05 mg to about 50 mg per kilogram of body weight per day; about 0.1 mg to about 10 mg per kilogram of body weight per day; about 0.5 to about 10 mg/kg/day; about 2 to about 6 mg/kg/day, administered twice a day; and about 0.5 to about 3 mg/kg/day, administered orally twice a day. 
     
     
         13 . The method of  claim 11 , wherein said immunosuppression is to treat or alleviate organ tissue transplant rejection. 
     
     
         14 . The method of  claim 13  wherein said organ or transplant rejection is selected from the group consisting of: heart, lung, combined heart-lung, liver, kidney, pancreatic, skin, bowel, and corneal transplants; T-cell mediated rejection; graft-versus-host disease; graft-versus-host disease following bone marrow transplantation; chronic rejection of a transplanted organ; graft vessel disease; xenograft rejection; acute, hyperacute and chronic rejection of an organ occurring when the organ donor is of a different species from the recipient; rejection mediated by B-cells; and antibody-mediated rejection. 
     
     
         15 . The method of  claim 12 , wherein said immunosuppression is to treat or alleviate an autoimmune disease or condition or in inflammatory disease or condition. 
     
     
         16 . The method of  claim 15  wherein said disease or condition is selected from the group consisting of: arthritis, rheumatoid arthritis, arthritis chronica progrediente, arthritis deformans, other rheumatic diseases, hematological disorders, hemolytic anemia, aplastic anemia, pure red cell anemia, idiopathic thrombocytopenia, systemic lupus erythematosus, polychondritis, sclerodoma, Wegener granulomatosis, dermatomyositis, chronic active hepatitis, myasthenia gravis, Steven-Johnson syndrome, idiopathic sprue, (autoimmune) inflammatory bowel disease, ulcerative colitis, Crohn's disease, endocrine ophthalmopathy, Graves' disease, sarcoidosis, multiple sclerosis, primary biliary cirrhosis, juvenile diabetes (diabetes mellitus type I), uveitis (anterior and posterior), keratoconjunctivitis sicca, vernal keratoconjunctivitis, interstitial lung fibrosis, psoriatic arthritis, glomerulonephritis, idiopathic nephrotic syndrome, minimal change nephropathy, juvenile dermatomyositis, psoriasis, contact dermatitis, atopic dermatitis, alopecia areata, erythema multiforma, dermatitis herpetiformis, scleroderma, vitiligo, hypersensitivity angiitis, urticaria, bullous pemphigoid, lupus erythematosus, pemphigus, epidermolysis bullosa acquisita, other inflammatory or allergic conditions of the skin, inflammatory conditions of the lungs and airways, asthma, allergies, and pneumoconiosis. 
     
     
         17 . A method of producing immunosuppression, the method comprising administering to a patient in need thereof an effective amount of a pharmaceutical composition according to  claim 2 . 
     
     
         18 . The method of  claim 17  wherein the pharmaceutical composition administered comprises an amount of isomeric cyclosporine analogue mixture selected from the group consisting of: about 0.05 mg to about 50 mg per kilogram of body weight per day; about 0.1 mg to about 10 mg per kilogram of body weight per day; about 0.5 to about 10 mg/kg/day; about 2 to about 6 mg/kg/day, administered twice a day; and about 0.5 to about 3 mg/kg/day, administered orally twice a day. 
     
     
         19 . The method of  claim 18 , wherein said immunosuppression is to treat or alleviate organ tissue transplant rejection. 
     
     
         20 . The method of  claim 19 , wherein said organ or transplant rejection is selected from the group consisting of: heart, lung, combined heart-lung, liver, kidney, pancreatic, skin, bowel, and corneal transplants; T-cell mediated rejection; graft-versus-host disease; graft-versus-host disease following bone marrow transplantation; chronic rejection of a transplanted organ; graft vessel disease; xenograft rejection; acute, hyperacute and chronic rejection of an organ occurring when the organ donor is of a different species from the recipient; rejection mediated by B-cells; and antibody-mediated rejection. 
     
     
         21 . The method of  claim 19 , wherein said immunosuppression is to treat or alleviate an autoimmune disease or condition or in inflammatory disease or condition. 
     
     
         22 . The method of  claim 21  wherein said disease or condition is selected from the group consisting of: arthritis, rheumatoid arthritis, arthritis chronica progrediente, arthritis deformans, other rheumatic diseases, hematological disorders, hemolytic anemia, aplastic anemia, pure red cell anemia, idiopathic thrombocytopenia, systemic lupus erythematosus, polychondritis, sclerodoma, Wegener granulomatosis, dermatomyositis, chronic active hepatitis, myasthenia gravis, Steven-Johnson syndrome, idiopathic sprue, (autoimmune) inflammatory bowel disease, ulcerative colitis, Crohn's disease, endocrine ophthalmopathy, Graves' disease, sarcoidosis, multiple sclerosis, primary biliary cirrhosis, juvenile diabetes (diabetes mellitus type I), uveitis (anterior and posterior), keratoconjunctivitis sicca, vernal keratoconjunctivitis, interstitial lung fibrosis, psoriatic arthritis, glomerulonephritis, idiopathic nephrotic syndrome, minimal change nephropathy, juvenile dermatomyositis, psoriasis, contact dermatitis, atopic dermatitis, alopecia areata, erythema multiforma, dermatitis herpetiformis, scleroderma, vitiligo, hypersensitivity angiitis, urticaria, bullous pemphigoid, lupus erythematosus, pemphigus, epidermolysis bullosa acquisita, other inflammatory or allergic conditions of the skin, inflammatory conditions of the lungs and airways, asthma, allergies, and pneumoconiosis. 
     
     
         23 . A method of reducing toxicity of an immunosuppressive cyclosporine analogue by preparing an isomeric mixture of  claim 1  for use as an immunosuppressive agent, the mixture having reduced toxicity relative to Cyclosporine A. 
     
     
         24 . The method of  claim 23  wherein the immunosuppressive agent comprises the isomeric cyclosporine analogue mixture in an amount selected from the group consisting of: about 0.05 mg to about 50 mg per kilogram of body weight per day; about 0.1 mg to about 10 mg per kilogram of body weight per day; about 0.5 to about 10 mg/kg/day; about 2 to about 6 mg/kg/day, administered orally b.i.d.; and about 0.5 to about 3 mg/kg/day, administered orally b.i.d. 
     
     
         25 . A method of increasing the efficacy of an immunosuppressive cyclosporine analogue by preparing an isomeric mixture of  claim 1  for use as an immunosuppressive agent, the mixture having increased efficacy relative to Cyclosporine A. 
     
     
         26 . The method of  claim 25  wherein the immunosuppressive agent comprises the isomeric cyclosporine analogue mixture in an amount selected from the group consisting of: about 0.05 mg to about 50 mg per kilogram of body weight per day; about 0.1 mg to about 10 mg per kilogram of body weight per day; about 0.5 to about 10 mg/kg/day; about 2 to about 6 mg/kg/day, administered twice a day; and about 0.5 to about 3 mg/kg/day, administered orally twice a day.