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Title:  Prevention and treatment of amyloid-associated disorders

United States Patent:  6,596,474

Issued:  July 22, 2003

Inventors:  Hyslop; Paul Andrew (Indianapolis, IN); Miller; Foy Dean (Camby, IN); Higgins; Linda S. (Palo Alto, CA); Catalano; Rosanne (Hayward, CA); Cordell; Barbara (Palo Alto, CA); Puchacz; Elizbieta (Pleasanton, CA)

Assignee:  Scios Inc. (Sunnyvale, CA); Eli Lilly and Company (Indianapolis, IN)

Appl. No.:  608640

Filed:  June 30, 2000

Abstract

The present invention provides assays to identify compounds that affect microglial cell activation, and specifically assays to identify compounds that affect secretion of cytokines from these microglial cells by modulating PGE2 -mediated activity. The assays of the invention include assays for testing microglial cell activation by contacting microglia with compounds that modulate .beta.-amyloid PGE2 -mediated activation, which can be identified by cellular activity such as secretion of cytokines, e.g., TNF-.alpha. and IL-1.alpha.. The effect of the candidate compound can be determined by comparing the effect with a control culture which is not contacted with the compound, or by comparing the effect with a standardized profile.

SUMMARY OF THE INVENTION

The present invention provides assays to identify compounds that affect microglial cell activation, compounds identified in these assays which inhibit A.beta.:PGE2 activation of microglial cells, and methods of using such compounds in therapeutic intervention. Assays of the invention affect microglia activation through modulation of A.beta.:PGE2 -mediated activity. A.beta.:PGE2 exposure to microglia activates the microglia to a greater extent than additive exposure to either agent alone. Since this synergistic activation of microglia presents a particularly pathogenic mechanism, methods of identifying compounds using the assays of the invention are particularly useful, since they can identify therapeutic agents that inhibit either or both arms of the synergistic effect. Moreover, the therapeutic agents identified using the assays of the invention may be particularly suited for patient intervention, as they exhibit a specific effect on this synergistic activation process.

The assays of the invention include assays for testing microglial cell activation by contacting microglia with compounds that modulate A.beta. and/or PGE2 -mediated activation. The effect of the candidate compound can be determined by comparing the effect with a control culture which is not in contact with the compound, for example by measuring secretion of cytokines such as TNF-.alpha. and IL-1.alpha. or by comparing the effect with a standardized cytokine profile.

In one preferred embodiment, the invention features an assay to identify compounds which alter, halt or prevent progression of an amyloid-associated disorder by culturing microglial cells with A.beta.:PGE2 and a compound to be tested. The culture is then examined for synergistic activation by A.beta.:PGE2 as evidence by a change in cellular activity, for example cytokine secretion, elevation of nitric oxide synthetase (NOS) or its products, reactive oxygen species (ROS) or expression of molecules associated with activation such as LFA-1, VLA-4, or Mac-1. The culture can also be compared to levels prior to exposure with the compound or, alternatively, to a standardized profile for one or more of these cellular activities. The compound may be added to the cells prior to exposure with the A.beta. peptide (e.g., to examine the ability of the compound to prevent plaque formation), simultaneously with the A.beta. peptide, or following incubation with the A.beta. peptide (e.g., to determine the ability of the compound to halt or reverse progression of plaque formation). Preferably, the amyloid-associated disorder is AD or CAA, and the cytokine used in the assay is preferably IL-1.alpha., IL-1.beta., TNF-.alpha. and/or IL-6.

The invention also features a method for determining the particular molecules that are therapeutic targets for modulation of microglia activation. For example, the receptor isoform involved in the A.beta.:PGE2 synergy was determined by using compounds that affects a particular isoform of PGE2, and the receptor isoform involved was identified by examining the effect of the compounds on microglia activation.

In another embodiment, the invention provides a method for modulating cytokine secretion in a patient by analyzing microglial cells from the central nervous system of a patient, determining the level of expression of cytokines from the microglial cells, and administering a compound in an amount sufficient to reduce cytokine expression. Cytokine secretion may be monitored, e.g., by monitoring soluble factors associated with microglial cell activation from the cerebrospinal fluid of a patient, which can be obtained via a spinal tap.

The invention also provides a method for reducing the level of .beta.-amyloid plaque in the brain tissue of a mammalian host by administering to the host a compound in an amount effective to reduce microglial activation. Preferably, the compound used in treatment reduces the microglial activation by 30 to 80%, and reduces cytokine secretion levels by 20 to 80%.

The invention also provides standardized cellular profiles and methods of using such standards as a positive control in a neurodegenerative disease assay. The assay may be a bioassay which uses transgenic animals or an immunoassay, and can be used for purposes such as diagnosis, prognosis, determination of the efficacy of a therapeutic, etc. The standards function to ensure reproducibility and specificity of an assay by functioning as a reference material with a known and consistent level of microglial activation. The standards also make it possible to determine sensitivity and to adjust selectivity relative to sensitivity as needed.

The invention also features a method of calibrating an assay using the standards of the invention. Calibration can be within a single assay, to determine efficacy at a given level of cytokine concentration, or between assays, to allow comparison of results of different assays by adjusting detection levels between assays. For example, if one, assay is more sensitive than another, calibration with a standard can be used to determine the factor for converting measured levels to corrected levels for comparison of results obtained using different assays.

The invention also features a method of determining the quality of reagents used in a diagnostic or prognostic assay by testing the reagents using standards of the invention. The standards provide a consistent level of microglial activation, and preferably a consistent background. Testing reagents against the standard can ensure selectivity and/or reproducibility of a reagent used in an assay.

An object of the invention is to identify therapeutic compounds that reduce amyloid plaque burden by regulating a PGE2 -mediated pathway.

Another object of the invention is to use the synergistic effects of the A.beta. peptide and certain cytokines to identify therapeutic agents for amyloid-associated disorders.

Another object of the invention is to identify the specific molecules involved in neurodegenerative disorders by using compounds targeted to specific molecules involved in microglia activation.

Another object of the invention is to treat patients with a neurodegenerative disorder by administering a compound identified using the assays of the invention.

Another object of the invention is to prevent amyloid plaque formation by administering a compound identified using the assays of the invention.

An advantage of the invention is that the assays of the invention can identify therapeutic agents that target a specific pathway, and thus have fewer general side effects.

Another advantage of the invention is that it provides more narrowly tailored therapeutic agents. In particular, since human microglia do not express EP3, therapeutics can be used that do not have side effects associated with targeting EP3.

These and other objects, advantages and features of the invention will become apparent to those skilled in the art upon reading this disclosure.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

Before the present methods and compounds are described, it is to be understood that this invention is not limited to particular methods or compounds described and may, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting, since the scope of the present invention will be limited only by the appended claims.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although any methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention, the preferred methods and materials are now described. All publications mentioned herein are incorporated herein by reference to disclose and describe the methods and/or materials in connection with which the publications are cited.

It must be noted that as used herein and in the appended claims, the singular forms "a", "an," and "the" include plural referents unless the context clearly dictates otherwise. Thus, for example, reference to "a compound" includes a plurality of such compounds and reference to "an AD-type pathology" includes reference to one or more such pathologies and equivalents thereof known to those skilled in the art, and so forth.

All publications mentioned herein are incorporated herein by reference for the purpose of =describing and disclosing, for example, the cell lines, constructs, and methodologies that are described in the publications which might be used in connection with the presently described invention. The publications discussed above and throughout the text are provided solely for their disclosure prior to the filing date of the present application. Nothing herein is to be construed as an admission that the inventors are not entitled to antedate such disclosure by virtue of prior invention. Further, the publication dates provided may be different from the actual publication date which may require independent verification.

DEFINITIONS

The terms "treatment", "treating", "treat" and the like are used herein to generally mean obtaining a desired pharmacologic and/or physiologic effect. The effect may be prophylactic in terms of completely or partially preventing a disease or symptom thereof and/or may be therapeutic in terms of a partial or complete cure for a disease and/or adverse effect attributable to the disease. "Treatment" as used herein covers any treatment of a disease in a mammal, particularly a human, and includes:

(a) preventing the disease or symptom from occurring in a subject which may be predisposed to the disease or symptom but has not yet been diagnosed as having it;

(b) inhibiting the disease symptom, i.e., arresting its development; or

(c) relieving the disease symptom, i.e., causing regression of the disease or symptom.

By "effective dose" or "amount effective" is meant an administration of a compound sufficient to provide the desired physiological and/or psychological change. This will vary depending on the patient, the disease and the treatment. The dose may either be a therapeutic dose, in which case it should sufficiently alter levels of amyloid plaques in the subject to alleviate or ameliorate the symptoms of the disorder or condition, or a prophylactic dose, which should be sufficient to prevent accumulation of amyloid plaques to an undesirable level.

The term "compound" as used herein describes any molecule, e.g., protein or small molecule pharmaceutical, with the capability of affecting the molecular and clinical phenomena associated with amyloid-associated disorders, and specifically AD- and/or CAA-mediated disorders.

The term "diagnosis" is used herein to cover any type of analysis used to determine or project a status which includes identification of a disease from its symptoms and determining the presence of molecules (e.g., TGF-.alpha. or IL-1.alpha.) in an area (e.g., brain tissue) which suggest a disease status (e.g., beginnings of Alzheimer's disease).

The term "unit dosage form," as used herein, refers to physically discrete units suitable as unitary dosages for human and animal subjects, each unit containing a predetermined quantity of compounds of the present invention calculated in an amount sufficient to produce the desired effect in association with a pharmaceutically acceptable diluent, carrier or vehicle. The specifications for the novel unit dosage forms of the present invention depend on the particular compound employed and the effect to be achieved, and the pharmacodynamics associated with each compound in the host.

The term "Alzheimer's disease" (abbreviated herein as "AD") as used herein refers to a condition associated with formation of neuritic plaques comprised primarily of .beta.-amyloid protein primarily in the hippocampus and cerebral cortex, as well as impairment in both learning and memory. "AD" as used herein is meant to encompass both AD as well as AD-type pathologies.

The term "AD-type pathology" as used herein refers to a combination of CNS alterations including, but not limited to, formation of neuritic plaques containing .beta.-amyloid protein in the hippocampus and cerebral cortex. Such AD-type pathologies can include, but are not necessarily limited to, disorders associated with aberrant expression and/or deposition of APP, overexpression of APP, expression of aberrant APP gene products, and other phenomena associated with AD. Exemplary AD-type pathologies include, but are not necessarily limited to, AD-type pathologies associated with Down's syndrome that is associated with overexpression of APP.

The term "phenomenon associated with Alzheimer's disease" as used herein refers to a structural, molecular, or functional event associated with AD, particularly such an event that is readily assessable in an animal model. Such events include, but are not limited to, amyloid deposition, neuropathological developments, learning and memory deficits, and other AD- associated characteristics.

The term "cerebral amyloid angiopathy" (abbreviated herein as CAA) as used herein refers to a condition associated with formation of amyloid deposition within cerebral vessels which can be complicated by cerebral parenchymal hemorrhage. CAA is associated with increased risk of stroke as well as development of cerebellar and subarachnoid hemorrhages Vinters (1987) Stroke 18:311-324; Haan et al. (1994) Dementia 5:210-213; Itoh et al. (1993) Neurol. Sci. 116:135-414). CAA can also be associated with dementia prior to onset of hemorrhages. The vascular amyloid deposits associated with CAA can exist in the absence of AD, but are more frequently associated with AD.

The term "phenomenon associated with cerebral amyloid angiopathy" as used herein refers to a molecular, structural, or functional event associated with CAA, particularly such an event that is readily assessable in an animal model. Such events include, but are not limited to, amyloid deposition, cerebral parenchymal hemorrhage, and other CAA-associated characteristics.

The term ".beta.-amyloid deposit" as used herein refers to a deposit in the brain composed of A.beta. as well as other substances.

The term "synergy" as used herein refers to a response to two or more stimuli that is greater than the sum of the response of the same stimuli applied alone. For example, microglial cells exposed to A.beta.:PGE2 exhibit a greater level than the sum of activation than either A.beta. or PGE2 alone, as evidenced for example by cytokine elevation. Similarly, a "synergistic effect" is an effect result from a synergy, e.g., increased expression of cytokines in response to A.beta.:PGE2 activation of microglial cells.

The term "a standardized profile", "standard" and the like as used herein refer to a preparation for microglial cell activation assays in which the level of a cellular activity, e.g., cytokine expression, and background characteristics are sufficiently established to allow the standard to function as a reference material, e.g., for immunoassays and/or bioassays. The standardized profiles have one or more properties sufficiently well established to be used to determine microglial activation. Such properties are preferably a change in cellular activity, for example cytokine secretion, elevation of nitric oxide synthetase (NOS) or its products, reactive oxygen species (ROS) or expression of molecules associated with activation such as LFA-1, VLA-4, or Mac-1.

GENERAL METHODOLOGY

The assays, methods, and compounds of the present invention are directed to the use of PGE2 receptors on microglia as therapeutic targets to modulate microglial, activation, and in particular to control microglial secretion, e.g., cytokine release. A central finding upon which the present invention is based is that PGE2 receptor isoforms EP2 and EP4 are present on microglia. The assays and methods of the present invention are based on the observations of: 1) a synergistic response between a PGE2 isoform and A.beta. in microglial activation, as evidenced by the induction of a second inflammatory mediator, TNF-.alpha.; and 2) synergistic responses between a PGE2 isoform and A.beta. in primary glial cell cultures as evidenced by IL-1.alpha. synthesis/secretion. These IL-1.alpha. responses may be used to identify the molecules involved in particular neurodegenerative diseases, and to identify compounds which alter, halt or prevent progression of these diseases by manipulation of PGE2 receptor isoform activity and/or activity of other molecules in the PGE2 signaling pathway. Compounds identified as controlling activity through a PGE2 receptor isoform can be used to alter microglial activation and protein secretion, thus altering the progression of inflammatory response in neurodegenerative disorders.

For example, the assays of the invention were used to identify the particular PGE2 receptor isoform involved in microglial activation in response to A.beta.. The finding that the EP4 isoform of the PGE2 receptor is involved in microglia activation allows therapeutic targeting of EP4 to control synergistic PGE2 :A.beta. microglial activation with compounds that are specific to the EP4 isoform, but that do not affect the other PGE2 isoforms. This is a major advantage over traditional NSAIDs and COX-2 inhibitors, effects of which include effects of other isoforms including EP3, since EP3 is known to mediate gastrointestinal disturbance including stomach bleeding and induction of ulcers. Compounds identified by the methods of the invention can be used to block the deleterious effect of PGE2 in microglia while preserving the positive effects of PGE2 in areas such as the gut.

EXEMPLARY ASSAYS OF THE INVENTION

To identify and characterize compounds which modulate A.beta.:PGE2 -mediated microglial activation, both in vivo or in vitro methods can be used. The test samples that may be used in the various in vitro assays include, but are not limited to, an aliquot of tissue culture medium conditioned by murine cultured cells, an aliquot of tissue culture medium conditioned by human cultured cells, murine cultured cell extract, tissue culture medium conditioned by mouse brain organotypic slice or explant, murine organotypic brain slice or explant extract, human cultured cell extract, mouse plasma, human plasma, plasma from transgenic mice genetically engineered to express any one of the three human apoE isoforms, plasma from transgenic mice having an altered APP, or human or mouse CSF or tissue extract.

In vitro Assays

Various in vitro assays can be used to measure effects of the inventive compounds to alter A.beta. and PGE2 -mediated microglial activation. The effect of compounds on A.beta. and PGE2 -mediated microglial secretion can be measured by methods including, but not limited to, an enzyme-linked immuno-sorbent assay (ELISA), Western blot analysis, or immunoprecipitation of the cellular media, immunocytochemistry, Griess reaction, or assessment of ROS or NO.

For example, an in vitro assay may determine the effect of a compound on the synergistic response between PGE2 and A.beta. by measuring levels of cytokine, and in particular TNF-.alpha., IL-1.alpha.. or IL-6. Equivalent amounts of a microglial cell line or primary brain cultures including microglia are cultured in a 96-well microtiter plate. Cultures are treated with A.beta. and PGE2. Varying doses of compounds (drug) are added to the cells to the microtiter plate, and the cells incubated for an appropriate period of time, e.g., 12 hours at 37oC. At the conclusion of the incubation, the levels of cytokine secreted into the cell media and lysates can be measured to determine the effect of the compound.

In yet another example, IL-1.alpha. or IL-6 responses may be used to identify the PGE2 receptor isoforms involved in particular neurodegenerative diseases, and to identify compounds which alter, halt or prevent progression of these diseases by manipulation of PGE2 activity. This is done by a direct assay on the cells themselves. Cells involved in a neurodgenerative pathological state, such as microglial cells, can be analyzed for the presence or absence of PGE2 recptor isoform mRNA, and in particular the EP4 isoform, by RT-PCR analysis.

In yet another example, a mixed lymphocyte reaction (MLR) provides a valuable screening tool to determine biological activity of each inventive compound using PMBC as a surrogate marker for microglial activation. In the MLR, PBMCs (peripheral blood mononuclear cells) are obtained by drawing whole blood from healthy volunteers in a heparinized container and diluted with an equal volume of hanks balanced salt solution (HBSS). This mixture is layered on a sucrose density gradient, such as a FICOLL-HYPAQUE.RTM. gradient, and centrifuged at 1000x g for 25 minutes at room temperature or cooler. PBMC are obtained from a band at a plasma-Ficoll interface, separated and washed at least twice in a saline solution, such as HBSS. Contaminated red cells are lysed, such as by ACK lysis for 10 min at 37oC., and the PBMCs are washed twice in HBSS. The pellet of purified PBMCs is resuspended in complete medium, such as RPMI 1640 plus 20% human inactivated serum. PBMC activation and/or cytokine secretion is determined in an MLR performed in a 96-well microtiter plate. Briefly, approximately 105 purified PBMC cells in 200 .mu.l complete medium are co-cultured, and treated with A.beta. and PGE2 either in the presence or absence of a candidate compound. The effect of the compound on microglial activation is then determined.

Other in vitro assays utilizing the methods of the invention may also be employed, and will be apparent to one skilled in the art upon reading this disclosure and the exemplary assays described herein.

Bioassays

Animal models for Alzheimer's disease may be used to determine the effect of compounds on PGE2 -mediated microglial activation. The screening for AD phenotype can include assessment of phenomena including, but not limited to: 1) analysis of molecular markers (e.g., levels of secretion of cytokines in brain tissue; presence/absence of PGE2 activity, presence/absence in brain tissue of various A.alpha. activated glia, formation of neurite plaques, and the like); 2) assessment of behavioral symptoms associated with memory and learning; 3) detection of neurodegeneration characterized by loss of select populations of neurons (neurodegeneration can be measured by, for example, detection of synaptophysin expression in brain tissue or by direct quantitation based on morphology after staining with a neuronal cell body protein such as neurofilament) (see, e.g., Games et al. (1995) Nature 373:523-7). The screening for CAA can include assessment of phenomena including, but not limited to: 1) analysis of molecular markers (e.g., levels of expression of proteins in brain vascular tissue; presence/absence in brain tissue of various genetic variants, isoforms, and mutants associated with CAA; formation of cerebrovascular amyloid deposits); and 2) detection of cerebral hemorrhage associated with amyloid deposition. These phenomena may be assessed in the screening assays either singly or in any combination.

Preferably, the screen will include control values (e.g., the level of amyloid production in the test animal in the absence of test compound(s)). Test substances which are considered positive (i.e., likely to be beneficial in the treatment of AD or CAA) will be those which have a substantial effect upon an AD- or CAA-associated phenomenon e.g., test agents that are able to reduce the level of A.alpha. deposition, preferably by at least 20%, more preferably by at least 50%, and most preferably by at least 80%.

Methods for assessing these phenomena, and the effects expected of a compound for treatment of AD and/or CAA, are well known in the art. For example, methods for using transgenic animals in various screening assays for, for example, testing compounds for an effect on AD, are found in WO 96/40896, published Dec. 19, 1996; WO 96/40895, published Dec. 19, 1996; WO 95/11994, published May 4, 1995 (describing methods and compositions for in vivo monitoring of A.beta.; each of which is incorporated herein by reference with respect to disclosure of methods and compositions for such screening assays and techniques).

After exposure to the compound, the animals are sacrificed and analyzed by immunohistology for either: 1) neuritic plaques in the brain (AD model) and/or 2) amyloid deposition on cerebrovascular walls (CAA model) and/or 3) microglial number and/or activation state (normal animal). The brain tissue is fixed (e.g, in 4% paraformladehyde) and sectioned; the sections are stained with antibodies reactive with expression of a sequence indicative of PGE2 -mediated microglial activation, such as TNF-.alpha., the A.beta. peptide, LFA-1, VLA-4, IL-6 or IL-1.alpha.. Secondary antibodies conjugated with fluorescein, rhodamine, horse radish peroxidase, or alkaline phosphatase are used to detect the primary antibody. These experiments permit identification of amyloid plaques and the regionalization of these plaques to specific areas of the of brain.

Sections are also stained with other antibodies diagnostic of Alzheimer's plaques, recognizing antigens such as Alz-50, tau, A2B5, neurofilaments, neuron-specific enolase, and others that are characteristic of Alzheimer's and/or CAA plaques. Staining with thioflavins and congo red can also be carried out to analyze co-localization of A.beta. deposits within the neuritic plaques and NFTs of AD or along the vascular walls as in CAA.

Standardized Profiles

In another embodiment of the invention, A.beta.:PGE2 -mediated microglial cell activation and/or cytokine production is determined using a standardized profile. This profile may be used to determine differences between cells treated with a compound, e.g., a PGE2 receptor antagonist, and a standardized profile of untreated cells of that particular cell type. The standardized profiles are created using a statistically significant number of samples, preferably at least 20, more preferably at least 50, and even more preferably at least 100. When primary cultures are used for the standard, the samples used to produce the standard profiles are preferably matched for age, phenotype, etc. For example, a standardized profile can be determined for peripheral blood samples from 70-84 year-old persons affected with AD. In another example, a standardized profile can be determined for cells from 70-85 year-old non-demented persons. In yet another example, a standard may be determined for a microglial cell line.

Once a standard has been generated and the critical properties determined, this standard can be used to harmonize data between assays. For example, comparative microglial activation assays may vary in protocol, resulting in different assay values for a human sample. By performing each of these assays on the standard with known properties as a control, a correction value may be determined to allow harmonization between different assays. The human CNS standard is diluted into multiple concentrations, for example a 1:2 dilution, a 1:5 dilution, a 1:10 dilution and a 1:50 dilution, and the comparative microglial activation assay performed on each of the dilutions of the human sample. The results of the assay values retrieved for each dilution are used to determine a correction value to harmonize the data to reflect the determined true value of the microglial activation in the sample.

COMPOUNDS OF THE INVENTION

The assays of the invention can be used to identify compounds for use as therapeutics in the treatment of neurological disorders, e.g., AD or CAA. Compounds of the invention may affect any pathway involved in the synergistic activation of microglia, and preferably alter activity mediated by a PGE2 receptor isoform, and in particular activity mediated by the EP4 isoform. Compounds identified as altering microglial activation using the methods of the invention can be used as therapeutic and/or prophylactic agents in the treatment of neurological disorders.

Candidate compounds can be obtained from a wide variety of sources including libraries of synthetic or natural compounds. For example, numerous means are available for random and directed synthesis of a wide variety of organic compounds and biomolecules, including expression of randomized oligonucleotides and oligopeptides. Alternatively, libraries of natural compounds in the form of bacterial, fungal, plant and animal extracts are available or readily produced. Additionally, natural or synthetically produced libraries and compounds are readily modified through conventional chemical, physical and biochemical means, and may be used to produce combinatorial libraries. Known pharmacological compounds may be subjected to directed or random chemical modifications, such as acylation, alkylation, esterification, amidification, etc. to produce structural analogs.

TREATMENT OF NEURODEGENERATIVE DISORDERS

Compounds identified using the methods and assays of the invention may be administered to a subject in need of treatment, i.e., a subject suffering from or at risk for a neurodegenerative disorder. The compounds can be administered to the subject using any convenient means capable of resulting in the desired effect, e.g., a decrease in microglial cell activation and/or cytokine secretion.

The compound can be incorporated into a variety of formulations for therapeutic administration. More particularly, the compounds of the present invention can be formulated into pharmaceutical compositions by combination with appropriate, pharmaceutically acceptable carriers or diluents, and may be formulated into preparations in solid, semi-solid, liquid or gaseous forms, such as tablets, capsules, powders, granules, ointments, solutions, transdermal patches, suppositories, injections, inhalants and aerosols.

As such, administration of the compounds can be achieved in various ways, including oral, buccal, rectal, parenteral, intraperitoneal, intradermal, transdermal, pulmonary, intratracheal, etc., administration.

In pharmaceutical dosage forms, the compounds can be administered in the form of their pharmaceutically acceptable salts, or they can also be used alone or in appropriate association, as well as in combination, with other pharmaceutically active compounds. The following methods and excipients are merely exemplary and are in no way limiting.

For oral preparations, the compounds can be used alone or in combination with appropriate additives to make tablets, powders, granules or capsules. Examples of additives are conventional additives, such as lactose, mannitol, corn starch or potato starch; binders, such as crystalline cellulose, cellulose derivatives, acacia, corn starch or gelatins; disintegrators, such as corn starch, potato starch or sodium carboxymethylcellulose; lubricants, such as talc or magnesium stearate; and if desired, diluents, buffering agents, moistening agents, preservatives and flavoring agents.

The compounds of the invention can be formulated into preparations for injection by dissolving, suspending or emulsifying them in an aqueous or nonaqueous solvent, such as vegetable or other similar oils, synthetic aliphatic acid glycerides, esters of higher aliphatic acids or propylene glycol. If desired, conventional additives such as solubilizers, isotonic agents, suspending agents; emulsifying agents, stabilizers and preservatives may also be added. The concentration of therapeutically active compound in the formulation may vary from about 0.5-100 wt. %.

The compounds can be utilized in aerosol formulation to be administered via inhalation. The compounds of the present invention can be formulated into pressurized acceptable propellants such as dichlorodifluoromethane, propane, nitrogen and the like. Additionally, the compounds can be aerosolized in either liquid form or as a dry powder.

Furthermore, the compounds can be made into suppositories by mixing with a variety of bases such as emulsifying bases or water-soluble bases. The compounds of the present invention can be administered rectally via a suppository. The suppository can include vehicles such as cocoa butter, carbowaxes and polyethylene glycols, which melt at body temperature, yet are solidified at room temperature.

Unit dosage forms for oral or rectal administration such as syrups, elixirs, and suspensions may be provided wherein each dosage unit (e.g., a teaspoonful, tablespoonful, tablet or suppository) contains a predetermined amount of the composition containing one or more inhibitors. Similarly, unit dosage forms for injection or intravenous administration may comprise the inhibitor(s) in a composition as a solution in sterile water, normal saline or another pharmaceutically acceptable carrier.

The pharmaceutically acceptable excipients, such as vehicles, adjuvants, carriers or diluents, are readily available to the public. Moreover, pharmaceutically acceptable auxiliary substances, such as pH adjusting and buffering agents, tonicity adjusting agents, stabilizers, wetting agents and the like, are readily available to the public.

Compounds for use in the method of the invention may also be small organic compounds having a molecular weight of more than 50 and less than about 2,500 daltons. Candidate compounds comprise functional groups necessary for structural interaction with proteins, particularly hydrogen bonding, and typically include at least an amine, carbonyl, hydroxyl or carboxyl group, preferably at least two of the functional chemical groups. The candidate compounds often comprise cyclical carbon or heterocyclic structures and/or aromatic or polyaromatic structures substituted with one or more of the above functional groups. Candidate compounds are also found among biomolecules including, but not limited to: peptides, saccharides, fatty acids, steroids, purines, pyrimidines, derivatives, structural analogs or combinations thereof.

The compounds are added to a host in a physiologically acceptable carrier, at a dosage from 5 mg to 1400 mg, more usually from 100 mg to 1000 mg, preferably 500 to 700 for a dose of 0.5 to 20 mg/kg weight. The dosage for compounds suppressing cholesterol biosynthesis is elected so that the cholesterol biosynthesis is reduced by 10 to 80%, more preferably 20 to 70% and even more preferably 25 to 50%. The dosage for compounds inhibiting the activity of PGE2 receptors is elected so that the cytokine and/or cytotoxin secretion is reduced by about 20 to 100%, preferably 40 to 60%. The dosage for compounds inhibiting PGE2 activity is elected so that the percentage of activity of the target molecule is reduced to a suitable level, e.g., microglial secretion is reduced by at least 50%.

The subject compositions will generally be administered daily, in an amount to provide at least about a 10 to 80%, more preferably 20 to 70%, even more preferably 25 to 50% decrease in the A.beta.:PGE2 -induced release of cytokines. Generally, the total daily dosage will be at least about 10 mg, usually at least about 400 mg to 500 mg, preferably about 700 mg, and not more than about 1500 mg, usually not more than about 1000 mg. The amount may vary with the general health of the patient, the response of the patient to the drug, whether the PGE2 antagonist is used by itself or in combination with other drugs, and the like. Daily administrations may be one or more times, usually not more than about four times, particularly depending upon the level of drug which is administered.

Claim 1 of 11 Claims

What is claimed is:

1. An assay comprising the acts of:

providing cultured cells, the cultured cells comprising microglia cells;

contacting the cultured cells with an amyloid .beta. (A.beta.) and a prostaglandin E2 compound;

contacting the cultured cells with a test compound;

determining the effect of the test compound on the cultured cells' activation, wherein determining the effect of the compound on the cultured cells' activation is by measuring an alteration of an A.beta.: Prostaglandin E2 synergy effect of a prostaglandin E2 -mediated pathway; and comparing the alteration of an A.beta.: Prostaglandin E2 synergy effect to a measurement of the an A.beta.: Prostaglandin E2 synergy effect of a control culture, wherein the control culture is in contact with an amyloid .beta. and a prostaglandin E2 compound and not in contact with the test compound.



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