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`us00659991482
`
`1ro¡ Patent No.: US 6'5991914 B2
`1+s¡ Date of Patent:
`Jril.29r2003
`
`Molet, S,, et al, Clinical and Experimental Allerg¡, "Inhibi-
`tory activity of loratadine . . . " 1997, vol. 27, pp. 1167 -II7 4.
`Genovese, 4., "Loratacline and desethoxylcarbonyl-lorata-
`dine . . . " , Clinicol and Expefimental Allergy , 1997 ,vol.27 ,
`pp, 559-567.
`Kleine{ebbe, J., et al, "Inhibition of IgE-and non-IgE-
`mediated histamine. . .",J. Allergy Clin. Innwnol., 1994,
`vol.23, No. 2, pp. 494-5OO.
`Schroeder, John T., "The Role of Basophil-Cytokine Net-
`works in Asthm a" , Asthnm and Allergic Disease , L998, pp.
`75-86.
`Lipozencic J., The EAACI 1997 Annual Meeting, Acra
`D e rn to t ovene rol o gi c a I G rct ic a, 1997, pp. 69-80,
`Federal Regisler,Oct.5, 1998, vol. 63, No. 192, p.53444.
`Gibbs, 8.F., "Inhibition of interleukin-4 and interleukin-
`13 . . . ",Arch Pharnncol.,1998, pp. 573-578.
`Kleine-Tebbe, J., "Influence of Descarbo, ethoxy-
`loratacline . . . ", Clinic of Dernmtology & OPD, 1992, vol.
`89, No. I,Part2,p.271.
`Segura, T., "Allergic Rhinitis: Basic Pathophysiology and
`Therapeutic Strategies", Can. J. of Allergy & CIin. Innut-
`nol.,1999, vol. 4, No. 7, pp. 318-330.
`Hayashi S., et a1., "Anti-Inflammatory actions of new anti-
`histamines", Clinical and ExperintenÍal Allerg, (1999) vol.
`29 (r2), pp. 1593-1596.
`* citecl by examiner
`
`Prinnry Exaniner-4rcclerick K¡ass
`(74) Attorney, Agent, or Fjn¡¡-Thomas D. HolÌman
`(s7)
`Methods of inhibiting the generation of pro-inflammatory
`cytokines such as IL-4 and IL-13 in a human patient in neecl
`of such inhibiting are clisclosecl.
`
`ABSTRACT
`
`4 Claims, 5 Drawing Sheets
`
`EXHIBIT
`
`td
`
`>0 / z
`
`ç åôozEÈ
`
`(12) United States Patent
`Schleimer et al.
`
`(s4)
`
`(7s)
`
`INHIBITION OF CYTOKINE GENERATTON
`
`Inventors: Robert P. Schleimer, Baltimore, MD
`(US); John Schroeder, Baltimore, MD
`(US); William Kreutner, West
`Paterson, NJ (US)
`
`(73) Assignee: Schering Corporation, Kenilworth, NJ
`(US)
`( - ) Notice: Subject to any clisclaimer, the term of this
`patent is extenclecl or adjusted under 35
`U.S.C. 154(t ) by 0 days.
`
`(2r)
`(22)
`
`(6s)
`
`Appl. No.: 09/841,506
`Filed: A.pr.24,2OOl
`hior Publication Data
`US 2002/0183344 Al Dec. 5,2OO2
`A61K 31/48
`Int. Cl.7
`51 41 29 l; 5 t 4 I 292: 5 t 41 826;
`U.S. CI.
`51.41849; 5141853; 5l4l8s4; 5141885; 514/886;
`5r41887
`(58) Field of Search
`5t41290,291,
`5141292, 826, 849, 8s3, 854, 885, 886,
`887
`
`(s1)
`(s2)
`
`(5ó)
`
`References Cited
`
`U.S, PAIENT DOCUMENTS
`5,595,99'7 A * l/1997 Aberg et al. ...........',... 51'41290
`OT}IER PUBLICATIONS
`Dorlancl's Illustrated Meclical Dictionary 26"' Edition,
`1981, pp. 299,368-369.
`Lippert, U., et al, "Pharmacological moclulation of IL-6 and
`IL-8 secretion . . ,",ExperinrcnÍal Dennatology, 1995, vol.
`4, pp. 272-276.
`
`I
`
`1
`
`CIP2145
`Argentum Pharmaceuticals v. Cipla Ltd.
`IPR2017-00807
`
`

`

`LJ.S. Patent
`
`Jur.29,2003 sheer 1 of 5
`
`us 6,599,914 82
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`LJ.S. Patent
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`Jù.29,2003 sheet 2 of 5
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`[I.S. Patent
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`JuL 29,2003 sheer 3 of 5
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`us 6,599,914 B2
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`Jú.29,2003 sheet 4 of 5
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`us 6,599,9t4 B2
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`1
`INHIBITION OF CYTOKINE GENERATION
`
`BACKGROUND OF THE INVENTION
`The present invention relates to methods of using deslo-
`ratadine to inhibit generation of pro-inflammatory cytokines,
`e.g., IL-4 ancl IL-13.
`Mast cells and basophils play a role in allergic and
`inflammatory diseases. These cells produce a wide variety of
`mediators such as prostaglandins, e.g., prostaglandin D2,
`leukotrienes, e.g., leukotriene Cu cytokines and histamine.
`Cylokines are polypeptides secreted by cells that affect the
`function of other cel1s. Cytokines, including interleukins,
`differ widely in the types of cells affected and in biological
`activities exhibited. Desloratadine, a non-sedating
`antihistamine, is disclosed by Lippert, U., et a1, Experinten'
`tal DernaÍology, 1995, Vo1. 4,272-276 to be active in vitro
`in inhibiting the release of the cytokines IL-6 by rtp fo 4OVo
`ancl IL-8 by up to 5O7o ftom human mast and basophilic cell
`lines. Human Fce RI* cells play a considerable pro-
`inflammatory role through the release of histamine, tryptase
`ancl chymase. However, since human mast and basophilic
`cell lines are defective in signaling through the high afEnity
`immunoglogulin-E(IgE) receptor, Fce RI, it is clifücult to
`preclict what effect, if any, desloratacline has on the IgE-
`mediated release of IL-ó ancl IL-8. . S. Molet, eI al., Clinicol
`and Experinental Allergy, 1997 , YoL 27 , pages 1167-1174
`disclose that desloratadine reduces histamine-incluced
`release of IL-6 and IL-8 in an in vitro study in endothelial
`cells. Kleine-Tebbe, J., et al,J. Allergy CIin. Inununol. L994,
`Vol. 93, No. 2, pages 494-500 disclose that desloratadine
`inhibits IgE- ancl non-IgE-mediated histamine release in an
`in vitro study in human basophilic leukocyte cells.
`Human basophils are a major source of the cytokines,
`IL-4 and IL-13 that are produced in vitro in mixecl leukocyte
`cultures. Production of IL-4 and IL-13 by basophils may
`play a role in modulating a variety of activities that are
`involvecl in the pathogenesis of allergic inflammatory con-
`ditions. For example, IL-4 ancl IL-13 each induce secretion
`of IgE- and IgG-4 by human B-cells. (See Schroeder, J.
`T.,"The role of basophil-cytokine networks in asthma." In
`Asthma and Allergic Diseases: Physiology,
`Immunopharmacology, and Treatment, Eclitors: G. Marone,
`K. F. Austen, S T Holgate, A. B. Kay, L. M. Lichtenstein,
`Academic Press, San Diego,75-84, 1998a). However, there
`is a no information on tbe effect of clesloratacline on the
`generation of cytokines such as IL-4 and IL-13 in basophils
`or any other cell types. One study by Gibbs, et al. Naunyn
`Schmiedebegs Arch. Pharmacol, 1998, Vol. 357: 573-578
`reports moderate (SOVo) inhibition of IL-4 and IL-13 secre-
`tion in vitro in basophilic cells using relatively high con-
`centrations of terfenacline, a non-setlating antihistamine.
`This study did not test whether the terfenadine concentra-
`tions used were toxic. The FDA has withdrawn the two
`terfenacline NDAs because of the lìnding that terfenadine
`was no longer safe for cardiac reasons for use in treating
`seasonal allergic rhinitis.(Federal Register, Oct. 5,1998, Vol.
`63, page 53444).
`There is a neecl for a safe, efective therapy to inhibit
`secretion of pro-inflammatory cytokines such as IL-4 and
`IL-13 to treat disease states, for example, allergic and/or
`infl ammatory conditions.
`
`SUMMARY OF TI{E INVENTION
`The present invention provides a method of inhibiting
`generation of IL-4 and IL-13 in a human patient in neecl of
`
`5
`
`10
`
`15
`
`20
`
`25
`
`30
`
`35
`
`40
`
`50
`
`55
`
`60
`
`65
`
`2
`such inhibiting which comprises aclministering to such a
`patient an effective amount of desloratadine.
`Typically. IL-4 and IL-13 is generatecl from human baso-
`phils as well as other cells, e.g., human B-cells.
`The present invention also provides a method of inhibit-
`ing generation of IL-4 and IL-13 from human basophils in
`a patient exhibiting the symptoms of an allergic and/or
`inflammatory condition which comprises administering to
`such a patient an amount of clesloratadine effective to inhibit
`the generation of IL-4 anc'l IL-13 and to concurrently treat
`the symptoms of such an allergic and/or inflammatory
`conditions.
`The present invention also provides a methocl of blocking
`generation of pro-inflammatory cytokines in a patient in
`need of such blocking which comprises administering to
`such a patient an effective amount of clesloratadine.
`The present invention also provicles a method of inhibit-
`ing secretion of pro-inflammatory cytokines from human
`basophils in a patient in neecl of such inhibiting which
`comprises administering to such a patient an effective
`amount of desloratadine.
`The preferred pro-inflammatory cytokines are IL-4 and
`IL-13.
`The patients in need of such inhibiting are those having
`symptoms of allergic/inflammatory conclitions of the airway
`passages, skin, eyes ancl intestinal tract.
`The present invention also provides a method of treating
`a patient exhibiting the symptoms of allergic/inflammatory
`conditions of the skin, eyes, intestinal tract,ancl/or upper and
`lower airway passages which comprises administering to
`such a patient an effective amount of desloratacline.
`The patients in need of such inhibiting are those having
`symptoms of an allergic and/or inflammatory condition of
`the skin, eyes, intestinal tract, ancl/or the upper and lower
`airway passages.
`The present invention also provicles a method of treating
`a disease state that has an allergic component and an
`inflammatory component which comprises administering to
`a patient in need of such treatment an amount of deslorata-
`dine effective to produce an anti-inflammatory effect.
`The present invention also provides a methocl of treating
`and/or preventing allergic asthma and inhibiting secretion of
`IL-4 and IL-13 in a patient in neecl of such treating which
`comprises administering to sucb a patient an effective
`amount of desloratacline.
`The present invention also provides a method of treating
`and/or preventing allergic rhinitis ancl inhibiting secretion of
`IL-4 ancl IL-L3 in a patient in oeecl of such treating which
`comprises administering to such a patient an effective
`amount of desloratacline.
`The present invention also provides a method of treating
`ancl/or preventing atopic dermatitis ancl inhibiting secretion
`ofIL-4 ancl IL-13 in a patient in need ofsuch treating which
`comprises administering to such a patient an effective
`ämount of desloratadine.
`The present invention also provides a method of treating
`and/or preventing urticaria ancl inhibiting secretion of IL-4
`and IL-13 in a patient in need of such treating which
`comprises aclministering to such a pâtient an eftèctive
`amount of desloratadine.
`The present invention also provides a method of treating
`IL-4 ancl IL-13 mediated disease states in a patient in neecl
`of such treating which comprises administering to such
`patients an effective amount of clesloratacline to inhibit
`generation of IL-4 and IL-13.
`
`7
`
`

`

`us 6,599,914 B2
`
`3
`The eftèctive amoun[ of clesloratacline is an amount srLf-
`lìcient to inhibit and preferably block generation of IL-4 ancl
`IL-13 from human cells.
`'lhe presenl invention also provicles a methocl of inhitrit-
`ing generation of IL-4 ancl IL-13 from humao basophils in
`a patient exhibiting the symptoms of an allergic ancl/or
`inflammatory conclition of the skin, eyes, intestinal tract,
`ancl/or the upper aocl lower airway passages which com-
`prises aclministering to such a patient an amount of cleslo-
`ratadine eftèctive to inhibit the generation ofIL-4 ancl IL-13
`¿rncl to concurrently treat the symptoms o[ such an allergic
`ancl/or infl ammatory conclition.
`
`BRIEF DESCRIPTION OF TTIE FIGURES
`
`FIGS. 1¿ ancl 1ó illustratc thc cft'cct of cleslorataclinc on
`histamine, leukotriene C4 ("LIC*") ancl IL-4 secretion by
`human basophils.
`FIG.2 graphically illuslrates 1lre elÏect of clesloratacline on
`histamine release ancl IL-4 secretion in response lo activa-
`tion by ionomycin.
`FIG. 3 graphically illustrates the ellèct of clesloratacline on
`IL-13 secretion by human basophils activatecl try anti-lgE
`ancl ionomycin.
`FIG. 4 graphically illustrates that clesloratacline inhibits
`IL-13 secretion from basophils activatecl with IL-3 ancl
`PMA,
`FIGS. 5o, 5ó, 5c and 5d graphically illustrate the inbibi-
`tion of IL-4 mRNA expression in basophils pretreated with
`clesloratacline.
`
`DETAILED DESCRIPTION OF THE
`INVENTION
`In accorclance with the methods of the present invention,
`we clemonstratecl the ability of clesloratacline to inhibit the
`generation of IL-4 ancl IL-13 from human basophils while
`concurrently comparing its efficacy in preventing mecliator
`release from these cells using a variety of stimuli. Deslora-
`tacline was founcl 1o be remarkably (nearly 6-7) times morc
`potent in reclucing the secretion of IL-4 and IL-13 tÌom
`human basophils inclucecl by anti-IgE than it was at inhib-
`iting the mecliators, histamine anci LTC.,, releasecl in the
`same cullure supernrtants. Thc cytokines, IL-4 ancl IL-13,
`were equally inhibitecl by clesloratacline following activation
`with ionomycin clespite the lack of an elÏèct on the histaminc
`release inclucecl witb ionomycin. Desloratacline hacl a lesser
`effect at inbibiting the IL-13 secretecl in response to IL-3 ancl
`PMA, suggesting that tbe antihistamine diftèrentially targets
`incliviclual pathways of cylokine generation. Finall¡ there
`was no eviclence that clesloratacline was cytotoxic, i.e., that
`it mediatecl its inhibitory effects by causing clecreasecl cell
`viability. In accorclancc with the present invention, IL-4
`mRNA accumulation was also remarkably inhilritecl, by as
`much as B0%, fbllowing pretreatment with clesloratacline,
`suggesling that clesloratacline targets signals regulating
`cytokine gene transcription in acldition to those controlling
`mecliator release.
`The phrase "an allergic and/or inflammatory conclition"
`means those allergic ancl inflammatory conclitions ancl symp-
`toms founcl on the skin,eyes, intestinal tract ancl/or in the
`upper ancl iower airway passages fÌom the nose to the lungs.
`Typical allergic ancl/or inflammatory conditions of the skin
`or upper ancl lower airway passages inclucle seasonal ancl
`perennial allergic rhinitis, non-allergic rhinitis, asthma
`inclucling allergic and non-allergic asthma, sinusitis, colcls,
`clermatitis, especially allergic ancl alopic clermatitis, and
`
`4
`urticaria ancl symptomatic clermographism. Typical allergic
`ancl/or inflammatory conclitions of the eyes inclucle, buf arc
`not limited to, allergic conjunctivitis. Typical allergic ancl/or
`inllammatory conclitioos of the intestinal lracl, trut are no1
`limitecl to, tbocl allergics.
`The term "human" as usecl herein inclucles a male or
`lèmale pecliatric subject of less than 12 years ol age to less
`than 18 years of age, a male or tèmale pecliatric subiect of
`greâter thân 12 years of ¿rge to less than 18 years, ancl male
`and I'em¿le aclults of 18 years of age ancl olcler.
`The term "pro-inllammalory cytokines" as usecl herein
`means those cylokines associatecl with allergic ancl inllam-
`matory reaclions of tbe skin, eyes, intestinal tract, ancl
`airway passages of humans exposecl to allergens. Typically
`suitable pro-inflammatory cytokines include IL-3, IL-4,
`IL-5, IL-6, IL-8, IL-g ancl IL-13.
`The amount of clesloralacline elÌ'ective lbr treating or
`preventing allergic ancl intlammatory ccrnclitions of the skin
`or airway passâgos will vary with the âge, sex, bocly weight
`ancl severity of the allergic and inllammatory conclilion of
`the patient. Typically, tbe amount of cleslorataclioe effective
`for lreating or prevcoling such allergic ancl inflammatory
`conclilions in an aclult human oI age olcler than 12 is in the
`range of alrout 2.5 mg/clay to about 45 mg/day, pret'eralrly
`about 2.5 mglclay to about 20 mglcl.'y, or about 5.0 mg/clay
`to âbout 15 mg/day, or about 5.0 mg/clay to about l0 mg/clây,
`more preferably about 5.0 mg/day to about 7.5 m/clay, ancl
`most prefèrably about -5.0 mg/day in single or cliviclecl doses,
`e.g,,2x2,5 mgtlay, or a single close of -5.0 mg/clay.
`Desloratadine is a non-scdating long acting histaminc
`ântagonist with potent ancl selective peripheral FIl-receptor
`antagonist activity. In vitro ancl in vivo animal pharmacol-
`stuclies have been concluctecl to assess various
`
`ASSESS-
`
`ing central nervous system ("CNS") activity in mrce,
`desloratacline was relatively free of proclucing alterations in
`behavior, neurologic or autonomic tinction, The potential
`for desloratacline to occupy brain Fl1-receptors was assessecl
`in guinea pigs followiog IP aclministration ancl results sug-
`gest poor access [o central histamine receptors 1'or cleslora-
`tacline.
`The clinicai etñcacy ancl safety of clesloratacline has lreen
`clocumentecl in over 3,200 seasonal allergic rhioitis patients
`in 4 clouble-blinclecl, ranclonrizecl clinical trials. The results
`of these clinical stuclies clemonstratecl the efficacy of cleslo-
`ratacline in the treatment of aclult ancl aclolescent patients
`with seasonal rhinitìs.
`Eï[cacy enclpoinls in all the stuclies were'fotal Symplom
`Score, Total Nasal Symptom Score, Total Non-nasal Symp-
`tom Score, and Health Quality of Litè (HQOL) analysis in
`efficacy trials. Desloratadine (5 mg once claily) signiflcantly
`recluced lhe total symptom scores (lhe sum of incliviclual
`scores tbr rhinorrhea, sneezing, congestion/stuffiness, nasal
`itching, itchy/trurning eyes, tearing, ocular reclness, ancl
`itchy ears/palate). f)esloratacline (5 mg) was signilìcantly
`(p<0.01) more effective than placebo in reclucing nasal
`symptoms. An important efficacy enclpoiot analyzecl in the
`desloratacline sluclies is the AM NOVy' total symptom score.
`This parameter measures the total symptom relief by the
`patient after 24 hours before taking the next clay close.
`Statistically signifìcant (p<0.05) reductions were maintainecl
`tbr tbe full 24 ho.ur closing interval over the enlire 5 mg to
`20 mg closage range.
`There were no signilìcant clifferences in the el1ècliveness
`of clesloratadine (over the entire 5 mg to 20 mg closage
`range) across subgroups of patients clefìnecl by gencler, age,
`
`5
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`

`us 6,599,914 B2
`
`5
`or râce. Desloratadine is particularly useful for the treatment
`and prevention of the nasal (stuf[ness/congestion,
`rhinorrhea, nasal itching, sneezing) ancl non-nasal (itchy/
`buming eyes, tearing/watery eyes, redness of the eyes,
`itching of the ears/palate) symptoms of seasonal allergic
`rhinitis, including nasal congestion, in patients in need of
`such treating and/or preventing.
`U.S. Pat. No. 4,659,716 cliscloses methods of making
`clesloratadine, pharmaceutical compositions containing it
`and methocls of using clesloratadine and pharmaceutical
`compositions containing it to treat allergic reaction in mam-
`mals.
`U.S. Pat. No. 5,595,997 cliscloses pharmaceutical com-
`positions containing desloratacline and methods of using
`desloratadine for treating and preventing various disease
`states. e.9., allergic rhinitis.
`U.S. Pat. No. ó,100,274 cliscloses stable pharmaceutical
`compositions containing desloratadine suitable for oral
`administration to treat allergic reactions, e.g., allergic rhini-
`tis.
`The pbarmaceutical compositions of clesloratadine can be
`adapted for any mocle of aclministration e.g., for oral,
`parenteral, e,g., subcutaneous ("SC"), intramuscular ("IM"),
`ancl intraperitoneal ("IP"), topical or vaginal administration
`or by inhalation (orally or intranasally). Preferably deslora-
`tadine is administerecì orally.
`Such pharmaceutical compositions may be formulated by
`combining desloratadine or an equivalent amount of a
`pharmaceutically acceptable salt thereof with a suitable,
`inert, pharmaceutically acceptable carrier or diluent that
`may be either solicl or liquicl. Desloratacline may be con-
`vertecl inlo the pharmaceutically acceptable acid addition
`salts by admixing it with an equivalent amount of a phar-
`maceutically acceptable acid. Typically suitable pharmaceu-
`tically acceptable acids include the mineral acids, e.g.,
`HNO3, H2SO4, H3PO4, HC1, HBr, organic acicls, including,
`but not limited to, acetic, trifluoroacetic, propionic, lactic,
`maleic, succinic, tartaric, glucuronic ancl citric acids as well
`as alkyl or arylsulfonic acids, such as p-toluenesulttrnic acid,
`2-naphthalenesulfonic acicl, or methanesulfonic acid. The
`preferrecl pharmaceutically acceptable salts are
`trifluoroacetate, tosylate, mesylate, and chloride. Deslorata-
`dine is more stable as the free base than as an acid acldilion
`salt and the use of the desloratacline free base in pharma-
`ceutical compositions of the present invention is more
`preferred. See U.S. Pat. No. 6,100,274.
`Solid form preparations inclucle powders, tablets, clispers-
`ible granules, capsules, cachets and suppositories. The pow-
`ders and tablets may be comprised of from about 2.5 to about
`95 percent active ingredient preferably from about 2.5 to
`about 20 percent, more preferably from about 2.5 to about 10
`percent, or from about 2.5 to about 5 percent and most
`preferably 5 percent of the active ingreclient. Suitable solid
`carriers are known in the art, e.g. magnesium carbonate,
`magnesium ste arate, talc, sugar or lâctos€. Tablets, powclers,
`cachets and capsules can be used as solicl closage fbrms
`suitable for oral administration. Examples of pharmaceuti-
`cally acceptable carriers and methods of manufacture for
`various compositions may be found in A. Gennaro (ecl.),
`Remington's Pharmaceutical Sciences, 18th Edition, (1990),
`Mack Publishing Co., Easton, Pa.
`Liquid form preparations include solutions, suspensions
`and emulsions. As an example may be mentioned water or
`water-propylene glycol solutions for parenteral injection.
`Solid form preparations may be converted into liquid prepa-
`rations shortly before use for either oral or administration.
`
`6
`Parenteral forms to be injected intravenously, intramuscu-
`larly or sulrcutaneously are usually in the form of sterile
`solutions and may contain tonicity agents (salts or glucose),
`and buffers. Opacifiers may be includetl in oral solutions,
`suspensions and emulsions. Liquid form preparations may
`also include solutions for intranasal administration, The
`liquid form preparations may comprise the same ranges of
`active ingredient is as used in solid form preparations.
`Aerosol preparations suitable for inhalation may include
`solutions and solids in powcler form, which may be in
`combination with a pharmaceutically acceptable carrier,
`such as an inert compressed gas, e.g., nitrogen.
`Also includecl are solid form preparations which are
`intended to be converted, shortly before use, to liquid form
`preparations for either oral or parenteral administration.
`Such liquid forms inclucle solutions, suspensions and emul-
`sions.
`The compounds of the invention may also be deliverable
`transdermally. The transclermal compositions can take the
`form of creams, lotions, aerosols and/or emulsions ancl can
`be included in a transdermal patch of the matrix or reservoir
`type ¿ìs are conventional in the art for this purpose.
`Preferably, the pharmaceutical preparation is in a unit
`dosage form. In such form, the preparation is subdiviclecl
`into suitably sized unit doses conlaining appropriate quan-
`tities of the active component, e.g., an effective amount to
`achieve the desired purpose.
`Further, desloratadine may be administered in association
`with therapeutically effective amounts of steroids, e.g,
`mometasone furoate, beclomethasone clipropinate or fluti-
`casone propinate, leukotriene inhibitors, e.g., montelukast
`sodium or zafirlukast, and/or an upper airway passage
`decongestant including, bul not limited to phenylepheclrine,
`pseudoephedrine and phenylpropanolamine or pharmaceu-
`tically acceptable salts thereof, in accordance with the
`dosing levels known to those skillecl in the art ancl as
`described in the Plrysicions' Desk Reference. The use of the
`upper airway passage decongestant, pseucloepheclrine HCl,
`is preferred.
`
`EXAMPLES
`
`MATERIALS AND METHODS
`Special Reagents
`All reagents were purchased unless otherwise notecl.
`Piperazine-N,N'-bis-2-ethanesulfonic acicl (PIPES),
`ionomycin, FMLP, PMA, and fetal bovine serum (FBS)
`from Sigma Chemical Co. (St. I-ouis, Mo.); RPMI-1ó40 and
`Iscove's modified Dulbecco's meclium (IMDM) both witb
`L-glutamine and containing 25 mM N-2-
`hyclroxyethylpiperazine-N'-2-ethanesulfonic acicl (HEPES),
`gentamicin, nonessenlial amino acicls (100x) from Life
`Technologies, Inc., Grancl Island, N,Y.); ancl Percoll from
`Pharmacia (Piscataway, N.J.). The desloratadine used in
`these experimenls was supplied by The Schering-Plough
`Research Institute. A 0.1 M stock solution was macle in
`DMSO, aliquotecl, and frozen af -20" C. All pipes-
`containing buffers were macle from stock 10X PIPES (250
`mM PIPES, l.2O M NaCl, anci 50 mM KCL, pH 7.3 and
`stored at 4' C.). Isotonic Percoll, (referred to as 1ff)%
`Percoll) was made by mixing 9 parts Percoll with L part 10X
`PIPES. PAG cootained one-tenth 10X PIPES.0.003% HAS,
`md fJ.1-Vo D-glucose. PAG-EDTA adclitionally contained 4
`mM EDTA. Percoll solutions used for cell isolation were all
`macle by mixing the appropriate amounts of 100% Percoll
`with lX PIPES.
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`7
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`Cell Preparation ancl Culture
`Mixecl leukocyte suspensions containing basophils were
`prepared either using cloulrle-Percoll clensity centrifugation
`as rlescribecl (Schroecler, et al., "/. Inurutnol.,L994, Vol. 153:
`1808, or by a combination of countercurrent elutriatioo ancl
`Percoll clensity centrifugation protocols (MacGlashan, et al.,
`J. Irtmunol.,L994, Vol. 153:3006-3016). The percentages of
`basophils obtained using these protocols typically rangecl
`between 5-50Vo ar,d IO-3Oo/o, respcctively, ancl were cleter-
`minecl by countingAlcian blue positive ancl negative stainecl
`cells on a Spiers-Levy chamber (Giibert and Ornstein,
`1975). For some experiments, the basophils were aclclition-
`ally purilìed to >99.97o using a negative-selection protocol
`(Miltenyi Corp., Auburn, Calif.), For all experiments other
`than those assessing Il,-4 mRNAexpression, the cells were
`cultured in 96-well flat-trottom microtiter plates (in
`cluplicate) using IMDM supplementecl with 5% heat-
`inactivatecl (56' C. for 30 min.) FBS, lxnon-essential amino
`acicls, and -5 ¡rglml geotamicin (C-IMDM). For the analysis
`oI IL-4 mRNA expression, cells in C-IMDM were culturecl
`in autcrclavecl (RNase-free) 1.5 ml microcentrifuge tubes
`(see Lrelow), since this allowed for a more precise way to
`quantilatively isolate mRNA without the neecl for transtèr-
`ring cells from culture wells before extraction. For eacb
`conclition, leukocyte suspensions containing approximately
`100,000-500,000 basophils in 100 ¡rl of C-IMDM were
`prewarmecl to 37o C. befbre aclcling 100 ¡r1 of clesloratacline
`concentrations in C-IMDM also prewarmed to 37o C. After
`15 minutes preincubation, the cells were then activatecl by
`aclding 50 ¡rl of 5x(5 times the flnal concentration) of
`stimulus. It is important to note here that the concentrations
`of stimuli usecl were optimal for IL-4 generation rather than
`mecliator release. This is particularly true fbr anti-IgE
`
`trations lO-fold less lban those causing optimal histamine
`release (Schroecler, et al., ibicl). For harvesting, cultures were
`centrifugecl ancl cell-free supernatants collectecl for mecliator
`release ancl cytokine analysis, as clescribecl (Schroecler, et al.,
`ibicl). Histamine, LTC', ancl IL-4 were all measured in
`aliquots of culture supernatant taken at 4 bours. For
`histamine, this meant taking 20-50 ¡rl of supernatant ancl
`cliluting it in 1 ml of PAG buftèr containing 1.6% HC1O.'.
`After an overnight precipitation at 4o C., the samples were
`assayed by automatecl tìuorimetry (Siraganian,R. P., Anol.
`]Jioclten. 1974, Vol.57:383-394). LIC* was measurecl by an
`in-house RIA (MacGlashan, et al., J. Ittnrurtol. 1.986,
`Yol.l36:2231-2239). lL-4 protein was measured by a com-
`mercial ELISA (Biosource International). Cllture superna-
`tants were harvestecl after 20 hours incubation lbr all experi-
`ments investigating the effects of clesloratadine on IL-13
`secretion. In some instances, IL-4 was also measured at this
`time point, particularly when ionomycin was usecl, since the
`kioetics for the secretion of this cytokine extend lreyoncl 4
`hours with this stimulus (Schroecler, et al,, J. Leuk. Biol.,
`1998, Vo1. 63:692-698).IL-13 protein measurements were
`also macle using a commercial ELISA(lmmunotech).
`RNA Isolation ancl Semi-Quantitative Analysis oi IL-4
`mRNA Expression
`Cultures for the analysis of IL-4 mRNAwere performecl
`in 1.5 ml polypropylene microcentrifuge tubes, as describecl
`above. Cells were pretreatecl witb clesloratacline (10 ¡rM) fbr
`15 minules prior to activating with anti-IgE antibocly (10-20
`ng/ml). 'Iotal RNA was isolated using the RNAzol protocol
`(Tel-test Inc., Frienclswoocl, Tex.) after 2 hours incubation,
`which is the time that IL-4 mess¿ìge expression peaks using
`IgE-clepenclent activation (Schroecler, et al., J.
`I nu¡utno l. 1997, Vol. 158:5448--5454). Following isopropanol
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`precipitation, the RNA was washecl with 7O7o ethanol ancl
`driecl uncler vacuum. Subsequently, the RNA was resus-
`pendecl in 25 ¡rl of cliethipyrocarbonate (DEPC){reatecl
`water ancl storecl ât -80" C. Reverse Transcription (RT) ancl
`polymerase chain reaction (PCR) were pertbrmecl with serial
`dilutions of RNA as previously detailecl (MacGlasban, et al.,
`J, Intnuuol,1994; Vol. 152:3006-3016; Schroecler, al al.,J.
`Innrunol., 1997, Vol. 158: 5448-5454) using the GeneAmp
`RNA PCR kit (Perkin-Elmer Cetus, Norwalk, Conn.). PCR
`proclucts were visualizecl in 3Vo agrose gels using ethiclium
`Lrromicle staining. ,{s noted elsewhere, two clistinct bancls fbr
`IL-4 were observecl. A clominant bancl was seen with a size
`of approximately 460 bp. The source of the smaller, fainter
`bancl is uncertain, but is thought to be an alternalively
`spliced t'orm of IL-4 (Atamas, et al., J. Itttnunol, 1996,
`Vol.156:435-441). The two bands are routinely observecl
`using either pure or enrichecl suspensions of basophils.
`FIGS. l¿ and lå graphically illustrate the effect of deslo-
`ratacline on histamine, LIC., and IL-4 secretion by buman
`basophils. For FIG. 14 mixecl leukocyte suspensions con-
`taining 3-557a basophils were preparecl from whole bloocl
`using Percoll clensity centrifugatioo. Cells werc pretreatecl
`l5 min. with the inclicatecl concentrâtions of clesloratacline
`betbre ¿ctivating with anli-IgE antibody (10-20 ng/ml), All
`three proclucts were measurecl using the same culture super-
`natânts h¿ìrvestecl after 4 hours incubation. Valucs arc tbc
`mean*SEM (n=-5). Control release for each procluct: Flista-
`mine:4}*6ok of total, lL-4:403t2O7 pg/106 basophils, ancl
`LTC': 860t127 pg/106 basophils. FIG. 1ó shows the ellect
`of clesloratacline on histamine, LTC*, ancl IL-4 secretion
`from humao basophils, 99%, purtty, Control release for
`bistamine, LIC., ancl IL-4 were 6OVo of totaÌ, 903 pg/10o
`basophils, and 854 pg/106 basophils, respectively.
`FIG. 2 illustrates the effect of clesloratacline on histamioe
`
`Basophil suspensions of 42, 99, ancl 98a/o purity were
`pretreatecl 1-5 min. with 0.1, 1.0, ancl 10 ¡rM desloratadine.
`Cclls wcrc then activatecl with ionomycin (500 ng/ml) for 4
`hours. Culture supernatants were harvested and assayecl for
`histamine ancl IL-4 prolein. Values represent the
`mean*SEM, n=3. Control levels of IL-4 were 3398, 2-53, anct
`348 pg/106 basophils. Percent histamine release in the same
`cultures was 91, 25, ancl 10%, respectively.
`FIG. 3 illustrates the effecl of c'lesloratacline on IL-13
`secretion by human basophils ¿rctivatecl by anti-IgE or
`ionomycin. Basophil suspensions ranging in purity between
`6-99%, were pretreated 15 min. with the inclicatecl concen-
`lrations of clesloratacline. Cells were activatecl with either
`anti-IgE (1G-20 ng/ml) or ionomycin (500 ng/ml). Culture
`supern¿ìlants were barvestecl aiter 18 hours incubatioo ancl
`assayecl tbr IL-13 protein by ELISA. Values with error bars
`represent the mean*SEM, n=3. IL-13 protein in control
`cultures averagecl 169=35 and 334=144pgllO6 basophils fbr
`anti-IgE ancl ionomycin, respectively. Values indicatecl by
`the open circles are the mean lbr two experiments (control
`levels o