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EP1687286A1 - Derives ameliores (2) de bleu de methylene biologiquement actifs - Google Patents

Derives ameliores (2) de bleu de methylene biologiquement actifs

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Publication number
EP1687286A1
EP1687286A1 EP04798628A EP04798628A EP1687286A1 EP 1687286 A1 EP1687286 A1 EP 1687286A1 EP 04798628 A EP04798628 A EP 04798628A EP 04798628 A EP04798628 A EP 04798628A EP 1687286 A1 EP1687286 A1 EP 1687286A1
Authority
EP
European Patent Office
Prior art keywords
ium
phenothiazin
compound
formula
alkyl
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP04798628A
Other languages
German (de)
English (en)
Inventor
Stanley Beames Brown
Cassandra Claire O'grady
John Griffiths
Kirste Joanne Mellish
Richard George Tunstall
David John Howard Roberts
David Ian Vernon
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Photopharmica Ltd
Original Assignee
Photopharmica Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from GBGB0327672.2A external-priority patent/GB0327672D0/en
Priority claimed from GB0329809A external-priority patent/GB0329809D0/en
Application filed by Photopharmica Ltd filed Critical Photopharmica Ltd
Publication of EP1687286A1 publication Critical patent/EP1687286A1/fr
Withdrawn legal-status Critical Current

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Classifications

    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D401/00—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom
    • C07D401/02—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings
    • C07D401/04—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings directly linked by a ring-member-to-ring-member bond
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D279/00—Heterocyclic compounds containing six-membered rings having one nitrogen atom and one sulfur atom as the only ring hetero atoms
    • C07D279/10—1,4-Thiazines; Hydrogenated 1,4-thiazines
    • C07D279/14—1,4-Thiazines; Hydrogenated 1,4-thiazines condensed with carbocyclic rings or ring systems
    • C07D279/18—[b, e]-condensed with two six-membered rings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/54—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame
    • A61K31/5415—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame ortho- or peri-condensed with carbocyclic ring systems, e.g. phenothiazine, chlorpromazine, piroxicam

Definitions

  • This invention relates to biologically active photosensitisers which are strongly photocytotoxic and have application in the areas of photodynamic therapy (PDT), their compositions, their uses as medicaments particularly in the treatment of cancer and in the treatment and prevention of microbial infections, their uses in diagnosis and detection of medical conditions and related uses in photochemical internalisation, in the production of cancer vaccines and in photodisinfection or photosterilisation.
  • PDT photodynamic therapy
  • the invention further relates to conjugates and composites of the photosensitisers which may be used in photodisinfection or photosterilisation.
  • photosensitisers can induce cell death by absorption of light in the presence of oxygen.
  • the cytotoxic effect involves Type I and/or Type II photooxidation.
  • photosensitisers find use in the treatment of cancer and other diseases or infections with light (photodynamic therapy) and in the sterilisation (including disinfection) of surfaces and fluids by the light-induced destruction of microbes.
  • sterilisation is taken to mean the reduction or elimination of microbes in a particular situation.
  • phenothiazinium compounds e.g. methylene blue
  • compounds of this type thus far have proved unsuitable or of low efficacy as sensitisers for photodynamic therapy, or have shown low photochemical antimicrobial activity, or have potential problems in use because they are Ames positive.
  • a good sensitiser must have at least some and preferably all of the following properties: • it should cause the destruction of target cells (for example tumour cells or bacterial cells) efficiently on exposure to light (preferably wavelengths ca.
  • Gram negative and Gram positive bacteria differ in the composition of their outer surface and respond differently to antimicrobial agents, especially in terms of uptake. Due to the high negatively charged surface of Gram negative bacteria they are relatively impermeable to neutral or anionic drugs, including most commonly used photosensitisers. Development of antimicrobial photosensitisers which are effective against Gram negative bacteria, as well as Gram positive bacteria would be highly beneficial to replace commonly used antibiotics and drugs which are becoming increasingly ineffective due to resistance. A number of different types of photosensitiser have been investigated in bacteria. These include phenothiazinium compounds, phthalocyanines, chlorins and naturally occurring photosensitisers.
  • Phenothiazinium compounds are blue dyes with maximum absorption at wavelengths between 600-700 nm. They have been studied for their non-photodynamic antibacterial properties but few apart from methylene blue and toluidine blue have been investigated photodynamically. Wainwright et al (1998) investigated the effect of a series of phenothiazinium methylene blue derivatives in tumour cell lines and bacteria. New methylene blue (NMB) and di methyl methylene blue (DMMB) were effective at inactivating MRSA and were shown to be more effective photosensitisers than methylene blue when acting on pigmented melanoma cell lines.
  • NMB New methylene blue
  • DMMB di methyl methylene blue
  • PCT application PCT/GB02/02278 describes certain phenothiazinium compounds which are biologically active and suggests that in a series of N, N, N, N terra n-C 1-6 alkyl derivatives that the tetra n-butyl derivative is the most active with activity decreasing rapidly as the number of carbon atoms in the chain increases.
  • phenothiazinium compounds derivatives have now been found which are biologically active and which are suitable for use as medicaments particularly in the prevention of microbial infections and in the treatment of cancer and microbial infections.
  • a phenothiazinium compound of Formula (I) for use as an antimicrobial agent for the prevention of microbial infections:
  • RI, R2, R3 and R4 each independently is an optionally substituted linear, branched or cyclic hydrocarbon group, or RI and R2 or R3 and R4 together with the N atom to which they are attached form an optionally substituted 5-, 6- or 7-membered ring;
  • X p" is a counteranion; and
  • P is 1, 2 or 3.
  • sterilisation means a significant reduction in bacterial load on, in or around a wound site which helps to promote efficient wound healing or which minimises the chance that wound infection will occur.
  • the use of the compounds of Formula (I) for the prevention of infection is preferably by PDT in which the compound is applied to a wound site followed by trie application of light.
  • Conventional antimicrobials suffer the disadvantage that they have a short lifetime for prevention of infection and need repeated applications, such as by swabbing, to maintain their effectiveness.
  • the compounds of Formula (I) have improved properties over previously known and used antimicrobial agents because the prevention effect is prolonged and can be reactivated as necessary by further application of light without the need to re-administer the compound.
  • the wound site can be maintained in a sterile condition by continuous exposure to light of a suitable wavelength or by the intermittent use of light of a suitable wavelength when needed.
  • a phenothiazinium compound of Formula (II) for use as an antiviral agent in which the compound of Formula (II) has the same structure as the compound of Formula (I) but wherein RI, R2, R3 and R4 each independently is an optionally substituted linear, branched or cyclic hydrocarbon group, or RI and R2 or R3 and R4 together with the N atom to which they are attached form an optionally substituted 5-, 6- or 7- membered ring; X p" is a counteranion; and P is 1, 2 or 3.
  • R2 R3 and R4 preferably contain from 1 to 12 carbon atoms.
  • each is linear or branched and contains 4 or 5 carbon atoms.
  • each is linear or branched and contains from 1 to 6 carbon atoms, and further that the total number of carbon atoms in RI, R2, R3 and R4 is from 8 to 18
  • a phenothiazinium compound of Formula (III) for use as an antimicrobial agent in the treatment of a microbial infection in which the compound of Formula (III) has the same structure as the compound of Formula (I) but wherein: i) RI, R2, R3 and R4 each independently is selected from straight, branched or cyclic C 1-12 -alkyl provided that at least one of RI, R2, R3 and R4 is C -12 -alkyl; or ii) RI, R2, R3 and R4 each independently is selected from straight, branched or cyclic C 1-12 -alkyl in which at least one of RI
  • a phenothiazinium compound of Formula (V) in which the compound of Formula (V) has the same structure as the compound of Formula (I) but wherein: i) RI, R2, R3 and R4 each independently is selected from straight, branched or cyclic C 1-1 -alkyl provided that at least one of RI, R2, R3 and R4 is C .
  • RI, R2, R3 and R4 each independently is selected from straight, branched or cyclic C 1-12 -alkyl in which at least one of RI, R2, R3 and R4 is branched or cyclic; or iii) RI, R2, R3 and R4 each independently is selected from straight, branched or cyclic C 1-12 -alkyl in which RI and R2 may be the same or different and R3 and R4 may be the same or different provided that at least one of RI and R2 is not the same as at least one of R3 and R4, except for the compound in which RI and R2 are both HO(CH 2 ) 2 - and R3 and R4 are both n-butyl or n-pentyl; or iv) RI, R2, R3 and R4 each independently is selected from straight, branched or cyclic C 1-12 -alkyl in which RI and R2 are different, or R3 and R R
  • linear and branched chain hydrocarbon groups represented by RI, R2, R3 and R4 in any one of the compounds of Formulae (I) to (V) may include one or more unsaturated links, for example one or more alkene groups, and may be optionally substituted by a group selected from H, F, Cl, Br, I, -OH, -OCi- ⁇ -alkyl, , - CN, -OCOC 1-6 -alkyl or aryl, such as phenyl.
  • These linear and branched chain hydrocarbon groups are preferably unsubstituted and are preferably saturated hydrocarbon groups.
  • the cyclic hydrocarbon groups represented by RI, R2, R3 and R4 in any one of the compounds of Formulae (I) to (V) contain from 3 to 8 carbon atoms, preferably from 4 to 6 carbon atoms and more preferably 6 carbon atoms.
  • These cyclic hydrocarbon groups may include one or more unsaturated links, they may be optionally substituted and may optionally include a heteroatom such as nitrogen.
  • RI and R2 and/or R3 and R4 in any one of the compounds of Formulae (I) to (V) together with the N atom to which they are attached form an optionally substituted 5-, 6- or 7-membered ring the ring may contain other heteroatoms and may be optionally substituted.
  • the heteroatoms are preferably selected from N, O or S. Where the heteroatoms is S this may be substituted with O, where the heteroatom is N this may be substituted with H, -CO C 1-6 -alkyl or C 1-6 -alkyl which is optionally substituted by -OH, preferred substituted heteroatoms are selected from SO 2 , NH, NCH 3 , NC 2 H 5 , NCH 2 CH 2 OH and NCOCH 3 .
  • the optional ring substituents may be selected from -Ci- ⁇ -alkyl, -OH, -OC 1-6 . alkyl, -OC OC 1-6- alkyl. Examples include:
  • Z is CH 2 , CH 2 -C 1-6 -alkyl, O, S, SO 2 , NH, NCH 3 , NC 2 H 5 , NCH 2 CH 2 OH, orNCOCH 3 .
  • the counteranion represented by X p" in any one of the compounds of Formulae (I) to (V) may be an organic or inorganic counteranion and is preferably selected from F " ,
  • SO 4 2" , HPO 4 2" , PO 4 3" acetate, lactate, citrate, tartrate, glycolate, glycerate, glutamate, ⁇ -hydroxyglutamate, glucouronate, gluconate, malate and aspartate.
  • the counteranion is selected from the group comprising Cl “ , Br-, I “ , F “ , NO 3 ⁇ HSO “ , CH 3 CO 2 “ , SO 4 2” , HPO 4 2' , or PO 4 3” or from the group comprising Cl “ , Br "
  • I " acetate, lactate, citrate, tartrate, glycolate, glycerate, glutamate, ⁇ - hydroxyglutamate, glucouronate, gluconate, malate, aspartate, and more preferably from the group comprising Cl “ , Br " , I " .
  • R2, R3 and R4 may be the same or different and the sum of the carbon atoms in the alkyl side chains I represented by R and R is from 14 to 40, preferably from 16 to 36, and more preferably from 18 to 30, and especially from 18 to 24.
  • R2 may be the same or different and the sum of the carbon atoms in the alkyl side chains represented by R 1 andR 2 is from 16 to 20 preferably from 18 to 20.
  • phenothiazinium compounds of Formulae (I) to (V) may be synthesised as follows:
  • the solid formed is collected by filtration and purified for example by flash column chromatography over silica gel 60, using chloroform, chloroform/methanol (98/2) and then chloroform/methanol (90/10).
  • the product may be further purified by precipitation from chloroform with petroleum ether (b.p. 60- 80°C).
  • reaction mixture is stirred overnight, the organic layer washed with dilute hydrochloric acid and water, separated and dried (MgSO 4 ). The majority of the solvent is evaporation and diethyl ether added to precipitate the product which is collected by filtration, washed with diethyl ether and dried. Further purification of the product, if necessary, may be by flash column chromatography.
  • compositions comprising a compound of Formula (V) together with one or more pharmaceutically acceptable carriers, diluents or excipients (each selected for certain characteristics that permit optimal formulation of a pharmaceutical composition) form a further feature of the present invention.
  • the compositions of the present invention also include those comprising any two or more compounds of Formulae (I) to (V) and those comprising any one or more compounds of Formulae (I) to (V) with one or more different therapeutic or active agents.
  • the compositions include liposomes, nanoparticles, colloidal suspensions, micelles, microemulsions, vesicles and nanospheres.
  • compositions may also comprise further components such as conventional delivery vehicles and excipients including solvents such as alcohols (for example ethanol, polyethylene glycol, glycerol or n-butanol), dimethyl sulphoxide, water, saline, solubilisers such as castor oil derivatives for example ethoxylated castor oils like Cremophor EL (trade mark BASF AG) or Tween (trade mark, ICI Americas Inc.) types or Solutol HS15 (Solutol is a trade mark of BASF AG) , isotonising agents such as urea, glycerol, aminoethanol, propylene glycol, pH regulators, dyes, gelling agents, thickeners, buffers, and combinations thereof.
  • solvents such as alcohols (for example ethanol, polyethylene glycol, glycerol or n-butanol), dimethyl sulphoxide, water, saline, solubilisers such as castor oil derivatives for example
  • compositions are prepared by mixing a compound of Formula (I) with one or more pharmaceutically acceptable carriers at an appropriate temperature, typically from 15° to 65 °C at an appropriate pH, typically from pH 3 to 9 and preferably at a physiologically acceptable pH, such as from pH 6.5 to 7.5.
  • concentration of the compounds in the compositions depends on the compound's photosensitising ability and is preferably in the range from 0.0005 to 20% for topical use and from lOO ⁇ M to 30mM for intravenous use.
  • Dry compositions which may be reconstituted before use, are also provided in the present invention. These may be prepared by dry mixing solid components of the composition or preparing a liquid composition which is evaporated to dryness generally under mild conditions under vacuum or in low temperature ovens.
  • the compounds of Formula(IV) and their compositions may be used as medicaments in the treatment of a variety of conditions including infection and cancer; the treatment of dermatological, ophthalmic, cardiovascular, gynaecological and dental conditions; and in the prevention of infection.
  • the use as medicaments is as anticancer agents, antibacterials, antifungals and antivirals. These uses may be in humans or animals.
  • a compound of any one of Formulae (I) to (V) is used as a PDT agent or a photodiagnostic agent.
  • Examples of uses of the various compounds of Formulae (I) to (V) and their compositions are as photosensitising drugs for PDT to treat cancer and pre-cancerous conditions including Barrett's oesophagus, vulval intraepithelial neoplasia (VIN) and cervical intraepithelial neoplasia (CIN), bladder cancer, colon cancer, non-melanoma skin cancer, actinic keratoses, melanoma, brain-pituitary cancer, brain-glioma, pancreatic cancer, head and neck cancer, lung cancer, particularly non small cell, mesothelioma, oesophageal cancer, stomach cancer, cutaneous T-cell lymphoma; to treat systemic and local infections, for example for use as anti-microbial and antifungal treatments for skin and wound infections such as burn wounds, in treatment of ulcers particularly leg ulcers more particularly infected chronic leg ulcers, nail infections; for parasitic infection, stomach infection, malaria, leprosy
  • the compounds may also be used in photochemical internalisation (the use of photosensitisers to assist the uptake and subcellular localisation of drugs) through their photosensitising properties and in non-therapeutic uses such as in photodiagnosis through their fluorescence properties.
  • photochemical internalisation the use of photosensitisers to assist the uptake and subcellular localisation of drugs
  • non-therapeutic uses such as in photodiagnosis through their fluorescence properties.
  • the latter approach takes advantage of the fact that the photosensitiser concentrates more in tumours than in surrounding healthy tissue and when induced to fluoresce (by application of blue light), the tumour fluoresces more strongly than the surrounding tissue.
  • applications areas include diagnoses for oral diseases and for diseases of the bladder, lung and skin.
  • the compounds of any of Formulae (I) to (V) and their compositions may be used as photosensitising drugs for PDT in veterinary applications, for example in treatment of cancers such as ear cancer in cats, as antifungal, antibacterial and antviral treatments, for sterilisation of wounds in animals and for ophthalmological treatments in animals.
  • any of the compounds of Formulae (I) to (V) and their compositions is preferably in treatments of localised and/or early cancer and/or pre-cancerous lesions in humans and in animals; or in the treatment and/or prevention of infections in wounds or skin in humans and animals.
  • the compounds of Formulae (I) to (V) are particularly useful as photosensitising drugs for PDT of conditions where treatment requires removal, deactivation or killing of unwanted tissue or cells such as cancer, precancerous disease, ophthalmic disease, vascular disease, autoimmune disease, and proliferative conditions of the skin and other organs.
  • any of the compounds of Formulae (I) and (V) and their compositions may be used in the treatment of various conditions and diseases described above by administration systemically, topically or locally, followed by application of light of an appropriate dose and wavelength or wavelength range.
  • the compounds may be delivered for example intravenously, orally, sub-cutaneously, intramuscularly, directly into affected tissues and organs, intraperitoneally, directly into tumours, intradermally or via an implant.
  • the compounds may be delivered via a variety of means for example via a spray, lotion, suspension, emulsion, gel, ointment, salves, sticks, soaps, liquid aerosols, powder aerosols, drops or paste.
  • the light source may be any appropriate light source such as a laser, laser diode or non-coherent light source.
  • the light dose administered during PDT can vary but preferably is from 1 to 200 J/cm 2 , more preferably from 20 to 100 J/cm 2 .
  • Light exposure may be given at any time after a drug is initially administered or up to 48 hours after drug administration and the time may be tailored according to the condition being treated, the method of drug delivery and the specific compound of Formulae (I) to (V) used.
  • Light exposure is preferably given at any time after a drug is initially administered up to 3 hours, more preferably from the time after a drug is initially administered up to 1 hour, especially up to 10 minutes.
  • Increased intensity of the light dose generally reduces exposure times. It is preferred that exposure to light is localised to the area/region to be treated, and where tumours are being treated more preferably localised to the tumour itself.
  • the compound of Formulae (I) to (V) or its composition is preferably administered to a subject in need of treatment and the light exposure is given up to 10 minutes after a drug is initially administered. In a further preferred embodiment of the invention, light exposure is given within 1 minute after a drug is initially administered.
  • the compounds of the present invention have the advantage, compared with other phenothiazinium photosensitisers, that they do not, in carrying out their cell- destroying activity, target the nucleus of the cell so that there is a much lower risk of the cells undergoing mutagenic transformations.
  • the compounds of Formulae (I), (II) and (III) have a number of advantages for the prevention and treatment of microbial infections, including bacterial, fungal and viral infections:
  • a compound of Formula (I), (II) and (III) or its composition is used in PDT as a photoactivatable antimicrobial to prevent or treat a microbial infection, including bacterial, fungal and viral infections, treatments for skin and other local infections, for sterilisation of burn wounds and other lesions, treatments for ulcers, for sterilisation of both recipient tissue and donated tissue during organ, including skin, transplantation and for the treatment of dental microbial disease, it is administered systemically, locally or topically (by any of the means described above) by applying to the area to be treated a therapeutically effective amount of the compound and exposing the area to light to render active the compound.
  • a microbial infection including bacterial, fungal and viral infections, treatments for skin and other local infections, for sterilisation of burn wounds and other lesions, treatments for ulcers, for sterilisation of both recipient tissue and donated tissue during organ, including skin, transplantation and for the treatment of dental microbial disease
  • the compounds of Formula (I) may be applied to prevent infection at any stage including wound contamination, where non-replicating organisms are present in a wound; wound colonisation where replicating microorganisms are present in a wound; and wound infection where replicating microorganisms are present that cause injury to the host.
  • wound contamination where non-replicating organisms are present in a wound
  • wound colonisation where replicating microorganisms are present in a wound
  • wound infection where replicating microorganisms are present that cause injury to the host.
  • the concentration used for bacterial cell kill in vitro is in the range from 0.1 to 100 ⁇ M, preferably from 1 to 50 ⁇ M and more preferably from 5 to 20 ⁇ M, especially lO ⁇ M.
  • the prevention of microbial infections preferably comprises the step of administering a compound according to Formula (I) in which RI, R2, R3 and R4 may be the same or different and are selected independently from ethyl, n-propyl, n-butyl, n-pentyl, i-pentyl, 2-ethylpiperidino, 2-methylpyrrolidino and cyclohexyl .
  • RI, R2, R3 and R4 may be the same or different and are selected independently from ethyl, n-propyl, n-butyl, n-pentyl, i-pentyl, 2-ethylpiperidino, 2-methylpyrrolidino and cyclohexyl .
  • Preferred moieties for use in the prevention of microbial infections or for use as antivirals are as follows: 3,7-(tetra-n-butylamino)-phenothiazin-5-ium; 3,7-(tetra-n-pentylamino)-phenothiazin-5-ium; 3,7-(tetra-iso-butylamino)-phenothiazin-5-ium; 3,7-(tetra-iso-pentylamino)-phenothiazin-5-ium; 3-(N,N-di-methylamino)-7-(N,N-di-n-propylamino)-phenothiazin-5-ium;
  • the compounds of Formula (I) and (III) preferably are used against bacteria, more preferably the compounds are used against antibiotic resistant bacteria.
  • Anticancer preferably is used against bacteria, more preferably the compounds are used against antibiotic resistant bacteria.
  • the compounds of Formula (IV) have a number of advantages for the treatment of cancer:
  • the compounds of the present invention are used as PDT agents for mammalian cells and tumours they may be administered using the above described compositions in a variety of ways, such as systemically, topically or locally (by any of the means described above) and may be used alone or as components or mixtures with other components and drugs.
  • the dose rates of the compounds of Formula (IV) for intravenous administration to humans for oncology treatments are in the range 0.01 to 10 ⁇ mol (micromole)/kg, preferably in the range 0.1 to 2.0 ⁇ mol (micromole) / kg.
  • To achieve a dose of say 2 ⁇ mol (micromole)/kg in a 70kg patient requires injection of 70ml of a 2mM solution, or 5ml at a concentration of 27mM (16mg/ml) or 2.8ml of a 50mM solution.
  • Typical injections volumes are in the range 0.1 to 100ml, preferably from 5 to 50ml.
  • the method for treatment of cancer comprises the step of administering a compound according to Formula (IV) where RI, R2, R3 and R4 are selected independently from ethyl, n-propyl, n-butyl, i-butyl, n-pentyl, i-pentyl, n- hexyl, 2-ethylpiperidino, 2-methylpyrrolidino, cyclohexyl, benzyl and HO(CH 2 ) 2 , preferably where RI, R2, R3 and R4 are selected independently from ethyl, n-propyl, n-butyl, i-butyl, n-pentyl, i-pentyl, n-hexyl, 2-ethylpiperidino, 2-methylpyrrolidino and benzyl.
  • RI, R2, R3 and R4 are selected independently from ethyl, n-propyl, n-buty
  • each one of RI, R2, R3 and R4 is preferably selected independently from ethyl, n-propyl, n-butyl, i-butyl, n-pentyl, i-pentyl, n-hexyl, 2- ethylpiperidino, 2-methylpyrrolidino, cyclohexyl, benzyl and HO(CH 2 ) 2 , more preferably where RI, R2, R3 and R4 are selected independently from ethyl, n-propyl, n-butyl, i-butyl, n-pentyl, i-pentyl, n-hexyl, 2-ethylpiperidino, 2-methylpyrrolidino and benzyl.
  • compounds of Formula (V) may be used as photoactivated antimicrobial agents, including antibacterial, antifungal and antiviral agents for general sterilisation of surfaces and fluids, for example they may be used to sterilise surgical implants and stents, particularly where these are coated or impregnated, to sterilise textiles such as bandages and dressings, IV lines and catheters, for sterilisation of water, air, blood, blood products, and food and food packaging to prevent transfer of infection, and for general household, hospital and office cleaning.
  • the compounds may be applied directly to or contacted with the surfaces and fluids and activating the compound by exposure to light. Additionally the surface to be sterilised may be immersed in a mixture or solution of the compound or the fluid to be sterilised may be mixed with the compound or a solution or mixture containing the compound.
  • the present invention further provides a conjugate or composite formed between a compound of Formula (V) and a polymer.
  • the term composite as used herein refers to the situation wherein a compound of the invention is embedded in a polymer or physically occluded within or adsorbed onto a matrix or substrate.
  • the polymer may be a biological polymer such as a peptide or a protein.
  • Preferred polymers include those having anhydride and/or ester groups.
  • Preferred compounds of Formula (V) which form a conjugate or composite with a polymer are those in which at least one of RI and R2 and/or R3 and R4 together with the N atom to which they are attached form a piperazinyl group.
  • the present invention further provides a compound formed by the reaction between a compound of Formula (V) and a chlorotriazine derivative.
  • the chlorotriazine derivative may be a polymer having chlorotriazine groups attached thereto.
  • Appropriate compounds of Formula (V) may be attached directly to a surface of an article, particularly a polymeric surface or via a conjugate or composite formed between a compound of Formula (V) and a polymer or via a chlorotriazine derivative, permanently by covalent bonds or reversibly by intermolecular interactions.
  • This provides a surface that can be sterilised whenever required by the application of light and is particularly useful, for example, with intravenous lines in patients and in sutures and catheters and intravenous lines, where maintaining long- term sterility of the relevant surfaces is problematical.
  • the resistance of the compounds to photobleaching is an advantage in such applications, where prolonged colour stability is required.
  • the present invention further provides an article having at least one surface to which is attached a compound of Formula (V).
  • the article is a medical device such as a venous, urinary or balloon catheter, suture, orthopaedic or artificial implant, heart valve, surgical screw or pin, pacemaker lead, feeding or breathing tube, vascular stent, intraocular lens, or small joint replacement.
  • the article may also be of use in wound care and for packaging materials for medical use, for example, materials for medical equipment.
  • a compound of Formula (V) may be applied to or contacted with walls, floors and ceilings of hospitals, clinical surfaces such as operating tables, abattoirs, clean rooms in scientific laboratories, fibres which may be converted into woven, knitted or non- woven textile articles such as cleaning cloths, wipes, surgical gowns, bed linen, wound dressings and bandages.
  • the compound may be applied directly or via attachment to a polymeric species.
  • a polymeric species where the compound is to be applied to walls, floors, ceilings, and work surfaces, it is envisaged that it will be used as a component of a paint or lacquer, which comprises the compound, film forming polymers, which may or may not be cross- linkable, and an appropriate solvent, optionally with drying agents and other colorants.
  • the surface coating may take the form of a solution or water-based dispersion.
  • the article is one for use in the food and beverage industry and may be an item of packaging, a wrapper or storage carton or a piece of processing equipment.
  • the article may be a refrigerator, vending machine, ice making machine, a piece of restaurant equipment or other kitchen appliance.
  • the present invention further provides a use of a compound of Formula (V) for sterilising a surface or a fluid comprising contacting or applying the compound of Formula (V) to said surface or fluid and activating said compound by means of light.
  • the compound of Formula (V) may be contacted or applied by any means, for example as a spray, liquid, solution, suspension, foam, cream, gel or emulsion.
  • a compound of Formula (I) to (V) for sterilising fluids in which the fluid is contacted with any one of a compound of Formulae (I) to (V) or with a conjugate or composite formed between any one of a compound of Formulae (I) to (V) and a polymer whilst the compound or the conjugate or composite is illuminated.
  • the fluid may be a liquid or a gas or a vapour.
  • the method may for example be applied to sterilisation of liquids, for example for sterilisation of water, or liquids used medically such as parenteral liquids for example saline or glucose and particularly for sterilisation of biological liquids such as blood, blood products, red cells, bone marrow cells, and stem cells.
  • the method may also be applied to sterilisation of gases such as air, particularly air used in air conditioning systems, and oxygen used medically. This method is particularly useful for sterilising materials which cannot be easily sterilised by filtration methods.
  • the method is used preferably for sterilisation of water, or liquids used medically such as parenteral liquids such as saline or glucose and for sterilisation of biological liquids such as bone marrow cells and stem cells.
  • Any of the compounds of Formulae (I) to (V) and their conjugates or composites may be used as is, preferably with its surface area maximised such as in a finely divided form or in the form of beads or plates, or it may be used on or associated with any support material which provides a large surface area such as glass, glass wool, ceramics, plastics, metals and metal oxides.
  • the support material is preferably transparent to light or allows light to pass through it. Where a support material is used this is arranged to maximise the surface area covered by the conjugate or composite and may be in the form of beads, plates, large surface areas in columns or tubes, foams or fibres.
  • Any one of the compounds of Formulae (I) to (V) or their conjugates or composites is preferably continuously illuminated at the wavelengths and at the light doses described above.
  • the preferred compounds of Formula (I) to (V) are those preferred in this sterilisation method.
  • any one of the compound s of Formulae (I) to (V) or their conjugates or composites either alone or on a support material is packed into a column, typically made of a material which is transparent to light, such as silica glass or synthetic fibres.
  • the fluid requiring sterilisation is passed into one end of the column, the whole column is continuously illuminated and sterilised material flows out from the other end of the column.
  • Certain novel moieties of the present include: 3,7-(N,N-tetra- iso-butylamino)-phenothiazin-5-ium;
  • novel moieties of the present invention exhibit unexpected advantages over compounds described in PCT/GB02/02778.
  • 3-(N,N-di-ethylamino)-7-(N,N-di-n-propylamino)-phenothiazin-5-ium has improved antibacterial activity when compared with both the tetraethyl and tetra n-propyl derivatives;
  • 3-(N,N-di-n-butylamino)-7-(N,N-di-n-propylamino)-phenothiazin-5-ium has better antibacterial activity and better Ames performance when compared with tetra n- propyl derivative and surprisingly is equivalent to the antibacterial activity and Ames performance of the tetra n-butyl derivative when expected to be somewhat worse;
  • 3-(N,N-di-n-pentylamino)-7-(N,N-di-n-propylamino)-phenothiazin-5-ium has better antibacterial activity and better Ames performance when compared with tetra n- propyl derivative and surprisingly is equivalent to the antibacterial activity and Ames performance of the tetra n-pentyl derivative when expected to be somewhat worse;
  • 3-(N,N-di-n-hexylamino)-7-(N,N-di-n-propylamino)-phenothiazin-5-ium has better antibacterial activity compared with both the tetra n-hexyl and tetra n-propyl derivatives, and has better performance than the tetra n-hexyl derivative as an anticancer agent and has equivalent performance as an anticancer agent at half the dose rate of the tetra n-propyl derivative;
  • 3-(N,N-di-n-butylamino)-7-(N,N-di-pentylamino)-phenothiazin-5-ium has better activity against Candida albicans than the tetra n-pentyl derivative and almost the same activity as the tetra n-butyl when expected to be somewhat worse;
  • 3-(N,N-di-n-butylamino)-7-(N,N-di-iso-pentylamino)-phenothiazin-5-ium has better activity against Candida albicans than both the tetra n-butyl and the tetra n-pentyl derivatives;
  • 3-(N,N-di-methylamino)-7-(N,N-di-n-octylamino)-phenothiazin-5-ium has better anti tumour activity than the tetra methyl derivative and causes minimal normal tissue damage when used as an anticancer agent;
  • 5-ium has better anti tumour activity than the tetra ethyl derivative and has better antibacterial activity compared with both the tetra ethyl and tetra n-hexyl derivatives; 3-(2-ethylpiperidino)-7-(N,N-di-n-pentylamino)-phenothiazin-5-ium when compared with the tetra n-pentyl derivative is effective at a shorter drug to light interval;
  • 3,7-(N,N-tetra- benzylamino)-phenothiazin-5-ium has better anti tumour activity than the tetra methyl derivative.
  • the chloroform solution was washed successively with HBr (2% aq., 2 x 50cm 3 ) and water (2 x 50cm 3 ), and then dried over MgSO 4 . After filtration, the majority of the solvent was removed by rotary evaporation, an excess of diethyl ether was added and the reaction mixture then left to stand. After some time, a large amount of colourless solid was deposited. This material was removed by filtration. The filtrate was evaporated to dryness and the residual crude product was purified by flash column chromatography over silica gel 60, employing sequentially a mobile phase of chloroform, chloroform/methanol (98/2) and finally chloroform/methanol (90/10).
  • This compound was obtained following isolation of 3-(NN-dipropylamino)- phenothiazin-5-ium triiodide and subsequent treatment with dihexylamine.
  • This compound was obtained following isolation of 3-(N,N-dipentylamino)- phenothiazin-5-ium triiodide and subsequent treatment with diethanolamine.
  • Me, Et, Pr, Bu, Pent, Hex, Hept, Oct in the above table and throughout this specification represent methyl, ethyl, propyl, butyl, pentyl, hexyl, heptyl and octyl respectively, and that n- and i- indicate nonnal and iso alkyl chains respectively.
  • the tumour was illuminated superficially with 60 J/cm2, 50 mW/cm2 light from a Paterson lamp using a 660 ⁇ 15nm filter.
  • Drug - light intervals ranged from Oh (in practice, 1-2 minutes) up to 96h.
  • 72h after illumination a cross sectional slice was removed from the centre of the tumour parallel to the incident light, an image of this was captured and the macroscopic necrotic area quantified using image analysis software. Necrosis was expressed as % area of the total tumour slice. % tumour necrosis in control tumours was generally ⁇ 10%.
  • Antitumour activity was categorized: None 0 - 10% tumour necrosis, Low 11 - 39% tumour necrosis, Medium 40 - 69% tumour necrosis, High 70 - 100% tumour necrosis.
  • Antitumour activity at the optimal dose and drug - light interval for each compound is shown in Table 4. Due to the close proximity of the subcutaneous tumour to internal organs such as kidney and liver in the mouse, damage to these organs is often observed after PDT in this model. Damage to internal organs following PDT was scored as shown in Table 3.
  • the following compounds showed relatively high antitumour activity with minimal normal tissue damage (average score ⁇ 1): Tetra isobutyl, dihexyl dipropyl, bis methyl octyl.
  • Table 4 PDT induced tumour necrosis in CBA gy mice following iv administration at the optimal dose and drug - light interval, and photoitiactivation of log phase E. coli and C. albicans using 1 O ⁇ M photosensitiser and illumination with 665nm laser light at a dose of 3.2J/cm , except for compounds 1,4,5,6 which were illuminated at a dose of 1.3 J/cm .
  • the present compounds have a number of advantages over currently available compounds such as Photofrin (trade mark, Axcan Pharma PDT Inc) and Foscan (trade mark, Bioscience Technology Investment Holdings Limited).
  • the compounds of the present invention are single isomer free compounds produced by relatively simple processes, whereas Photofrin is a complex mixture of porphyrin derivatives.
  • a short drug administration to light interval is desirable both in terms of patient convenience and time in hospital during treatment and associated costs.
  • Photofrin requires a long drug administration to light interval, typically of 48 hours, as unacceptable damage to normal tissues surrounding the tumour occurs at short drug-to-light intervals.
  • the compounds of the present invention are active at short drug-light intervals without any damage to normal tissue surrounding the tumour.
  • the dibutyl dipropyl derivative causes 98% tumour necrosis where illumination is immediately after administration.
  • Comparison of damage to skin overlying the tumour shows that with all of the present compounds no scab formation is observed at any drug to light interval whereas Photofrin gave up to 25% scab formation at short drug to light intervals (0 - 3 hours), longer drug to light intervals of 48 hours gave no scab formation but tumour necrosis was only 50%.
  • Foscan there is a delay of 4 days, to allow time for accumulation in the cancer cells, between injection into the bloodstream and activation with laser light. Administration of Foscan results in patients becoming highly sensitive to light, with a period of sensitivity of approximately 15 days.
  • Photo-antimicrobial activity 1) General Methods Method for microbial bacterial photoinactivation experiment a) Standard preparation ofphotosensitsiers
  • a single bacterial colony from an agar plate was used to aseptically inoculate 100 ml of nutrient media (0.5 % yeast extract: 1.0 % tryptone w/v) in a 1 1 conical flask.
  • nutrient media 0.5 % yeast extract: 1.0 % tryptone w/v
  • C. albicans a single fungal colony was used to inoculate 100 ml of sabouraud dextrose media in a 11 conical flask.
  • the culture was incubated in a shaking incubator overnight, at 37 °C.
  • the incubator was set to 250 strokes per minute and a rotary motion of a 2.5cm circle. This culture was used for the stationary phase experiments.
  • the log or stationary phase cells were collected by centrifugation and washed twice in 0.1 M potassium phosphate buffer (pH 7.0). Following washing, the cells were resuspended in the same buffer to an absorbance of 0.87 at 650 nm. This absorbance was equivalent to 3.5xl0 8 CFU/ml or 8.5 log t oCFU/ml for E. coli, S. aureus, MRSA and P. aeruginosa. For C. albicans this correlated to l.OxlO 7 CFU/ml or 7.0 log 10 CFU/ml. For photoinactivation of E. coli cells in media, the bacteria were resuspended in nutrient media at this stage. Microbial cell photoinactivation experiments Standard incubation with photosensitiser
  • the suspension was irradiated by a 500W halogen lamp, from a distance of 75cm, for 60 minutes, the power of the lamp was 1.3mW/cm 2 giving 4.68 J/cm 2 over the hour illumination. Illumination from a 665nm laser
  • Bacterial and yeast survival analysis 50ml of the illuminated and non-illuminated samples of the suspension were removed and diluted in 0.1 M pH 7.0 potassium phosphate buffer. 50 ⁇ l of the diluted suspension was then plated on nutrient agar (0.5% yeast extract, 1.0% tryptone, 2.0% agar w/v) for bacteria, or sabouraud dextrose agar for C. albicans. The plates were incubated overnight at 37°C to give a number of colony forming units between 30-300. Cell inactivation was then measured. Control studies involving plating out of bacteria before and after the 30 minute incubation step with no phenothiazinium compound but 0.25mls DMSO showed no change in CFU/ml.
  • the suspension was incubated at 37°C and 250rpm in a shaking incubator in the dark, lml samples were taken every hour for 6 hours and turbidity based on apparent optical density at 550nm caused by light scattering was measured. Control studies show this wavelength is out of the region of photosensitiser absorption. Following optical density readings the 1.0ml sample was spun in a MS ⁇ Micro-Centaur centrifuge (10 OOOg x 5 minutes) and the absorbance spectra of the supernatant read spectrophotometrically. For the tetra-n-butyl derivative only, similar experiments were carried out where the bacteria were allowed to grow without photosensitiser for 3 hours, after which time the phenothiazinium compounds was added.
  • Inactivation of bacteria may be more challenging in a therapeutic environment, because the sensitiser may bind preferentially to extracellular proteins rather than the bacterial lipopolysaccharide membrane. This was tested by resuspending the bacteria in nutrient medium containing many factors which might compete with bacterial cells for photosensitiser binding.
  • S.aureus is a Gram positive organism which differs from Gram negative organis s in that it has a thick outer peptidoglycan layer and no external lipopolysaccharide.
  • the bacterial structure is the same as in MRS A (Methicillin resistant S.aureus) which is resistant to almost all commonly used antibiotics.
  • MRS A Metal-resistant S.aureus
  • the data show that after only a 1 minute illumination almost 99% of the bacteria are inactivated and that after 10 minutes there is almost 5 logs of cell kill, illustrating the very high photoactivity of the tetra-n-butyl derivative against this Gram positive organism. It is important to determine if the photosensitiser would also be active against the antibiotic resistant form, MRS A, as this would have major health and industrial applications.
  • the photosensitiser was incubated with cells of Candida albicans and the culture was subjected to laser light as described above. .
  • This photosensitiser is therefore also highly photoactive against this fungal organism which is responsible for many common infections e.g. thrush.
  • Selectivity for bacterial cells versus mammalian tissues It is clearly important for therapeutic purposes that there is minimal damage to host tissues while microorganisms are being destroyed.
  • the possible effects on the host tissue were assessed by measuring any increase in ear thickness. This is a standard model for detecting photodynamic reactions in the skin.
  • Photobleaching removes detectable colour from the photosensitiser, rendering it inactive and is the result of its instability to light and reduction or oxidation. Such photobleaching may have advantages or disadvantages depending on the potential application. For example, photobleaching is undesirable in the coating of lines and catheters.
  • Two sets of experiments were carried out; one at a high light dose (9.0m W/cm ) and one at a low light dose (1.3mW/cm ) with and without tryptophan as described above.
  • Absorption spectra at low light dose, with and without tryptophan showed no changes for any of the phenothiazinium compounds demonstrating they are stable at this dose.
  • spectral changes were observed for the methylene blue, indicating photobleaching.
  • the maximum absorbance decreased and the wavelength peak shifted over the one hour illumination. These changes occurred to the same extent with and without tryptophan.
  • none of the other phenothiazinium compounds showed this degradation and remained stable to photobleaching at the high light dose.
  • the data in the table above show the log reduction in CFU/ml of bacteria or yeast incubated with lO ⁇ M photosensitiser, and illuminated using a 665nm laser for lOmin, at a fluence of 3.2 J/cm 2 .
  • the susceptibility of bacteria to phenothiazinium mediated PDT can depend on if the bacteria are Gram-positive or Gram-negative.
  • Gram-positive bacteria S. aureus, MRSA
  • Gram negative bacteria E. coli, P. aeruginosa
  • MRSA an antibiotic resistant strain of S. aureus is a major cause of nosocomal infection. MRSA and S.
  • aureus are equally susceptible to tetra- «-pentyl-3,7- diaminophenothiazin-5-ium compound mediated anti microbial PDT. There was a log reduction of 3.80 log ⁇ 0 CFU/ml using the tetra- «-pentyl-3,7-diaminophenothiazin- 5-ium compound against log phase MRSA.
  • Ames testing was carried out (using a kit from Discovery Partners International) in S. typhimurium mixed strains (TA7001, TA7002, TA7003, TA7004, TA7005 and TA7006) which detect base pair substitution mutagens at both GC and AT sites, and strain TA98 which detects frame shift mutagens (Gee et al, Proc Natl Acad Sci, 91, 11606-11610, 1994).
  • TA7001, TA7002, TA7003, TA7004, TA7005 and TA7006 which detect base pair substitution mutagens at both GC and AT sites
  • strain TA98 which detects frame shift mutagens (Gee et al, Proc Natl Acad Sci, 91, 11606-11610, 1994).
  • Approximately 107 bacteria in medium containing sufficient histidine for 2 cell divisions were incubated (in triplicate) at 37°C, 250rpm for 90 min with 6 concentrations of the test agent, solvent control and positive control.
  • Incubations were carried out in both light and dark conditions and with and without metabolic activation with S9 rat liver extract (4.5%).
  • the light source was a bank of seven Sylvania Grolux 30W light tubes.
  • a 2-fold dilution series of the test agent was used with the top concentration being a toxic concentration (i.e. a concentration causing a visible reduction in cell number in a prescreen) or the maximum soluble concentration.
  • the positive control was a mixture of 4- nitroquinoline-N-oxide (500 ng/ml) and 2-nitrofluorene (2 ⁇ g/ml).
  • the positive control was 2-aminoanthracene (10 ⁇ g/ml).
  • bacteria were diluted with pH indicator medium lacking histidine and transferred to 384 well plates to give 48 wells per concentration in triplicate. The plates were incubated at 37°C for 48h, then positive wells (wells in which the growth of his+ reverse mutants has reduced the pH, producing a colour change from purple to yellow) were counted. Results were expressed as positive wells per 48 (mean ⁇ SD).
  • a positive response was defined as a concentration related increase in the number of positive wells and a significant increase in the number of positive wells at one or more test agent concentrations compared to negative control, with statistical significance assessed using an unpaired two-tailed Student's t-test.
  • the film shows typical singlet oxygen generating properties on exposure to light for example an aerated red solution of tetraphenylcyclopentadienone (a characteristic singlet oxygen detector) in toluene containing the film is rapidly bleached on exposure to light from a 40 w tungsten filament lamp. An identical solution showed no bleaching when irradiated for the same period of time in the absence of the film.
  • Adsorption on polymers This may be illustrated by a phenothiazinium compound (la) which may be made according to the following reaction scheme:
  • both R groups n-pentyl.
  • the compound will be extremely basic and readily protonated in dilute acids to give (Ila) below, which could be adsorbed strongly on polymeric surfaces, e.g. polyamides, polyacrylates, polyesters, polycarbonates, polyurethanes, and strongly resisted removal by water or solvents. Alternatively la could be adsorbed directly onto acidic surfaces to give their corresponding cationic salts directly.

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Abstract

Composé de phénothiazinium représenté par la formule (I) et utilisé en tant qu'agent antimicrobien afin de prévenir des infections microbiennes dans laquelle R1, R2, R3 et R4 représentent chacun indépendamment un groupe hydrocarbure éventuellement substitué, linéaire, ramifié ou cyclique; ou R1 et R2 ou R3 et R4 avec l'atome de N auquel ils sont fixés, constituent un noyau éventuellement substitué à 5, 6 ou 7 éléments; XP- représente un contre-anion; et P est 1, 2 ou 3. L'invention concerne également des compositions comprenant des composés de phénothiazinium, des composés sélectionnés et leur utilisation sous forme de médicaments, d'agents PDT, d'agents de photodiagnostic, un conjugué ou composite placé entre un phénothiazinium et un polymère, ainsi qu'un procédé servant à stériliser des liquides et consistant à faire passer ce liquide au-dessus du conjugué ou du composite, tandis qu'il est éclairé. Ces composés sont des photosensibilisants biologiquements actifs extrêmement photocytoxiques et peuvent être utilisés dans des domaines de thérapie photodynamique (PDT), ainsi que pour diagnostiquer ou détecter des états pathologiques. Ils peuvent également être mis en application en internalisation photochimique, pour la préparation de vaccins anti-cancer, pour traiter ou prévenir des infections microbiennes et en photodésinfection ou photostérilisation.
EP04798628A 2003-11-28 2004-11-22 Derives ameliores (2) de bleu de methylene biologiquement actifs Withdrawn EP1687286A1 (fr)

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GBGB0327672.2A GB0327672D0 (en) 2003-11-28 2003-11-28 Developments in biologically active methylene blue derivatives (phenothiazines)
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JP2007512297A (ja) 2007-05-17
AU2004295148A1 (en) 2005-06-16
WO2005054217A1 (fr) 2005-06-16
KR20060111536A (ko) 2006-10-27
CA2547556A1 (fr) 2005-06-16

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