Nitrosated proton pump inhibitors, compositions and methods of use

Abstract

The invention describes novel nitrosated proton pump inhibitor compounds and pharmaceutically acceptable salts thereof, and novel compositions comprising at least one nitrosated proton pump inhibitor compound, and, optionally, at least one compound that donates, transfers or releases nitric oxide, stimulates endogenous synthesis of nitric oxide, elevates endogenous levels of endothelium-derived relaxing factor or is a substrate for nitric oxide synthase, and / or at least one therapeutic agent. The invention also provides novel compositions comprising at least one nitrosated proton pump inhibitor compound, and at least one compound that donates, transfers or releases nitric oxide, elevates endogenous levels of endothelium-derived relaxing factor, stimulates endogenous synthesis of nitric oxide or is a substrate for nitric oxide synthase and / or at least one therapeutic agent. The invention also provides novel kits comprising at least one nitrosated proton pump inhibitor compound, and, optionally, at least one nitric oxide donor and / or at least one therapeutic agent. The invention also provides methods for treating gastrointestinal disorders; facilitating ulcer healing; decreasing the recurrence of ulcers; improving gastroprotective properties, anti-Helicobacter pylori properties or antacid properties of proton pump inhibitors; decreasing or reducing the gastrointestinal toxicity associated with the use of nonsteroidal antiinflammatory compounds; treating bacterial infections and / or viral infections.

Description

RELATED APPLICATIONS [0001] This application claims priority to U.S. Application No. 60 / 399,715 filed Aug. 1, 2002. FIELD OF THE INVENTION [0002] The invention describes novel nitrosated proton pump inhibitor compounds and pharmaceutically acceptable salts thereof, and novel compositions comprising at least one nitrosated proton pump inhibitor compound, and, optionally, at least one compound that donates, transfers or releases nitric oxide, stimulates endogenous synthesis of nitric oxide, elevates endogenous levels of endothelium-derived relaxing factor or is a substrate for nitric oxide synthase, and / or at least one therapeutic agent. The invention also provides novel compositions comprising at least one nitrosated proton pump inhibitor compound, and at least one compound that donates, transfers or releases nitric oxide, elevates endogenous levels of endothelium-derived relaxing factor, stimulates endogenous synthesis of nitric oxide or is a substrate for nitric oxide synthase and / ...

AI Technical Summary

Benefits of technology

[0011] The invention is also based on the discovery that administering at least one proton pump inhibitor that is substituted with at least one NO2 group (i.e., nitrosated), and, optionally, at least one nitric oxide donor improves the properties of the proton pump inhibitor. Nitric oxide donors include, for example, S-nitrosothiols, nitrites, nitrates, N-oxo-N-nitrosamines, SPM 3672, SPM 5185, SPM 5186 and analogues thereof, and substrates of the various isozymes of nitric oxide synthase. Thus, another embodiment of the invention provides compositions comprising at least one nitrosated proton pump inhibitor and at least one compound that donates, transfers or releases nitric oxide as a charged species, i.e., nitrosonium (NO+) or nitroxyl (NO—), or as the neutral species, nitric oxide (NO.), and / or stimulates endogenous production of nitric oxide or EDRF in vivo and / or is a substrate for nitric oxide synthase. The invention also provides for such compositions in a pharmaceutically acceptable carrier.

[0013] Yet another embodiment of the invention provides methods for treating gastrointestinal disorders, methods for improving the gastroprotective properties, anti-Helicobacter properties and antacid properties of proton pump inhibitors, methods for facilitating ulcer healing and methods for decreasing the rate of recurrence of ulcers in a patient in need thereof comprising administering to the patient a therapeutically effective amount of at least one proton pump inhibitor that is substituted with at least one NO2 group (i.e., nitrosated), and, optionally, at least one compound that donates, transfers or releases nitric oxide as a charged species, i.e., nitrosonium (NO+) or nitroxyl (NO—), or as the neutral species, nitric oxide (NO.), and / or stimulates endogenous production of nitric oxide or EDRF in vivo and / or is a substrate for nitric oxide synthase (i.e. NO donor). The methods can optionally further comprise the administration of at least one therapeutic agent, such as, for example, nonsteroidal antiinflammatory compounds (NSAID), selective COX-2 inhibitor, antacids, bismuth-containing reagents, antibacterial compounds, H2 receptor antagonists, Helicobacter pylori inhibitors, gastroprokinetic compounds, and mixtures of two or more thereof. In this embodiment of the invention, the methods can involve administering the nitrosated proton pump inhibitors, administering the nitrosated proton pump inhibitors and NO donors, administering the nitrosated proton pump inhibitors and therapeutic agents, or administering the nitrosated proton pump inhibitors, NO donors, and therapeutic agents. The nitrosated proton pump inhibitors, nitric oxide donors, and / or therapeutic agents can be administered separately or as components of the same composition in one or more pharmaceutically acceptable carriers.

[0014] Yet another embodiment of the invention provides methods for decrease or reverse gastrointestinal toxicity resulting from the administration of nonsteroidal antiinflammatory compounds (NSAIDs) and / or selective COX-2 inhibitors, and methods for facilitating ulcer healing resulting from the administration of NSAIDs and / or selective COX-2 inhibitors, in a patient in need thereof comprising administering to the patient a therapeutically effective amount of at least one proton pump inhibitor that is substituted with at least one NO2 group (i.e., nitrosated), and, optionally, at least one compound that donates, transfers or releases nitric oxide as a charged species, i.e., nitrosonium (NO+) or nitroxyl (NO—), or as the neutral species, nitric oxide (NO.), and / or stimulates endogenous production of nitric oxide or EDRF in vivo and / or is a substrate for nitric oxide synthase and / or stimulates endogenous production of NO or EDRF in vivo and / or is a substrate for nitric oxide synthase (i.e. NO donor). The methods can optionally further comprise the administration of at least one therapeutic agent, such as, for example, nonsteroidal antiinflammatory compounds (NSAID), selective COX-2 inhibitors, antacids, bismuth-containing reagents, antibacterial compounds, H2 antagonists, Helicobacter pylori inhibitors, gastroprokinetic compounds, and mixtures of two or more thereof. In this embodiment of the invention, the methods can involve administering the nitrosated proton pump inhibitors, administering the nitrosated proton pump inhibitors and NO donors, administering the nitrosated proton pump inhibitors and therapeutic agents, or administering the nitrosated proton pump inhibitors, NO donors, and therapeutic agents. The nitrosated proton pump inhibitors, nitric oxide donors, and / or therapeutic agents can be administered separately or as components of the same composition in one or more pharmaceutically acceptable carriers.

Problems solved by technology

In addition, there is a high relapse rate associated with treating gastrointestinal disorders with proton pump inhibitors as they do not eliminate Helicobacter pylori (Campylobacter pylori), the bacteria responsible for peptic ulcer disease, gastric lymphoma and adenocarcinoma.

Prolonged administration of high doses of the drugs can cause hyperplasia of oxyntic mucosal cells.

The drugs can also result in bacterial overgrowth in the gastrointestinal tract and the development of nosocomial pneumonia.

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