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Description  |
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This application is a 371 of PCT/DE94/00756 which is now published as WO
95/01168 on Jan. 12, 1995.
The present invention relates to a novel pharmaceutical preparation,
containing an active ingredient having at least one active amidine group,
and to its use.
In order to treat pneumocystis carinii pneumonia, which affects almost 70%
of all AIDS patients without prophylactic measures in the course of their
illness, it is known to use aqueous solutions of pentamidine diisethionate
with the aid of special atomisers in aerosol form. In this case this known
pentamidine diisethionate has a structure as illustrated by the following
formula P:
##STR2##
However, the known pentamidine isethionate has the disadvantage that when
applied orally it is poorly resorbed, and thus with this type of
administration cannot exert any pharmacological effect in the body. For
this reason the preparation has been given to the patients intramuscularly
or intravenously. The galenic formulations available for this, however,
have serious side-effects, which are to be ascribed to the form of
administration.
In intravenous administration, intense blood-pressure drop (hypotonia)
linked with malaise and vomiting, to the extent of unconsciousness, can
occur. Nor does intramuscular administration offer any particular
advantages, as frequently extreme pain at the point of injection, leading
to tissue necrosis, which require tedious follow-up treatment, are
observed.
These side-effects do not occur with the atomisation of pentamidine
diisethionate already described. However, only slight to mildly serious
cases of pneumocystis carinii pneumonia may be treated by atomisation, as
a severe attack renders inhalation of the aerosol impossible, or at least
extremely difficult. This form of administration also requires a high
degree of cooperation from the patient, as he must learn the correct
inhalation technique in order to achieve a uniform distribution of the
active ingredient, which is essential for successful therapy.
Some serious disadvantages, however, stand in the way of this form of
administration, with its low systemic stress and ensuing lower toxicity.
Each administration requires an ambulatory stay in hospital, during which
at least one doctor should be present as, in aerosol therapy, frequently
(in up to 15% of administrations), bronchial spasm can occur,
necessitating medical countermeasures. Also, pulmonary administration
requires a special atomiser which can generate a uniform particle size of
0.5 to 30 .mu.m in diameter.
Depending on the type of atomiser and on the type of setting for this
apparatus, sufficient concentrations of active ingredient frequently do
not reach the required locus of action.
Cases with extrapulmonary involvement cannot be treated in this way.
Connected with this, the recurrence rate of pneumocystis carinii pneumonia
is increased when proper, regular prophylactic aerosol therapy is not
carried out.
As stated above, pharmaceutical preparations containing pentamidine applied
orally have practically no pharmacological effect. An essential condition
for a therapeutic effect of an active ingredient given orally is its
take-up from the gastro-intestinal tract. The most important mechanism for
such membrane penetration in this case is passive diffusion. The degree of
resorption by way of passive diffusion is dependent on lipophily, and is
thus closely connected with the acidity or the basicity of the active
ingredient. An intensely basic compound such as pentamidine (pK.sub.4
=11.4) is present in the stomach (pH=1) and in the gut (pH=7.4) in an
almost totally ionised form. The molecule is hydrophilic during the entire
gastro-intestinal passage. Oral resorption, which is connected with
passage through a lipophilic membrane, therefore succeeds only to a very
restricted degree. The high basicity of pentamidine is to be ascribed to
its functional groups, i.e. the amidines. This is clearly the obstacle
which explains why in the past oral administration resulted in entirely
insufficient resorption and thus over a long period a very restricted
pharmacological effect.
It is presumed that clearly all active ingredients having an amidine as a
functional group reveal insufficient resorption when given orally.
Proceeding from this, the object of the present invention is to propose a
pharmaceutical preparation containing a pharmaceutically effective amidine
group which may be used orally.
This object is achieved by a pharmaceutical preparation with the
characterising features of Patent claim 1. The sub-claims indicate
advantageous further developments.
Accordingly, it is proposed according to the invention that the
pharmaceutical preparation uses the pharmaceutical active ingredient which
contains at least one amidine effective functional group in the form of at
least one compound of the following formulae:
##STR3##
R.sub.7 being an alkyl residue and/or an aryl residue. Amidoximes,
amidoxime esters and 1, 2, 4 oxadiazoles are now orally resorbed, and
converted back ("pro-drug" principle) by esterases and N reduction back
into the actual active forms, the amidines. Thus there is available for
oral administration an optimum medical form which may be used for the most
varied indications. The pharmaceutical preparation proposed gains
particular importance through the fact that the functional group amidines
is an essential component of active ingredients, of varying degrees of
importance, for various fields of appplication. Among others, the amidine
group is a component of the following active ingredients or classes of
ingredients: pentamidine, diminazen, isometamidium and thrombin
inhibitors. Active ingredients containing an active amidine group can
among other things be used for the following applications:
prophylaxis and therapy of visceral Leishmanioses and cutaneous
Leishmanioses;
prophylaxis and therapy of trypanosomiasis (African sleeping sickness);
prophylaxis and therapy of pneumonia caused by pneumocystis carinii (PcP);
inhibition of proteases, thrombin inhibitors, fibrinogen receptor
antagonists, platelet aggregation inhibitors;
inhibition of the growth of malign tumours (cancer chemotherapy);
lowering blood pressure;
N-methyl-D-aspartat receptor antagonists and thus neuroprotection.
The excellent resorptive capacity of the converted amidine functions in the
gastro-intestinal tract is clearly due to the greatly reduced basicity and
increased lipophily of the molecules of the active ingredient. As already
stated, take-up from the gastro-intestinal tract is important for a
therapeutic effect of an active ingredient after oral administration; this
is closely connected with the acidity or basicity of the active
ingredient. With chemical conversion of the amidine function as far as
amidoxime esters or oxadiazol, however, basicity is reduced to a
considerable degree. The PK.sub.2 value of amidine, which stands at 11,
drops when reaching amidoxime ester or oxadiazol to values beneath 5. The
percentage proportion of free bases at pH 7.4 thus rises from amidine at
zero to amidoxime ester or oxadiazol at 100. Thus in the gut, the main
locus of resorption for active ingredients, amidoxime or amidoxime ester
or oxadiazol, are present almost entirely in the form of free bases. In
parallel with the reduction in basicity, due to the conversion of the
amidine function undertaken, the lipophily of the corresponding active
ingredients increases. The pharmaceutical preparations with converted
amidine function proposed according to the invention thus show outstanding
oral resorption capacity, and thus clearly increase the pharmacological
effect of the amidine. The active ingredients proposed are not only
resorbable in the stomach and/or gut, but are also capable of overcoming
the blood/brain barrier. It is therefore sufficient if the active
ingredient contains at least one active amidine group in the proposed
form. The invention basically encompasses all active ingredients having at
least one amidine group.
Accordingly, the active ingredient can contain a plurality of amidine
groups (e.g. two with pentamidine); in that case at least one of these
groups is modified in the way described above. In exactly the same way,
mixtures of active ingredients may be used, insofar as at least on active
ingredient has an amidine group.
Preferred active ingredients are chosen from: pentamidine, diminazen,
isometamidium or thrombin inhibitors.
It is particularly preferred if the pharmaceutical preparation has an
active ingredient such as that illustrated by the following general
formula 1:
##STR4##
In formula 1, R.sub.1 and R.sub.6 are identical or different, on condition
however that R.sub.1 and R.sub.6 are not simultaneously an amidine group
and means the groupings:
##STR5##
R.sub.7 being hydrogen, an alkyl residue and/or an aryl residue, and its
salts. Furthermore, in formula I R.sub.2, R.sub.3, R.sub.4 and R.sub.5 are
identical or different and mean hydrogen, a --NO.sub.2 group, halogens
and/or an OR.sub.3 grouping; R.sub.3 in this case can be hydrogen and/or
an alkyl group. X and Y, which may be identical or different, stand in
formula I for oxygen, nitrogen or sulphur, while n is a whole number
between 0 and 8.
It was discovered, surprisingly, that the pharmaceutical preparation
according to the invention containing the active ingredient named above
and shown in formula I has excellent prophylactic and therapeutic
properties when the preparation according to the invention is used for
prophylaxis and/or therapy of pneumocystis carinii pneumonia. In
particular, it became apparent that the active ingredient shown in formula
I does not possess the disadvantages already described in connection with
the known pentamidine isethionate, and thus for example causing no tissue
necrosis and hypotension when the pharmaceutical preparation according to
the invention containing the active ingredient named above and shown in
formula I is administered in a manner other than by atomisation. In
addition, such an oral administration has the added advantage that the
active ingredient contained in the pharmaceutical preparation according to
the invention may be particularly simply and reproducibly dosed so that
accordingly prophylaxis and/or therapy upon using the pharmaceutical
preparation according to the invention is considerably improved. Salts of
the active ingredient according to formula I also reveal a comparable
effect.
In a further, particularly advantageous embodiment of the pharmaceutical
preparation according to the invention, the preparation according to the
invention has an active ingredient as shown above by the general formula
I; in this embodiment, R.sub.1 and R.sub.6 are not simultaneously
identical or different, and mean the groupings:
##STR6##
if n=5 and R.sub.2 and R.sub.5 are hydrogen, and if x and Y are identical,
and mean oxygen.
Such an embodiment of the preparation according to the invention is
particularly characterised in that, in comparison with pentamidine
diisethionate, it has a greater lipophily and a lower basicity, and thus
is orally resorbable and XNS-accessible, considerably improving the
possibility of therapy and/or prophylaxis.
A further, likewise advantageous embodiment of the pharmaceutical
preparation according to the invention has an active ingredient in which,
in formula I, R.sub.1 and R.sub.6 are identical or different and mean the
grouping:
##STR7##
R7 being hydrogen, and alkyl residue and/or an aryl residue, and their
salts.
Particularly when the active ingredient shown in formula I and contained in
the pharmaceutical preparation according to the invention has a chemical
structure in which R.sub.7 means, in the general formulae:
##STR8##
a C.sub.1 -C.sub.4 alkyl group, particularly a methyl group, or a C.sub.12
-C.sub.18 alkyl residue, the pharmaceutical effectiveness of such a
preparation is yet further improved, so that accordingly the concentration
of the active ingredient in the pharmaceutical preparation is reduced, or
the daily dose to be administered can be reduced.
As already stated with respect to the preparation according to the
invention, in the formula I R.sub.1 and R.sub.6 can be identical or
different. Particularly when R.sub.1 and R.sub.6 are identical in formula
I, an active ingredient built up in this way may be particularly easily
synthesised, as in this way costly isolation of such an active ingredient
may be eliminated by synthesis.
As already stated, in the general formula I n can mean a whole number
between 0 and 8. Preferably, however, the preparation according to the
invention has a structure in which n stands for a whole number between 2
and 6.
In another advantageous further development of the preparation according to
the invention, characterised by an extremely high degree of pharmaceutical
effectiveness and facility for simple synthesis of the active ingredient
of the general formula I, R.sub.2, R.sub.3, R.sub.4 and/or R.sub.5 mean an
OCH.sub.3 group.
The concentration of the active ingredient in the pharmaceutical
preparations according to the invention depends on the respective case of
administration and on the daily dosage. The preparation according to the
invention preferably has the active ingredient according to formula I in a
concentration between 0.01% by weight and 50% by weight, particularly in a
concentration between 1% by weight and 20% by weight.
In the above it has always been a matter, in connection with the
pharmaceutical preparation according to the invention, of the preparation
according to the invention containing the active ingredient. Naturally,
however, it is also possible to provide here a mixture of active
ingredients.
In the oral administration according to the invention it is now ensured to
a particular degree that the active ingredient can be reproducibly dosed;
this has a decisive influence on therapy and prophylaxis in the treatment
of pneumocystis carinii pneumonia. Furthermore, oral administration
ensures that even severe cases with extrapulmonary involvement, which may
not be treated, or only with difficulty, by aerosol, can now be made
accessible to therapy.
It also became apparent, surprisingly, that the pharmaceutical preparation
according to the invention can be used not only for prophylaxis and/or
therapy of pneumocystis carinii pneumonia, but also for prophylaxis and/or
therapy of animal or human trypanosome infections and/or of Leishmanioses.
Here also oral administration of the pharmaceutical preparation according
to the invention is indicated; in this oral administration, surprisingly,
the side-effects already described with respect to pentamidine isethionate
do not occur.
This high degree of effectiveness of the pharmaceutical preparation
according to the invention, as already described, is ascribed to the fact
that the active ingredient in formula I, due to its lower basicity and
higher lipophily compared to pentamidine diisethionate, is resorbed to a
large extent when administered orally during its passage through the
gastro-intestinal tract. During or after completed resorption,
metabolisation takes place in the body, to provide the corresponding
diamidine or diamidine derivate which due to its hydrophily in oral
administration would not be resorbed, or only slightly, in the
gastro-intestinal tract, but otherwise has the desired pharmaceutical
effectiveness.
The metabolisation briefly described above, and taking place in vivo, of
the pharmaceutical preparation according to the invention, may be
diagrammatically illustrated by the layout reproduced in the following,
using the example of variants of embodiments of the pharmaceutical
preparations according to the invention.
##STR9##
A particularly suitable embodiment of the pharmaceutical preparations
according to the invention has an active ingredient as characterised by
the formulae II, III or IV shown below:
##STR10##
These special embodiments of the pharmaceutical preparations according to
the invention, which contain the active ingredients according to the above
formulae II to IV, may be used orally with outstanding success in the
treatment and/or prophylaxis of pneumocystis carinii pneumonia and/or
Leishmanioses, trypanosome infections and/or as cytostatics.
Basically it should be noted with respect to the active ingredients
contained in the preparation according to the invention, for example as
shown by the general formulae I to IV, that the improved pharmaceutical
effect of the claimed preparation according to the invention is ascribed
among other things to the fact that the preparation according to the
invention is clearly capable of overcoming the blood-brain barrier. This
in turn means that with the pharmaceutical preparations according to the
invention, particularly also in the embodiment described above and
containing an active ingredient according to formulae II to IV, also
successfully fight exciters which have attacked the patient's central
nervous system; this is not possible with the known pentamidine
diisethionate.
Thus the pharmaceutical preparation according to the invention makes
available an effective agent for treatment of central nervous system forms
of trypanosome infections, this agent not having the high toxicity of the
arsenic-containing therapeutic means previously used for this purpose.
The form for oral administration may be prepared as a liquid, semisolid or
solid preparation, particularly as tablets, sugar-coated pills, pellets or
microcapsules. In this respect for embodiments in which liquid
preparations are used, the active ingredient of mixture of active
ingredients can be accommodated in a suitable non-toxic solvent such for
example as water, univalent alcohols, particularly ethanols, multivalent
alcohols, particularly glycerine and/or propandiol, polyglycols,
particularly polyethylene glycols and/or miglycol, glycerine methylal,
dimethylisosorbite, natural and/or synthetic oils and/or esters.
For the manufacture of semisolid or solid preparations, the conventional
basic fillers may be used, such for example as bentonite, veegum, guar
flour and/or cellulose derivatives, particularly methyl cellulose and/or
carboxymethyl cellulose, as well as polymers from vinyl alcohols and/or
vinyl pyrrodilones, alginates, pectins, polyacrylates, solid and/or liquid
polyethyl glycols, paraffins, fatty alcohols, vaseline and/or waxes, fatty
acids and/or fatty-acid esters. Also, fillers known per se may be
contained in solid preparations, such for example as colloidal silicic
acids, talcum, lactose, starch powder, sugar, gelatine, metallic oxides
and/or metallic salts. Further possible additives are stabilisers,
emulsifiers, dispersants and preservatives.
Advantageous further developments of the preparation according to the
invention are indicated in the sub-claims.
The preparation according to the invention will be explained in more detail
in the following with reference to embodiments given by way of example.
EMBODIMENT 1
##STR11##
1 g of 4, 4'-pentamethylenedioxydibenzamidoxim was slowly mixed with
approx. 10 ml freshly-distilled acetic anhydride, and left stirring for an
hour at room temperature. At the end of the reaction the excess acetic
anhydride was hydrolised with water. The resultant precipitate was fritted
off and washed with 5 ml of 3n ammonia solution. The precipitate thus
treated was washed with demineralised water until no further ammonia odour
was discernible. Finally the precipitate was dried for one hour at
100.degree. C. in a drying cabinet and recrystallised from acetonitrile.
______________________________________
Yield: 590 mg (48% of the theoretical yield),
fine colourless needles
Melting.: 152.degree. C.
IR Data KBr--: 3500 (NH), 1752 (COOR), 1620
Compact in cm.sup.-1 :
(C.dbd.N)
1.sub.H -NMR Data:
1.61 l (quint, 2H, --CH.sub.2 --); 1.81
400 MHZ spectrum:
(quint, 4H, 2-CH.sub.2 .dbd.); 2.15 (S, 6H,
(›D.sub.6 !-DMSO) in ppm
2-CO--CH.sub.3), 4.05(t, 4H, 2CH.sub.2 --
O); 6.7(s, 4H, 2 HN.sub.2); 7.34
(mc, AA' BB', 8H, aromatics-H)
.sup.13 C-NMR Data:
21.47(--CO--CH.sub.3); 23.77(--CH.sub.2);
400 MHZ spectrum
29.94(--CH.sub.2 --); 69.13(--O--CH.sub.2);
(›D.sub.6 !-DMSO) in ppm
115.71(c-3 c-3'); 125.18
(--C.dbd.N--); 129.72(c-2, c02');
157.69(C-4); 161.95(C-1);
170.15(--O--CO--CH.sub.3)
C.sub.23 H.sub.28 O.sub.6 N.sub.4 (456.45)
Rep. C 60,52% H6, 18% N 12.27%
Found. C 60, 58% H 6, 15% N 12.65%
______________________________________
EMBODIMENT 2
##STR12##
1 g of 4, 4'-pentamethylenedioxydibenzamidoxin were mixed with 10 ml
freshly-distilled acetic anhydride and heated for 5 minutes with reflux.
After cooling and hydrolysis of the excess acetic anhydride, a light
yellow-coloured raw product was obtained, which was cleaned
column-chromatographically (silica gel 60--CHCl.sub.3 /MeOH (V:V, 9:1),
and was then recrystallised out of absolute ethanol.
______________________________________
Yield: 677 mg (60% of theoretical yield),
fine, colourless needles.
Melting: 137.degree. C.
IR data (KBr--:
1620(C.dbd.N), 1275(C--O--C)
compact in cm.sup.-1
1H-NMR data: 1.69(quint, 2H, --CH.sub.2 --); 1.90
400 MHZ spectrum:
(quint, 4H, --CH.sub.2 --); 2.63(s,
(CDC13) in ppm
6H, --CH.sub.3), 4.06(t, 4H, --O--CH.sub.2 --),
7.48(mc, AA', BB', 8 aromatics H)
.sup.13 C-NMR data:
12.31(--CH.sub.3); 22.65(--CH.sub.2);28.37
400 MHZ spectrum
(--CH.sub.2); 67.78(--OCH.sub.2 --)114.69
(CDCl.sub.3) in ppm
C-3, C-3'); 119.11
(--C.dbd.N--); 128.88(C-2, C-2');
161.30(C-4); 168.4(C-1);
176.18'(CH.sub.3 --C.sup.N O)
C.sub.23 H.sub.34 O.sub.4 N.sub.4
Rep. C 65.70% H 5.75% N 13.32%
Found. C 65.91% H 5.72% N 13.71%
______________________________________
EMBODIMENT 3
##STR13##
1g of diacetyl-4, 4'-pentamethylenedioxydibenzamidoxim were dissolved in
100 ml of a solvent mix consisting of chloroform -methanol in a volume
ratio of 9:1, and mixed with 5 g of pig pancreas lipase (PPL) (Company
Sigmfa, type crude), and left stirring at room temperature. The reaction
was pursued by thin-layer chromatography (silica gel--CHCl.sub.3 /eOH
(9:1)) and interrupted as soon as pentamethylenedioxydibenzamidoxim had
formed. Thereafter the lipase was filtered off and the clear filtrate
saturated with oxalic acid, and mixed with a threefold volume of ether.
The preparation was left to stand overnight in a refrigerator. The
precipitated product was dissolved in chloroform/methanol (V;V 9:1) and
cleaned by column chromatography (silica gel, chloroform/methanol (V;V
9:1)).
______________________________________
Yield: 40 mg (4.4% theoretical yield)
Melting: 110.degree. C.
IR data (KBr--:
3510(NH), 3375(NH), 3200(OH), 1750
compact) (CH.sub.3 --COOR), 1670(C.dbd.N--OH), 1620
in cm.sup.-1 (C.dbd.N--O--COCH.sub.3)
.sup.1 H-NMR data:
1.60(quint, 2H; CH.sub.2), 1.82
(›D.sub.6 !-DMSO) in ppm
(quint, 4 H, CH.sub.2), 2.15(s,
3 H, --COCH.sub.3); 4.06(t, 4 H,
--O--CH.sub.2); 6.65(s, 2 H, NH.sub.2);
6.71(s, 2 H, NH.sub.2); 7.32
(mc, AA'BB', 4 H, aromatics H),
7.34 (mc, AA'BB', 4 H, aromatics
H); 10-12 (bs, 1 H, OH)
.sup.13 c-NMR data:
19.90(CH.sub.3 --); 22.18(--CH.sub.2 --);
(›D.sub.6 !-DMSO) in ppm
28.23,(--CH.sub.2 --); 67.54(--O--CH.sub.2 --);
67.72(--O--CH.sub.2); 114.13(C3',
C3"); 114.32(C3, C3'), 122.31
(C.dbd.N--OH); 122.59(C.dbd.N--OCOR);
127.86(C2', C2"); 128.13(C2,
C2'); 156.10(C4); 160(C4');
160.51(C1); 162.57(C1'); 168.56
(O--COCH.sub.3)
C.sub.21 H.sub.26 O.sub.5 N.sub.4 (414.45):
Rep. C 60, 85% H 6.27% N 13.51
Found. C 60.51% H 6.20% N 13.91%
______________________________________
On the basis of the analytical data given above it can be ascertained that
the products manufactured according to embodiments 1 to 3 have a chemical
structure such as that shown above by the formulae A, B and C.
In order to prove their pharmaceutical effectiveness, the products
described above were tested for their action against pneumocystis carinii.
For this purpose female Sprague-Dawley rats with an average weight of 200
to 220 g were given medicated drinking water containing 1.5 mg
dexamethason and 10 mg ofloxazin per litre for a period of 8 weeks. At the
end of this preliminary medication, a group of the animals were given
bronchial lavage under nembutal narcosis to ascertain whether infection
with pneumocystis carinii was present. The lavage material was centrifuged
at 3,000 rpm, 10 .mu.l of the resuspended product was dripped on to a
specimen slide and allowed to dry in the air. The substances thus prepared
were subjected to Giemsa rapid pigmentation and were microscopically
examined. When an infection with pneumocystis carinii was detected,
testing of the active ingredient could begin.
The animals were treated for 10 days with the active ingredients to be
tested. At the end of this test period bronchial lavage was undertaken on
the animals under nembutal narcosis. This lavage fluid was processed with
the aid of the pneumocystis direct indication test of the company Progen
(Progen Biotechnik GmbH, Heidelberg). In this test fluorescein
isothiocyanate-marked monoclonal antibodies react with pneumocystis
carinii in various development stages, and thus become visible in the
fluorescence microscope. In accordance with an evaluation scale which
extends in six graduations from 0 to 100, the degree of infection of the
respective lavage fluid was determined microscopically.
The result of Compound 1 (Embodiment 1, formula A) is shown in comparison
to the known pentamidine isethionate.
TABLE 1
______________________________________
Evaluation of Test for Effectiveness against Pneumocystis
______________________________________
carinii.
No. of substs.
No. of
tested Animals Microscopic Evaluation
______________________________________
1 9 ++, ++, +, +, +-, +-, + -, +-, (+)
2 11 -, (+), ++, +, ++, +, (+), +-, +,
++, +-
3 10 +, ++, +-, +-, +, +-, ++, +++,
+++, ++
4 11 ++, +++, ++, ++, +++, ++, +++,
+++, +++, +++
5 11 ++, +++, ++, ++, +, ++, +, +, ++,
+,+
6 19 ++, ++, +++, ++, ++, ++, +-, +,
++, ++, ++, +, ++, ++, ++, +++,
+++, +. +++
7 10 -, (+), -, -, -, -, (+), -, -, -
______________________________________
1 = diacetyl-4,4'-Pentamethylendioxidebenzamidoxim;
23 mg/kg - oral (pre-dissolved in 5% DMSO and filled with 0,04
Tylose; Formula A, Embodiment 1).
2 = pentamidine isethionate in distilled water; 20 mg/kg- i.m.
3 = pentamidine isethionate in distilled water; 40 mg/kg- i.m.
4 = pentamidine isethionate in distilled water; 20 mg/kg - oral
5 = pentamidine isethionate in distilled water; 40 mg/kg - oral
6 = untreated animals, immunosuppressed by dexamathason
premedication
7 = untreated animals, not immunosuppressed
______________________________________
Evaluation Table:
______________________________________
+++ = 100 infection
++ = 75
+ = 50
+- = 25
(+) = 10
- = 0
______________________________________
No. tested
No. of Median Standard
Reduction
substances
Animals value dev. (in %)
______________________________________
1 9 40 24 44.6
2 11 45 25 37.7
3 10 60 29 16.9
4 11 82 30 --
5 11 66 17 8.7
6 19 72 19 --
7 10 2 4 --
______________________________________
As is to be seen from Table 1, compound 1 reveals substantially greater
effectiveness against pneumocystis carinii than the known pentamidine
isethionate. It is particularly noteworthy that compound 1 when applied
orally showed high effectiveness, whereas the known pentamidine
isethionate only had any therapeutic effect when applied parenterally.
In order to illustrate the effectiveness of the compound 1 own above
(Embodiment 1, Formula A) against trypanosome infections, the test shown
below was carried out. In this case effectiveness against the following
was investigated:
the animal-pathogenic exciters trypanosoma brucei,
trypanosoma vivax, trypanosoma congolense and trypanosoma evansi, as well
as the exciter of human sleeping sickness,
trypanosoma rhodesiense.
Tests were carried out on a mouse model, the known pentamidine isethionate
serving as a comparative substance. The substance to be tested was
administered subcutaneously to the animals infected with the respective
trypanosoma lines. As a control, the same number of infected animals was
left untreated. After observation for 3 weeks, the number of cured
animals, the dosis curativa (D. A.), the relapse dose (R. D.) and the
inhibitor dose (H. D.) were determined. The results of these tests are
given by way of example in tables 2 to 6; further detailed data on the
test methods used are also to be found in these tables.
TABLE 2
______________________________________
Effect of Diacetyl-4,4'-Pentamethylendioxydibenzami-
doxim (1) against Trypanosoma brucei (line 8/18) in the NMRI
______________________________________
mouse
Test Animal:
Albino mouse (HOE; NMRKF; SPF 71),
KGW 17-18 g
Inoculation:
1 .times. 10.sup.5 Trypanosomes from N.sub.2 Stability per
mouse,
intraperitoneally
Treatment:
2 .times. subcutaneous (1 h before, 1 h after infection)
Test Duration:
21 days
______________________________________
Dose Survival times
No. of
Preparation
mg/kg days after animals
(solubility)
base infection cured/in all
Effect
______________________________________
1 30 21 21 21 21 21 5/5 DC
(DMSO-MEIS-
10 21 21 21 21 21 5/5 DC
embryo oil)
3 21 21 21 21 21 5/5 DC
1 10 12 20 21 21 2/5 RD
Pentamidin-17
(10) 21 21 21 21 21 5/5 DC
Isethionate 5.2
(3) 21 21 21 21 21 5/5 DC
(a. dist.) 1.7
(1) 21 21 21 21 21 5/5 DC
infected 0 5 5 5 5 5 0/5 --
untreated
controls (IK)
______________________________________
DC = dosis curativa
RD = relapse dose
TABLE 3
______________________________________
Effect of Diacetyl-4,4.sup.1 -Pentamethylendioxydibenzamidoxim (1)
against Trypanosoma vivax (line Zaria Y58) in the NMRI mouse.
______________________________________
Test Animal:
Albino mouse (HOE; NMRKF; SPF 71),
KGW 18-20 g
Inoculation:
1 .times. 10.sup.4 Trypanosoma from N.sub.2 stabilisate per
mouse intraperitoneally
Treatment:
1 .times. subcutaneous (2 days after infection)
Test duration:
25 days
______________________________________
Dose Survival times
No. of
Preparation
mg/kg days after animals
(solubility)
base infection cured/in all
Effect
______________________________________
1 30 21 21 21 21 21 0/5 DC
(DMSO- 15 17 17 21 21 0/5 HD
Meis-10
embryo oil
3 10 10 14 21 21 0/5 ineffect-
ive
Pentamidine-52
(30) 21 21 21 21 21 5/5 DC
isethionat 17
(10) 21 21 21 21 21 5/5 DC
(A.dist.) 5,2
(3) 20 21 21 21 21 3/5 RD
1.7 (1) 15 21 21 21 21 0/5 HD
Infected 0 9 13 15 21 21 0/5 --
untreated
Controls (IK)
______________________________________
DC = Dosis curativa
RD = Relapse dose
HD = inhibiting dose.
TABLE 4
______________________________________
Effect of Diacetyl-4,4'-Pentamethylenedioxydibenzamidoxim
(1) against Trypanosoma evansi (line Bogor) in the NMRI
______________________________________
mouse.
Test Animal:
Albino mouse (HOE; NMRKF; SPF 71), KGW 18-20 g
Inoculation:
1 .times. 10.sup.4 Trypanosomes from N.sub.2 stabilisate
per mouse intraperitoneally
Treatment:
1 .times. subcutaneous (2 days after infection)
Test duration:
21 days
______________________________________
Dose Survival times
No. of
Preparation
mg/kg days after animals
(solubility)
base infection cured/in all
Effect
______________________________________
1 30 3 3 3 3 4 0/5 HD
(Dmso Meis
10 3 4 4 4 4 0/5 HD
embryo oil
3 3 3 3 4 5 0/5 HD
Pentamidine-52
(30) 6 8 8 9 21 1/5 RD
Isethionate 17
(10) 5 5 5 5 5 0/5 HD
(A. dist.)
Infected 0 2 2 2 3 4 0/5 --
untreated
Controls (IK)
______________________________________
DC = Dosis curativa
RD = relapse dose
HD = inhibiting dose
TABLE 5
______________________________________
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