NEUROGENESIS BY MUSCARINIC RECEPTOR MODULATION
The instant disclosure describes methods for treating diseases and conditions of the central and peripheral nervous system by stimulating or increasing neurogenesis. The disclosure includes compositions and methods based on muscarinic receptor modulation, such as via inhibition of acetylcholine esterase (AChE) activity, alone or in combination with another neurogenic agent to stimulate or activate the formation of new nerve cells.
1 . A composition comprising a muscarinic receptor modulator or an AChE inhibitor, in combination with one or more neurogenic agent or neurogenic sensitizing agent.
2 . The composition of claim 1 wherein the muscarinic receptor modulator is of Formula I
R 1 is hydrogen, substituted or unsubstituted C 1 -C 3 alkyl, substituted or unsubstituted C 3 -C 6 cycloalkyl, substituted or unsubstituted C 2 -C 4 alkenyl, substituted or unsubstituted C 2 -C 4 alkynyl; and
R 2′ and R 3′ are hydrogen, or together as depicted by the dotted line form a double bond; and
R 2 is hydrogen, substituted or unsubstituted C 1 -C 3 alkyl, substituted or unsubstituted C 3 -C 6 cycloalkyl, substituted or unsubstituted C 2 -C 4 alkenyl, C 2 -C 4 alkynyl, substituted C 2 -C 4 alkynyl, or of formula (a) below wherein;
R 5 is OR 9 , OCOR 10 , or NR 11 R 12 , wherein R 9 is substituted or unsubstituted C 1 -C 4 alkyl, substituted or unsubstituted C 2 -C 4 alkenyl; R 10 is hydrogen, substituted or unsubstituted C 1 -C 4 alkyl, substituted or unsubstituted C 2 -C 4 alkenyl; and R 11 and R 12 are independently hydrogen, substituted or unsubstituted C 1 -C 4 alkyl; and
R 6 is hydrogen, a halogen, OR 9 , SR 9 , CN, substituted or unsubstituted C 1 -C 3 alkyl, substituted or unsubstituted C 3 -C 5 cycloalkyl, or of the formula —(CH 2 ) m —R 13 wherein R 13 is selected from a halogen, OH, SH, OR 9 , SR 9 , CN, substituted or unsubstituted C 1 -C 3 alkyl, substituted or unsubstituted C 3 -C 5 cycloalkyl, and m is 1 or 2; or
alternatively, R 1 and R 2′ , or R 1 and R 3′ together form a bridge of formula —(CH 2 ) n — wherein n is 1, 2, or 3; or
R 1 and R 2 , when taken together form a bridge of formula —(CH 2 ) n — where n is selected from 1, 2 or 3; and
R 3 is hydrogen or of formula (a) as described above or of formula (b) described below wherein;
Ar is a substituted or unsubstituted aryl, a substituted or unsubstituted heteroaryl ring system; and
R 7 and R 8 are independently hydrogen, alkyl, substituted alkyl, alkenyl, substituted alkenyl, alkynyl, substituted alkynyl, cycloalkyl, substituted cycloalkyl, alkoxy, substituted alkoxy, alkozyaryl, alkoxyalkenyl, alkoxyalkynyl, alkylthio, substituted alkylthio, alkylaryl or alkenyl-N—O-alkyl; and
R 4 is hydrogen, substituted or unsubstituted C 1 -C 3 alkyl, substituted or unsubstituted C 3 -C 6 cycloalkyl, substituted or unsubstituted C 2 -C 4 alkenyl, substituted or unsubstituted C 2 -C 4 alkynyl.
3 . The composition of claim 2 , wherein the muscarinic receptor modulator is sabcomeline, milameline, xanomeline, oxotremorine or pharmaceutically acceptable salts or solvates thereof.
4 . The composition of claim 1 wherein the AChE inhibitor is of Formula II
R 14 , R 15 , R 16 and R 17 are independently hydrogen, halogen, nitrile, nitro, substituted or unsubstituted C 1 -C 3 alkyl, substituted or unsubstituted C 3 -C 6 cycloalkyl, substituted or unsubstituted C 2 -C 4 alkenyl, C 2 -C 4 alkynyl, substituted C 2 -C 4 alkynyl, C 1 -C 6 alkoxy, or substituted C 1 -C 6 alkoxy; and
R 18 is hydrogen, C 1 -C 10 alkyl, substituted C 1 -C 6 alkyl, C 1 -C 3 alkylaryl or in some cases R 18 forms a chain of formula —(CH 2 ) o — acting as a linker connecting 2 compounds of formula II above, wherein o is selected from 6, 7, 8, 9 or 10; and
R 19 and R 20 together form the following radicals,
wherein
R 21 is hydrogen, hydroxyl, OR 9′ or C 1 -C 4 alkyl wherein R 9′ is a C 1 -C 4 alkyl; and
p is 0, 1, 2 or 3; and
X is CH 2 , CH 2 CH 2 , or CH 2 O and the dashed lines represent optional double bonds.
5 . The composition of claim 1 wherein the AChE inhibitor is of Formula IV
R 25 and R 26 are independent and selected from hydrogen, substituted or unsubstituted C 1 -C 6 alkyl, substituted or unsubstituted C 3 -C 8 cycloalkyl, substituted or unsubstituted C 2 -C 6 alkenyl, substituted or unsubstituted C 2 -C 6 alkynyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, or alternatively, R 25 and R 26 , together with the atoms to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring; and
Ar 1 is an aryl, substituted aryl, heteroaryl, substituted heteroaryl, cycloalkyl or substituted cycloalkyl.
6 . The composition of claim 1 wherein the AChE inhibitor is of Formula V
Ar 2 is an aryl, substituted aryl, heteroaryl, substituted heteroaryl, cycloalkyl or substituted cycloalkyl ring; and
s is 1 or 2; and
t is selected from 1, 2, or 3; and
R 38 is hydrogen, alkyl, substituted alkyl, acyl, substituted acyl, cycloalkyl, substituted cycloalkyl, alkenyl, substituted alkenyl, alkynyl, substituted alkynyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, cycloheteroalkyl, substituted cycloheteroalkyl, NR 39 R 40 , NR 39 COR 41 , COR 41 or alkyl-COR 41 ; wherein
R 39 , R 40 , and R 41 are independent and selected from hydrogen, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, substituted alkenyl, alkynyl, substituted alkynyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, cycloheteroalkyl or substituted cycloheteroalkyl.
7 . The composition of claim 1 , wherein, the AChE inhibitor is tacrine, donepezil, rivastigimine, physostigmine, neostigmine, phenserine or pharmaceutically acceptable salts or solvates thereof.
8 . The composition of claim 1 wherein the neurogenic agent is a 5HT1a agonist, a natural product, a PPAR agonist and the neurogenic sensitizing agent is melatonin or a melatonin analog.
9 . The composition of claim 4 wherein the 5HT1a agonist is buspirone, the natural product is folic acid, the PPAR agonist is rosiglitazone and the melatonin analogs are 2-iodomelatonin and 6-chloromelatonin.
10 . The composition of claim 1 , wherein the muscarinic receptor modulator or AChE inhibitor, in combination with one or more neurogenic agent or neurogenic sensitizing agent are in a pharmaceutically acceptable formulation.
11 . The composition of claim 1 , wherein the combination is sabcomeline and melatonin; milameline and melatonin; xanomeline and melatonin; oxotremorine and melatonin; sabcomeline and buspirone; sabcomeline and folic acid; sabcomeline and rosiglitazone; donepezil and buspirone; donepezil and melatonin; donepezil and 2-iodomelatonin; donepezil and 6-chloromelatonin; tacrine and melatonin; tacrine and buspirone; tacrine and rivastigmine; galantamine and melatonin; rivastigmine and melatonin; rivastigmine and 2-iodomelatonin; or rivastigmine and 6-chloromelatonin.
12 . A method for stimulating or increasing neurogenesis in a cell or tissue, comprising contacting the cell or tissue with a composition of claim 1 , wherein the composition is effective to stimulate or increase neurogenesis in the cell or tissue.
13 . The method of claim 12 , wherein the cell or tissue is in an animal subject or a human patient.
14 . The method of claim 13 , wherein the patient is in need of neurogenesis or has been diagnosed with a disease, condition, or injury of the central or peripheral nervous system.
15 . The method of claim 12 , wherein the neurogenesis comprises differentiation of neural stem cells (NSCs) along a neuronal lineage.
16 . The method of claim 12 , wherein the neurogenesis comprises differentiation of neural stem cells (NSCs) along a glial lineage.
17 . The method of claim 12 , wherein the cell or tissue exhibits decreased neurogenesis or is subjected to an agent which decreases or inhibits neurogenesis.
18 . The method of claim 13 , wherein the subject or patient has one or more chemical addiction or dependency.
19 . A method of treating a nervous system disorder, wherein the nervous system disorder is related to cellular degeneration, a psychiatric condition, cognitive impairment, cellular trauma or injury, or another neurologically related condition in a subject or patient, the method comprising administering the composition of claim 1 to a subject or patient in need thereof, wherein the composition is effective to treat the nervous system disorder in the subject or patient.
20 . The method of claim 19 , wherein the cellular degeneration is a neurodegenerative disorder, a neural stem cell disorder, a neural progenitor cell disorder, an ischemic disorder, or a combination thereof.
21 . The method of claim 20 , wherein the neurodegenerative disorder is a degenerative disease of the retina, lissencephaly syndrome, or cerebral palsy, or a combination thereof.
22 . The method of claim 19 , wherein the psychiatric condition is a neuropsychiatric disorder, an affective disorder, or a combination thereof.
23 . The method of claim 22 , wherein the neuropsychiatric disorder is schizophrenia.
24 . The method of claim 22 , wherein the affective disorder is a mood disorder, an anxiety disorder or a combination thereof.
25 . The method of claim 24 , wherein the mood disorder is a depressive disorder.
26 . The method of claim 25 , wherein the depressive disorder is depression, major depressive disorder, depression due to drug and/or alcohol abuse, post-pain depression, post-partum depression, seasonal mood disorder, or a combination thereof.
27 . The method of claim 24 , wherein the anxiety disorder is general anxiety disorder, post-traumatic stress-disorder (PTSD), obsessive-compulsive disorder, panic attacks, or a combination thereof.
28 . The method of claim 20 , wherein cognitive impairment is due to a memory disorder, memory loss separate from dementia, mild cognitive impairment (MCI), age related cognitive decline, age-associated memory impairment, cognitive decline resulting from use of general anesthetics, chemotherapy, radiation treatment, post-surgical trauma, therapeutic intervention, cognitive decline associated with Alzheimer's Disease or epilepsy, dementia, delirium, or a combination thereof.
29 . The method of claim 19 , wherein the cellular trauma or injury is a neurological trauma or injury, brain or spinal cord trauma or injury related to surgery, retinal injury or trauma, injury related to epilepsy, brain or spinal cord related injury or trauma, brain or spinal cord injury related to cancer treatment, brain or spinal cord injury related to infection, brain or spinal cord injury related to inflammation, brain or spinal cord injury related to environmental toxin, or a combination thereof.
30 . The method of claim 19 , wherein the neurologically related condition is a learning disorder, autism, attention deficit disorder, narcolepsy, sleep disorder, epilepsy, temporal lobe epilepsy, or a combination thereof.