beta-hydroxybutyrate and butanediol s-enantiomers and methods for their use

专利摘要:
In various embodiments, a compound is provided which comprises the enantiomerically enriched S-isomer S-BHB-S-1,3-butanediol, together with methods of using it.
公开号:BR112020001285A2
申请号:R112020001285-8
申请日:2018-07-19
公开日:2020-07-28
发明作者:Eric Verdin；John C. Newman
申请人:Buck Institute For Research On Aging；The Regents Of The University Of California；The J. David Gladstone Institutes；
IPC主号:

专利说明:

[0001] [0001] This application claims the benefit of and priority for USSN 62 / 535,754, filed on July 21, 2017, which is incorporated into this specification by reference in its entirety for all purposes. GOVERNMENTAL SUPPORT DECLARATION
[0002] [0002] This invention was made with government support under Concessions No. R24DK085610 and KO8AGO48354, both granted by the "National Institutes of Health". The Government has some rights in this invention. FUNDAMENTALS
[0003] [0003] Ketogenic diets and ketone bodies are of interest for the treatment of several human disorders, including epilepsy, dementia and diseases of aging. Ketone bodies are small compounds created by fat that serve as a substitute for sugar when the body's energy stores are depleted, for example, when fasting or during strenuous exercise. Ketogenic diets stimulate the production of ketone bodies because they contain very little sugar or other carbohydrates. The primary ketone bodies in humans are acetoacetate (AcAc) and 6B-hydroxybutyrate (BHB), in particular, the BHB R-enantiomer. Ketogenic diets are used clinically as a therapy for epilepsy, but they are often difficult to adhere to for long periods of time. Extremely high fat content (and low carbohydrate content) can make foods on a ketogenic diet unpleasant, and sometimes cause gastrointestinal problems, kidney stones, high cholesterol and other side effects.
[0004] [0004] The BHB R-enantiomer is a metabolic intermediate that is a currency for the generation of cellular energy, but also has several signaling functions separate from energy production. The energy and signaling functions, one or both, may be important for the effects of BHB on human disease. During times of glucose scarcity, for example, during fasting or strenuous exercise, BHB is the currency by which the energy stored in adipose tissue is transformed into fuel that can be used by cells throughout the body to support its functions. The fat mobilized from the adipose tissue is transported to the liver and converted to BHB. BHB circulates in the blood to all tissues. After being absorbed into a cell, BHB is degraded in the mitochondria to generate acetyl-CoA, which is further metabolized to ATP. This is the canonical function of “energy currency” at BHB.
[0005] [0005] In addition, BHB is believed to have several signaling functions. Most of them are independent of their function as an energy currency, insofar as they are actions of the BHB molecule itself, and are generally not side effects of its metabolism in acetyl-CoA and ATP. Signaling functions may include, but are not limited to: 1) inhibition of class I and IIa deacetylases-histone, with changes resulting in histone gene expression and modifications, as well as changes in acetylation status and non-histone protein activity; 2) metabolism in acetyl-CoA results in increased cell production of acetyl-CoA to serve as a substrate for acetyltransferase enzymes, resulting in similar changes in histone and non-histone protein acetylation as inhibition of deacetylase; 3) covalent adhesion to histones and possibly other proteins in the form of Bm hydroxybutyrylation of lysine, which can have similar effects to lysine acetylation; 4) binding and activation of the hydroxycarboxylic acid receptor 2 (HCAR2) with changes resulting in the metabolism of adipose tissue; 5) binding and inhibition of the free fatty acid receptor 3 (FFAR3) with changes resulting in the activation of the sympathetic nervous system and the metabolic rate of the whole body; and 6) inhibition of NOD-like 3 (NLRP3) inflammasome. SUMMARY
[0006] [0006] In certain embodiments, specifications and methods are provided that reflect the discovery that the beta-hydroxybutyrate S-enantiomer (S-BHB) retains the natural signaling activities that are observed for the R-enantiomer; however, the S-enantiomer provides improved pharmacokinetics when compared to the R-enantiomer. In particular, the S-enantiomer provides substantially increased serum half-life. Consequently, in certain embodiments, methods of using the S-enantiomer or BHB are provided. In addition, a new compound, S-BHB-S-1,3-butanediol, is provided, as well as methods of using that compound.
[0007] [0007] Several modalities contemplated in this specification can include, without limitation, one or more of the following:
[0008] [0008] Mode 1: A compound comprising an S-enantiomer of beta-hydroxybutyrate-1,3-butanediol according to Formula 1: OH oO OH ALAN
[0009] [0009] Mode 2: A composition comprising beta-hydroxybutyrate-1,3-butanediol enriched for the S-BHB-S-1,3-butanediol enantiomer represented by Formula I: OH or OH ALLAH I
[0010] [0010] Mode 3: The composition of mode 2, wherein the Formula I enantiomer comprises at least about 90% of the 1,3-butanediol beta-hydroxybutyrate that comprises said composition.
[0011] [0011] Mode 4: The composition of mode 2, wherein the Formula I enantiomer comprises at least about 95% of the 1,3-butanediol beta-hydroxybutyrate that comprises said composition.
[0012] [0012] Mode 5: The composition of mode 2, wherein the Formula I enantiomer comprises at least about 99% of the 1,3-butanediol beta-hydroxybutyrate that comprises said composition.
[0013] [0013] Mode 6: A pharmaceutical formulation comprising a compound of mode 1 and / or a composition according to any of modalities 2-5, and a pharmaceutically acceptable carrier.
[0014] [0014] Mode 7: A pharmaceutical formulation comprising: a pharmaceutically acceptable carrier: and beta-hydroxybutyrate, in which said beta-hydroxybutyrate is enriched for the S-BHB enantiomer represented by Formula II: OH the MA, II
[0015] [0015] Mode 8: The formulation of mode 7, wherein the Formula II enantiomer comprises at least about 90% of the beta-hydroxybutyrate that comprises said formulation.
[0016] [0016] Mode 9: The formulation of mode 7, wherein the Formula II enantiomer comprises at least about 95% of the beta-hydroxybutyrate that comprises said formulation.
[0017] [0017] Mode 10: The formulation of mode 7, wherein the Formula II enantiomer comprises at least about 99% of the beta-hydroxybutyrate that comprises said formulation.
[0018] [0018] Mode 11: The formulation according to any of the modalities 6-10, wherein said formulation is for administration through a modality selected from the group consisting of intraperitoneal administration, topical administration, oral administration, administration by inhalation , transdermal administration, subdermal deposit administration and rectal administration.
[0019] [0019] Mode 12: The formulation according to any of the modalities 6-10, wherein said formulation is substantially sterile.
[0020] [0020] Modality 13: The formulation according to any of the modalities 6-12, in which the said formulation meets the manufacturing guidelines of the FDA ("Food and Drug Administration" - agency of the United States government with the function of controlling food and medicines, through various tests and research) for orally administered pharmaceutical products.
[0021] [0021] Mode 14: The formulation according to any of modalities 6-13, wherein said formulation is a unit dosage formulation.
[0022] [0022] Mode 15: An ingestible composition comprising a compound according to any one of the modalities, a compound of the modality 1, and / or a composition according to any of the 2-5 modalities, and / or an S-BHB enantiomer substantially pure, and a dietetically or pharmaceutically acceptable carrier.
[0023] [0023] Mode 16: The composition of the mode 15, wherein said composition comprises a compound of the mode 1, and / or a composition according to any one of the modalities 2-5.
[0024] [0024] Mode 17: The composition of mode 15, wherein said composition comprises a substantially pure S-BHB enantiomer.
[0025] [0025] Mode 18: The composition according to any of the modalities 15-17, wherein said composition comprises a dietetically acceptable carrier.
[0026] [0026] Modality 19: The composition of modality 18, wherein said composition comprises a food product, a drink, a drink, a food supplement, a dietary supplement, a functional food or a nutraceutical.
[0027] [0027] Modality 20: A food supplement comprising a compound of modality 1, and / or a composition according to any of modalities 2-5, and / or a substantially pure S-BHB enantiomer.
[0028] [0028] Modality 21: The food supplement of modality 20, wherein said composition comprises a compound of modality 1, and / or a composition according to any of the modalities 2-5.
[0029] [0029] Mode 22: the food supplement of mode 20, wherein said composition comprises a substantially pure S-BHB enantiomer.
[0030] [0030] Mode 23: A composition comprising: a food supplement comprising a compound of mode 1 and / or a composition according to any one of modalities 2-5, and / or a substantially pure S-BHB enantiomer; and one or more components of a ketogenic diet.
[0031] [0031] Mode 24: The composition of mode 23, wherein the compound and / or Oo referred to — substantially pure S-BHB enantiomer is present in the composition in an amount of about 1% w / w to about 25% w / P.
[0032] [0032] Mode 25: The composition of mode 23, wherein the compound and / or said substantially pure S-BHB enantiomer is present in the composition in an amount of about 5% w / w to about 15% w / w .
[0033] [0033] Mode 26: The composition of mode 23, wherein the substantially pure compound and / or said S-BHB enantiomer is present in the composition in an amount of about 10% w / w.
[0034] [0034] Mode 27: The composition according to any of the modalities 23-26, in which the ketogenic diet comprises a ratio of mass of fat to protein and carbohydrates of about 2: 1 to about 10: 1.
[0035] [0035] Mode 28: The composition of mode 23-26 in which the ketogenic diet comprises a mass to fat to protein and carbohydrate ratio of about 3: 1 to about 6: 1.
[0036] [0036] Mode 29: The composition according to mode 23-26, in which the ketogenic diet comprises a ratio of mass of fat to protein and carbohydrates of about 4: 1.
[0037] [0037] Mode 30: A method of treating dementia or another neurocognitive disorder, said method “comprising administering to an individual in need of an effective amount of a mode 1 compound, and / or a composition according to any one modalities 2-5, and / or pharmaceutical formulation according to any of modalities 6-14.
[0038] [0038] Mode 31: The method of mode 30, wherein said method comprises the treatment of mild cognitive impairment or Alzheimer's disease, and the method comprises administering to an individual in need of a modality 1 compound, and / or a composition according to any of modalities 2-5, and / or a pharmaceutical formulation according to any of modalities 6-11 in an amount sufficient to ameliorate one or more symptoms of Mild Cognitive Deficit and / or Alzheimer's disease.
[0039] [0039] Mode 32: A method of preventing or delaying the onset of a pre-Alzheimer's condition and / or cognitive impairment, and / or ameliorating one or more symptoms of a pre-Alzheimer's condition and / or cognitive impairment, or prevention or delaying the progression of a pre-Alzheimer's condition or cognitive impairment to Alzheimer's disease, said method comprising: administering to an individual in need of a modality 1 compound, and / or a composition according to any of the modalities 2-5 , and / or pharmaceutical formulation according to any of modalities 6-14 in an amount sufficient to prevent or delay the onset of a pre-Alzheimer's cognitive impairment, and / or to improve one or more symptoms of a pre-Alzheimer's cognitive impairment , and / or to prevent or slow the progression from pre-Alzheimer's cognitive impairment to Alzheimer's disease.
[0040] [0040] Mode 33: The method of mode 32, in which said method is a method of preventing or delaying the transition from a cognitively asymptomatic pre-Alzheimer's condition to a pre-Alzheimer's cognitive dysfunction.
[0041] [0041] Modality 34: The method of modality 32, wherein said method is a method of preventing or delaying the appearance of a pre-Alzheimer's cognitive dysfunction.
[0042] [0042] Mode 35: The method of mode 32, wherein said method comprises improvement of one or more symptoms of a pre-Alzheimer's cognitive dysfunction.
[0043] [0043] Mode 36: The method of mode 32, wherein said method comprises preventing or delaying the progression of a pre-Alzheimer's cognitive impairment to Alzheimer's disease.
[0044] [0044] Mode 37: The method according to any of the modalities 30-36, in which said individual exhibits positivity of AB biomarker in a clinically normal human individual aged 50 years or more.
[0045] [0045] Mode 38: The method according to any of the modalities 30-37, in which said individual exhibits asymptomatic cerebral amyloidosis.
[0046] [0046] Mode 39: The method according to any of the modalities 30-37, in which said individual exhibits cerebral amyloidosis in combination with downstream neurodegeneration
[0047] [0047] Mode 40: The method of mode 39, in which said downstream neurodegeneration is determined by one or more elevated neuronal injury markers selected from the group consisting of tau and FDG uptake.
[0048] [0048] Mode 41: The method according to any of the modalities 30-36, in which said individual is an individual diagnosed with mild cognitive impairment.
[0049] [0049] Mode 42: The method according to any of the modalities 30-41, in which the referred individual exhibits a clinical dementia classification above zero and below about 1.5.
[0050] [0050] Mode 43: The method according to any of the modalities 30-36, in which the individual is at risk of developing Alzheimer's disease.
[0051] [0051] Modality 44: The method according to any of the modalities 30-43, in which the individual has a family risk for having Alzheimer's disease.
[0052] [0052] Mode 45: The method according to any of the modalities 30-43, in which the individual has a familial mutation of Alzheimer's disease (FAD).
[0053] [0053] Mode 46: The method according to any of the 30-43 modes, in which the individual has the allele
[0054] [0054] Mode 47: The method according to any of the modalities 30-46, in which the administration of said compound slows or prevents the progression of MCI to Alzheimer's disease.
[0055] [0055] Mode 48: The method according to any of the modalities 30-47, in which said administration produces a reduction in the CSF of the levels of one or more components selected from the group consisting of AÇB42, sAPPB, Tau-total ( tTau), phospho Tau (pTau), APPneo, soluble ARB40, pTau / AB42 ratio and tTau / AB42 ratio, and / or an increase in the CSF of the levels of one or more components selected from the group consisting of AB42 / AB40 ratio, ratio AB42 / AB38, sAPPa, sAPPa / sAPPÉB ratio, sAPPa / AB40 ratio and sAPPa / AB42 ratio.
[0056] [0056] Mode 49: The method according to any of the modalities 30-48, in which said administration produces an improvement in the individual's cognitive skills.
[0057] [0057] Mode 50: The method according to any of the modalities 30-48, in which said administration produces an improvement, a stabilization or a reduction in the rate of decline of the individual's clinical dementia classification (CDR).
[0058] [0058] Mode 51: A method of reducing epileptiform activity in an individual's brain, said method comprising administering to said individual an effective amount of a mode 1 compound, and / or a composition according to any one modalities 2-5, and / or pharmaceutical formulation according to any of modalities 6-14.
[0059] [0059] Mode 52: The method of mode 51, wherein said effective amount is sufficient to reduce epileptiform activity in the brain of said individual.
[0060] [0060] Mode 53: A method for the treatment, in an individual, of one or more of epilepsy, Parkinson's disease, heart failure, traumatic brain injury, stroke, hemorrhagic shock, acute lung injury after fluid resuscitation, injury acute kidney, myocardial infarction, myocardial ischemia, diabetes, glioblastoma multiforme, diabetic neuropathy, prostate cancer, amyotrophic lateral sclerosis, Huntington's disease, cutaneous T-cell lymphoma, multiple myeloma, peripheral T-cell lymphoma, HIV, Niemann's disease -Pick Type C, degeneration - age-related macular, gout, atherosclerosis, rheumatoid arthritis and multiple sclerosis, comprising: administering to said individual an effective amount of a modality 1 compound, and / or a composition accordingly with any of modalities 2-5, and / or pharmaceutical formulation according to any of modalities 6-14,
[0061] [0061] Mode 54: The method of mode 55, in which the therapeutically effective amount is sufficient to reduce the epileptiform activity in the brain of said individual.
[0062] [0062] Mode 55: A method of treating a condition that is caused, exacerbated or associated with elevated plasma levels of free fatty acids in a human or animal subject, the method of which involves administering to the individual an effective amount of a compound of the modality 1, and / or a composition according to any of modalities 2-5, and / or pharmaceutical formulation according to any of modalities 6-14.
[0063] [0063] Mode 56: A method of treating a condition in which weight loss or weight gain is involved, the method of which comprises administering to an individual in need of an effective amount of a modality 1 compound, and / or a composition according to any of modalities 2-5, and / or pharmaceutical formulation according to any of modalities 6-
[0064] [0064] Mode 57: A method of suppressing appetite, treating obesity, promoting weight loss, maintaining a healthy weight or decreasing the ratio of fat to lean muscle mass, said method comprising administration to an individual in need of an effective amount of a compound of mode 1, and / or a composition according to any of modalities 2-5, and / or a pharmaceutical formulation according to any of modalities 6-14.
[0065] [0065] Mode 58: A method of preventing or treating a selected condition of cognitive dysfunction, neurodegenerative disease or disorder, muscle impairment, muscle fatigue and fatigue, said method comprising administering to an individual in need of an effective amount of a compound of modality 1, and / or a composition according to any of modalities 2-5, and / or pharmaceutical formulation according to any of modalities 6-14.
[0066] [0066] Mode 59: A method of treating an individual suffering from a selected condition of diabetes, hyperthyroidism, metabolic syndrome x, or for the treatment of a geriatric patient, said method comprising administering to him an effective amount of a compound of modality 1, and / or a composition according to any of modalities 2-5, and / or a pharmaceutical formulation according to any of modalities 6-14,
[0067] [0067] Mode 60: A method of treatment, prevention or reduction of the effects of neurodegeneration, free radical toxicity, hypoxic conditions or hyperglycemia, said method comprising administering to an individual in need of an effective amount of a mode 1 compound, and / or a composition according to any of modalities 2-5, and / or a pharmaceutical formulation according to any of modalities 6-14.
[0068] [0068] Mode 61: A method of treating, preventing or reducing the effects of neurodegeneration, said method comprising an effective amount of a compound of mode 1, and / or a composition according to any one of modalities 2-5, and / or pharmaceutical formulation according to any of modalities 6-14.
[0069] [0069] Mode 62: A method according to either mode 60 or 61, in which neurodegeneration is caused by aging, trauma, anoxia or a neurodegenerative disease or disorder.
[0070] [0070] Mode 63: A method of preventing or treating a neurodegenerative disease or disorder selected from Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, epilepsy, astrocytoma,
[0071] [0071] Mode 64: A method of promoting attention or improving cognitive function in an individual, said method comprising administering to said individual an effective amount of a modality 1 compound, and / or a composition according to any of modalities 2-5, and / or pharmaceutical formulation according to any of modalities 6-14.
[0072] [0072] Modality 65: The method according to any of the 30-64 modalities, in which said individual is a human.
[0073] [0073] Mode 66: The method according to any of the modalities 30-64, wherein said individual is a non-human mammal. DEFINITIONS
[0074] [0074] As used in this specification, the phrase "a needy individual" refers to an individual, as described below, who suffers or is at risk of suffering (for example, predisposed, for example, genetically predisposed) from diseases or conditions listed in that specification.
[0075] [0075] The terms "person", "individual" and "patient" can be used interchangeably and refer to a mammal, preferably a human or a non-human primate, but also domesticated mammals (for example, canine or feline) , laboratory mammals (for example, mouse, rat, rabbit, hamster, guinea pig), and agricultural mammals (for example, horses, cattle, pigs, sheep). In various modalities, the individual may be a human (for example, adult man, adult woman, adolescent man, adolescent woman, male child, female child) under the care of a doctor or other health professional in a hospital , psychiatric care facility, such as an outpatient, or other clinical setting. In certain modalities, the individual may not be under the care or prescription of a doctor or other health professional.
[0076] [0076] An "effective amount" refers to an effective amount, in the dosages and for periods of time necessary, to obtain the desired therapeutic or prophylactic result. A "therapeutically effective amount" can vary according to factors such as, for example, the individual's disease state, age, sex and weight, and the ability of the pharmaceutical product to elicit a desired response in the individual. A therapeutically effective amount is also one in which any toxic or harmful effects of a treatment are substantially absent or are outweighed by the therapeutically beneficial effects. In certain embodiments, the term "therapeutically effective amount" refers to an amount of an active agent or composition that comprises the same that is effective in "treating" a disease or disorder in a mammal (for example, a patient or a non-mammal) human). In one embodiment, a therapeutically effective amount is an amount sufficient to ameliorate at least one symptom associated with a condition such as, for example, mild cognitive impairment (MCI), Alzheimer's disease (AD), epilepsy, Parkinson's disease, heart failure, traumatic brain injury, stroke, hemorrhagic shock, acute lung injury after fluid resuscitation, acute kidney injury, myocardial infarction, myocardial ischemia, diabetes, glioblastoma multiforme, diabetic neuropathy, prostate cancer, amyotrophic lateral sclerosis, Huntington's disease, cutaneous T-cell lymphoma, multiple myelin, peripheral T-cell lymphoma, HIV, Niemann-Pick Type C disease, degeneration - age-related, gout, atherosclerosis, rheumatoid arthritis, multiple sclerosis and the like. In certain embodiments, an effective amount is an amount sufficient to prevent progression or disease, delay progression, or cause a disease to regress, or which is capable of reducing the symptoms caused by the disease.
[0077] [0077] A "prophylactically effective amount" refers to an effective amount, in the dosages and for periods of time necessary, to obtain the desired prophylactic result. Typically, but not necessarily, as a prophylactic dose is used in individuals before or in the early stages of the disease, the prophylactically effective amount is less than the therapeutically effective amount.
[0078] [0078] The terms "treatment", "which treats" or "treat", as used in this specification, refer to actions that produce a desired effect on the symptoms or pathology of a disease or condition, particularly those that can be performed using the compositions described in that specification, and may include, without limitation,
[0079] [0079] The term "mitigation" refers to the reduction or elimination of one or more symptoms of that pathology or disease, and / or a reduction in the rate or delay in the appearance or severity of one or more symptoms of that pathology or disease, and / or the prevention of that pathology or disease.
[0080] [0080] As used in this specification, the phrases "improve at least one symptom" or "improve one or more symptoms" or their equivalents, refer to the reduction, elimination or prevention of one or more symptoms of pathology or disease.
[0081] [0081] The term "active agent" refers to a substance or chemical compound that exerts a pharmacological action and is capable of treating, preventing or ameliorating one or more conditions / illnesses (for example, Alzheimer's disease) as described in this report descriptive. Examples of active agents of interest include S-BHB and S-BHB-S-1,3-butanediol described in this specification.
[0082] [0082] The term "substantially pure", when used with respect to enantiomers, indicates that a particular enantiomer (for example, an sS-enantiomer) is substantially free of its stereoisomer. In various embodiments, substantially pure indicates that a particular enantiomer is at least 70%, or at least 80%, or at least 90%, or at least 95%, or at least 98%, or at least 99% of the purified compound. Methods of producing substantially pure enantiomers are well known to those skilled in the art. BRIEF DESCRIPTION OF THE DRAWINGS
[0083] [0083] Figure 1 illustrates the structures of BHB's R and -S enantiomers (R-BHB and S-BHB, respectively), the R-and -S enantiomers of 1,3-butanediol and the structures of R -BHB-R-1,3-butanediol and S-BHB-S-1,3-butanediol. Note that the orientation of butanediol is reversed in the ester, as BHB and butanediol are joined “head to head”.
[0084] [0084] Figure 2 illustrates the inhibition of HDAC by the sodium salt of the BH-R-enantiomer (R-BHB) (upper) and the sodium salt of the S-enantiomer (S-BHB) (lower). DETAILED DESCRIPTION
[0085] [0085] In certain embodiments, compositions and methods are provided in this specification that reflect the discovery that the S-enantiomer of beta-hydroxybutyrate (S-BHB) retains the natural signaling activities that are observed for the R-enantiomer. However, the S-enantiomer provides improved pharmacokinetics when compared to the R-enantiomer. In particular, the S-enantiomer provides, inter alia, a substantially increased serum half-life. Consequently, in certain embodiments, methods of using the BHB S-enantiomer are provided. In addition, a new compound, S-BHB-S-1,3-butanediol, is provided, as well as methods of using that compound.
[0086] [0086] Beta-hydroxybutyrate (BHB) is a chiral molecule, and R-BHB is the enantiomer generated and readily consumed in normal mammalian metabolism. Signaling functions or other effects that depend on BHB rapid catabolism and are therefore only relevant for the R-enantiomer. It was discovered, however, that signaling functions that are direct actions of BHB are recapitulated, in part or totally, by S-BHB, depending on the stereoselectivity of the proteins involved. In fact, several of the direct signaling functions described in this specification appear to be non-stereoselective
[0087] [0087] For example, the stereoselectivity of HDB inhibition by BHB was previously unknown. However, as demonstrated in that specification (see, for example, Example 1 and Figure 2), the S-BHB enantiomer is an effective inhibitor of HDAC activity (IC50 = 7.3 mM) and, surprisingly, it is even more effective than R-BHB, possibly because R-BHB is rapidly metabolized.
[0088] [0088] Additionally, it is believed that S-BHB can bind to GPCR HCAR2Q, although with a slightly lower affinity than R-BHB.
[0089] [0089] It is also believed that S-BHB, when administered to a mammal, can also block the activation of the inflammasome. This can be readily assessed by testing S-BHB in an assay that comprises the use of caspase-1 activation in bone marrow-derived macrophage cells treated with lipopolysaccharide as an in vitro assay for NLRP3 inflammation activation.
[0090] [0090] In view of the above, it is believed that S-BHB, as well as the ester (S-BHB-S-1l, 3-butanediol), can be therapeutically useful through the signaling activities that S-BHB share with R-BHB.
[0091] [0091] Consequently, in certain embodiments, methods that comprise the administration of the BHB S-enantiomer (see, for example, Figure 1) or compounds that, when administered to an individual (for example, to a human or non-human mammal) are metabolized to produce the BHB S-enantiomer.
[0092] [0092] Thus, in certain embodiments, a compound is provided which is the S-enantiomer of BHB-1,3-butanediol and is designated S-BHB-S-1,3-butanediol, as represented by Formula I, below : oH O OH
[0093] [0093] The compounds, compositions and formulations contemplated in this specification are enriched for the S-enantiomers shown in Figure 11 (for example, S-BHB and S-BHB-1,3-butanediol). The term “enriched” as used in this specification, means that the level of the enriched enantiomer is higher than the level at which that enantiomer would typically be present / would be produced in a racemic mixture. When a percentage of enrichment is referred to, the enriched enantiomer constitutes that percentage of the racemic mixture (for example, total BHB or BHB-1,3-butanediol) present. Generally, S-BHB, or S-BHB-S-1,3-butanediol, is enantiomerically enriched up to 60%, or up to at least 70%, or up to at least 80%, or up to at least 90%, preferably by at least 95%, or at least 98%, or at least 99% of the racemic mixture of total BHB, or BHB-1,3-butanediol. In certain embodiments, the S-BHB, or S-BHB-S-1,3-butanediol enantiomer is substantially pure.
[0094] [0094] In certain embodiments, the S-BHB-S-1,3-butanediol enantiomer can be prepared by a process that comprises carrying out a transesterification reaction between ethyl (3S) -hydroxybutyrate and (3S) -l1,3 -butanediol in the presence of a lipase enzyme. In certain modalities, the reaction can be carried out at around 40ºC for a period of about 96 hours.
[0095] [0095] The reaction product can be purified using standard methods well known to those skilled in the art. For example, in an illustrative but not limiting modality, the reaction product can be subjected to sliding film distillation (GMP). This comprises a degassing passage, a second pass with a light cut to remove starting materials and then a final passage. In illustrative, but not limiting, conditions of the final passage are 145ºC to 1.8 Ton. The preparation and purification of the corresponding R-enantiomer are described in US Patent No. 8,642,654 B2 and, using the teachings provided therein, those skilled in the art can readily produce the S-enantiomer described in that specification at any desired purity level. .
[0096] [0096] A sample of S-BHB-S-1,3-butanediol (for example, enriched with respect to the (38, 3S ') enantiomer) is believed to generate measurable high blood levels of (38) -hydroxybutyrate when ingested orally. The S-BHB-S-1,3-butanediol enantiomer, therefore, represents an effective means of releasing (3S) - hydroxybutyrate to an individual. In certain embodiments, however, the S-BHB enantiomer can be administered directly.
[0097] [0097] It will be noted that when the methods described in that specification refer to the administration of an S-enantiomer described in that specification (for example, S-BHB-S-1,3-butanediol and S-BHB or compositions / formulations of these), it is contemplated that the S-enantiomer (s) is enriched in the administered composition, for example, where "enriched" is as described above. In certain embodiments, the S-enantiomer (s) are substantially Similarly, in the compositions and formulations described in this specification, it is contemplated that the BHB or BHB-1,3-butanediol component of the composition / formulation is enriched for the S-enantiomer for example, where "enriched" is as described In certain embodiments, the BHB or BHB-11,3-butanediol component of the composition / formulation is substantially pure.
[0098] [0098] The S-enantiomers described in this specification (for example, S-BHB-S-1,3-butanediol and S-BHB (see, Figure 1)) are believed to be effective in reducing plasma levels of acids fatty. Consequently, in certain embodiments, it is believed that these compounds, and compositions / formulations that comprise these compounds, can be used to reduce the level of free fatty acids circulating in the plasma of an individual (eg, a human, or a non-mammal) human). In this way, they can be used to treat a condition that is caused, exacerbated or associated with elevated plasma levels of free fatty acids in a human or non-human animal. Thus, in certain modalities, a human or animal individual can be treated by a method that comprises administering to him one or both of the S-enantiomers described in that specification and / or compositions / formulations that comprise those enantiomers. The condition of the individual can thus be improved or improved.
[0099] [0099] Conditions that are caused, exacerbated or associated with high plasma levels of free fatty acids include, without limitation, neurodegenerative diseases or disorders, for example, Alzheimer's disease, Parkinson's disease, Huntington's chorea; hypoxic states, for example, angina pectoris, extreme physical exhaustion, intermittent claudication, hypoxia, stroke and myocardial infarction; insulin-resistant states, for example, infection, stress, obesity, diabetes and heart failure; and inflammatory conditions, including infection and autoimmune disease.
[0100] [0100] In addition to reducing plasma fatty acid levels, it is believed that the S-enantiomers described in this specification (for example, S-BHB-S-1,3-butanediol and S-BHB) act on the centers of the appetite in the brain. In particular, it is believed that these enantiomers may increase the levels of several anorexigenic neuropeptides (neuropeptides “known to be associated with decreased food intake and decreased appetite) in the brain's appetite centers and also induce higher levels of malonyl-CoA, an associated metabolite with decreased appetite and food intake.
[0101] [0101] Consequently, in certain embodiments, the S-enantiomers described in that specification (for example, S-BHB-S-1,3-butanediol and S-BHB) are believed to be useful in their treatment of a condition in which weight loss or weight gain is involved. For example, enantiomers and / or compositions / formulations thereof can be used to suppress appetite, treat obesity, promote weight loss, maintain a healthy weight, or decrease the ratio of fat to lean muscle mass in an individual. In various modalities, the individual in each case can be a healthy individual or a committed individual. A healthy individual can be, for example, a healthy weight individual for whom physical performance and / or physical appearance is important. Examples include, without limitation, members of the armed forces, athletes, bodybuilders and fashion models. A compromised individual may be an unhealthy weight individual, for example, an overweight, clinically obese, or clinically very obese individual. A committed individual can,
[0102] [0102] A healthy weight person typically has a body mass index (BMI) of about 18.5 to about 24.9, an overweight person typically has a body mass index (BMI) of about 25 to about 29.9, an individual who is clinically obese typically has a body mass index of about 30 to 39.9, and an individual who is clinically very obese typically has a body mass index of about 40 or more.
[0103] [0103] In addition to reducing plasma fatty acid levels and acting on appetite centers in the brain, it is believed that the S-enantiomers described in this specification (for example, S-BHB-S-1,3-butanediol and S -BHB) and compositions / formulations of these can increase the metabolic efficiency of the brain, by increasing the potential phosphorylation of the brain and the AG 'of ATP hydrolysis. Consequently, it is believed that the S-enantiomers described in this specification (for example, S-BHB-S-1,3-butanediol and S-BHB) and their compositions / formulations can promote enhanced cognitive function and can be used to treat cognitive dysfunction or to reduce the effects of neurodegeneration.
[0104] [0104] It is also believed that the S-enantiomers described in this specification (for example, S-BHB-S-1,3-butanediol and S-BHB) and their compositions / formulations may increase the level of the Neurotrophic Factor Derived from Neuropeptide brain (BDNF), both in the paraventricular nucleus (the brain's appetite center) and in the hippocampus (a part of the brain wisely important for memory). It is known that BDNF prevents apoptosis and promotes neuronal growth in the basal ganglia and other areas of interest and, therefore, it is expected that the increased levels of BDNF produced by the enantiomers described in this specification and / or their compositions / formulations will inhibit neurodegeneration, limit neural tissue death after hypoxia or trauma and promote growth of neural tissue.
[0105] [0105] It is also believed that the S-enantiomers described in this specification (for example, S-BHB-S-1,3-butanediol and S-BHB) and their compositions / formulations increase the level of the Cocaine-e Responsive Transcript - Amphetamine (CART) of the anorexigenic neuropeptide. CART is known to promote attention as well as decrease appetite. Thus, it is expected that the increased levels of CART produced by the S-enantiomers described in this specification and / or their compositions / formulations will improve cognitive function. Therefore, the S-enantiomers described in this specification and / or their compositions / formulations are expected to be useful for: (a) promoting attention and enhanced cognitive function; and / or (b) inhibition of neurodegeneration.
[0106] [0106] In certain embodiments, the S-enantiomers described in this specification and / or compositions / formulations thereof are provided for use in promoting attention or improving cognitive function, or in treating cognitive dysfunction.
[0107] [0107] In certain embodiments, the S-enantiomers described in this specification and / or compositions / formulations thereof are provided for use in the treatment, prevention or reduction of the effects of neurodegeneration, free radical toxicity, hypoxic conditions or hyperglycemia.
[0108] [0108] In one embodiment, the S-enantiomers described in this specification and / or compositions / formulations thereof are provided for use in the treatment, prevention or reduction of the effects of neurodegeneration. Thus, it is believed that S-enantiomers and / or their compositions / formulations can be used to treat, prevent or reduce the effects of neurodegeneration resulting from any particular cause. Neurodegeneration can be caused, for example, by a neurodegenerative disease or disorder, or it can be caused by aging, trauma, anoxia and the like. Examples of neurodegenerative diseases or disorders that can be treated with the use of the S-enantiomers described in that specification and / or compositions / formulations thereof include, without limitation, Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, epilepsy, astrocytoma, glioblastoma and Huntington's chorea.
[0109] [0109] Additional examples of conditions that the S-enantiomers described in this specification and / or their compositions / formulations can be used to prevent or treat include, without limitation, muscle impairment, muscle fatigue and fatigue. Muscle impairment and muscle fatigue can be prevented or treated in a healthy or compromised individual. A compromised individual can be, for example, an individual who suffers from fibromyalgia or myalgic encephalomyelitis (ME, or chronic fatigue syndrome), or the symptoms thereof. In certain embodiments, the S-enantiomers described in that specification and / or compositions / formulations thereof can be used to treat an individual suffering from a condition such as diabetes, metabolic syndrome X or hyperthyroidism, or a geriatric patient.
[0110] [0110] In certain embodiments, methods are provided for mild cognitive impairment (MCI) or Alzheimer's disease, where the methods involve administering to an individual in need of one or more of the S-enantiomers described in that specification and / or compositions / formulations of these in an amount sufficient to improve one or more symptoms of Mild Cognitive Deficit and / or Alzheimer's disease. Similar methods are also provided for preventing or delaying the onset of a pre-Alzheimer's condition and / or cognitive impairment, and / or ameliorating one or more symptoms of a pre-Alzheimer's condition and / or cognitive impairment, or preventing or delaying progression of a pre-Alzheimer's condition or cognitive impairment for Alzheimer's disease, where the methods involve administering to an individual in need of one or more of the S-enantiomers described in that specification and / or compositions / formulations thereof in an amount sufficient to avoid or delay the onset of a pre-Alzheimer's cognitive impairment, and / or to improve one or more symptoms of a pre-Alzheimer's cognitive impairment, and / or to prevent or slow the progression of a pre-Alzheimer's cognitive impairment to Alzheimer's disease. In certain modalities, the method is a method of preventing or delaying the transition from a cognitively asymptomatic pre-Alzheimer's condition to a pre-Alzheimer's cognitive dysfunction.
[0111] [0111] In certain embodiments, the S-enantiomers described in that specification (for example, S-BHB-S-1,3-butanediol and S-BHB) and / or compositions / formulations thereof are administered to an individual to increase the cognition in the individual. For example, the methods in question may include administering an amount of the S-enantiomers described in that specification and / or compositions / formulations thereof in an amount to increase cognition in the subject by 5% or more, for example, 10% or more, for example, 15% or more, for example, 25% or more, for example, 40% or more, for example, 50% or more, for example, 75% or more, for example, 90% or more, for example, 95% or more, for example, 99% or more and including increased cognition in the individual by 99.9% or more.
[0112] [0112] In still other cases, the amount of (one or more) S-enantiomers described in that specification and / or their compositions / formulations administered to the individual is sufficient to reduce the rate of decline in cognition in the individual. For example, the methods in question may include administering a number of the S-enantiomers described in that specification and / or compositions / formulations thereof to decrease the rate of cognitive decline in the individual by 5% or more, for example, 10 % or more, for example, 15% or more, for example, 25% or more, for example, 40% or more, for example, 50% or more, for example, 75% or more, for example, 90% or more for example, 95% or more, for example, 99% or more and included reducing the rate of decline in cognition in the individual by 99.9% or more.
[0113] [0113] The level of cognition in an individual can be assessed by any convenient protocol including, without limitation, the “Montreal Cognitive Assessment” (MoCA), “St. Louis University Mental State Exam ”(SLUMS),“ Mini Mental State Exam ”(MMSE) and, for research purposes, the“ Alzheimer's Disease Assessment Scale, Cognition ”(ADAS-Cog), as well as assessments that include“ Activities of Daily Living ”(ADLs) and“ Instrumental Activities of Daily Living ”(IADLs).
[0114] [0114] In certain embodiments, one or more of the S-enantiomers described in that specification and / or their compositions / formulations are administered to improve the individual's daily functions, for example, as determined by assessments by “Activities of Daily Living” (ADLS) and “Instrumental Activities of Daily Living” (IADLsS).
[0115] [0115] In other embodiments, one or more of the S-enantiomers described in this specification and / or their compositions / formulations are administered to reduce agitated behavior in the individual. For example, the methods in question may include administering an amount of one or more of the S-enantiomers described in that specification and / or compositions / formulations thereof sufficient to reduce agitated behavior in the individual by 5% or more, for example, 10% or more, for example, 15% or more, for example, 25% or more, for example, 40% or more,
[0116] [0116] In yet other modalities, one or more of the S-enantiomers described in this specification and / or their compositions / formulations are administered to reduce delirium in the individual. For example, the methods in question may include administering an amount of one or more of the S-enantiomers described in that specification and / or compositions / formulations thereof sufficient to reduce delirium in the individual by 5% or more, for example, 10 % or more, for example, 15% or more, for example, 25% or more, for example, 40% or more, for example, 50% or more, for example, 75% or more, for example, 90% or more for example, 95% or more, for example, 99% or more and including the reduction of delirium in the individual in the individual by 99.9% or more.
[0117] [0117] In yet other modalities, one or more of the S-enantiomers described in this specification and / or their compositions / formulations are administered to the individual to reduce stress presented by a caregiver to the individual. For example, the methods in question may include administering an amount of one or more of the S-enantiomers described in that specification and / or compositions / formulations of these sufficient to reduce stress presented by a caregiver to the individual by 5%
[0118] [0118] Methods are also provided for the treatment of one or more of epilepsy, Parkinson's disease, heart failure, traumatic brain injury, stroke, hemorrhagic shock, acute lung injury after fluid resuscitation, acute kidney injury, myocardial infarction, myocardial ischemia, diabetes, glioblastoma multiforme, diabetic neuropathy, prostate cancer, amyotrophic lateral sclerosis, Huntington's disease, cutaneous T-cell lymphoma, multiple myeloma, peripheral T-cell lymphoma, HIV, Niemann-Pick Type C disease, macular degeneration related to age, gout, atherosclerosis, rheumatoid arthritis and multiple sclerosis can administer one or more S-enantiomers described in this specification and / or compositions / formulations thereof.
[0119] [0119] The conditions mentioned above are examples of conditions that can be caused, exacerbated or associated with high plasma levels of free fatty acids and, consequently, it is believed that the Ss enantiomers described in this specification and / or compositions / formulations of these can be used to treat these conditions.
[0120] [0120] However, in other modalities, it is believed that the S-enantiomers described in this specification and / or their compositions / formulations can be used to treat an individual suffering from a condition such as diabetes, hyperpyrexia, hyperthyroidism, metabolic syndrome X, fever and / or an infection.
[0121] [0121] In certain embodiments, the S-enantiomers described in that specification (for example, S-BHB-S-1,3-butanediol and S-BHB) and compositions / formulations thereof can be administered in combination with one or more agents additional. These agents include, without limitation, micronutrients and drugs. In certain embodiments, the S-enantiomer (s) and the additional agent (s) can be formulated together into a single composition for ingestion. Alternatively, the S-enantiomers described in this specification and the additional agent can be formulated separately for separate, simultaneous or sequential administration.
[0122] [0122] When the additional agent is a medication, it can be, for example, a standard therapy for a condition from which the individual suffers. For example, in certain embodiments, the S-enantiomers described in that specification (for example, S-BHB-S-1,3-butanediol and S-BHB) and compositions / formulations thereof can be administered in combination with conventional antidiabetic agents to an individual suffering from diabetes. Conventional antidiabetic agents include, but are not limited to, insulin sensitizers such as thiazolidinediones, insulin secretagogues such as sulphonylureas, biguanide antihyperglycemic agents such as
[0123] [0123] In certain embodiments, when the additional agent comprises a micronutrient, it can be, for example, a mineral or a vitamin. Examples include, without limitation, iron, calcium, magnesium, vitamin A, B vitamins, vitamin C, vitamin D and vitamin E.
[0124] [0124] Ketone bodies act on niacin receptors. Consequently, in certain embodiments, the S-enantiomers described in that specification (for example, S-BHB-S-1,3-butanediol and S-BHB) and compositions / formulations thereof can be advantageously administered in combination with niacin (vitamin B3 ), as both ketone bodies and niacin act on adipose tissue to inhibit the release of free fatty acid.
[0125] [0125] In certain embodiments, the S-enantiomers described in this specification (for example, S-BHB-S-1,3-butanediol and S-BHB) and compositions / formulations of these can be formulated into an ingestible composition that still comprises a dietetically or pharmaceutically acceptable carrier. The compositions may include, without limitation, food products, drinks, drinks, supplements, dietary supplements, functional foods, nutraceuticals or medications.
[0126] [0126] In various modalities, the concentration of the S-enantiomer (s) in the ingestible composition depends on several factors, including the particular shape of the composition, the intended use of the composition and the target population. Generally, the composition will contain the -S enantiomer (s) in an amount effective to reduce plasma levels of free fatty acids Typically, the amount is that required to obtain a circulating concentration of S-beta-hydroxybutyrate (S-BHB) and / or acetoacetate from about 10 pM to about 20 mM, or from about 50 pyM to about 10 mM, or from about 100 UM to about 5 mM, in an individual (for example, a human or non-human mammal) that ingests the composition In one embodiment, an amount is used to obtain a circulating concentration of about 0.7 mM to about 5 mM, for example, from about 1 mM to about 5 mM.
[0127] [0127] When consumed, the S-BHB-S-1,3-butanediol described in this specification can be hydrolyzed into two products, S-beta-hydroxybutyrate (S-BHB) and (S) -l1,3-butanediol, which can provide a source of calories that can be classified as a food and can form part of a food product.
[0128] [0128] A food product is an edible material composed primarily of one or more of the macronutrients protein, carbohydrate and fat, which is used in the body of an organism (for example, a mammal) to support growth, repair damage, assist processes vital or provide energy. A food product can also contain one or more micronutrients, such as vitamins or minerals, or additional dietary ingredients, such as flavoring and coloring.
[0129] [0129] Examples of food products in which the S-enantiomers described in that specification or compositions / formulations thereof can be incorporated as an additive include, without limitation, energy bars,
[0130] [0130] Examples of beverages and drinks include, without limitation, soft drinks, energy drinks, powdered drinks, nutritional drinks, drinks that replace a meal or food, rehydration compositions (for example, during or after exercise), and teas (for herbal teas) for infusion or herbal mixtures for decoction in water.
[0131] [0131] In certain embodiments, a rehydration composition typically comprises water, a sugar (or non-sugar sweetener), carbohydrate and one or more of the S-enantiomers described in this specification. In certain embodiments, the composition may also comprise suitable flavorings, dyes and preservatives, as will be seen by those skilled in the art. Carbohydrate sugar, when present, can provide a source of energy, and suitable sugars are known, including glucose and trehalose. In certain embodiments, a drink that replaces a meal or food may be the type that is commonly advocated for use in weight loss regimes. Such beverage formulations typically comprise appropriate amounts of one or more macronutrients, that is, sources of protein, fat and / or carbohydrate, along with optional additional ingredients such as, for example, solubilizing agents, preservatives, sweetening agents, flavoring and coloring agents.
[0132] [0132] A nutraceutical is a food ingredient, food supplement or food product that is considered to provide a medical or health benefit, including disease prevention and treatment. In general, a nutraceutical is specifically adapted to confer a particular health benefit to the consumer. In various embodiments, a nutraceutical typically comprises a micronutrient such as a vitamin, mineral, herb and / or phytochemical at a higher level than would be found in a corresponding regular (natural) food product. The level is typically selected to optimize the nutraceutical's desired health benefit when taken as a single serving or as part of a diet regimen or nutritional therapy period. In certain embodiments, the level would be an effective level for reducing plasma fatty acid levels.
[0133] [0133] A functional food is a food that is marketed as providing a health benefit beyond that of providing pure nutrition to the consumer. A functional food typically incorporates an ingredient, such as a micronutrient as mentioned above, that confers a specific medical or physiological benefit in addition to a nutritional effect. A functional food typically carries a health warning on the packaging.
[0134] [0134] In certain embodiments, a nutraceutical or functional food product typically contains one or both of the S-enantiomers described in this specification in an amount effective to reduce plasma levels of free fatty acids in an individual. More typically, the nutraceutical or functional food product contains the S-enantiomer (s) in an amount effective to suppress appetite, treat obesity or promote weight loss in an individual.
[0135] [0135] A dietary supplement is a product intended to supplement the normal diet of an individual (for example, a human individual) and which contains a dietary ingredient such as a vitamin, mineral, herb or other botanical product, or amino acid. A dietary supplement is typically presented in a unit dosage format and is designed for consumption with, before or after food, but not in place of food. A dietary supplement is therefore often presented as a tablet or capsule, or as a dry powder or granules to sprinkle over food or to add to water or a beverage. Pharmaceutical and / or dietary formulations.
[0136] [0136] In certain embodiments, the S-enantiomers described in this specification (for example, S-BHB-S-1,3-butanediol and S-BHB (see, for example, Figure 1) can be formulated into a drug or a dietary supplement by mixing with a dietetic or pharmaceutically acceptable carrier or excipient, that carrier or excipient may comprise, without limitation, a solvent, dispersion medium, coating, isotonic or absorption retarding agent, sweetener or the like. all solvents, dispersion media, coatings, isotonic and absorption retarding agents, sweeteners and the like .. Suitable carriers can be prepared from a wide range of materials including, without limitation, diluents, binders and adhesives, lubricants, disintegrants, coloring agents, bulking agents, flavoring agents, sweetening agents and various materials such as buffers and adsorbents that may be needed in order to prevent and stopping a particular dosage form. The use of these means and agents for pharmaceutically active substances is well known in the art.
[0137] [0137] The S-enantiomers described in this specification can be administered in the “native” form, if desired, in the form of salts, esters, amides, derivatives and the like, provided that the salt, ester, amide or derivative is pharmacologically suitable, for example, effective in the present method (s). Salts, esters, amides and other derivatives of S-enantiomers can be prepared using standard procedures known to those skilled in the technique of synthetic organic chemistry and described , for example, by March (1992) "Advanced Organic Chemistry; Reactions, Mechanisms and Structure", 4th Edition, NY Wiley- Interscience.
[0138] [0138] Methods of formulating these derivatives are known to those skilled in the art. For example, a pharmaceutically acceptable salt can be prepared for any compound described in that specification that has a functionality capable of forming a salt (for example, a carboxylic acid functionality of the compounds described in that specification). A pharmaceutically acceptable salt is any salt that retains the activity of the parent compound and does not transmit any harmful or unwanted effects on the individual to whom it is administered and in the context in which it is administered.
[0139] [0139] Methods for pharmaceutically formulating the compounds described in that specification as salts, esters, amides and the like are well known to those skilled in the art.
[0140] [0140] For the preparation of salt forms of basic drugs, the pKa of the counterion is preferably at least about 2 pH units lower than the pKa of the drug. Similarly, for the preparation of salt forms of acidic drugs, the pKa of the counterion is preferably at least about 2 pH units higher than the pKa of the drug. This allows the counterion to bring the pH of the solution below the pHmax until it reaches the salt plateau, where the solubility of the salt prevails over the solubility of the acid or free base. The generalized rule of difference in the pKa units of the ionizable group in the active pharmaceutical ingredient (API) and in the acid or base aims to make the transfer of protons energetically favorable. When the API and counter-ion pKa are not significantly different, a solid complex can form, but it can quickly disproportionate (for example, degrade into individual drug and counter-ion entities) in an aqueous environment.
[0141] [0141] In several embodiments, the counterion is a pharmaceutically acceptable counterion. Suitable anionic salt forms include, without limitation, acetate, benzoate, benzylate, bitartrate, bromide, carbonate, chloride, citrate, edetate, edisylate, stolate, formate, fumarate, gluceptate, gluconate, hydrobromide, hydrochloride, iodide, lactate, lactobionate, malate, maleate, mandelate, mesylate, methyl bromide, methyl sulfate, mucate, napsylate, nitrate, pamoate (embonate), phosphate and diphosphate, salicylate and disalicylate, stearate, succinate, sulfate, tartrate, tosylate, trietiodide, valerate and the like, Suitable cationic salt forms include, without limitation, aluminum, benzathine, calcium, ethylene diamine, lysine, magnesium, meglumine, potassium, procaine, sodium, tromethamine, zinc and the like.
[0142] [0142] The preparation of esters typically involves the functionalization of hydroxyl and / or carboxyl groups that are present within the molecular structure of the active agent (for example, S-enantiomers described in this specification). In certain embodiments, esters are typically acyl-substituted derivatives of free alcohol groups, for example, portions that are derived from carboxylic acids of the formula RCOOH, where R is alkyl, and preferably is lower alkyl. Esters can be converted to free acids, if desired, using conventional hydrogenolysis or hydrolysis procedures.
[0143] [0143] Amides can also be prepared using techniques known to those skilled in the art or described in the relevant literature. For example, amides can be prepared from esters, using suitable amine reagents, or they can be prepared from an anhydride or an acid chloride by reaction with ammonia or a lower alkyl amine.
[0144] [0144] In various embodiments, the compounds identified in this specification are useful for parenteral, topical, oral, nasal (or otherwise inhaled), rectal or local administration, for example, by aerosol or transdermally, for prophylactic treatment and / or therapeutic of one or more of the pathologies / indications described in this specification
[0145] [0145] The active agents described in this specification (for example, S-enantiomers) can also be combined with a pharmaceutically acceptable carrier (excipient) to form a pharmacological composition. Pharmaceutically acceptable carriers can contain one or more physiologically acceptable compounds that act, for example, to stabilize the composition or to increase or decrease the absorption of the sS-enantiomers. Physiologically acceptable compounds may include, for example, carbohydrates, for example, glucose, sucrose, or dextrans, antioxidants, for example, ascorbic acid or glutathione, chelating agents, low molecular weight proteins, protection and uptake enhancers such as lipids, compositions that reduce the clearance or hydrolysis of the S-enantiomers, or excipients or other stabilizers and / or buffers.
[0146] [0146] Other physiologically acceptable compounds, particularly for use in the preparation of tablets, capsules, gel caps and the like include, without limitation, binders, diluent / fillers, disintegrants, lubricants, suspending agents and the like.
[0147] [0147] In certain embodiments, for the manufacture of an oral dosage form (for example, a tablet), an excipient (for example, lactose, sucrose, starch, mannitol etc.), an optional disintegrant (for example, carbonate of calcium, calcium carboxymethylcellulose, sodium starch glycolate, crospovidone, etc.), a binder (eg alpha starch, gum arabic, microcrystalline cellulose, carboxymethylcellulose, polyvinylpyrrolidone,
[0148] [0148] Other physiologically acceptable compounds include wetting agents, emulsifying agents, dispersing agents or preservatives that are particularly useful for preventing the growth or action of microorganisms. Various preservatives are well known and include, for example, phenol and ascorbic acid. Those skilled in the art would note that the choice of the pharmaceutically acceptable carrier (or carriers), including a physiologically acceptable compound, depends, for example, on the route of administration of the S-enantiomers described in that specification and on the particular physicochemical characteristics of the enantiomers- sS.
[0149] [0149] In certain embodiments, excipients are sterile and generally free of unwanted matter. Such compositions can be sterilized by conventional, well-known sterilization techniques. For various excipients of the oral dosage form, for example, tablets and capsules, sterility is not necessary. The USP / NF standard is usually sufficient.
[0150] [0150] The pharmaceutical compositions can be administered in several unit dosage forms, depending on the method of administration. Suitable unit dosage forms include, without limitation, powders, tablets, pills, capsules, lozenges, suppositories, plasters, nasal sprays, injectable, implantable, sustained-release formulations, mucus-adherent films, topical varnishes, lipid complexes, etc.
[0151] [0151] Pharmaceutical compositions that comprise the S-enantiomers described in this specification can be manufactured using conventional processes of mixing, dissolving, granulating, making pills, levitating, emulsifying, encapsulating, capturing or lyophilizing. The pharmaceutical compositions can be formulated in a conventional manner with the use of one or more physiologically acceptable carriers, diluents, excipients or auxiliaries that facilitate the processing of the S-enantiomers in preparations that can be used pharmaceutically. The appropriate formulation depends on the chosen route of administration.
[0152] [0152] Systemic formulations include, without limitation, those designed for injection administration, For example, subcutaneous, intravenous, intramuscular, intrathecal or intraperitoneal injection, as well as those designed for transdermal, oral transmucosal or pulmonary administration. For injection, the S-enantiomers described in this specification can be formulated in aqueous solutions, preferably in physiologically compatible buffers such as, for example, Hanks' solution buffer, Ringer's solution or saline and / or in certain emulsion formulations. The solution may contain formulation agents, such as suspending, stabilizing and / or dispersing agents. In certain embodiments, S-enantiomers can be supplied in powder form for reconstitution with a suitable vehicle, for example, sterile pyrogen-free water, before use. For transmucosal administration, penetrants appropriate to the barrier to be permeated can be used in the formulation. Such penetrants are generally known in the art.
[0153] [0153] For oral administration, the compounds can be readily formulated by combining the S-enantiomers with pharmaceutically acceptable carriers well known in the art. These carriers allow the compounds described in this specification to be formulated as tablets, pills, pills, capsules, liquids, gels, syrups, slurries, suspensions and the like, for oral ingestion by a patient to be treated. For solid oral formulations such as, for example, powders, capsules and tablets, suitable excipients include fillers such as, for example, sugars, for example, lactose, sucrose, mannitol and sorbitol; cellulose preparations such as, for example, corn starch, wheat starch, rice starch, potato starch, gelatin, tragacanth gum, methyl cellulose, hydroxypropylmethylcellulose, sodium carboxymethylcellulose and / or polyvinylpyrrolidone (PVP); granulating agents; and binding agents. If desired, disintegrating agents, for example, cross-linked polyvinylpyrrolidone, agar or alginic acid or a salt thereof, such as sodium alginate, can be added. If desired, solid dosage forms can be coated with sugar or enteric coated using standard techniques.
[0154] [0154] For liquid oral preparations such as suspensions, elixirs and solutions, carriers, excipients or suitable diluents include water, glycols, oils, alcohols etc. In addition, flavoring agents, preservatives, coloring agents and the like can be added. For oral administration, the compositions may take the form of tablets, lozenges, etc., formulated in a conventional manner.
[0155] [0155] For administration by inhalation, the S-enantiomers described in this specification are conveniently released in the form of an aerosol spray by pressurized packaging or a nebulizer, using a suitable propellant, for example, dichlorodifluoromethane, trichlorofluoromethane, dichlorotetrafluoroethane, carbon dioxide or other suitable gas. In the case of a pressurized aerosol, the dosage unit can be determined by providing a valve to deliver a metered quantity. Capsules and cartridges of, for example, gelatin, for use in an inhaler or insufflator, can be formulated containing a powdered mixture of the compound and a suitable powder base such as, for example, lactose or starch.
[0156] [0156] In various modalities, the S-enantiomers described in this specification can be formulated in rectal or vaginal compositions, such as suppositories or retention enemas, for example, containing conventional suppository bases such as, for example,
[0157] [0157] In addition to the formulations described previously, S-enantiomers can also be formulated as a deposit preparation. These long-acting formulations can be administered by implantation (for example, subcutaneously or intramuscularly) or by intramuscular injection. Thus, for example, the compounds can be formulated with suitable polymeric or hydrophobic materials (for example, as an emulsion in an acceptable oil) or ion exchange resins, or as sparingly soluble derivatives, for example, as a sparingly soluble salt .
[0158] [0158] Alternatively, other pharmaceutical delivery systems can be employed. Liposomes and emulsions are well-known examples of delivery vehicles that can be used to protect and release pharmaceutically active compounds. Certain organic solvents, such as dimethyl sulfoxide, can also be used, although “usually at the expense of increased toxicity. In addition, the compounds can be released using a sustained release system, for example, semipermeable matrices of solid polymers that contain the therapeutic agent. Various uses of sustained release materials have been established and are well known to those skilled in the art. Sustained-release capsules can, depending on their chemical nature, release compounds within a few weeks to more than 100 days. Depending on the chemical nature and biological stability of the therapeutic reagent, additional strategies for protein stabilization may be employed.
[0159] [0159] In certain modalities, the S-enantiomers and / or formulations described in this specification are administered orally. This is readily achieved by using tablets, capsules, lozenges, liquids and the like.
[0160] [0160] In certain embodiments, the S-enantiomers and / or formulations described in this specification are administered systemically (for example, orally, or as an injectable) according to standardized methods well known to those skilled in the art. In other modalities, agents can also be released through the skin with the use of conventional transdermal drug delivery systems, for example, “patches”, in which the compound (s) and / or formulations described in this specification they are typically contained within a laminated structure that serves as a drug delivery device to be attached to the skin. In this structure, the pharmacological composition is typically contained in a layer, or "reservoir", underlying an upper layer. It will be noted that the term "reservoir", in this context, refers to an amount of "active ingredient (s)" that will ultimately be available for release to the skin surface. Thus, for example, the “reservoir” may include the active ingredient (s) in an adhesive of a plaster covering layer, or in any of several different matrix formulations known to those skilled in the art. technical. The plaster can contain a single reservoir, or it can contain multiple reservoirs.
[0161] [0161] In an illustrative embodiment, the reservoir comprises a polymeric matrix of a pharmaceutically acceptable skin contact adhesive material that serves to affix the system to the skin during the release of the drug. Examples of suitable skin contact adhesive materials include, without limitation, polyethylene polysiloxanes, polyisobutylene, polyacrylates, polyurethanes and the like. Alternatively, the reservoir containing the drug and the skin contact adhesive are present as separate and distinct layers, with the adhesive underlying the reservoir which, in this case, can be a polymeric matrix as described above, or it can be a reservoir of liquid or hydrogel, or it can take another form. The lining layer in these laminates, which serves as the top surface of the device, preferably functions as a primary structural element of the "plaster" and provides the device with a good deal of its flexibility. The material selected for the bedding layer is preferably substantially impermeable to the S-enantiomers and to any other materials that are present.
[0162] [0162] In certain embodiments, one or more S-enantiomers described in this specification can be supplied as a “concentrate”, for example, in a storage container (for example, in a previously measured volume) ready for dilution, or in a soluble capsule ready to be added to a volume of water, alcohol, hydrogen peroxide or other diluent.
[0163] [0163] In certain embodiments, the S-enantiomers described in this specification are suitable for oral administration. In various embodiments, the compound (s) in the oral compositions can be coated or uncoated. The preparation of enteric coated particles is disclosed, for example, in U.S. Patent No. 4,786,505 and
[0164] [0164] In various embodiments, the compositions contemplated in this specification typically comprise one or more of the S-enantiomers described in that specification in an amount effective to achieve a pharmacological effect or therapeutic improvement without undue adverse side effects. Illustrative pharmacological effects or therapeutic improvements include, without limitation, a reduction or cessation in the rate of bone resorption at one or more locations, an increase in bone density, a reduction in tumor volume, a reduction in arthritic pathology and the like.
[0165] [0165] In several modalities, the typical daily dose of S-enantiomers varies and will depend on several factors, such as, for example, individual patient requirements and the disease to be diagnosed and / or treated. In general, the daily dose of compounds can be in the range of 1-1,000 mg or 1-800 mg, or 1-600 mg, or 1-500 mg or 1-400 mg. In an illustrative embodiment, an approximate standard amount of the S-enantiomers described above present in the composition can typically be about 1 to 1,000 mg, more preferably about 5 to 500 mg and, most importantly, about 10 to 100 mg. In certain modalities, the probes are administered only once, or for follow-up, as necessary. In certain modalities, the S-enantiomers and / or formulations of these are administered once daily, in certain modalities, administered twice daily, in certain modalities, administered 3 times / day and, in certain modalities, administered 4, or 6 , or 6 or 7, or 8 times / day.
[0166] [0166] In certain embodiments, the active ingredients (S-enantiomers described in this specification) are formulated in a single oral dosage form that contains all active ingredients. These oral formulations include solid and liquid forms. It is observed that solid formulations typically provide increased stability, compared to liquid formulations, and can often generate better patient acceptance.
[0167] [0167] In an illustrative embodiment, the (one or more) S-enantiomers described in this specification are formulated in a single solid dosage form such as, for example, single-layer or multilayer tablets, suspension tablets, effervescent tablets, powder , pellets, granules or capsules comprising multiple microparticles, as well as a capsule within a capsule or a double chamber capsule. In another embodiment, the S-enantiomers of this specification can be formulated in a single liquid dosage form such as, for example, a suspension containing all active ingredients or a dry suspension to be reconstituted before use.
[0168] [0168] In certain embodiments, the S-enantiomers described in this specification are formulated as enteric-coated delayed release granules or as granules coated with non-enteric time-dependent release polymers in order to avoid contact with gastric juice. Non-limiting examples of suitable enteric coated pH-dependent polymers are: cellulose acetate phthalate, hydroxypropylmethylcellulose phthalate, polyvinylacetate phthalate, methacrylic acid copolymer, shellac, hydroxypropylmethylcellulose succinate, any cellulose acetate, mixtures of any cellulose acetate. previously mentioned. A suitable commercially available enteric material, for example, is sold under the trade name EUDRAGIT L 100-550. This coating can be sprayed onto a substrate.
[0169] [0169] Illustrative time-dependent release polymers without enteric coating include, for example, one or more polymers that swell in the stomach by absorbing water from the gastric fluid thereby increasing the size of the particles to create a thick coating layer . The time-dependent release coating generally has erosion and / or diffusion properties that are independent of the pH of the external aqueous medium. In this way, the active ingredient is released slowly by the particles by diffusion or after slow erosion of the particles in the stomach.
[0170] [0170] Illustrative non-enteric time-dependent release coatings are, for example: film-forming compounds such as cellulose derivatives, for example, methylcellulose, hydroxypropyl methylcellulose (HPMC), hydroxyethylcellulose and / or acrylic polymers, including forms non-enteric substances in EUDRAGITO brand polymers. Other film-forming materials can be used alone or in combination with each other or with those listed above. These other film-forming materials generally include, for example, poly (vinylpyrrolidone), Zeine, poly (ethylene glycol), poly (ethylene oxide), poly (vinyl alcohol), poly (vinyl acetate) and ethyl cellulose, in addition to others pharmaceutically acceptable hydrophilic and hydrophobic film-forming materials. These film-forming materials can be applied to the substrate cores using water as the vehicle or, alternatively, a solvent system. Hydroalcoholic systems can also be employed to serve as a vehicle for film formation.
[0171] [0171] Other materials suitable for producing the time-dependent release coating of the compounds described in this specification include, by way of example only and without limitation, water-soluble polysaccharide gums such as carrageenan, fucoidan, ghatti gum, tragacanth, arabinogalactane , pectin and xanthan; water-soluble salts of polysaccharide gums such as, for example, sodium alginate, sodium tragacanthin and sodium kate gum; water-soluble hydroxyalkylcellulose in which the alkyl member is linear or branched from 1 to 7 carbons such as, for example, hydroxymethylcellulose, hydroxyethylcellulose and hydroxypropylcellulose; cellulose-based synthetic water-soluble sheet former such as, for example, methyl cellulose and its cellulose and hydroxyalkyl derivatives —methylcellulose, for example, a member selected from the group consisting of hydroxyethyl methylcellulose, hydroxypropyl methylcellulose and hydroxybutyl methylcellulose; other cellulose polymers, for example, sodium carboxymethyl cellulose; and other materials known to those skilled in the art. Other sheet-forming materials that can be used for this purpose include, without limitation, poly (vinylpyrrolidone), polyvinyl alcohol, polyethylene oxide, a mixture of gelatin and polyvinyl-pyrrolidone, gelatin, glucose, saccharides, povidone, copovidone, copolymer of poly (vinylpyrrolidone) -poly (vinyl acetate).
[0172] [0172] Although S-enantiomers and formulations of these and methods of using these are described in this specification with respect to use in humans, they are also suitable for animal use, for example, veterinary use. Accordingly, certain illustrative organisms include, without limitation, humans, non-human primates, canines, horses, felines, pigs, ungulates, lagomorphs and the like.
[0173] [0173] The formulations and administration methods presented above are intended to be illustrative and not limiting. It will be noted that, using the teachings provided in this specification, other suitable formulations and modes of administration can be readily anticipated.
[0174] [0174] In various modalities, the S-enantiomers described in this specification and / or formulations described in that specification can be packaged in multiple or single dose containers. Packaged agents can be supplied in kits, for example, including component parts that can be assembled for use. For example, an active agent in lyophilized form and a suitable diluent can be provided as separate components for combination before use. A kit can include an active agent and a second therapeutic agent for co-administration. The active agent and the second therapeutic agent can be provided as separate component parts. A kit can include several containers, each container containing one or more unit doses of the compounds. The containers are preferably adapted to the desired mode of administration including, without limitation, tablets, gel capsules, sustained release capsules and the like, for oral administration; depot products, pre-filled syringes, ampoules, vials and the like, for parenteral administration; and plasters, medicated dressings, creams and the like, for topical administration, for example, as described in that specification.
[0175] [0175] In certain embodiments, a kit is provided, in which the kit comprises one or more S-enantiomers described in that specification and / or formulations / compositions thereof, or pharmaceutically acceptable salt or solvate of the enantiomer (s) preferably supplied as a pharmaceutical composition and in a suitable container or containers and / or with suitable packaging; optionally, one or more additional active agents, which, if present, are preferably provided as a pharmaceutical composition and in a suitable container or containers and / or with suitable packaging; and, optionally, instructions for use eg written instructions on how to administer the compound or compositions.
[0176] [0176] As with any pharmaceutical product, the packaging material (or materials) and / or container (s) is designed to protect the stability of the product during storage and shipping. In addition, the kits may include instructions for use or other information material that can advise the user, such as a doctor, technician or patient, on how to properly administer the composition (or compositions) as a prophylactic, therapeutic or palliative treatment. disease of interest. In some embodiments, the instructions may indicate or suggest a dosage regimen that includes, without limitation, actual doses and monitoring procedures.
[0177] [0177] In some modalities, the instructions may include informational material that indicates that the administration of the compositions may result in adverse reactions that include, without limitation, allergic reactions such as, for example, anaphylaxis. Information material can indicate that allergic reactions can present only as itchy rashes or can be severe and include erythroderma, vasculitis, anaphylaxis, Steven-Johnson syndrome and the like. In certain embodiments, information material (or materials) can indicate that anaphylaxis can be fatal and can occur when any foreign protein is introduced into the body. In certain modalities, informational material may indicate that these allergic reactions may manifest as hives or a rash and develop into lethal systemic reactions and may occur shortly after exposure, for example, within 10 minutes. Information material may also indicate that an allergic reaction may cause an individual to experience paresthesia, hypotension, laryngeal edema, changes in mental status, facial or pharyngeal angioedema, airway obstruction, bronchospasm, hives and itching, serum sickness. , arthritis, allergic nephritis, glomerulonephritis, temporal arthritis, eosinophilia, or a combination of these.
[0178] [0178] Although informational materials typically comprise written or printed materials, they are not limited in this way. Any means capable of storing these instructions and communicating them to an end user is covered in this specification. Such media include, without limitation, electronic storage media (for example, magnetic disks, tapes, cartridges, chips), optical media (for example, CD-ROM) and the like. These means may include addresses of web pages that provide these informational materials. EXAMPLES
[0179] [0179] The following examples are offered to illustrate, but not limit, the claimed invention.
[0180] [0180] The activity of S-BHB and R-BHB Enantiomers in inhibiting histone deacetylases was tested. The results are shown in Figure 2.
[0181] [0181] This is an in vitro HDAC assay performed using the sodium salt of S-BHB and R-BHB with a commercial assay kit, “Fluor de Lys Green” by Enzo.
[0182] [0182] S-BHB demonstrated dose-dependent inhibition of deacetylase activity in that assay. The potency of S-BHB for HDAC inhibition in that assay was similar (within 2 times) to the potency of R-BHB as demonstrated by a different previously published assay (Shimazu et al. (2013 Science, 339 (6116): 211- 214) .R-BHB was processed in the same assay as S-BHB, and showed partial inhibition of HDAC activity, reaching a maximum of about 50% inhibition. Without attaching to a particular theory, it is believed that the R-BHB may be metabolized more quickly than S-BHB, which results in decreased maximum inhibition.
[0183] [0183] It is understood that the examples and modalities described in this specification are for illustrative purposes only and that various modifications or alterations in the light of these will be suggested by those skilled in the art and should be included within the spirit and scope of that request and the scope of the attached claims.
All publications, patents and patent applications cited in this specification are hereby incorporated by reference in their entirety for all purposes.

权利要求:
Claims (66)
[1]
1. Compound characterized by comprising an S-enantiomer of beta-hydroxybutyrate-1,3-butanediol according to Formula 1: OH or OH
AL AR
I or a pharmaceutically acceptable solvate thereof.
[2]
2. Composition characterized by comprising beta-hydroxybutyrate-1,3-butanediol enriched for the S-BHB-S-1,3-butanediol enantiomer represented by Formula I: OH oO OH
ALAN
I
[3]
Composition according to claim 2, characterized by the fact that the Formula I enantiomer comprises at least about 90% of the beta-hydroxybutyrate-1,3-butanediol that comprises said composition.
[4]
4, Composition according to claim 2, characterized by the fact that the Formula I enantiomer comprises at least about 95% of the beta-hydroxybutyrate-1,3-butanediol that comprises said composition.
[5]
5. Composition according to claim 2, characterized by the fact that the Formula I enantiomer comprises at least about 99% of the beta-hydroxybutyrate-1,3-butanediol that comprises said composition.
[6]
Pharmaceutical formulation characterized in that it comprises a compound, as defined in claim 1 and / or a composition, as defined in any of claims 2 to 5, and a pharmaceutically acceptable carrier.
[7]
7. Pharmaceutical formulation characterized by comprising: a pharmaceutically acceptable carrier: and beta-hydroxybutyrate, in which said beta-hydroxybutyrate is enriched for the S-BHB enantiomer represented by Formula 11: oH o AA, IL.
[8]
8. Formulation according to claim 7, characterized by the fact that the Formula II enantiomer comprises at least about 90% of the beta-hydroxybutyrate that comprises said formulation.
[9]
Formulation according to claim 7, characterized by the fact that the Formula II enantiomer comprises at least about 95% of the beta-hydroxybutyrate that comprises said formulation.
[10]
Formulation according to claim 7, characterized by the fact that the Formula II enantiomer comprises at least about 99% of the beta-hydroxybutyrate that comprises said formulation.
[11]
Formulation according to any one of claims 6 to 10, characterized in that said formulation is for administration through a modality selected from the group consisting of intraperitoneal administration, topical administration, oral administration, administration by inhalation, administration transdermal, subdermal deposit administration and rectal administration.
[12]
Formulation according to any one of claims 6 to 10, characterized in that said formulation is substantially sterile.
[13]
13. Formulation according to any of claims 6 to 12, characterized by the fact that said formulation meets the FDA's manufacturing guidelines for orally administered pharmaceutical products.
[14]
Formulation according to any of claims 6 to 13, characterized in that said formulation is a unit dosage formulation.
[15]
Ingestible composition characterized in that it comprises a compound, as defined in any one of claims, a compound as defined in claim 1, and / or a composition, as defined in any one of claims 2 to 5, and / or a substantially S-BHB enantiomer pure, and a dietetically or pharmaceutically acceptable carrier.
[16]
16. Composition according to claim 15, characterized in that said composition comprises a compound, as defined in claim 1, and / or a composition, as defined in any one of claims 2 to 5.
[17]
17. Composition according to claim 15, characterized in that said composition comprises a substantially pure S-BHB enantiomer.
[18]
Composition according to any one of claims 15 to 17, characterized in that said composition comprises a dietetically acceptable carrier.
[19]
19. Composition, according to claim 18,
characterized by the fact that said composition comprises a food product, a drink, a drink, a food supplement, a dietary supplement, a functional food or a nutraceutical.
[20]
Food supplement characterized in that it comprises a compound, as defined in claim 1, and / or a composition, as defined in any one of claims 2 to 5, and / or a substantially pure S-BHB enantiomer.
[21]
21. Food supplement according to claim 20, characterized in that said composition comprises a compound, as defined in claim 1, and / or a composition, as defined in any of claims 2 to 5.
[22]
22. Food supplement according to the claim characterized by the fact that said composition comprises a substantially pure S-BHB enantiomer.
[23]
23. Composition characterized by comprising: a food supplement comprising a compound, as defined in claim 1, and / or a composition, as defined in any one of claims 2 to 5, and / or a substantially pure S-BHB enantiomer; and one or more components of a ketogenic diet.
[24]
24. Composition according to claim 23 characterized in that the compound and / or said substantially pure S-BHB enantiomer is present in the composition in an amount of about 1% w / w to about 25% w / P.
[25]
25. Composition according to claim 23, characterized in that the compound and / or said substantially pure S-BHB enantiomer is present in the composition in an amount of about 5% w / w to about 15% w /P.
[26]
26. Composition according to claim 23, characterized in that the substantially pure compound and / or said S-BHB enantiomer is present in the composition in an amount of about 10% w / w.
[27]
27. Composition according to any one of claims 23 to 26, characterized in that the ketogenic diet comprises a fat to protein to carbohydrate weight ratio of about 2: 1 to about 10: 1.
[28]
28. Composition according to any one of claims 23 to 26, characterized in that the ketogenic diet comprises a fat to protein to carbohydrate weight ratio of about 3: 1 to about 6: 1.
[29]
29. Composition according to any one of claims 23 to 26, characterized by the fact that the ketogenic diet comprises a fat to protein to carbohydrate weight ratio of about 4: 1.
[30]
30. Method of treating dementia or other neurocognitive disorder, said method comprising: administering to an individual in need of an effective amount of a compound, as defined in claim 1, and / or a composition, as defined in any one claims 2 to 5, and / or pharmaceutical formulation, as defined in any one of claims 6 to 14.
[31]
31. The method of claim 30,
characterized by the fact that said method comprises the treatment of mild cognitive impairment or Alzheimer's disease, and method comprises: administration to an individual in need of a compound, as defined in claim 1, and / or a composition, as defined in any one of claims 2 to 5, and / or pharmaceutical formulation, as defined in any of claims 6 to 14, in an amount sufficient to ameliorate one or more symptoms of Mild Cognitive Deficit and / or Alzheimer's disease.
[32]
32. Method for preventing or delaying the appearance of a pre-Alzheimer's condition and / or cognitive impairment and / or ameliorating one or more symptoms of a pre-Alzheimer's condition and / or cognitive impairment, or preventing or delaying the progression of a condition pre-Alzheimer's or cognitive impairment for Alzheimer's disease, said method comprising: administering to a subject in need of a compound, as defined in claim 1, and / or a composition, as defined in any of claims 2 to 5 , and / or a pharmaceutical formulation, as defined in any one of claims 6 to 14, in an amount sufficient to prevent or delay the onset of a pre-Alzheimer's cognitive impairment, and / or to improve one or more symptoms of a cognitive impairment pre-Alzheimer's disease, and / or to prevent or slow the progression of a pre-Alzheimer's cognitive impairment to Alzheimer's disease.
[33]
33. Method according to claim 32, characterized by the fact that said method is a method of preventing or delaying the transition from a pre-condition
Cognitive asymptomatic Alzheimer's for pre-Alzheimer's cognitive dysfunction.
[34]
34. Method according to claim 32, characterized by the fact that said method is a method of preventing or delaying the appearance of a pre-Alzheimer's cognitive dysfunction.
[35]
35. Method according to claim 32, characterized in that said method comprises improvement of one or more symptoms of a pre-Alzheimer's cognitive dysfunction.
[36]
36. Method according to claim 32, characterized in that said method comprises preventing or delaying the progression of a pre-Alzheimer's cognitive dysfunction to Alzheimer's disease.
[37]
37. Method according to any one of claims 30 to 36, characterized in that said individual exhibits positivity for AB biomarker in a clinically normal human subject aged 50 years or older.
[38]
38. Method according to any one of claims 30 to 37, characterized in that said individual exhibits asymptomatic cerebral amyloidosis.
[39]
39. Method according to any one of claims 30 to 37, characterized in that said individual exhibits cerebral amyloidosis in combination with downstream neurodegeneration.
[40]
40. Method according to claim 39, characterized by the fact that said downstream neurodegeneration is determined by one or more elevated neuronal injury markers selected from the group consisting of tau and FDG uptake.
[41]
41. Method according to any of claims 30 to 36, characterized by the fact that said individual is an individual diagnosed with mild cognitive impairment.
[42]
42. Method according to any one of claims 30 to 41, characterized in that said individual exhibits a clinical dementia rating above zero and below about 1.5.
[43]
43. The method of any one of claims 30 to 36, characterized by the fact that the individual is at risk of developing Alzheimer's disease.
[44]
44, Method according to any one of claims 30 to 43, characterized by the fact that the individual has a family risk for having Alzheimer's disease.
[45]
45. Method according to any of claims 30 to 43, characterized in that the individual has a familial mutation of Alzheimer's disease (FAD).
[46]
46. Method according to any of claims 30 to 43, characterized in that the individual has the £ 4 allele of APOE.
[47]
47. Method according to any one of claims 30 to 46, characterized in that the administration of said compound slows or prevents the progression of MCI to Alzheimer's disease.
[48]
48. Method according to any one of claims 30 to 47, characterized by the fact that said administration produces a reduction in the CSF of the levels of one or more components selected from the group consisting of AB42, sAPPRB, Tau-total (tTau ), phospho-Tau (pTau), APPneo, soluble AB40, pTau / AB42 ratio and tTau / AB42 ratio, and / or an increase in CSF levels of one or more components selected from the group consisting of AB42 / AB40 ratio, proportion AB42 / AB38, sAPPa, sAPPa / SsAPPB ratio, SsAPPa / AB40 ratio and sAPPa / AB42 ratio.
[49]
49. Method according to any of claims 30 to 48, characterized by the fact that said administration produces an improvement in the individual's cognitive skills.
[50]
50. Method according to any of claims 30 to 48, characterized by the fact that said administration produces an improvement, a stabilization or a reduction in the rate of decline of the individual's clinical dementia classification (CDR).
[51]
51. Method of reducing epileptiform activity in the brain of an individual, said method comprising comprising administering to said individual an effective amount of a compound, as defined in claim 1, and / or a composition, as defined in any one claims 2 to 5, and / or pharmaceutical formulation, as defined in any one of claims 6 to 14.
[52]
52. Method according to claim 51, characterized by the fact that said effective amount is sufficient to reduce the epileptiform activity in the brain of said individual.
[53]
53. Method for the treatment, in an individual, of one or more of epilepsy, Parkinson's disease, heart failure, traumatic brain injury, stroke, hemorrhagic shock, acute lung injury after fluid resuscitation, acute kidney injury, heart attack myocardium, myocardial ischemia, diabetes, glioblastoma multiforme, diabetic neuropathy, prostate cancer, amyotrophic lateral sclerosis, Huntington's disease, cutaneous T-cell lymphoma, multiple myeloma, peripheral T-cell lymphoma, HIV, Niemann-Pick Type C disease, age-related macular degeneration, gout, atherosclerosis, rheumatoid arthritis and multiple sclerosis, comprising: administering to said individual an effective amount of a compound, as defined in claim 1, and / or a composition, as defined in any one claims 2 to 5, and / or pharmaceutical formulation, as defined in any one of claims 6 to 14.
[54]
54. Method according to claim 55, characterized in that the therapeutically effective amount is sufficient to reduce the epileptiform activity in the brain of said individual.
[55]
55. Method of treating a condition that is caused, exacerbated or associated with elevated plasma levels of free fatty acids in a human or animal subject, a method characterized by comprising administering to the subject an effective amount of a compound, as defined in the claim 1, and / or a composition, as defined in any one of claims 2 to 5, and / or a pharmaceutical formulation, as defined in any one of claims 6 to 14.
[56]
56. Method of treating a condition in which weight loss or weight gain is involved, the method of which is characterized by administering to an individual in need of an effective amount of a compound, as defined in claim 1, and / or a composition, as defined in any one of claims 2 to 5, and / or pharmaceutical formulation, as defined in any one of claims 6 to 14.
[57]
57. Method of suppressing appetite, treating obesity, promoting weight loss, maintaining a healthy weight or decreasing the ratio of fat to lean muscle mass, said method comprising understanding the administration to an individual in need of an effective amount of a compound, as defined in claim 1, and / or a composition, as defined in any of claims 2 to 5, and / or pharmaceutical formulation, as defined in any of claims 6 to 14.
[58]
58. Method of prevention or treatment of a selected condition of cognitive dysfunction, neurodegenerative disease or disorder, muscle impairment, muscle fatigue and fatigue, said method comprising understanding the administration to an individual in need of an effective amount of a compound, such as defined in claim 1, and / or a composition, as defined in any of claims 2 to 5, and / or pharmaceutical formulation, as defined in any of claims 6 to 14.
[59]
59. Method of treatment for an individual suffering from a selected condition of diabetes, hyperthyroidism, metabolic syndrome X, or for the treatment of a geriatric patient, said method characterized by comprising administering to him an effective amount of a compound, as defined in claim 1, and / or a composition, as defined in any of claims 2 to 5, and / or pharmaceutical formulation, as defined in any of claims 6 to 14.
[60]
60. Method of treatment, prevention or reduction of the effects of neurodegeneration, free radical toxicity, hypoxic conditions or hyperglycemia, said method comprising comprising administering to an individual in need of an effective amount of a compound, as defined in claim 1, and / or a composition, as defined in any of claims 2 to 5, and / or a pharmaceutical formulation, as defined in any of claims 6 to 14.
[61]
61. Method of treatment, prevention or reduction of the effects of neurodegeneration, said method characterized by comprising an effective amount of a compound, as defined in claim 1, and / or a composition, as defined in any of claims 2 to 5, and / or pharmaceutical formulation, as defined in any one of claims 6 to 14.
[62]
62. Method according to claim 60 or 61, characterized by the fact that neurodegeneration is caused by aging, trauma, anoxia or a neurodegenerative disease or disorder.
[63]
63. Method of prevention or treatment of a disease or disorder - “neurodegenerative disease selected from Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, epilepsy, astrocytoma, glioblastoma and Huntington's chorea, the aforementioned - method characterized by understanding the administration to a subject in need of an effective amount of a compound, as defined in claim 1, and / or a composition, as defined in any of claims 2 to 5, and / or pharmaceutical formulation, as defined in any of claims 6 to 14.
[64]
64. Method of promoting attention or improving cognitive function in an individual, said method comprising administering to said individual an effective amount of a compound, as defined in claim 1, and / or a composition, as defined in any of claims 2 to 5, and / or pharmaceutical formulation, as defined in any of claims 6 to 14.
[65]
65. Method according to any one of claims 30 to 64, characterized in that said individual is a human.
[66]
66. Method according to any one of claims 30 to 64, characterized in that said individual is a non-human mammal.

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同族专利:

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公开号 | 公开日

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KR20200029547A|2020-03-18|

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JP2020527583A|2020-09-10|

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IL272173D0|2020-03-31|

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CN111050764A|2020-04-21|

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EP3654963A1|2020-05-27|

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AU2018304380A1|2020-01-30|

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US20200140371A1|2020-05-07|

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WO2019018683A1|2019-01-24|

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CA3070453A1|2019-01-24|

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EP3654963A4|2021-04-14|

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法律状态:
2021-10-26| B11A| Dismissal acc. art.33 of ipl - examination not requested within 36 months of filing|

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2021-11-03| B350| Update of information on the portal [chapter 15.35 patent gazette]|

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2022-01-11| B11Y| Definitive dismissal - extension of time limit for request of examination expired [chapter 11.1.1 patent gazette]|

优先权:

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US201762535754P| true| 2017-07-21|2017-07-21|

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US62/535,754|2017-07-21|

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PCT/US2018/042948|WO2019018683A1|2017-07-21|2018-07-19|S-enantiomers of beta-hydroxybutyrate and butanediol and methods for using same|

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