(12) Patent Application Publication (10) Pub. No.: US 2003/0008919 A1 Roullet Et Al

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(12) Patent Application Publication (10) Pub. No.: US 2003/0008919 A1 Roullet Et Al US 20030008919A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2003/0008919 A1 ROullet et al. (43) Pub. Date: Jan. 9, 2003 (54) USE OF RETINOIDS TO TREAT HIGH Related U.S. Application Data BLOOD PRESSURE AND OTHER CARDOWASCULAR DISEASE (62) Division of application No. 09/325,241, filed on Jun. 3, 1999, now Pat. No. 6,437,003. (76) Inventors: Jean-Baptiste Roullet, Portland, OR (US); David A. McCarron, Portland, Publication Classification OR (US) (51) Int. Cl." ........................ A61K 31/203; A61K 31/07 Correspondence Address: (52) U.S. Cl. ............................................ 514/559; 514/725 MCDONNELL BOEHNEN HULBERT & BERGHOFF (57) ABSTRACT 300 SOUTHWACKER DRIVE SUTE 3200 This invention provides methods of treating a disease in a CHICAGO, IL 60606 (US) mammal where the disease is characterized by a Symptom ameliorated by inhibition of cellular calcium influx. The (21) Appl. No.: 10/223,970 methods involve administering to the mammal an effective amount of a retinoid and a pharmacologically acceptable (22) Filed: Aug. 20, 2002 excipient. Patent Application Publication Jan. 9, 2003 Sheet 1 of 7 US 2003/0008919 A1 Vehicle e Retino O 20 40 SO 80 100 KCI), mM Fig. 1 Patent Application Publication Jan. 9, 2003 Sheet 2 of 7 US 2003/0008919 A1 5 4. KX-O E E 3 O E 2 K 1 occa - 8 ... 7 - 6 - 5 - 4 NE, log(M) Fig. 2 Patent Application Publication Jan. 9, 2003 Sheet 3 of 7 US 2003/0008919 A1 400 300 200 100 Fig. 3 Patent Application Publication Jan. 9, 2003 Sheet 4 of 7 US 2003/0008919 A1 100 80 60 40 20 O 2OO 400 600 (Ca?"), nM Fig. 4 Patent Application Publication Jan. 9, 2003 Sheet 5 of 7 US 2003/0008919 A1 vehicle 100 o - 8O O is Lu £ 60 () N1 C sE 40 O SS 2O O 20 40 60 80 100 KCl), M Fig. 5 Patent Application Publication Jan. 9, 2003 Sheet 6 of 7 US 2003/0008919 A1 NE, logM) Fig. 6 Patent Application Publication Jan. 9, 2003 Sheet 7 of 7 US 2003/0008919 A1 -50 O 50 100 US 2003/OOO8919 A1 Jan. 9, 2003 USE OF RETINOIDS TO TREAT HIGH BLOOD 0006 Thus, in one embodiment, this invention provides PRESSURE AND OTHER CARDIOWASCULAR a method of treating a disease in a mammal where the Said DISEASE disease is characterized by a Symptom ameliorated by inhi bition of cellular calcium influx. The method typically CROSS-REFERENCE TO RELATED involves administering to the mammal an effective amount INVENTIONS of a retinoid and a pharmacologically acceptable excipient. It will be appreciated that while a major application of the 0001. Not Applicable method involves treatment of humans, the methods are not So limited and treatment of virtually any mammal is con STATEMENT AS TO RIGHTS TO INVENTIONS templated. In a particularly preferred embodiment, the mam MADE UNDER FEDERALLY SPONSORED mal is Selected from the group of mammals having a disease RESEARCH AND DEVELOPMENT characterized by one or more Symptoms responsive to 0002) Not Applicable (ameliorated by) inhibition of calcium influx into a cell. 0007. It is primarily contemplated that the methods will BACKGROUND OF THE INVENTION be practiced for the primary purpose of treatment of a condition one or more Symptoms of which are responsive to 0.003 Calcium channel blockers are a relatively recently calcium channel blockage. The methods do not contemplate discovered class of compounds which possess a wide Spec administration of a retinoid for the purpose of diet Supple trum of properties useful in the treatment of cardiovascular, mentation. Thus, the retinoid is not a dietary Supplement. cerebrovascular, intraocular, and other disorders. Calcium The methods may thus additionally involve the step of channel blockers were initially identified as a method for the assaying for retinoid-mediated amelioration of a Symptom of control of hypertension (Fleckenstein et al. (1967) Z. Krei a disease State. Typically the Symptom will be one expected slauforsch, 56: 716), and are routinely used in the control of to be responsive to a calcium channel blocker. Similarly, the hypertension and other disorders. In particular, calcium methods may additionally involve identifying a Subject blockers have shown Some useful therapeutic properties in mammal (e.g., a patient) having a disease State expected to the treatment of classic exertional angina, vasospastic prove responsive to a calcium channel blocker. angina, angina pectoris, acute myocardial infarction, cardiac 0008. The methods can be used to treat a wide variety of arrhythmias, Systemic arterial hypertension, pulmonary arte diseases including, but not limited to essential hypertension, rial hypertension, and cardiomyopathies. In addition, cal hypertension associated with end Stage renal failure, hyper cium channel blockers have shown therapeutic properties in tension associated with pregnancy (preeclampsia), Salt Sen the treatment of various cerebrovascular disorders, including Sitivity hypertension, type II diabetes hypertension, hyper but not limited to migraine headaches, and convulsive tension associated with alcohol abuse, obesity associated epilepsy. hypertension, Systolic hypertension in elderly, asthma, aller 0004 Several structural classes of compounds are known gies, migraine headache, gastrointestinal motility disorders, which exhibit calcium channel blocking utility and have Alzheimer's disease, Senile dementia, angina pectoris, pre been used as therapeutics in a variety of contexts. The three mature labor, cerebrovascular diseases, and convulsive epi major classes include dihydropynidines (e.g., nifedipine, lepsy. The methods, however, are particularly well Suited for felodipine, isradipine, and amlodipine), the benzothiaz treatment of essential hypertension and intra-ocular hyper epines (e.g., diltiazem), and the phenylalkylamines (e.g., tension. Verapamil). Three calcium channel blockers are currently of 0009 Any of a variety of retinoids are suitable. Particu primary clinical Significance in the United States, Verapamil, larly preferred retinoids include retinoic acid and retinol, nifedipine and diltiazem. All three achieve their antihyper with retinol being most preferred. The pharmacologically tensive effect by inhibiting the entry of calcium ions into acceptable excipient is preferably lipid compatible. A most vascular Smooth muscle. The ultimate effect is vasodilation. preferred retinoid inhibits cellular influx of calcium through These calcium blockers are, however, contraindicated in inhibition of Voltage gated channels in particular L-type various circumstances (e.g., where there is impaired left Voltage-gated calcium channels. ventricular function). Thus, there is a need for other calcium blocking agents. 0010. In another embodiment, this invention provides a method of treating a disorder which is responsive to the SUMMARY OF THE INVENTION partial or complete blockade of calcium channels of the central nervous System of a living mammal. Again the 0005 The present identifies previously unknown calcium method involves administering to Such a living mammal in channel blocking properties of retinoids, in particular ret need thereof, a therapeutically effective amount of a retinoid inol, and provides methods of treating pathological condi as described herein. The disorder can include Stroke, anoxia, tions characterized by and ameliorated by inhibition of ischemia, migraine or epilepsy, psychosis, Parkinsonism, cellular calcium influx using retinoids. Retinoids (e.g., Vita depression, or any other convulsive disorder. In Still another min A and analogues) are lipid-Soluble and can therefore embodiment, the method involves treating the degenerative achieve extensive distribution within body tissues. They are changes, connected with Stroke, anoxia, ischemia, migraine, also rapidly absorbed after oral or intravenous administra Parkinsonism, epilepsy or any other convulsive disorder, tion and, because of their affinity for fatty tissues, provide a responsive to the partial or complete blockade of calcium reservoir that maintains elevated retinoid levels for Some channels of the central nervous System of a living animal time after administration. In addition, the physiological body, by administering to a living animal body in need tolerance for many retinoids (e.g., vitamin A) has been thereof a therapeutically-effective amount of a retinoid as repeatedly demonstrated and well characterized. described herein. US 2003/OOO8919 A1 Jan. 9, 2003 0011. In still another embodiment, this invention pro of a drug Sufficient to transiently or permanently reduce vides methods of inhibiting calcium influx into a mamma blood pressure (e.g., diastolic pressure) or to reduce the lian cell. The methods involve contacting the cell with a likelihood of the onset of a stroke. retinoid. The retinoid is present in an amount Sufficient to 0016 A calcium channel is a passive transport mecha inhibit, partially or fully, a calcium channel, more preferably nism by which calcium ions move down their electrochemi a L-type Voltage-gated calcium channel. Virtually any ret cal gradient. In all cells, calcium concentration is low inside inoid is Suitable, however in a preferred embodiment, the the cell (e.g., 107M) and high in the extracellular medium retinoid is retinol or retinoic acid, more preferably retinol. (e.g., 10M) and so a calcium channel allows calcium to go The cell can be virtually any mammalian cell, however into the cell. By contrast, outward calcium transport takes preferred cells include muscle cells, more preferably Smooth place via "a calcium pump, an entirely different mechanism muscle cells, most preferably vascular
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