US2020347110A1PendingUtilityA1

Composition and Methods for Stimulating Gastrointestinal Motility

76
Assignee: IPSEN PHARMA SASPriority: Sep 29, 2005Filed: Dec 20, 2019Published: Nov 5, 2020
Est. expirySep 29, 2025(expired)· nominal 20-yr term from priority
A61K 38/25C07K 14/5759C07K 14/4705A61K 38/2264A61P 1/00A61P 1/04A61P 1/14C07K 14/60A61P 1/10C07K 14/575A61K 38/00A61P 1/08A61P 43/00
76
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Claims

Abstract

The present invention relates to a method of treating a transient impairment of the motility of the gastrointestinal system resulting from postoperative ileus in a patient wherein said method includes the step of administering a therapeutically effective amount of a peptidyl analog of ghrelin to said patient.

Claims

exact text as granted — not AI-modified
1 . A method of stimulating the motility of the gastrointestinal system in a patient, said method comprising administering a peptidyl analog of ghrelin, a prodrug thereof, or a pharmaceutically acceptable salt of said analog or said prodrug. 
     
     
         2 . The method of  claim 1 , wherein said patient is experiencing postoperative ileus following gastrointestinal surgery. 
     
     
         3 . (canceled) 
     
     
         4 . The method of  claim 3  wherein said peptidyl analog of ghrelin comprises the following formula (I):
   (R 2 R 3 )-A 1 -A 2 -A 3 -A 4 -A 5 -A 6 -A 7 -A 8 -A 9 -A 10 -A 11 -A 12 -A 13 -A 14 -A 15 -A 16 -A 17 -A 18 -A 19 -A 20 -A 21 -A 22 -A 23 -A 24 -A 25 -A 26 -A 27 -A 28 -R 1   (I)
 
 
       wherein:
 A 1  is Gly, Aib, Ala, B-Ala, or Acc; 
 A 2  is Ser, Aib, Act, Ala, Acc, Abu, Ava, Thr, or Val; 
 A 3  is Ser, Ser(C(O)—R 4 ), Asp(O—R 8 ), Asp(NH—R 9 ), Cys(S—R 14 ), Dap(S(O) 2 —R 10 ) Dab(S(O) 2 —R 11 ), Glu(O—R 6 ), Glu(NH—R 7 ), Thr, Thr(C(O)—R 5 ), or HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O); 
 A 4  is Phe, Acc, Aic, Cha, 2-Fua, 1-Nal, 2-Nal, 2-Pal, 3-Pal, 4-Pal, hPhe, (X 1 ,X 2 ,X 3 ,X 4 ,X 5 )Phe, Taz, 2-Thi, 3-Thi, Trp, or Tyr; 
 A 5  is Leu, Abu, Acc, Aib, Ala, Cha, Ile, hLeu, Nle, Nva, Phe, Tle, or Val; 
 A 6  is Ser, Abu, Acc, Act, Aib, Ala, Gly, Thr, or Val; 
 A 7  is Pro, Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz, Tic, or deleted; 
 A 8  is Glu, Acc, Aib, Arg, Asn, Asp, Dab, Dap, Gln, Lys, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 9  is His, Apc, Aib, Acc, 2-Fua, 2-Pal, 3-Pal, 4-Pal, Taz, 2-Thi, 3-Thi, (X 1 ,X 2 ,X 3 ,X 4 ,X 5 -)Phe or deleted; 
 A 10  is Gln, Acc, Aib, Asn, Asp, Glu, or deleted; 
 A 11  is Arg, Apc, hArg, Dab, Dap, Lys, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 12  is Val, Abu, Acc, Aib, Ala, Cha, Nva, Gly, Ile, Leu, Nle, Tle, or deleted; 
 A 13  is Gln, Acc, Aib, Asn, Asp, Glu, or deleted; 
 A 14  is Gln, Acc, Aib, Asn, Asp, Glu, or deleted; 
 A 15  is Arg, hArg, Acc, Aib, Apc, Dab, Dap, Lys, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 16  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 17  is Glu, Arg, Asn, Asp, Dab, Dap, Gln, Lys, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 18  is Ser, Abu, Acc, Act, Aib, Ala, Thr, Val, or deleted; 
 A 19  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 20  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 21  is Pro, Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz, Tic, or deleted; 
 A 22  is Pro, Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz, Tic, or deleted; 
 A 23  is Abu, Acc, Act, Aib, Ala, Apc, Gly, Nva, Val, or deleted; 
 A 24  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 25  is Leu, Abu, Acc, Aib, Ala, Cha, Ile, hLeu, Nle, Nva, Phe, Tle, Val, or deleted; 
 A 26  is Gln, Aib, Asn, Asp, Glu, or deleted; 
 A 27  is Pro, Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz, Tic, or deleted; 
 A 28  is Acc, Aib, Apc, Arg, hArg, Dab, Dap, Lys, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 R 1  is —OH, —NH 2 , —(C 1 -C 30 )alkoxy, or NH—X 6 —CH 2 —Z 0 , wherein X 6  is a (C 1 -C 12 )alkyl, (C 2 -C 12 )alkenyl, and Z 0  is —H, —OH, —CO 2 H or —C(O)—NH 2 ; 
 R 2  and R 3  each is, independently for each occurrence, H, (C 1 -C 20 )alkyl or (C 1 -C 20 )acyl; 
 R 4 , R 5 , R 6 , R 7 , R 8 , R 9 , R 10 , R 11  and R 14  each is, independently for each occurrence, (C 1 -C 40 )alkyl, (C 2 -C 40 )alkenyl, substituted (C 1 -C 40 ) alkyl, substituted (C 2 -C 40 ) alkenyl, alkylaryl, substituted alklyaryl, aryl or substituted aryl; 
 R 12  and R 13  each is, independently for each occurrence, H, (C 1 -C 40 )alkyl, (C 1 -C 40 )acyl, (C 1 -C 30 )alkylsulfonyl, or —C(NH)—NH 2 , wherein when R 12  is (C 1 -C 40 )acyl, (C 1 -C 30 )alkylsulfonyl, or —C(NH)—NH 2 , then R 13  is H or (C 1 -C 40 )alkyl; 
 n is, independently for each occurrence, 1, 2, 3, 4 or 5; 
 X 1 , X 2 , X 3 , X 4 , and X 5  each is, independently for each occurrence, H, F, Cl, Br, I, (C 1-10 )alkyl, substituted (C 1-10 )alkyl, aryl, substituted aryl, OH, NH 2 , NO 2 , or CN; 
 provided that the peptide contains at least one amino acid selected from the groups consisting of: 
 A 2  is Aib, Acc, or Act; 
 A 3  is Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ), Glu(NH-Hexyl), or Cys(S-Decyl); 
 A 5  is Abu, Acc, Aib, Ala, Cha, Ile, hLeu, Nle, Nva, Phe, Tle, or Val; 
 A 6  is Abu, Acc, Act, Aib, Ala, Gly, Thr or Val; 
 A 7  is Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz or Tic; 
 A 8  is Acc, Aib, Arg, Asn, Asp, Dab, Dap, Gln, Lys, Orn, or HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O); 
 A 9  is Aib, Acc, Apc, 2-Fua, 2-Pal, 3-Pal, 4-Pal, Taz, 2-Thi, 3-Thi, or (X 1 ,X 2 ,X 3 ,X 4 ,X 5 -)Phe; and 
 A 10  is Acc, Aib, Asn, Asp, or Glu; 
 
       and further provided that the peptide is not (Lys 8 )hGhrelin(1-8)-NH 2  or (Arg 8 )hGhrelin(1-8)-NH 2 ; or a pharmaceutically acceptable salt thereof. 
     
     
         5 . The method of  claim 3  wherein said peptidyl ghrelin analog comprises the following formula (II):
   R 1 -A 1 -A 2 -A 3 -A 4 -A 5 -R 2    (II)
 
 
       wherein:
 A 1  is Aib, Apc or Inp; 
 A 2  is D-Bal, D-Bip, D-Bpa, D-Dip, D-1-Nal, D-2-Nal, D-Ser(Bzl), or D-Trp; 
 A 3  is D-Bal, D-Bip, D-Bpa, D-Dip, D-1-Nal, D-2-Nal, D-Ser(Bzl), or D-Trp; 
 A 4  is 2-Fua, Orn, 2-Pal, 3-Pal, 4-Pal, Pff, Phe, Pim, Taz, 2-Thi, 3-Thi, Thr(Bzl); 
 A 5  is Apc, Dab, Dap, Lys, Orn, or deleted; 
 R 1  is hydrogen, (C 1-6 )alkyl, (C 5-14 )aryl, (C 1-6 )alkyl(C 5-14 )aryl, (C 3-8 )cycloakyl, or (C 2-10 )acyl; and 
 R 2  is OH or NH 2 ; 
 
       provided that when A 5  is Dab, Dap, Lys, or Orn, then:
 A 2  is D-Bip, D-Bpa, D-Dip or D-Bal; or 
 A 3  is D-Bip, D-Bpa, D-Dip or D-Bal; or 
 A 4  is 2-Thi, 3-Thi, Taz, 2-Fua, 2-Pal, 3-Pal, 4-Pal, Orn, Thr(Bzl), or Pff; 
 
       when A 5  is deleted, then:
 A 3  is D-Bip, D-Bpa, or D-Dip; or 
 A 4  is 2-Fua, Pff, Taz, or Thr(Bzl); or 
 A 1  is Apc when
 A 2  is D-Bip, D-Bpa, D-Dip or D-Bal; or 
 A 3  is D-Bip, D-Bpa, D-Dip or D-Bal; or 
 A 4  is 2-Thi, 3-Thi, Orn, 2-Pal, 3-Pal or 4-Pal; 
 
 
       or a pharmaceutically acceptable salt thereof. 
     
     
         6 . A method of  claim 3  wherein said peptidyl ghrelin analog comprises the following formula (III):
   (R 2 R 3 )-A 1 -A 2 -A 3 -A 4 -A 5 -A 6 -A 7 -A 8 -A 9 -A 10 -A 11 -A 12 -A 13 -A 14 -A 15 -A 16 -A 17 -A 18 -A 19 -A 20 -A 21 -A 22 -A 23 -A 24 -A 25 -A 26 -A 27 -A 28 -R 1    (III)
 
 
       wherein:
 A 1  is Gly, Aib, Ala, B-Ala, Acc or Gly(myristyl); 
 A 2  is Ser, Aib, Ala, Acc, Abu, Act, Ava, Thr or Val; 
 A 3  is Ser, Ser(C(O)—R 4 ), Asp(O—R 8 ), Asp(NH—R 9 ), Cys(S—R 14 ), Dap(S(O) 2 —R 10 ) Dab(S(O) 2 —R 11 ), Glu(O—R 6 ), Glu(NH—R 7 ), Thr(C(O)—R 5 ) or HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O); 
 A 4  is Phe, Acc, Aic, Cha, 2-Fua, 1-Nal, 2-Nal, 2-Pal, 3-Pal, 4-Pal, hPhe, (X 1 ,X 2 ,X 3 ,X 4 ,X 5 )Phe, Taz, 2-Thi, 3-Thi, Trp or Tyr; 
 A 5  is Leu, Abu, Acc, Aib, Ala, Cha, Ile, hLeu, Nle, Nva, Phe, Tle or Val; 
 A 6  is Ser, Abu, Acc, Act, Aib, Ala, Gly, Thr or Val; 
 A 7  is Pro, Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz or Tic; 
 A 8  is Glu, Acc, Aib, Arg, Asn, Asp, Dab, Dap, Gln, Lys, Orn or HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O); 
 A 9  is His, Apc, Aib, Acc, 2-Fua, 2-Pal, 3-Pal, 4-Pal, Taz, 2-Thi, 3-Thi or (X 1 , X 2 , X 3 , X 4 , and X 5 -)Phe; 
 A 10  is Gln, Acc, Aib, Asn, Asp or Glu; 
 A 11  is Arg, Apc, hArg, Dab, Dap, Lys, Orn or HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O); 
 A 12  is Val, Abu, Acc, Aib, Ala, Cha, Nva, Gly, Ile, Leu, Nle, Tle or Cha; 
 A 13  is Gln, Acc, Aib, Asn, Asp or Glu; 
 A 14  is Gln, Acc, Aib, Asn, Asp or Glu; 
 A 15  is Arg, hArg, Acc, Aib, Apc, Dab, Dap, Lys, Orn, Ser(C(O)—R 4 ), Thr(C(O)—R 5 ), Glu(O—R 6 ), Glu(NH—R 7 ), Asp(O—R 8 ), Asp(NH—R 9 ), Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ) HN CH((CH 2 ) n —N(R 12 R 13 ))—C(O), Cys(S—R 14 ), Cys(R 15 ), hCys(S—R 16 ) or hCys(R 17 ); 
 A 16  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, Ser(C(O)—R 4 ), Thr(C(O)—R 5 ), Glu(O—R 6 ), Glu(NH—R 7 ), Asp(O—R 8 ), Asp(NH—R 9 ), Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ), HNCH((CH 2 ) n —N(R 12 R 13 ))—C(O), Cys(S—R 14 ), Cys(R 15 ), hCys(S—R 16 ), hCys(R 17 ) or deleted; 
 A 17  is Glu, Arg, Asn, Asp, Dab, Dap, Gln, Lys, Orn, Ser(C(O)—R 4 ), Thr(C(O)—R 5 ), Glu(O—R 6 ), Glu(NH—R 7 ), Asp(O—R 8 ), Asp(NH—R 9 ), Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ) HN CH((CH 2 ) n —N(R 12 R 13 ))—C(O), Cys(S—R 14 ), Cys(R 15 ), hCys(S—R 16 ), hCys(R 17 ), Lys(biotinyl) or deleted; 
 A 18  is Ser, Abu, Acc, Act, Aib, Ala, Thr, Val, Ser(C(O)—R 4 ), Thr(C(O)—R 5 ), Glu(O—R 6 ), Glu(NH—R 7 ), Asp(O—R 8 ), Asp(NH—R 9 ), Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ), HNCH—((CH 2 ) n —N(R 12 R 13 ))—C(O), Cys(S—R 14 ), Cys(R 15 ), hCys(S—R 16 ), hCys(R 17 ), or deleted; 
 A 19  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, Ser(C(O)—R 4 ), Thr(C(O)—R 5 ), Glu(O—R 6 ), Glu(NH—R 7 ), Asp(O—R 8 ), Asp(NH—R 9 ), Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ), HNCH—((CH 2 ) n —N(R 12 R 13 ))—C(O), Cys(S—R 14 ), Cys(R 15 ), hCys(S—R 16 ), hCys(R 17 ), or deleted; 
 A 20  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, Ser(C(O)—R 4 ), Thr(C(O)—R 5 ), Glu(O-R 6 ), Glu(NH—R 7 ), Asp(O—R 8 ), Asp(NH—R 9 ), Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ), HNCH—((CH 2 ) n —N(R 12 R 13 ))—C(O), Cys(S—R 14 ), Cys(R 15 ), hCys(S—R 16 ), hCys(R 17 ), or deleted; 
 A 21  is Pro, Dhp, Dmt, Inc, 3-Hyp, 4-Hyp, Ktp, Oic, Pip, Thz, Tic or deleted; 
 A 22  is Pro, Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz, Tic or deleted; 
 A 23  is Abu, Acc, Act, Aib, Ala, Apc, Gly, Nva, Val or deleted; 
 A 24  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O) or deleted; 
 A 25  is Leu, Abu, Acc, Aib, Ala, Cha, Ile, hLeu, Nle, Nva, Phe, Tle, Val or deleted; 
 A 26  is Gln, Aib, Asn, Asp, Glu or deleted; 
 A 27  is Pro, Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz, Tic or deleted; 
 A 28  is Acc, Aib, Apc, Arg, hArg, Dab, Dap, Lys, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O) or deleted; 
 R 1  is —OH, —NH 2 , —(C 1 -C 30 )alkoxy or NH—X 6 —CH 2 —Z 0 , wherein X 6  is a (C 1 -C 12 )alkyl, (C 2 -C 12 )alkenyl and Z 0  is —H, —OH, —CO 2 H or —C(O)—NH 2 ; 
 R 2  and R 3  is, independently for each occurrence thereof, selected from the group consisting of H, (C 1 -C 30 )alkyl, (C 1 -C 30 )heteroalkyl, (C 1 -C 30 )acyl, (C 2 -C 30 )alkenyl, (C 2 -C 30 )alkynyl, aryl(C 1 -C 30 )alkyl, aryl(C 1 -C 30 )acyl, substituted (C 1 -C 30 )alkyl, substituted (C 1 -C 30 )heteroalkyl, substituted (C 2 -C 30 )acyl, substituted (C 2 -C 30 )alkenyl, substituted aryl(C 1 -C 30 )alkyl and substituted aryl(C 1 -C 30 )acyl; 
 R 4 , R 5 , R 6 , R 7 , R 8 , R 9 , R 10 , R 11 , R 14 , R 15 , R 16  and R 17  is, independently for each occurrence thereof, selected from the group consisting of (C 1 -C 40 )alkyl, (C 2 -C 40 )alkenyl, substituted (C 1 -C 40 ) alkyl, substituted (C 2 -C 40 ) alkenyl, alkylaryl, substituted alklyaryl, aryl and substituted aryl; 
 R 12  and R 13  is, independently for each occurrence thereof, selected from the group consisting of H, (C 1 -C 40 )alkyl, (C 1 -C 40 )acyl, (C 1 -C 30 )alkylsulfonyl, biotinyl and —C(NH)—NH 2 , 
 X 1 , X 2 , X 3 , X 4 , and X 5  is, independently for each occurrence thereof, selected from the group consisting of H, F, Cl, Br, I, (C 1-10 )alkyl, substituted (C 1-10 )alkyl, aryl, substituted aryl, OH, NH 2 , NO 2  and CN; and 
 n is, independently for each occurrence thereof, 1, 2, 3, 4 or 5; 
 provided that: 
 (I). when R 2  is (C 1 -C 30 )acyl, aryl(C 1 -C 30 )acyl, substituted (C 2 -C 30 )acyl, or substituted aryl(C 1 -C 30 )acyl, R 3  is H, (C 1 -C 30 )alkyl, (C 1 -C 30 )heteroalkyl, (C 2 -C 30 )alkenyl, aryl(C 1 -C 30 )alkyl, substituted (C 1 -C 30 )alkyl, substituted (C 1 -C 30 )heteroalkyl, substituted (C 2 -C 30 )alkenyl or substituted aryl(C 1 -C 30 )alkyl; 
 (II). when R 12  is (C 1 -C 40 )acyl, (C 1 -C 30 )alkylsulfonyl, biotinyl or —C(NH)—NH 2 , then R 13  is H or (C 1 -C 40 )alkyl; 
 (III). at least one of A 15 , A 16 , A 17 , A 18 , A 19  or A 20  must be selected from the group consisting of Ser(C(O)—R 4 ), Thr(C(O)—R 5 ), Glu(O—R 6 ), Glu(NH—R 7 ), Asp(O—R 8 ), Asp(NH 2 5 R 9 ), Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ), HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), Cys(S—R 14 ) Cys(R 15 ), hCys(S—R 16 ) and hCys(R 17 ); and 
 (IV). when any of the group consisting of A 15 , A 16 , A 17 , A 19  and A 20  is HNCH((CH 2 ) n —N(R 12 R 13 ))—C(O), then R 12  must be biotinylated; 
 
       or a pharmaceutically acceptable salt thereof. 
     
     
         7 - 10 . (canceled) 
     
     
         11 . A method of treating opioid-related bowel dysfunction in a patent, said method comprising administering a peptidyl analog of ghrelin, a prodrug thereof, or a pharmaceutically acceptable salt of said analog or said prodrug. 
     
     
         12 . The method of  claim 11 , wherein said peptidyl analog of ghrelin comprises the following formula (I):
   (R 2 R 3 )-A 1 -A 2 -A 3 -A 4 -A 5 -A 6 -A 7 -A 8 -A 9 -A 10 -A 11 -A 12 -A 13 -A 14 -A 15 -A 16 -A 17 -A 18 -A 19 -A 20 -A 21 -A 22 -A 23 -A 24 -A 25 -A 26 -A 27 -A 28 -R 1   (I)
   
       wherein:
 A 1  is Gly, Aib, Ala, B-Ala, or Acc; 
 A 2  is Ser, Aib, Act, Ala, Acc, Abu, Ava, Thr, or Val; 
 A 3  is Ser, Ser(C(O)—R 4 ), Asp(O—R 8 ), Asp(NH—R 9 ), Cys(S—R 14 ), Dap(S(O) 2 —R 10 ) Dab(S(O) 2 —R 11 ), Glu(O—R 6 ), Glu(NH—R 7 ), Thr, Thr(C(O)—R 5 ), or HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O); 
 A 4  is Phe, Acc, Aic, Cha, 2-Fua, 1-Nal, 2-Nal, 2-Pal, 3-Pal, 4-Pal, hPhe, (X 1 ,X 2 ,X 3 ,X 4 ,X 5 )Phe, Taz, 2-Thi, 3-Thi, Trp, or Tyr; 
 A 5  is Leu, Abu, Acc, Aib, Ala, Cha, Ile, hLeu, Nle, Nva, Phe, Tle, or Val; 
 A 6  is Ser, Abu, Acc, Act, Aib, Ala, Gly, Thr, or Val; 
 A 7  is Pro, Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz, Tic, or deleted; 
 A 8  is Glu, Acc, Aib, Arg, Asn, Asp, Dab, Dap, Gln, Lys, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 9  is His, Apc, Aib, Acc, 2-Fua, 2-Pal, 3-Pal, 4-Pal, Taz, 2-Thi, 3-Thi, (X 1 ,X 2 ,X 3 ,X 4 ,X 5 -)Phe or deleted; 
 A 10  is Gln, Acc, Aib, Asn, Asp, Glu, or deleted; 
 A 11  is Arg, Apc, hArg, Dab, Dap, Lys, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 12  is Val, Abu, Acc, Aib, Ala, Cha, Nva, Gly, Ile, Leu, Nle, Tle, or deleted; 
 A 13  is Gln, Acc, Aib, Asn, Asp, Glu, or deleted; 
 A 14  is Gln, Acc, Aib, Asn, Asp, Glu, or deleted; 
 A 15  is Arg, hArg, Acc, Aib, Apc, Dab, Dap, Lys, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 16  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 17  is Glu, Arg, Asn, Asp, Dab, Dap, Gln, Lys, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 18  is Ser, Abu, Acc, Act, Aib, Ala, Thr, Val, or deleted; 
 A 19  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 20  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 21  is Pro, Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz, Tic, or deleted; 
 A 22  is Pro, Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz, Tic, or deleted; 
 A 23  is Abu, Acc, Act, Aib, Ala, Apc, Gly, Nva, Val, or deleted; 
 A 24  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 A 25  is Leu, Abu, Acc, Aib, Ala, Cha, Ile, hLeu, Nle, Nva, Phe, Tle, Val, or deleted; 
 A 26  is Gln, Aib, Asn, Asp, Glu, or deleted; 
 A 27  is Pro, Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz, Tic, or deleted; 
 A 28  is Acc, Aib, Apc, Arg, hArg, Dab, Dap, Lys, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), or deleted; 
 R 1  is —OH, —NH 2 , —(C 1 -C 30 )alkoxy, or NH—X 6 —CH 2 —Z 0 , wherein X 6  is a (C 1 -C 12 )alkyl, (C 2 -C 12 )alkenyl, and Z 0  is —H, —OH, —CO 2 H or —C(O)—NH 2 ; 
 R 2  and R 3  each is, independently for each occurrence, H, (C 1 -C 20 )alkyl or (C 1 -C 20 )acyl; 
 R 4 , R 5 , R 6 , R 7 , R 8 , R 9 , R 10 , R 11  and R 14  each is, independently for each occurrence, (C 1 -C 40 )alkyl, (C 2 -C 40 )alkenyl, substituted (C 1 -C 40 ) alkyl, substituted (C 2 -C 40 ) alkenyl, alkylaryl, substituted alklyaryl, aryl or substituted aryl; 
 R 12  and R 13  each is, independently for each occurrence, H, (C 1 -C 40 )alkyl, (C 1 -C 40 )acyl, (C 1 -C 30 )alkylsulfonyl, or —C(NH)—NH 2 , wherein when R 12  is (C 1 -C 40 )acyl, (C 1 -C 30 )alkylsulfonyl, or —C(NH)—NH 2 , then R 13  is H or (C 1 -C 40 )alkyl; 
 n is, independently for each occurrence, 1, 2, 3, 4 or 5; 
 X 1 , X 2 , X 3 , X 4 , and X 5  each is, independently for each occurrence, H, F, Cl, Br, I, (C 1-10 )alkyl, substituted (C 1-10 )alkyl, aryl, substituted aryl, OH, NH 2 , NO 2 , or CN; 
 provided that the peptide contains at least one amino acid selected from the groups consisting of: 
 A 2  is Aib, Acc, or Act; 
 A 3  is Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ), Glu(NH-Hexyl), or Cys(S-Decyl); 
 A 5  is Abu, Acc, Aib, Ala, Cha, Ile, hLeu, Nle, Nva, Phe, Tle, or Val; 
 A 6  is Abu, Acc, Act, Aib, Ala, Gly, Thr or Val; 
 A 7  is Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz or Tic; 
 A 8  is Acc, Aib, Arg, Asn, Asp, Dab, Dap, Gln, Lys, Orn, or HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O); 
 A 9  is Aib, Acc, Apc, 2-Fua, 2-Pal, 3-Pal, 4-Pal, Taz, 2-Thi, 3-Thi, or (X 1 ,X 2 ,X 3 ,X 4 ,X 5 -)Phe; and 
 A 10  is Acc, Aib, Asn, Asp, or Glu; 
 
       and further provided that the peptide is not (Lys 8 )hGhrelin(1-8)-NH 2  or (Arg 8 )hGhrelin(1-8)-NH 2 ; or a pharmaceutically acceptable salt thereof. 
     
     
         13 . The method of  claim 11  wherein said peptidyl ghrelin analog comprises the following formula (II):
   R 1 -A 1 -A 2 -A 3 -A 4 -A 5 -R 2    (II)
 
 
       wherein:
 A 1  is Aib, Apc or Inp; 
 A 2  is D-Bal, D-Bip, D-Bpa, D-Dip, D-1-Nal, D-2-Nal, D-Ser(Bzl), or D-Trp; 
 A 3  is D-Bal, D-Bip, D-Bpa, D-Dip, D-1-Nal, D-2-Nal, D-Ser(Bzl), or D-Trp; 
 A 4  is 2-Fua, Orn, 2-Pal, 3-Pal, 4-Pal, Pff, Phe, Pim, Taz, 2-Thi, 3-Thi, Thr(Bzl); 
 A 5  is Apc, Dab, Dap, Lys, Orn, or deleted; 
 R 1  is hydrogen, (C 1-6 )alkyl, (C 5-14 )aryl, (C 1-6 )alkyl(C 5-14 )aryl, (C 3-8 )cycloakyl, or (C 2-10 )acyl; and 
 R 2  is OH or NH 2 ; 
 
       provided that when A 5  is Dab, Dap, Lys, or Orn, then:
 A 2  is D-Bip, D-Bpa, D-Dip or D-Bal; or 
 A 3  is D-Bip, D-Bpa, D-Dip or D-Bal; or 
 A 4  is 2-Thi, 3-Thi, Taz, 2-Fua, 2-Pal, 3-Pal, 4-Pal, Orn, Thr(Bzl), or Pff; 
 
       when A 5  is deleted, then:
 A 3  is D-Bip, D-Bpa, or D-Dip; or 
 A 4  is 2-Fua, Pff, Taz, or Thr(Bzl); or 
 A 1  is Apc when
 A 2  is D-Bip, D-Bpa, D-Dip or D-Bal; or 
 A 3  is D-Bip, D-Bpa, D-Dip or D-Bal; or 
 A 4  is 2-Thi, 3-Thi, Orn, 2-Pal, 3-Pal or 4-Pal; 
 
 
       or a pharmaceutically acceptable salt thereof. 
     
     
         14 . A method of  claim 11  wherein said peptidyl ghrelin analog comprises the following formula (III):
 formula (III):
   (R 2 R 3 )-A 1 -A 2 -A 3 -A 4 -A 5 -A 6 -A 7 -A 8 -A 9 -A 10 -A 11 -A 12 -A 13 -A 14 -A 15 -A 16 -A 17 -A 18 -A 19 -A 20 -A 21 -A 22 -A 23 -A 24 -A 25 -A 26 -A 27 -A 28 -R 1    (III)
 
 
 wherein:
 A 1  is Gly, Aib, Ala, B-Ala, Acc or Gly(myristyl); 
 A 2  is Ser, Aib, Ala, Acc, Abu, Act, Ava, Thr or Val; 
 A 3  is Ser, Ser(C(O)—R 4 ), Asp(O—R 8 ), Asp(NH—R 9 ), Cys(S—R 14 ), Dap(S(O) 2 —R 10 ) Dab(S(O) 2 —R 11 ), Glu(O—R 6 ), Glu(NH—R 7 ), Thr(C(O)—R 5 ) or HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O); 
 A 4  is Phe, Acc, Aic, Cha, 2-Fua, 1-Nal, 2-Nal, 2-Pal, 3-Pal, 4-Pal, hPhe, (X 1 ,X 2 ,X 3 ,X 4 ,X 5 )Phe, Taz, 2-Thi, 3-Thi, Trp or Tyr; 
 A 5  is Leu, Abu, Acc, Aib, Ala, Cha, Ile, hLeu, Nle, Nva, Phe, Tle or Val; 
 A 6  is Ser, Abu, Acc, Act, Aib, Ala, Gly, Thr or Val; 
 A 7  is Pro, Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz or Tic; 
 A 8  is Glu, Acc, Aib, Arg, Asn, Asp, Dab, Dap, Gln, Lys, Orn or HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O); 
 A 9  is His, Apc, Aib, Acc, 2-Fua, 2-Pal, 3-Pal, 4-Pal, Taz, 2-Thi, 3-Thi or (X 1 , X 2 , X 3 , X 4 , and X 5 -)Phe; 
 A 10  is Gln, Acc, Aib, Asn, Asp or Glu; 
 A 11  is Arg, Apc, hArg, Dab, Dap, Lys, Orn or HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O); 
 A 12  is Val, Abu, Acc, Aib, Ala, Cha, Nva, Gly, Ile, Leu, Nle, Tle or Cha; 
 A 13  is Gln, Acc, Aib, Asn, Asp or Glu; 
 A 14  is Gln, Acc, Aib, Asn, Asp or Glu; 
 A 15  is Arg, hArg, Acc, Aib, Apc, Dab, Dap, Lys, Orn, Ser(C(O)—R 4 ), Thr(C(O)—R 5 ), Glu(O—R 6 ), Glu(NH—R 7 ), Asp(O—R 8 ), Asp(NH—R 9 ), Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ) HN CH((CH 2 ) n —N(R 12 R 13 ))—C(O), Cys(S—R 14 ), Cys(R 15 ), hCys(S—R 16 ) or hCys(R 17 ); 
 A 16  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, Ser(C(O)—R 4 ), Thr(C(O)—R 5 ), Glu(O—R 6 ), Glu(NH—R 7 ), Asp(O—R 8 ), Asp(NH—R 9 ), Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ), HNCH((CH 2 ) n —N(R 12 R 13 ))—C(O), Cys(S—R 14 ), Cys(R 15 ), hCys(S—R 16 ), hCys(R 17 ) or deleted; 
 A 17  is Glu, Arg, Asn, Asp, Dab, Dap, Gln, Lys, Orn, Ser(C(O)—R 4 ), Thr(C(O)—R 5 ), Glu(O—R 6 ), Glu(NH—R 7 ), Asp(O—R 8 ), Asp(NH—R 9 ), Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ) HN CH((CH 2 ) n —N(R 12 R 13 ))—C(O), Cys(S—R 14 ), Cys(R 15 ), hCys(S—R 16 ), hCys(R 17 ), Lys(biotinyl) or deleted; 
 A 18  is Ser, Abu, Acc, Act, Aib, Ala, Thr, Val, Ser(C(O)—R 4 ), Thr(C(O)—R 5 ), Glu(O—R 6 ), Glu(NH—R 7 ), Asp(O—R 8 ), Asp(NH—R 9 ), Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ), HNCH—((CH 2 ) n —N(R 12 R 13 ))—C(O), Cys(S—R 14 ), Cys(R 15 ), hCys(S—R 16 ), hCys(R 17 ), or deleted; 
 A 19  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, Ser(C(O)—R 4 ), Thr(C(O)—R 5 ), Glu(O—R 6 ), Glu(NH—R 7 ), Asp(O—R 8 ), Asp(NH—R 9 ), Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ), HNCH—((CH 2 ) n —N(R 12 R 13 ))—C(O), Cys(S—R 14 ), Cys(R 15 ), hCys(S—R 16 ), hCys(R 17 ), or deleted; 
 A 20  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, Ser(C(O)—R 4 ), Thr(C(O)—R 5 ), Glu(O—R 6 ), Glu(NH—R 7 ), Asp(O—R 8 ), Asp(NH—R 9 ), Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ), HNCH—((CH 2 ) n —N(R 12 R 13 ))—C(O), Cys(S—R 14 ), Cys(R 15 ), hCys(S—R 16 ), hCys(R 17 ), or deleted; 
 A 21  is Pro, Dhp, Dmt, Inc, 3-Hyp, 4-Hyp, Ktp, Oic, Pip, Thz, Tic or deleted; 
 A 22  is Pro, Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz, Tic or deleted; 
 A 23  is Abu, Acc, Act, Aib, Ala, Apc, Gly, Nva, Val or deleted; 
 A 24  is Lys, Acc, Aib, Apc, Arg, hArg, Dab, Dap, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O) or deleted; 
 A 25  is Leu, Abu, Acc, Aib, Ala, Cha, Ile, hLeu, Nle, Nva, Phe, Tle, Val or deleted; 
 A 26  is Gln, Aib, Asn, Asp, Glu or deleted; 
 A 27  is Pro, Dhp, Dmt, 3-Hyp, 4-Hyp, Inc, Ktp, Oic, Pip, Thz, Tic or deleted; 
 A 28  is Acc, Aib, Apc, Arg, hArg, Dab, Dap, Lys, Orn, HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O) or deleted; 
 R 1  is —OH, —NH 2 , —(C 1 -C 30 )alkoxy or NH—X 6 —CH 2 —Z 0 , wherein X 6  is a (C 1 -C 12 )alkyl, (C 2 -C 12 )alkenyl and Z 0  is —H, —OH, —CO 2 H or —C(O)—NH 2 ; 
 R 2  and R 3  is, independently for each occurrence thereof, selected from the group consisting of H, (C 1 -C 30 )alkyl, (C 1 -C 30 )heteroalkyl, (C 1 -C 30 )acyl, (C 2 -C 30 )alkenyl, (C 2 -C 30 )alkynyl, aryl(C 1 -C 30 )alkyl, aryl(C 1 -C 30 )acyl, substituted (C 1 -C 30 )alkyl, substituted (C 1 -C 30 )heteroalkyl, substituted (C 2 -C 30 )acyl, substituted (C 2 -C 30 )alkenyl, substituted aryl(C 1 -C 30 )alkyl and substituted aryl(C 1 -C 30 )acyl; 
 R 4 , R 5 , R 6 , R 7 , R 8 , R 9 , R 10 , R 11 , R 14 , R 15 , R 16  and R 17  is, independently for each occurrence thereof, selected from the group consisting of (C 1 -C 40 )alkyl, (C 2 -C 40 )alkenyl, substituted (C 1 -C 40 ) alkyl, substituted (C 2 -C 40 ) alkenyl, alkylaryl, substituted alklyaryl, aryl and substituted aryl; 
 R 12  and R 13  is, independently for each occurrence thereof, selected from the group consisting of H, (C 1 -C 40 )alkyl, (C 1 -C 40 )acyl, (C 1 -C 30 )alkylsulfonyl, biotinyl and —C(NH)—NH 2 , 
 X 1 , X 2 , X 3 , X 4 , and X 5  is, independently for each occurrence thereof, selected from the group consisting of H, F, Cl, Br, I, (C 1-10 )alkyl, substituted (C 1-10 )alkyl, aryl, substituted aryl, OH, NH 2 , NO 2  and CN; and 
 n is, independently for each occurrence thereof, 1, 2, 3, 4 or 5; 
 provided that: 
 (I). when R2 is (C 1 -C 30 )acyl, aryl(C 1 -C 30 )acyl, substituted (C 2 -C 30 )acyl, or substituted aryl(C 1 -C 30 )acyl, R 3  is H, (C 1 -C 30 )alkyl, (C 1 -C 30 )heteroalkyl, (C 2 -C 30 )alkenyl, aryl(C 1 -C 30 )alkyl, substituted (C 1 -C 30 )alkyl, substituted (C 1 -C 30 )heteroalkyl, substituted (C 2 -C 30 )alkenyl or substituted aryl(C 1 -C 30 )alkyl; 
 (II). when R12 is (C 1 -C 40 )acyl, (C 1 -C 30 )alkylsulfonyl, biotinyl or —C(NH)—NH 2 , then R 13  is H or (C 1 -C 40 )alkyl; 
 (III). at least one of A 15 , A 16 , A 17 , A 18 , A 19  or A 20  must be selected from the group consisting of Ser(C(O)—R 4 ), Thr(C(O)—R 5 ), Glu(O—R 6 ), Glu(NH—R 7 ), Asp(O—R 8 ), Asp(NH 2 5 R 9 ), Dap(S(O) 2 —R 10 ), Dab(S(O) 2 —R 11 ), HN—CH((CH 2 ) n —N(R 12 R 13 ))—C(O), Cys(S—R 14 ) Cys(R 15 ), hCys(S—R 16 ) and hCys(R 17 ); and 
 (IV). when any of the group consisting of A 15 , A 16 , A 17 , A 19  and A 20  is HNCH((CH 2 ) n —N(R 12 R 13 ))—C(O), then R 12  must be biotinylated; 
 
 or a pharmaceutically acceptable salt thereof. 
 
     
     
         15 - 18 . (canceled) 
     
     
         19 . A method of  claim 1 , wherein said patient is a human. 
     
     
         20 . A method of  claim 1 , wherein said patient in need of gastrointestinal stimulation is experiencing gastroesophageal reflux disease, ileus, emesis, gastroparesis, IBS, constipation, or colonic pseudo-obstruction. 
     
     
         21 . A method according to  claim 20 , wherein said patient is experiencing ileus, emesis or gastroparesis. 
     
     
         22 - 27 . (canceled) 
     
     
         28 . A method according to  claim 21 , wherein said patient is experiencing emesis. 
     
     
         29 . A method according to  claim 28 , wherein said patient is experiencing emesis associated with treatment with an anti-cancer chemotherapeutic agent, pregnancy, bulimia, or anorexia. 
     
     
         30 . A method according to  claim 29 , wherein said emesis is associated with treatment with an anti-cancer chemotherapeutic agent. 
     
     
         31 - 33 . (canceled) 
     
     
         34 . A method according to  claim 21 , wherein said patient is experiencing gastroparesis. 
     
     
         35 . A method according to  claim 34 , wherein said gastroparesis is associated with diabetes. 
     
     
         36 - 37 . (canceled)

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