LDH inhibitors as treatment for fibrosis and fibrotic-related disorders

1. A method of treating a fibrotic condition in an individual, said method comprising:

administering to an individual having a fibrotic condition an effect amount of a lactic dehydrogenase (LDH) inhibitor, wherein the fibrotic condition involves an internal organ or tissue, or ocular tissue, and said administering is effective to treat the fibrotic condition, and wherein the fibrotic condition is not a cancerous proliferative disorder, idiopathic arthrofibrosis, or dermatological scarring.

2. The method according to claim 1 , wherein the method consists of said administering.

3. The method according to claim 1 , wherein the method excludes administration of a cancer therapy.

4. The method according to claim 1 , wherein the LDH inhibitor is an LDH5 inhibitor.

5. The method according to claim 1 , wherein the LDH inhibitor is an RNAi specific for LDH, oxamate, gossypol, galloflavin, 3-hydroxyisoxazole-4-carboxylic acid (HICA), 4-hydroxy-1,2,5-thiadiazole-3-carboxylic acid (HTCA), a derivative of 8-deoxyhemigossylic (2,3-dihydroxynaphtalen-1-carboxylic) acid, an N-hydroxyindole-based inhibitor designated FX11, or elesclomol.

6. The method according to claim 1 , wherein the LDH inhibitor is a compound according to formula (I):

wherein:

n is selected from the group consisting of: 0 and 1;

X is selected from the group consisting of: N, N + —O − , and C—Z;

Y is selected from the group consisting of: S, O, and C=R 2 ;

Z is selected from the group consisting of: hydrogen, OR A , NR A R B , halogen, cyano, nitro, alkoxy, aryloxy, heteroaryloxy, —C(O)C 1-6 -alkyl, —C(O)phenyl, —C(O)benzyl, —C(O)C 5-6 -heterocycle, —S—C 1-6 -alkyl, —S-phenyl, —S-benzyl, —S—C 5-6 -heterocycle, —S(O)C 1-6 -alkyl, —S(O)phenyl, —S(O)benzyl—S(O) 2 C 5-6 -heterocycle, —S(O) 2 C 1-6 -alkyl, —S(O) 2 phenyl, —S(O) 2 benzyl, —S(O) 2 C 5-6 -heterocycle, —S(O) 2 NR A R B , C 1-6 -alkyl, halo-C 1-6 -alkyl, dihalo-C 1-6 -alkyl, trihalo-C 1-6 -alkyl, C 2-6 -alkenyl, C 2-6 -alkynyl, C 3-8 -cycloalkyl, C 3-8 -cycloalkyl-C 1-6 -alkyl, phenyl, benzyl, and C 5-6 -heterocycle;

R 1 is selected from:

 and R 2 together with R 1 is

R 3 is selected from the group consisting of: hydrogen, C 1-4 -alkyl, halo-C 1-4 -alkyl, dihalo-C 1-4 -alkyl, trihalo-C 1-4 -alkyl, C 2-6 -alkenyl, C 2-4 -alkynyl, C 3-6 -cycloalkyl, C 3-6 -cycloalkyl-C 1-2 -alkyl, phenyl, benzyl, and C 5-6 -heterocycle;

R 4 , R 5 , R 6 , R 7 are independently selected from the group consisting of: hydrogen, OR A , NR A R B , —C(O)R A , —C(O)OR A , —C(O)NR A R B , halogen, cyano, nitro, alkoxy, aryloxy, heteroaryloxy, —C(O)C 1-6 -alkyl, —C(O)phenyl, —C(O)benzyl, —C(O)C 5-6 -heterocycle, —S—C 1-6 -alkyl, —S-phenyl, —S-benzyl, —S—C 5-6 -heterocycle, —S(O)C 1-6 -alkyl, —S(O)phenyl, —S(O)benzyl, —S(O)C 5-6 -heterocycle, —S(O) 2 C 1-6 -alkyl, —S(O) 2 phenyl, —S(O) 2 benzyl, —S(O) 2 C 5-6 -heterocycle, —S(O) 2 NR A R B , C 1-6 -alkyl, halo-C 1-6 -alkyl, dihalo-C 1-6 -alkyl, trihalo-C 1-6 -alkyl, C 2-6 -alkenyl, C 2-6 -alkynyl, C 3-8 -cycloalkyl, C 3-8 -cycloalkyl-C 1-6 -alkyl, phenyl, benzyl, naphthyl, and C 5-6 -heterocycle;

wherein the phenyl, benzyl, naphthyl and C 5-6 heterocycle of the R 3 , R 4 R 5 , R 6 , R 7 , R A , or R B group may optionally be substituted with 1 to 3 groups independently selected from OR C wherein two OR C groups may concur into forming a cycle, NR C R D , —C(O)R C , —C(O)OR C , C 1-4 -alkyl-OR C , C 1-4 -alkyl-C(O)OR C , —C(O)NR C R D , —S(O) 2NR C R D , —S(O) 2 C 1-6 -alkyl, halogen, cyano, nitro, C 1-4 -alkyl, halo-C 1-4 -alkyl, dihalo-C 1-4 -alkyl, trihalo-C 1-4 -alkyl, aryl or heteroaryl optionally substituted with C(O)OR C ;

wherein any atom of the C 5 -C 6 heterocycle of the R 3 , R 4 , R 5 , R 6 and R 7 group may be bound to an oxygen so as to form an oxo or a sulfoxo moiety;

wherein any alkyl, alkenyl and alkynyl groups of the R A , R B , R 4 , R 5 , R 6 or R 7 may optionally be substituted with 1-3 groups independently selected from OR C , NR C R D , halogen, cyano and nitro;

wherein any carbon-bound hydrogen atom may be substituted with a fluorine atom; and

R A , R B , R C and R D are independently selected from the group consisting of: hydrogen, —C(O)C 1-6 -alkyl, —C(O)phenyl, —C(O)benzyl, —C(O)C 5-6 -heterocycle, —S(O) 2 C 1-6 a 1 kyl, —S(O) 2 phenyl, —S(O) 2 benzyl, —S(O) 2 C 5-6 -heterocycle, C 1-6 -alkyl, halo-C 1-6 -alkyl, dihalo-C 1-6 -alkyl, trihalo-C 1-6 -alkyl, C 2-6 -alkenyl, C 2-6 -alkynyl, C 3-8 -cycloalkyl, C 3-8 -cycloalkyl-C 1-6 -alkyl, phenyl, benzyl, and C 5-6 -heterocycle.

7. The method of claim 1 , wherein said internal organ comprises lung, liver, kidney, heart, pancreas, gastrointestinal organs, or genitourinary organs.

8. The method of claim 1 , wherein said internal tissue comprises vascular tissue.

9. The method of claim 1 , wherein said ocular tissue comprises corneal tissue or retinal tissue.

10. The method of claim 1 , wherein the fibrosis is pulmonary fibrosis.

11. The method of claim 1 , wherein said administering is effective to inhibit one or more of TGF-β-induced myofibroblast differentiation, pro-fibrotic gene expression, lactic acid production that reduces extracellular pH, and progression of the fibrosis.

12. The method of claim 1 , wherein said administering is carried out orally, parenterally, periadventitially, subcutaneously, intravenously, intramuscularly, intraperitoneally, by inhalation, by intranasal instillation, by implantation, by intracavitary or intravesical instillation, intraocularly, intraarterially, intralesionally, transdermally, intradermally or by application to mucous membranes.

13. The method according to claim 1 , further comprising administering at least one additional anti-fibrotic agent to the individual.

14. The method according to claim 13 , wherein said additional anti-fibrotic agent is selected from the group consisting of calcium channel blockers, cytotoxic agents, cytokines, chemokines, integrins, growth factors, hormones, lysophosphatidic acid (LPA) receptor 1 antagonists, agents that modulate the TGF-β pathway, endothelin receptor antagonists, agents that reduce connective tissue growth factor (CTGF) activity, matrix metalloproteinase (MMP) inhibitors, agents that reduce the activity of platelet-derived growth factor (PDGF), agents that interfere with integrin function, agents that interfere with the pro-fibrotic activities of cytokines, agents that reduce oxidative stress, PDE4 inhibitors, PDE5 inhibitors, mTor inhibitors, modifiers of the arachidonic acid pathway, peroxisome proliferator-activated receptor (PPAR)-γ agonists, kinase inhibitors, inhibitors of VEGF signaling pathway, matrix metalloproteinases, tissue inhibitors of metalloproteinases (TIMPs), HGF agonists, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor antagonists, inhibitors of advanced glycation endproducts (AGEs) or their receptors (RAGEs), Rho kinase inhibitors, PKC inhibitors, ADAM-10 inhibitor, farnesoid X receptor agonists, caspase inhibitors, anti-oxidants, inhibitors of collagen expression, LMW heparin or heparin analogs, copper chelators, TNF-α blocking agents, HMG-CoA reductase inhibitors, and Thy-1 (CD90) inhibitors.

15. The method according to claim 13 , wherein said administering of the at least one additional anti-fibrotic agent is carried out orally, parenterally, periadventitially, subcutaneously, intravenously, intramuscularly, intraperitoneally, by inhalation, by intranasal instillation, by implantation, by intracavitary or intravesical instillation, intraocularly, intraarterially, intralesionally, transdermally, intradermally or by application to mucous membranes.