(+)-morphinans as antagonists of toll-like receptor 9 and therapeutic uses thereof

1. A method for therapeutically treating a hepatic disorder mediated by Toll-like receptor 9 (TLR9) in a subject in need thereof, the method comprising administering to the subject a compound of Formula (IIb) or a pharmaceutically acceptable salt thereof:

wherein:

R is hydrogen, alkyl, allyl, cyclopropylmethyl, or cyclobutylmethyl;

R a is chosen from hydrogen, alkyl, or phenyl;

R b is hydrogen, alkyl, alkylalcohol, alkylcarboxyl, alkylcarboxylalkylester, acyl, acylalkyl, acylaryl, acyloxy, acyloxyalkyl, or acyloxyaryl; and

Y is chosen from hydrogen and hydroxy;

provided that R is other than allyl when R a is methyl, R b is propyl; and Y is hydrogen.

2. The method of claim 1 , wherein R is cyclopropylmethyl, R a is hydrogen, R b is methyl, and Y is hydroxy.

3. The method of claim 1 , wherein R is methyl, R a is methyl, R b is methylacetylmethylester; and Y is hydrogen.

4. The method of claim 1 , wherein R is allyl, R a is methyl, R b is ethylalcohol; and Y is hydrogen.

5. The method of claim 1 , wherein the hepatic disorder is an inflammatory disorder.

6. The method of claim 1 , wherein the hepatic disorder is ischemic-reperfusion injury.

7. The method of claim 1 , wherein the hepatic disorder is chosen from hepatic steatosis, hepatic steatosis post-liver transplantation, hepatitis, autoimmune hepatitis, alcoholic hepatitis, viral hepatitis, non-alcoholic fatty liver disease, ischemic hepatitis, metabolic disorder hepatitis, chronic liver inflammation, hepatic fibrosis, cholestasis, steatosis, hepatic granulomas, acute or chronic liver transplant rejection and metabolic conditions, hepatocellular carcinoma, cholangiocarcinoma, primary sclerosing cholangitis, cirrhosis, primary biliary cirrhosis, zonal necrosis, hemochromatosis, Wilson's disease, alpha 1-antitrypsin deficiency, glycogen storage disease type II, Gilbert's syndrome, portal hypertension, portal vein thrombosis, ascites, variceal bleeding, budd chiari, hepatic viral infections, hepatic bacterial infections, hepatic parasitic infections, liver abscess, or a combination thereof.

8. A method for inhibiting hepatic ischemic-reperfusion injury in a subject in need thereof, the method comprising administering to the subject a compound of Formula (IIb) or a pharmaceutically acceptable salt thereof:

wherein:

R is hydrogen, alkyl, allyl, cyclopropylmethyl, or cyclobutylmethyl;

R a is hydrogen, alkyl, or phenyl;

R b is hydrogen, alkyl, alkylalcohol, alkylcarboxyl, alkylcarboxylalkylester, acyl, acylalkyl, acylaryl, acyloxy, acyloxyalkyl, or acyloxyaryl; and

Y is hydrogen or hydroxy;

provided that R is other than allyl when R a is methyl, R b is propyl; and Y is hydrogen.

9. The method of claim 8 , wherein the subject is undergoing a hepatic resection or a liver transplantation.

10. The method of claim 8 , wherein R is cyclopropylmethyl, R a is hydrogen, R b is methyl, and Y is hydroxy.

11. The method of claim 8 , wherein R is methyl, R a is methyl, R b is methylacetylmethylester, and Y is hydrogen.

12. The method of claim 8 , wherein R is allyl, R a is methyl, R b is ethylalcohol, and Y is hydrogen.