AU2005203635B2 - Methods and compounds for inhibiting amyloid deposits - Google Patents

Description

-1-

AUSTRALIA

PATENTS ACT 1990 COMPLETE SPECIFICATION FOR A STANDARD PATENT

ORIGINAL

Name of Applicant/s: Actual Inventor/s: Queen's University At Kingston and Neurochem (International) Limited Walter A. Szarek and Donald F. Weaver and Xianqi Kong and Ajay Gupta and David Migneault Address for Service is: SHELSTON IP Margaret Street SYDNEY NSW 2000 CCN: 3710000352 Attorney Code: SW Telephone No: Facsimile No.

(02) 97771111 (02) 9241 4666 Invention Title: METHODS

DEPOSITS

AND COMPOUNDS FOR INHIBITING AMYLOID Details of Original Application No. 49050/00 dated 24 May 2000 The following statement is a full description of this invention, including the best method of performing it known to me/us:- File: 34172AUP01 500665040 1.DOC/5844 00 -la-

O

METHODS AND COMPOUNDS FOR INHIBITING AMYLOID

DEPOSITS

The present application is a divisional application of Australian Application No.

49050/00, which is incorporated in its entirety herein by reference.

This application claims the benefit of priority under 35 U.S.C. 119(e) to U.S.

c Provisional Application No. 60/135,545, filed on May 24, 1999, and U.S. Provisional (N Application No. 60/143,123, filed on July 9, 1999, the entire contents of which are 0incorporated herein by reference. This application is also related to U.S. Patent No.

C 5,972,328, issued October 26, 1999, the entire contents of which are incorporated herein by reference.

BACKGROUND OF THE INVENTION Any discussion of the prior art throughout the specification should in no way be considered as an admission that such prior art is widely known or forms part of common general knowledge in the field.

Amyloidosis refers to a pathological condition characterized by the presence of amyloid. Amyloid is a generic term referring to a group of diverse but specific intracellular and extracellular protein deposits which are associated with a number of different diseases. Though diverse in their occurrence, all amyloid deposits have common morphologic properties, including that they stain with specific dyes Congo red), and have a characteristic birefringent appearance (sometimes characterized as "red-green") in polarized light after staining. They also share common ultrastructural features and common x-ray diffraction and infrared spectra.

Amyloidosis can be classified clinically as primary, secondary, familial and/or isolated. Isolated forms of amyloidosis are those that tend to involve a single organ system. Different amyloids are also characterized by the type of protein present in the deposit. For example, neurodegenerative diseases such as scrapie, bovine spongiform encephalitis, Creutzfeldt-Jakob disease and the like are characterized by the appearance and accumulation of a protease-resistant form of a prion protein (referred to as AScr or PrP-27) in the central nervous system. Similarly, Alzheimer's disease, another neurodegenerative disorder, is characterized by congophilic angiopathy, neuritic plaques and neurofibrillary tangles, all of which have the characteristics of amyloids. In this 00 O case, the plaque and blood vessel amyloid is formed by the beta protein. Other diseases, such as juvenile and adult-onset diabetes, complications of long-term hemodialysis and sequelae of long-standing inflammation or plasma cell dyscrasias are characterized by Sthe accumulation of amyloids systemically. In each of these cases, a different amyloidogenic protein is involved in amyloid deposition.

Islet amyloid polypeptide (IAPP) is known to be capable of forming fibrils which are deposited in the pancreas of patients with Type II diabetes, forming amyloid Sdeposits. Once these deposits have formed, there is no known therapy or treatment which significantly reduces or clears the deposits in situ.

It is an object of the present invention to overcome or ameliorate at least one of the disadvantages of the prior art, or to provide a useful alternative.

SUMMARY OF THE INVENTION According to a first aspect, the present invention provides use of an IAPPinhibiting compound of the formula R7 (R8 )n

R

14 >A2 CH)q /R 13 CH)p (A3 n CH) A6) R9 n R12

(A

4 )n (A 5 )n RIo R 11 wherein A A 2

A

3

A

4

A

5 and A 6 are independently alkyl, O, S, or -NH; m and n (for each individual A group) are independently 0 or 1; 1, p and q are independently 0, 1 or 2; R 7 R R 9

R

1 0 R R 1 2, RI3 and R 1 4 are independently hydrogen, alkyl, alicyclyl, heterocyclyl or aryl, and adjacent R groups may form an unsubstituted or substituted cyclic or heterocyclic ring or a pharmaceutically acceptable salt thereof; for -2a- C the manufacture of a medicament for treating a disease state characterized by IAPPassociated amyloid deposits.

According to a second aspect, the present invention provides use of a compound of the formula

IND

8c R 7 SR R 1 4 SA2 CH)q /R 13 CH

(A

3 H)A6

R

9 I R12

(A

4 )n (A 5 )n RiO R 11 wherein A 2

A

3

A

4

A

5 and A 6 are independently alkyl, 0, S, or -NH; m and n (for each individual A group) are independently 0 or 1; 1, p and q are independently 0, 1 or 2; R 8

R

9 RIO, R R 1 2

R

1 3 and R 1 4 are independently hydrogen, alkyl, alicyclyl, heterocyclyl or aryl, and adjacent R groups may form an unsubstituted or substituted cyclic or heterocyclic ring or a pharmaceutically acceptable salt thereof; for the manufacture of a medicament for treating diabetes.

According to a third aspect, the present invention provides a compound selected from the group consisting of: 2-(2-sulfobenzoyl)-1,2,3,4-tetrahydroisoquinoline; 2-(2sulfobenzyl)-1,2,3,4-tetrahydroisoquinoline; 3-[2-(3-carboxy-1,2,3,4tetrahydroisoquinolinyl)]- 1-propanesulfonic acid; N-methyl-N-phenyl-3-[2-(1,2,3,4tetrahydroisoquinolinyl)]-1-propanesulfonic acid; 4-[2-(6,7-dimethoxy- 1,2,3,4tetrahydroisoquinolinyl)]-l-butanesulfonic acid; 4-[2-(6-methoxy-l,2,3,4tetrahydroisoquinolinyl)]-l-butanesulfonic acid; 3-[2-(1,2,3,4-tetrahydroisoquinolinyl)]- 1-propylthiophosphonic acid; 3-[2-(8-methoxy-1,2,3,4-tetrahydroisoquinolinyl)]-1propanesulfonic acid; 1,2,3,4-tetrahydro-8-isoquinolinesulfonic acid; 2b dimethylamino- 1,2,3 ,4-tetrahydroisoquinolinyl)]- I -propanesulfonic acid; 3- [2-(6-chloro- 1,2,3 ,4-tetrahydroisoquinolinyl)]- 1 -propanesulfonic acid; 1,2,3 isoquinolinylsul fonic acid; 1 -sulfopropyl-2-[2-(1I,2,3,4-tetrahydroisoquinolinyl)methyl] 3- [7-methoxy-2-( 1,2,3 ,4-tetrahydroisoquinolinyl)] -1propyiphosphonic acid; 3-[6-methoxy-2-( 1,2,3,4-tetrahydroisoquinolinyl)]- 1propyiphosphonic acid; 3-[8-methoxy-2-( 1,2,3,4-tetrahydroisoquinolinyl)]- 1prpIhshncai;3ND(3mtoyabnl 4terhdosqioiy) 1 M propyiphosphonic acid; 3 -[6--methoxy-( 1,2,3 ,,4-tetrahydroisoquinolinyl)]- propyiphosphonic acid, dithl ser6-[-et hoxy-2-( 1,2,3 ,4-etraydroisoquinolinyl)] I1-propyiphosphonic acid, diethyl ester; N-phosphonoacetyl-6-methoxy- 1,2,3,4tetrahydroisoquinoline; N-sulfoacetyl- 1,2,3 ,4-tetrahydroisoquinoline; N-propyl-6methoxy- 1,2,3 ,4-tetrahydroisoquinoline; 1,2,3 ,4-tetrahydroisoquinolin-2yl)methyl] isoxazol-3 -ol; 5- [(6-methoxy- 1,2,3 ,4-tetrahydroisoquinolin-2yl)methyl] isoxazol-3 -ol; I-[5-chloro-2-(methylamino)phenyl]- 1,2,3,4tetrahydroisoquinoline; 3-methyl-5-[2-( 1,2,3,4-tetrahydroisoquinolinyl) methyl] isoxazole; 1,2,3,4-tetrahydroisoquinolinyl)methyl]isoxazole-3-carboxylic acid; 5-phenyl-3-12-( 1,2,3 ,4-tetrahydroisoquinolinyl)methyl] isoxazole; 3 1,2,3,4tetrahydroisoquinolinyl)methyl] isoxazole-5-carboxylic acid; (2S)-2-amino-2-[3-( 1,2,3,4tetrahydroisoquinolin-2-ylmethyl] isoxazol-5-yl] acetic acid; 3 1,2,3,4tetrahydroisoquinolinyl)methyl] isoxazole-5-L-alanine; 1,2,3,4tetrahydroisoquinolinyl)methyl] -L-phenylalanine; 1,2,3 ,4-tetrahydroisoquinolinyl) methyl] -1H- 1,2,3 ,4-tetrazole; 1,2,3 ,4-tetrahydroisoquinolin-6-yl)- IH- 1,2,3,4tetrazole; 1,2,3,4-tetrahydroisoquinolinyl)methyl]-1 H-I ,2,3,4-tetrazole; 5- (1,2,3 ,4-tetrahydroisoquinolinyl)] ethyl)} -1 H- 1,2,3 ,4-tetrazole; 1,2,3,4tetrahydroisoquinolin-7-yl)- IH-I ,2,3,4-tetrazole; 1,2,3,4tetrahydroisoquinolinyl)methyl]- IH- 1,2,3 ,4-tetrazole; 5- 1,2,3,4tetrahydroisoquinolinyl)] ethyl I -I IH- I ,2,3,4-tetrazole; and 7-(3,4,5trimethoxybenzoyl)amino- 1,2,3 ,4-tetrahydroisoquinoline; or a pharmaceutically acceptable salt thereof.

According to a fourth aspect, the present invention provides a pharmaceutical composition comprising a compound according to the third aspect together with a pharmnaceutically acceptable carrner.

2c According to a fifth aspect, the present invention provides use of a compound according to the third aspect for the manufacture of a medicament for treating a disease state characterized by IAPP-associated amyloid deposits.

According to a sixth aspect, the present invention provides use of a compound according to the third aspect for the manufacture of a medicament for treating diabetes.

According to a seventh aspect, the present invention provides a method of treating a disease state characterized by IAPP-associated amyloid deposits comprising administering to a subject in need of treatment an IAPP-inhibiting compound of the formula

R

7 R8 n R14 "A2 CH)q R 13

SCH),

(A

3 n

CH)

R9 I R12

(A

4 n (A 5 )n Ro R 1 wherein A 2

A

3

A

4

A

5 and A 6 are independently alkyl, 0, S, or -NH; m and n (for each individual A group) are independently 0 or 1; 1, p and q are independently 0, 1 or 2; R 7

R

9

R

10

R

I

R

12

R

13 and R 14 are independently hydrogen, alkyl, alicyclyl, heterocyclyl or aryl, and adjacent R groups may form an unsubstituted or substituted cyclic or heterocyclic ring or a pharmaceutically acceptable salt thereof.

According to an eighth aspect, the present invention provides a method of treating diabetes comprising administering to a subject in need of treatment a compound of the formula 00 2d c-i R8

(A

3

CH)

0 R9 I R12 N (A n (A 1)n 0 I N

R

10

R

11 wherein A 2

A

3 A A 5 and A 6 are independently alkyl, 0, S, or -NH; m and n (for each individual A group) are independently 0 or 1; 1, p and q are independently 0, 1 or 2; R 7

R

8

R

9

R

I

o, R

I

R

12

R

1 3 and R 14 are independently hydrogen, alkyl, alicyclyl, heterocyclyl or aryl, and adjacent R groups may form an unsubstituted or substituted cyclic or heterocyclic ring or a pharmaceutically acceptable salt thereof.

According to a ninth aspect, the present invention provides a method of treating a disease state characterized by IAPP-associated amyloid deposits comprising administering to a subject in need of treatment a compound according to the third aspect.

According to a tenth aspect, the present invention provides a method of treating diabetes comprising administering to a subject in need of treatment a compound according to the third aspect.

Unless the context clearly requires otherwise, throughout the description and the claims, the words "comprise", "comprising", and the like are to be construed in an inclusive sense as opposed to an exclusive or exhaustive sense; that is to say, in the sense of "including, but not limited to".

In one or more preferred embodiments, the present invention relates to methods and compositions which are useful in the treatment ofamyloidosis. In particular, methods and compositions are disclosed for inhibiting, preventing and treating amyloid deposition, in pancreatic islets wherein the amyloidotic deposits to be treated are, islet amyloid polypeptide (IAPP)-associated amyloid deposits having at least some 00 -2e- S-sheet structure. The methods of the invention involve administering to a subject a therapeutic compound which inhibits, reduces or disrupts amyloid deposits, IAPPassociated amyloid deposits. Accordingly, the compositions and methods of the Sinvention are useful for inhibiting amyloidosis in disorders in which such amyloid deposition occurs, such as diabetes.

In one embodiment, a method for inhibiting amyloid deposition, particularly IAPP-associated amyloid deposition, in a subject is provided, wherein an effective amount of an IAPP-inhibiting compound, or a pharmaceutically acceptable salt thereof, 0is administered to the subject such that said IAPP-associated amyloid deposition is inhibited. Such compounds include those of the following general formula -3wherein C is carbon, N is nitrogen, I, m, o, p and q are independently 0 or 1; n is an integer from 0 to 3; W is hydrogen or an anionic group at physiological pH; Y is an anionic group at physiological pH; R' and R 2 are independently hydrogen, alkyl, an anionic group at physiological pH, or R: and R 2 taken together with the nitrogen to which they are attached, may form an unsubstituted or substituted heterocycle having from 3 to 7 atoms in the heterocyclic ring; R' is hydrogen, halogen, thiol or hydroxyl; R 4 and R 6 are independently hydrogen or halogen; and A is hydrogen or C 1 to C, alkyl; or a pharmaceutically acceptable ester, acid or salt thereof.

Preferred therapeutic compounds include 3-(3-hydroxy-l-propyl)amino-lpropanesulfonic acid; 2-amino-5-phosphovaleric acid; 4-phenyl-l-(3'-sulfopropyl)- 1,2,3,6-tetrahydropyridine; cyclohexylsulfamic acid; O-phospho-L-serine; hexafluoroglutaric acid; 3-amino-2-hydroxy-l-propanesulfonic acid; quinolinesulfonic acid; and 3-dimethylamino-1-propanesulfonic acid, the compounds depicted in FIGs 10-14, and pharmaceutically acceptable esters, acids or salts thereof.

In another embodiment a method for inhibiting amyloid deposition, particularly APP-associated amyloid deposition, in a subject is provided, wherein an effective amount of an LAPP-inhibiting compound, or a pharmaceutically acceptable ester, acid or salt thereof, is administered to the subject such that said IAPP-associated amyloid deposition is inhibited. Such compounds include those of the following general formula -4-

R

8 I

(A

2 )n (CH)q R13 (CH)p (N)m

R

9 (A3)n (H) I (A)n R12

R

9

R

1 2

(A

4

(A

5 R11 R R wherein A 2 A A 4 A' and A 6 are independently alkyl, 0, S, or -NH; m and n (for each individual A group) are independently 0 or 1; 1, p and q are independently 0, 1, or 2; R 7

R

8

R

9

R

1

R

11

R

1 2

R'

3 and R' 4 are independently hydrogen, alkyl, alicyclyl, heterocyclyl or aryl, and adjacent R groups R and

R

8 may form an unsubstituted or substituted cyclic or heterocyclic ring. In an Sembodiment, R" may be anionic.

Preferred therapeutic compounds include 1,2,3,4-tetrahydroisoquinoline, and the compounds depicted in FIGs 1-9.

In another embodiment the invention relates to a method for reducing IAPP-associated amyloid deposits in a subject having APP-associated amyloid deposits, the method comprising administering to a subject an effective amount of an IAPP inhibiting compound, or a pharmaceutically acceptable ester, acid or salt thereof, such that IAPP-associated amyloid deposits are reduced.

The therapeutic compounds of the invention are administered to a subject by a route which is effective for inhibiting IAPP-associated amyloid deposition.

-Suitable routes of administration include oral, transdermal, subcutaneous, sublingual, buccal, intravenous and intraperitoneal injection. The therapeutic compounds can be administered with a pharmaceutically acceptable vehicle.

o The invention further provides pharmaceutical compositions for treating n amyloidosis. The pharmaceutical compositions include a therapeutic compound of Cc€ 0 the invention in an amount effective to inhibit IAPP-associated amyloid deposition, Cc€ O and a pharmaceutically acceptable vehicle.

BRIEF DESCRIPTION OF THE DRAWING iFigures 1-14 depict exemplary chemical structures of compounds described in the specification.

DETAILED DESCRIPTION OF THE INVENTION The present invention will be more fully illustrated by reference to the definitions set forth below.

"Amyloid" includes IAPP-associated amyloid, including, but not limited to, P-sheet amyloid assembled substantially from IAPP subunits. "Inhibition" of amyloid deposition includes preventing or stopping of IAPP-associated amyloid formation, fibrillogenesis, inhibiting or slowing down of further IAPPassociated amyloid deposition in a subject with amyloidosis, already having amyloid deposits, and reducing or reversing IAPP-associated amyloid deposits in a subject with ongoing amyloidosis. Inhibition of amyloid deposition is determined relative to an untreated subject, or relative to the treated subject prior to treatment, or, determined by clinically measurable improvement in pancreatic function in a diabetic patient.

Pharmaceutically acceptable esters, acids or salts of the therapeutic compound, where applicable, are within the scope of the invention, alkali metal, alkaline earth metal, higher valency cation aluminum salt), polycationic counter ion or ammonium salts. Where a compound is anibnic, a preferred pharmaceutically acceptable salt is a sodium salt. Other salts are also contemplated, HCI, citric acid, tartaric acid salts, within their pharmaceutically acceptable ranges.

The therapeutic compound of the invention can be administered in a pharmaceutically acceptable vehicle. As used herein "pharmaceutically acceptable vehicle" includes any and all solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents, and the like which are tf compatible with the activity of the compound and are physiologically acceptable to O the subject. An example of a pharmaceutically acceptable vehicle is buffered

O

-6normal saline (0.15 molar NaCI). Except insofar as any conventional media or l 5 )agent is incompatible with the therapeutic compound, use thereof in the compositions suitable for pharmaceutical administration is contemplated.

Supplementary active compounds can also be incorporated into the compositions.

An "anionic group," as used herein, refers to a group that is negatively charged at physiological pH. Preferred anionic groups include carboxylate, sulfate, sulfonate, sulfinate, sulfamate, tetrazolyl, phosphate, phosphonate, phosphinate, c and phosphorothioate or functional equivalents thereof. "Functional equivalents" of anionic groups include bioisosteres, bioisosteres of a carboxylate group.

Bioisosteres encompass both classical bioisosteric equivalents and non-classical bioisosteric equivalents. Classical and non-classical bioisosteres are known in the art (see, Silverman, R.B. The Organic Chemistry of Drug Design and Drug Action, Academic Press, Inc.: San Diego, CA, 1992, pp.19-23). A particularly preferred anionic group is a carboxylate.

The term "alkyl" includes saturated aliphatic groups, including straightchain alkyl-groups, branched-chain alkyl groups, cycloalkyl (alicyclic) groups, alkyl substituted cycloalkyl groups, and cycloalkyl substituted alkyl groups. In preferred embodiments, a straight chain or branched chain alkcy has 30 or fewer carbon atoms in its backbone C -C 30 for straight chain, C 3

-C

30 for branched chain), and more preferably has 20 or fewer carbon atoms in the backbone.

Likewise, cycloalkyls may have from 4-10 carbon atoms in their ring structure, more preferably have 5, 6 or 7 carbons in the ring structure.

Moreover, the term alkyl includes both "unsubstituted alkyls" and "substituted alkyls", the latter of which refers to alkyl moieties having substituents replacing a hydrogen on one or more carbons of the hydrocarbon backbone. Such substituents can include, for example, halogen, hydroxyl, alkylcarbonyloxy, arylcarbonyloxy, alkoxycarbonyloxy, aryloxycarbonyloxy, carboxylate,

I

-7alkylcarbonyl, alkoxycarbonyl, aminocarbonyl, alkylthiocarbonyl, alkoxyl, phosphate, phosphonato, phosphinato, cyano, amino (including alkyl amino, dialkylamino, arylamino, diarylamino, and alylarylamino), acylamino (including alkylcarbonylamino, arylcarbonylamino, carbamoyl and ureido), amidino, imino, sulfhydryl, alkylthio, arylthio, thiocarboxylate, sulfate, sulfonato, sulfamoyl, sulfonamido, nitro, trifluoromethyl, cyano, azido, heterocyclyl, or an aromatic or heteroaromatic moiety. It will be understood by those skilled in the art that the moieties substituted on the hydrocarbon chain can themselves be substituted, if appropriate. Cycloalkyls can be further substituted, with the substituents described above. An "aralkyl" moiety is an alkyl substituted with an aryl phenylmethyl (benzyl)).

The term "atyl" herein includes 5- and 6-membered single-ring aromatic groups that may include from zero to four heteroatoms, for example, benzene, pyrrole, furan, thiophene, imidazole, oxazole, thiazole, triazole, tetrazole, pyrazole, pyridine, pyrazine, pyridazine and pyrimidine, and the like. Aryl groups also include polycyclic fused aromatic groups such as naphthyl, quinolyl, indolyl, and the like. Those aryl groups having heteroatoms in the ring structure may also be referred to as "aryl heterocycles", "heteroaryls" or "heteroaromatics". The aromatic ring can be substituted at one or more ring positions with such substituents as described above, as for example, halogen, hydroxyl, alkylcarbonyloxy, arylcarbonyloxy, alkoxycarbonyloxy, aryloxycarbonyloxy, carboxylate, alkylcarbonyl, alkoxycarbonyl, aminocarbonyl, alkylthiocarbonyl, alkoxyl, phosphate, phosphonato, phosphinato, cyano, amino (including alyl amino, diallckylamino, arylamino, diarylamino, and allcylarylamino), acylamino (including alkylcarbonylamino, arylcarbonylamino, carbamoyl and ureido), amidino, imino, sulfhvdryl, alkylthio, arylthio, thiocarboxylate, sulfate, sulfonato, sulfamoyl, sulfonamido, nitro, trifluoromethyl, cyano, azido, heterocyclyl, or an aromatic or heteroaromatic moiety. Aryl groups can also be fused or bridged with alicyclic or heterocyclic rings which are not aromatic so as to form a polycycle tetralin).

0 -8- The terms "alkenyl" and "alkynyl" include unsaturated aliphatic groups n analogous in length and possible substitution to the alkyls described above, but that Scontain at least one double or triple bond respectively.

Ce¢ C1 Unless the number of carbons is otherwise specified, "lower alkyl" means an alkyl group, as defined above, but having from one to ten carbons, more preferably from one to six carbon atoms in its backbone structure. Likewise, "lower alkenyl" and "lower alkynyl" have similar chain lengths. Preferred alkyl groups are lower alkyls.

The terms "heterocyclyl" or "heterocyclic group" include 3- to membered ring structures, more preferably 4- to 7- membered rings, which ring K structures include one to four heteroatoms. Heterocyclyl groups include pyrrolidine, oxolane, thiolane, piperidine, piperazine, morpholine, lactones, lactams such as azetidinones and pyrrolidinones, sultams, sultones, and the like.

The heterocyclic ring can be substituted at one or more positions with such substituents as described above, as for example, halogen, hydroxyl, alkylcarbonyloxy, arylcarbonyloxy, alkoxycarbonyloxy, aryloxycarbonyloxy, carboxylate, alkylcarbonyl, alkoxycarbonyl, aminocarbonyl, alkylthiocarbonyl, alkoxyl, phosphate, phosphonato, phosphinato, cyano, amino (including alkyl amino, dialkylamino, arylamino, diarylamino, and alkylarylamino), acylamino (including alkylcarbonylamino, arylcarbonylamino, carbamoyl and ureido), amidino, imino, sulfhydryl, alkylthio, arylthio, thiocarboxylate, sulfate, sulfonato, sulfamoyl, sulfonamido, nitro, trifluoromethyl, cyano, azido, heterocyclyl, or an aromatic or heteroaromatic moiety.

The terms "polycyclyl" or "polycyclic group" include two or more cyclic rings cycloalkyls, cycloalkenyls, cycloalkynyls, aryls and/or heterocyclyls) in which two or more carbons are common to two adjoining rings, the rings are "fused rings". Rings that are joined through non-adjacent atoms are termed "bridged" rings. Each of the rings of the polycycle can be substituted with such substituents as described above, as for example, halogen, hydroxyl, alkylcarbonyloxy, arylcarbonyloxy, alkoxycarbonyloxy, aryloxycarbonyloxy, -9carboxylate, alkylcarbonyl, alkoxycarbonyl, aminocarbonyl, alkylthiocarbonyl, alkoxyl, phosphate, phosphonato, phosphinato, cyano, amino (including alkyl amino, dialkylamino, arylamino, diarylamino, and alkylarylamino), acylamino (including alkylcarbonylamino, arylcarbonylamino, carbamoyl and ureido), amidino, imino, sulfhydryl, alkylthio, arylthio, thiocarboxylate, sulfate, sulfonato, sulfamoyl, sulfonamido, nitro, trifluoromethyl, cyano, azido, heterocyclyl, or an aromatic or heteroaromatic moiety.

The term "heteroatom" includes an atom of any element other than carbon or hydrogen. Preferred heteroatoms are nitrogen, oxygen, sulfur and phosphorus.

The term "aryl aldehyde," as used herein, includes compounds represented (by the formula Ar-C(O)H, in which Ar is an aryl moiety (as described above) and -C(O)H is a formyl or aldehydo group.

It will be noted that the structures of some of the compounds of this invention include asymmetric carbon atoms. It is to be understood accordingly that the isomers arising from such asymmetry all enantiomers and diastereomers) are included within the scope of this invention, unless indicated otherwise. Such isomers can be obtained in substantially pure form by classical separation techniques and by stereochemically controlled synthesis. Furthermore, alkenes or alkynes can include either the E- or Z- geometry, where appropriate.

The present methods and compositions, in embodiments, inhibit, prevent and treat amylqid deposition in pancreatic islets wherein the amyloidotic deposits to be treated are islet amyloid polypeptide (IAPP)-associated amyloid deposits, having at least some p-sheet structure. The methods of the invention include administering to a subject a therapeutic compound which inhibits. reduces or disrupts IAPP-associated amyloid deposits. Accordingly, the compositions and methods of the invention are useful for inhibiting amyloidosis in disorders in which such amyloid deposition occurs, such as diabetes.

In one embodiment, a method for inhibiting IAPP-associated amyloid deposition in a subject is provided, wherein an effective amount of an IAPPinhibiting compound, or a pharmaceutically acceptable ester, acid or salt thereof, is administered to the subject such that said IAPP-associated amyloid deposition is inhibited. Such compounds include those of the following general formula:

(RNR

2 )q

R

3

R

(C)

0 (Y)p

R

4

R

6 wherein C is carbon, N is nitrogen, 1, m, o, p and q are independently 0 or 1; n is an integer from 0 to 3; W is hydrogen or an anionic group at physiological pH; Y is an anionic group at physiological pH; R' and R are independently hydrogen, alkyl, an anionic group at physiological pH, or R' and R taken together with the nitrogen to which they are attached, may form an unsubstituted or substituted heterocycle having from 3 to 7 atoms in the heterocyclic ring; R 3 is hydrogen, halogen, thiol or hydroxyl; R 4

R

3 and R' are independently hydrogen or halogen; and A is hydrogen or Ci to C 6 alkyl; or a pharmaceutically acceptable ester, acid or salt thereof.

In an embodiment, W is preferably -COOH; Y is preferably -COOH,

SO

3 H, -PO3H 2 or -OP(O)(OH) 2 is preferably H, Me or hydroxypropyl; R 2 is preferably H, Me or -SO 3 H; R 3 is preferably H, F, or OH; when R' and R 2 taken together with the nitrogen to which they are attached, form an unsubstituted or substituted heterocycle, preferred groups include -CHS ON C H 2

H

2

-CH

2

-CH

2 Me SONa -11-

R

4

R

5 and R 6 are preferably H or F; A is preferably H, CH, CF 2 or alkyl which may be substituted or unsubstituted, straight, branched or cyclic, e.g., cyclohexyl.

Preferred therapeutic compounds include 3-(3-hydroxy-l-propyl)amino-1propanesulfonic acid; 2-Amino-5-phosphovaleric acid; 4-phenyl-l-(3'sulfopropyl)-1,2,3,6-tetrahydropyridine; cyclohexylsulfamic acid; O-phospho-Lserine; hexafluoroglutaric acid; 3-amino-2-hydroxy-l-propanesulfonic acid; 8acid; and 3-dimethylamino-1-propanesulfonic acid, the compounds depicted in FIGs 10-14, and pharmaceutically acceptable esters, acids or salts thereof.

In another embodiment, a method for inhibiting IAPP-associated amyloid deposition in a subject is provided, wherein an effective amount of an IAPPinhibiting compound, or a pharmaceutically acceptable ester, acid or salt thereof, is administered to the subject such that said IAPP-associated amyloid deposition is inhibited. Such compounds include those of the following general formula:

R

7 ln R 1 4 S14 S"(CH)p (N)m

R

9 (A)n (CH) (A')n R

R

12

(A

4 ,n (As)n 110 i11 R R wherein A A 2

A

3

A

4

A

5 and A 6 are independently alkyl, 0, S, or -NH; m and n (for each individual A group) are independently 0 or 1; 1, p and q are independently 0, 1, or 2; R 7

R

8

R

9

R

I

R

11

R"

I

R3, and R 4 are independently hydrogen, alkyl, alicyclyl, heterocyclyl or aryl, and adjacent R groups R and -12- R may form an unsubstituted or substituted cyclic or heterocyclic ring. In an embodiment, R' may.be anionic.

Preferred therapeutic compounds include 1,2,3,4-tetrahydroisoquinoline, and the compounds depicted in FIGs 1-9.

A further aspect of the invention includes pharmaceutical compositions for treating amyloidosis. The therapeutic compounds in the methods of the invention, as described hereinbefore, can be incorporated into a pharmaceutical composition in an amount effective to inhibit amyloidosis or reduce amyloid deposits, in a pharmaceutically acceptable vehicle.

In the methods of the invention, amyloid deposition in a subject is inhibited by administering a therapeutic compound of the invention to the subject. The term subject includes living organisms in which amyloidosis can occur. Examples of subjects include humans, apes, monkeys, cows, sheep, goats, dogs, cats, mice, rats, and transgenic species thereof. Administration of the compositions of the present invention to a subject to be treated can be carried out using known procedures, at dosages and for periods of time effective to inhibit amyloid deposition or reduce amyloid deposits in the subject. An effective amount of the therapeutic compound necessary to achieve a therapeutic effect may vary according to factors such as the amount of amyloid already deposited at the clinical site in the subject, the age, sex, and weight of the subject, and the ability of the therapeutic compound to inhibit amyloid deposition or reduce amyloid deposits in the subject. Dosage regimens can be adjusted to provide the optimum therapeutic response. For example, several divided doses may be administered daily or the dose may be proportionally reduced as indicated by the exigencies of the therapeutic situation.

The active compound may be administered by routes such as oral, sublingual, buccal, transdermal, subcutaneous, intravenous, and intraperitoneal administration. Depending on the route of administration, the active compound may be coated in a material to protect the compound from the action of acids, enzymes and other natural conditions which may inactivate the compound.

I -13- The compounds of the invention can be formulated to ensure proper distribution in vivo. For example, the therapeutic compounds of the invention can be formulated, for example, in liposomes. For methods of manufacturing liposomes, see, U.S.'Patents 4,522,811; 5,374,548; and 5,399,331. The liposomes may comprise one or more moieties which are selectively transported into specific cells or organs ("targeting moieties"), thus providing targeted drug delivery (see, V.V. Ranade (1989) J. Clin. Pharmacol. 29:685). Exemplary targeting moieties include folate or biotin (see, U.S. Patent 5,416,016 to Low et mannosides (Umezawa et al., (1988) Biochem. Biophys. Res. Commun.

153:1038); antibodies Bloeman et al. (1995) FEBSLett. 357:140; M. Owais et al. (1995) Antimicrob. Agents Chemother. 39:180); surfactant protein A receptor (Briscoe et al. (1995) Am. J. Physiol. 1233:134); gpl20 (Schreier et al. (1994) J.

Biol. Chem. 269:9090); see also K. Keinanen; M.L. Laukkanen (1994) FEBS Lett.

346:123; J.J. Killion; I.J Fidler (1994) Immunomethods 4:273. In a preferred embodiment, the therapeutic compounds of the invention are formulated in liposomes; in a more preferred embodiment, the liposomes include a targeting moiety.

To administer the therapeutic compound by other than parenteral administration, it may be necessary to coat the compound with, or co-administer the compound with, a material to prevent its inactivation. For example, the therapeutic compound may be administered to a subject in an appropriate carrier, for example, liposomes, or a diluent. Pharmaceutically acceptable diluents include saline and aqueous buffer solutions. Liposomes include water-in-oil-in-water CGF emulsions as well as conventional liposomes (Strejan et al., (1984) J.

Neuroimmunol. 7:27).

The therapeutic compound may also be administered parenterally, sublingually, buccally, intraperitoneally, intraspinally, or intracerebrally.

Dispersions can be prepared in, glycerol, liquid polyethylene glycols, and mixtures thereof, and in oils. Under ordinary conditions of storage and use, these preparations may contain a preservative to prevent the growth of microorganisms.

-14- Pharmaceutical compositions suitable for injectable use include sterile aqueous solutions (where water soluble) or dispersions and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersion. In all cases, the composition must be sterile and must be fluid to the extent that easy syringability exists. It must be stable under the conditions of manufacture and storage and must be preserved against the contaminating action of microorganisms such as bacteria and fungi. The vehicle can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, and liquid polyethylene glycol, and the like), suitable mixtures thereof, and vegetable oils. The proper fluidity can be maintained, for example, by the use of a coating such as lecithin, by the maintenance of the required particle size in the case Sof dispersion and by the use of surfactants. Prevention of the action of microorganisms can be achieved by various antibacterial and aritifungal agents, for example, parabens, chlorobutanol, phenol, ascorbic acid, thimerosal, and the like.

In many cases, it will be preferable to include isotonic agents, for example, sugars, sodium chloride, or polyalcohols such as mannitol and sorbitol, in the composition.

Prolonged absorption of the injectable compositions can be brought about by including in the composition an agent which delays absorption, for example, aluminum monostearate or gelatin.

Sterile injectable solutions can be prepared by incorporating the therapeutic compound in the required amount in an appropriate solvent with one or a combination of ingredients enumerated above, as required, followed by filter sterilization. Generally, dispersions are prepared by incorporating the therapeutic compound into a sterile vehicle which contains a basic dispersion medium and the required other ingredients from those enumerated above. In the case of sterile powders for the preparation of sterile injectable solutions, the preferred methods of preparation are vacuum drying and freeze-drying which yield a powder of the active ingredient the therapeutic compound) plus any additional desired ingredient from a previously sterile-filtered solution thereof.

The therapeutic compound can be orally administered, for example, with an inert diluent or an assimilable edible carrier. The therapeutic compound and other ingredients may also be enclosed in a hard or soft shell gelatin capsule, compressed into tablets, or incorporated directly into the subject's diet. For oral therapeutic administration, the therapeutic compound may be incorporated with excipients and used in the form of ingestible tablets, sublingual/buccal tablets, troches, capsules, elixirs, suspensions, syrups, wafers, and the like. The percentage of the therapeutic compound in the compositions and preparations may, of course, be varied. The amount of the therapeutic compound in such therapeutically useful compositions is such that a suitable dosage will be obtained.

It is especially advantageous to formulate parenteral compositions in dosage unit form for ease of administration and uniformity of dosage. Dosage unit form as used herein refers to physically discrete units suited as unitary dosages for the subjects to be treated; each unit containing a predetermined quantity of therapeutic compound calculated to produce the desired therapeutic effect in association with the required pharmaceutical vehicle. The specification for the dosage unit forms of the invention are dictated by and directly dependent on the unique characteristics of the therapeutic compound and the particular therapeutic effect to be achieved, and the limitations inherent in the art of compounding such a therapeutic compound for the treatment of amyloid deposition in subjects.

Active compounds are administered at a therapeutically effective dosage sufficient to inhibit amyloid deposition in a subject. A "therapeutically effective dosage" preferably inhibits amyloid deposition and/or reduces amyloid deposits by at least about 20%, more preferably by at least about 40%, even more preferably by at least about 60%, and still more preferably by at least about 80% relative to untreated subjects or to the same subject prior to treatment.

The ability of a compound to inhibit amyloid deposition or reduce amyloid deposits can be evaluated in an animal model system that may be predictive of efficacy in inhibiting amyloid deposition or reducing amyloid deposits in human diseases. The ability of a compound to inhibit amyloid deposition can also be -16evaluated by examining the ability of the compound to inhibit amyloid deposition in vitro or ex vivo, using an ELISA assay. The effect of a compound on the secondary structure of the amyloid can further be determined by thioflavine T (ThT) assay, circular dichroism (CD) or infrared (IR) spectroscopy.

CD and IR spectroscopy are particularly useful techniques because the information obtained is a direct measure of the ability of a test compound to prevent or reverse amyloidosis, by determining the structural effect of a compound on amyloid protein folding and/or fibril formation. This contrasts with previously known methods which measure cellular trafficking of amyloid protein precursors or interactions between amyloid and extracellular matrix proteins, providing only indirect evidence of potential amyloid-inhibiting activity. It should further be noted that CD and IR spectroscopy can also detect compounds which cause an increase in, p-sheet folding of amyloid protein, and thereby stabilize the formation of amyloid fibrils.

The deposition of amyloid is a multi-stage process. Accordingly, an agent useful for treating amyloidosis has many potential modes of action. An agent which inhibits amyloid deposition could act in one or more of the following ways, which are shown by way of illustration and not limitation: 1. Inhibition or delay of protein folding in solution; 2. Inhibition or delay of aggregation/elongation of oligomerized amyloid peptides into fibrils and/or deposits; and 3. Disruption/dissolution/modification of amyloid fibrils and/or deposits; Categories 1 and 2 correspond to prevention of the formation of amyloid deposits (slowing down or halting amyloid deposition), and category 3 corresponds to removal or modification of deposits already formed (removal or reduction of existing amyloid deposits).

The invention is further illustrated by the following examples which should not be construed as further limiting the subject invention.

-17- EXAMPLE 1 Determination of the rate of amvloid fibril formation by Thioflavine T spectroscopy Thioflavine T (ThT) binds to amyloid proteins in P-sheet formation, exhibiting a yellow fluorescence from tissue sections and fibrils in vitro. Detection of ThT fluorescence can be used as a sensitive assay for amyloid fibril formation under different conditions. This assay has been used in experiments to determine the effects of compounds of the invention on amyloid fibril formation.

Method Synthetic human IAPP (Bachem) was dissolved in 40% trifluoroethanol and freeze-dried into conveniently-sized aliquots. IAPP was prepared immediately before the measurements by dissolving in 40% 1,1,1,3,3,3-hexafluoro-2-propanol (HFIP) in water to maintain the peptide in alpha helical conformation and soluble.

A stock solution of ThT (2.5mM) was prepared, 7.9mg in 10mL Tris-HCI pH and filtered (0.22 gm). Solutions were kept in the dark until use. Fluorescence was examined at 440nm excitation (slit 5nm), and emission at 482nm (slit with stirring. 25ml of ThT stock (final concentration 62.5 lM) was added to peptide sample and made up to ImL in the cuvette. The sample was stirred for min. before taking a reading. Measurements were made at an initial time point min. from sample preparation), at intervals over the next 4-6h and after overnight incubation at room temperature.

Certain compounds (or their salts, as noted) as disclosed herein, 3-(3hydroxy-l-propyl)amino-l-propanesulfonic acid; 2-amino-5-phosphovaleric acid; 4-phenyl-l-(3 '-sulfopropyl)-1,2,3,6-tetrahydropyridine; cyclohexylsulfamic acid; O-phospho-L-serine; hexafluoroglutaric acid; 8-methoxy-5-quinolinesulfonic acid; 3-amino-2-hydroxy-1-propanesulfonic acid; and 3-dimethylamino-lpropanesulfonic acid, and 1,2,3,4-tetrahydroisoquinoline, were found, using this assay, to inhibit or prevent IAPP-associated fibril assembly.

-18- EXAMPLE 2 Circular dichroism analysis was conducted to confirm the activity of certain therapeutic compounds in preventing or inhibiting IAPP-associated fibril formation in accordance with the present disclosure by determining the presence or absence of p-sheet conformation. The results are presented in Table 1.

The assay is conducted as follows: INSTRUMENT AND PARAMETERS Instrument: JASCO J-715 Spectropolarimeter Cell/cuvette: Hellma quartz (QS) with 1.0 mm pathlength Room temperature Wavelength interval: 250 nm-190 nm Resolution: 0.1 nm (Bandwidth: 1.0 nm Response time: 1 sec Scanning speed: 20 nm/min Number of spectra run: The assay, a co-incubation procedure, examines the ability of a compound or substance to inhibit the assembly of amyloid fibrils, to test for the presence of the amyloidotic p-sheet conformation in the presence of soluble LAPP. Samples are run in the presence and absence water alone) of buffering agent, which is done to determine if competitive effects are seen with the ionic buffer (usually phosphate).

A. Assay in Water Only Add components used at a molar ratio of 1:10 [peptide:compound]; add pL of 10 mg/mL'IAPP stock solution (final 100 gg peptide) to the aqueous solution containing compound to a final volume of 400 l. The pH of the final assay solution is measured to ensure there is no fluctuation and the spectrum is accumulated using the parameters as shown above.

B. Assay in Phosphate Buffer Add desired amount of compound to achieve a 1:10 molar ratio in 10 mM phosphate buffer, pH 7. Add 10 pL of 10 mgimL LAPP stock solution (final peptide 100 pg) to the phosphate buffered solution containing the compound and bring to a final volume of 400 pL. The pH of the final assay solution is measured -19to ensure there is no fluctuation and the spectrum is accumulated using the parameters as shown above.

In both assays, a control sample is run with each test group. This control contains peptide only in water or buffer at a similar final volume of 400 j l.

Spectra for the control are collected initially (first run) and at the end of the test (final run) to ensure that the peptide has not undergone extensive aggregation during the course of the assay. Spectra for the controls are used to compare with the measurements obtained with the treated samples.

CO-INCUBATION:

Make fresh 1 mg/mL stock solution of IAPP in 10 mM phosphate buffer, pH 7. Add desired amount of compound to achieve a 1:10 molar ratio in 10 mM phosphate buffer, pH 7. Incubate for 3 days at room temperature. Make up to final volume of 400 VL with 10 mM phosphate buffer, pH 7. The pH of the final assay solution is measured to ensure there is no fluctuation and the spectrum is accumulated using the parameters as shown above.

A similar control is run for comparative purposes.

DATA ANALYSIS Plots of the spectra (control and treated) are individually assembled and the changes in ellipticity at 218 nm are examined. This minimum is directly correlated with the amount of P-sheet present in the sample. Changes in either a positive or negative direction are noted and a relative value ("active" or "not active") assigned to the compound'as a measure of activity.

TABLE I Compound Activity 3-(3-hydroxy-l1 propyl)ami'no-1-propanesulfornc acid Active acid Active 1,2"3 4-tetrahydroisoquinoiline, HCl Active cyclohexylsulfamic acid, sodium salt Active O-phospho-L-serine Active hexatluorogilutaric acid Active acid, sodium salt Active 4-phenyl- 1-(3 '-sul1fopropyl)-1 ,2,3 ,6-tetrahydropyridine, sodium Active salt 3-amino-2-hydroxy-I -prop anesulfonic acid Active 3-dimethylamino-1-propanesulfonic acid Active EXAMPLE 3 The synthesis of a compound of the invention, 4-phenyt-1I-(3 '-sulfopropyl)- 1,2,3,6-tetrahydropyridine, in the sodium salt form, is described below.

To a solut~on of 4-phenylpyridine (15.5 g, 0.1 mot) in acetone (100 mL) was added 1,3-propane sultone (12.2 mol) at room temperature. The mixture was then heated at reflux-temperature overniight. The resultant suspension was cooled to room temnperature. The solid was collected by filtration and washed with acetone. To a solution of the solid (31 g) in methanol (500 mE) was added sodium borohydride (10 g,260 mmol) portionwise, and the mixture was-stir-red at room temperature for 2. Ditled water (50 mL) was added to destroy the excess of sodium borohydride. The mixture was diluted with methanol (200 ml), and neutralized with Amberlite IR-120 ion-exchange resin form, 300 A white -21precipitate was formed. The precipitate and the resin were removed by filtration and treated with distilled water (400 mL) at -100 The mixture was filtered and the residual resin was washed with hot distilled water (2 x 200 mL). The filtrates and washings were combined and concentrated to dryness. The residue was coevaporated with methanol (3 x 200 mL), and then recrystallized from ethanol-water (8:2 to afford 4-phenyl-l-(3'-sulfopropyl)-l,2,3,6tetrahydropyridine as white crystals (26 g, The 'H and "C NMR spectra were in agreement with the structure.

To a solution of 4-phenyl-1-(3'-sulfopropyl)-1,2,3,6-tetrahydropyridine (5.6 g, 20 mmol) obtained above in ethanol (180 mL) was added sodium hydroxide (1.2 g, 30 mmol). The suspension was heated at reflux temperature for 30 min. The mixture was then cooled to room temperature. The first crop of product (3.9 g, 64%) was collected by filtration. The filtrate was concentrated to dryness, and the residue was recrystallized from ethanol to afford the second crop of product (2.0 g, 'H NMR (400 MHz, DO): 8 1.85 (quintet, 2 H, J 8.7, 7.7 Hz, 2 2.39-2.45 4 H, 2 H-3' and 2 2.59 2 H, J 5.6 Hz, 2 2.80 2 H, J 7.7 Hz, 2 3.00 (br s, 2 H, 2 6.00 (br s, 1H, 7.18-7.36 5 H, Ar). "C NMR (100.6 MHz, DzO): 5 23.90 29.01 51.69, 51.76 (C-2, 54.45 58.12 123.75 127.31, 130.01, 131.24 (Ar), 136.89 142.47 (Ar).

EQUIVALENTS

Those skilled in the art will recognize, or be able to ascertain using no more than routine experimentation, numerous equivalents to the specific procedures described herein. Such equivalents are considered to be within the scope of this invention and are covered by the following claims. The contents of all references, issued patents, and published patent applications cited throughout this application are hereby incorporated by reference.

Claims (13)

1. 2. The use according to claim 1, wherein 1, m, p and q are each 1.
2. 3. The use according to claim 1, wherein said compound is selected from the group consisting of 3-[2-(6,7-dimethoxy-1,2,3,4-tetrahydroisoquinolinyl)]-l-propanesulfonic acid; 3-[2-(6-methoxy-1,2,3,4-tetrahydroisoquinolinyl)]-l-propanesulfonic acid; 3-[2-(1,2,3,4-tetrahydroisoquinolinyl)]- 1-propanesulfonic acid; tetrahydroisoquinolinyl)]-l-butanesulfonic acid; 1,2,3,4-tetrahydroisoquinoline; 2-(2-sulfobenzoyl)-1,2,3,4-tetrahydroisoquinoline; 2-(2-sulfobenzyl)-1,2,3,4- tetrahydroisoquinoline; 3-[2-(3-carboxy- 1,2,3,4-tetrahydroisoquinolinyl)]-1 propanesulfonic acid; N-methyl-N-phenyl-3-[2-(1,2,3,4-tetrahydroisoquinolinyl)]-1- propanesulfonic acid; 4-[2-(6,7-dimethoxy-1,2,3,4-tetrahydroisoquinolinyl)]-1- 00 -23- butanesul fonic acid; 4- [2-(6-methoxy- 1,2,3 ,4-tetrahydroisoquinolinyl)] -1-butanesulfonic acid; 1,2,3,4-tetrahydroisoquinolinyl)]-lI-propyithiophosphonic acid; methoxy- 1,2,3 ,4-tetrahydroisoquinolinyl)]- 1 -propanesulfonic acid; 1,2,3 ,4-tetrahydro-8- isoquinolinesulfonic acid; 3-[2-(6-dimethylamino- 1,2,3 ,4-tetrahydroisoquinolinyl)]- 1- propanesulfonic acid; 3- [2-(6-chloro- 1,2,3 ,4-tetrahydroisoquinolinyl)]- 1- propanesulfonic acid; I ,2,3,4-tetrahydro-5-isoquinolinylsulfonic acid; 1 -sulfopropyl-2- 1,2,3 ,4-tetrahydroisoquinolinyl)methyl]-4,5-dihydroimidazole; 3-[7-methoxy-2- (1 ,2,3 ,4-tetrahydroisoquinolinyl)] -1-propyiphosphonic acid; 3 -[6-methoxy-2-( 1,2,3,4- tetrahydroisoquinolinyl)] -1 -propyiphosphonic acid; 3 -[8-methoxy-2-( 1,2,3,4- (Ni 1 tetrahydroisoquinolinyl)]- I -propyiphosphonic acid; 3-[2-(3-methoxycarbonyl- 1,2,3,4- tetrahydroisoquinolinyl)]- I -propyiphosphonic acid; 3 -[6-methoxy-2-( 1,2,3,4- tetrahydroisoquinolinyl)]- I -propyiphosphonic acid, diethyl ester; 3- [7-methoxy-2- (1,2,3 ,4-tetrahydroisoquinolinyl)] -1-propyiphosphonic acid, diethyl ester; N-phosphonoacetyl-6-methoxy- 1,2,3 ,4-tetrahydroisoquinoline; 6-methoxy- 1,2,3,4- tetrahydroisoquinoline; N-sulfoacetyl- 1,2,3 ,4-tetrahydroisoquinoline; N-ethyl- 1,2,3,4- tetrahydroisoquinoline; N-propyl- 1,2,3 ,4-tetrahydroisoquinoline; N-propyl-6-methoxy- 1 ,2,3,4-tetrahydroisoquinoline; 5-[(1I,2,3,4-tetrahydroisoquinolin-2-yl)methyllisoxazol- 3 -ol; 5-[(6-methoxy- 1,2,3 ,4-tetrahydroisoquinolin-2-yl)methyl] isoxazol-3 -ol; (±)-laudanosoline; 1-[5-chloro-2-(methylamino)phenyl]- 1,2,3,4- tetrahydroisoquinoline; 1,2,3 ,4-tetrahydro-3 -isoquinolinecarboxylic acid; tetrahydropapaveroline; 3-phenyl-5-[2-(1 ,2,3,4- tetrahydroisoquinolinyl)methyflisoxazole; 3-methyl-5-[2-( 1,2,3,4- tetrahydroisoquinolinyl)methyl]isoxazole; ,2,3,4- tetrahydroisoquinolinyl)methyl] isoxazole-3 -carboxylic acid; 5-phenyl-3 1,2,3,4- tetrahydroisoquinolinyl)methyllisoxazole; 1,2,3,4- acid; (2S)-2-amino-2-[3-( 1,2,3,4- tetrahydroisoquinolin-2-ylmethyl] isoxazol-5-yl] acetic acid; 1,2,3,4- tetrahydroisoquinolinyl)methyl] isoxazole-5-L-alanine; 1,2,3,4- tetrahydroisoquinolinyl)methyl] -L-phenylalanine; 5- 1,2,3 ,4-tetrahydroisoquinolinyl) methyl]- IH-i ,2,3,4-tetrazole; 5-(1I,2,3,4-tetrahydroisoquinolil-6-yl)- 1H- 1,2,3,4- tetrazole; 1,2,3,4-tetrahydroisoquinolinyl)methyl]- IH-I ,2,3,4-tetrazole; 5- (1 ,2,3 ,4-tetrahydroi soquinol inyl)] ethyl)} -1 H-i ,2,3,4-tetrazole; 1,2,3,4- tetrahydroisoquinolin-7-yl)- 1H- 1,2,3 ,4-tetrazole; 1,2,3,4- 00 -24- tetrahydroisoquinolinyl)methyl]- lH- 1,2,3 ,4-tetrazole; 5- 1,2,3,4- tetrahydroisoquinolinyl)] ethyl) -I H-I ,2,3,4-tetrazole; 7-methoxy- 1,2,3,4- tetrahydroisoquinoline; 6,7-dimethoxy- 1,2,3 ,4-tetrahydroisoquinoline; 1,2,3,4- tetrahydroisoquinoline-6-carbonitrile; 1,2,3 ,4-tetrahydroisoquinoline-7-carbonitrile;
3. 6-amino-i ,2,3,4-tetrahydroisoquinoline; 7-amino- 1,2,3 ,4-tetrahydroisoquinoline;
4. 7-(3 ,4,5-trimethoxybenzoyl)amino- 1,2,3 ,4-tetrahydroisoquinoline; 7-f3-D- M glucopyranosyl-6-methoxy- 1,2,3 ,4-tetrahydroisoquinoline; 6-f3-D-glucopyranosyl-7- methoxy- 1,2,3,4-tetrahydroisoquinoline; (1 ,2,3,4-tetrahydroisoquinolin-1I-yl)phosphonic acid; 5,6,7,8-tetrahydro-2H- 1,3-dioxoleno[4,5-glisoquinoline; 1,2,3,4- C110 tetrahydrobenzo i soquino line; (1 ,2,3 ,4-tetrahydroisoquinolin-7-ylsulfonyl) aminobenzene; 1 ,4-tetrahydroisoquinolin-7-ylsulfonyl)amino] -3,4- dichlorobenzene; 7-(2,2,2-trifluoroacetyl)- 1,2,3 ,4-tetrahydroisoquinoline; 7-benzyl- 1,2,3 ,4-tetrahydroisoquinoline; 7-benzoyl- 1,2,3 ,4-tetrahydroisoquinoline; 7-acetyl- 1,2,3 ,4-tetrahydroisoquinoline; 1,2,3 ,4-tetrahydroisoquinoline-7-carboxylic acid; 1,2,3 ,4-tetrahydroisoquinoline-7-carboxamide; 7-aminomethyl- 1,2,3,4- tetrahydroisoquinoline; 7-hydroxymethyl- 1,2,3 ,4-tetrahydroisoquinoline; 7-methyl- 1,2,3 ,4-tetrahydroisoquinoline; 7-hydroxy- 1,2,3 ,4-tetrahydroisoquinoline; 7-(methanesulfonyl)amino- 1,2,3 ,4-tetrahydroisoquinoline; 7-(methanesulfonyl) aminomethyl- 1,2,3 ,4-tetrahydroisoquinoline; 7-nitro- 1,2,3 ,4-tetrahydroisoquinoline; 1,2,3 ,4-tetrahydroisoquinoline-7-sulfonamide; 7-trifluoromethyl- 1,2,3,4- tetrahydroisoquinoline; and 7-methylthio- 1,2,3 ,4-tetrahydroisoquinoline; or a pharmaceutically acceptable salt thereof. 4. The use according to claim 3, wherein said compound is 1,2,3,4- tetrahydroisoquinoline or a pharmaceutically acceptable salt thereof. 5. The use according to any one of the preceding claims a) wherein said IAPP-associated amyloid deposits occur in pancreatic islets; or b) such that IAPP fibrillogenesis is inhibited; or c) such that said IAPP-associated amyloid deposits are inhibited; or d) such that IAPP-associated deposits are reduced. 00 6. The use according to any one of the preceding claims, wherein the disease state is diabetes. 7. Use of a compound of the formula '--(A2AR13 >A2~ CH)q (A3 nCH) R9 3 1 R12) (A 4 )n VA 5 wherein A 2 A 3 A 4 A5 and A 6 are independently alkyl, 0, S, or -NH; m and n (for each individual A group) are independently 0 or 1; 1, p and q are independently 0, 1 or 2; R 7, R O, R 12 R' 3 and R'1 4 are independently hydrogen, alkyl, alicyclyl, heterocyclyl or aryl, and adjacent R groups may form an unsubstituted or substituted cyclic or heterocyclic ring or a pharmnaceutically acceptable salt thereof; for the manufacture of a medicament for treating diabetes.
5. 8. The use according to claim 7, wherein said compound is selected from the group consisting of: 3 -[2-(6,7-dimethoxy- 1,2,3 ,4-tetrahydroisoquinolinyl)]-l1-propanesulfonic acid; 3- [2-(6-methoxy- 1,2,3 ,4-tetrahydroisoquinolinyl)]-lI-propanesulfonic acid; 1,2,3 ,4-tetrahydroisoquinolinyl)]- I -propanesulfonic acid; 1,2,3,4- tetrahydroisoquinolinyl)]- 1 -butanesulfonic acid; 1,2,3 ,4-tetrahydroisoquinoline; 2-(2-sulfobenzoyl)- 1,2,3 ,4-tetrahydroisoquinoline; 2-(2-sulfobenzyl)- 1,2,3,4- tetrahydroisoquinoline; 3 -carboxy- 1,2,3 ,4-tetrahydroisoquinolinyl)]- 1- propanesulfonic acid; N-methyl-N-phenyl-3-[2-( 1,2,3 ,4-tetrahydroisoquinolinyl)]- 1- propanesul fonic acid; 4-[2-(6,7-dimethoxy- 1,2,3 ,4-tetrahydroisoquinolinyl)]- 1- butanesulfonic acid; 4-[2-(6-methoxy- 1,2,3 ,4-tetrahydroisoquinolinyl)] -1 -butanesulfonic acid; 3 1,2,3 ,4-tetrahydroisoquinolinyl)] -lI-propyithiophosphonic acid; 00 -26- 3-[2-(8-methoxy- 1,2,3 ,4-tetrahydroisoquinolinyl)]- I -propanesulfonic acid; 1,2,3,4- tetrahydro-8-isoquinolinesulfonic acid; 3 -[2-(6-dimethylamino- 1,2,3,4- tetrahydroisoquinolinyl)]-l1-propanesulfonic acid; 3-[2-(6-chloro- 1,2,3,4- tetrahydroisoquinolinyl)] -1-propanesulfonic acid; 1,2,3 isoquinolinylsulfonic acid; 1 -sulfopropyl-2-[2-( 1,2,3 ,4-tetrahydroisoquinol inyl)methyl]- 3-[7-methoxy-2-( 1,2,3,4-tetrahydroisoquinolinyl)]- 1- propyiphosphonic acid; 3 -[6-methoxy-2-( 1,2,3 ,4-tetrahydroisoquinolinyl)]- I1- propyiphosphonic acid; 3 -[8-methoxy-2-( 1,2,3 ,4-tetrahydroisoquinolinyl)]- I1- propyiphosphonic acid; 3 -methoxycarbonyl- 1,2,3 ,4-tetrahydroisoquinolinyl)] -1- propyiphosphonic acid; 3 -[6-methoxy-2-( 1,2,3 ,4-tetrahydroisoquinolinyl)]- 1- propyiphosphonic acid, diethyl. ester; 3 -[7-methoxy-2-( 1,2,3 ,4-tetrahydroisoquinolinyl)] 1 -propylphosphonic acid, diethyl ester; N-phosphonoacetyl-6-methoxy- 1,2,3,4- tetrahydroisoquinoline; 6-methoxy- 1,2,3 ,4-tetrahydroisoquinoline; N-sulfoacetyl- 1,2,3 ,4-tetrahydroisoquinoline; N-ethyl- 1,2,3 ,4-tetrahydroisoquinoline; N-propyl- 1,2,3 ,4-tetrahydroisoquinoline; N-propyl-6-methoxy- 1,2,3 ,4-tetrahydroisoquinoline; ,2,3 ,4-tetrahydroisoquinolin-2-yl)methyl] isoxazol-3-ol; 5-[(6-methoxy- 1,2,3,4- tetrahydroisoquinolin-2-yl)methyl] isoxazol-3-ol; (±)-laudanosoline; I -15-chloro-2- (methylamino)phenyl] -1 ,2,3 ,4-tetrahydroisoquinoline; 1,2,3 ,4-tetrahydro-3 isoquinolinecarboxylic acid; tetrahydropapaveroline; 3 -phenyl-5- 1,2,3,4- tetrahydroisoquinolinyl)methyl] isoxazole; 3 -methyl-5-[2-( 1,2,3,4- tetrahydroisoquinolinyl) methyl]isoxazole; ,2,3,4- tetrahydroisoquinolinyl)methyl] isoxazole-3 -carboxylic acid; 5-phenyl-3 1,2,3,4- tetrahydroisoquinolinyl)methyl]isoxazole; 3 1,2,3,4- acid; (2S)-2-amino-2-[3-( 1,2,3,4- tetrahydroisoquinolin-2-ylmethyl] isoxazol-5-yl] acetic acid; 3 1,2,3,4- tetrahydroisoquinolinyl)methyl] isoxazole-5-L-alanine; 1,2,3,4- tetrahydroisoquinolinyl)methyl] -L-phenylalanine; 1,2,3 ,4-tetrahydroisoquinolinyl) methyl]- IH- 1,2,3 ,4-tetrazole; 5-(1I,2,3,4-tetrahydroisoquinolin-6-yl)- 1H- 1,2,3,4- tetrazole; 5-[6-(1I,2,3,4-tetrahydroisoquinolinyl)methyl]- IH- 1,2,3 ,4-tetrazole; 1,2,3 ,4-tetrahydroisoquinol inyl)] ethyl)} -I H-i ,2,3,4-tetrazole; 1,2,3,4- tetrahydroisoquinolin-7-yl)- IH-1I,2,3,4-tetrazole; 1,2,3,4- tetrahydroisoquinolinyl)methyl]- 1H- 1,2,3 ,4-tetrazole; 5- 1,2,3,4- tetrahydroisoquinolinyl)] ethyl I IH- 1,2,3 ,4-tetrazole; 7-methoxy- 1,2,3,4- 00 -27- tetrahydroisoquinoline; 6,7-dimethoxy- I ,2,3 ,4-tetrahydroisoquinoline; 1,2,3,4- tetrahydroisoquinoline-6-carbonitrile; 1,2,3 ,4-tetrahydroisoquinoline-7-carbonitrile; 6-amino- 1,2,3 ,4-tetrahydroisoquinoline; 7-amino- 1,2,3 ,4-tetrahydroisoquinoline; 7- (3 ,4,5-trimethoxybenzoyl)amino- 1,2,3 ,4-tetrahydroisoquinoline; 7-1-D-glucopyranosyl- 6-methoxy- 1,2,3 ,4-tetrahydroisoquinoline; 6-0-D-gucopyranosy1-7-methoxy- 1,2,3,4- tetrahydroisoquinoline; (1,2,3 ,4-tetrahydroisoquinolin- 1-yl)phosphonic acid; 5,6,7,8- tetrahydro-2H- 1,3 -dioxoleno[4,5-g]isoquinoline; 1,2,3,4- tetrahydrobenzo[g] isoquinoline; (1,2,3 ,4-tetrahydroisoquinolin-7-ylsulfonyl) aminobenzene; 1 ,4-tetrahydroisoquinolin-7-ylsulfonyl)amino]-3 ,4- dichlorobenzene; 7-(2,2,2-trifluoroacetyl)- 1,2,3 ,4-tetrahydroisoquinoline; 7-benzyl- 1,2,3 ,4-tetrahydroisoquinoline; 7-benzoyl- 1,2,3 ,4-tetrahydroisoquinoline; 7-acetyl- 1,2,3 ,4-tetrahydroisoquinoline; 1,2,3 ,4-tetrahydroisoquinoline-7-carboxylic acid; 1,2,3 ,4-tetrahydroisoquinoline-7-carboxamide; 7-aminomethyl- 1,2,3,4- tetrahydroisoquinoline; 7-hydroxym ethyl- 1,2,3 ,4-tetrahydroisoquinoline; 7-methyl- 1,2,3 ,4-tetrahydroisoquinoline; 7-hydroxy- 1,2,3 ,4-tetrahydroisoquinoline; 7-(methanesulfonyl)amino- 1,2,3 ,4-tetrahydroisoquinoline; 7-(methanesulfonyl) aminomethyl- 1,2,3 ,4-tetrahydroisoquinoline; 7-nitro- 1,2,3 ,4-tetrahydroisoquinoline; 1,2,3 ,4-tetrahydroisoquinoline-7-sulfonamide; 7-trifluoromethyl- 1,2,3,4- tetrahydroisoquinoline; and 7-methylthio- 1,2,3 ,4-tetrahydroisoquinoline; or a pharmnaceutically acceptable salt thereof.
6. 9. The use according to claim 8, wherein said compound is 1,2,3,4- tetrahydroisoquinoline or a pharmaceutically acceptable salt thereof A compound selected from the group consisting of. 2-(2-sulfobenzoyl)- 1,2,3 ,4-tetrahydroisoquinoline; 2-(2-sulfobenzyl)- 1,2,3,4- tetrahydroisoquinoline; 3 -[2-(3-carboxy- 1,2,3 ,4-tetrahydroisoquinolinyl)] -1- propanesulfonic acid; N-methyl-N-phenyl-3- 1,2,3 ,4-tetrahydroisoquinolinyl)] -1- propanesulfonic acid; 4-[2-(6,7-dimethoxy- 1,2,3 ,4-tetrahydroisoquinolinyl)]- 1- butanesulfonic acid; 4-[2-(6-methoxy- 1,2,3 ,4-tetrahydroisoquinolinyl)]-l1-butanesulfonic acid; 3 ,4-tetrahydroisoquinolinyl)]-l1-propylthiophosphonic acid; methoxy- 1,2,3 ,4-tetrahydroisoquinolinyl)]-lI-propanesulfonic acid; 1,2,3 ,4-tetrahydro-8- isoquinolinesulfonic acid; 3-[2-(6-dimethylamino- 1,2,3 ,4-tetrahydroisoquinolinyl)]- 1- 00 -28- propanesulfonic acid; 3 -[2-(6-chloro- 1,2,3 ,4-tetrahydroi soquinolinyl)]- 1- propanesulfonic acid; 1,2,3 ,4-tetrahydro-5-isoquinolinylsulfonic acid; I -sulfopropyl-2- ,2,3,4-tetrahydroisoquinolinyl)methyl]-4,5-dihydroimidazole; 3-[7-methoxy-2- (1 ,2,3,4-tetrahydroisoquinolinyl)]-lI-propyiphosphonic acid; 3-[6-methoxy-2-( 1,2,3,4- tetrahydroisoquinolinyl)] -1 -propyiphosphonic acid; 3 -[8-methoxy-2-( 1,2,3,4- tetrahydroisoquinolinyl)] 1 -propyiphosphonic, acid; 3 -methoxycarbonyl- 1,2,3,4- tetrahydroisoquinolinyl)] I -propyiphosphonic acid; 3 -[6-methoxy-2-( 1,2,3,4- tetrahydroisoquinolinyl)]- I -propyiphosphonic acid, diethyl ester; 3-[7-methoxy-2- (I ,2,3 ,4-tetrahydroisoquinolinyl)]-lI-propyiphosphonic acid, diethyl ester; C1 10 N-phosphonoacetyl-6-methoxy- 1,2,3 ,4-tetrahydroisoquinoline; N-sulfoacetyl- 1,2,3,4- tetrahydroisoquinoline; N-propyl-6-methoxy-1I,2,3,4-tetrahydroisoquinoline; 1,2,3,4- tetrahydroisoquinoiin-2-yl)methyl] isoxazol-3 -ol; 5-[(6-methoxy- 1,2,3,4- tetrahydroisoquinolin-2-yl)methyl] isoxazol-3 -ol; 1-[5-chloro-2- (methylamino)phenyl]- 1,2,3 ,4-tetrahydroisoquinoline; 3 -methyl-5- 1,2,3,4- tetrahydroisoquinolinyl) methyl]isoxazole; 1,2,3,4- tetrahydroisoquinolinyl)methyl] isoxazole-3-carboxylic acid; 5-phenyl-3 1,2,3,4- tetrahydroisoquinolinyl)methyl]isoxazole; ,2,3,4- tetrahydroisoquinolinyl)methyl] isoxazole-5-carboxylic acid; (2S)-2-amino-2-[3-( 1,2,3,4- acetic acid; 3 1,2,3,4- tetrahydroisoquinolinyl)methyl]isoxazole-5-L-alanine; tetrahydroisoquinolinyl)methyl] -L-phenylalanine; 1,2,3 ,4-tetrahydroisoquinolinyl) methyl]- 1H- 1,2,3 ,4-tetrazole; 1,2,3 ,4-tetrahydroisoquinolin-6-yl)- IH- 1,2,3,4- tetrazole; 1,2,3 ,4-tetrahydroisoquinolinyl)methyl]- IH-I ,2,3,4-tetrazole; 5- 1,2,3 ,4-tetrahydroi soquinolinyl)] ethyl}I -1 H-i ,2,3,4-tetrazole; 1,2,3,4- tetrahydroisoquinolin-7-yl)- 1H- 1,2,3 ,4-tetrazole; 1,2,3,4- tetrahydroisoquinolinyl)methyl] -1H- 1,2,3 ,4-tetrazole; 5- 1,2,3,4- tetrahydroisoquinolinyl)] ethyl I -1 H- 1,2,3 ,4-tetrazole; and 7-(3 trimethoxybenzoyl)amino- 1,2,3 ,4-tetrahydroisoquinoline; or a pharmaceutically acceptable salt thereof.
7. 11. A pharmaceutical composition comprising a compound according to claim together with a pharmaceutically acceptable carrier. -29-
8. 12. Use of a compound according to claim 10 for the manufacture of a medicament for treating a disease state characterized by IAPP-associated amyloid deposits. 13 Use of a compound according to claim 10 for the manufacture of a medicament for treating diabetes.
9. 14. The use according to any one of claims 7 to 9 or 13 wherein said diabetes is selected from juvenile and adult-onset diabetes. The use according to any one of claims 7 to 9 or 13 wherein said diabetes is type II diabetes.
10. 16. A method of treating a disease state characterized by IAPP-associated amyloid deposits comprising administering to a subject in need of treatment an IAPP-inhibiting compound of the formula R 7 R8 R 14 A 2 CH)q /R 1 3 iN) (A3 n CH) A)n R 9 R12 wherein A 2 A 3 A 4 A 5 and A 6 are independently alkyl, 0, S, or -NH; m and n (for each individual A group) are independently 0 or 1; 1, p and q are independently 0, 1 or 2; R 7 R 8 R 9 R 1 0 R, R 2 R 1 3 and R 1 4 are independently hydrogen, alkyl, alicyclyl, heterocyclyl or aryl, and adjacent R groups may form an unsubstituted or substituted cyclic or heterocyclic ring or a pharmaceutically acceptable salt thereof.
11. 17. A method of treating diabetes comprising administering to a subject in need of treatment an IAPP-inhibiting compound of the formula R 7 R8( )n R 14 R8 A2 .CH)q ,R 1 3 SCH)p I,(A 3 n CH) A) R 9 I I- R12 wherein A 2 A 3 A 4 A 5 and A 6 are independently alkyl, 0, S, or -NH; m and n (for each individual A group) are independently 0 or 1; 1, p and q are independently 0, 1 or 2; R 7 R 8 R 9 R' 1 R 1 2 R 3 and R 1 4 are independently hydrogen, alkyl, alicyclyl, heterocyclyl or aryl, and adjacent R groups may form an unsubstituted or substituted cyclic or heterocyclic ring or a pharmaceutically acceptable salt thereof.
12. 18. A method of treating a disease state characterized by IAPP-associated amyloid deposits comprising administering to a subject in need of treatment a compound according to claim
13. 19. A method of treating diabetes comprising administering to a subject in need of treatment a compound according to claim Use of an IAPP-inhibiting compound; use of a compound; a pharmaceutical composition; a method of treating diabetes; or a method of treating a disease state characterized by IAPP-associated amyloid deposits, substantially as herein described with reference to any one or more of the examples but excluding comparative examples.