New use of peptides derived from vasoactive intestinal peptide
Topically applied VIP analogues with 3 to 21 N-terminal amino acids address the unmet need for direct VL treatment by relaxing vaginal muscles and enhancing sexual function, offering a non-invasive alternative to surgery.
Patent Information
- Application Number
- PCT/CN2025/083665
- Authority / Receiving Office
- WO · WO
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2024-03-20
- Filing Date
- 2025-03-20
- Publication Date
- 2025-09-25
AI Technical Summary
There is a clinical need for direct and immediate medical treatment options for vaginal laxity (VL) that are not currently met by existing surgical or non-invasive methods, which often have limitations and side effects.
Topically applied VIP analogues comprising 3 to 21 N-terminal amino acids, optionally coupled with latanoprost molecules or lipids, are used to treat VL, leveraging their ability to relax smooth muscle and improve vaginal lubrication.
The VIP analogues provide significant clinical benefit in treating VL by relaxing vaginal muscles and improving sexual function without the need for invasive procedures.
Smart Images

Figure PCTCN2025083665-FTAPPB-I100001 
Figure PCTCN2025083665-FTAPPB-I100002 
Figure PCTCN2025083665-FTAPPB-I100003
Abstract
Description
NEW USE OF PEPTIDES DERIVED FROM VASOACTIVE INTESTINAL PEPTIDEField of the Invention
[0001] This invention relates the use of peptides, some of which are new, in human medicine, in the treatment of vaginal laxity and related conditions.Background and Prior Art
[0002] Vaginal laxity (VL) may be defined as looseness of the vagina which may develop after pregnancy and / or vaginal delivery, although it may also be brought on by pelvic surgery, menopause, and aging.
[0003] The condition is not well defined and likely underreported, although it is known to cause decreased genito-pelvic sensation during sexual intercourse adversely impacting sexual quality of life, as well as further issues, such as incontinence, vaginal dryness and sagging skin.
[0004] VL may be treated via so-called ‘vaginal rejuvenation’ , which aims to restore the look and / or function of the vagina, usually through surgery (vaginoplasty; often carried out by plastic surgeons, urologists or gynaecologists) and / or non-invasively using energy-based (radiofrequency or laser) devices which are designed to promote tissue remodelling. Patients that have undergone vaginoplasty repairs for introital laxity have reported improved sexual function.
[0005] However, there remains a clear unmet clinical need for medicines that may be used in the direct, immediate treatment of VL.
[0006] Vasoactive intestinal peptide (VIP) is an endogenous peptide hormone consisting of 28 amino acid residues. It belongs to a glucagon / secretin superfamily of peptides and is synthesised in many tissues including the gut, the pancreas and the hypothalamus.
[0007] VIP has many known biological actions, including vasodilation causing a hypotensive effect, bronchodilation, which, along with pulmonary vasodilation and bronchial secretion promotes ventilation and protects against acute lung injury (ALI) , stimulation of glycogenolysis and gluconeogenesis, stimulation of the release of numerous hormones from glands in the endocrine and neuroendocrine systems, in addition to playing a role in the central nervous and immune systems.
[0008] According to the clinicaltrials. gov website, human studies have been conducted testing VIP in the treatment of Covid-19.
[0009] VIP is also known to relax the smooth muscle in the respiratory and the gastrointestinal systems, as well as in the reproductive system of males and females. In particular, VIP causes relaxation of the smooth muscle tube and cervix, inhibits myometrial contractions, and increases uterine blood flow and vaginal lubrication in the female reproductive system.
[0010] Gourlet et al summarised in Peptides, 17, 825 (1996) prior reports indicating that VIP cannot be significantly shortened at the C-terminus without a loss in resultant peptides’ binding affinities. A later publication by Onoue et al, Life Sciences, 74, 1465 (2004) reported that receptor binding activity dropped off dramatically in proportion to a decrease in C-terminal amino acid residues, with VIP (1-22) and VIP (1-21) exhibiting little binding activity even at high concentrations. These authors concluded that a minimum of 23 amino acid residues are required for conservation of VIP receptor binding activity.
[0011] We have now found, surprisingly, that topically-applied VIP analogues comprising considerably fewer than 23 N-terminal amino acid residues exhibit significant clinical benefit in the treatment of VL.
[0012] Disclosure of the Invention
[0013] According to a first aspect of the invention, there is provided a compound consisting essentially of between 3 and 21 N-terminal amino acids of the peptide sequence:
[0014] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys-Lys (SEQ ID No: 1)
[0015] wherein:
[0016] each of X4, X5, X9, X11 and / or X13 independently represent an amino acid selected from the group Ala, Val, Ile, Gly, Asn, Ser, Thr, Tyr and Leu;
[0017] which peptide sequence is optionally coupled to the group Y or, in cases where the C-terminal amino acid is not Lys, to the group -Lys-Y; and
[0018] Y represents one or more latanoprost molecules and / or one or more lipid, which lipid is selected from the group consisting of vitamin A, vitamin E, cholesterol and a fatty acid comprising one or more carboxylic acid groups, 1 to 50 carbons, and / or one or more cyclic rings, is linear or branched, saturated or unsaturated with between 1 and 10 carbon-carbon double bonds and / or substituted by between 1 to 10 -OH groups, or a derivative of any of these lipids;
[0019] as well as regioisomers, stereoisomers, and pharmaceutically-or cosmetically-acceptable salts of such compounds,
[0020] for use in the treatment of VL or a related disorder,
[0021] which compounds, regioisomers, stereoisomers and salts thereof for use are hereafter referred to as ‘compounds of the invention’ .
[0022] In some embodiments, the peptide sequence of the compound of the invention is:
[0023] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (SEQ ID No: 2) ;
[0024] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val (SEQ ID No: 3) ;
[0025] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala (SEQ ID No: 4) ;
[0026] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met (SEQ ID No: 5) ;
[0027] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln (SEQ ID No: 6) ;
[0028] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (SEQ ID No: 7) ;
[0029] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg (SEQ ID No: 8) ;
[0030] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13 (SEQ ID No: 9) ;
[0031] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg (SEQ ID No: 10) ;
[0032] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11 (SEQ ID No: 11) ;
[0033] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr (SEQ ID No: 12) ;
[0034] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9 (SEQ ID No: 13) ;
[0035] His-Ser-Asp-X4-X5-Phe-Thr-Asp (SEQ ID No: 14) ;
[0036] His-Ser-Asp-X4-X5-Phe-Thr (SEQ ID No: 15) ;
[0037] His-Ser-Asp-X4-X5-Phe (SEQ ID No: 16) ;
[0038] His-Ser-Asp-X4-X5 (SEQ ID No: 17) ;
[0039] His-Ser-Asp-X4 (SEQ ID No: 18) ; or
[0040] His-Ser-Asp (SEQ ID No: 19) ,
[0041] any of which sequences may be optionally coupled to the group Y or, in cases where the C-terminal amino acid is not Lys, to the group -Lys-Y.
[0042] More preferred compound of the invention include those of the peptide sequence:
[0043] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met (SEQ ID No: 5) ; or
[0044] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13 (SEQ ID No: 9) , such as:
[0045] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln (SEQ ID No: 6) ; or
[0046] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg (SEQ ID No: 8) and, especially,
[0047] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (SEQ ID No: 7) ,
[0048] any of which sequences may be optionally coupled to the group Y or, in cases where the C-terminal amino acid is not Lys, to the group -Lys-Y.
[0049] Optional Y groups (i.e. one or more latanoprost (propan-2-yl (Z) -7- [ (1R, 2R, 3R, 5S) -3, 5-dihydroxy-2- [ (3R) -3-hydroxy-5-phenylpentyl] cyclopentyl] hept-5-enoate) molecules or one or more lipids) may be covalently bonded to one or more amino acid fragments of the peptide in a compound of the invention through amide bonds formed between respective carboxylic acid residues of Y and one or more free -NH2 residues that are present in amino acids of the peptide. This includes coupling at the N-terminus of the peptide sequence and / or -NH2 groups in one or more Lys amino acids that are present elsewhere in the sequence.
[0050] Optional Y groups may in the alternative, and / or in addition, be covalently bonded to one or more amino acid fragments of the peptide in a compound of the invention through ester bonds formed between respective -OH residues in e.g. serine, threonine and / or tyrosine and one or more free carboxylic acid residues that may be present Y, and / or through ester bonds formed between respective -OH residues in Y and the free carboxylic acid group at the C-terminus of the peptide sequence.
[0051] Similarly, -Lys-Y groups are covalently bonded to an amino acid fragment at the C-terminus of the peptide sequence in a compound of the invention through amide bonds formed between respective -NH2 residues of the Lys fragment and a free carboxylic acid residue that is present in relevant amino acid at the C-terminus of the peptide sequence.
[0052] Compounds of the invention that may be mentioned include those in which Y is not present, such that the compound of the invention is an isolated peptide compound consisting essentially of any one of the aforementioned peptide sequences or a regioisomer, a stereoisomer, or a pharmaceutically-or a cosmetically-acceptable salt of said compound.
[0053] The term ‘consisting essentially of’ a specific peptide sequence and / or N-terminal amino acids will be understood to mean that that relevant sequence comprises only that sequence of amino acids (or those amino acids) , along with other features and / or components that do not materially affect the basic and novel characteristic (s) of that sequence.
[0054] When Y is present, it may represent one or more lipids, in which case the lipid (s) may be selected from the group consisting of palmitic acid, stearic acid, oleic acid, octadecanedioic acid, docosahexaenoic acid and leukotriene B4 (LTB4) , or a derivative of any of these.
[0055] Further preferred compounds of the invention also include those in which said one or more lipids comprise a polyunsaturated fatty acid, or a derivative thereof. In such embodiments, the derivative may be a specialized pro-resolving mediator (SPM) .
[0056] Further preferred compounds of the invention also include those in which said one or more lipids comprise a derivative of a fatty acid, such as a glycerolipid, glycerophospholipid, sphingolipid or saccharolipid.
[0057] Further preferred compounds of the invention also include those in which said one or more lipids comprise palmitic acid, or a derivative thereof. In such embodiments, the derivative may be phosphatidylserine, or more preferably, the derivative is 1, 2-dipalmitoyl-sn-glycero-3-phospho-l-serine (DPPS) . In such embodiments, the derivative may be phosphatidylethanolamine, or more preferably, the derivative is 1, 2-dipalmitoyl-sn-glycero-3-phosphoethanolamine (DPPE) .
[0058] Further preferred compounds of the invention also include those in which said one or more lipids comprise stearic acid, or a derivative thereof. In such embodiments, the derivative may be 1, 2-distearoyl-sn-glycero-3-phospho-l-serine.
[0059] Further preferred compounds of the invention also include those in which said one or more lipids comprise oleic acid, or a derivative thereof. In such embodiments, the derivative may be 1, 2-dioleoyl-sn-glycero-3-phospho-L-serine.
[0060] Further preferred compounds of the invention also include those in which said one or more lipids comprise palmitoylethanolamide (PEA) .
[0061] Further preferred compounds of the invention also include those in which said one or more lipids are selected from the group consisting of vitamin E, vitamin A, and cholesterol, or a derivative of any of these. In such embodiments, the derivative of cholesterol may be cholesterol-acetic acid.
[0062] Further preferred compounds of the invention also include those in which the lipid is a fatty acid as hereinbefore defined, which fatty acid may comprise 1 to 5 -OH groups, such as 1 to 2 -OH groups. In other embodiments, the fatty acid may have 1 to 10 cyclic rings, such as 1 to 8 cyclic rings.
[0063] Compounds of the invention that may be mentioned include those in which Y represents at least one lipid as hereinbefore defined.
[0064] Thus, compounds of the invention that may be mentioned include:
[0065] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys-Lys (Palm) (SEQ ID No: 20) ;
[0066] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (Palm) (SEQ ID No: 21) ;
[0067] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Lys (Palm) (SEQ ID No: 22) ;
[0068] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Lys (Palm) (SEQ ID No: 23) ;
[0069] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Lys (Palm) (SEQ ID No: 24) ;
[0070] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) (SEQ ID No: 25) ;
[0071] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Lys (Palm) (SEQ ID No: 26) ;
[0072] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-Lys (Palm) (SEQ ID No: 27) ;
[0073] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Lys (Palm) (SEQ ID No: 28) ;
[0074] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-Lys (Palm) (SEQ ID No: 29) ;
[0075] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Lys (Palm) (SEQ ID No: 30) ;
[0076] His-Ser-Asp-X4-X5-Phe-Thr-Asp-Lys (Palm) (SEQ ID No: 31) ;
[0077] His-Ser-Asp-X4-X5-Phe-Thr-Lys (Palm) (SEQ ID No: 32) ;
[0078] His-Ser-Asp-X4-X5-Phe-Lys (Palm) (SEQ ID No: 33) ;
[0079] His-Ser-Asp-X4-X5-Lys (Palm) (SEQ ID No: 34) ;
[0080] His-Ser-Asp-X4-Lys (Palm) (SEQ ID No: 35) ; or
[0081] His-Ser-Asp-Lys (Palm) (SEQ ID No: 36) .
[0082] More preferred compound of the invention include:
[0083] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Lys (Palm) (SEQ ID No: 23) , or
[0084] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-Lys (Palm) (SEQ ID No: 27) ; such as: His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Lys (Palm) (SEQ ID No: 24) or
[0085] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Lys (Palm) (SEQ ID No: 26) ; and, especially,
[0086] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) (SEQ ID No: 25) .
[0087] In the alternative, compounds of the invention that may be mentioned include: His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys-Lys (SEQ ID No: 37) ;
[0088] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (Palm) -Lys (SEQ ID No: 38) ;
[0089] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (Palm) -Lys (SEQ ID No: 39) ;
[0090] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys-Lys (Palm) (SEQ ID No: 40) ;
[0091] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (Palm) -Lys (Palm) (SEQ ID No: 41) ;
[0092] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (Palm) -Lys (Palm) (SEQ ID No: 42) ;
[0093] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (SEQ ID No: 43) ;
[0094] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (Palm) (SEQ ID No: 44) ;
[0095] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val (SEQ ID No: 45) ;
[0096] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala (SEQ ID No:46) ;
[0097] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Lys (Palm) (SEQ ID No: 47) ;
[0098] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met (SEQ ID No: 48) ;
[0099] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Lys (Palm) (SEQ ID No: 49) ;
[0100] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln (SEQ ID No: 50) ; or
[0101] His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Lys (Palm) (SEQ ID No: 51) .
[0102] Compounds of the invention that may be mentioned include:
[0103] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys-Lys (SEQ ID No: 52) ;
[0104] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (SEQ ID No: 53) ;
[0105] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val (SEQ ID No: 54) ;
[0106] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala (SEQ ID No: 55) ;
[0107] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met (SEQ ID No: 56) ;
[0108] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln (SEQ ID No: 57) ;
[0109] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (SEQ ID No: 58) ;
[0110] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg (SEQ ID No: 59) ;
[0111] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13 (SEQ ID No: 60) ;
[0112] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg (SEQ ID No: 61) ;
[0113] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11 (SEQ ID No: 62) ;
[0114] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr (SEQ ID No: 63) ;
[0115] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9 (SEQ ID No: 64) ;
[0116] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp (SEQ ID No: 65) ;
[0117] Palm-His-Ser-Asp-X4-X5-Phe-Thr (SEQ ID No: 66) ;
[0118] Palm-His-Ser-Asp-X4-X5-Phe (SEQ ID No: 67) ;
[0119] Palm-His-Ser-Asp-X4-X5 (SEQ ID No: 68) ;
[0120] Palm-His-Ser-Asp-X4 (SEQ ID No: 69) ; or
[0121] Palm-His-Ser-Asp (SEQ ID No: 70) .
[0122] More preferred compound of the invention thus also include:
[0123] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met (SEQ ID No: 56) ; or
[0124] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13 (SEQ ID No: 60) , such as
[0125] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln (SEQ ID No: 57) ; or
[0126] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg (SEQ ID No: 59) and, especially
[0127] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (SEQ ID No: 58) .
[0128] Compounds of the invention that may be mentioned include:
[0129] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys-Lys (SEQ ID No: 71) ;
[0130] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (Palm) -Lys (SEQ ID No: 72) ;
[0131] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys-Lys (Palm) (SEQ ID No: 73) ;
[0132] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (Palm) -Lys (SEQ ID No: 74) ;
[0133] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys-Lys (Palm) (SEQ ID No: 75) ;
[0134] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (Palm) -Lys (Palm) (SEQ ID No: 76) ;
[0135] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (Palm) -Lys (Palm) (SEQ ID No: 77) ;
[0136] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (SEQ ID No: 78) ;
[0137] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (Palm) (SEQ ID No: 79) ;
[0138] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (Palm) (SEQ ID No: 80) ;
[0139] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val (SEQ ID No: 81) ;
[0140] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (Palm) (SEQ ID No: 82) ;
[0141] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (Palm) (SEQ ID No: 83) ;
[0142] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala (SEQ ID No: 84) ;
[0143] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Lys (Palm) (SEQ ID No: 85) ;
[0144] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Lys (Palm) (SEQ ID No: 86) ;
[0145] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met (SEQ ID No:87) ;
[0146] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Lys (Palm) (SEQ ID No: 88) ;
[0147] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Lys (Palm) (SEQ ID No: 89) ;
[0148] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln (SEQ ID No: 90) ;
[0149] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Lys (Palm) (SEQ ID No: 91) ;
[0150] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Lys (Palm) (SEQ ID No: 92) ;
[0151] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) (SEQ ID No: 93) ;
[0152] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Lys (Palm) (SEQ ID No: 94) ;
[0153] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-Lys (Palm) (SEQ ID No: 95) ;
[0154] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Lys (Palm) (SEQ ID No: 96) ;
[0155] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-Lys (Palm) (SEQ ID No: 97) ;
[0156] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Lys (Palm) (SEQ ID No: 98) ;
[0157] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-Lys (Palm) (SEQ ID No: 99) ;
[0158] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Lys (Palm) (SEQ ID No: 100) ;
[0159] Palm-His-Ser-Asp-X4-X5-Phe-Lys (Palm) (SEQ ID No: 101) ;
[0160] Palm-His-Ser-Asp-X4-X5-Lys (Palm) (SEQ ID No: 102) ;
[0161] Palm-His-Ser-Asp-X4-Lys (Palm) (SEQ ID No: 103) ; or
[0162] Palm-His-Ser-Asp-Lys (Palm) (SEQ ID No: 104) .
[0163] More preferred compound of the invention include:
[0164] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met (SEQ ID No: 87) ;
[0165] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Lys (Palm) (SEQ ID No: 88) ;
[0166] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Lys (Palm) (SEQ ID No: 89) ; or
[0167] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-Lys (Palm) (SEQ ID No: 95) , such as Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln (SEQ ID No: 90) ;
[0168] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Lys (Palm) (SEQ ID No:91) ;
[0169] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Lys (Palm) (SEQ ID No: 92) ; or
[0170] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Lys (Palm) (SEQ ID No: 94) and, especially,
[0171] Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) (SEQ ID No: 93) .
[0172] According to a further aspect of the invention, there is provided an isolated compound consisting essentially of any one of the peptide sequences defined by SEQ IDs Nos: 7, 8, 9 or any one of 11 to 104, as well as regioisomers, stereoisomers, and pharmaceutically-or cosmetically-acceptable salts of such compounds.
[0173] Particular compounds that may be mentioned in this respect include isolated compounds consisting essentially of any one of peptide sequences with SEQ IDs Nos: 7, 8, 9, any one of SEQ IDs Nos: 23 to 25, any one of SEQ IDs Nos: 56 to 60, or any one of SEQ IDs Nos: 87-95, as well as regioisomers, stereoisomers, and pharmaceutically-or cosmetically-acceptable salts of such compounds.
[0174] In any of the above-mentioned peptide sequences, any and each of X4, X5, X9, X11 and / or
[0175] X13 (if present) may represent Ala, Val, Ile, Gly, Asn, Ser, Thr, Tyr and / or Leu. However, it is preferred that:
[0176] X4 represents Gly or Ala;
[0177] X5 represents Ile or Val;
[0178] X9 represents Ser or Asn;
[0179] X11 represent Ser or Thr; and / or
[0180] X13 represents Tyr or Leu.
[0181] According to a further aspect of the invention, there is provided an isolated compound consisting of the peptide sequences defined by:
[0182] (i) SEQ IDs Nos: 7, 8, 9 or any one of 11 to 104, as well as regioisomers, stereoisomers, and pharmaceutically-or cosmetically-acceptable salts of such compounds; more preferably
[0183] (ii) isolated compounds consisting essentially of any one of peptide sequences with SEQ IDs Nos: 7, 8, 9, any one of SEQ IDs Nos: 23 to 25, any one of SEQ IDs Nos: 56 to 60, or any one of SEQ IDs Nos: 87-95; and especially
[0184] (iii) any one of SEQ IDs Nos: 7, 25, 58 and 93,
[0185] in which X4 represents Gly or (preferably) Ala, X5 represents Val, X9 represents Asn, X11 represent Thr and X13 represents Leu, as well as regioisomers, stereoisomers, and pharmaceutically-or cosmetically-acceptable salts of such compounds.
[0186] In this respect, further compounds of the invention that may be mentioned include:
[0187] His-Ser-Asp-Gly-Ile-Phe (SEQ ID No: 105) ;
[0188] His-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg-Leu-Arg-Lys (SEQ ID No: 107) ;
[0189] Palm-His-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg-Leu-Arg-Lys (SEQ ID No: 108) ;
[0190] His-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg-Leu-Arg-Lys (Palm) (SEQ ID No: 109) .
[0191] As used herein, His represents, Ser represents serine, Asp represents aspartic acid, Phe represents phenylalanine, Thr represents threonine, Tyr represents tyrosine, Arg represents arginine, Lys represents lysine, Gln represents glutamine, Met represents methionine, Ala represents alanine, Val represents valine, Gly represents glycine, Ile represents isoleucine, Asn represents asparagine, Leu represents leucine, and Palm represents palmitic acid.
[0192] Compounds of the invention, whether in the form of salts or otherwise, include regioisomers within amino acids of the peptides (for example Tyr moieties) , as well as mixtures of such regioisomers. For example, included within the definition of Tyr are, not only tyrosine (4-hydroxyphenylalanine) , but also 2-and 3-hydroxyphenylalanine.
[0193] Also, in addition to the standard central carbon atom of the amino acids in the compounds of the invention (which are normally but not exclusively in the L-configuration) , certain amino acids in the sequence comprise further chiral carbon atoms. All such stereoisomers and mixtures (including racemic mixtures) thereof are included within the scope of the invention.
[0194] Compounds of the invention may be in the form of salts. Salts that may be mentioned include pharmaceutically-acceptable and / or cosmetically-acceptable salts, such as pharmaceutically-and / or cosmetically-acceptable acid addition salts and base addition salts. Such salts may be formed by conventional means, for example by reaction of a compound of the invention with one or more equivalents of an appropriate acid or base, optionally in a solvent, or in a medium in which the salt is insoluble, followed by removal of said solvent, or said medium, using standard techniques (e.g. in vacuo, by freeze-drying or by filtration) . Salts may also be prepared by exchanging a counter-ion of the compound of the invention in the form of a salt with another counter-ion, for example using a suitable ion exchange resin.
[0195] Preferred salts include, for example, acetate, hydrochloride, trifluoroacetic acid, bisulfate, maleate, mesylate, tosylate, alkaline earth metal salts, such as calcium and magnesium, or alkali metal salts, such as sodium and potassium salts. Most preferably, compounds of the invention may be in the form of acetate salts.
[0196] Compounds of the invention may be prepared by way of conventional techniques, for example by way of standard amino acid coupling techniques, using standard coupling reagents and solvents, for example as described hereinafter. Compounds of the invention may be synthesised from available starting materials using appropriate reagents and reaction conditions. In this respect, the skilled person may refer to inter alia “Comprehensive Organic Synthesis” by B.M. Trost and I. Fleming, Pergamon Press, 1991. Further references that may be employed include “Heterocyclic Chemistry” by J.A. Joule, K. Mills and G. F. Smith, 3rd edition, published by Chapman &Hall, “Comprehensive Heterocyclic Chemistry II” by A.R. Katritzky, C.W. Rees and E.F.V. Scriven, Pergamon Press, 1996 and “Science of Synthesis” , Volumes 9-17 (Hetarenes and Related Ring Systems) , Georg Thieme Verlag, 2006.
[0197] Compounds of the invention may be isolated from their reaction mixtures and, if necessary, purified using conventional techniques as known to those skilled in the art. Thus, processes for preparation of compounds of the invention as described herein may include, as a final step, isolation and optionally purification of the compound of the invention.
[0198] It will be appreciated by those skilled in the art that, in the processes described above and hereinafter, the functional groups of intermediate compounds may need to be protected by protecting groups. The protection and deprotection of functional groups may take place before or after a reaction.
[0199] Protecting groups may be applied and removed in accordance with techniques that are well-known to those skilled in the art and as described hereinafter. For example, protected compounds / intermediates described herein may be converted chemically to unprotected compounds using standard deprotection techniques. The type of chemistry involved will dictate the need, and type, of protecting groups as well as the sequence for accomplishing the synthesis. The use of protecting groups is fully described in ‘Protective Groups in Organic Synthesis’ , 5th edition, T. W. Greene &P. G. M. Wutz, Wiley-Interscience (2014) , the contents of which are incorporated herein by reference.
[0200] Compounds of the invention are useful as human and animal medicine. They are therefore indicated as pharmaceuticals (and / or in veterinary science) , although they may also be used as cosmetics and / or as part of a medical device, as well as a disinfectant product that may be used on a daily basis.
[0201] Compounds of the invention may also possess pharmacological activity as such, certain pharmaceutically-acceptable (e.g. ‘protected’ ) derivatives of compounds of the invention may exist or may be prepared which may not possess such activity, but which may be administered and thereafter be metabolised or chemically transformed to form compounds of the invention. Such compounds (which may possess some pharmacological activity, provided that such activity is appreciably lower than that of the active compounds to which they are metabolised / transformed) may therefore be described as ‘prodrugs’ of compounds of the invention.
[0202] As used herein, references to prodrugs will include compounds that form a compound of the invention, in an experimentally-detectable amount, within a predetermined time, following administration. All prodrugs of the compounds of the invention are included within the scope of the invention.
[0203] Compounds of the invention are particularly useful in the treatment of VL and related disorders.
[0204] The term ‘VL’ will be understood by those skilled in the art to include any condition characterised by measurable looseness of the vagina, for example at the introitus, characterised by a loss of elasticity and strength of the vagina and / or its surrounding tissues. In the context of the present invention, the term VL also includes the perception by a patient of such looseness, and may be brought on by several causes, included childbirth, menopause, aging, genetics, pelvic surgery and the like. Measurement of VL may correlate to pelvic floor muscle strength, sexual function and / or sexual partner perception.
[0205] Further, compounds of the invention may be employed as, or as part of a vaginal rejuvenation program, and so restore the aesthetic appearance and / or function of the vagina. Compounds of the invention may thus be employed as part of a vaginal rejuvenation program in conjunction with surgery (vaginoplasty) and / or energy-based (radiofrequency or laser) devices to promote tissue remodelling.
[0206] In this respect, compounds of the invention may provide medium-to long-term therapeutic benefits, giving rise to improvements in VL, in which the function of the vagina during sexual intimacy and / or sexual intercourse is improved or rectified. This in turn may serve to increase the sensitivity of the female reproductive organs and enhance sexual arousal.
[0207] Compounds of the invention may in addition and / or in the alternative treat disorders that are related to VL. For example, compounds of the invention may be applied with the intention of giving rise to vaginal contraction on a more short-term (e.g. immediate) basis, prior to sexual intimacy and / or intercourse, in order to in improve the function of the vagina and / or increase the sensitivity of the female reproductive organs and enhance sexual arousal, even in subjects that do not suffer directly from VL.
[0208] Furthermore, compounds of the invention may also be employed other in the treatment of sexual frigidity generally, as well as the treatment of pelvic floor muscle dysfunction, such as pelvic organ prolapse (POP) . POP may be defined as any disorder in which one or more of the pelvic organs descends from the normal position.
[0209] Compounds of the invention may also be employed to treat certain respiratory and / or inflammatory disorders, such as asthma, erectile dysfunction in men (and women) , blood pressure regulation, in endocrinology and / or in the treatment of tumors.
[0210] According to a further aspect of the invention there is provided a method of treatment of VL or a related disorder, which method comprises the administration of a compound of the invention or a salt thereof to a patient in need of such treatment.
[0211] For the avoidance of doubt, in the context of the present invention, the terms ‘treatment’ , ‘therapy’ and ‘therapy method’ include the therapeutic, or palliative, treatment of patients in need of, as well as the prophylactic treatment and / or diagnosis of patients which are susceptible to, VL and / or certain related disorders.
[0212] ‘Patients’ include mammalian (particularly human) patients.
[0213] In accordance with the invention, compounds of the invention may be administered locally or systemically, for example orally, intravenously or intraarterially (including by intravascular and other perivascular devices / dosage forms (e.g. stents) ) , intramuscularly, cutaneously, subcutaneously, transmucosally (e.g. sublingually or buccally) , rectally, intravaginally, intradermally, transdermally, nasally, pulmonarily (e.g. tracheally or bronchially) , for example by way of direct injection, or by way of any other parenteral route, in the form of a pharmaceutical preparation comprising the compound (s) in pharmaceutically acceptable dosage form (s) .
[0214] When administered by direct systemic parenteral administration, such administration may be useful in methods of treatment of one or more of the aforementioned disorders or conditions of one or more internal organs of a patient, including the stomach, the intestines, the pancreas, the liver, the spleen, the bladder, the vascular system, the ovaries, the prostate, preferably the heart and the kidneys and the lungs.
[0215] Compounds of the invention may be administered by intradermal injection, but are preferably administered topically, such as to the skin or, more preferably, to a mucosal surface, in particular the vaginal mucosa, in the form of a pharmaceutical preparation comprising the compound (s) in pharmaceutically acceptable dosage form (s) .
[0216] Pharmaceutically-acceptable formulations for use in the above-mentioned routes of administration may thus comprise compounds of the invention in admixture with a pharmaceutically-acceptable adjuvant, diluent or carrier, which may be selected with due regard to the intended route of administration and standard pharmaceutical practice. Such pharmaceutically-acceptable carriers may be chemically inert to the active compounds and may have no detrimental side effects or toxicity under the conditions of use. Such pharmaceutically-acceptable carriers may also impart an immediate, or a modified, release of the compound of the invention.
[0217] Preferred modes of delivery of compounds of the invention include topically to the skin and / or, preferably, to the vaginal mucosa in an appropriate (for example pharmaceutically-and topically-acceptable) vehicle suitable for application to the mucosal surface.
[0218] Suitable pharmaceutical formulations may be commercially available or otherwise prepared according to techniques that are described in the literature, for example, Remington The Science and Practice of Pharmacy, 22nd edition, Pharmaceutical Press (2012) and Martindale –The Complete Drug Reference, 38th Edition, Pharmaceutical Press (2014) and the documents referred to therein, the relevant disclosures in all of which documents are hereby incorporated by reference. Otherwise, the preparation of suitable formulations including compounds of the invention may be achieved non-inventively by the skilled person using routine techniques.
[0219] Compounds of the invention are preferably administered in the form of a liquid, a gel, a cream, an emulsion, an essence or a powder. Compounds of the invention may also be in the form of a sanitary towel, a sanitary tampon, a suppository, a capsule or a tablet.
[0220] Aqueous formulations may comprise an emulsion, a suspension and / or, more preferably a solution (e.g. an (optionally) buffered aqueous formulation (e.g. solution) , such as a physiological saline-containing formulation (e.g. solution) , a phosphate-containing formulation (e.g. solution) , an acetate-containing formulation (e.g. solution) or a borate-containing formulation (e.g. solution) , or a freeze-dried powder that may be reconstituted with a vehicle, such as an aqueous vehicle prior to use.
[0221] Such formulations may include other suitable excipients known to those skilled in the art, such as solvents (e.g. water) , co-solvents, solubilizing agents (e.g. cyclodextrins) , wetting agents, suspending agents, emulsifying agents, thickening agents, chelating agents, antioxidants, reducing agents, antimicrobial preservatives, bulking agents and / or protectants, and may be buffered by standard techniques to physiologically-acceptable pH values (e.g. pHs of between about 4.5 and about 9.5, e.g. about 6 and about 9, such as between about 6.5 and about 8.5) using buffers and / or pH modifiers as described herein, and / or may further comprise tonicity-modifying agents (such as sodium chloride) .
[0222] Compounds of the invention may further and / or in the alternative be combined with appropriate excipients to prepare:
[0223] · gel formulations (for which suitable gel matrix materials include cellulose derivatives, carbomer and alginates, gummi tragacanthae, gelatin, pectin, carrageenan, gellan gum, starch, Xanthan gum, cationic guar gum, agar, noncellulosic polysaccharides, saccharides such as glucose, glycerin, propanediol, vinyl polymers, acrylic resins, polyvinyl alcohol, carboxyvinyl polymer and, particularly, hyaluronic acid) ;
[0224] · lotions (for which suitable matrix materials include cellulose derivatives, glycerin, noncellulosic polysaccharides, polyethylene glycols of different molecular weights and propanediol) ;
[0225] · pastes or ointments (for which suitable paste matrix materials include glycerin, vaseline, paraffin, polyethylene glycols of different molecular weights, etc. ) ;
[0226] · creams or foams (for which suitable excipients (e.g. foaming agents) include hydroxypropyl methyl cellulose, gelatin, polyethylene glycols of different molecular weights, sodium dodecyl sulfate, sodium fatty alcohol polyoxyethylene ether sulfonate, corn gluten powder and acrylamide) ;
[0227] · powder aerosols (for which suitable excipients include mannitol, glycine, dextrin, dextrose, sucrose, lactose, sorbitol and polysorbates, e.g. a dry powder inhalant) ; and / or
[0228] · liquid, for example, water (aerosol) sprays for oral use or for inhalation (for which suitable excipients include viscosity modifiers, such as hyaluronic acid, sugars, such as glucose and lactose, emulsifiers, buffering agents, alcohols, water, preservatives, sweeteners, flavours, etc. ) ;
[0229] · injectable solutions or suspensions (which may be aqueous or otherwise and for which suitable excipients include solvents and co-solvents, solubilizing agents, wetting agents, suspending agents, emulsifying agents, thickening agents, chelating agents, antioxidants, reducing agents, antimicrobial preservatives, buffers and / or pH modifiers, bulking agents, protectants and tonicity-modifying agents) , particular injectable solutions or suspensions that may be mentioned include dermal fillers (i.e. injectable fillers or soft-tissue fillers) , particularly when the compound of the invention is combined with hyaluronic acid;
[0230] · oral tablets (for which suitable excipients include binding agents, for example, syrup, acacia, gelatin, sorbitol, tragacanth, celluloses or polyvinylpyrrolidone; fillers, such as lactose, sucrose, corn starch, calcium phosphate, sorbitol, or glycine; lubricants, such as magnesium stearate, talc, polyethylene glycol, or silica; and surfactants, such as sodium lauryl sulfate) ;
[0231] · effervescent products.
[0232] Moisturizing agents, such as glycerol, glycerin, polyethylene glycol, trehalose, glycerol, petrolatum, paraffin oil, silicone oil, hyaluronic acid and salts (e.g. sodium and potassium salts) thereof, octanoic / caprylic triglyceride, and the like; and / or antioxidants, such as vitamins and glutathione; and / or pH modifiers, such as acids, bases and pH buffers, may also be included in such formulations, as appropriate. Furthermore, surfactants / emulsifiers, such as hexadecanol (cetyl alcohol) , fatty acids (e.g. stearic acid) , sodium dodecyl sulfate (sodium lauryl sulfate) , sorbitan esters (e.g. sorbitan stearate, sorbitan oleate, etc. ) , monoacyl glycerides (such as glyceryl monostearate) , polyethoxylated alcohols, polyvinyl alcohols, polyol esters, polyoxyethylene alkyl ethers (e.g. polyoxyethylene sorbitan monooleate) , polyoxyethylene castor oil derivatives, ethoxylated fatty acid esters, polyoxylglycerides, lauryl dimethyl amine oxide, bile salts (e.g. sodium deoxycholate, sodium cholate) , lipids (e.g. fatty acids, glycerolipids, glycerophospholipids, sphingolipids, sterols, prenols, saccharolipids, polyketides) , phospholipids, N, N-dimethyldodecylamine-N-oxide, hexadecyltrimethyl-ammonium bromide, poloxamers, lecithin, sterols (e.g. cholesterol) , sugar esters, polysorbates, and the like; preservatives, such as phenoxyethanol, ethylhexyl glycerin, and the like; and thickeners, such as acryloyldimethyltaurate / VP copolymer, may be included. In particular, stearic acid, glyceryl monostearate, hexadecanol, sorbitan stearate, cetyl alcohol, octanoic / capric glyceride etc. may be included, particularly in cream formulations.
[0233] According to a further aspect of the invention there is provided a process for the preparation of a pharmaceutical composition / formulation, as defined herein, which process comprises bringing into association a compound of the invention, as hereinbefore defined, with one or more pharmaceutically-acceptable excipient, as hereinbefore defined.
[0234] According to a further aspect of the invention there is provided a (e.g. pharmaceutical) composition comprising a compound of the invention and one or more pharmaceutically-acceptable excipient, such as an adjuvant, diluent or carrier. Preferred formulations are suitable for application locally to e.g. the mucosa (including the vaginal mucosa) and therefore comprise a topically-acceptable adjuvant, diluent or carrier.
[0235] There is, thus, further provided pharmaceutical compositions comprising compounds of the invention that are suitable for, adapted for, and / or packaged and presented for topical administration (e.g. to the mucosa, including the vaginal mucosa) , as well as the use of such a formulation in the treatment of VL or a related disorder by way of direct topical administration of that formulation (e.g. to the mucosa, including the vaginal mucosa) .
[0236] In relation to this aspect of the invention, for the avoidance of doubt, topical formulations comprising compounds of the invention may be used in any and all conditions described herein, including treatments of VL and related disorders as hereinbefore mentioned, defined or described. Similarly, topical formulations comprising compounds of the invention that may be mentioned include any and all of those mentioned, defined or described herein. Any and all of the relevant disclosures herein are hereby incorporated by reference in conjunction with this aspect of the invention.
[0237] Administration of compounds of the invention may be continuous or, preferably, intermittent, for example as prescribed by a physician. The mode of administration may also be determined by the timing and frequency of administration, but is also dependent, in the case of the therapeutic treatment of inflammation, on the severity of the condition.
[0238] Depending on the disorder, and the patient, to be treated, as well as the route of administration, compounds of the invention may be administered at varying therapeutically effective doses to a patient in need thereof.
[0239] Similarly, the amount of compound of the invention in a formulation will depend on the severity of the condition, and on the patient, to be treated, but may be determined by the skilled person.
[0240] In any event, the medical practitioner, or other skilled person, will be able to determine routinely the actual dosage, which will be most suitable for an individual patient, depending on the severity of the condition and route of administration. The dosages mentioned herein are exemplary of the average case; there can, of course, be individual instances where higher or lower dosage ranges are merited, and such are within the scope of this invention.
[0241] Compounds of the invention may be used on a daily basis. Doses may be administered between once and four (e.g. three) times daily.
[0242] Compounds of the invention may alternatively be used on an occasional, ad hoc basis over a time period of a few days, weeks and / or months, or otherwise on an ‘on demand basis, for example just before or at the same time of the sexual intercourse. Compounds of the invention may in the alternative be used on a regular but, non-daily, basis, for example every other day over several weeks, months or years.
[0243] Appropriate concentrations of compounds of the invention in an aqueous solution product may be about 0.01 mg / mL (e.g. about 0.1 mg / mL, such as about 1 mg / mL) up to about 30 mg / mL. including about 15.0 mg / mL, such as about 5 mg / mL, about 2 mg / mL or about 1 mg / mL, in all cases calculated as the free (non-salt) compound.
[0244] Appropriate topical doses of compounds of the invention are in the range of about 0.05 to about 50 μg / cm2 of treated area, such as about 0.1 (e.g. about 0.5) to about 20 μg / cm2 of treated area, including about 1 to about 10 μg / cm2 of treated area, such as about 5 μg / cm2 of treated area, in all cases calculated as the free (non-salt) compound.
[0245] We prefer that pH values of formulations comprising compounds of the invention are in the range of about 1.0 to about 9.0 (for example about 3.0 to about 8.0, such as about 4.0 to about 6.0) .
[0246] In any event, the dose administered to a mammal, particularly a human, in the context of the present invention should be sufficient to effect a therapeutic response in the mammal over a reasonable timeframe (as described hereinbefore) . One skilled in the art will recognize that the selection of the exact dose and composition and the most appropriate delivery regimen will also be influenced by inter alia the pharmacological properties of the formulation, the nature and severity of the condition being treated, and the physical condition and mental acuity of the recipient, as well as the age, condition, body weight, sex and response of the patient to be treated, and the stage / severity of the disease, as well as genetic differences between patients.
[0247] Compounds of the invention are useful in human and animal medicine. In this respect, and as described above, compounds of the invention that possess an appropriate degree of relevant pharmacological (or biological) activity per se may be used as human, and / or animal, medicines.
[0248] Compounds of the invention may be combined with a multitude of known pharmaceutically-active ingredients and may be so combined irrespective of whether the compound of the invention is employed:
[0249] · as a separate pharmaceutically-active ingredient per se in combination therapy;
[0250] · as, or as part of, a medical device; or
[0251] · as, or as the medical device part of, a drug-medical device combination.
[0252] Such patients may also (and / or may already) be receiving therapy based upon administration of one or more of such other, known pharmaceutically-active ingredients, by which we mean receiving a prescribed dose of one or more of the active ingredients mentioned herein, prior to, in addition to, and / or following, treatment with a compound of the invention.
[0253] Pharmaceutically-active agents that may be co-administered with a compound of the invention include any agent, or drug, that is capable of producing some sort of physiological effect (whether in a therapeutic or prophylactic capacity against a particular disease state or condition) in a living subject, including, in particular, mammalian and especially human subjects (patients) .
[0254] Pharmaceutically-active agents that may be used along with compounds of the invention may, for example, be selected from anti-inflammatory agents, antibiotics, anti-bacterial and / or antiprotozoal agents, antiviral agents (e.g. protease inhibitors) .
[0255] Non-limiting examples of anti-inflammatory drugs which may be used also include those used in the treatment of rheumatic diseases and / or arthritis (such as cataflam, betamethasone, naproxen, cyclosporin, chondroitin, celecoxib, etodolac, meclofenamate, salsalate, methylprednisolone, and piroxicam) ; osteoarthritis (such as sulindac, meloxicam, fenoprofen, etoricoxib, and nabumetone) ; inflammation and its symptoms, e.g. fever, pain, itchiness and / or swelling (such as mefenamic acid, indomethacin, aspirin, ketorolac, fluorometholone, loteprednol, hydrocortisone, fluorometholone, bromfenac, prednisolone acetate, indomethacin, and ibuprofen) ; allergies and their symptoms (such as pheniramine, diphenhydramine, naphazoline, antazoline, prednisolone, lodoxamide, pemirolast, oxymetazoline, ketotifen, naphazoline, emestine fumarate, olopatadine, azelastine, tranilast, levocabastine, cortisone, ephedrine, cetirizine, levocetirizine, pseudophedrine, fexofenadine, terfenadine, loratadine, and alexis) ; respiratory diseases, including asthma and / or COPD (such as budesonide, ciclesonide, nedocromil, dexamethasone, ambroxol, and pranlukast) ; skin diseases (such as mometasone, triamcinolone, desonide, sulfacetamide, tacrolimus, allantoin, and triamcinolone) ; mastocytosis (such as cromolyn) ; gout (such as diclofenac, and febuxostat) ; conjunctivitis (such as hydrobenzole, pranoprofen, and zinc sulfate) ; eye diseases (such as dextran 70, thyroxine / liothyronine, and ocular extractives) , known or commercially-available pharmaceutically acceptable salts of any of the foregoing, and combinations of any of the forgoing compounds and / or salts.
[0256] Anti-inflammatory drugs that may be mentioned include endogenous (and / or exogenous) lipid-based pro-resolving, anti-inflammatory molecules or mediators, such as lipoxins, resolvins, and protectins. Pro-inflammatory agents that may be mentioned include prostaglandins (e.g. latanoprost, prostaglandin E1, and prostaglandin E2) , and leukotrienes (e.g. Leukotriene B4) .
[0257] Other anti-inflammatory drugs that may be mentioned include one or more mussel adhesive proteins (MAPs) , which includes any adhesive protein that may be derived from mussel species, such as Mytilus edulis (blue mussel) , including full length proteins, including all sub-types, that are or may be derived from mussels, such as the collagens pre-COL-P, pre-COL-D and pre-COL-NG, the mussel feet matrix proteins PTMP and DTMP, and, more preferably, mfps or mefps, such as mefp-2, mefp-3, mefp-4, mefp-5, mefp-6 and especially mefp-1, and includes mixtures or combinations of any of these proteins, such as mefps. Naturally-occurring MAPs may be prepared, for example by mixed adsorption chromatography (see Chinese Patent No. ZL200710179491.0) , by carboxymethyl ion exchange chromatography (see Chinese Patent No. ZL200710179492.5) , and / or by salting out and dialysis (Chinese Patent No. ZL200910087567.6) . Commericial sources of MAPs include USUN Bio Co. (China; sold as MAP Medical ) , BD Biosciences (USA) , Kollodis (South Korea) and Biopolymer (Sweden) . MAPs may alternatively be produced using known recombinant DNA methods.
[0258] Hydrolyzed versions of the aforementioned MAPs may also be employed.
[0259] Anti-inflammatory compounds that may in particular be mentioned include those generically and specifically described in international patent applications WO 2017 / 028777, WO 2019 / 007355, WO 2019 / 228307, WO 2020 / 052677, WO 2021 / 047648, WO 2021 / 110061, WO 2021 / 110063, WO 2021 / 110064, WO 2022 / 194238, WO 2022 / 194239, WO 2024 / 169972 and WO 2024 / 260465, as well as unpublished international patent application No. PCT / CN2024 / 126655, the disclosures in all of which documents are hereby incorporated by reference.
[0260] Particular compounds that are specifically disclosed in the above-mentioned international patent applications that may be mentioned for potential combination with compounds of the invention include isolated peptide compounds of the sequences:
[0261] Ala-Lys-Pro-Ser-Tyr-Hyp-Hyp-Thr-DOPA-Lys (SEQ ID No: 111) ;
[0262] Ala-Lys-Pro-Ser-Tyr-Hyp-Hyp-Thr-Tyr-Lys (SEQ ID No: 112) ;
[0263] DOPA-Ala-Lys-Pro-Ser-Tyr-Hyp-Thr-Tyr-Hyp-Lys (SEQ ID No: 113) ;
[0264] DOPA-Ala-Lys-Pro-Ser-Tyr-Hyp-Hyp-Thr-Tyr-Lys (SEQ ID No: 114) ;
[0265] HCA-Ala-Lys-Pro-Ser-Tyr-Hyp-Thr-Tyr-Hyp-Lys (SEQ ID No: 115) ;
[0266] HCA-Ala-Lys-Pro-Ser-Tyr-Hyp-Hyp-Thr-Tyr-Lys (SEQ ID No: 116) ;
[0267] Ala-Lys-Pro-Ser-Tyr-Hyp-Thr-Tyr-Hyp-Lys-Dopamine (SEQ ID No: 117) ;
[0268] Ala-Lys-Pro-Ser-Tyr-Hyp-Hyp-Thr-Tyr-Hyp-Lys-Dopamine (SEQ ID No: 118) ;
[0269] Ala-Lys-Pro-Ser-Tyr-Hyp-Hyp-Thr-Tyr-Hyp-Lys (SEQ ID No: 119) ;
[0270] Ala-Lys-Pro-Ser-Tyr-Hyp-Hyp-Thr-DOPA-Hyp-Lys (SEQ ID No: 120) ;
[0271] Ala-Lys-Pro-Ser-Tyr-Hyp-Hyp-Thr-Tyr-Lys (SEQ ID No: 121) ;
[0272] Ala-Lys-Pro-Ser-Tyr-Hyp-Hyp-Thr-DOPA-Lys (SEQ ID No: 122) ;
[0273] Ala-Lys-Pro-Ser-Tyr-Hyp-Thr-Tyr-Hyp-Lys (SEQ ID No: 123) ;
[0274] Ala-Lys-Pro-Ser-Tyr-Hyp-Thr-DOPA-Hyp-Lys (SEQ ID No: 124) ;
[0275] Ala-Lys-Hyp-Ser-Tyr-Hyp-Hyp-Thr-Tyr-Lys (SEQ ID No: 125) ;
[0276] Ala-Lys-Hyp-Ser-Tyr-Hyp-Hyp-Thr-DOPA-Lys (SEQ ID No: 126) ;
[0277] Ala-Lys-Hyp-Ser-Tyr-Hyp-Thr-Tyr-Hyp-Lys (SEQ ID No: 127) ;
[0278] Ala-Lys-Hyp-Ser-Tyr-Hyp-Thr-DOPA-Hyp-Lys (SEQ ID No: 128) ;
[0279] Lys-Pro-Ser-Tyr-Hyp-Tyr-Lys (SEQ ID No: 129) ; and
[0280] Lys-Pro-Ser-Tyr-Hyp-DOPA-Lys (SEQ ID No: 130) ,
[0281] as well as possible linear repeat sequences of these peptides, Lys-branched repeats of these peptide sequences, for example as described in international patent application WO 2021 / 110064 and / or PEG branched repeats of these peptide sequences, for example as described in international patent application WO 2024 / 169972.
[0282] Non-limiting examples of anti-bacterial drugs which may be used also include chloramphenicol, ofloxacin, levofloxacin, tobramycin, norfloxacin, ciprofloxacin, lomefloxacin, lincomycin, fluconazole, enoxacin, furazolidone, nitrofurazone, rifampicin, micronomicin, gentamicin, cetylpyridinium, neomycin, roxithromycin, sulfadiazine silver, clarithromycin, clindamycin, metronidazole, azithromycin, mafenide, sulfamethoxazole, paracetamol, chloramphenicol, pseudoephedrine, mupirocin, amoxicillin, amoxicillin / clavulanic acid, trimethoprim / sulfamethoxazole, cefalexin, moxifloxacin, known or commercially-available pharmaceutically acceptable salts of any of the foregoing, and combinations of any of the foregoing compounds and / or salts.
[0283] Non-limiting examples of antiviral drugs which may be used also include tobramycin ribavirin, acyclovir, moroxydine, foscarnet, ganciclovir, idoxuridine, trifluridine, brivudine, vidarabine, entecavir, telbivudine, foscarnet, zidovudine, didanosine, zalcitabine, stavudine, lamivudine, abacavir, emtricitabine, nevirapine, delavirdine, efavirenz, etravirine, rilpivirine, saquinavir, ritonavir, indinavir, nelfinavir, amprenavir, lopinavir, ritonavir, atazanavir, fosamprenavir, tipranavir, darunavir, telaprevir, boceprevir, simeprevir, asunaprevir, raltegravir, elvitegravir, dolutegravir, rsv-igiv, palivizumab, docosanol, enfuvirtide, maraviroc, vzig, varizig, acyclovir, ganciclovir, famciclovir, valacyclovir, penciclovir, valganciclovir, cidofovir, tenofovir disoproxil fumarate, adefovir dipivoxil, fomivirsen, podofilox, imiquimod, sinecatechins, interferon-α 2b (recombinant, human) , known or commercially-available pharmaceutically acceptable salts of any of the foregoing, and combinations of any of the foregoing compounds and / or salts.
[0284] Such pharmaceutically-active ingredients include those that may be administered topically, e.g. to a mucosal surface along with a compound of the invention. In this respect, preferred active ingredients from the above list include cyclosporin, chondroitin, loteprednol, fluorometholone, bromfenac, prednisolone acetate, indomethacin, oxymetazoline, ketotifen, naphazoline, emestine fumarate, olopatadine, azelastine, tranilast, levocabastine, cortisone, ephedrine, cetirizine, pseudoephedrine, levocetirizine, fexofenadine, terfenadine, loratadine, alexis, dexamethasone, ambroxol) , sulfacetamide, tacrolimus, allantoin, triamcinolone, cromolyn, nedocromil, diclofenac, hydrobenzole, pranoprofen, zinc sulfate, dextran 70, thyroxine / liothyronine, ocular extractives, Pro-inflammatory agents that may be mentioned include prostaglandins (e.g. latanoprost, prostaglandin E1, and prostaglandin E2) , and leukotrienes (e.g. Leukotriene B4) , chloramphenicol, ofloxacin, levofloxacin, tobramycin, norfloxacin, ciprofloxacin, lomefloxacin, lincomycin, fluconazole, enoxacin, furazolidone, nitrofurazone, rifampicin, micronomicin, gentamicin, cetylpyridinium, neomycin, roxithromycin, sulfadiazine silver, sulfadiazine zinc, clarithromycin, sulfamethoxazole, chloramphenicol, tobramycin ribavirin, acyclovir, moroxydine, foscarnet, ganciclovir, interferon-α 2b (recombinant, human) , and known or commercially-available pharmaceutically acceptable salts of any of the foregoing, and combinations of any of the foregoing compounds and / or salts.
[0285] More preferred pharmaceutically-active ingredients that may be co-administered along with compositions of the invention include prostaglandins (especially latanoprost) and anti-inflammatory agents (especially aspirin, montelukast, one or more of the MAPs listed hereinbefore (including hydrolysed versions thereof) and / or one of more of the anti-inflammatory peptides specifically listed above and having SEQ ID Nos: 111 to 130, inclusive) , or anti-bacterial agents (especially metronidazole, clindamycin and povidone iodine) . and / or anti-viral agents (especially salicylic acid, imiquimod, Pudafilo and trichloroacetic acid) .
[0286] Other known pharmaceutically-active ingredients may also be administered in combination with compounds of the invention in numerous ways.
[0287] For example, compounds of the invention may be ‘combined’ with the (or with the other) pharmaceutically-active ingredients (or ‘therapeutic agents’ ) for administration together in the same (e.g. pharmaceutical) formulation, or administration separately (simultaneously or sequentially) in different (e.g. pharmaceutical) formulations.
[0288] Thus, such combination products provide for the administration of compounds of the invention in conjunction with the (or with the other) therapeutic agent, and may thus be presented either as separate formulations, wherein at least one of those formulations comprises a compound of the invention, and at least one comprises the (or the other) therapeutic agent, or may be presented (i.e. formulated) as a combined preparation (i.e. presented as a single formulation including a compound of the invention and the (or the other) therapeutic agent) .
[0289] Thus, there is further provided:
[0290] (1) a (e.g. pharmaceutical) formulation including a compound of the invention; another pharmaceutically-active ingredient (e.g. one or more of those described hereinbefore) ; and, optionally, a pharmaceutically-acceptable inactive excipient (e.g. adjuvant, diluent or carrier) , which formulation is hereinafter referred to as a ‘combined preparation’ ; and
[0291] (2) a kit of parts comprising components:
[0292] (A) a compound of the invention, optionally in the form of an (e.g. pharmaceutical) formulation in admixture with a pharmaceutically-acceptable inactive excipient (e.g. adjuvant, diluent or carrier) ; and
[0293] (B) another pharmaceutically-active ingredient (e.g. one or more of those described hereinbefore) , optionally in the form of a (e.g. pharmaceutical) formulation in admixture with a pharmaceutically-acceptable adjuvant, diluent or carrier,
[0294] which components (A) and (B) are each provided in a form that is suitable for administration in conjunction with the other.
[0295] In a further aspect of the invention, there is provided a process for the preparation of a combined preparation (1) as hereinbefore defined, which process comprises bringing into association a compound of the invention, the other pharmaceutically-active ingredient, and at least one (e.g. pharmaceutically-acceptable) excipient.
[0296] In a further aspect of the invention, there is provided a process for the preparation of a kit-of-parts (2) as hereinbefore defined, which process comprises bringing into association components (A) and (B) . As used herein, references to bringing into association will mean that the two components are rendered suitable for administration in conjunction with each other.
[0297] Thus, in relation to the process for the preparation of a kit-of-parts as hereinbefore defined, by bringing the two components ‘into association with’ each other, we include that the two components of the kit-of-parts may be:
[0298] (i) provided separately (i.e. independently of one another) , which are subsequently brought together for use in conjunction with each other in combination therapy; or
[0299] (ii) packaged and presented together as separate components of a ‘combination pack’ for use in conjunction with each other in combination therapy.
[0300] Thus, there is further provided a kit of parts comprising:
[0301] (I) one of components (A) and (B) as defined herein; together with
[0302] (II) instructions to use that component in conjunction with the other of the two components.
[0303] In relation to kits of parts described above, although the compound of the invention may be provided in the form of an (e.g. pharmaceutical) formulation, in admixture with one or more additional pharmaceutically-acceptable excipients (e.g. adjuvants, diluents or carriers) . It is in any event preferred that the (other) pharmaceutically-active ingredient of the kit of parts is provided in the form of a pharmaceutical formulation in admixture with a pharmaceutically-acceptable adjuvant, diluent or carrier.
[0304] The kits of parts described herein may comprise more than one (e.g. formulation including an) appropriate quantity / dose of a compound of the invention, and / or more than one (e.g. formulation including an) appropriate quantity / dose of the other pharmaceutically-active ingredient, in order to provide for repeat dosing. If more than one formulation comprising or quantity / dose of either of the foregoing is present, such may be the same, or may be different in terms of the dose of either compound, chemical composition (s) and / or physical form (s) .
[0305] With respect to the kits of parts as described herein, by ‘administration in conjunction with’ , we include that respective components are administered, sequentially, separately and / or simultaneously, over the course of treatment of the relevant condition.
[0306] Thus, in respect of the combination product according to the invention, the term ‘administration in conjunction with’ includes that the two components of the combination product (compound of the invention and other pharmaceutically-active ingredient) are administered (optionally repeatedly) , either together, or sufficiently closely in time, to enable a beneficial effect for the patient, that is greater, over the course of the treatment of the relevant condition, than if either the compound of the invention, or (e.g. a formulation comprising) the other agent, are administered (optionally repeatedly) alone, in the absence of the other component, over the same course of treatment. Determination of whether a combination provides a greater beneficial effect in respect of, and over the course of treatment of, a particular condition will depend upon the condition to be treated or prevented, but may be achieved routinely by the skilled person.
[0307] Further, in the context of a kit of parts according to the invention, the term ‘in conjunction with’ includes that one or other of the two components may be administered (optionally repeatedly) prior to, after, and / or at the same time as, administration of the other component. When used in this context, the terms ‘administered simultaneously’ and ‘administered at the same time as’ include that individual quantities / doses of the relevant compound of the invention and other active pharmaceutical ingredient are administered within 48 hours (e.g. 24 hours) of each other.
[0308] In relation to combined preparations and kits of parts described above, it is preferred that the other pharmaceutically-active ingredient is an anti-inflammatory agent as hereinbefore described.
[0309] Wherever the word ‘about’ is employed herein, for example in the context of amounts, such as concentrations and / or doses of active ingredients and / or compounds of the invention, molecular weights or pHs, it will be appreciated that such variables are approximate and as such may vary by ± 10%, for example ± 5%and preferably ± 2%(e.g. ± 1%) from the numbers specified herein. In this respect, the term ‘about 10%’ means e.g. ±10%about the number 10, i.e. between 9%and 11%.
[0310] Compounds of the invention have the advantage that they are useful in the treatment of VL and related disorders.
[0311] The compounds, uses and methods described herein may also have the advantage that, in the treatments mentioned hereinbefore, they may be more convenient for the physician and / or patient than, be more efficacious than, be less toxic than, have a broader range of activity than, be more potent than, produce fewer side effects than, or that it / they may have other useful pharmacological properties over, similar compounds or methods (treatments) known in the prior art, whether for use in the treatment of any of the aforementioned conditions, including of the VL and related conditions, other conditions mentioned hereinbefore, or otherwise.
[0312] The invention is illustrated, but in no way limited, by the following examples. with reference to the figures, in which Figures 1 and 2 show results for vaginal smooth muscle contraction in in vitro studies in rabbits for various test compounds of the invention, and Figure 3 shows a summary of feedback in relation to the effectiveness of a gel comprising a test compound of the invention, which feedback was obtained during a clinical study.Examples
[0313] Example 1
[0314] His-Ser-Asp (SEQ ID No: 19)
[0315] Fmoc-Asp (OtBu) -Wang resin (9.87 g, 3 mmol; GL Biochem, Shanghai, China) was loaded into a glass reaction column.
[0316] Methylene chloride (DCM, 200 mL; Shandong Jinling Chemical Industry Co. Ltd., Shandong, China) was added to the column and allowed to soak the resin for about half an hour. The DCM was then removed by vacuum filtration.
[0317] The resin was washed then 3 times with N, N-dimethylformamide (DMF, 200 mL; Shandong Shitaifeng Fertilizer Industry Co. Ltd., Shandong, China) . A 20%piperidine (Shandong Shitaifeng Fertilizer Industry Co. Ltd., Shandong, China) solution in DMF (DBLK, 200 mL) was then added as a deprotection solution and reacted for 20 minutes. The solution was then removed by vacuum filtration and the gel was washed with DMF for six times.
[0318] Fmoc-Ser (tBu) -OH (3.45 g, 9mmol; GL Biochem, Shanghai, China) and 2- (1H-benzotriazole-1-yl) -1, 1, 3, 3-tetramethylaminium tetrafluoroborate (TBTU, 2.89 g, 9mmol; GL Biochem, Shanghai, China) were added to the resin. DMF (150 mL) was added to the reaction column, followed by N, N-diisopropylethylamine (DIPEA, 2.33 g, 9 mmol; Suzhou Highfine Biotech Co. Ltd., Jiangsu, China) . A Kaiser Test was carried out on a portion of the resin after 30 minutes of reaction time, which indicated that the reaction was complete. The solvent was removed by vacuum filtration.
[0319] The above coupling steps were repeated to couple the remaining amino acid (using : Boc-His (Trt) -OH) in the same molar amounts.
[0320] After Boc-His (Trt) -OH was coupled, the resin was washed three times with each of the following solvents, DMF (200 mL each time) , DCM (200 mL each time) and methanol (200 mL each time; Xilong Scientific Co., Ltd., Guangdong, China) . The resin was dried under vacuum for about 2 hours.
[0321] 100.0 mL (i.e. 10 mL per gram of the dried resin) of lysate, which comprised of 95%trifluoroacetic acid (TFA, Macklin, Shanghai, China) , 2.5%water and 2.5%triisopropylsilane (Tis, Macklin, Shanghai, China) , were added to immerse the resin-bounded peptide-containing compound. After the cleavage reaction had been undertaken for about 2 hours, the solid support was removed by filtration and the filtrate was collected under reduced pressure.
[0322] The filtrate was precipitated with 1000 mL (i.e. 10 mL per ml of the filtrate) of diethyl ether (Xilong Scientific Co., Ltd., Guangdong, China) and the sediment was collected by filtration. The sediment was dried by vacuum over about 2 hours, yielding 1.12 g of crude title compound.
[0323] The crude product was firstly analysed as a 1 mg / mL sample in pure water using a Shimadzu LCMS-8050 system (Shimadzu, Japan) . The analysis column was an Agilent ZORBAX Eclipse SB-C18 (4.6 × 250 mm, 5 μm column; detection: UV at 220 nm; solvent A: 0.1%TFA in MeCN, solvent B: 0.1%TFA in water, with a linear gradient from 5%~90%solvent A concentration in 50 minutes; flow rate 1.0 mL / min; sample volume: 10 μL) .
[0324] The target peak was eluted at 8.291 minutes and had the expected molecular weight, with a purity of 86.992%.
[0325] MS: m / z 357.32
[0326] 1.1 g of crude product was then dissolved in 30 mL of pure water and purified using NP7010C semi-preparation equipment (Hanbon Sci. &Tech. Co., Ltd., Jiangsu, China) . The preparation column model was a Dubhe-C18 model (Hanbon Sci. &Tech. Co., Ltd., Jiangsu, China) (50*250 mm, column; detection: UV at 220 nm) . The appropriate gradient for elution was calculated from LCMS detection step (Solvent A: 0.1%TFA in MeCN, solvent B: 0.1%TFA in water, with a linear gradient from 5%~20%solvent A concentration in 30 minutes; flow rate 60.0 mL / min; ) . Fractions were collected and analyzed using a Shimadzu LC-20 HPLC system (Shimadzu, Japan) (column as above, except with a linear gradient from 5%-20%solvent A concentration in 25 minutes) .
[0327] Fractions with a purity of higher than 90%were then mixed together for use in an anion exchange step. This was achieved using a NP7010C semi-preparation equipment, preparation column model: Dubhe-C18 model (as above) . The fractions were diluted one time with pure water and loaded to the column directly, after that the column was washed with 3.2%of ammonium acetate in pure water for about 20 minutes followed by pure water for another 10 minutes at the flow rate of 60 mL / min, then eluted with the following gradient (Solvent A: 0.1%HAc in MeCN, solvent B: 0.1%HAc in water, with a linear gradient from 5%~20%solvent A concentration in 30 minutes; flow rate 60.0 mL / min) .
[0328] Fractions were collected and analyzed using Shimadzu LC-20 HPLC system (column and conditions as above) . Fractions with a purity of higher than 95%were mixed and freeze-dried to give 0.78 g of the purified title compound.
[0329] Example 2
[0330] His-Ser-Asp-Gly-Ile-Phe (SEQ ID No: 105)
[0331] The title compound was prepared using essentially the same synthesis procedure as that described in Example 1 above, except that Fmoc-Phe-Wang resin was used instead of Fmoc-Asp (OtBu) -Wang resin (in the same molar amount) and, after that, appropriate protected amino acids were used in the same molar amounts as appropriate, in the relevant peptide coupling sequence (i.e. Fmoc-Ile-OH, Fmoc-Gly-OH, Fmoc-Asp (OtBu) -OH, Fmoc-Ser(tBu) -OH and Boc-His (Trt) -OH) .
[0332] This resulted in a batch of crude title compound (yield 2.19 g) . Analysis showed a target peak that was eluted at 25.839 minutes with the expected molecular weight, with a purity of 71.827%.
[0333] MS: m / z 674.71
[0334] 2.1 g of the crude product was then purified using essentially the same purification procedure as described in Example 1 above, except that a gradient of 25%~40%was used instead of 5%~20%, to give 1.39 g of pure title compound after freeze-drying.
[0335] Example 3
[0336] His-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg (Compound I; SEQ ID No: 106)
[0337] The title compound was prepared using essentially the same synthesis procedure as that described in Example 1 above, except that Fmoc-Arg (Pbf) -Wang resin was used instead of Fmoc-Asp (OtBu) -Wang resin in the same amounts (by mols) at the beginning and, after that, appropriate amino acids were used in the same molar amounts as appropriate in the relevant peptide coupling sequences (i.e. Fmoc-Thr (tBu) -OH, Fmoc-Tyr (tBu) -OH, Fmoc-Asn(Trt) -OH, Fmoc-Asp (OtBu) -OH, Fmoc-Thr (tBu) -OH, Fmoc-Phe-OH, Fmoc-Val-OH, Fmoc-Ala-OH, Fmoc-Asp (OtBu) -OH, Fmoc-Ser (tBu) -OH and Boc-His (Trt) -OH) .
[0338] Repeating essentially the same procedure as that described in Example 1 above gave a batch of crude title compound (yield 4.35 g) . Analysis showed a target peak that was eluted at 20.182 minutes with the expected molecular weight and a purity of 62.381%.
[0339] MS: m / z 1425.48
[0340] 4.3 g of the crude product was then purified using essentially the same purification procedure as described in Example 1 above, except that the gradient 20%~35%was used instead of 5%~20%, to give 2.06 g of pure title compound after freeze-drying.
[0341] Example 4
[0342] His-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg-Leu-Arg-Lys (Compound II; SEQ ID No: 107)
[0343] The title compound was prepared using essentially the same synthesis procedure as that described in Example 1 above, except that Fmoc-Lys (Boc) -Wang resin was used instead of Fmoc-Asp (OtBu) -Wang resin in the same molar amount and, after that, appropriate amino acids were used in the same molar amounts as appropriate in the relevant peptide coupling sequence (i.e. Fmoc-Arg (Pbf) -OH, Fmoc-Leu-OH, Fmoc-Thr (tBu) -OH, Fmoc-Tyr (tBu) -OH, Fmoc-Asn (Trt) -OH, Fmoc-Asp (OtBu) -OH, Fmoc-Thr (tBu) -OH, Fmoc-Phe-OH, Fmoc-Val-OH, Fmoc-Ala-OH, Fmoc-Asp (OtBu) -OH, Fmoc-Ser (tBu) -OH and Boc-His (Trt) -OH) .
[0344] Essentially the same procedure as that described in Example 1 above gave a batch of crude title compound (yield 5.59 g) . Analysis showed a target peak that was eluted at 23.827 minutes with the expected molecular weight. The purity was 58.938%.
[0345] MS: m / z 1823.00
[0346] 5.5 g of the crude product was then purified using essentially the same purification procedure as that described in Example 1 above, except that the gradient 25%~40%was used instead of 5%~20%, to give 2.19 g of pure title compound after freeze-drying.
[0347] Example 5
[0348] Palm-His-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg-Leu-Arg-Lys (SEQ ID No: 108)
[0349] The title compound was prepared using essentially the same synthesis procedure as that described in Example 4 above, except that Fmoc-His (Trt) -OH was used instead of Boc-His (Trt) -OH. After that, a separate coupling step was carried out to couple palmitic acid (2.31 g, 9 mmol; Merck KGaA, Darmstadt, Germany) in the same molar amount.
[0350] Essentially the same procedure as that described in Example 1 above gave a batch of crude title compound (yield 6.21 g) . Analysis showed a target peak that was eluted at 40.278 minutes with the expected molecular weight and a purity of 56.811%.
[0351] MS: m / z 2061.42
[0352] 6.2 g of the crude product was then purified using essentially the same purification procedure as that described in Example 1 above, except that the gradient 55%~70%was used instead of 5%~20%, to give 2.79 g of pure title compound after freeze-drying.
[0353] Example 6
[0354] His-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg-Leu-Arg-Lys (Palm) (SEQ ID No: 109)
[0355] The title compound was prepared using essentially the same synthesis procedure as that described in Example 4 above.
[0356] Fmoc-Lys (Dde) -Wang resin was used instead of Fmoc-Lys (Boc) -Wang resin in the same molar amount at the beginning and, after the resin was swelled, a side-chain coupling step was firstly carried out, firstly by washing the resin 3 times with DMF (200 mL) , followed by adding a 5%hydrazine monohydrate (Merck KGaA, Darmstadt, Germany) solution in DMF (200 mL) as a deprotection solution, which was reacted for 20 minutes. The solution was then removed by vacuum filtration and the column was washed with DMF for six times.
[0357] Palmitic acid (2.31 g, 9 mmol) and TBTU (2.89 g, 9mmol) were added to the resin. DMF (150 mL) was added to the reaction column, followed by DIPEA (2.33 g, 9mmol) . A Kaiser Test was carried out with few of the resin after 30 minutes reaction indicating the reaction was complete. The solvent was removed by vacuum filtration.
[0358] After the palmitic acid was coupled, the other amino acids were then coupled to the resin. Repeat identically the same synthesize process as that described in Example 3 above, from to obtain the title compound.
[0359] Repeating essentially the same procedure as that described in Example 1 above gave a batch of crude title compound (yield 6.15 g) . Analysis showed a target peak that was eluted at 39.928 minutes with the expected molecular weight and a purity of 55.298%.
[0360] MS: m / z 2061.42
[0361] 6.1 g of the crude product was then purified using essentially the same purification procedure as described in Example 1 above, except that the gradient 55%~70%was used instead of 5%~20%, to give 2.66 g of pure title compound after freeze-drying.
[0362] Example 7 (Comparative)
[0363] His-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg-Leu-Arg-Lys-Gln-Met-Ala-Val-Lys-Lys-Tyr-Leu-Asn-Ser-Ile-Leu-Asn-NH2 (VIP; Compound III; SEQ ID No: 110)
[0364] The title compound was prepared using essentially the same synthesis procedure as that described in Example 1 above, except that Fmoc-Asn (Trt) -Rink Amide Resin was used instead of Fmoc-Asp (OtBu) -Wang resin in the same molar amount at the beginning and, after that, appropriate amino acids were used in the same molar amounts as appropriate in the relevant peptide coupling sequence (i.e. Fmoc-Leu-OH, Fmoc-Ile-OH, Fmoc-Ser(tBu) -OH, Fmoc-Asn (Trt) -OH, Fmoc-Leu-OH, Fmoc-Tyr (tBu) -OH, Fmoc-Lys (Boc) -OH, Fmoc-Lys (Boc) -OH, Fmoc-Val-OH, Fmoc-Met-OH, Fmoc-Gln (Trt) -OH, Fmoc-Arg (Pbf) -OH, Fmoc-Leu-OH, Fmoc-Thr (tBu) -OH, Fmoc-Tyr (tBu) -OH, Fmoc-Asn (Trt) -OH, Fmoc-Asp(OtBu) -OH, Fmoc-Thr (tBu) -OH, Fmoc-Phe-OH, Fmoc-Val-OH, Fmoc-Ala-OH, Fmoc-Asp(OtBu) -OH, Fmoc-Ser (tBu) -OH and Boc-His (Trt) -OH) .
[0365] Repeating essentially the same procedure as that described in Example 1 above gave a batch of crude title compound (yield 10.21 g) . Analysis showed a target peak that was eluted at 43.272 minutes with the expected molecular weight and a purity of 47.828%.
[0366] MS: m / z 3325.85
[0367] 10.2 g of the crude product was then purified using essentially the same purification procedure as described in Example 1 above, except that the gradient 65%~80%was used instead of 5%~20%, to give 3.25 g of pure title compound after freeze-drying.
[0368] Example 8
[0369] Gynaecological Gels
[0370] Various gels were prepared with compositions as shown in Table 1 below.
[0371] The ingredients of respective components ‘A’ (i.e. components A1 to A4) , which were made with and without an optional component ‘B’ , were firstly mixed and stirred for 5 minutes to make a clear solution. After that, respective components ‘C’ (i.e. C1 to C3) were added and stirred for 30 minutes to make six different gels comprising different gelling agents (Hyaluronic acid (HA) gel, Carbomer gel and Methylcellulose (MC) gel, each with and without mussel adhesive protein (MAP) ) . Each mixture was allowed to swell for about 4 hours for the system to become uniform.
[0372] Table 1
[0373] The concentration of Compound II in the above gels was 0.1% (i.e. 1 mg / mL) . Similar gels were made with 1.5 mg / mL and 2 mg / mL of Compound II (reducing the amount of water vehicle by 0.05%and 0.1%, respectively, from the above listed value accordingly) . More particularly, a 1.5 mg / mL carbomer gel, and 2 mg / mL HA and cellulose gels, were made.
[0374] The above procedure was employed to give 12 further gynaecological gels, except that Compounds I and III were used instead of Compound II.
[0375] Example 9
[0376] Clinical Studies
[0377] (A) 2 mL of the Compound II HA gel (1 mg / g; see Example 8 above) was applied to the vagina of a woman in her late 50s using a commercial vaginal applicator. After five minutes, spasmodic contractions of the subject’s vagina were observed. This reaction became stronger over the next thirty minutes before decreasing.
[0378] (B) 2 mL of a Compound II cellulose gel (2 mg / g; see Example 8 above) was applied to the vagina of a woman in her late 50s using a commercial vaginal applicator. Ten minutes later, the subject’s vagina became very sensitive and slight pain was reported. Significant secretion of mucus from the subject vagina was also observed. Twenty minutes later, the subject’s vagina became very narrow. Forty minutes later, the woman experienced uterine contractions.
[0379] (C) 2 mL of a Compound II HA gel (2 mg / g; see Example 8 above) was applied to the vagina of a woman in her late 50s using a commercial vaginal applicator, 15 minutes prior to sexual intercourse. The subject reported that (1) her vagina felt very sensitive and watery from the outset, (2) she reached orgasm quicker than usual; and (3) she experienced a much stronger orgasm compared to her normal orgasms.
[0380] (D) 2 mL of a the Compound I HA gel (1 mg / g; see Example 8 above) was applied to the vagina of a woman in her late 50s using a commercial vaginal applicator. The subject reported that her vagina became slightly sensitive, but reported nothing further.
[0381] (E) 2 mL of a Compound II carbomer gel (1.5 mg / g; see Example 8 above) was applied to the vagina of a woman in her late 50s using a commercial vaginal applicator every other day over two weeks. 15 minutes after administration, the subject noted spasmodic contraction of her vagina, which also become watery. After two weeks of therapy, her vagina became noticeably tighter and more watery than usual.
[0382] Example 10
[0383] In Vitro Study on Vaginal Smooth Muscle Contraction I
[0384] 18 healthy female New Zealand White Rabbits (Shanghai Songjiang Chedun Experimental Animal Breeding Co., Ltd) that were at least 10 weeks old and had an average body weight of 2 to 3 kg were housed in individual cages in a room equipped with high-efficiency air filters at Novopathway’s animal facility. The ventilation rate was 15-25 air changes per hour. The temperature was maintained at 20-26℃, and the relative humidity was 40-70%.
[0385] Lighting was provided for 12 hours (08: 00-20: 00) daily. The rabbits had free access to food and water.
[0386] After 7 days of adaptation, the rabbits were anesthetized and euthanized. Vaginas were separated, with each being cut into four muscle strips of 1.5 cm in length and 0.3 cm in width. These strips were assigned to a positive control group (G1; estradiol benzoate (Shanghai Yuanye Bio-Technology Co., Ltd. ) ) , or low dose (G2) , medium dose (G3) , and high dose (G4) of test substance (His-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg-Leu-Arg-Lys; SEQ ID No: 107; see Example 4 above; hereinafter “Compound II” ) groups, with 18 strips per group. The experimental groups are outlined in Table 2 below.
[0387] Table 2
[0388] Muscle strips were placed in 30 mL Tyrode's solution, oxygenated, and balanced. Baseline tension was measured. 3 mg of estradiol, and 3 mg, 15 mg and 60 mg, respectively, of Compound II were added to give the concentrations described in Table 2 above. Tension was measured post-administration for all 18 strips in each group.
[0389] The contraction intensity displayed by the multi-channel physiological signal acquisition and processing system was recorded before and after administration. Data are expressed as mean±standard error. Statistical analysis was performed using GraphPad Prism software. A p-value < 0.05 was considered statistically significant, with experimental results being shown in Table 3 below and in Figure 1.
[0390] Table 3
[0391] *: Compared with the positive control group, **p < 0.01; ***p < 0.001; ****p < 0.0001
[0392] The in vitro vaginal smooth muscle contraction experiment showed that Compound II induced contraction at a minimum concentration of 0.1 mg / mL. A significant contraction was observed at 0.5 mg / mL, while the contraction effect slightly decreased at 2.0 mg / mL. The contraction tension induced by the medium and high doses of Compound II was higher than that of the positive control, estradiol.
[0393] Example 11
[0394] In Vitro Study on Vaginal Smooth Muscle Contraction II
[0395] An experiment was carried out according to essentially the same procedure as that described in Example 10 above for Compound II and the following two test compounds:
[0396] · Palm-His-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg-Leu-Arg-Lys (SEQ ID No: 108; see Example 5 above; hereinafter “Compound IV” ) ; and
[0397] · His-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg-Leu-Arg-Lys (Palm) (SEQ ID No: 109; see Example 6 above; hereinafter “Compound V” ) ,
[0398] with study groups as set out in in Table 4 below.
[0399] Table 4
[0400] The results are presented in Table 5 below and in Figure 2.
[0401] Table 5
[0402] *: Compared with the positive control group, **p < 0.01; ***p < 0.001; ****p < 0.0001 The results show that Compounds II, IV and V all induced a significant contraction at a concentration of 0.5 mg / mL, which was the maximum effective contraction observed for Compound II in Example 10 above. All three test compounds demonstrated higher vaginal contraction than the positive control, estradiol.
[0403] Example 12
[0404] Clinical Study
[0405] 36 women aged 31 to 57 (median age 43.5 years) participated in this clinical study.
[0406] 11 of the subjects had already reached menopause. All received 1 to 3 doses of a gynaecological gel that was prepared as described in Example 8 above, with Compound II as the active ingredient at a concentration of 1 mg / mL.
[0407] 2 mL of the gel was pre-packed in a commercial vaginal applicator, which was ready to use. 29 volunteers applied one dose of gel, 4 applied 2 doses (1 tube each time) , and 3 subjects applied 3 doses (1 tube each time) .
[0408] All the participants were asked to fill in a feedback form, which included names, ages, whether subjects were at the menopause or not, time to last menstruation, as well as personal, and their respective partner’s , subjective feelings about levels of moisturizing sensation, vaginal tightness, and other feelings including sexual arousal. The results showed an overall effectiveness level of 94% (34 / 36) .
[0409] Amongst the participants, 24 / 36 gave feedback that they had experienced a significant improvement in moisturizing sensation, and 20 / 36 gave feedback that they had experienced vaginal tightening. In addition, 4 participants who had urinary leakage caused relaxation of the pelvic floor muscle. After using the gel, all 4 of these subjects reported an improvement in this problem.
[0410] The summary of the feedback forms is shown in Figure 3.
Claims
1.A compound consisting essentially of between 3 and 21 N-terminal amino acids of the peptide sequence:His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys-Lys (SEQ ID No: 1)wherein:each of X4, X5, X9, X11 and / or X13 independently represent an amino acid selected from the group Ala, Val, Ile, Gly, Asn, Ser, Thr, Tyr and Leu;which peptide sequence is optionally coupled to the group Y or, in cases where the C-terminal amino acid is not Lys, to the group -Lys-Y; andY represents one or more latanoprost molecules and / or one or more lipid, which lipid is selected from the group consisting of vitamin A, vitamin E, cholesterol and a fatty acid comprising one or more carboxylic acid groups, 1 to 50 carbons, and / or one or more cyclic rings, is linear or branched, saturated or unsaturated with between 1 and 10 carbon-carbon double bonds and / or substituted by between 1 to 10 -OH groups, or a derivative of any of these lipids;or a regioisomer, a stereoisomer, or a pharmaceutically-or cosmetically-acceptable salt thereof, for use in the treatment of vaginal laxity or a related disorder.2.The compound for use as claimed in Claim 1, wherein Y or -Lys-Y are not present.3.The compound for use as claimed in Claim 2, wherein the peptide sequence is selected from the group:His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (SEQ ID No: 2) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val (SEQ ID No: 3) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala (SEQ ID No: 4) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met (SEQ ID No: 5) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln (SEQ ID No: 6) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (SEQ ID No: 7) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg (SEQ ID No: 8) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13 (SEQ ID No: 9) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg (SEQ ID No: 10) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11 (SEQ ID No: 11) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr (SEQ ID No: 12) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9 (SEQ ID No: 13) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp (SEQ ID No: 14) ;His-Ser-Asp-X4-X5-Phe-Thr (SEQ ID No: 15) ;His-Ser-Asp-X4-X5-Phe (SEQ ID No: 16) ;His-Ser-Asp-X4-X5 (SEQ ID No: 17) ;His-Ser-Asp-X4 (SEQ ID No: 18) ; andHis-Ser-Asp (SEQ ID No: 19) .4.The compound for use as claimed in Claim 1, wherein Y represents at least one lipid as defined in Claim 1.5.The compound for use as claimed in Claim 1 or Claim 4, wherein Y represents a lipid selected from a derivative of a fatty acid as defined in Claim 1.6.The compound as claimed in Claim 5, wherein the lipid is selected from the group consisting of palmitic acid, stearic acid, oleic acid, octadecanedioic acid, docosahexaenoic acid and leukotriene B4 (LTB4) , or a derivative of any of these.7.The compound as claimed in any one of Claims 1 or 4 to 6, wherein the lipid is palmitic acid, or a derivative thereof.8.The compound for use as claimed in Claim 7, wherein the peptide sequence is selected from the group:His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys-Lys (Palm) (SEQ ID No: 20) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (Palm) (SEQ ID No: 21) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Lys (Palm) (SEQ ID No: 22) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Lys (Palm) (SEQ ID No: 23) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Lys (Palm) (SEQ ID No: 24) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) (SEQ ID No: 25) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Lys (Palm) (SEQ ID No: 26) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-Lys (Palm) (SEQ ID No: 27) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Lys (Palm) (SEQ ID No: 28) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-Lys (Palm) (SEQ ID No: 29) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Lys (Palm) (SEQ ID No: 30) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-Lys (Palm) (SEQ ID No: 31) ;His-Ser-Asp-X4-X5-Phe-Thr-Lys (Palm) (SEQ ID No: 32) ;His-Ser-Asp-X4-X5-Phe-Lys (Palm) (SEQ ID No: 33) ;His-Ser-Asp-X4-X5-Lys (Palm) (SEQ ID No: 34) ;His-Ser-Asp-X4-Lys (Palm) (SEQ ID No: 35) ;His-Ser-Asp-Lys (Palm) (SEQ ID No: 36) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys-Lys (SEQ ID No: 37) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (Palm) -Lys (SEQ ID No: 38) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (Palm) -Lys (SEQ ID No: 39) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys-Lys (Palm) (SEQ ID No: 40) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (Palm) -Lys (Palm) (SEQ ID No: 41) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (Palm) -Lys (Palm) (SEQ ID No: 42) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (SEQ ID No: 43) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (Palm) (SEQ ID No: 44) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val (SEQ ID No: 45) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala (SEQ ID No: 46) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Lys (Palm) (SEQ ID No: 47) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met (SEQ ID No: 48) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Lys (Palm) (SEQ ID No: 49) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln (SEQ ID No: 50) ; His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Lys (Palm) (SEQ ID No: 51) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys-Lys (SEQ ID No: 52) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (SEQ ID No: 53) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val (SEQ ID No: 54) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala (SEQ ID No: 55) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met (SEQ ID No: 56) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln (SEQ ID No: 57) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (SEQ ID No: 58) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg (SEQ ID No: 59) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13 (SEQ ID No: 60) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg (SEQ ID No: 61) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11 (SEQ ID No: 62) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr (SEQ ID No: 63) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9 (SEQ ID No: 64) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp (SEQ ID No: 65) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr (SEQ ID No: 66) ;Palm-His-Ser-Asp-X4-X5-Phe (SEQ ID No: 67) ;Palm-His-Ser-Asp-X4-X5 (SEQ ID No: 68) ;Palm-His-Ser-Asp-X4 (SEQ ID No: 69) ;Palm-His-Ser-Asp (SEQ ID No: 70) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys-Lys (SEQ ID No: 71) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (Palm) -Lys (SEQ ID No: 72) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys-Lys (Palm) (SEQ ID No: 73) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (Palm) -Lys (SEQ ID No: 74) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys-Lys (Palm) (SEQ ID No: 75) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (Palm) -Lys (Palm) (SEQ ID No: 76) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (Palm) -Lys (Palm) (SEQ ID No: 77) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (SEQ ID No: 78) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (Palm) (SEQ ID No: 79) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (Palm) (SEQ ID No: 80) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val (SEQ ID No: 81) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Val-Lys (Palm) (SEQ ID No: 82) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Val-Lys (Palm) (SEQ ID No: 83) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala (SEQ ID No: 84) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Ala-Lys (Palm) (SEQ ID No: 85) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Ala-Lys (Palm) (SEQ ID No: 86) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met (SEQ ID No: 87) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Lys (Palm) (SEQ ID No: 88) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Lys (Palm) (SEQ ID No: 89) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln (SEQ ID No: 90) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Lys (Palm) (SEQ ID No: 91) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Lys (Palm) (SEQ ID No: 92) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) (SEQ ID No: 93) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Lys (Palm) (SEQ ID No: 94) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-Lys (Palm) (SEQ ID No: 95) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Lys (Palm) (SEQ ID No: 96) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-Lys (Palm) (SEQ ID No: 97) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Lys (Palm) (SEQ ID No: 98) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-Lys (Palm) (SEQ ID No: 99) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Lys (Palm) (SEQ ID No: 100) ;Palm-His-Ser-Asp-X4-X5-Phe-Lys (Palm) (SEQ ID No: 101) ;Palm-His-Ser-Asp-X4-X5-Lys (Palm) (SEQ ID No: 102) ;Palm-His-Ser-Asp-X4-Lys (Palm) (SEQ ID No: 103) ; andPalm-His-Ser-Asp-Lys (Palm) (SEQ ID No: 104) .9.The compound for use as claimed in Claim 3 or Claim 8, wherein the peptide sequence is selected from the group:His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met (SEQ ID No: 5) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln (SEQ ID No: 6) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (SEQ ID No: 7) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg (SEQ ID No: 8) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13 (SEQ ID No: 9) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Lys (Palm) (SEQ ID No: 23) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Lys (Palm) (SEQ ID No: 24);His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) (SEQ ID No: 25) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Lys (Palm) (SEQ ID No: 26) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-Lys (Palm) (SEQ ID No: 27) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met (SEQ ID No: 56) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln (SEQ ID No: 57) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (SEQ ID No: 58) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg (SEQ ID No: 59) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13 (SEQ ID No: 60) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met (SEQ ID No: 87) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Met-Lys (Palm) (SEQ ID No: 88) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Met-Lys (Palm) (SEQ ID No: 89) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln (SEQ ID No: 90) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys-Gln-Lys (Palm) (SEQ ID No: 91) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) -Gln-Lys (Palm) (SEQ ID No: 92) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (Palm) (SEQ ID No: 93) ;Palm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Lys (Palm) (SEQ ID No: 94) ; andPalm-His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-Lys (Palm) (SEQ ID No: 95) .10.The compound for use as claimed in any one of the preceding claims, wherein X4 represents Gly or Ala.11.The compound for use as claimed in any one of the preceding claims, wherein X5 represents Ile or Val.12.The compound for use as claimed in any one of the preceding claims, wherein X9 represents Ser or Asn.13.The compound for use as claimed in any one of the preceding claims, wherein X11 represent Ser or Thr.14.The compound for use as claimed in any one of the preceding claims, wherein X13 represents Tyr or Leu.15.The compound for use as claimed in any one of Claims 10 to 14, wherein the peptide sequence is selected from the group:His-Ser-Asp-Gly-Ile-Phe (SEQ ID No: 105) ;His-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg-Leu-Arg-Lys (SEQ ID No: 107) ;Palm-His-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg-Leu-Arg-Lys (SEQ ID No: 108) ; andHis-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg-Leu-Arg-Lys (Palm) (SEQ ID No: 109) .16.The compound for use as claimed in any one of the preceding claims, wherein the vaginal laxity is characterised by measurable loss of elasticity and strength of the vagina and / or its surrounding tissues, and / or a perception by a patient or a sexual partner of the same.17.The compound for use as claimed in any one of the preceding claims, wherein the vaginal laxity is brought on by childbirth, menopause, aging, genetics and / or pelvic surgery and the like.18.The compound for use as claimed in any one of the preceding claims, wherein the treatment is, or is part of, a vaginal rejuvenation program.19.The compound for use as claimed in Claim 18, wherein the vaginal rejuvenation program is intended to restore the aesthetic appearance and / or function of the vagina.20.The compound for use as claims in Claim 18 or Claim 19, wherein the vaginal rejuvenation program also comprises surgery, vaginoplasty and / or energy-based devices to promote tissue remodelling.21.The compound for use as claimed in any one of Claim 1 to 16, wherein the treatment is of sexual frigidity generally.22.The compounds for use as claimed in any one of the preceding claims, wherein the treatment is applied immediately prior to sexual intimacy and / or intercourse.23.The compound for use as claimed in any one of the preceding claims, wherein the treatment gives rise to improvements in the function of the vagina during sexual intimacy and / or sexual intercourse, increases the sensitivity of the female reproductive organs and / or enhances sexual arousal.24.An isolated compound consisting essentially of any one of the peptide sequences:His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg-Lys (SEQ ID No: 7) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13-Arg (SEQ ID No: 8) ;His-Ser-Asp-X4-X5-Phe-Thr-Asp-X9-Tyr-X11-Arg-X13 (SEQ ID No: 9) ; orany one of the peptides sequences with SEQ ID Nos: 4 to 105, 107, 108 or 109 as defined in any one of Claims 3, 8, 9 or 15 (as appropriate) , or a regioisomer, a stereoisomer or a pharmaceutically-or cosmetically-acceptable salt thereof.25.An isolated compound as claimed in Claim 24, wherein the peptide sequence is as defined in Claim 9 or Claim 15, or a regioisomer, a stereoisomer or a pharmaceutically-or cosmetically-acceptable salt thereof.26.An isolated compounds as claimed in Claim 24, consisting essentially of any one of peptide sequences with SEQ IDs Nos: 7, 8, 9, 23 to 25, 56 to 60, 87-95, 105 or 107 to 109, as well as regioisomers, stereoisomers, and pharmaceutically-or cosmetically-acceptable salts of such compounds.27.A compound as defined in any one of Claims 24 to 26, for use in human or animal medicine.28.A compound as defined in any one of Claims 24 to 26, for use as a pharmaceutical.29.A pharmaceutical formulation comprising a compound as defined in any one of Claims 24 to 26.30.A pharmaceutical formulation as claimed in Claim 29, which further comprises a pharmaceutically-or cosmetically-acceptable, adjuvant, diluent or carrier.31.A pharmaceutical formulation as claimed in Claim 29 or Claim 30 that is suitable for, adapted for, and / or packaged and presented for, topical administration, wherein the pharmaceutically-or cosmetically-acceptable adjuvant, diluent or carrier is a topical adjuvant, diluent or carrier.32.A pharmaceutical formulation as claimed in any one of Claims 29 to 31, which is in the form of a liquid, gel, cream, emulsion, essence, powder, a foam, an effervescent composition, or a suppository.33.A pharmaceutical formulation as claimed in any one of Claims 29 to 32, which further includes a further pharmaceutically-active ingredient.34.A kit of parts comprising components:(A) a compound as defined in any one of Claims 1 to 15 or 24 to 26, or a pharmaceutical formulation as defined in any one of Claims 29 to 33; and(B) a pharmaceutical formulation including a further pharmaceutically-active ingredient in admixture with a pharmaceutically-acceptable adjuvant, diluent or carrier, which components (A) and (B) are each provided in a form that is suitable for administration in conjunction with the other.35.A pharmaceutical formulation as claimed in Claim 33, or a kit of parts as claimed in Claim 34 wherein the pharmaceutically-active ingredient is an anti-inflammatory agent, a pro-inflammatory agent, an antibiotics, an anti-bacterial agent, an antiprotozoal agent or an antiviral agent.36.A pharmaceutical formulation or a kit of parts as claimed in Claim 35, wherein the pharmaceutically-active ingredient is an anti-inflammatory agent.37.A compound as defined in any one of Claims 1 to 15 or 24 to 26, a formulation as claimed in any one of Claims 29 to 33, 35 or 36, or a kit of parts as claimed in any one of Claim 34 to 36, for use in the treatment of vaginal laxity or a related disorder as defined in any one of Claim 1 or 16 to 23.38.The use of a compound as defined in any one of Claims 1 to 15 or 24 to 26, a formulation as claimed in any one of Claims 29 to 33, 35 or 36, or a kit of parts as claimed in any one of Claim 34 to 36, for the manufacture a medicament for the treatment of vaginal laxity or a related disorder as defined in any one of Claim 1 or 16 to 23.39.A method of treatment of vaginal laxity or a related disorder as defined in any one of Claim 1 or 16 to 23, which method comprises the administration of a compound as defined in Claims 1 to 15 or 24 to 26, a formulation as claimed in any one of Claims 29 to 33, 35 or 36, or a kit of parts as claimed in any one of Claim 34 to 36, to a patient in need of such treatment.
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