(12) (19) STANDARD PATENT AUSTRALIAN PATENT OFFICE (11) Application No. AU 2015296210 B2

Total Page:16

File Type:pdf, Size:1020Kb

(12) (19) STANDARD PATENT AUSTRALIAN PATENT OFFICE (11) Application No. AU 2015296210 B2 (12) STANDARD PATENT (11) Application No. AU 2015296210 B2 (19) AUSTRALIAN PATENT OFFICE (54) Title Indolizine derivatives which are applicable to neurodegenerative diseases (51) International Patent Classification(s) C07D 471/04 (2006.01) A61P 25/28 (2006.01) A61K 31/437 (2006.01) (21) Application No: 2015296210 (22) Date of Filing: 2015.07.31 (87) WIPO No: WO16/019228 (30) Priority Data (31) Number (32) Date (33) Country 62/031,237 2014.07.31 US (43) Publication Date: 2016.02.04 (44) Accepted Journal Date: 2019.08.15 (71) Applicant(s) Merck Patent GmbH (72) Inventor(s) Karra, Srinivasa R.;Goutopoulos, Andreas (74) Agent / Attorney Griffith Hack, GPO Box 1285, MELBOURNE, VIC, 3001, AU (56) Related Art CAS RN 345292-71-9, STN Entry Date 11 Jul 2001 WO 2012080727 A2 US 7056941 B1 Ito N, Tamano S, Shirai T. A medium-term rat liver bioassay for rapid in vivo detection of carcinogenic potential of chemicals. Cancer Sci. 2003 Jan;94(1 ):3-8. WO 2007095223 A2 (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII International Bureau (10) International Publication Number (43) International Publication Date WO 2016/019228 Al 4 February 2016 (04.02.2016) WIPO I PCT (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every C07D 471/04 (2006.01) A61P 25/28 (2006.01) kind of national protection available): AE, AG, AL, AM, A61K 31/437 (2006.01) AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, (21) International Application Number: DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, PCT/US2015/043090 HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR, (22) International Filing Date: KZ, LA, LC, LK, LR, LS, LU, LY, MA, MD, ME, MG, 31 July 2015 (31.07.2015) MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, SC, (25) Filing Language: English SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, (26) Publication Language: English TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (30) Priority Data: (84) Designated States (unless otherwise indicated, for every 62/031,237 31 July 2014 (31.07.2014) US kind of regional protection available): ARIPO (BW, GH, GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, ST, SZ, (71) Applicant: MERCK PATENT GMBH [DE/DE]; Frank­ TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, furter Strasse 250, 64293 Darmstadt (DE). TJ, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, EE, ES, FI, FR, GB, GR, HR, HU, IE, IS, IT, LT, LU, (72) Inventors; and LV, MC, MK, MT, NL, NO, PL, PT, RO, RS, SE, SI, SK, (71) Appficants for US only): KARRA, Srinivasa R. SM, TR), OAPI (BF, BJ, CF, CG, CI, CM, GA, GN, GQ, [US/US]; 58 Four Winds Drive, Pembroke, Massachusetts GW, KM, ML, MR, NE, SN, TD, TG). 02359 (US). GOUTOPOUUOS, Andreas [GR/US]; 73 Worcester Street, Apt 5, Boston, Massachusetts 02118 Published: — with international search report (Art. 21(3)) (74) Agent: KIM, Dwight D.; EMD Serono Research and De­ velopment Instiute, One Technology Place, Rockland, Massachusetts 02370 (US). Al 2016/019228 (54) Title: INDOLIZINE DERIVATIVES WHICH ARE APPLICABLE TO NEURODEGENERATIVE DISEASES (57) Abstract: The present invention relates to indolizine compounds, and pharmaceutically acceptable compositions thereof, useful as antagonists of P2X7, and for the treatment of P2X7-related disorders. WO WO 2016/019228 PCT/US2015/043090 INDOLIZINE DERIVATIVES WHICH ARE APPLICABLE TO NEURODEGENERATIVE DISEASES RELATED APPLICATION [0001] This application claims the benefit of U.S. Provisional application 62/031,237, filed on July 31, 2014, the content of which is incorporated by reference in its entirety. Technical Field of the Invention [0002] The present invention relates to indolizine compounds useful as antagonists of P2X7. The invention also provides pharmaceutically acceptable compositions comprising compounds of the present invention and methods of using said compositions in the treatment of various disorders. Background of the Invention [0003] The P2X7 receptor is a ligand-gated ion channel that belongs to the Purinergic Receptor Family. The receptor is expressed on many cell types related to the immune and nervous systems. In the nervous system P2X7 is expressed on microglia, oligodendrocytes and astrocytes. Brief activation of the P2X7 receptor channel with its endogenous ligand ATP leads to several downstream events including the processing and release of the proinflammatory cytokine ILl-β from monocytes and macrophages. P2X7 activation also plays an important role in regulating the glutamate release/uptake in astrocytes. [0004] P2X7 receptors are ionotropic receptors activated by ATP, which may regulate neuro transmission in the CNS by activating presynaptic and/or postsynaptic P2X7 receptors on central and peripheral neurons and glia (Deuchars S. A. et al., J. Neurosci. 21:7143-7152, (2001), Kanjhan R. et al., J. Comp. Neurol. 407:11-32 (1997), Le K. T. et al., Neuroscience 83:177-190 (1998)). Activation of the P2X7 receptor on cells of the immune system (macrophages, mast cells and lymphocytes) leads to release of interleukin-1β (IL-Ιβ), giant cell formation, degranulation, and L-selectin shedding. ATP is able to increase local release and process of IL-1 in rats through a P2X7receptor mediated mechanism following lipopolysaccharide (LPS) intraperitoneal injections (Griffiths et al., J. Immunology Vol. 154, pages 2821-2828 (1995); Solle et al., J. Biol. Chemistry, Vol. 276, pages 125-132, (2001)). Docket no.: P 14/143 WO [0005] Antagonism of the P2X7 receptor is considered to be an attractive therapeutic approach for the treatment of multiple sclerosis and Alzheimer’s disease, due to its significant 2019 role in dampening the CNS inflammation and supporting neuroprotection. Jul Summary of the Invention 15 [0006] Compounds of this invention, and pharmaceutically acceptable compositions thereof, may be effective as antagonists of P2X7. Such compounds have general formula I: 2015296210 1 or a pharmaceutically acceptable salt thereof, wherein each of Ring A, X, Y, Z, R1, Ra, m, n, and p, is as defined and described in embodiments herein. [0007] Compounds of the present invention, and pharmaceutically acceptable compositions thereof, are useful for treating a variety of diseases, disorders or conditions, associated with P2X7 activity. Such diseases, disorders, or conditions include those described herein. Detailed Description of Certain Embodiments 1. General Description of Compounds of the Invention [0008] In certain embodiments, the present invention provides antagonists of P2X7. In some embodiments, such compounds include those of the formulae described herein, or a pharmaceutically acceptable salt thereof, wherein each variable is as defined and described herein. 2. Compounds and Definitions [0009] Compounds of this invention include those described generally above, and are further illustrated by the classes, subclasses, and species disclosed herein. As used herein, the following definitions shall apply unless otherwise indicated. For purposes of this invention, the chemical elements are identified in accordance with the Periodic Table of the Elements, CAS version, Handbook of Chemistry and Physics, 75th Ed. Additionally, general principles of organic chemistry are described in “Organic Chemistry”, Thomas Sorrell, University Science Books, 2 11525626_1 (GHMatters) P105007.AU WO 2016/019228 PCT/US2015/043090 Sausalito: 1999, and “March’s Advanced Organic Chemistry”, 5th Ed., Ed.: Smith, M.B. and March, J., John Wiley & Sons, New York: 2001, the entire contents of which are hereby incorporated by reference. [0010] The term “aliphatic” or “aliphatic group”, as used herein, means a straight-chain (i.e., unbranched) or branched, substituted or unsubstituted hydrocarbon chain that is completely saturated or that contains one or more units of unsaturation, or a monocyclic hydrocarbon or bicyclic hydrocarbon that is completely saturated or that contains one or more units of unsaturation, but which is not aromatic (also referred to herein as “carbocycle” “cycloaliphatic” or “cycloalkyl”), that has a single point of attachment to the rest of the molecule. Unless otherwise specified, aliphatic groups contain 1-6 aliphatic carbon atoms. In some embodiments, aliphatic groups contain 1-5 aliphatic carbon atoms. In other embodiments, aliphatic groups contain 1-4 aliphatic carbon atoms. In still other embodiments, aliphatic groups contain 1-3 aliphatic carbon atoms, and in yet other embodiments, aliphatic groups contain 1-2 aliphatic carbon atoms. In some embodiments, “cycloaliphatic” (or “carbocycle” or “cycloalkyl”) refers to a monocyclic C3-C7 hydrocarbon that is completely saturated or that contains one or more units of unsaturation, but which is not aromatic, that has a single point of attachment to the rest of the molecule. Exemplary aliphatic groups are linear or branched, substituted or unsubstituted Ci-Cs alkyl, C2-C8 alkenyl, C2-C8 alkynyl groups and hybrids thereof such as (cycloalkyl)alkyl, (cycloalkenyl)alkyl or (cycloalkyl)alkenyl. [0011] The term “lower alkyl” refers to a C1-4 straight or branched alkyl group. Exemplary lower alkyl groups are methyl, ethyl, propyl, isopropyl, butyl, isobutyl, and tert-butyl. [0012] The term “lower haloalkyl” refers to a C1-4 straight or branched alkyl group that is substituted with one or more halogen atoms. [0013] The term “heteroatom” means one or more of oxygen, sulfur, nitrogen, or phosphorus (including, any oxidized form of nitrogen, sulfur, or phosphorus; the quaternized form of any basic nitrogen or; a substitutable nitrogen of a heterocyclic ring, for example N (as in 3,4-dihydro-2//- pyrrolyl), NH (as in pyrrolidinyl) or NR+ (as in N-substituted pyrrolidinyl)). [0014] The term “unsaturated”, as used herein, means that a moiety has one or more units of unsaturation. 3 WO 2016/019228 PCT/US2015/043090 [0015] As used herein, the term “bivalent Ci-s (or Ci-ό) saturated or unsaturated, straight or branched, hydrocarbon chain”, refers to bivalent alkylene, alkenylene, and alkynylene chains that are straight or branched as defined herein.
Recommended publications
  • Drug Information Sheet("Kusuri-No-Shiori")
    Drug Information Sheet("Kusuri-no-Shiori") Internal Published: 05/2017 The information on this sheet is based on approvals granted by the Japanese regulatory authority. Approval details may vary by country. Medicines have adverse reactions (risks) as well as efficacies (benefits). It is important to minimize adverse reactions and maximize efficacy. To obtain a better therapeutic response, patients should understand their medication and cooperate with the treatment. Brand name:PRANLUKAST TABLETS 112.5mg "CEO" Active ingredient:Pranlukast hydrate Dosage form:white to pale yellow tablet, diameter: 7.5 mm, thickness: 2.7 mm Print on wrapping:(face) プランルカスト 112.5mg「CEO」, CEO 131, プランルカスト 112.5mg (back) PRANLUKAST 112.5mg「CEO」, CEO 131, プランルカスト 112.5mg Effects of this medicine This medicine selectively binds to leukotriene receptor and inhibits its action. It consequently suppresses increase in airway contraction, vascular permeability, mucosal edema and hypersensitivity. It is usually used to treat bronchial asthma and allergic rhinitis. However, it cannot stop the attack of bronchial asthma already in progress but prevents the asthma attack. Before using this medicine, be sure to tell your doctor and pharmacist ・If you have previously experienced any allergic reactions (itch, rash, etc.) to any medicines. ・If you are pregnant or breastfeeding. ・If you are taking any other medicinal products. (Some medicines may interact to enhance or diminish medicinal effects. Beware of over-the-counter medicines and dietary supplements as well as other prescription medicines.) Dosing schedule (How to take this medicine) ・Your dosing schedule prescribed by your doctor is(( to be written by a healthcare professional)) ・In general, for adults, take 2 tablets (225 mg of the active ingredient) at a time, twice a day after breakfast and dinner.
    [Show full text]
  • Inhibitory Activity of Pranlukast and Montelukas Against Histamine
    Showa Univ J Med Sci 21(2), 77~84, June 2009 Original Inhibitory Activity of Pranlukast and Montelukas Against Histamine Release and LTC4 Production from Human Basophils 1, 2 1 1 Satoshi HIBINO ), Ryoko ITO ), Taeru KITABAYASHI ), 1 2 Kazuo ITAHASHI ) and Toshio NAKADATE ) Abstract : Leukotriene receptor antagonists(LTRAs)are routinely used to treat bronchial asthma and are thought to act mostly by inhibiting leukotriene receptors. However, there is no preclinical or clinical evidence of the direct effect of LTRAs on histamine release from and leukotriene(LT)C4 produc- tion by basophils. We used anti-IgE antibody(Ab), FMLP, and C5a to induce histamine release, and anti-IgE Ab and FMLP to stimulate LTC 4 production. Basophils were exposed to different concentrations of pranlukast and montelu- kast, and then to anti-IgE Ab, FMLP, and C5a. Culture supernatant histamine and LTC 4 levels were measured by using a histamine ELISA kit and a LTC 4 EIA kit, respectively. Histamine release was expressed as a percentage of the total histamine content(%HR)induced by anti-IgE Ab, FMLP, or C5a. To evaluate the effects of pranlukast and montelukast on histamine release and LTC 4 production, we calculated the percent inhibition of histamine release and LTC 4 production, expressed as percent inhibition, at different concentrations of pranlukast and montelukast. Pranlukast significantly inhibited histamine release stimulated by FMLP and C5a, but had no effect on histamine release stimulated by anti-IgE Ab. By comparison, montelukast signicantly inhibited histamine release stimulated by FMLP, C5a, and anti-IgE Ab, in a concentration-dependent manner. Both pranlukast and montelukast signicantly inhibited LTC 4 production stimulated by anti-IgE Ab and FMLP.
    [Show full text]
  • Tanibirumab (CUI C3490677) Add to Cart
    5/17/2018 NCI Metathesaurus Contains Exact Match Begins With Name Code Property Relationship Source ALL Advanced Search NCIm Version: 201706 Version 2.8 (using LexEVS 6.5) Home | NCIt Hierarchy | Sources | Help Suggest changes to this concept Tanibirumab (CUI C3490677) Add to Cart Table of Contents Terms & Properties Synonym Details Relationships By Source Terms & Properties Concept Unique Identifier (CUI): C3490677 NCI Thesaurus Code: C102877 (see NCI Thesaurus info) Semantic Type: Immunologic Factor Semantic Type: Amino Acid, Peptide, or Protein Semantic Type: Pharmacologic Substance NCIt Definition: A fully human monoclonal antibody targeting the vascular endothelial growth factor receptor 2 (VEGFR2), with potential antiangiogenic activity. Upon administration, tanibirumab specifically binds to VEGFR2, thereby preventing the binding of its ligand VEGF. This may result in the inhibition of tumor angiogenesis and a decrease in tumor nutrient supply. VEGFR2 is a pro-angiogenic growth factor receptor tyrosine kinase expressed by endothelial cells, while VEGF is overexpressed in many tumors and is correlated to tumor progression. PDQ Definition: A fully human monoclonal antibody targeting the vascular endothelial growth factor receptor 2 (VEGFR2), with potential antiangiogenic activity. Upon administration, tanibirumab specifically binds to VEGFR2, thereby preventing the binding of its ligand VEGF. This may result in the inhibition of tumor angiogenesis and a decrease in tumor nutrient supply. VEGFR2 is a pro-angiogenic growth factor receptor
    [Show full text]
  • Drug Class Review Controller Medications for Asthma
    Drug Class Review Controller Medications for Asthma Final Update 1 Report April 2011 The Agency for Healthcare Research and Quality has not yet seen or approved this report. The purpose of this report is to make available information regarding the comparative effectiveness and safety profiles of different drugs within pharmaceutical classes. Reports are not usage guidelines, nor should they be read as an endorsement of, or recommendation for, any particular drug, use or approach. Oregon Health & Science University does not recommend or endorse any guideline or recommendation developed by users of these reports. Original Report: November 2008 Daniel E. Jonas, MD, MPH Roberta C. M. Wines, MPH Marcy DelMonte, PharmD, BCPS Halle R. Amick, MSPH Tania M. Wilkins, MS Brett D. Einerson, MPH Christine L. Schuler, MD Blake A. Wynia, MPH Betsy Bryant Shilliday, Pharm.D., CDE, CPP Produced by RTI-UNC Evidence-based Practice Center Cecil G. Sheps Center for Health Services Research University of North Carolina at Chapel Hill 725 Martin Luther King Jr. Blvd, CB# 7590 Chapel Hill, NC 27599-7590 Tim Carey, M.D., M.P.H., Director Oregon Evidence-based Practice Center Oregon Health & Science University Mark Helfand, MD, MPH, Director Copyright © 2011 by Oregon Health & Science University Portland, Oregon 97239. All rights reserved. Final Update 1 Report Drug Effectiveness Review Project The medical literature relating to this topic is scanned periodically. (See http://www.ohsu.edu/xd/research/centers-institutes/evidence-based-policy- center/derp/documents/methods.cfm for description of scanning process). Prior versions of this report can be accessed at the DERP website.
    [Show full text]
  • Stems for Nonproprietary Drug Names
    USAN STEM LIST STEM DEFINITION EXAMPLES -abine (see -arabine, -citabine) -ac anti-inflammatory agents (acetic acid derivatives) bromfenac dexpemedolac -acetam (see -racetam) -adol or analgesics (mixed opiate receptor agonists/ tazadolene -adol- antagonists) spiradolene levonantradol -adox antibacterials (quinoline dioxide derivatives) carbadox -afenone antiarrhythmics (propafenone derivatives) alprafenone diprafenonex -afil PDE5 inhibitors tadalafil -aj- antiarrhythmics (ajmaline derivatives) lorajmine -aldrate antacid aluminum salts magaldrate -algron alpha1 - and alpha2 - adrenoreceptor agonists dabuzalgron -alol combined alpha and beta blockers labetalol medroxalol -amidis antimyloidotics tafamidis -amivir (see -vir) -ampa ionotropic non-NMDA glutamate receptors (AMPA and/or KA receptors) subgroup: -ampanel antagonists becampanel -ampator modulators forampator -anib angiogenesis inhibitors pegaptanib cediranib 1 subgroup: -siranib siRNA bevasiranib -andr- androgens nandrolone -anserin serotonin 5-HT2 receptor antagonists altanserin tropanserin adatanserin -antel anthelmintics (undefined group) carbantel subgroup: -quantel 2-deoxoparaherquamide A derivatives derquantel -antrone antineoplastics; anthraquinone derivatives pixantrone -apsel P-selectin antagonists torapsel -arabine antineoplastics (arabinofuranosyl derivatives) fazarabine fludarabine aril-, -aril, -aril- antiviral (arildone derivatives) pleconaril arildone fosarilate -arit antirheumatics (lobenzarit type) lobenzarit clobuzarit -arol anticoagulants (dicumarol type) dicumarol
    [Show full text]
  • Understanding Interparticle Interactions in Dry Powder Inhalation: Glass Beads As an Innovative Model Carrier System
    UNDERSTANDING INTERPARTICLE INTERACTIONS IN DRY POWDER INHALATION: GLASS BEADS AS AN INNOVATIVE MODEL CARRIER SYSTEM DOCTORAL THESIS SUMBITTED IN FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR IN NATURAL SCIENCES AT KIEL UNIVERSITY, GERMANY by Niklas Ludwig Renner Kiel 2017 Referee: Prof. Dr. Regina Scherließ Co-Referee: Prof. Dr. Thomas Kunze Date of Exam: 13.10.2017 Accepted for publication: 13.10.2017 Prof. Dr. Natascha Oppelt (Dean) Published research articles contributing to the present thesis: Renner, N.; Steckel, H.; Urbanetz, N.A.; Scherließ, R. Tailoring the surface topography of a model carrier to alter dry powder inhaler performance Dalby, R.N. (Ed.), RDD Europe 2017 2 (2017), 195-200 Renner, N; Steckel, H.; Urbanetz, N.A.; Scherließ, R. Nano- and microstructured model carrier surfaces to alter dry powder inhaler performance International Journal of Pharmaceutics 518 (2017), 20-28 Conference contributions: Renner, N.; Steckel, H.; Urbanetz, N.A.; Scherließ, R. Tailoring the surface topography of a model carrier to alter dry powder inhaler per- formance Respiratory Drug Delivery, Nice, France (2017) Renner, N.; Steckel, H.; Urbanetz, N.A.; Scherließ, R. A deeper insight into the impact of chemical surface properties on inhalation perfor- mance Drug Delivery to the Lungs 27, Edinburgh, Scotland (2016) Renner, N.; Scherließ, R.; Steckel, H. Glass beads as model carriers in dry powder inhalers: the influence of chemical sur- face properties on inhalation performance International Congress on Particle Technology, Nurnberg, Germany (2016) Renner, N.; Scherließ, R.; Steckel, H. Investigating the influence of carrier surface roughness on drug delivery in DPIs 10th World Meeting on Pharmaceutics, Biopharmaceutics and Pharmaceutical Tech- nology, Glasgow, Scotland (2016) Renner, N.; Kutelova, Z.; Scherließ, R.; Steckel, H.
    [Show full text]
  • The Role of 5-Lipoxygenase in Pathophysiology and Management of Neuropathic Pain
    REVIEW ARTICLE THE ROLE OF 5-LIPOXYGENASE IN PATHOPHYSIOLOGY AND MANAGEMENT OF NEUROPATHIC PAIN Pascanus Lamsihar PT∗, Faldi Yaputra∗∗, Jimmy FA Barus4 and I Putu Eka Widyadharma∗∗,1 ∗Department of Neurology, Provincial Mental Hospital, West Borneo, Indonesia., ∗∗Department of Neurology, Faculty of Medicine, Udayana University-Sanglah General Hospital, Bali, Indonesia., 4Department of Neurology, Faculty of Medicine, Atma Jaya Catholic University, Jakarta-Indonesia. ABSTRACT Neuropathic pain (NP) is a pain caused by lesions in the nervous system. Several causes of NP are traumatic, metabolic disorders, ischemia, toxins, infections, immune-related, and hereditary. The pathophysiology of NP is very complicated and unknown entirely. Therefore the treatment of NP is still unsatisfactory. Recent studies believed the critical role of primary inflammatory mediators in the pathophysiology of NP especially leukotrienes (LTs). The 5- lipoxygenase enzyme (5-LOX) is an enzyme that plays a role in the metabolism of arachidonic acid into LTs. Leukotrienes (LTs) are the essential inflammatory mediators in the pathophysiology of NP. Leukotriene B4 (LTB4) can cause chemotaxis on neutrophils, lowering nociceptors threshold and may contribute to NP. Several studies believed the administration of 5-LOX inhibitors or LTs receptor antagonists could be useful in the management of NP. The purpose of this review is to summarize the involvement of 5-LOX enzyme as an essential role in the pathophysiology and management of NP. KEYWORDS 5-lipoxygenase, leukotrienes,
    [Show full text]
  • The Role of Pharmacogenomics in Improving the Management of Asthma
    The Role of Pharmacogenomics in Improving the Management of Asthma The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters Citation Kazani S, ME Wechsler, E. Israel. 2010. TThe Role of Pharmacogenomics in Improving the Management of Asthma. Journal of Allergy and Clinical Immunology 125, no. 2: 295–302. Published Version 10.1016/j.jaci.2009.12.014 Citable link http://nrs.harvard.edu/urn-3:HUL.InstRepos:42659246 Terms of Use This article was downloaded from Harvard University’s DASH repository, and is made available under the terms and conditions applicable to Open Access Policy Articles, as set forth at http:// nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of- use#OAP NIH Public Access Author Manuscript J Allergy Clin Immunol. Author manuscript; available in PMC 2011 February 1. NIH-PA Author ManuscriptPublished NIH-PA Author Manuscript in final edited NIH-PA Author Manuscript form as: J Allergy Clin Immunol. 2010 February ; 125(2): 295±302. doi:10.1016/j.jaci.2009.12.014. THE ROLE OF PHARMACOGENOMICS IN IMPROVING THE MANAGEMENT OF ASTHMA Shamsah Kazani, M.D. [Instructor in Medicine] Harvard Medical School Brigham and Women's Hospital Boston, Massachusetts Michael E. Wechsler, M.D. [Assistant Professor of Medicine] Harvard Medical School Brigham and Women's Hospital Boston, Massachusetts Elliot Israel, M.D. [Associate Professor of Medicine] Harvard Medical School Brigham and Women's Hospital Boston, Massachusetts Abstract There is a large amount of interindividual variability in both therapeutic and adverse responses to asthma therapies. Genetic variability may account for 50–60% of this variability.
    [Show full text]
  • Downloaded from Survive Nursing | Survivenursing.Com V20110426
    Generic Stem Stem Definition Examples -abine (see -arabine, -citabine) decitabine -ac Anti-inflammatory agents (acetic acid derivatives) bromfenac; dexpemedolac -acetam See -racetam -actide Synthetic corticotropins seractide -adol or -aldol- Analgesics (mixed opiate receptor agonists/ antagonists) tazadolene; spiradolene; levonantradol -adox Antibacterials (quinoline dioxide derivatives) carbadox -afenone Antiarrhythmics (propafenone derivatives) alprafenone; diprafenone -afil PDE5 inhibitors tadalafil -aj- Antiarrhythmics (ajmaline derivatives) lorajmine -aldrate Antacid aluminum salts magaldrate -algron Alpha1 - and alpha2 - adrenoreceptor agonists dabuzalgron -alol Combined alpha and beta blockers labetalol; medroxalol -amivir (see -vir) -ampa Ionotropic non-NMDA glutamate receptors (AMPA and/or KA receptors) -ampanel Ionotropic non-NMDA glutamate receptors (AMPA and/or KA receptors) ; becampanel antagonists -ampator Ionotropic non-NMDA glutamate receptors (AMPA and/or KA receptors) ; forampator modulators -andr- Androgens nandrolone -anib Angiogenesis inhibitors semaxanib -anserin Serotonin 5-HT2 receptor antagonists altanserin; tropanserin; adatanserin -antel Anthelmintics (undefined group) carbantel -antrone Antineoplastics; anthraquinone derivatives pixantrone -apsel P-selectin antagonists torapsel -arabine Antineoplastics (arabinofuranosyl derivatives) fazarabine; fludarabine aril-, -aril, -aril- Antiviral (arildone derivatives) pleconaril; arildone; fosarilate -arit Antirheumatics (lobenzarit type) lobenzarit; clobuzarit -arol
    [Show full text]
  • Asthma (1 of 26)
    Asthma (1 of 26) 1 Patient presents w/ signs & symptoms suggestive of asthma 2 3 DIAGNOSIS No ALTERNATIVE Is asthma DIAGNOSIS confi rmed? Yes ASSESS THE LEVEL OF CONTROL OF ASTHMA FOR THE PAST 4 WEEKS Controlled Partly Controlled Uncontrolled (All of the (Presence of 1-2 of these) (Presence of 3-4 of these) following) Children Adolescents Children Adolescents & ≤5 years old & Children ≤5 years old Children 6-11 years old 6-11 years old Frequency of daytime None >Few >2x/week >Few >2x/week symptoms minutes, minutes, >once a week >once a week Limitation of activities None Any Any Any Any Nocturnal waking up or None Any Any Any Any coughing due to asthma Need for reliever None >once/week >2x/week >once/week >2x/week medication* *Reliever medications taken prior to exercise excluded. Modified from: Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention: Updated 2020. TREATMENT A Patient/guardian/caregiver education B Initial treatment of asthma C Management plans for long-term asthma control D Primary prevention E © Periodic assessmentMIMS & monitoring Not all products are available or approved for above use in all countries. Specifi c prescribing information may be found in the latest MIMS. B13 © MIMS Pediatrics 2020 Asthma (2 of 26) 1 ASTHMA • A heterogeneous disease w/ chronic infl ammatory disorder of the airways • e most common chronic disease in pediatric age groups that causes signifi cant morbidity • Characterized by history of respiratory symptoms eg wheeze, shortness of breath, chest tightness & cough
    [Show full text]
  • 2020 GINA Pocket Guide for Asthma Management and Prevention
    POCKET GUIDE FOR ASTHMA MANAGEMENT AND PREVENTION (for Adults and Children Older than 5 Years) DISTRIBUTE OR COPY NOT DO MATERIAL- COPYRIGHTED A Pocket Guide for Health Professionals Updated 2020 BASED ON THE GLOBAL STRATEGY FOR ASTHMA MANAGEMENT AND PREVENTION © 2020 Global Initiative for Asthma GLOBAL INITIATIVE FOR ASTHMA ASTHMA MANAGEMENT AND PREVENTION DISTRIBUTE for adults and children older ORthan 5 years COPY NOT A POCKET GUIDE FOR HEALTHDO PROFESSIONALS MATERIAL-Updated 2020 GINA Science Committee Chair: Helen Reddel, MBBS PhD COPYRIGHTED GINA Board of Directors Chair: Louis-Philippe Boulet, MD GINA Dissemination and Implementation Committee Chair: Mark Levy, MD (to Sept 2019); Alvaro Cruz, MD (from Sept 2019) GINA Assembly The GINA Assembly includes members from many countries, listed on the GINA website www.ginasthma.org. GINA Executive Director Rebecca Decker, BS, MSJ Names of members of the GINA Committees are listed on page 48. 1 LIST OF ABBREVIATIONS BDP Beclometasone dipropionate COPD Chronic obstructive pulmonary disease CXR Chest X-ray DPI Dry powder inhaler FeNO Fraction of exhaled nitric oxide FEV1 Forced expiratory volume in 1 second FVC Forced vital capacity GERD Gastroesophageal reflux disease HDM House dust mite ICS Inhaled corticosteroids ICS-LABA Combination ICS and LABA Ig Immunoglobulin IL Interleukin DISTRIBUTE IV Intravenous OR LABA Long-acting beta2-agonist COPY LAMA Long-acting muscarinic antagonist NOT LTRA Leukotriene receptor antagonistDO n.a. Not applicable NSAID Nonsteroidal anti-inflammatory drug MATERIAL- O2 Oxygen OCS Oral corticosteroids PEF Peak expiratory flow pMDI PressurizedCOPYRIGHTED metered dose inhaler SABA Short-acting beta2-agonist SC Subcutaneous SLIT Sublingual immunotherapy 2 TABLE OF CONTENTS List of abbreviations ........................................................................................
    [Show full text]
  • Inflammation, Cancer and Oxidative Lipoxygenase Activity Are Intimately Linked
    Cancers 2014, 6, 1500-1521; doi:10.3390/cancers6031500 OPEN ACCESS cancers ISSN 2072-6694 www.mdpi.com/journal/cancers Review Inflammation, Cancer and Oxidative Lipoxygenase Activity are Intimately Linked Rosalina Wisastra and Frank J. Dekker * Pharmaceutical Gene Modulation, Groningen Research Institute of Pharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; E-Mail: [email protected] * Author to whom correspondence should be addressed; E-Mail: [email protected]; Tel.: +31-5-3638030; Fax: +31-5-3637953. Received: 16 April 2014; in revised form: 27 June 2014 / Accepted: 2 July 2014 / Published: 17 July 2014 Abstract: Cancer and inflammation are intimately linked due to specific oxidative processes in the tumor microenvironment. Lipoxygenases are a versatile class of oxidative enzymes involved in arachidonic acid metabolism. An increasing number of arachidonic acid metabolites is being discovered and apart from their classically recognized pro-inflammatory effects, anti-inflammatory effects are also being described in recent years. Interestingly, these lipid mediators are involved in activation of pro-inflammatory signal transduction pathways such as the nuclear factor κB (NF-κB) pathway, which illustrates the intimate link between lipid signaling and transcription factor activation. The identification of the role of arachidonic acid metabolites in several inflammatory diseases led to a significant drug discovery effort around arachidonic acid metabolizing enzymes. However, to date success in this area has been limited. This might be attributed to the lack of selectivity of the developed inhibitors and to a lack of detailed understanding of the functional roles of arachidonic acid metabolites in inflammatory responses and cancer.
    [Show full text]