Bicyclic compounds and methods for their use in treating Pitt Hopkins syndrome
Embodiments of this invention provide compounds, compositions, methods, and uses for therapeutic diketopiperazines, including cyclic G-2-Allyl Proline and other cyclic Glycyl Proline compounds to treat Pitt Hopkins Syndrome and symptoms thereof, as well as manufacture of compositions, medicaments including tablets, capsules, liquid formulations, gels, injectable solutions, and other formulations that are useful for treatment of such conditions.
1 . A method for treating a mammal having Pitt Hopkins Syndrome, comprising administering to the mammal, a compound having the formula:
or a pharmaceutically acceptable salt or hydrate thereof, wherein
X 1 is selected from the group consisting of NR′, O and S;
X 2 is selected from the group consisting of CH 2 , NR′, O and S;
R 1 , R 2 , R 3 , R 4 and R 5 are independently selected from the group consisting of —H, —OR′, —SR′, —NR′R′, —NO 2 , —CN, —C(O) R′, —C(O) OR′, —C(O) NR′R′, —C(NR′) NR′R′, trihalomethyl, halogen, alkyl, substituted alkyl, heteroalkyl, substituted heteroalkyl, alkenyl, substituted alkenyl, alkynyl, substituted alkynyl, aryl, substituted aryl, heteroaryl, substituted heteroaryl, arylalkyl, substituted arylalkyl, heteroarylalkyl and substituted heteroarylalkyl; each R′ is independently selected from the group consisting of —H, alkyl, heteroalkyl, alkenyl, alkynyl, aryl, arylalkyl, heteroaryl and heteroarylalkyl;
or R 4 and R 5 taken together are —CH 2 —(CH 2 ) n —CH 2 — where n is an integer from 0-6;
or R 2 and R 3 taken together are —CH 2 —(CH 2 ) n —CH 2 — where n is an integer from 0-6;
with the proviso that when R 1 =methyl and R 2 =R 3 =R 4 =H then R 5 ≠benzyl and;
when R 1 =H, at least one of R 2 and R 3 ≠H.
2 . The method of claim 1 where R 1 =methyl.
3 . The method of claim 1 where R 1 =allyl.
4 . The method of claim 1 where R 2 =R 3 =methyl and X 2 =S.
5 . The method of claim 1 where R 1 =allyl, R 2 =R 3 =R 4 =R 5 =H, X 1 =NH, X 2 =CH 2 (cG-2-AllylP).
6 . The method of claim 1 where R 1 =methyl, R 2 =R 3 =H, R 4 and R 5 taken together are —CH 2 —(CH 2 ) 3-CH 2 —, X 1 =NH, X 2 =CH 2 .
7 . The method of claim 1 where R 1 =methyl, R 2 =R 3 =H, R 4 and R 5 taken together are —CH 2 —(CH 2 ) 2-CH 2 —, X 1 =NH, X 2 =CH 2 .
8 . The method of claim 1 , where the method further comprises administering said compound along with a pharmaceutically acceptable excipient, and/or in a gel.
9 . The method of claim 1 , where the method further comprises administering said compound along with a pharmaceutically acceptable excipient and a binder.
10 . The method of claim 1 , where the method further comprises administering said compound along with a pharmaceutically acceptable excipient, or in a capsule.
11 . The method of claim 1 , further comprising administering at least one anti-apoptotic compound, anti-necrotic compound, neuroprotective agent or an anti-inflammatory agent.
12 . The method of claim 11 where the anti-apoptotic compound, anti-necrotic compound, or neuroprotective agent is selected from the group consisting of insulin-like growth factor-I (IGF-I), insulin-like growth factor-II (IGF-II), transforming growth factor-β1, activin, growth hormone, nerve growth factor, growth hormone binding protein, IGFBP-3, basic fibroblast growth factor, acidic fibroblast growth factor, the hst/Kfgk gene product, FGF-3, FGF-4, FGF-6, keratinocyte growth factor, androgen-induced growth factor, int-2, fibroblast growth factor homologous factor-1 (FHF-1), FHF-2, FHF-3, FHF-4, keratinocyte growth factor 2, glial-activating factor, FGF-10, FGF-16, ciliary neurotrophic factor, brain derived growth factor, neurotrophin 3, neurotrophin 4, bone morphogenetic protein 2 (BMP-2), glial-cell line derived neurotrophic factor, activity-dependant neurotrophic factor, cytokine leukaemia inhibiting factor, oncostatin M, an interleukin, α-interferon, β-interferon, γ-interferon, consensus interferon, TNF-α, clomethiazole; kynurenic acid, Semax, tacrolimus, L-threo-1-phenyl-2-decanoylamino-3-morpholino-1-propanol, adrenocorticotropin-(4-9) analogue (ORG 2766), dizolcipine [MK-, 801], selegiline, NPS1506, GV1505260, MK-801, GV150526, 2,3-dihydroxy-6-nitro-7-sulfamoylbenzo (f) quinoxaline (NBQX), LY303070, LY300164, and the anti-MAdCAM-1 antibody MECA-367.
13 . The method of claim 1 , wherein said compound is cyclic cyclohexyl-G-2MeP.
14 . The method of claim 1 , wherein said compound is cyclic cyclopentyl-G-2MeP.
15 . The method of claim 1 , wherein said treatment produces an improvement in a symptom of the disorder as assessed using one or more clinical tests selected from the group consisting of Aberrant Behavior Checklist Community Edition (ABC), Vineland Adaptive Behavior Scales, Clinical Global Impression of Severity (CGI-S), Clinical Global Impression Improvement (CGI-1), the Caregiver Strain Questionnaire (CSQ), electroencephalogram (EEG) spike frequency, overall power in frequency bands of an EEG, hemispheric coherence of EEG frequencies, stereotypic hand movement, eye tracking, QTc variability, heart rate variability (HRV), respiratory irregularities, and abnormal coupling of cardiac and respiratory function compared to control animals not suffering from said disorder.
16 . The method of claim 1 , wherein said treatment reduces at least one symptom selected from the group consisting of anxiety, depression, cognitive impairment, cognitive dysfunction, memory loss, loss of spatial orientation, decreased ability to learn, decreased ability to form short- or long-term memory, decreased episodic memory, decreased ability to consolidate memory, decreased spatial memory, decreased synaptogenesis, decreased synaptic stability, deficits in executive function, deficits in cognitive mapping and scene memory, deficits in declarative and relational memory, decreased rapid acquisition of configural or conjunctive associations, decreased context-specific encoding and retrieval of specific events, decreased episodic and/or episodic-like memory, abnormal fear conditioning, abnormal social behaviour, repetitive behaviour, abnormal nocturnal behavior, seizure activity, abnormal locomotion, abnormal expression of Phospho-ERK1/2, abnormal expression of Phospho-Akt, and bradycardia.
17 . The method of claim 1 , wherein the dose of the compound is from about 0.001 mg/kg to about 600 mg/kg.
18 . The method of claim 1 , wherein said mammal is a human being.