WO2001034550A2 - 15-hydroxyeicosatetraenoic acid analogs with enhanced metabolic stability and methods of their use in treating dry eye disorders - Google Patents

15-hydroxyeicosatetraenoic acid analogs with enhanced metabolic stability and methods of their use in treating dry eye disorders Download PDF

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WO2001034550A2
WO2001034550A2 PCT/US2000/029234 US0029234W WO0134550A2 WO 2001034550 A2 WO2001034550 A2 WO 2001034550A2 US 0029234 W US0029234 W US 0029234W WO 0134550 A2 WO0134550 A2 WO 0134550A2
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pharmaceutically acceptable
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dry eye
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David B. Belanger
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Alcon Universal Ltd.
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Abstract

15-HETE derivatives with enhanced metabolic stability and methods of their use for treating dry eye are disclosed.

Description

15-Hydroxyeicosatetraenoic Acid Analogs with Enhanced Metabolic Stability and Methods of Their Use in Treating Dry Eye Disorders
The present invention is directed to novel hydroxyeicosatetraenoic acid related
compounds, compositions and methods of use. The compounds are particularly useful
in treating dry eye.
Background of the Invention
Dry eye, also known generically as keratoconjunctivitis sicca, is a common
ophthalmological disorder affecting millions of Americans each year. The condition
is particularly widespread among post-menopausal women due to hormonal changes
following the cessation of fertility. Dry eye may afflict an individual with varying
severity. In mild cases, a patient may experience burning, a feeling of dryness, and
persistent irritation such as is often caused by small bodies lodging between the eye
lid and the eye surface. In severe cases, vision may be substantially impaired. Other
diseases, such as Sjogren's disease and cicatricial pemphigoid manifest dry eye
complications.
Although it appears that dry eye may result from a number of unrelated
pathogenic causes, all presentations of the complication share a common effect, that is
the breakdown of the pre-ocular tear film, which results in dehydration of the exposed
outer surface and many of the symptoms outlined above (Lemp, Report of the
National Eye Institute/Industry Workshop on Clinical Trials in Dry Eyes, The CLAO
Journal, volume 21, number 4, pages 221-231 (1995)). Practitioners have taken several approaches to the treatment of dry eye. One
common approach has been to supplement and stabilize the ocular tear film using
so-called artificial tears instilled throughout the day. Other approaches include the use
of ocular inserts that provide a tear substitute or stimulation of endogenous tear
production.
Examples of the tear substitution approach include the use of buffered,
isotonic saline solutions, aqueous solutions containing water soluble polymers that
render the solutions more viscous and thus less easily shed by the eye. Tear reconstitution is also attempted by providing one or more components of the tear film
such as phospholipids and oils. Phospholipid compositions have been shown to be useful in treating dry eye; see, e.g., McCulley and Shine, Tear film structure and dry
eye, Contactologia, volume 20(4), pages 145-49 (1998); and Shine and McCulley,
Keratoconjunctivitis sicca associated with meibomian secretion polar lipid
abnormality, Archives of Ophthalmology, volume 116(7), pages 849-52 (1998). Examples of phospholipid compositions for the treatment of dry eye are disclosed in
United States Patent Nos. 4,131,651 (Shah et al.), 4,370,325 (Packman), 4,409,205
(Shively), 4,744,980 and 4,883,658 (Holly), 4,914,088 (Glonek), 5,075,104 (Gressel
et al.), 5,278,151 (Korb et al.), 5,294,607 (Glonek et al.), 5,371,108 (Korb et al.) and
5,578,586 (Glonek et al.). U.S. Patent No. 5,174,988 (Mautone et al.) discloses
phospholipid drug delivery systems involving phospholipids, propellants and an active
substance.
United States Patent No. 3,991,759 (Urquhart) discloses the use of ocular
inserts in the treatment of dry eye. Other semi-solid therapy has included the administration of carrageenans (United States Patent No. 5,403,841, Lang) which gel
upon contact with naturally occurring tear film.
Another approach involves the provision of lubricating substances in lieu of
artificial tears. For example, United States Patent No. 4,818,537 (Guo) discloses the
use of a lubricating, liposome-based composition, and United States Patent No.
5,800,807 (Hu et al.) discloses compositions containing glycerin and propylene glycol
for treating dry eye.
Aside from the above efforts, which are directed primarily to the alleviation of
symptoms associated with dry eye, methods and compositions directed to treatment of
the dry eye condition have also been pursued. For example, United States Patent No.
5,041,434 (Lubkin) discloses the use of sex steroids, such as conjugated estrogens, to
treat dry eye condition in post-menopausal women; United States Patent No.
5,290,572 (MacKeen) discloses the use of finely divided calcium ion compositions to stimulate pre-ocular tear film production; and United States Patent No. 4,966,773
(Gressel et al.) discloses the use of microfme particles of one or more retinoids for
ocular tissue normalization.
Although these approaches have met with some success, problems in the
treatment of dry eye nevertheless remain. The use of tear substitutes, while
temporarily effective, generally requires repeated application over the course of a
patient's waking hours. It is not uncommon for a patient to have to apply artificial
tear solution ten to twenty times over the course of the day. Such an undertaking is
not only cumbersome and time consuming, but is also potentially very expensive.
Transient symptoms of dry eye associated with refractive surgery have been reported to last in some cases from six weeks to six months or more following
surgery.
The use of ocular inserts is also problematic. Aside from cost, they are often
unwieldy and uncomfortable. Further, as foreign bodies introduced in the eye, they
can be a source of contamination leading to infections. In situations where the insert
does not itself produce and deliver a tear film, artificial tears must still be delivered on
a regular and frequent basis.
Mucins are proteins which are heavily glycosylated with glucosamine-based
moieties. Mucins provide protective and lubricating effects to epithelial cells,
especially those of mucosal membranes. Mucins have been shown to be secreted by
vesicles and discharged on the surface of the conjunctival epithelium of human eyes (Greiner et al., Mucous Secretory Vesicles in Conjunctival Epithelial Cells of Wearers
of Contact Lenses, Archives of Ophthalmology, volume 98, pages 1843-1846 (1980); and Dilly et al., Surface Changes in the Anaesthetic Conjunctiva in Man, with Special
Reference to the Production of Mucous from a Non-Goblet-Cell Source, British
Journal of Ophthalmology, volume 65, pages 833-842 (1981)). A number of human-
derived mucins which reside in the apical and subapical corneal epithelium have been
discovered and cloned (Watanabe et al., Human Corneal and Conjunctival Epithelia
Produce a Mucin-Like Glycoprotein for the Apical Surface, Investigative
Ophthalmology and Visual Science, volume 36, number 2, pages 337-344 (1995)).
Recently, Watanabe discovered a new mucin which is secreted via the cornea apical
and subapical cells as well as the conjunctival epithelium of the human eye (Watanabe
et al., IOVS, volume 36, number 2, pages 337-344 (1995)). These mucins provide lubrication, and additionally attract and hold moisture and sebaceous material for
lubrication and the corneal refraction of light.
Mucins are also produced and secreted in other parts of the body including
lung airway passages, and more specifically from goblet cells interspersed among
tracheal/bronchial epithelial cells. Certain arachidonic acid metabolites have been
shown to stimulate mucin production in these cells. Yanni reported the increased
secretion of mucosal glycoproteins in rat lung by hydroxyeicosatetraenoic acid
("HETE") derivatives (Yanni et al, Effect of Intravenously Administered Lipoxygenase
Metabolites on Rat Trachael Mucous Gel Layer Thickness, International Archives of
Allergy And Applied Immunology, volume 90, pages 307-309 (1989)). Similarly,
Marom has reported the production of mucosal glycoproteins in human lung by HETE
derivatives (Marom et al., Human Airway Monohydroxy- eicosatetraenoic Acid Generation and Mucous Release, Journal of Clinical Investigation, volume 72, pages
122-127 (1983)).
Agents claimed for increasing ocular mucin and/or tear production include
vasoactive intestinal polypeptide (Dartt et. al., Vasoactive intestinal peptide-
stimulated glycocongjugate secretion from conjunctival goblet cells, Experimental
Eye Research, volume 63, pages 27-34, (1996)), gefarnate (Nakmura et. al., Gefarnate
stimulates secretion of mucin-like glycoproteins by corneal epithelium in vitro and
protects corneal epithelium from dessication in vivo, Experimental Eye Research,
volume 65, pages 569-574 (1997)), liposomes (U.S. Patent No. 4,818,537), androgens
(U.S. Patent No. 5,620,921), melanocycte stimulating hormones (U.S. Patent No.
4,868,154), phosphodiesterase inhibitors (U.S. Patent No. 4,753,945), and retinoids
(U.S. Patent No. 5,455,265). However, many of these compounds or treatments suffer from a lack of specificity, efficacy and potency and none of these agents have been
marketed so far as therapeutically useful products to treat dry eye and related ocular
surface diseases.
U.S. Patent No. 5,696,166 (Yanni et al.) discloses compositions containing
naturally occurring HETEs, or derivatives thereof, and methods of use for treating dry
eye. Yanni et al. discovered that compositions comprising HETEs increase ocular
mucin secretion when administered to a patient and are thus useful in treating dry eye.
In view of the foregoing, there is a need for an effective, convenient treatment
for dry eye that is capable of alleviating symptoms, as well as treating the underlying
physical and physiological deficiencies of dry eye.
Summary of the Invention
The present invention is directed to compounds, compositions and methods of use. The present invention is particularly directed to compositions and methods for
the treatment of dry eye and other disorders requiring the wetting of the eye, including
symptoms of dry eye associated with refractive surgery such as LASIK surgery. More
specifically, the present invention discloses derivatives of (5Z,8Z,11Z,13E)-15-
hydroxyeicosa-5,8,ll,13-tetraenoic acid (15-HΕTΕ) in which the ω-chain is modified
as to inhibit metabolic oxidation at C-15. Preferably, the compositions are
administered topically to the eye.
The compounds of the present invention are believed to be more stable than
the naturally occurring HETE-related compounds. Detailed Description of the Invention
The present invention is directed to novel 15-HETE-related derivatives,
compositions and methods of use. It is believed that, among other utilities, the
compounds stimulate ocular mucin production and/or secretion following topical
ocular application and are therefore believed to be useful in treating dry eye. These
Figure imgf000008_0001
compounds are of formula I: wherein:
R1 is (CH2)nCO2R, (CH2)nCONR2R3, (CH2)nCH2OR4, (CH2)nCH2NR5R6, (CH2)nCH2N3, (CH2)„CH2Hal, (CH2)nCH2NO2, (CH2)nCH2SR20, (CH2)nCOSR21 or (CH2)n-2,3,4,5-tetrazol-l -yl, wherein:
R is H or CO2R forms a pharmaceutically acceptable salt or a pharmaceutically acceptable ester;
NR2R3 and NR5R6 are the same or different and comprise a free or functionally modified amino group, e.g., R2, R3, R5 and R6 are the same or different and are H, alkyl, cycloalkyl, aralkyl, aryl, OH, or alkoxy, with the proviso that at most only one of R2 and R3 are OH or alkoxy and at most only one of R5 and R6 are
OH or alkoxy;
OR4 comprises a free or functionally modified hydroxy group, e.g., R4 is H, acyl; alkyl, cycloalkyl, aralkyl, or aryl;
Hal is F, Cl, Br or I;
SR comprises a free or functionally modified thiol group;
R21 is H or COSR21 forms a pharmaceutically acceptable salt or a pharmaceutically acceptable thioester;
n is 0 or 2;
A, B, C and D is Cι-C alkyl, alkenyl, or alkynyl or a C -C5 allenyl group; Y is
Figure imgf000009_0001
wherein R is H or CH3, and
X is CH2, CH(CH3) or C(CH3)2; or
Y is CH2, CH(CH3) or C(CH3)2, and X is
Figure imgf000009_0002
or wherein R is H or CH3, with the proviso that Y cannot be CH2 when X is
Figure imgf000009_0003
; and R7O comprises a free or functionally modified hydroxy group.
The compounds of formula (I) may also be incorporated into phospholipids as glyceryl esters or sphingomyelin amides. Phospholipid sphingomyelin amides of the
compounds of formula (I) will typically comprise a formula (I) compound amidated
via its carbon 1 carboxylate to the amino group of the sphingomyelin backbone. The
phospholipid formula (I) esters will comprise various phospholipids. Phospholipid
esters of the compounds of formula (I) will typically comprise a formula (I) compound
esterified via its carbon 1 carboxylate to the sn-l or sn-2 position alcohol, or both, of
the glycerol backbone of the phospholipid. If the sn-l or sn-2 position of the glyceryl
ester class does not contain an ester of a compound of formula (I), then such carbon positions of the glycerol backbone will comprise a methylene, ether or ester moiety
linked to a substituted or unsubstituted Cι2- 0 alkyl or alkenyl (the alkenyl group
containing one or more double bonds); alkyl(cycloalkyl)alkyl; alkyl(cycloalkyl);
alkyl(heteroaryl); alkyl(heteroaryl)alkyl; or alkyl-M-Q; wherein the substitution is
alkyl, halo, hydroxy, or functionally modified hydroxy; M is O or S; and Q is H, alkyl,
alkyl(cycloalkyl)alkyl, alkyl(cycloalkyl), alkyl(heteroaryl) or alkyl(heteroaryl)alkyl.
However, at least one of the sn-l or sn-2 position alcohols of the glycerol backbone
must form an ester with a compound of formula (I) via the carbon 1 carboxylate of the
latter. Preferred phospholipid-formula (I) esters will be of the
phosphatidylethanolamine, phosphatidylcholine, phosphatidylserine, and phospatidylinositol type. The most preferred phospholipid-formula (I) esters will
comprise a formula (I) compound esterified via its carbon 1 carboxylate to the alcohol
at the sn-2 position of phosphatidylcholine, phosphatidylethanolamine or phosphatidylinositol. The phospholipid-formula (I) esters and sphingomyelin amides
may be synthesized using various phospholipid synthetic methods known in the art;
see for example, Tsai et al., Biochemistry, volume 27, page 4619 (1988); and Dennis
et al., Biochemistry, volume 32, page 10185 (1993).
Included within the scope of the present invention are the individual
enantiomers of the compounds of the present invention, as well as their racemic and
non-racemic mixtures. The individual enantiomers can be enantioselectively
synthesized from the appropriate enantiomerically pure or enriched starting material
by means such as those described below. Alternatively, they may be
enantioselectively synthesized from racemic/non-racemic or achiral starting materials.
(Asymmetric Synthesis; J. D. Morrison and J. W. Scott, Eds.; Academic Press Publishers: New York, 1983-1985, volumes 1-5; Principles of Asymmetric Synthesis;
R.E. Gawley and J. Aube, Eds.; Elsevier Publishers: Amsterdam, 1996). They may
also be isolated from racemic and non-racemic mixtures by a number of known
methods, e.g. by purification of a sample by chiral HPLC (A Practical Guide to Chiral
Separations by HPLC; G. Subramanian, Ed.; VCH Publishers: New York, 1994;
Chiral Separations by HPLC; A.M. Krstulovic, Ed.; Ellis Horwood Ltd. Publishers,
1989), or by enantioselective hydrolysis of a carboxylic acid ester sample by an
enzyme (Ohno, M.; Otsuka, M. Organic Reactions, volume 37, page 1 (1989)). Those
skilled in the art will appreciate that racemic and non-racemic mixtures may be
obtained by several means, including without limitation, nonenantioselective
synthesis, partial resolution, or even mixing samples having different enantiomeric ratios. Departures may be made from such details within the scope of the
accompanying claims without departing from the principles of the invention and
without sacrificing its advantages. Also included within the scope of the present
invention are the individual isomers substantially free of their respective enantiomers.
As used herein, the terms "pharmaceutically acceptable salt", "pharmaceutically acceptable ester" and pharmaceutically acceptable thioester" means
any salt, ester or thioester, respectively, that would be suitable for therapeutic
administration to a patient by any conventional means without significant deleterious
health consequences; and "ophthalmically acceptable salt", "ophthalmically
acceptable ester" and "ophthalmically acceptable thioester" means any
pharmaceutically acceptable salt, ester or thioester, respectively, that would be
suitable for ophthalmic application, i.e. non-toxic and non-irritating. The term "free hydroxy group" means an OH. The term "functionally
modified hydroxy group" means an OH which has been functionalized to form: an
ether, in which an alkyl, aryl, cycloalkyl, heterocycloalkyl, alkenyl, cycloalkenyl,
heterocycloalkenyl, alkynyl, or heteroaryl group is substituted for the hydrogen; an
ester, in which an acyl group is substituted for the hydrogen; a carbamate, in which an
aminocarbonyl group is substituted for the hydrogen; or a carbonate, in which an
aryloxy-, heteroaryloxy-, alkoxy-, cycloalkoxy-, heterocycloalkoxy-, alkenyloxy-,
cycloalkenyloxy-, heterocycloalkenyloxy-, or alkynyloxy-carbonyl group is substituted
for the hydrogen. Preferred moieties include OH, OCH2C(O)CH3,OCH2C(O)C2H5,
OCH3, OCH2CH3, OC(O)CH3, and OC(O)C2H5.
The term "free amino group" means an NH2. The term "functionally modified amino group" means an NH2 which has been functionalized to form: an aryloxy-,
heteroaryloxy-, alkoxy-, cycloalkoxy-, heterocycloalkoxy-, alkenyl-, cycloalkenyl-,
heterocycloalkenyl-, alkynyl-, or hydroxy-amino group, wherein the appropriate group is substituted for one of the hydrogens; an aryl-, heteroaryl-, alkyl-, cycloalkyl-,
heterocycloalkyl-, alkenyl-, cycloalkenyl-, heterocycloalkenyl-, or alkynyl-amino
group, wherein the appropriate group is substituted for one or both of the hydrogens;
an amide, in which an acyl group is substituted for one of the hydrogens; a carbamate,
in which an aryloxy-, heteroaryloxy-, alkoxy-, cycloalkoxy-, heterocycloalkoxy-,
alkenyl-, cycloalkenyl-, heterocycloalkenyl-, or alkynyl-carbonyl group is substituted
for one of the hydrogens; or a urea, in which an aminocarbonyl group is substituted
for one of the hydrogens. Combinations of these substitution patterns, for example an
NH2 in which one of the hydrogens is replaced by an alkyl group and the other
hydrogen is replaced by an alkoxycarbonyl group, also fall under the definition of a functionally modified amino group and are included within the scope of the present
invention. Preferred moieties include NH2, NHCH3, NHC2H5, N(CH3)2,
NHC(O)CH3, NHOH, and NH(OCH3).
The term "free thiol group" means an SH. The term "functionally modified
thiol group" means an SH which has been functionalized to form: a thioether, where
an alkyl, aryl, cycloalkyl, heterocycloalkyl, alkenyl, cycloalkenyl, heterocycloalkenyl,
alkynyl, or heteroaryl group is substituted for the hydrogen; or a thioester, in which an
acyl group is substituted for the hydrogen. Preferred moieties include SH, SC(O)CH3,
SCH3, SC2H5, SCH2C(O)C2H5, and SCH2C(O)CH3.
The term "acyl" represents a group that is linked by a carbon atom that has a double bond to an oxygen atom and a single bond to another carbon atom.
The term "alkyl" includes straight or branched chain aliphatic hydrocarbon
groups that are saturated and have 1 to 15 carbon atoms. The alkyl groups may be interrupted by one or more heteroatoms, such as oxygen, nitrogen, or sulfur, and may
be substituted with other groups, such as halogen, hydroxyl, aryl, cycloalkyl, aryloxy,
or alkoxy. Preferred straight or branched alkyl groups include methyl, ethyl, propyl, isopropyl, butyl and t-butyl.
The term "cycloalkyl" includes straight or branched chain, saturated or
unsaturated aliphatic hydrocarbon groups which connect to form one or more rings,
which can be fused or isolated. The rings may be substituted with other groups, such
as halogen, hydroxyl, aryl, aryloxy, alkoxy, or lower alkyl. Preferred cycloalkyl
groups include cyclopropyl, cyclobutyl, cyclopentyl and cyclohexyl.
The term "heterocycloalkyl" refers to cycloalkyl rings that contain at least one
heteroatom such as O, S, or N in the ring, and can be fused or isolated. The rings may be substituted with other groups, such as halogen, hydroxyl, aryl, aryloxy, alkoxy, or
lower alkyl. Preferred heterocycloalkyl groups include pyrrolidinyl, tetrahydrofuranyl,
piperazinyl, and tetrahydropyranyl.
The term "alkenyl" includes straight or branched chain hydrocarbon groups
having 1 to 15 carbon atoms with at least one carbon-carbon double bond, the chain
being optionally interrupted by one or more heteroatoms. The chain hydrogens may
be substituted with other groups, such as halogen. Preferred straight or branched
alkenyl groups include, allyl, 1-butenyl, l-methyl-2-propenyl and 4-pentenyl.
The term "cycloalkenyl" includes straight or branched chain, saturated or
unsaturated aliphatic hydrocarbon groups which connect to form one or more non-
aromatic rings containing a carbon-carbon double bond, which can be fused or isolated. The rings may be substituted with other groups, such as halogen, hydroxyl,
alkoxy, or lower alkyl. Preferred cycloalkenyl groups include cyclopentenyl and cyclohexenyl.
The term "heterocycloalkenyl" refers to cycloalkenyl rings which contain one
or more heteroatoms such as O, N, or S in the ring, and can be fused or isolated. The
rings may be substituted with other groups, such as halogen, hydroxyl, aryl, aryloxy,
alkoxy, or lower alkyl. Preferred heterocycloalkenyl groups include pyrrolidinyl,
dihydropyranyl, and dihydrofuranyl.
The term "carbonyl group" represents a carbon atom double bonded to an
oxygen atom, wherein the carbon atom has two free valencies.
The term "aminocarbonyl" represents a free or functionally modified amino
group bonded from its nitrogen atom to the carbon atom of a carbonyl group, the
carbonyl group itself being bonded to another atom through its carbon atom. The term "lower alkyl" represents alkyl groups containing one to six carbons
(C1-C6).
The term "halogen" represents fluoro, chloro, bromo, or iodo.
The term "aryl" refers to carbon-based rings which are aromatic. The rings
may be isolated, such as phenyl, or fused, such as naphthyl. The ring hydrogens may
be substituted with other groups, such as lower alkyl, halogen, free or functionalized
hydroxy, trihalomethyl, etc. Preferred aryl groups include phenyl, 3-
(trifluoromethyl)phenyl, 3-chlorophenyl, and 4-fluorophenyl.
The term "heteroaryl" refers to aromatic hydrocarbon rings which contain at
least one heteroatom such as O, S, or N in the ring. Heteroaryl rings may be isolated, with 5 to 6 ring atoms, or fused, with 8 to 10 atoms. The heteroaryl ring(s) hydrogens
or heteroatoms with open valency may be substituted with other groups, such as lower
alkyl or halogen. Examples of heteroaryl groups include imidazole, pyridine, indole, quinoline, furan, thiophene, pyrrole, tetrahydroquinoline, dihydrobenzofuran, and
dihydrobenzindole.
The terms "aryloxy", "heteroaryloxy", "alkoxy", "cycloalkoxy",
"heterocycloalkoxy", "alkenyloxy", "cycloalkenyloxy", "heterocycloalkenyloxy", and
"alkynyloxy" represent an aryl, heteroaryl, alkyl, cycloalkyl, heterocycloalkyl, alkenyl,
cycloalkenyl, heterocycloalkenyl, or alkynyl group, respectively, attached through an
oxygen linkage.
The terms "alkoxycarbonyl", "aryloxycarbonyl", "heteroaryloxycarbonyl",
"cycloalkoxycarbonyl", "heterocycloalkoxycarbonyl", "alkenyloxycarbonyl",
"cycloalkenyloxycarbonyl", "heterocycloalkenyloxycarbonyl", and
"alkynyloxycarbonyl" represent an alkoxy, aryloxy, heteroaryloxy, cycloalkoxy, heterocycloalkoxy, alkenyloxy, cycloalkenyloxy, heterocycloalkenyloxy, or
alkynyloxy group, respectively, bonded from its oxygen atom to the carbon of a
carbonyl group, the carbonyl group itself being bonded to another atom through its
carbon atom.
Preferred compounds of the present invention include those of formula I, wherein:
R1 is CO2R, wherein R is H or CO R forms an ophthalmically acceptable salt or an ophthalmically acceptable ester;
n is 0;
A, B, C and D are the same or different and are CH=CH or C≡C;
Y is
Figure imgf000016_0001
and
X is CH2, CH(CH3) or C(CH3) 2, or
Y is CH2, CH(CH3) or C(CH3)2, and X is
Figure imgf000016_0002
with the proviso that Y cannot be CH2 when X is
Figure imgf000016_0003
or Among the particularly preferred compounds of formula (I) are compounds 2-
5, whose preparations are detailed in the following examples 1-4:
Figure imgf000017_0001
2 3
(5Z,8Z,11Z,13E)-(16/?S)-16-hydroxy-16-methyl (5Z,8Z,11Z,13£)-(15RS)-16,16-dimethyl-15-hydroxy- eicosa-5,8,11 ,13-tetraenoic acid eicosa-5,8,11 ,13-tetraenoic acid
Figure imgf000017_0002
(5Z,11Z,13£)-(16 ?S)-16-hydroxy-16-methyl- (5Z,11Z,13£)-(15RS)-16,16-dimethyl-15-hydroxy- eicosa-5,11 ,13-trienoic acid eicosa-5,11 ,13-trienoic acid
Example 1
Synthesis of 2
Figure imgf000018_0001
(5Z.8Z.1 lZ,13E)-(16RS)-16-Hvdroxy-16-methyleicosa-5.8.11,13-tetraenoic acid (2)
Treatment of propargyl alcohol 6 (prepared according to the method of
Takahashi, O. et. al. Tetrahedron Lett. 1989, 30, 1583-1584) with «-Bu3SnH and
AIBN, followed by treatment with I2 affords the vinyl iodide 7. Palladium-catalyzed
cross-coupling of vinyl iodide 7 and alkyne 8 (prepared according to the method of
Nicolaou, K. C. et. al. J. Chem. Soc, Chem. Commun. 1985, 1580-1581) followed by
reduction with H2 and Pd/C /BaSO4 gives the tetraene 9. Treatment of tetraene 9 with
LiOH in THF/H20 gives the title compound 2. Example 2
Synthesis of 3
Figure imgf000019_0001
(5Z,8Z,1 lZ,13E)-(15RS)-16,16-Dimethyl-15-hvdroxyeicosa-5,8,l 1.13-tetraenoic acid ω
Alkylation of methyl isobutyrate 10 followed by reduction with DIBAL gives
the aldehyde 11. Treatment of the aldehyde 11 with lithium acetylide affords the
propargyl alcohol 12. The vinyl iodide 13 is prepared in two steps from n-
Bu3SnH/AIBN and I2. Palladium-catalyzed cross-coupling of vinyl iodide 13 and
ester 8, followed by reduction gives the tetraene 14. Saponification of tetraene 14
with LiOH gives the title compound 3. Example 3
Synthesis of 4
Figure imgf000020_0001
3. I2, morphoiine
15 16
Figure imgf000020_0002
17
n-Bu3S
Figure imgf000020_0003
17
Wittig
Figure imgf000020_0005
Figure imgf000020_0004
(5Z.1 lZ,13E)-(16RS)-16-Hvdroxy-16-methyl-eicosa-5,l 1,13-trienoic acid (4)
Sequential treatment of 1-hexyne 15 with n-BuLi and paraformaldehyde
affords the propargyl alcohol (not shown). Alkyne isomerization with KH/1,3-
diaminopropane and subsequent conversion to the corresponding iodoalkyne 16 is
accomplished with I2/morpholine. Selective reduction with gives the vinyl iodide 17.
Treatment of propargyl alcohol 6 (prepared according to the method of Takahashi, O.
et. al. Tetrahedron Lett. 1989, 30, 1583-1584) with «-Bu3SnH and AIBN affords the
vinyl stannane 18. Stille coupling of vinyl iodide 17 and vinyl stannane 18, followed
by Jones oxidation gives aldehyde 19. Treatment of aldehyde 19 with the appropriate
Wittig reagent gives the title compound 4.
Example 4 Synthesis of 5
Figure imgf000022_0001
17
Figure imgf000022_0002
(5Z.1 lZ,13E)-(15i.S)-16.16-Dimethyl-15-hydroxyeicosa-5,l 1,13-trienoic acid
(5)
Alkylation of methyl isobutyrate 10 with 1-iodobutane, followed by
DIBAL reduction affords the aldehyde 11. Treatment of aldehyde 11 with lithium
acetylide gives the propargyl alcohol 12. Sequential treatment of 1-hexyne 15 with n-
BuLi and paraformaldehyde affords the propargyl alcohol (not shown). Alkyne
isomerization with KH/l,3-diaminopropane and subsequent conversion to the
corresponding iodoalkyne 16 is accomplished with I2/morpholine. Selective reduction
with gives the cis- vinyl iodide 17. Sonagashira coupling of cts-vinyl iodide 17 with
propargyl alcohol 12, reduction with LiAlH , followed by selective oxidation gives
aldehyde 20. Wittig olefination of aldehyde 20 affords the HΕTΕ analog 5.
Salt forms of the formula (I) compounds are preferred as it is believed that the
neat salts are more stable than the corresponding neat acids. Preferred salts of the
present invention are those wherein a terminal carboxylate of formula (I) (i.e., wherein R1 is CO2R) forms a salt with cations selected from: Na+, K+, NH +,
benzyltrimethylammonium ion, tetrabutylammonium ion, and phenyltrimethyl
ammonium ion.
As used hereinafter, the term "compounds of formula (I)," refers to
compounds of formula (I), and/or the phospholipid-formula (I) esters or amides
described above. The compositions of the present invention comprise one or more
compounds of formula (I) and a pharmaceutically acceptable carrier. The
compositions are formulated in accordance with methods known in the art for the
particular route of administration desired for the prevention, treatment or amelioration
of the particular disease or disorder targeted. The level of peroxy compounds in the HETE derivative raw materials that are used to prepare the pharmaceutical
formulations of the present invention may have an impact on the HETE derivative's
biological activity. Although the precise relationship has not been defined, it is
preferable to use HETE derivative raw material supplies containing peroxy
compounds at levels no greater than about 0.3 ppm. Methods for determining peroxy
levels are known in the art (e.g., European Pharmacopoeia 1997 3rd Ed., Method 2.5.5 - Peroxide Value).
As used herein, the term "pharmaceutically acceptable carrier" refers to any
formulation which is safe, and provides the appropriate delivery of an effective amount
of one or more compounds of formula (I) for the prevention, treatment or amelioration of the disease or disorder targeted.
As used herein, the term "pharmaceutically effective amount" refers to an
amount of one or more compounds of formula (I) that, when administered to a patient, prevents, treats or ameliorates a disease or disorder, or conditions associated thereof. As used herein, "an ophthalmically effective amount" refers to an amount of one or
more compounds of formula (I) that, when administered to a patient, prevents, treats
or ameliorates an ophthalmic disease or disorder, or conditions associated thereof.
For the treatment of dry eye, such an effective amount will stimulate secretion of
mucin in the eye and thus eliminate or improve dry eye conditions when administered
to the eye. As used herein, "an effective amount to treat dry eye" refers to an amount
of one or more compounds of formula (I) that, when administered to a patient,
prevents, treats or ameliorates a dry eye disease or disorder, or conditions associated
thereof. Generally, the compounds of formula (I) will be contained in a composition
of the present invention in a concentration range of about 0.00001 to 10 per cent weight/volume ("% w/v"). Preferred ophthalmic, including dry eye-treatment,
compositions will contain one or more compounds of formula (I) in a concentration of
from about 0.00001-0.01% w/v.
The present invention is particularly directed to compositions useful in treating
dry eye. Preferably, such compositions will be formulated as solutions, suspensions
and other dosage forms for topical administration. Aqueous solutions are generally
preferred, based on ease of formulation, biological compatibility (especially in view of
the malady to be treated, e.g., dry eye-type diseases and disorders), as well as a
patient's ability to easily administer such compositions by means of instilling one to
two drops of the solutions in the affected eyes. However, the compositions may also
be suspensions, viscous or semi-viscous gels, or other types of solid or semi-solid
compositions. Suspensions may be preferred for compounds of formula (I) which are
less soluble in water.
Preferably, the ophthalmic compositions of the present invention will also contain ethanol. As used herein, "an effective concentration of ethanol" refers to a
concentration that enhances the biological efficacy of the formula (I) compositions in
vivo. In general, the concentration of ethanol necessary for the enhancement of the
compounds of formula (I) is believed to be somewhat proportional to the
concentration of the formula (I) compound(s) administered. If a relatively high
concentration of formula (I) compound(s), e.g., above 0.01% w/v, is administered, the
concentration of ethanol in such compositions may be proportionally less than
analogous compositions containing lower concentrations of formula (I) compounds.
In general, however, the ethanol concentration contained in the ophthalmic
compositions of the present invention will range from about 0.001-2% w/v. Compositions containing formula (I) concentrations of about 0.00001-0.02% w/v
preferably will contain ethanol in a concentration of about 0.005-0.2% w/v, and most
preferably, about 0.02-0.10% w/v.
Preferably, the compositions of the present invention will also contain a
surfactant. Various surfactants useful in topical ophthalmic formulations may be
employed. The surfactant(s) may provide additional chemical stabilization of the
formula (I) compounds and may further provide for the physical stability of the
compounds. In other words, the surfactants may aid in preventing chemical
degradation of the compounds of formula (I) and also prevent the compounds from
binding to the containers in which their compositions are packaged. As used herein,
"an effective concentration of surfactant(s)" refers to a concentration that enhances the chemical and physical stability of formula (I) compound(s). Examples of surfactants
include, but are not limited to: Cremophor® EL, polyoxyl 20 ceto stearyl ether,
polyoxyl 40 hydrogenated castor oil, polyoxyl 23 lauryl ether and poloxamer 407 may be used in the compositions. A preferred surfactant is polyoxyl 40 stearate. The
concentration of surfactant will vary, depending on the concentration of formula (I)
compound(s) and optional ethanol present in the formulation. In general, however, the surfactant(s) concentration will be about 0.001 to 2.0% w/v. Preferred
compositions of the present invention will contain about 0.1% w/v of polyoxyl 40
stearate.
The compositions of the present invention may also include various other
ingredients, such as tonicity agents, buffers, preservatives, co-solvents and viscosity
building agents. Various tonicity agents may be employed to adjust the tonicity of the
composition, preferably to that of natural tears for ophthalmic compositions. For
example, sodium chloride, potassium chloride, magnesium chloride, calcium chloride,
dextrose and or mannitol may be added to the composition to approximate
physiological tonicity. Such an amount of tonicity agent will vary, depending on the
particular agent to be added. In general, however, the compositions will have a
tonicity agent concentration of about 0.1-1.5% w/v. Sodium chloride in the amount of
0.75% w/v is preferred.
An appropriate buffer system (e.g., sodium phosphate, sodium acetate, sodium
citrate, sodium borate or boric acid) may be added to the compositions to prevent pH drift under storage conditions. The particular concentration will vary, depending on
the agent employed. In general, however, such a concentration will range from about
0.02 to 2.0% w/v. Preferred compositions will contain about 0.25% w/v of boric acid.
Antioxidants may be added to compositions of the present invention to protect
the formula (I) compounds from oxidation during storage. Examples of such
antioxidants include, but are not limited to, vitamin E and analogs thereof, ascorbic
acid and derivatives, and butylated hydroxyanisole (BHA).
Compositions formulated for the treatment of dry eye-type diseases and
disorders may also comprise aqueous carriers designed to provide immediate, short-
term relief of dry eye-type conditions. Such carriers can be formulated as a
phospholipid carrier or an artificial tears carrier, or mixtures of both. As used in this
paragraph and the immediately succeeding paragraph, the term "phospholipid" refers
only to the phospholipids of the phospholipid carrier, does not refer to a compound of
formula (I) and, as such, does not contain a formula (I) compound. As used herein, "phospholipid carrier" and "artificial tears carrier" refer to aqueous compositions
which: (i) comprise one or more phospholipids (in the case of phospholipid carriers)
or other compounds, which lubricate, "wet," approximate the consistency of
endogenous tears, aid in natural tear build-up, or otherwise provide temporary relief of
dry eye symptoms and conditions upon ocular administration; (ii) are safe; and (iii)
provide the appropriate delivery vehicle for the topical administration of an effective
amount of one or more compounds of formula (I). Examples or artificial tears
compositions useful as artificial tears carriers include, but are not limited to, commercial
products, such as Tears Naturale®, Tears Naturale II®, Tears Naturale Free®, and Bion
Tears® (Alcon Laboratories, Inc., Fort Worth, Texas). Examples of phospholipid carrier formulations include those disclosed in U.S. Patent Nos. 4,804,539 (Guo et al.),
4,883,658 (Holly), 4,914,088 (Glonek), 5,075,104 (Gressel et al.), 5,278,151 (Korb et
al.), 5,294,607 (Glonek et al.), 5,371,108 (Korb et al), 5,578,586 (Glonek et al.); the foregoing patents are incorporated herein by reference to the extent they disclose
phospholipid compositions useful as phospholipid carriers of the present invention.
The phospholipids useful in the phospholipid carriers are any natural or
synthetic phospholipid compound comprising a glycerol-phosphoric acid ester or
sphingomyelin backbone. Examples of phospholipids useful in the present invention
include those of formula (II):
Figure imgf000029_0001
(II) wherein, X21 and X22 are the same or different and are O, NH(C=O), O(C=O), or a direct bond;
R22 is H or CH=CH(CH2),2CH3;
X21-R! is OH, or R1 is Cι2-26 substituted or unsubstituted alkyl or alkenyl;
R2 is Cι2-26 substituted or unsubstituted alkyl or alkenyl; and
R3 is H, OH, OCH2CH(NH3 +)COO\ OCH2CH2NH3 +, OCH2CH2N+(CH3)3,
OCH2CH(OH)CH2OH and O-inositol.
The phospholipids may be present as racemic or non-racemic compounds. Preferred phospholipids are those wherein X -R and or X -R comprise fatty acid esters or
amides. Natural fatty acids are saturated, monounsaturated or polyunsaturated.
Examples of fatty acid residues include, but are not limited to, laurate, myristate,
palmitate, palmitoleate, stearate, oleate, linoleate, linolenate, eicosanoate, docosanoate
and lignocerate. Preferred phospholipid types are the phosphatidylethanolamines,
phosphatidylcholines, phosphatidylserines, phospatidylinositols and sphingomyelins.
Examples of specific phospholipids include: 1,2-dipalmitoyl phosphatidyl choline
("DPPC") 1,2-dipalmityl phosphatidyl glycerol ("DPPG"), N-stearyl sphingomyelin,
N-palmityl sphingomyelin, N-oleyl sphingomyelin, 1,2-distearoyl phosphatidyl
ethanolamine ("DSPE"), 1,2-distearoyl phosphatidyl inositol ("DSPI"), l-stearoyl-2-
palmitoyl phosphatidyl ethanolamine ("SPPE"), l-stearoyl-2 -palmitoyl phosphatidyl
choline ("SPPC"), 1,2-dipalmitoyl phosphatidyl ethanolamine ("DPPE"), 1,2-dioleoyl phophatidyl ethanolamine ("DOPE"), 1,2-dioleoyl phophatidyl serine ("DOPS"), and
1,2-dipalmitoyl phosphatidyl serine ("DPPS"). The most preferred phospholipid
carriers are the phosphatidylethanolamines and sphingomyelins. Phospholipids are
available from a variety of natural sources and may be synthesized by methods known
in the art; see, for example, Tsai et al., Biochemistry, volume 27, page 4619 (1988);
and Dennis et. al., Biochemistry, volume 32, page 10185 (1993).
Other compounds designed to lubricate, "wet," approximate the consistency of
endogenous tears, aid in natural tear build-up, or otherwise provide temporary relief of
dry eye symptoms and conditions upon ocular administration the eye are known in the
art. Such compounds may enhance the viscosity of the composition, and include, but
are not limited to: monomeric polyols, such as, glycerol, propylene glycol, ethylene glycol; polymeric polyols, such as, polyethylene glycol, hydroxypropylmethyl
cellulose ("HPMC"), carboxy methylcellulose sodium, hydroxy propylcellulose
("HPC"), dextrans, such as, dextran 70; water soluble proteins, such as gelatin; and vinyl polymers, such as, polyvinyl alcohol, polyvinylpyrrolidone, povidone and
carbomers, such as, carbomer 934P, carbomer 941, carbomer 940, carbomer 974P.
Other compounds may also be added to the ophthalmic compositions of the
present invention to increase the viscosity of the carrier. Examples of viscosity
enhancing agents include, but are not limited to: polysaccharides, such as hyaluronic
acid and its salts, chondroitin sulfate and its salts, dextrans, various polymers of the
cellulose family; vinyl polymers; and acrylic acid polymers. In general, the
phospholipid carrier or artificial tears carrier compositions will exhibit a viscosity of 1
to 400 centipoises ("cps"). Preferred compositions containing artificial tears or
phospholipid carriers will exhibit a viscosity of about 25 cps. Topical ophthalmic products are typically packaged in multidose form.
Preservatives are thus required to prevent microbial contamination during use.
Suitable preservatives include: benzalkonium chloride, chlorobutanol,
benzododecinium bromide, methyl paraben, propyl paraben, phenylethyl alcohol,
edetate disodium, sorbic acid, polyquaternium-1, or other agents known to those
skilled in the art. Such preservatives are typically employed at a level of from 0.001
to 1.0% w/v. Unit dose compositions of the present invention will be sterile, but
typically unpreserved. Such compositions, therefore, generally will not contain
preservatives.
The preferred compositions of the present invention are intended for
administration to a human patient suffering from dry eye or symptoms of dry eye. Preferably, such compositions will be administered topically. In general, the doses
used for the above described purposes will vary, but will be in an effective amount to
increase mucin production in the eye and thus eliminate or improve dry eye
conditions. Generally, 1-2 drops of such compositions will be administered 1-10
times per day for the treatment of dry eye or other ocular disease or disorder.
Preferably, 1-2 drops of the compositions will be administered 1-4 times per day.
The present invention is also directed to stable, stock compositions comprising
one or more compounds of formula (I) and ethanol. The inventors believe that storing
the compounds of formula (I) in an ethanolic solution provides greater stability of the
compounds of formula (I) over analogous aqueous compositions, or neat compounds
of formula (I) compositions. Such compositions comprise one or more compounds of
formula (I) and an amount of ethanol to solubilize the compounds of formula (I) in
solution. Preferably, the ethanolic stock solutions will contain anhydrous ethanol, but aqueous ethanolic solutions are also contemplated by the present invention.
Generally, the stock solutions will contain ethanol in a concentration of about 25 to
100 % volume/volume ("v/v"). Typically, such stock solutions will contain
compounds of formula (I) in high concentration relative to the pharmaceutical
compositions of the present invention.
The following Examples 1-5 describe preferred compositions of the present
invention. The actual pH of the compositions may vary (e.g., between 6-8), and the
concentrations of the various ingredients included in the exemplified compositions
may vary, but are included in the compositions in the approximate amounts shown.
Example 1
Figure imgf000033_0001
The above composition is prepared by the following method. The batch quantities of polyoxyl 40 stearate, boric acid, sodium chloride, disodium edetate, and
polyquaternium-1 are weighed and dissolved by stirring in 90% of the batch quantity
of purified water. The pH is adjusted to 7.5 ± 0.1 with NaOH and/or HCl. Under
yellow light or reduced lighting, the batch quantity of Compound 1 as a stock solution
in ethanol and the additional quantity of ethanol necessary for the batch are measured
and added. Purified water is added to q.s. to 100%. The mixture is stirred for five
minutes to homogenize and then filtered through a sterilizing filter membrane into a
sterile recipient.
Preferably, the above process is performed using glass, plastic or other non-
metallic containers or containers lined with such materials. Example 2
Figure imgf000034_0001
The above formulation may be made by a method similar to the method described in
Example 1.
Example 3
Figure imgf000034_0002
The above formulation may be made by a method similar to the method described in
Example 1. Example 4
The following is an example of an artificial tears carrier-composition of the present
invention:
Figure imgf000035_0001
The above formulation may be made by a method similar to the method described in
Example 1.
Example 5
The following is an example of a phospholipid carrier-composition of the present invention:
Figure imgf000036_0001
The above formulation may be made by a method similar to the method described in
Example 1.
The invention in its broader aspects is not limited to the specific details shown
and described above. Departures may be made from such details within the scope of the
accompanying claims without departing from the principles of the invention and without
sacrificing its advantages.

Claims

WHAT IS CLAIMED IS:
1. A composition for the treatment of dry eye and other disorders requiring the
wetting of the eye comprising a pharmaceutically acceptable carrier and a
pharmaceutically effective amount of one or more compounds of the following
formula I:
Figure imgf000037_0001
wherein:
R1 is (CH2)nCO2R, (CH2)nCONR2R3, (CH2)nCH2OR4, (CH2)nCH2NR5R6, (CH2)nCH2N3, (CH2)nCH2Hal, (CH2)nCH2NO2, (CH2)nCH2SR20, (CH2)nCOSR21 or (CH2)n-2,3,4,5-tetrazol-l-yl, wherein:
R is H or CO R forms a pharmaceutically acceptable salt or a pharmaceutically acceptable ester;
NR R3 and NR5R6 are the same or different and comprise a free or functionally modified amino group;
OR4 comprises a free or functionally modified hydroxy group;
Hal is F, CL Br or l;
SR20 comprises a free or functionally modified thiol group;
R21 is H or COSR21 forms a pharmaceutically acceptable salt or a pharmaceutically acceptable thioester;
n is 0 or 2;
A, B, C and D is Cι-C alkyl, alkenyl, or alkynyl or a C -C5 allenyl group;
Y is
Figure imgf000037_0002
wherein R is H or CH3, and
X is CH2, CH(CH3) or C(CH3)2; or Y is CH2, CH(CH3) or C(CH3)2, and X is
Figure imgf000038_0001
wherein R is H or CH3, with the proviso that Y cannot be CH2 when X is
Figure imgf000038_0002
or
; and
R O comprises a free or functionally modified hydroxy group.
2. The composition of Claim 1, wherein for the compound of formula I:
R1 is CO2R, wherein R is H or CO2R forms an ophthalmically acceptable salt or an ophthalmically acceptable ester; n is O;
A, B, C and D are the same or different and are CH=CH or C≡C;
Y is
Figure imgf000038_0003
or and
X is CH2, CH(CH3) or C(CH3) 2, or
Y is CH2, CH(CH3) or C(CH3)2, and X is
Figure imgf000038_0004
with the proviso that Y cannot be CH2 when X is
Figure imgf000039_0001
3. The composition of Claim 2, wherein the compound of formula (I) is selected
from the group consisting of:
Figure imgf000039_0002
Figure imgf000039_0003
; and
4. The composition of Claim 1, wherein the composition is a topical ophthalmic
formulation.
5. A method for the treatment of dry eye and other disorders requiring the wetting of the eye which comprises administering to a mammal a composition comprising a
pharmaceutically acceptable carrier and a pharmaceutically effective amount of one or
more compounds of the following formula I:
Figure imgf000040_0001
wherein:
R1 is (CH2)nCO2R, (CH2)nCONR2R3, (CH2)nCH2OR4, (CH2)nCH2NR5R° ( (CCHH22))nnCCHH22NN33,, ((CCHH22))nnCCHH22HHaall,, ((CCHH22)nCH2NO2, (CH2)nCH2SR20, (CH2)nCOSR21 or (CH2)n-2,3,4,5-tetrazol-l-yl, wherein:
R is H or CO2R forms a pharmaceutically acceptable salt or a pharmaceutically acceptable ester;
NR2R3 and NR5R6 are the same or different and comprise a free or functionally modified amino group;
OR4 comprises a free or functionally modified hydroxy group;
Hal is F, Cl, Br or I; f)
SR comprises a free or functionally modified thiol group;
R21 is H or COSR21 forms a pharmaceutically acceptable salt or a pharmaceutically acceptable thioester;
n is 0 or 2;
A, B, C and D is Cι-C5 alkyl, alkenyl, or alkynyl or a C -C5 allenyl group;
Y is
Figure imgf000040_0002
or wherein R is H or CH3, and
X is CH2, CH(CH3) or C(CH3)2; or
Y is CH2, CH(CH3) or C(CH3)2, and X is
Figure imgf000041_0001
or wherein R8 is H or CH , with the proviso that Y cannot be CH when X is
Figure imgf000041_0002
and
R7O comprises a free or functionally modified hydroxy group.
6. The method of Claim 5, wherein for the compound of formula I:
R1 is CO2R, wherein R is H or CO R forms an ophthalmically acceptable salt or an ophthalmically acceptable ester;
n is 0;
A, B, C and D are the same or different and are CH=CH or C≡C; Y is
Figure imgf000041_0003
and
X is CH2, CH(CH3) or C(CH3)2, or
Y is CH , CH(CH3) or C(CH3)2, and X is
Figure imgf000041_0004
or with the proviso that Y cannot be CH2 when X is
Figure imgf000042_0001
or
7. The method of Claim 5, wherein the compound of formula (I) is selected from
the group consisting of:
Figure imgf000042_0002
Figure imgf000042_0003
and
8. The method of Claim 5, wherein the composition is a topical ophthalmic
formulation.
9. The method of Claim 5 wherein the dry eye and other disorders requiring the
wetting of the eye is symptoms of dry eye associated with refractive surgery.
10. A compound according to formula (I):
Figure imgf000043_0001
I wherein:
R1 is (CH2)nCO2R, (CH2)nCONR2R3, (CH2)nCH2OR\ (CH2)nCH2NRJR° ( (CCHH22))nnCCHH22NN33,, ((CCHH22))nnCCHH22HHaall,, ((CCHH22)nCH2NO2, (CH2)nCH2SR20, (CH2)nCOSR21 or (CH2)n-2,3,4,5-tetrazol-l-yl, wherein:
R is H or CO2R forms a pharmaceutically acceptable salt or a pharmaceutically acceptable ester;
NR2R3 and NR5R6 are the same or different and comprise a free or functionally modified amino group;
OR4 comprises a free or functionally modified hydroxy group;
Hal is F, Cl, Br or I;
SR comprises a free or functionally modified thiol group;
R21 is H or COSR21 forms a pharmaceutically acceptable salt or a pharmaceutically acceptable thioester;
n is 0 or 2;
A, B, C and D is C1-C5 alkyl, alkenyl, or alkynyl or a C3-C5 allenyl group;
Y is
Figure imgf000043_0002
Figure imgf000043_0003
tfc 'Rβ or wherein R is H or CH3, and
X is CH2, CH(CH3) or C(CH3)2; or Y is CH2, CH(CH3) or C(CH3)2, and X is
Figure imgf000044_0001
wherein R is H or CH , with the proviso that Y cannot be CH2 when X is
Figure imgf000044_0002
and
R7O comprises a free or functionally modified hydroxy group.
11. The compound of Claim 10, wherein for the compound of formula I:
R1 is CO2R, wherein R is H or CO2R forms an ophthalmically acceptable salt or an ophthalmically acceptable ester;
n is 0;
A, B, C and D are the same or different and are CH=CH or C≡C;
Y is
Figure imgf000044_0003
or and
X is CH2, CH(CH3) or C(CH3)2, or
Y is CH2, CH(CH3) or C(CH3)2, and X is
Figure imgf000044_0004
with the proviso that Y cannot be CH when X is
Figure imgf000045_0001
12. The compound of Claim 10, wherein the compound is selected from the group
consisting of:
Figure imgf000045_0002
Figure imgf000045_0003
and
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