TITLE OF THE INVENTION
NITROSYLATED ANALGESIC AND/OR ANTI-INFLAMMATORY DRUGS HAVING ANTIVIRAL ACTIVITY
5 ****** The present invention relates to the use of drugs for treating viral diseases and/or their complications. More specifically, the present invention relates to the use of nitroderivatives for treatment of influenza, cold and viral 10 infections affecting the cardiovascular system, in particular the heart muscle. The viral infections are very diffused. The cold and influenza are the common infectious diseases of the respiratory tract caused by different viruses (rhinovirus, 15 influenza viruses) . The influenza produces symptoms that are more severe, such as a fever, runny nose, sore throat, cough, headache and muscle aches. Complications may prolong the illness, some people develop secondary bacterial infections such as otitis 20 media, sinuses, bronchitis and pneumonia. Vaccination is the best way to avoid contracting influenza and several antiviral drugs can be used to prevent infection and are also helpful in treating people who have influenza. 25 The drawback of vaccines is that the virus can change each year. Amantadine and rimantadine are older antiviral drugs that offer protection against influenza type A but not influenza type B. These drugs can cause side effects such 30 as stomach upset, nervousness and sleeplessness. New analogs, oseltamivir and zanamivirm can prevent infection with either influenza virus types.
However, the use of antiviral drugs does not eliminate the risk of complications and these drugs work only if taken in the first day or two of illness. In addition, the virus rapidly develops resistance to them (The Merck Manual of Medical Information, Second Home Edition, Chapter 198, Viral Infections) . Other used compounds are paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) . It has been reported that paracetamol causes damages at hepatic level (hepatic toxicity) and it has been known that the use of NSAIDs is often accompanied by several side effects, mainly at the charge of the gastrointestinal tract. For the cold treatment there are generally no effective antiviral drugs and an effective vaccine has not yet been developed (The Merck Manual of Medical Information, Second Home Edition, Chapter 198, Viral Infections) . The viral infections affecting the heart muscle (myocarditis) are caused by different viruses such as coxsackie, adenovirus, and echovirus. The therapeutic treatment is generally unsatisfactory for the viral myocarditis . The need was felt to have available compounds active in viral infections, specifically those affecting the cardiovascular system, in particular the heart muscle, and for the prevention and/or treatment of influenza and cold. It has been surprisingly and unexpectedly found by the Applicant that it is possible to solve the above technical problem with specific nitroderivatives as described hereunder . Object of the present invention is the use, for the prevention and/or treatment of viral diseases and/or their complications, of nitroderivatives of general formula (I)
or pharmaceutically acceptable salts or stereoisomers thereof: A-T-Y-ON02 (I) wherein A is the residue of a drug (A -OH or A-H) selected from the group consisting of non-steroidal anti- inflammatory, analgesic and antipyretic drugs and COX-2 inhibitors, in which T = -0-, -NH-, -S-, -CO- or - (CH2)niOCO- wherein nl is an integer from 1 to 20; A is selected from the group consisting of: Ha)
where c and d are independently 0 or 1;
RD is selected from the group consisting of H, a linear or branched C1-C12 alkyl, C-Cι2 alkenyl; when c is equal to 0 , d is 1, RA is selected from the group consisting of:
wherein: R
c is selected from the group consisting of H, halogen, amino, R
ECONH- and -OCOR; R
D is H, OH, halogen, a linear or branched C1-C4 alkyl, a linear or branched C1-C4 alkoxyl, trifluoromethyl, amino, mono- or di-(Cι~C
4) alkylamino; R
F' is H and a linear or branched C1-C
5 alkyl; e is 0 or 1; M is carbon or nitrogen atom; when c is equal to 1, d is equal to 1, R
B is hydrogen, R
A is selected from the group consisting of:
wherein R is H or CH
3 and Εr is Cl or F; when c is equal to 1, d is equal to 1 and R
B is CH
3, R
A is selected from the group consisting of:
when c is equal to 0, d is equal to 0, R
A is selected from the group consisting of:
lib)
RD is as above defined;
RG is selected from the group consisting of:
wherein R
H is phenyl or cyclohexyl; lid)
Y is a bivalent radical having the following meaning: a) - linear or branched C1-C20 alkylene, preferably having from 2 to 5 carbon atoms; cycloalkylene with 5 to 7 carbon atoms into cycloalkylene ring, the ring being optionally substituted with side chains R1, wherein R1 is linear or branched alkyl with from 1 to 10 carbon atoms, preferably CH3; b)
wherein n is an integer from 0 to 20, and nl is an integer from 1 to 20 as above defined; d)
wherein : nl is as defined above and n2 is an integer from 0 to 2;
X! -OCO- or -COO- and R is H or CH3;
wherein: nl, n2,R
? and Xi are as above defined; Y
1 is -CH2-CH2- or -CH=CH- (CH
2)n2-; f)
wherein: nl and R
? are as above defined, R
3 is H or COCH
3; with the proviso that when Y is selected from bivalent radicals mentioned under b) -f) , the -ONO2 group is linked to a -CH
2 group; g) R
2 R
2 —(CH-CH^X^CH-CHj- —(CH
2-CH-X
2)
n—CH
2-CH- R
2 R
2 wherein X
2 is -0- or -S-, n3 is an integer from 1 to preferably from 1 to 4, R
? is as above defined;
h)
wherein : n4 is an integer from 0 to 10; n5 is an integer from 1 to 10;
R4, R 5, R6, R7 are the same or different, and are H or straight or branched C1-C4 alkyl, preferably R4, R5, R6, R7 are H; and wherein the -ON02 group is bound to
-[C]„5
n5 being as defined above;
Y2 is a 5 or 6 member saturated, unsaturated or aromatic heterocyclic ring, containing one or more heteroatoms selected from nitrogen, oxygen, sulfur, and selected for example from
Non limiting examples of non-steroidal anti- inflammatory, analgesic and antipyretic drugs (A-OH or A-H) used in the present invention are:
Aspirin, Salicylic acid, Mesalamine, Acetylsalicylsalicylic acid, 5-amino-acetylsalicylic acid, Flunixin, Ketorolac, Tolfenamic acid, Niflumic acid, Mefenamic acid, Meclofenamic acid, Flufenamic acid, Enfenamic acid, Etodolac, Pirazolac, Tolmetin, Bromefenac, Fenbufen, Mofezolac, Diclofenac, Pemedolac, Sulindac, Indomethacin, Suprofen, Ketoprofen, Tiaprofenic acid, Fenoprofen, Indoprofen, Carprofen, Naproxen, Loxoprofen, Ibuprofen, Pranoprofen, Bermoprofen, CS-670, Zaltoprofen, Flurbiprofen, Tenoxicam, Piroxicam, Meloxicam, Lornoxicam, Paracetamol and Salacetamide. Preferably, the COX-2 inhibitors used in the present invention are selected from the group consisting of: Celecoxib, Valdecoxib, JTE-522 (Tilmacoxib) , COX-189 (Lumiracoxib) , Nimesulide, N- (4-nitro-2-cycloexyloxy- phenyl)methanesulfonanilide (NS-398) and N-[6-[(2,4- difluorophenyl) thio] -2, 3-dihydro-l-oxo-lH-inden-5-yl] - methanesulfonamide (L-745337) . The compounds of formula (I), according to the present invention, when they contain in the molecule one salifiable nitrogen atom, can be transformed into the corresponding salts by reaction in organic solvent such as acetonitrile, tetrahydrofuran with the corresponding organic or inorganic acid.
Examples of organic acids are: oxalic, tartaric, maleic, succinic, citric acid. Examples of inorganic acids are: nitric, hydrochloric, sulphuric, phosphoric acid. Salts with nitric or hydrochloric acid are preferred. The compounds of the invention which have one or more asymmetric carbon atoms can exist as the optically pure enantiomers, pure diastereomers, enantiomers mixtures, diastereomers mixtures, enantiomer racemic mixtures, racemates or racemate mixtures. Within the object of the invention are also all the possible isomers, stereoisomers and their mixtures of the compounds of formula (I) . The preferred compounds according to the present invention are those wherein: T = -0-, -NH-, -S- or -CO-;
A is selected from the group consisting of: Ha)
where c and d are independently 0 or 1;
RB is selected from the group consisting of H, a linear or branched C1-C12 alkyl; when c is equal to 0 , d is 1, RA is selected from the group consisting of:
wherein:
Rc is -OCOCH3 in ortho-position with respect to -CO- and RD is H; when c is equal to 1, d is equal to 1 and RB is CH3, RA is selected from the group consisting of:
when c is equal to 0, d is equal to 0, R
A is:
Y is a bivalent radical having the following meaning: a) linear Ci-Cδ alkylene, preferably having from 3 to 5 carbon atoms; b)
wherein n is an integer from 0 to 5, and nl is an integer from 1 to 5; d)
wherein : nl is as defined above and n2 is an integer from 0 to 2; Xi = -OCO- or -COO- and R
2 is H or CH
3;
e)
wherein: nl, n2,R and Xi are as above defined; Y
1 is -CH=CH-; f)
wherein : nl and R
2 are as above defined, R
3 is H or COCH
3; with the proviso that when Y is selected from bivalent radicals mentioned under b) -f) , the -ON0
2 group is linked to a -CH2 group; g
)
wherein X
2 is -0- or -S-, n3 is an integer from 1 to 4 , preferably 1 , R
7 is as above defined; h)
wherein : n4 is an integer from 0 to 3; n5 is an integer from 1 to 3;
R4, R5, R6, R7 are the same and are H; and wherein the -ONO2 group is bound to
■ [C]π3
Y is a 6 member saturated, unsaturated or aromatic heterocyclic ring, containing one or more atoms of nitrogen and selected for example from
(Y13! The preferred compounds of formula (I) for the use according to the present invention are the following:
(3)
(7) (CH
2)
3-ON0
2 o O H.C N
3 H (8)

The preparation of the compounds of formula (I) with the linking group Y of formula h) is described in published PCT application WO 00/51988, pages 28-31, in the name of the Applicant, herein incorporated by reference. When Y is selected from bivalent radicals mentioned under a)-c) and g) , the compounds of formula (I) can be obtained according to U.S. Pat. No. 5,861,426, pages 15-16, in the name of the Applicant, herein incorporated by reference. The preparation of the compounds of formula (I) with the linking group Y selected from bivalent radicals mentioned under d) -f) is described in published PCT application WO 00/61537, pages 49-59, in the name of the Applicant, herein incorporated by reference. The preparation of the compounds of formula (I) wherein A is selected from the groups lib) -lid) is described in not published application PCT/EP03/06502 pages 12-19, in the name of the Applicant, herein incorporated by reference. The compounds object of the present invention are formulated in the corresponding pharmaceutical compositions for parenteral, oral and topical use according to the techniques well known in the art, together with the usual excipients; see for example the volume "Remington's Pharmaceutical Sciences 15
th Ed.". The amount on a molar basis of the active principle in said formulations is the same, or lower, with respect to that used as anti-inflammatory, analgesic and antipyretic drug of the corresponding precursor drug. The daily administrable doses are those of the precursor drugs, or optionally lower. The daily doses can be found in the publications of the field, such as for example in "Physician's Desk reference".
The following examples are to further illustrate the invention without limiting it.
Example 1 Subconfluent monolayers of MDCK cells are grown Petri dishes (60 mm diameter) . Cells are infected with influenza virus A/NWS/33 (MOI=l, multiplicity of infection) , and three different concentrations of 4- (acetylamino)phenyl 4- (nitrooxy) butanoate (corresponding to compound (8)) (1 to 100 μM) were tested. Assays were performed in double for each concentration and compared to control non infected dishes . The viral replication after 24 hours infective cycle (preliminary results at 10 hours are available) was titrated by the plaque infectivity assay, using supernatant dilutions from 10_1 a 10"8 plus the undiluted supernatant. Results allowed to assess the antiviral activity of compound (8) in influenza virus A/NWS/33 -infected MDCK cells at 24 hours (and one evidence at 10 hours) post infection. Virus replication is assessed by infectivity plaque assay expressed as UFP/ml (UFP: unity forming plaque) and the obtained results, reported in Table 1, are expressed as % infectivity vs control.
Table 1
Furthermore, the effect of compound (8) on viral nucleoprotein (NP) expression and distribution in influenza virus A/NWS/33 -infected MDCK after a replication cycle of 10 hours is determined by immunoflurescence assay using a monoclonal antibody specific for NP. The obtained results, reported in Table 2, are expressed as % of the total. Table 2
ECP- = no cytopathic effect induced by the virus
4- (acetylamino)phenyl 4- (nitrooxy)butanoate (compound
(8) ) showed antiviral effect against human influenza virus (A/NWS/33 type) , reducing the viral production with a infective title ratio ranging from 3.5 (Exp 1) to 1.98 (Exp
2), with a mean of 2.74. Furthermore the anti-viral effect was reduced in a concentration dependent manner, suggesting specificity for the antiviral activity of compound (8) . The treatment with 100 μM of compound (8) for 10 hours after viral infection reduced the viral nucleoprotein expression by 20% of monolayer cells when compared to the control infection plates.