Inhibitors of ABC drug transporters at the blood-brain barrier

Abstract

The present invention relates to inhibitors of drug transporters of the ABC protein superfamily, particularly transporters present at the blood brain barrier. ABC transporter inhibitors identified according to the invention increase brain concentrations of CNS-active agents. Such inhibitors increase the influx into the brain and / or reduce the efflux from the brain of such CNS-active agents.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS [0001] This application claims priority of the following U.S. Patent Application Nos. 60 / 244,482, filed Oct. 30, 2000 (provisional); 60 / 245,110, filed Nov. 1, 2000 (provisional); and 60 / 245,235, filed Nov. 2, 2000 (provisional). The applications cited above are hereby incorporated herein by reference in their entirety to provide continuity of disclosure.INTRODUCTION Background [0002] ATP-binding cassette (ABC) proteins play a central role in living cells through their role in nutrient uptake, protein, drug and antibiotic secretion, osmoregulation, antigen presentation, signal transduction and others. The majority of ABC proteins have a translocation function either in import of substrates or secretion of cellular products or xenobiotics. [0003] The ATP-binding cassette (ABC) superfamily is one of the largest superfamilies known. With the multiplication of genome sequencing projects, new sequences appear every week in the GenBank database. Memb...

AI Technical Summary

Benefits of technology

[0012] The present invention is directed to novel methods and compositions with drug transporter inhibitors. Such inhibitors according to the invention modulate the activity of ABC transporter proteins and include inhibitors of MDR proteins, such as PGP, as well as MRP proteins. Such methods and compositions are designed to achieve, for example, enhanced efficacy of opioid and / or non-opioid CNS-active agents, prevention and / or reversal of tolerance to, dependence upon or withdrawal from opioid and / or non-opioid CNS-active agents, as well as improved treatment of chronic pain patients.

[0013] The present invention is based in part on surprising results from transport studies of drug agents across the blood brain barrier that demonstrate that compounds of a defined structure according to the invention, including naltrexone, nalmafene and naloxone, are inhibitors of ABC transporter proteins, such as PGP, and unexpectedly increase the concentration in the brain of CNS-active agents, including opioid receptor agonists such as morphine and oxycodone. Also unexpectedly demonstrated is the reduction of efflux of such CNS-active agents from the brain by inhibitors of ABC transporter proteins according to the invention. The present invention provides a novel class of drug transporter inhibitors that act by inhibiting ABC transporter proteins and further provides a pharmacophore that allows the identification of new drug targets that are inhibitors of ABC transporter proteins. Also provided are new methods of screening for and / or identifying compounds that inhibit the transport (e.g., efflux or influx) of CNS-active agents across the blood brain barrier. Further provided are new methods of screening for and / or identifying CNS-active agents that are substrates for ABC transporter proteins. ABC transporter inhibitors identified according to the invention increase brain concentrations of CNS-active agents. Such inhibitors increase the influx into the brain and / or or reduce the efflux from the brain of such CNS-active agents.

[0016] The present invention further provides methods and compositions for reversing or preventing tolerance to CNS-active agent, including an opioid CNS-active agent, by administering a drug transporter inhibitor to a patient, including a patient who is tolerant to the CNS-active agent, such that the amount of drug transporter inhibitor administered is sufficient to decrease efflux of the CNS-active agent form the brain and / or to increase the concentration of the CNS-active agent in the brain.

[0018] The invention also provides methods of controlling chronic pain without tolerance, dependence and / or withdrawal by co-administering a therapeutic or sub-therapeutic dose of a CNS-active agent, including an opioid CNS-active agent, and an amount of a drug transporter inhibitor effective to decrease efflux of the CNS-active agent form the brain and / or increase the concentration of CNS-active agent, including an opioid CNS-active agent, in the brain.

[0019] The present invention further provides methods and composition for enhancing the efficacy of a non-opioid CNS-active agent by co-administering non-opioid CNS-active agent with an opioid receptor antagonist, such that the amount of antagonist is effective to reduce efflux of the agent from the brain and / or increase the concentration of the agent in the brain.

Problems solved by technology

For example, resistance modulators useful against P-glycoprotein are less effective in reversing MRP-mediated resistance.

However, delivering these pharmaceutical substances to their active sites in the central nervous system (CNS), particularly the brain, can be problematic due to the very limited permeability of the blood brain barrier, which discourages transport of many therapeutically active agents into the brain.

The ability of the blood brain barrier to protect the nervous system from exogenous substances has impeded the development of therapies for a wide variety of disorders and conditions of the central nervous system.

The blood brain barrier presents a particularly difficult obstacle to treating conditions in which the therapeutic agents must act upon sites within the central nervous system, particularly the brain.

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