阅读说明：本技术 线粒体靶向、mptp调节以及线粒体反应物质和/或线粒体反应脂质物质的还原 (Mitochondrial targeting, MPTP modulation, and reduction of mitochondrial reactive and/or mitochondrial reactive lipid materials ) 是由 C·杜克 于 2018-12-05 设计创作，主要内容包括：本文提供与反应性脂质物质反应以形成无毒产物或活性产物的化合物。还提供了还原反应性脂质物质的方法。另外提供了在患有线粒体功能障碍的患者中治疗线粒体的方法。在其他实施例中,提供了一种化合物,其与在线粒体中存在的活化剂反应以形成抑制或增强线粒体通透性转化孔(MPTP)的开放的活性产物。在另外的实施例中,提供了抑制或增强MPTP的开放的方法。还提供了能够穿过血脑屏障(BBB)进入中枢神经系统(CNS)的非极性化合物。(Provided herein are compounds that react with reactive lipid species to form non-toxic products or active products. Methods of reducing reactive lipid species are also provided. Further provided are methods of treating mitochondria in a patient suffering from mitochondrial dysfunction. In other embodiments, a compound is provided that reacts with an activator present in mitochondria to form an active product that inhibits or enhances opening of Mitochondrial Permeability Transition Pore (MPTP). In further embodiments, methods of inhibiting or enhancing the patency of MPTP are provided. Also provided are non-polar compounds capable of crossing the Blood Brain Barrier (BBB) into the Central Nervous System (CNS).)

1. A compound that reacts with a reactive lipid species to form a non-toxic product or a compound that is an active product, wherein the compound comprises any one of the following structures:

wherein

A₁、A₂、A₃And A₄Each independently C, S, N, Si or P;

X₁、X₂、X₃and X₄Each independently O, N, S or P; and

R₁-R₁₈each independently is an electron, hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted heteroalkyl, substituted or unsubstituted cycloalkyl, substituted or unsubstituted heterocycloalkyl, substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, electron donating group (e.g., O, N, P or S), electron withdrawing group, halogen, resonant or non-resonant moiety, conjugated or non-conjugated moiety, substituted or unsubstituted arylalkyl, or substituted or unsubstituted heteroarylalkyl, wherein more than one R group is present, two R groupsMay be joined together to form a ring.

2. The compound of claim 1, having the structure:

3. the compound of claim 1, wherein the compound forms an active product upon reaction with a reactive lipid species.

4. The compound of claim 3, wherein the active product is a specific binding agent, biocide, fragrance, cosmetic, dye, antioxidant, fertilizer, nutrient, metabolite, or drug.

5. The compound of claim 3, wherein the active product is a food ingredient.

6. The compound of claim 1, wherein the non-toxic or active product comprises an alpha-hydroxyaldehyde.

7. The compound of claim 6, wherein the alpha-hydroxyaldehyde is a sugar.

8. The compound of claim 3, wherein the active product inhibits or enhances opening of Mitochondrial Permeability Transition Pore (MPTP).

9. The compound of claim 8, wherein the non-toxic or active product comprises an alpha-dicarbonyl.

10. The compound of claim 1, wherein the non-toxic or active product does not inhibit or enhance the opening of Mitochondrial Permeability Transition Pore (MPTP).

11. The compound of claim 1, wherein the reactive lipid species is in mitochondria.

12. The compound of claim 11, wherein the reactive lipid species is cardiolipin hydroperoxide or cardiolipin peroxy free radical.

13. The compound of claim 12, wherein a hydroperoxide or peroxy radical is reduced to a (-O-) radical or a non-radical moiety.

14. The compound of claim 1, wherein the non-toxic or active product has a formal charge that is neutral or negative, wherein the compound has a cationic charge.

15. The compound of claim 1, which is produced after reaction of a precursor compound with an enzyme.

16. The compound of claim 1 or 15, wherein the compound comprises a lipophilic moiety and a cationic moiety.

17. The compound of claim 1 or 15, wherein the compound comprises a lipophilic moiety and a water soluble moiety.

18. The compound of any one of claims 1-17, formulated as a pharmaceutical excipient.

19. The compound of claim 18, wherein the excipient comprises a particle.

20. The compound of claim 19, wherein the particle is a liposome or liposome-like vesicle.

21. The compound of any one of claims 1-17, comprising a dienol ether, a divinyl sulfide, a dienamine, an enol ether, a vinyl sulfide, an enamine, or a combination thereof.

22. A method of reducing a reactive lipid species, the method comprising contacting the reactive lipid species with a compound of any one of claims 1-21.

23. A method of treating mitochondria in a patient comprising mitochondrial dysfunction, the method comprising contacting the mitochondria with a compound of any one of claims 1-21.

24. The method of claim 23, wherein the product reduces cardiolipin hydroperoxide or cardiolipin peroxy radicals to (-O-) radicals or non-radical moieties.

25. The method of claim 23, wherein the active product inhibits or enhances opening of a Mitochondrial Permeability Transition Pore (MPTP).

26. The method of claim 25, wherein the non-toxic or active product comprises an alpha-dicarbonyl.

27. The method of claim 23, wherein the patient has diabetes, excessive aging, pancreatitis, heart disease, neurodegenerative disease, alzheimer's disease, parkinson's disease, huntington's disease, amyotrophic lateral sclerosis, multiple sclerosis, muscle dystrophy, or has a stroke.

28. The method of claim 23, wherein the patient has heart failure or ischemic disease, has myocardial infarction, or is at risk of ischemia-reperfusion injury.

29. A compound that reacts with an activator present in mitochondria to form an active product that inhibits or enhances opening of Mitochondrial Permeability Transition Pore (MPTP).

30. The compound of claim 29, comprising a dienol ether, a divinyl sulfide, a dienamine, an enol ether, a vinyl sulfide, an enamine, or a combination thereof.

31. The compound of claim 29, wherein the activator is a free radical, a reactive oxygen species, a reactive lipid species, another active species, or an enzyme present in mitochondria.

32. The compound of claim 29, wherein the activator is a free radical, a reactive oxygen species, a reactive lipid species, or another active species.

33. The compound of claim 29, wherein the activator is a reactive lipid that is reduced in a reaction.

34. The compound of claim 29, comprising a delocalized lipophilic cation.

35. The compound of claim 29, wherein the activator is an enzyme.

36. The compound of claim 35, wherein the enzyme is an esterase, peroxidase, monooxygenase, or lipase.

37. The compound of claim 29, wherein the active product is α -dicarbonyl.

38. The compound of claim 29, wherein the active product is glyoxal, methylglyoxal, diacetal, levulinyl, acetosyringae, benzoyl, phenylglyoxal, a-hydroxyketone, a-hydroxyaldehyde, diketone, a-ketoaldehyde and a-chloroketone, a-chloroaldehyde, p-hydroxyphenylglyoxal, or substituted phenylglyoxal.

39. The compound of claim 29, wherein the active product inhibits the opening of the MPTP.

40. The compound of claim 39, wherein the active product is PGO, Me-PGO, MeO-PGO, F-PGO, 2,4-diF-PGO, Cl-PGO, methylglyoxal, or ML-404.

41. The compound of claim 29, wherein the active product enhances the patency of the MPTP.

42. The compound of claim 41, wherein the active product is NO-PGO, OH-PGO, (O)^-)-PGO、CamOH-PGO、Cam(O^-) -PGO, lonidamine or solanine.

43. The compound of claim 29, wherein the compound comprises any one of:

wherein R is₁、R₂、R₃、R₄、R₅And R₆Each independently is an electron, hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted heteroalkyl, substituted or unsubstituted cycloalkyl, substituted or unsubstituted heterocycloalkyl, lone pair of substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, an electron donating group, halogen, substituted or unsubstituted arylalkyl, or substituted or unsubstituted heteroarylalkyl, wherein, when more than one R group is present, two R groups can be joined together to form a ring structure.

44. A method of inhibiting or enhancing the opening of MPTP, the method comprising contacting mitochondria with a compound of any one of claims 29-43 in a manner sufficient to react the compound with an activator to form an active product.

45. The method of claim 44, wherein the active product inhibits the opening of the MPTP.

46. The method of claim 45, wherein the active product is PGO, Me-PGO, MeO-PGO, F-PGO, 2,4-diF-PGO, Cl-PGO, methylglyoxal, or ML-404.

47. The method of claim 45, wherein the MPTP is part of mitochondria in a patient in need of inhibition of patency of the MPTP.

48. The method of claim 47, wherein the patient has diabetes, excessive aging, pancreatitis, heart disease, neurodegenerative disease, Alzheimer's disease, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, multiple sclerosis, muscle dystrophy, or has a stroke.

49. The method of claim 47, wherein the patient has heart failure or ischemic disease, has myocardial infarction, or is at risk of ischemia-reperfusion injury.

50. The method of claim 44, wherein the active product enhances the patency of the MPTP.

51. The method of claim 50, wherein the active product is NO-PGO, OH-PGO, (O)^-)-PGO、CamOH-PGO、Cam(O^-) -PGO, lonidamine or solanine.

52. The method of claim 50, wherein the MPTP is part of mitochondria in a patient in need of enhanced patency of MPTP.

53. The method of claim 52, wherein the patient has cancer.

54. A non-polar compound capable of crossing the Blood Brain Barrier (BBB) into the Central Nervous System (CNS), wherein said compound reacts with an activating agent in the CNS to form an active cationic product which reacts with a mitochondrial reactive lipid species and/or inhibits or enhances the opening of the Mitochondrial Permeability Transition Pore (MPTP).

55. The compound of claim 54, wherein the activator is NADH dehydrogenase.

56. The compound of claim 54, wherein the compound also passes through the skin.

57. The compound of claim 54, wherein the compound comprises any one of:

(1) Field of the invention

The present application relates generally to the targeting of mitochondria, the modulation of Mitochondrial Permeability Transition Pore (MPTP), and the reduction of mitochondrial reactive species and/or mitochondrial reactive lipid species. More particularly, the present application relates to compounds and methods for targeting mitochondria, reducing mitochondrial-reactive and/or mitochondrial-reactive lipid materials, inhibiting or enhancing MPTP patency using prodrugs and/or inactive compounds, and treating diseases with mitochondrial components using the prodrugs and/or inactive compounds.

Background

Disclosure of Invention

Provided herein are compounds that react with reactive lipid species to form a non-toxic product or an active product, wherein the compounds comprise any one of the following structures:

wherein

A₁、A₂、A₃And A₄Each independently C, S, N, Si or P;

X₁、X₂、X₃and X₄Each independently O, N, S or P; and

R₁-R₁₈each independently is an electron, hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted heteroalkyl, substituted or unsubstituted cycloalkyl, substituted or unsubstituted heterocycloalkyl, substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, electron donating group (e.g., O, N, P or S), electron withdrawing group, halogen, resonant or non-resonant moiety, conjugated or non-conjugated moiety, substituted or unsubstituted arylalkyl, or substituted or unsubstituted heteroarylalkyl, wherein there is more than one R group, and two R groups can be joined together to form a ring.

Methods of reducing reactive lipid species are also provided. The method comprises contacting a reactive lipid material with any of the above compounds.

Additionally provided is a method of treating mitochondria in a patient suffering from mitochondrial dysfunction. The method comprises contacting the mitochondria with any of the compounds described above.

In other embodiments, a compound is provided that reacts with an activator present in mitochondria to form an active product that inhibits or enhances opening of Mitochondrial Permeability Transition Pore (MPTP).

In a further embodiment, a method of inhibiting or enhancing the patency of MPTP is provided. The method comprises contacting the mitochondria with any compound immediately above in a manner sufficient to react the compound with an activator to form an active product.

Also provided is a non-polar compound capable of crossing the Blood Brain Barrier (BBB) into the Central Nervous System (CNS). In these embodiments, the compounds react with activators in the CNS to form active cationic products that react with mitochondrial reactive lipid species and/or inhibit or enhance opening of Mitochondrial Permeability Transition Pore (MPTP).

Detailed Description

As used herein, the singular forms "a", "an" and "the" are intended to include the plural forms as well, unless the context clearly indicates otherwise. In addition, use of "or" is intended to include "and/or" unless the context clearly indicates otherwise.

As used herein, "free radical, ROS [ reactive oxygen species ], or another reactive species" includes any of the following: organic peroxides, peracids, dioxygen, hypochlorite, reactive halogenated compounds, peroxy salts, alkoxides, reactive phosphorus oxides, peroxynitrite. Nitric acid, sulfuric acid, phosphoric acid, peroxycarbonate nitrite, carbonate, dinitrogen trioxide, nitrogen dioxide, hydroxide ion, dinitrogen monoxide, peroxynitrate, peroxynitrous acid, nitrite anion, nitrous acid, nitrosyl chloride, nitrosyl cation, hypochlorous acid, hydrochloric acid, lipid peroxygen, peroxynitrite, alkyl peroxide, alkyl peroxynitrite, perhydroxy group, diatomic oxygen, free electron, sulfur dioxide, radical, superoxide, hydrogen peroxide, hydroxyl group, nitric oxide, peroxynitrite, hypochlorous acid, persulfide, polysulfide, thiosulfate, organic group, peroxy group, alkoxy group, thienyl group, sulfonyl group, thienyl peroxy group, sulfur polycation, sulfide, oxo acid, oxo anion, sulfur trioxide, sulfite, pyrosulfuric acid, hydrogen peroxide, hydroxyl radical, free electron, sulfur dioxide, hydroxyl radical, hydrogen sulfide, hydrogen peroxide, peroxynitrite, sodium dithionite, oxygen halide, sulfuric acid derivative, hydrogen sulfide, sulfurous acid, active oxygen, active nitrogen, active sulfur, active phosphorus, singlet oxygen, dioxygen, triplet oxygen, ozone (including atmospheric ozone), reactive nitroxide, reactive sulfur oxide, ozonide, dioxycarbonyl cation, atomic oxygen, carbon monoxide, peroxide, organic hydroperoxide, nitrosoperoxycarbonate anion, nitrocarbonate anion, dinitrogen dioxide, nitrated nitrogen, atomic oxygen, hydroxyl anion, lipid radical, cardiolipin radical, lipid peroxy radical, lipid alkoxy radical, cardiolipin peroxy radical, cardiolipin alkoxy radical, fatty acid alkoxy radical, fatty acid peroxy radical, lipid hydroperoxide, cardiolipin hydroperoxide, fatty acid hydroperoxide, active nitrogen oxide, active nitrogen, active sulfur, active phosphorus, singlet oxygen, dioxygen, superoxide, dioxygen, hydrogen peroxide, and, Lipid peroxides, cardiolipin-lipid peroxides, and cardiolipin-cardiolipin peroxides.

As used herein, "reactive lipid species or mitochondrial reactive lipid species" includes any of the following: lipid free radical, cardiolipin free radical, lipid peroxidation free radical, lipid alkoxy free radical, cardiolipin peroxidation free radical, cardiolipin alkoxy free radical, fatty acid. Alkoxy, fatty acid peroxy radicals, lipid hydroperoxides, cardiolipin hydroperoxides, fatty acid hydroperoxides, lipid peroxides, cardiolipin lipid peroxides, and cardiolipin peroxides.

Non-limiting examples of free radicals are superoxide, hydrogen peroxide, hydroxyl radicals, perhydroxy radicals, nitric oxide, peroxynitrite, peroxy radicals, organic radicals, peroxy radicals, lipid radicals, cardiolipin alkoxy radicals, cardiolipin peroxy radicals, fatty acid peroxy radicals, cardiolipin radicals, alkoxy, mercapto, sulfonyl, and mercapto peroxy radicals; non-limiting examples of ROS are singlet oxygen, dioxygen, triplet oxygen, ozone (including atmospheric ozone), nitroxides, ozonides, dioxygen carbonyl cations, atomic oxygen, oxysulfides, ammonia, hydroxyl anions, carbon monoxide, lipid radicals, cardiolipin radicals, lipid alkoxy radicals, cardiolipin alkoxy radicals, fatty acid alkoxy radicals, cardiolipin radicals, peroxides, including (but not limited to) hydrogen peroxide, alkyl peroxides, peroxy radicals, organic hydroperoxides, peroxide ions, organic peroxides, peracids, peroxysulfuric acid, peroxymonosulfuric acid, peroxydisulfuric acid, peroxyphosphoric acid, m-chloroperoxybenzoic acid, peresters, peroxyacetic acid, peroxyanions, performic acid, nitrosoperoxycarbonate anions; a carbonate anion, dinitrogen dioxide, nitrated nitrogen, atomic oxygen, lipid peroxidation free radicals, cardiolipin peroxidation free radicals, fatty acid peroxidation free radicals, lipid hydroperoxides, cardiolipin hydroperoxides, fatty acid hydroperoxides, lipid peroxides, lipid cardioperoxides, and cardiolipin-cardiolipin peroxides.

In all compounds or products provided herein, where relevant and not otherwise specified or apparent, X, Y, Z or n is an integer from 1 to 1,000,000, and any R group is an electron, hydrogen, lone pair of substituted or unsubstituted alkyl, substituted or unsubstituted heteroalkyl, substituted or unsubstituted cycloalkyl, substituted or unsubstituted heterocycloalkyl, substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, an electron donating group (e.g., O, N, P or S), halogen, substituted or unsubstituted aralkyl, or substituted or unsubstituted heteroarylalkyl. When multiple R groups are present, two R groups may be joined together to form a ring structure. These R groups may be conjugated or non-conjugated groups, electron donating and/or electron withdrawing conjugated and/or non-conjugated groups, resonating or non-resonating groups, ionic or non-ionic, cationic, anionic, or neutral, polar or non-polar, bulky or non-bulky, or lipophilic or non-lipophilic.

Any R group may be repeated any number of times in the sequence or at different R group positions. A particularly common repeating moiety in the compounds provided herein is a vinyl ether structure.

These R groups may be conjugated or non-conjugated groups, electron donating and/or electron withdrawing conjugated and/or non-conjugated groups, reactive and/or reactive lipid sensitive, resonant or non-resonant groups, cis or trans, ionic or non-ionic groups, charged or uncharged, cationic, anionic, polar or non-polar, aromatic, non-aromatic or anti-aromatic, bulky or non-bulky, lipophilic or non-lipophilic.

The skilled person will also appreciate that any reactive moiety that reacts with radicals, ROS, or other reactive species described in PCT patent application publications WO 2016/023015, WO2017/049305, and WO2018/102463, whether as monomers or using any polymer backbone, can be modified to produce these mitochondrially targeted prodrugs and prodrugs targeted to other subcellular organelles or structures. In addition, unless otherwise indicated, any non-toxic or active product released from the compounds described herein by reaction with a reactive substance or enzyme may be any reaction product described in WO 2016/023015, WO2017/049305 or WO 2018/102463.

The compounds provided in this specification may be monomers, typically having a molecular weight of less than 1000, or oligomers or polymers, typically having a molecular weight of greater than 1000. When the prodrug is a polymer, any polymer backbone, including but not limited to any moiety that may suitably use the polymer backbone provided in WO 2016/023015, WO2017/049305 or WO 2018/102463.

The present invention is based, in part, on the following indications: mitochondrial reactive substances and reactive lipid substances may directly and indirectly affect the induction of MPTP, which may also directly and indirectly affect the levels of reactive substances and reactive lipid substances. Due to this strong link between these two entities, targeting and treating one of these groups, whether MPTP or reactive and/or reactive lipid species, will generally help to treat the other directly or indirectly.

Accordingly, the present invention provides, in part, prodrugs and/or inactive compounds that target and react with reactive species and/or reactive lipid species present in mitochondria to form activation products, such as drugs, that directly inhibit or enhance the opening of the Mitochondrial Permeability Transition Pore (MPTP); and prodrugs and/or inactive compounds that target and react with reactive species and/or reactive lipid species present in mitochondria that indirectly affect MPTP opening or closing.

Reduction reaction substance

In some embodiments, compounds are provided that react with reactive lipid species to form non-toxic products or active products. The compounds in these embodiments comprise any one of the following structures:

wherein

A₁、A₂、A₃And A₄Each independently C, S, N, Si or P;

X₁、X₂、X₃and X₄Each independently O, N, S or P; and

R₁-R₁₈each independently is an electron, hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted heteroalkyl, substituted or unsubstituted cycloalkyl, substituted or unsubstituted heterocycloalkyl, substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, electron donating group (e.g., O, N, P or S), electron withdrawing group, halogen, resonant or non-resonant moiety, conjugated or non-conjugated moiety, substituted or unsubstituted arylalkyl, or substituted or unsubstituted heteroarylalkyl, wherein there is more than one R group, and two R groups can be joined together to form a ring.

In some embodiments, the compound comprises a dienol ether, a divinyl sulfide, a dienamine, an enol ether, a vinyl sulfide, an enamine, or a combination thereof. Such compounds are generally provided in WO2018/102463, but the compounds of the invention are designed to react with reactive lipid species (such as those found in the inner mitochondrial membrane). However, these embodiments are not limited to compounds that react with reactive lipid species in mitochondria, but also include compounds that react with reactive lipid species outside of any tissue, cell, organelle, or living system.

The use of enol ethers, vinyl sulfides, enamines, dienol ethers, divinyl sulfides, and/or dienamines provides the following advantages: olefins react with all reactive species and produce specific functional groups upon reaction. Furthermore, vinyl ether groups are the first target for the reaction of reactive species compared to conventional olefins (Stadelmann-Ingrand et al, 2001). The benefits of the dienol ether, dienamine or divinyl sulfide and/or combinations are not only a single electron donating group adjacent to the olefin, but also the additional electron donating group increases the frequency at which the olefin receives electron density, thus forming a formal negative charge on one carbon in the olefin and allowing for faster reaction with reactive species and free radicals. This allows not only stable prodrugs (since enol ether functionality is already highly present throughout the body of mammals), but also very sensitive prodrugs to be activated in the presence of reactive species and free radicals, which are common component pathological conditions in many organisms. Also, by using two electron donating groups on either side of the alkene, no dicarbonyl can be produced physiologically in the mitochondrial matrix in any other way (see below).

In some embodiments, the compound forms an active product upon reaction with a reactive lipid species. Examples of such active products are specific binders, biocides, fragrances, cosmetics, dyes, antioxidants, fertilizers, nutrients, metabolites, food ingredients or pharmaceuticals, as described in WO2017/049305 and WO2018/102463, incorporated herein by reference.

In various embodiments, upon reaction with a compound, the reactive species or reactive lipid species (-O-O-) free radical or non-free radical moiety will be reduced to a (-O-) free radical or non-free radical moiety. Examples of such mechanisms are provided. Important reactive lipid species that are reduced when reacting with the compounds of the present invention include cardiolipin hydroperoxide and cardiolipin peroxy radical. Reduction of these cardiolipin-reactive species helps restore normal mitochondrial function.

It should be noted that the compounds of the invention intended to target mitochondria are cations, which are directed to negatively charged mitochondria.

In some embodiments, when the compound is reacted with a reactive substance, such as a reactive lipid substance, the non-toxic or active product comprises an alpha-hydroxyaldehyde, such as glyceraldehyde. Non-limiting examples of such compounds include:

wherein

A₁And A₂Independently C, S, N, Si or P; and

X₁is O, N, S or P; and

R₁、R₂、R₃、R₄、R₅and R₆Each independently is a lone pair of an electron, hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted heteroalkyl, substituted or unsubstituted cycloalkyl, substituted or unsubstituted heterocycloalkyl, substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, an electron donating group (e.g., O, N, P or S), an electron withdrawing group, a halogen, a resonant or non-resonant moiety, a conjugated or non-conjugated moiety, a substituted or unsubstituted aralkyl, or a substituted or unsubstituted heteroarylalkyl. When multiple R groups are present, two R groups may be joined together to form a ring structure.

In some of these embodiments, the α -hydroxyaldehyde is a sugar. Non-limiting examples of sugars that can be made in these examples include trisaccharides, tetrasaccharides, ketoses, and aldoses.

The above mechanism shows an example of a compound targeting a mitochondrial lipid-reactive substance. Cationic charge targets compounds to mitochondria. The newly formed hydroxyl groups on the cationic product are rapidly removed from the lipid bilayer. This product does not target MPTP.

The above compounds will produce vanillin and glyceraldehyde after reaction with the reactive species and will not target MPTP.

In some of these embodiments, the reactive lipid species is cardiolipin hydroperoxide or cardiolipin peroxy radical.

Mechanism of cardiolipin reduction

The upper panel shows the general mechanism by which polyunsaturated fatty acids (e.g., cardiolipin) are oxidized by free radical reactions and form peroxy or hydroperoxide fatty acids. Both of these are highly toxic to cells, particularly to cardiolipin. Hydroperoxide fatty acids are also very stable, so their accumulation in large amounts occurs on the inner mitochondrial membrane. Removal of these reactive peroxy or hydroperoxide groups from these fatty acids can restore normal mitochondrial function by generating the corresponding hydroxy fatty acids. Vinyl ethers can remove fatty acid peroxy radicals very quickly. Peroxy radicals are reactive, while hydroperoxides are stable rather than reactive. Fortunately, hydroperoxyl cardiolipin and peroxy radical cardiolipin will interconvert because their hydrogens are readily abstracted by the perhydroxyl radical formed from superoxide. Without being bound by any particular mechanism, it is believed that this is the breakdown of fatty acids in the lipid bilayer and the initiation of these free radical chain reactions, caused by the abstraction of hydrogen from the hydroperoxide lipid by the perhydroxyl group entering the lipid bilayer. Free radical chain reactions and lipid peroxidation chemistry. Although the reactions used herein do not regenerate unreacted cardiolipin molecules, they do produce alcohol forms that behave the same as the original unreacted cardiolipin molecules. Since vinyl ethers react specifically with peroxy free-radical lipids and convert them into alkoxy groups, thereby forming alcohol groups very quickly, we can remove both peroxy free-radical lipids and hydroperoxide cardiolipin molecules-as already mentioned, they are constantly reformed into peroxy free-radical lipids. Thus, the process converts harmful lipids into benign lipids by producing alcohols from these harmful lipids. Since plasmalogens (vinyl ethers) terminate free radical chain reactions, this process also terminates these chain reactions. As shown in the above figure, the compound, upon reaction with peroxy radicals, produces an active or non-toxic product which, depending on its structure, may or may not target MPTP.

The compounds have a permanent cationic charge and are designed to rapidly insert into the Inner Mitochondrial Membrane (IMM). Likewise, these compounds have a cationic group at the distal end of their lipophilic chain from the lipophilic chain. This allows the compound to insert itself into the IMM as much as possible, and possibly below the negative charge on the phospholipid bilayer. It is clear that this is what happens with the fluorescent molecule APP + of a small lipophilic cationic compound and that after depolarization of the mitochondria it remains attached to the membrane, suggesting that it may be blocked by some phospholipid moieties in the bilayer. A possible explanation for this is that the cationic groups are somehow partially captured and may be located under certain parts of the lipid, which makes them not well separated, in particular because of the presence of small lipophilic chains associated with the molecule.

The above compounds target cardiolipin hydroperoxides, cross the blood brain barrier, and are activated by enzymes once the following positively charged molecules are formed in the tissue. These advantages will be discussed in further detail below.

By reacting with the reactive substance, the above compound will produce three molecules of glyceraldehyde and vanillin. Due to its lipophilic chain length, it is primarily targeted to reactive lipids, including cardiolipin peroxide. It does not target MPTP because the α -dicarbonyl molecule is not produced here.

When reacted with reactive species, the above compounds yield tetrahydrofurfuryl esters and MPTP products that target phenylglyoxal.

These reactive species reaction compounds may also be alkynes, similar to the alkynes described in WO2018/102463, which is incorporated herein by reference. Examples of such compounds are as follows

Alkyl ether mechanism

Without being bound by any particular reaction mechanism, the above scheme illustrates a general alkyne reaction mechanism with reactive species. An alkyl ether is shown which reacts with a reactive species by free radical addition to form a hydroxyl group and a free radical. The free radicals rapidly combine with oxygen and undergo hemiacetal recombination to form dicarbonyl groups with esters. This can be further decomposed by esterase or chemical means to produce a carboxylic acid (here pyruvate) and an alcohol. Acetylenic ethers are useful compounds in these examples because they are generally free radical reactive because they have electron rich pi bonds.

The above compounds are another example of useful alkynes. Has a cationic charge, which targets the mitochondria.

The above compound is a derivative of nonyl a pyridine orange. Nonyl a-pyridine orange targets cardiolipin, especially the inner mitochondrial membrane, and serves as a specific marker for cardiolipin. Thus, the above compounds utilize their non-polar chains in the IMM lipid bilayer, and the vinyl ether groups target the peroxidized cardiolipin hydroperoxides and peroxy radicals.

The above compounds are derivatives of SS peptides, in particular SS-31. SS-31 targets cardiolipin molecules, particularly peroxidized cardiolipin molecules. SS-31 and other SS peptides help to prevent peroxidase activity of Complex III and promote oxidase activity. By adding a vinyl ether group to tryptophan or other amino acid or derivative, the chain is designed to insert into the bilayer and contribute to the reduction of superoxide and peroxy radicals of cardiolipin. Thus, the compounds have a variety of functions, including stabilizing the activity of cardiolipin-protein complex oxidases, and reducing peroxidized cardiolipin chains. This will provide specificity and allow mitochondrial targeting without the use of cations. Likewise, thiol allyl groups will form allyl thiols upon oxidation of reactive species and reactive lipid species. Allyl thiol is one of the most potent HDAC inhibitors, which is an example of another therapeutic molecule or drug we can create in this process, which can help in the treatment of multiple pathways.

The above compounds target all reactive species, including lipid reactive species. Since there is no cationic charge on the compound, it will cross the blood brain barrier and target reactive species everywhere, not just the mitochondria. Moreover, it forms vanillin, benzoic acid and glyceraldehyde as its metabolic byproducts.

Although many of the compounds thus provided have a cationic charge that targets mitochondria, similar compounds are also provided, but without a cationic charge. These neutrally charged compounds do not target mitochondria, but rather are useful for neutralizing reactive species throughout the body and are capable of crossing the blood-brain barrier. These examples are as follows. The compound immediately below reacts with the reactive species to form phenylglyoxal, which will target and inhibit MPTP; other compounds do not produce MPTP reactive compounds, but are designed only to reduce reactive species, such as hydroperoxide lipids.

In other embodiments, compounds are provided that produce an alpha-dicarbonyl group when reacted with a reactive species or a reactive lipid species. These compounds include the following structures

Wherein

A₁And A₂Independently C, S, N, Si or P; and

R₁、R₂、R₃and R₄Each is a lone pair of an electron, hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted heteroalkyl, substituted or unsubstituted cycloalkyl, substituted or unsubstituted heterocycloalkyl, substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, an electron-donor group (e.g., O, N, P or S), an electron-withdrawing group, a halogen, a resonant or non-resonant moiety, a conjugated or non-conjugated moiety, a substituted or unsubstituted aralkyl, or a substituted or unsubstituted heteroarylalkyl. When multiple R groups are present, two R groups may be joined together to form a ring structure.

Since many α -dicarbonyl compounds bind to arginine residues on MPTP and inhibit or enhance MPTP opening, these compounds are particularly useful for affecting MPTP opening. Please refer to the discussion below.

Also provided herein are methods of reducing reactive lipid species. The method comprises contacting a reactive lipid material with any of the compounds described above.

In some embodiments of these methods, the compound reduces a cardiolipin hydroperoxide or cardiolipin peroxy radical to a (-O-) radical or a non-radical moiety. In other embodiments, the active product inhibits or enhances the opening of Mitochondrial Permeability Transition Pore (MPTP). In some of those embodiments, the non-toxic or active product comprises an alpha-dicarbonyl group.

Targeting Mitochondrial Permeability Transition Pore (MPTP)

Also provided herein are compounds that react with activators present in mitochondria to form activation products that inhibit or enhance opening of Mitochondrial Permeable Transition Pore (MPTP).

Most activated compounds that inhibit or enhance MPTP opening, including α -oxo aldehydes and α -oxo ketones, and aldehydes and ketones in general, cannot be prepared by existing prodrug technologies, which are more limited to targeting enzymes and undergoing traditional enzymatic reactions such as cleavage of peptides, esters, etc. to produce alcohols, carboxylic acids, amines, amides, thiols, etc. Using prodrug technology, these activated molecules can be generated directly inside the mitochondrial matrix, e.g., inside the matrix at the inner mitochondrial membrane surface-at the same location as MPTP-can reduce non-targeted effects, e.g., the health of the mitochondria can change rapidly with toxicity or side effects.

MPTP is an extremely important target for the treatment of disease, since once opened it enables Ca⁺²Rapidly fluctuating inside and outside the mitochondrial matrix. This results in a change in the concentration gradient, depolarization of the mitochondrial membrane potential, a decrease in energy production, mitochondrial swelling, and release of apoptotic proteins (e.g., cytochrome c) into the remaining cells, thereby triggering necrosis or apoptosis. Also, MPTP is not present in all cells, but is formed in the mitochondrial inner membrane resulting from trauma or disease. Increased ROS levels result in Ca⁺²Flow into the mitochondrial matrix, thereby causing the MPTP to electrically remove its componentsFormation of pressure-dependent anion channels (VDAC), Adenine Nucleotide Transporters (ANT), cyclophilins d (cypd), and other molecules (Rao et al, 2014). After binding to MPTP, methylglyoxal was shown not only to close the MPTP channel, but also to show no other negative side effects in the cells (Speer et al, 2003), suggesting that the compounds provided herein may provide patients with effective therapeutic mechanisms targeting a variety of acute and chronic pathological diseases and disorders without the deleterious side effects caused by non-specific and reactive drugs.

In some embodiments, the inactive compound comprises a dialkenol ether, divinyl sulfide, a diene amine, an enol ether, a vinyl sulfide, an enamine, or a combination thereof. These moieties react with various activators such as free radicals, ROS, and other reactive species to form activated compounds, as described in WO 2016/023015, WO2017/049305, and WO 2018/102463.

The effectiveness of a prodrug can be increased by having more than one reactive moiety on the compound, such as a dienol ether, divinyl sulfide, or dienamine. In addition, more than one therapeutically active product, i.e. the same product or different products, may be released by reaction with the active agent. In some embodiments, this is achieved by a polymeric prodrug comprising a plurality of units that are activated by cleaving each unit from the polymer. See, for example, polymers and polyfunctional compounds in WO 2016/023015, WO2017/049305 and WO 2018/102463.

A benefit of using an enol ether as the reactive moiety is that enol ethers are already common functional groups present in many mammalian (including human) tissues. These groups are located on plasmalogens, which are phospholipids found at high concentrations in the nervous, immune and cardiovascular systems of mammals (Braverman and Moser, 2012). The prodrug compounds provided herein are only reactive towards high energy reactive chemicals, such as hydroxyl radicals, hydrogen peroxide and superoxide.

The reactivity of the prodrug compound thus provided can be modified by adding another electron donating group to the other side of the enol ether or derivative thereof, increasing the electron density assignment to the reactive alkenyl group, making it more sensitive to reactive species. Other ways of altering the reactivity of compounds are provided in WO2017/049305 and WO2018/102463, which are incorporated herein by reference.

For example, by forming dienol ethers and derivatives thereof into cyclic structures, such as heterocyclic 5-membered rings, in which one carbon atom is attached to two oxygen atoms on the other side, the reactivity towards ROS can be greatly increased after the initial ROS attack. This is because electron transfer from each bond will form a ring, resulting in the formation of another by-product. Formaldehyde can be formed as one of the by-products and adds significant value by this technique, since the intramitochondrial matrix antioxidant glutathione attacks aldehydes (e.g. formaldehyde) as well as dicarbonyl groups. The formation of another aldehyde by-product competes with the prodrug dicarbonyl for binding to glutathione. By creating competitive inhibitors, the half-life of our activated product can be extended, allowing more time to bind to MPTP. The formation of excess aldehydes and ketones may reduce the therapeutic dose of the prodrug by half, thereby potentially significantly increasing safety and non-toxicity.

The reactivity of the compounds provided herein with reactive species can be altered by adding or removing binding. For example, the structures above and to the left have conjugated aromatic compounds. This is extremely stable to free radicals and the higher the stability of the free radical structurally, the faster it occurs after the initial radical reaction. Thus, the addition of an aromatic compound conjugated to a divinyl ether increases the sensitivity of the prodrug to reactive sensitive olefins. Although there are many olefins on the benzene ring, it is an aromatic compound, and thus the radical will not be bonded to an oxygen atom. The only carbon oxidized is carbon that is part of the reactivity-sensitive olefin attached to the oxygen atom.

On the right side, glyoxal can be formed where no other functional groups are attached. This may reduce the sensitivity somewhat, but if a particular reactive species is to be targeted, this is required.

Note that the above two compounds do not have alpha-hydrogen atoms on adjacent carbons. Free radicals attack the alpha hydrogens next to the olefins because resonance results in low bond dissociation energy at these carbons. By removing them, pure compounds are formed upon attack by the reaction mass, where the only reactions that occur are epoxidation and free radical addition of the olefin, rather than hydrogen abstraction reactions that may cause other byproducts.

In various embodiments, the activator is a free radical, a reactive oxygen species, a reactive lipid species, another active species, or an enzyme present in the mitochondria.

In many of these embodiments, and as further detailed in WO2017/049305 and WO2018/102463, the activator is a free radical, a reactive oxygen species, a reactive lipid species, or another active species. These reactive species will be reduced in the reaction.

In other embodiments, the activator is electromagnetic radiation, wherein the prodrug has a light absorbing group (e.g., a dye) that modifies the prodrug upon stimulation with light of a particular wavelength to form or produce an MPTP modifying active agent. React with enzymes, free radicals, ROS, reactive lipid species, or other reactive species to form modified prodrugs of MPTP-modified active agents. For a further detailed description of these examples, see WO 2018/102463.

In further embodiments, the activator is an enzyme, used with other prodrugs. Non-limiting examples of enzymes that may be used are carboxylesterase, acetylcholinesterase, esterase, butyrylcholinesterase, paraoxonase, matrix metalloproteinase, alkaline phosphatase, beta-glucuronidase, human valerian cyclase, hydrolase, plasmin, protease, prostate specific antigen, purine nucleoside phosphorylase, carboxypeptidase, penicillin amidase, beta-lactamase, beta-galactosidase, cytosine deaminase, serine hydrolase, cholinesterase, phosphorylase, acetaldehyde dehydrogenase, aldoxygenase, amino acid oxidase, P450 reductase, DT-xanthotransferase, thymidine phosphorylase, deoxycytidine kinase, lyase, thymidylate synthase, tyrosinase, methionine-lyase, cytosine deaminase, beta-lactamase, penicillin amidase, tyrosinase, tyrosine, methionine-lyase, cytosine deaminase, beta-lactamase, penicillin amidase, Carboxypeptidase, beta-glucuronidase, thymidine kinase and nitrosoreductase. In some embodiments, the enzyme is an oxidoreductase, such as an aldehyde oxidase, an amino acid oxidase, a cytochrome P450 reductase, DT-diaphorase, cytochrome P450, or tyrosinase; class 2 transferases, such as thymidylate synthase, thymidine phosphorylase, glutathione S-transferase or deoxycytidine kinase; or class 3 hydrolases, such as carboxylesterase, alkaline phosphatase, or β -glucuronidase. ADEPT, VDEPT or GDEPT methods may also be used (Rooseboom et al, 2004).

A potential benefit of this approach is that certain enzymes, proteins, bioactivators may be elevated or lowered between diseased and healthy cells or between different types of cells, often allowing us to have a higher specificity for the target site. For example, in Alzheimer's patients, the activity of acetylcholinesterase in the brain is greatly reduced (Garcia-Ayll on 2011). Thus, it would be unlikely that a prodrug provided activation by acetylcholinesterase would target cells in the brain. Also, the situation may be the same for different regions of the body and cells that may experience higher or lower reactivity, or the same type of approach may be used to target different locations.

Prodrugs can be activated in other ways by using enzymatic or hydrolytic methods. These cleavable groups may include, but are not limited to, esters, amides, thioesters, formyl, thiocarbonyl, and formamide. Cleavable bonds that can be cleaved can include, but are not limited to, C-N, O-C, S-C and P-C.

The lower panel shows the reaction mechanism of two compounds activated by the enzyme.

Mechanism 1

Mechanism 2

Mechanism 1 has enzymatic esterase cleavage, which will rapidly form aldehyde groups, which will cause resonance movement of electrons to form phenylglyoxal compounds. Mechanism 2 has two ester groups that can be cleaved by esterase to form an MPTP targeting group, in this case phenylglyoxal.

After cleavage by esterase, the above activation product forms p-hydroxyphenylglyoxal, which irreversibly activates MPTP. The prodrugs are intended to cross the blood brain barrier to treat tumors.

The above provides another prodrug structure that is designed to cross the blood brain barrier but upon activation and further esterase cleavage forms the MPTP activating molecule 3-hydroxyglyoxal.

In various embodiments, in addition to activating the active product of MPTP, the prodrug, when activated, forms another useful product, such as another therapeutic molecule. For example, a prodrug may be administered any drug now known or later discovered and which simultaneously activates and inhibits MPTP. This would allow for the simultaneous activation of one or more therapeutic pathways to achieve better treatment and a broader range of treatments, as well as a more robust therapeutic pathway. Additional one or more activated compounds may, but are not limited to, increased penetration, increased accumulation at desired cellular, subcellular, and human locations, increased efficacy through one or more therapeutic pathways, and/or other means. An example of this is how to usefully produce prodrugs of dopamine which, due to its high polarity, is unable to cross the blood brain barrier by itself. The prodrug can mask hydroxyl hydrogens and cross the blood brain barrier once and form hydrogen within the mitochondria. This may allow for better efficacy of both our compounds and other drugs that would benefit each other in terms of delivery to therapeutic activity. Examples of drugs that may be products of any of the compounds provided herein are provided in WO2017/049305, pages 26-42, which is incorporated herein by reference.

The active product of these examples can be any compound that inhibits or enhances the opening of MPTP. Examples of such products include Eriksson et al, 1998; speer et al, 2003; johans et al, 2005; linder et al, 2001; sileikyte et al, 2015; bhutia et al, 2016; sun et al, 2014. Thus, in some embodiments, the activation product is an α -dicarbonyl group, e.g., as described in Eriksson et al, 1998; speer et al, 2003; johans et al, 2005; and Linder et al, 2001. These specific aldehyde and ketone α -dicarbonyl products specifically target the mitochondrial pore on the stroma side and bind specific arginine residues through covalent or non-covalent interactions, depending on the activated compound. Non-limiting examples of these alpha-dicarbonyl groups are glyoxal, methylglyoxal, diacetals, levulinyl, acetosyringyl, benzoyl, phenylglyoxal, alpha-hydroxyketones, alpha-hydroxyaldehydes, diketones, alpha-ketoaldehydes and alpha-chloroketones, alpha-chloroaldehydes, p-hydroxyphenylglyoxal or substituted phenylglyoxal as described below, and similar compounds, any of which may be used as the product of the composition of the invention.

An example of an alpha-dicarbonyl group particularly useful in these embodiments is methylglyoxal. Incubation of methylglyoxal with isolated mitochondria showed complete inhibition of permeability transition by covalent binding to MPTP (Speer et al, 2003). Glyoxal also exhibits covalent bonding. The methylglyoxal reaction rapidly suppresses the osmotic transition that occurs within 5 minutes. Since no other mitochondrial function is interfered with by this process, the open binding and inhibition of MPTP is very selective and specific. The reaction is reversible, with the transition pore returning to its original state over time (Speer et al, 2003).

The compounds of these embodiments can be designed to target MPTP without targeting lipid peroxidation. This is achieved by designing compounds that are water soluble or have bulky groups that will not allow efficient insertion into the lipid bilayer. Thus, the only reactions that will occur will be the polar medium of the mitochondria or other locations in the cell. The following are two examples of these molecular types.

The left molecule has bulky triphenylphosphonium groups and small chains, preventing its insertion into the lipid bilayer. The reaction product of this compound with the reactive material is glyoxal, which inhibits the opening of MPTP. The right compound is very soluble in water and, after reacting with the reactive substance, produces a highly polar α -dicarbonyl that activates MPTP, resulting in mitochondrial dysfunction, which is a potential cancer treatment.

The underlying molecule already has a permanent cationic charge so it does not cross the skin or BBB. Due to its polar hydroxyl groups, it will associate mainly in the mitochondrial matrix and form MPTP open 4-hydroxyphenylglyoxal groups after the reactive species react.

Mitochondrial delivery vectors

Delivery of the active product may result from a prodrug compound, wherein the active product is attached to a naturally occurring molecule or analog thereof that is safe, naturally metabolized, and/or delivered to a specific site in the body. Riboflavin is an example, where it crosses the blood-brain barrier across the pores and enters the mitochondrial matrix. The use of a prodrug comprising riboflavin or other energy production related molecule which is released when the inactive compound reacts with the activator, can target those areas in vivo and in cells, thus providing more specificity to our targeting method.

Mitochondrial-specific targeting methods can also be used (Frantz and Wipf, 2010; Eirin et al, 2017), including use with particles (Wong rakpanich et al, 2014).

In some embodiments, a delocalized lipophilic cation, such as a triphenylphosh moiety, is utilized on the compound to aid in delivery of the compound to the mitochondrial matrix (Murphy 2008). Due to the hyperpolarized mitochondrial membrane potential, these cations are attracted to the negative charges found in the matrix, while their lipophilicity allows them to pass through the membrane. Using this method, large doses of these cations can accumulate at targeted locations within the mitochondrial matrix. In addition, many diseases have increased hyperpolarized mitochondrial membrane potential, for example in cancer cells and cancer stem cells. Using this approach, the mitochondrial matrix targets diseased and cancer cells more targeted than normal cells for more specific and effective treatment with fewer side effects (Wong et al, 1995; Ye et al, 2011).

Furthermore, these delocalized lipophilic cations are located on the matrix side of the lipophilic mitochondrial inner membrane, identical to the target arginine residue binding site on MPTP. This can be demonstrated by antioxidant molecules such as mitochondrial quinones and their derivatives, which not only accumulate in mitochondria in large quantities, but also adsorb on the surface (substrate side) of the inner mitochondrial membrane with its lipophilic tail embedded in the bilayer (Sheu et al, 2006). By using delocalised lipophilic cations, it is possible to target diseased cells and deliver the prodrug and its corresponding activation product directly to the site of MPTP (Ross et al, 2006; Severina et al, 2007).

In addition, over time, the delocalized lipophilic cations are secreted from the cells and excreted from the body, and thus, permanent depolarization of the cells or accumulation of these therapeutic agents in the body over time after treatment with the delocalized lipophilic cations is a minimal problem. Indeed, when one test group was administered one year a day with a blood-brain barrier permeable delocalised lipophilic cation, no signs of toxicity were shown throughout the test or thereafter (Ross et al, 2006; Severina et al, 2007; Snow 2010).

Specific examples of mitochondrial targeting compounds include the following compounds which are delocalized lipophilic cations. The two molecules on the right can form two activated therapeutic molecules immediately after ROS attack.

Specific examples of mitochondrial targeting compounds include the following molecules that change from positive to negative or neutral charge upon reaction with ROS in the mitochondrial matrix:

following the ROS reaction, the following molecules change from a neutral charge to a negative charge. Because they are neutral, they do not specifically target the mitochondrial matrix, but rather can cross the membrane and reach many different locations in the cell and blood.

The following molecules are attached to drug delivery vehicles, including riboflavin, FMN, and FAD analogs, which have reactive substance sensitive groups attached and will cross the membrane and blood-brain barrier. Riboflavin, FMN and FAD are used for oxidative phosphorylation in the mitochondrial matrix, thereby targeting these molecules for energy production.

Specific examples of mitochondrial targeting compounds include molecules with structures similar to known mitochondrial inner membrane targeting/adsorbing molecular mitochondrial quinones. The binding of our prodrug to the mitochondrial inner membrane should be similar to that of mifenone. One structure is an open-celled prodrug because it forms a soluble α -dicarbonyl moiety upon reaction of the reactant species, while the other structure is a closed-celled prodrug because it forms a lipophilic and highly non-polar activator upon reaction of the reactant species.

The following molecules are exemplary of the simultaneous production of an alpha-dicarbonyl activator and another drug. In this case, dopamine is incorporated into the molecule and is released upon reaction of the molecule with the reactive substance. Dopamine is not able to cross the blood brain barrier and so this is an example of our technique to help other molecules pass across the blood brain barrier, which would not otherwise be the case. After crossing the blood brain barrier, the prodrug will be activated in the mitochondria, which will lead to α -dicarbonyl MPTP modulators as well as dopamine as neurotransmitter.

The following molecules are examples of generally cyclic prodrugs that may be used in the compounds of the present invention to target MPTP and/or reactive species.

Examples of cyclic prodrugs

Additional compounds are provided above which upon reaction with a reactive material produce an MPTP inhibitor.

By reaction with the reactive species, the above compounds yield products that are MPTP activators.

The above compounds are designed to form nitrogen gas upon reaction with the reactive species, while the nitrogen atoms in the unreacted compound provide electron density to the olefin, thereby making the compound more reactive.

The above compounds enter the inner mitochondrial membrane and react with reactive species (e.g., reactive lipid species such as cardiolipin hydroperoxide or cardiolipin peroxy free radical) to generate MPTP binding molecules, while reducing the lipid peroxy groups. The leftmost compound produces glyoxal and ethanol; the second compound produces phenylglyoxal; the third compound is glyoxal. Note that a comparison of the first and third structures, both producing the same MPTP group, but with a third compound cyclic structure, therefore no other molecules are produced in the reaction, while the first produces ethanol.

Upon reaction with the reactive species, the above structure produces phenylglyoxal, benzoic acid, and glycerol. This compound has a longer chain than the other compounds, which makes it possible to further reduce hydroperoxide and peroxylipid radicals.

Upon reaction with the reactive species, the above compounds produce phenethyl alcohol, benzoic acid and glyceraldehyde.

In all of these aspects, although they are designed to remove lipid peroxidation groups, they can also react with free-flowing reactive species (e.g. perhydroxyl) which is also important because they initiate lipid peroxidation free radical reactions. Thus, these compounds are designed to target and terminate initiation and propagation steps during radical chain reactions, as are acetal vinyl ether groups.

Mechanism for controlling a motor

Without being bound by any particular mechanism, it is believed that the mechanisms of the embodiments described herein are described below.

Hole-targeting prodrug mechanism

The following mechanisms are examples of biologically and/or enzymatically cleavable prodrugs which are then activated to form MPTP targeted α dicarbonyl therapeutic agents. This mechanism has resonance, causing displacement of other acetyl groups that combine with hydrolysis reactions to produce the desired α -dicarbonyl activated therapeutic agent.

Enzymatic activation of alpha-dicarbonyl

Mechanism 1

Mechanism 2

5-membered heterocyclic ROS activation pathway

Mechanism 3

The above mechanism of the compounds of the invention shows mitochondrial targeting, particularly to specific hydroxyls, superoxides, hydrogen peroxide and other reactive species in the inner mitochondrial membrane or elsewhere. These figures provide a dienol ether at the top, a cyclic dienol ether at the bottom, and another cyclic structure with two sets of dienol ethers. The oxygen atom on the dienol ether may be substituted with N, S or P or a combination thereof. Dienol ethers may be used to form the alpha-dicarbonyl group.

Acyclic mechanism 1 forms an alcohol. In the cyclic mechanism of mechanism 2, the hydrolysis reaction will cause a rapid change in electron density, thereby forming another formaldehyde by-product, formaldehyde. Mechanism 3 shows that two activated dicarbonyl groups are generated by reaction of one reactive species, followed by hydrolysis.

Other mechanisms of reactive species

The top panel shows epoxide formation with cyclic structures, yielding carbon dioxide or molecules such as carbonyl sulfide and α -dicarbonyl and carbonyl sulfide derivatives, which are used to alter the reactivity, stability and efficacy of specific amino acid targeting compounds (e.g., lysine residues). The compounds can be designed to use a hydrogen abstraction mechanism pathway in which the reactive species cause a resonance reaction that produces alpha-dicarbonyl formation. An example is shown above. The hydrogen is placed directly on the enol ether group, or as part of an aromatic group, where the resonance cascade to the enol ether or derivative forms the corresponding glyoxal derivative.

Examples of mitochondrial Charge targeting mechanisms

The top mechanism above shows a dienol ether, such as a dienamine or divinyl sulfide, or combinations thereof, which reacts with the reactive species to produce phosphate, methylglyoxal and alcohol. The most abundant reactive species in the mitochondrial matrix are superoxide, hydrogen peroxide and hydroxyl radicals.

The bottom mechanism shows an enol ether, which may be substituted with an enamine or vinyl sulfide. When a reactive species or radical reaction occurs, it forms phosphate and alpha-hydroxyaldehyde.

In these examples, the phosphorus +1 cationic charge becomes a (-3) anionic phosphate charge after the reactive species or radical reaction. Thus, this prodrug technology can break down the positive charge after delivery of the prodrug to the interior of the mitochondrial matrix. After reaction, they can form safe and non-toxic molecules (e.g., phosphates) or therapeutic compounds (e.g., thiophosphates) for cancer therapy. The decomposition of the cationic charge into negative charge prevents the accumulation of cations in the matrix, thereby affecting the polarization of the membrane. It can also increase the accumulation of anionic charge and restore polarization. The production of beneficial phosphates, sulfates and nitrates may also help the cells benefit. Nitrite is oxidized to nitrate and then undergoes further chemical reactions to produce nitric oxide, an important molecule of body function. Neutral charges can also be converted to negative charges.

Pharmaceutical use

Numerous diseases involving mitochondrial dysfunction are characterized by high levels of ROS production, low levels of antioxidants, increased Ca⁺²Influx and reduced ATP production levels: (And Bertram, 2015). Diseases of mitochondrial dysfunction include neurodegenerative diseases and stroke (Prentice et al 2015), pancreatitis (Maleth and Higyi 2016), ischemia (Motloch et al 2015), ischemia reperfusion injury (Javadov et al 2017), and pancreatic cancer (Sun et al 2014) as well as many other cancers (Ponnalag and Singh 2017). Indeed, mitochondrial dysfunction is associated with aging (Wagner and Payne, 2011; Rottenberg and Hoek, 2017). Treatment of these diseases with any of the above compounds advantageously reduces mitochondrial dysfunction.

Accordingly, also provided herein is a method of treating mitochondria in a patient comprising mitochondrial dysfunction. The method comprises contacting the mitochondria with any of the compounds identified above. In some embodiments, the patient has diabetes, excessive aging, pancreatitis, heart disease, neurodegenerative disease, alzheimer's disease, parkinson's disease, huntington's disease, amyotrophic lateral sclerosis, multiple sclerosis, muscular dystrophy, or has a stroke. In some of these embodiments, the patient has heart failure or an ischemic disease, has a myocardial infarction, or is at risk of ischemia-reperfusion injury.

More generally, since optimizing mitochondrial health is beneficial for treating any disease, in these examples, the patient suffers from any of the following diseases: hemophilia, hepatitis a, AAA (abdominal aortic aneurysm), AAT (Alpha 1 antitrypsin deficiency), AATD (Alpha 1) antitrypsin deficiency), abdominal adhesions (scar tissue), abdominal aortic aneurysm, abdominal colic (hot spasm), abdominal Hernia (Hernia), abdominal migraine, abdominal pain, abnormal double rhythm, arrhythmia, abnormal vaginal bleeding of arrhythmia (vaginal bleeding), abscess, skin (sore), menstruation (amenorrhea), somnolence, fluid accumulation (ascites), acetaminophen liver damage (tenor liver damage), aphtha, soreness, osteomalacia, chondrodynoplasia, acid reflux (GERD), acid reflux, cyst (sore), acne rosacea (rosacea), acne scars (scars), acne, acquired brain injury and age D, acquired bronchiectasis (bronchodilation, acquired, or recurrent bleeding), abdominal adhesion (scar tissue), abdominal cavity adhesion (abdominal scar tissue), abdominal aortic aneurysm, abdominal pain, abnormal double rhythm, abdominal pain, abnormal rhythm, arrhythmia, abdominal pain, abnormal vaginal bleeding (vaginal bleeding), abscess, skin (sore), menstrual period (amenorrhea), somnolenia, fluid accumulation (ascites), abdominal fluid accumulation (ascites), congenital)), acquired aphasia epilepticus (Landau-Kleffner syndrome), acquired Hydrocephalus (Hydrocephalus), acquired immunodeficiency syndrome (AIDS), high head malformations (skincos) dependent on ACTH, ACTH independent hypercortisolism (cushing's syndrome), actinic keratosis, acoustic neuroma (vertigo), acute and chronic bursitis, acute bacterial prostatitis (prostatitis)), acute compartment syndrome (compartment syndrome and acute disease), acute myelogenous leukemia, acute hepatitis b (hepatitis b), acute intermittent porphyria (porphyria), acute renal failure (renal failure), acute lung injury (ARDS), acute lymphocytic leukemia (leukemia), acute myelogenous leukemia, acute pancreatitis (pancreatitis), acute porphyria (porphyria), Acute Respiratory Distress Syndrome (ARDS), acute valley fever (valley fever), Ad14 (killer cold) virus (adenovirus infection, Ad14), additive (childhood hyperkinetic syndrome), addiction, addict anemia (pernicious anemia), addison's disease, adenocarcinoma, adenomatous polyposis coli (gardner's syndrome), adenosis (uterine fibroids), adenosis, adenovirus infection, ADHD, adrenal cancer, adrenal tumor (pheochromocytoma), adrenal insufficiency (addison's disease), adrenal pheochromocytoma (pheochromocytoma), adrenal cortical cancer, adult acne (roses), adult diabetes, adult tills disease (adult tills disease), ganglioneuropathy (megacolon disease), age-related macular degeneration (macular degeneration), taste loss (dysgeusia), Absence, face (facial blindness (agnosia)), phobia, agranulocytosis (neutropenia), aphasia, aids, motion sickness (seasickness, car sickness)), AKU (alkalopathy), ALAD porphyria (porphyria), albinism (birthmarks and other skin pigmentation disorders), black urine disease (black uricuria), alcohol abuse and intoxication, exotic hand syndrome, ALK (keratoplasty eye surgery (ALK)), black uricemia, allen-herden-darby syndrome, allergic conjunctivitis (pink eye), allergic granuloma and vasculitis (allergic granulomatosis), allergic purpura (anaphylactoid purpura), anaphylaxis (allergy), allergic rhinitis (fever), allergy, eczema (atopic dermatitis), allergy, anaphylaxis, hypoimmunity, hypo, Eye (ocular allergy), allergy, food (food allergy), allergy, insect (insect allergy), allergy, latex (latex allergy), allergy, plant contact (poison ivy, oak and soybean), alopecia, Alpha 1 antitrypsin deficiency, thalassemia, Alpha-1 protease inhibitor (Alpha 1 antitrypsin deficiency), Alpha-1 associated emphysema (Alpha 1 antitrypsin deficiency), Alpha-galactosidase deficiency (fabry disease), Alport syndrome, ALS (amyotrophic lateral sclerosis), alveolar osteomyelitis (fossa alveoli) alveolar cancer (oral cancer), a alzheimer's disease, AMA (mitochondrial antibodies), black hair disease, amblyopia, amenorrhea, trypanosomiasis (chagas disease), AML (leukemia), aminodermatitis (diaper rash), ammonia rash (diaper rash), amnesia, AML Amnitis, amnitis sclerosis, total sky (antinuclear antibodies), anal cancer, anal fissure, allergic purpura (anaphylactoid purpura), anaphylaxis, anaplastic astrocytoma (brain cancer), anaplastic cancer (thyroid cancer), anemia, anencephaly, anesthesia-related hyperthermia (malignancy), aneurysm, angman syndrome, vasculitis (vasculitis), angina pectoris symptoms, angioedema (hive), cardiac angiography (coronary angiography), vascular hypertrophy syndrome (cremophor syndrome), angioplasty (coronary angioplasty), angiosarcoma, ankylosing spondylitis, anorexia neuropathy (anorexia), hypoxic encephalopathy (encephalopathy), goose muscle bursitis (knee bursitis), anterior ear slippage (spondylolisthesis), anthrax, antibiotics, antibiotic-induced colitis (antibiotic-related enteritis), Antibiotic-resistant tuberculosis (extensively drug-resistant tuberculosis) drug-resistant tuberculosis XDR-TB (extensively drug-resistant tuberculosis (XDR TB)), anticardiolipin antibodies (antiphospholipid syndrome), anti-CCP (citrulline antibody), antiemetics, anti-nausea (antiemetics), antinuclear antibodies, antiphospholipid syndrome personality disorders, antitrypsin (Alpha 1 antitrypsin deficiency), antiemetics (antiemetics), antoni paralysis (facial nerve problem), Antro-duoden motor studies, anxiety disorders, aortic dissection, aortic valve replacement (heart valve disease treatment), aortic stenosis, APC (gardner syndrome), APD (child auditory processing disorder), Apgar score, aphasia with tic disorders (raoke syndrome), aphasia, aphtha, ulcers (airway ulcers), apnea, sleep (sleep apnea), Nonarthrophoritis (severe condition) of calcaneus, appendectomy, appendicitis, appendiceal cancer, disuse, forebrain (anencephalia), arachnoiditis, ARDS, areola (breast anatomy), arm spasm (muscle spasm), arnold-yuya malformation, arrest, heart (sudden heart death), arrhythmia (arrhythmia), ART (infertility), arteriosclerosis (heart disease (coronary artery disease)), arteriovenous malformation, arteritis (vasculitis), arterial, carotid artery disease (carotid artery disease), arthralgia (arthritis), childhood arthritis (juvenile arthritis), arthritis, ankylosing spondylitis, arthritis, degeneration (osteoarthritis), arthritis, infection of us (septic arthritis), arthritis, juvenile (juvenile arthritis), arthritis, lyme (lyme disease), Arthritis, MCTD (mixed connective tissue disease), arthritis, vegetative (vegetative synovitis), arthritis, pseudogout (pseudogout), arthritis, psoriasis (psoriatic arthritis), arthritis, querery (querery arthritis), arthritis, reactive (reactive arthritis), arthritis, rett's disease (reactive arthritis), arthritis, rheumatoid (rheumatoid arthritis), arthritis, sarcoid (sarcoidosis), arthritic scleroderma, arthritis, sjogren's syndrome (sjogren's syndrome), arthritis, SLE (systemic lupus), arthritis, steles ' disease (steles disease), arthrocentesis (joint puncture), arthroscope, artificial kidney (hemodialysis), AS (siberger syndrome), asbestosis (asbestos-related disease), asbestos-related disease, aortic dissection (aortic dissection), joint puncture, artificial kidney (hemodialysis), AS (siberger's syndrome), asbestosis (asbestos-related disease), asbestos-related disease, ascending aortic dissection (aortic dissection), Ascites, aseptic necrosis, physical cognition disability, ASPA deficiency (canavan disease), ASPD (antisocial personality disorder), asperger's disease (asperger syndrome), aspiration, articulation (combined aspiration), assisted reproductive technology (infertility), asthma, astrocytoma (brain tumor), asymptomatic inflammatory prostatitis (prostatitis)), ataxia, atherosclerosis (peripheral vascular disease) preventing atherosclerosis (preventing heart attacks and atherosclerosis), atherosclerotic renal vascular disease (renal stenosis), tinea pedis, generalized seizures (seizures), atopic dermatitis, ATR-16 syndrome, atrial fibrillation (atrial fibrillation) arrhythmia, atrial tachycardia, paroxysmal supraventricular tachycardia (PSVT)), atrial reentry tachycardia (pre-excitation syndrome), Atrophy, vagina (vaginal dryness and atrophy), attention deficit Hyperactivity Disorder (HD) disease, ear canal hematoma (hematoma), Autistic Spectrum Disorder (ASD), autism, autoimmune cholangiopathy (primary biliary cirrhosis (PBC)), autoimmune disease, autoimmune thrombocytopenic purpura (ITP)), autoimmune thyroid disease (hashimoto's thyroiditis), autoimmune thyroiditis (hashimoto's thyroiditis), autopilot behavior (allergic lethargy), autonomic neuropathy, autonomic thyroid nodule (thyroid nodule), autosomal dominant PKD (polycystic kidney), autosomal recessive PKD (polycystic kidney), avascular necrosis (aseptic necrosis), avian influenza (avian flu), AVM (arteriovenous malformation), axillary hyperhidrosis (hyperhidrosis), Hemophilia B (hemophilia), infantile melancholia (postpartum depression), bacterial arthritis (septic arthritis), bacterial endocarditis (endocarditis), bacterial gastroenteritis (gastro-enteritis)), bacterial infection, bacterial pleuritis, halitosis, harmful cholesterol, beck cysts, balance (vestibular balance disorder), alopecia (alopecia), cardiac balloon angioplasty (coronary angioplasty), balloon endoscopy (balloon endoscopy), balloon mitral valve prolapse, balloon valvuloplasty (heart valve disease treatment), hairdresser's itch (tinea), barium enema, Barlow syndrome (mitral valve) valve prolapse, Barrett's esophagus (Barrett's esophagus), Barrett's body infection (scratch disease), basal cell carcinoma (skin cancer), Barter's syndrome (concussion), B-cell lymphoma (non-hodgkin's lymphoma), BDD (allotype) disease, bee and wasp St injury, behavioral disorders (mental health (psychology)), beset's syndrome (beset's syndrome), beset's syndrome, bell's palsy (facial nerve problem), bell's palsy, benign prostatic hyperplasia, bernard suria disease, berry, beta thalassemia, beta globinopathies methemoglobinemia (methemoglobinemia), boyle's syndrome (williams syndrome), BH4 deficiency (tetrahydrobiopterin deficiency), cholangiocarcinoma (cholangiocellular carcinoma of the bile duct), biliary cirrhosis, primary (primary biliary cirrhosis (PBC)), biliary colic (gall bladder pain), biliary drainage (duodenal biliary tract drainage), mitral valve rolling (mitral valve prolapse), biliary tree death, and bee death, bee and wasp St, behavioral disorders (mental health, psychology), mental health (psychology), Behcet's syndrome, Behcet al's syndrome, Behc, Bexas disease, biotherapy, treatment of biological valve (heart valve) disease), Bi-PAP (sleep apnea), bipolar disorder, birth defects, birthmarks and other skin pigmentation problems, bites, snake (snake bite), black death (plague), black eye circles, blacktongue (tongue disease), blackhead acne (acne), blackout (desalination), bladder cancer, bladder incontinence (urinary incontinence), bladder infection, bleeding disorders (hemophilia), intraocular bleeding (subconjunctival bleeding), nasal bleeding (nasal bleeding), variceal bleeding, blepharospasm (dystonia), blindness, lymphatic vessel occlusion (lymphedema), hematologic cancer, blood cell cancer (leukemia), leg thrombosis (deep vein thrombosis), pulmonary thrombosis (pulmonary embolism), thrombosis, blood poisoning (sepsis), blepharospasm (septicemia), and other disorders of the skin, Blood pressure (hypertension), gestational blood pressure (pregnancy induced hypertension), blood pressure, hypotension (hypotension), blood transfusion, blue infant syndrome (methemoglobinemia), BMS (burning mouth disease), bocavirus infection, body deformation disorder, ils sore, bone cancer, bone marrow disease, osteosarcoma, bony spur, borderline personality disorder, botulism, bovine spongiform encephalopathy (encephalopathy), bovine spongiform encephalopathy (mad cow disease), intestinal cancer (colorectal cancer), hirsutella angulata (cauliflower ear), BPD (borderline personality disorder), BPH (prostatic hypertrophy), brachial plexus nerve injury, bradycardia (arrhythmia), cerebral aneurysm, brain cancer, concussion, brain injury, cerebral hemorrhage, cerebral lesion (encephalopathy), brain lesion, brain metastasis (cerebroma), brain stem glioma (brain cancer), cerebroma, peripheral blood pressure, bone cancer, bone marrow disease, bone sarcoma, bone, Amoeba cerebri (Negerella infection), parotitis, osteomalacia (dengue fever), breast cancer, broken blood vessels in the eye (subconjunctival hemorrhage), bone fractures, bronchiectasis (acquired, congenital), bronchitis (acute), bronchitis, chronic (chronic bronchitis), mad cow disease (mad cow disease) cattle disease), Brucella pestis, buccal mucosal cancer (oral cancer), Buerger's disease (vascular disease), bullous pemphigus, burn syndrome, burned tongue syndrome (tongue problem), burn, bursitis, tinnitus (tinnitus) ear)), BV (bacterial vaginosis), C diffuse (Clostridium difficile colitis), CAD (heart disease (coronary artery disease)), calcium pyrophosphate deposition disease (pseudocanine disease), calicivirus infection (norovirus infection), California valley fever (valley fever), Brachydactyly, canavan disease, lymphoma (non-hodgkins lymphoma), anal cancer (anal cancer), bladder cancer (bladder cancer), hematological cancer (leukemia), brain cancer (brain cancer), cancer breast cancer (breast cancer), cervical cancer (cervical cancer), colon cancer (colon cancer), colon and rectal cancer (colon cancer), endometrial cancer (uterine cancer), esophageal cancer (esophageal cancer), gallbladder cancer (gallbladder cancer), head and neck cancer (head and neck cancer), kidney cancer (kidney cancer), cancer larynx cancer (larynx cancer), nasopharyngeal cancer (nasopharyngeal cancer), ovarian cancer (ovarian cancer), pancreatic cancer (pancreatic cancer), penile cancer (penile cancer), peritoneal cancer (mesothelioma), pleural cancer (mesothelioma), prostate cancer (prostate cancer), salivary gland cancer (salivary gland carcinoma), skin cancer (skin cancer), gastric cancer (stomach cancer), sympathetic nervous system (neuroblastoma), Testicular cancer (testicular cancer), thyroid cancer (thyroid cancer), urinary bladder cancer (bladder cancer), uterine cancer (uterine cancer), vaginal cancer (vaginal cancer), cancer P-cause (Ain), cancer prophylaxis, cancer, ulcer sore, Capsella delusions, carcinoid embryonic antigen, carcinoid syndrome, carcinoid tumor, laryngeal cancer (laryngeal cancer), ovarian cancer (ovarian cancer), thyroid cancer (thyroid cancer), cardiac arrest, cardiogenic pulmonary edema (pulmonary edema), cardiolipin antibody (antiphospholipid syndrome), cardiomyopathy, heart and kidney, carotid artery disease, carpal tunnel syndrome, cerebral palsy (neuroparalysis), cataract, cauda syndrome, cauliflower reflex, causalgia syndrome, causalgia, cavernous hemangioma (hepatic hemangioma), CEA (carcinomatous antigen), celiac disease (mucedine bowel disease), celiac disease, cellulitis, and cervical cancer, Central nervous system diseases, central pain syndromes, central neurite myeliysis, central myopathy, brain diseases, scalp hematoma (neonatal jaundice), cerebral aneurysm, cerebral arteriosclerosis, cerebral aneurysm, cerebral giant brain syndrome, cerebral palsy, cerebrovascular inflammation, cerebroside syndrome (gaucher's disease), cervical dysplasia, cervical canal stenosis, CF (cystic fibrosis), CFIDS (chronic fatigue syndrome), American trypanosomiasis, meibomian cyst, peroneal muscle atrophy, Charr's disease (Quackery arthritis), chemical burn (burn), chemotherapy, chickenpox (chicken pox), chikunin (chilblain), cholelithiasis (gallstone), cholera, cholecystography, cholesterol management, chondromalacia Pat bone (Pa cartilage syndrome, chondroid syndrome, choroiditis (uveitis), chronic bronchitis, chronic room syndrome (compartment syndrome), Chronic cough, chronic diseases and disorders, chronic fatigue syndrome, chronic hepatitis b (hepatitis b), chronic inflammatory demyelinating polyneuropathy, chronic insomnia (chronic) pneumonia (pulmonary fibrosis), chronic lymphocytic leukemia, chronic myelogenous leukemia (leukemia), chronic obstructive pulmonary disease (CO), PD (chronic obstructive pulmonary disease), chronic postural intolerance (POT syndrome), chronic pain, chronic pancreatitis (pancreatitis), chronic pelvic pain syndrome (prostatitis)), chronic renal insufficiency (renal artery) chronic rhinitis, chronic ulcerative colitis (ulcerative colitis), vasculitis syndrome circulatory system disease, cirrhosis of the liver, Primary Biliary Cirrhosis (PBC)), CJD (creutzfeldt-jakob disease), classical li disease (li's syndrome (lie disease)), chronic inflammatory demyelinating polyneuropathy, Cranial dysplasia (cranial clavicle dysplasia), cranial dysplasia, click noise syndrome (mitral valve prolapse), clinking in Ear (tinnitus), CLL (leukemia), clostridium difficile colitis, coagulation, blood (blood) clot), group B antisocial personality disorder (antisocial personality disorder), group headache, CML (leukemia), CMT (charcot-marie tooth disease), CMV (cytomegalovirus (CMV)), disease of gaussian D, coccidioidomycosis (valley fever), globalgia, cockscone syndrome, Coffin-Lowry syndrome, cold (common cold), colitis, collagenous (lymphocytic colitis), colitis, crohn's disease (crohn's disease), colitis, lymphocytic (lymphocytic) colitis, microscopic examination (lymphocytic colitis), Colitis, ulcerative (ulcerative colitis), collagen vascular disease (connective tissue disease), collagen colitis (lymphocytic colitis), colon cancer, achromatopsia, colorectal cancer (colon cancer), coma, combat fatigue (post-traumatic stress disorder), compartment syndrome, complex regional pain syndrome, complex twitch (Tourette syndrome), spinal nerve compression (radiculopathy), compulsive behavior, concussion (concussion), concussion, congenital cerebral ischemia (anencephaly), congenital ganglionic megacolon (megacolon disease), congenital AVM (arteriovenous malformation), congenital bronchiectasis (congenital bronchiectasis), congenital defect (congenital defect) spinal muscular atrophy, congenital dysplastic vasodilation (Klippel-trenaunaay-Weber syndrome), congenital erythropoietic porphyria (porphyria), Congenital facial paralysis, congenital glaucoma (glaucoma), congenital heart disease, congenital heart murmurmur (murmurmur), congenital hydrocephalus, congenital kyphosis (kyphosis), congenital lymphedema, congenital malformation (retronatal), congenital methemoglobinemia (methemoglobinemia), congenital myasthenia syndrome, congenital myopathy, congenital podophyllotosis dermatitis (rodyng thomson syndrome), conjunctivitis (pink eye), connective tissue disease, constipation, constitutional hepatic insufficiency (gilbert syndrome), buchi (buchholz contraction), tics (seizure), kuri anemia (beta-thalassemia), COPD (chronic obstructive pulmonary disease), filthy language (tourette syndrome), keratopathy, corneal ulcer, coronary angiography, coronary bypass graft (coronary artery), Coronary artery disease (heart disease (coronary artery disease)), coronary atherosclerosis, cortical dementia (dementia), corticobasal degeneration (dementia), Cowsonia syndrome (temporomandibular joint syndrome (TMJ), costal chondritis and Tietz syndrome, CP (cerebral palsy), CPAP (sleep apnea), CPPD (pseudogout), spasmodic tethering syndrome, spasms, cranial arteritis (Pol rheumatic myalgia), cranial dystonia (dystonia), craniopharyngioma (brain tumor), cranial protrusion, CRE infection, CREST syndrome (scleroderma), Creutzfeldt-Jakob disease, crib-Dimenses (SIDS), intensive care pathology, Crohn's disease (Crohn's disease), cryptosporidiosis, CSD (cat scratch disease), CTD (connective tissue disease), CUC (ulcerative colitis), cumulative trauma disease, curved spinal column (scoliosis), Cushing's syndrome, cutaneous lymphoma (skin cancer), cutaneous melanoma (melanoma), wound, CVD (connective tissue disease), CVS (circulatory vomiting syndrome (CVS)), cyclitis (uveitis), cyclosporine infection (cyclosporine), cytochrome disorders, cylindrical bronchiectasis (acquired, congenital)), cystic fibrosis, cystic cystitis (urinary tract infection), sarcoma granuloma (breast cancer), giant cell inclusion body disease, Cytomegalovirus (CMV), dandruff (seborrhea), dandy fever (dengue), dandy-wack syndrome, danlos syndrome (ellis-donoshi syndrome), dawsonia, De Morsier syndrome, De Quervain tenosynovitis, deafness, deep vein thrombosis, degenerative arthritis (osteoarthritis), degenerative joint disease (osteoarthritis), Degenerative spondylolisthesis (spondylolisthesis), brachial plexus paralysis, Detherm-Sowthistle disease, Pugistica dementia, dengue fever, depression, skin lesions, dermatitis (eczema), dermatomyositis (polymyositis), dermatomyositis, retinal detachment (retinoschisis), developmental retinal detachment, Devic syndrome, diabetes insipidus, diabetes prevention, diabetes treatment, diabetes, type 1 (diabetes mellitus), diabetes, type 2 (diabetes mellitus), diabetic encephalopathy (encephalopathy), diabetic focal neuropathy (diabetic neuropathy), diabetic hyperglycemia (hyperglycemia), diabetic neuropathy, diarrhea, refractory Clostridium (Clostridium difficile colitis), biswallow (achalasia), diffuse astrocytoma, diffuse fibrosing alveolitis (pulmonary fibrosis), Diffuse idiopathic skeletal hypertrophy, diffuse sclerosis, diplopia, discoid lupus (systemic lupus), disease prevention (prophylaxis), disease, syndrome, carotid artery (carotid artery disease), disease, peroneal muscular atrophy (peroneal muscular atrophy), disease, gaucher's disease, grave's disease, li's syndrome (li's disease), disease, marfan's syndrome, disease, meniere's disease, mitochondria (mitochondrial disease), disease, non-poliomyelitis enterovirus (enterovirus infection), disease, parkinson's disease, thyroid (thyroid disease), aging imbalance (vertigo summary), DISH (diffuse idiopathic skeletal hypertrophy), disease, conditions, Asperger's disease (asperger's syndrome), mitochondria (mitochondrial disease), disturbance of consciousness, disorder of disjunctive cognition, distal hereditary motor neuropathy type V, distal haplotype type 1p36(1p36 deletion syndrome), distal spinal muscular atrophy type 1, distal spinal muscular atrophy type 2, nocturnal sleep disorder (nalke's disease), diverticular disease (diverticulosis), diverticulitis (diverticulitis), diverticulum, duodenum (duodenal diverticulum), fission, pancreas (pancreatic fission), dizziness (DJD), DJD (osteoarthritis), down's syndrome, madinella (Drine) drug abuse, age-related macular degeneration (macular degeneration), dry eye disease (dry eye), gangrene (gangrene), duchenne muscular dystrophy, ductal carcinoma, duodenal biliary tract drainage, duodenal diverticulum, duodenal ulcer (peptic ulcer), DVT (deep vein thrombosis), dwarfism (ear cartilage disease), dwarfism, campberolifer (campher atypical hyperplasia), dysarthria, autonomic nerve dysfunction, dysplasia, dysgustatory disorders (dysgeusia), Dy sleep disorders, dyskinesia, dyskinetic cerebral palsy (cerebral palsy), dyslexia, dysmenorrhea (menstrual tidal bore), dyskinetic syndromes (metabolic syndrome), dyspepsia, dysplasia spondylolisthesis (spondylosynovitis, congestive congestion, congestive arrhythmia) diseases (anorexia nervosa), diet, binge eating (binge eating disorder), ebola hemorrhagic fever (ebola HF), cholera (tourette syndrome), eczema, edema (lung), edema, EDS (naloxone's disease), einkorse-down syndrome, entero (eic), octa measles (measles)), (measles), Congenital elephantiasis (Klippel-Trenaunay-Weber syndrome), elevated calcium levels, elevated intraocular pressure (glaucoma), demon-phase syndrome (williams syndrome), hypercalcemia (williams syndrome), embolism, lung (pulmonary embolism), mood disorders (mental well-being (psychology)), emphysema (pulmonary disease), anomalar-malar, encephalitis, cerebral bulging, primary hemangioma of the brain, coexistence of the demon phase of encephalitis, end-stage renal disease (kidney failure), endocarditis, endometrial cancer (uterine cancer), endometriosis, end-stage renal disease (renal artery stenosis), enlarged organs, enteroviruses (non-poliomyelitis enterovirus infection), enuresis, environmental diseases (pathologic syndrome), eosinophilic esophagitis, eosinophilic fasciitis, meningioma (brain tumor), mumps (mumps), Epididymitis (testicular disease), epilepsy (seizure), episiotomy, epithelioid sarcoma, epo (erythoropictein) mononucleosis), balance (vestibular balance disorder), eburnine, ERCP, infectious erythema (fifth disease), migraine erythema (lyme disease), erythema nodosum, lupus erythematosus, ESDR (renal artery stenosis), esophageal cancer, atypical hyperplasia of esophageal cancer (barrett's esophagus), esophagus, barrett's esophagus, ewing sarcoma (bone cancer), ocular cancer, ocular buoy, fabry disease, artificial disease, fal syndrome, F-examination, salpingectomy (hysterectomy), pseudoparturition (bushie), familial hiberna syndrome (Kleine-Levin syndrome), familial turner syndrome (nonon syndrome), fatigue, Felty's syndrome, Fetal Alcohol Syndrome (FAS), fag, Fibrillation), fibrocystic breast disease, pancreatic fibrocystic disease (cystic fibrosis), myoma (uterine fibroids), fibromyalgia, fibrosarcoma, fibrosis, fifth disease, fire (burn), Fisher's syndrome, influenza (flu), flu, humoral lung, focal neuropathy, diabetes (diabetic neuropathy), follicular cancer (thyroid cancer), folliculitis, Folin's disease (phenylketonuria), forest disease (diffuse idiopathic skeletal hypertrophy), Pneumonias (gangrene), hematoma (Freuler's syndrome), Fragile X syndrome, Fragile X-related tremor/ataxia syndrome, India pox (Yaskan pox), France schetti-Zwahlen-Klein syndrome (Triacter-Kleens syndrome), Friedreich's ataxia, frontotemporal dementia (dementia), Gallbladder cancer, ganser's syndrome (as a sexual disorder), gardci human papilloma virus vaccine, gardner syndrome, gastritis, gastroenteritis (stomach flu), gastrointestinal cancer, gaucher's disease, hereditary diseases, german measles, gerstman syndrome, giant platelet syndrome (giant platelet disease), intestinal brevibacterium, gilbert syndrome, gingivitis (gum disease), glaucoma, glioblastoma, glioma (brain tumor), globuloleukodystrophy, glucocerebrosidase deficiency (gaucher's disease), granulocytopenia (neutropenia), graves disease, polio ectopic disease, guillain-helminth syndrome, guinea pig disease, helicobacter pylori (helicobacter pylori), hair growth, alopecia, Hallervorden-Spatz syndrome, Hamman-Rich syndrome (pulmonary fibrosis), Hansen's disease (leprosy), hantavirus lung syndrome, HAPE (pulmonary edema), hashimoto's thyroiditis (hashimoto's thyroiditis) hashimoto's encephalopathy (encephalopathy), hashimoto's thyroiditis, pollinosis, HBV disease (hepatitis b), HCV disease (hepatitis c), HD (large stealth disease), head injury, headache, hearing (deafness), hearing loss, heart attack, heart disease, heart failure, heart inflammation (myocarditis), heart murmurmurmur, valvular heart disease, helicobacter pylori, vasodilatory hypertrophy (Klippel-trenauay-Weber syndrome), endothelioma, hemangioma, liver (hepatic hemangioma), hematoma, hemiplegia, hemolytic uremia, allergic purpura, hepatic insufficiency, body constitution (gilbert's syndrome), hepatic hemangioma, hepatitis (viral hepatitis), hepatocellular carcinoma, hereditary porphyria (porphyria), She editorial motor neuropathy, hereditary pancreatitis (pancreatitis), hereditary spastic paraplegia, hereditary paralysis in an amorphous state, hereditary disease, hypertension, Pingshan syndrome, Hirschspung disease, Hodgkin's lymphoma, Hodgkin's disease, Folmosman Adi syndrome, Hoplor's encephalopathy Henoch-Schonlein purpura, Huhs syndrome (antiphospholipid syndrome), Human Immunodeficiency Virus (HIV), Huntington's chorea, HUS (hemolytic uremia syndrome), Harkinson-Gilford syndrome (seng syndrome), hydrocephalus, hydronephrosis, hypercalcemia-superior valvular aortic stenosis (Williams syndrome), hypercortisolism (Cushing syndrome), hyperglycemia, hyperhidrosis, hyperkalemia, hyperkinesia impulsivity disorder, impulse disorder, Hyperkinetic syndrome, renal disease (kidney cancer), hyperparathyroidism, hypertrophy, hypertension, hyperthyroidism (dysgeusia), hypoglycemia, hyponatremia anemia, hypoparathyroidism, laryngeal carcinoma, hypotension (hypotension), hypertensive encephalopathy (encephalopathy), hypothalamic disease (hypothyroidism), hypothyroidism, cerebral palsy, hypoxia, IBS (irritable bowel syndrome, IBS), edema (Meniere's disease), idiopathic intracranial hypertension (pseudoneoplastic brain), idiopathic pulmonary fibrosis (pulmonary fibrosis), idiopathic pulmonary hypertension (pulmonary hypertension), Idiopathic Thrombocytopenic Purpura (ITP), ileitis (Crohn's disease) orchestra syndrome, immune diseases, stroke syndrome, inclusion body myositis, permeability pulmonary edema (ARDS), pediatric postnatal aphasia (Landau-Kleffner syndrome), Infection, inflammatory breast cancer, inflammatory disease, inflamed organ, influenza, injury wound, IPF (pulmonary fibrosis), iritis, Irritable Bowel Syndrome (IBS), sasa syndrome, ischemia reperfusion injury, ischemic colitis (colitis), ischemic heart disease, ischemic nephropathy (renal artery stenosis), ischemic psychosis, ischemic nephropathy (renal artery stenosis), ischemic cystitis (hip bursitis), ischemic lumbar spondylolisthesis (spondylolisthesis) (I tibiostrand syndrome), brunettle-cruz-felder's disease (creutzfeldt-jakob disease), jaundice, hyperactive joint syndrome (hyperkinetic syndrome), georget syndrome, karaoke syndrome, kawasaki disease, kawasaki-scher syndrome, keratitis, keratoconacokeratopathy, keratopathy kidney cancer, kidney disease, abnormal kidney development, Kidney failure, Kinsbourne syndrome, Kleine-Levin syndrome, Klinefelter syndrome, Klippel Feil syndrome, Klippel trenaunaunay-Weber syndrome, KLS (Kleine-Levin syndrome), knee bursitis, Krabbe's disease, kts (Klippel) -trenaunaunay-Weber syndrome), Kufor-Rakeb syndrome, Lafora disease, Lambert-Eaton myasthenia gravis syndrome, giardiasis (giardia), Landau-Kleffner syndrome, laryngeal cancer (laryngeal carcinoma), laryngitis, laryngeal carcinoma, lateral femoral cutaneous nerve syndrome (paresthesia), lateral myeloid (Wallenberg) syndrome, lattice dystrophy (corneal disease), learning disorders, legionnaires disease, bipedal, restless leg (restless leg syndrome) leishmaniasis, smooth muscle (soft tissue sarcoma), leishmaniasis, renerg-lekt syndrome, leprosy-leprosy syndrome, han-lesoni-brussel disease, han-bruise syndrome, hakumi-kumi syndrome, kraw-kumi syndrome, kraw-kokumi syndrome, kumi-kumi syndrome, kumi-kumi, kumi, Leukodystrophy, leukopenia (vitiligo), leukopenia (neutropenia), vitiligo, nodular dementia (D) lichen planus, lichen scleroderma, linear scleroderma (scleroderma), lipoid histiocytosis (gaucher's disease), liposarcoma, listeria, liver cancer, liver cirrhosis (cirrhosis), liver disease, LKS (Landau-Kleffner syndrome), lobectomy (surgical selection for epilepsy), lobular cancer, Loeys-Dietz syndrome, Lou Gehrig's disease (amyotrophic lateral sclerosis), low-energy lumbar spinal stenosis, lung cancer, lyme disease, lymph nodes (enlarged lymph nodes), lymphangiotomy (Hemapheresis), lymphedema, lymphoblastic leukemia, lymphocytic colitis, lymphocytic thyroiditis (hypothyroidism), lymphoma, macledo-joseph's disease, lymphoblastic thyroiditis (hypothyroidism), lymphoma, maculopathy, morus-joseph's disease, chronic myelogenous leukemia, chronic, Giant malformation, macular degeneration, mad cow disease, malaria (cancer), Marfan's syndrome, Martin Bell's syndrome (Fragile X syndrome), measles, medullary carcinoma, medulloblastoma (brain tumor), giant colon (megacolon), melanoma, MELAS syndrome, chloasma, neuropathies, Melson-Rosettar syndrome, hypomnesia (dementia, Meniere's disease, meningioma (brain tumor), meningitis, meningococcemia, Menkes disease, mental health (psychology), psychological diseases, mesothelioma, metabolic encephalopathy (encephalopathy), metabolic syndrome, chromophoric leukodystrophy, metastatic cancer, methicillin-resistant MRSA infections), microcephaline malformations, migraine, mitochondrial diseases, mitochondrial disorders, mitochondrial dysfunction, psychosomatic m's disease, Mobius syndrome, Morphea (scleroderma), Morton's neuroma, Morvan's syndrome, motor skills disorder, mountain sickness, movement disorder, Moyamoya's disease, mucocutaneous lymph node syndrome (Kawasaki disease), multiple myeloma, multiple organ failure, multiple personality disorder (dissociative) identity disorder), Multiple Sclerosis (MS), Monkhausen's syndrome, muscular dystrophy, musculoskeletal pain, myogenic encephalomyelitis (chronic fatigue syndrome), myasthenia gravis syndrome, myeloma (multiple myeloma), myopathy, myotonic myopathy, myoclonic myopathy, nasopharyngeal carcinoma, tumor (cancer), neurological disease, neurobeset's disease, neuroblastoma, neurodermatitis (atopic dermatitis), neurofibromatosis, antipsychotic malignancy syndrome, neurological disease, neuromuscular disease, neuropathy, neutrophilic reduction, Neisspeck's disease pulmonary fibrosis), NMO (de's syndrome), nodules, non-hodgkin's lymphoma, non-H odgkin's lymphoma, non-small cell lung cancer (NSCLC), norian syndrome, norovirus (norovirus infection), obesity, obsessive-compulsive disorder (OCD), ocular cancer, tada-sythesis, oligodendroglioma (brain tumor), cerebellar atrophy, open-angle glaucoma (glaucoma), optic neuritis syndrome, optic neuritis, optic neuropathy (glaucoma), oral cancer, oral health problems, organ diseases and dysfunction, organ failure, organ transplantation, osteoporosis, osteoarthritis deformans (paget's disease), osteoarthritis, osteochondritis, osteodystrophy, osteogenic sarcoma (bone cancer), nevus hypertrophic (Klippel-Trenaunay-Weber syndrome), osteomalacia (osteodystrophy), osteomyelitis, osteonecrosis (aseptic necrosis), Bone reduction, osteoporosis (RMDs)), oxidative stress disorder, Paget's disease, pain, pancreatic cancer (pancreatic cancer), pancreatic fibrocystic disease (Cys) fibrosis), pancreatitis, PANDAS, panic attack (panic disorder), panniculitis, idiopathic sarcoidosis (Weber-Klebsiella disease), pancreatitis (uveitis), papillary carcinoma, paralysis, paranasal sinus carcinoma, paraneoplastic disease, Parkinson's disease, Parry-Romberg syndrome, Pat's syndrome, Pelizaeus-Merzbacher disease, Pendred syndrome, pericarditis, peripheral lymphatic fistula (vestibular balance disorder), peripheral vascular disease, pervasive developmental disorder, Pick's disease, Pin nerve, plantar fasciitis (PMDD)), pneumonia, poisoning, poliomyelitis, polycystic kidney disease, polycystic ovary syndrome, and kidney disease, Polycystic kidney disease (polycystic kidney disease), Pontiam fever, myocardial infarction, post-operative pancreatitis (pancreatitis), post-partum depression, stroke, post-operative surgery, post-traumatic stress disorder, prader Willi syndrome (prader-Willi syndrome), pre-excitation syndrome (Walff-Parkinson-white syndrome)), premenstrual dysphoric disorder (PMDD), primary Central Nervous System (CNS) lymphoma, primary dementia (Dmentia), primary lateral sclerosis, primary lymphedema (lymphedema), premature senility syndrome, progressive systemic sclerosis (scleroderma), prostate cancer, psoriasis, psoriatic arthritis, psychiatric diseases, schizophrenia, post-traumatic stress disorder (post-traumatic stress disorder), adolescent gynecomastia (female mammary dysplasia), Pulmonary fibrosis, reflex neurovascular dystrophy, renal cell carcinoma, renal disease (renal artery stenosis), renal failure), reperfusion injury, restless leg syndrome, retinoblastoma, rheumatoid arthritis, rosacea, rubella (german measles), salivary gland carcinoma, sarcoma, schizophrenia, seborrheic dermatitis, secondary glaucoma, seizure, sepsis, septic arthritis (sepsis), morbid syndrome, sinusitis, skin cancer, skin disease, sleep apnea, Small Cell Lung Cancer (SCLC), soft tissue sarcoma, spina bifida, spinal and bulbar muscular atrophy, spinal cancer, spinal cord injury, spinal muscular atrophy, spinal stenosis (lumbar spinal stenosis), spinal curvature (scoliosis), squamous cell carcinoma, gastric cancer, stress, prevention of stroke, stress, and other conditions, Stroke therapy, stroke, subacute thyroiditis (thyroiditis), subclinical hypothyroidism (hypothyroidism), subconjunctival hemorrhage, subcortical arteriosclerotic encephalopathy (binswan's disease), surgery, syndromes, asperger's disease (asperger), Behcet's syndrome, systemic lupus, Takayasu arteritis, tarsal tunnel syndrome (carpal tunnel syndrome), familial Meng's dementia, TB (tuberculosis (TB)), dental conditions, tendonitis, testicular cancer, testicular disease, tetanus, laryngeal carcinoma, thyroid cancer, thyroid disease, Gilles de la Tourette syndrome, Toxic Shock Syndrome (TSS), transient ischemic attack, transplantation, heart (heart transplant), trauma (post-traumatic stress) disease, craniocerebral trauma, tremor, dyspnea, Tuberculosis (TB), neoplastic diseases, Type 2 diabetes, ulcerative colitis, uterine cancer, vascular disease, vertigo, viral infection, Williams ' syndrome, Wilson's disease or Zellweger's syndrome.

Crossing the blood brain barrier

Cationic molecules and other charged molecules have difficulty crossing the Blood Brain Barrier (BBB). As a result, there is a need for methods that allow drugs to cross the blood-brain barrier and stay there. In one approach, chemical drug delivery systems (CDS) use enzymes to activate prodrugs and provide cationic charges to molecules after they enter tissue from blood vessels (Bodor and Buchwald, 2002).

The above figure provides a mechanism for this system to utilize the reactive lipids and MPTP targeting moieties previously discussed in this application. Compound (1) contains on the left side a 1, 4-dihydro-N-methylnicotinic acid (dihydrotrimaltine) prodrug moiety and a reactive enol ether. After reaction with the active substance, the compound produces vitamin B3 and MPTP-bound phenylglyoxal. Such lipophilic prodrugs can penetrate tissues, including the Central Nervous System (CNS). After entering the central nervous system, the dihydrotrigonelline moiety is deprotonated by NADH dehydrogenase (anemia), converting it into an activated trigonelline structure. Now, this activated structure has a charged cationic pyridinium group that does not allow it to re-cross the blood brain barrier and enter other parts of the body. Thus, any prodrug that is generally designed to enter the Central Nervous System (CNS) and be activated by this enzyme is now retained within the CNS ("locked out"), while the remaining portion of the activated drug is effectively excreted. This allows for the accumulation of therapeutic amounts of drug in the CNS. Preferably, the ester group of the prodrug of trigonelline will hydrolyze slowly over several days and weeks to provide a stable active drug to the tissues of the central nervous system, while the prodrug of trigonelline will be naturally metabolized to niacin or vitamin B3, thus leaving no positive charges or unwanted byproducts to accumulate in the central nervous system or brain.

Cationic groups on the pyridinium moiety are particularly useful for targeting mitochondria, especially the Inner Mitochondrial Membrane (IMM), because cationic charges can rapidly accumulate in mitochondria. If they have both cationic charges and lipophilic chains or groups, they are inserted into the IMM membrane bilayer on the outer and inner leaflet where cardiolipin and other key lipids reside.

Thus, in some embodiments, a non-polar compound capable of crossing the Blood Brain Barrier (BBB) into the Central Nervous System (CNS) is provided. In these embodiments, the compounds react with activators in the CNS to form active cationic products that react with mitochondrial reactive lipid species and/or inhibit or enhance opening of Mitochondrial Permeability Transition Pore (MPTP).

In these embodiments, the activator may be any enzyme that is more highly expressed in the CNS than in the blood. Alternatively, if the compound is administered directly into the CNS, the enzyme need only be any enzyme expressed in the CNS, without concern for whether it is differentially expressed in the CNS. Non-limiting examples of such enzymes include carboxylesterase, acetylcholinesterase, esterase, butyrylcholinesterase, paraoxonase, matrix metalloproteinase, alkaline phosphatase, beta-glucuronidase, human vascular cyclooxygenase, hydrolase, plasmin, protease, prostate-specific antigen, purine nucleoside phosphorylase, carboxypeptidase penicillinase, beta-lactamase, beta-galactosidase, cytosine deaminase, serine hydrolase, cholinesterase, phosphorylase, acetaldehyde dehydrogenase, aldoxygenase, amino acid oxidase, P450 reductase, DT-diaphorase, thymine phosphorylase, deoxycytidine kinase, lyase, thymidylate synthase, nuclease, methionine-lyase, cytosine deaminase, beta-lactamase, penicillin amidase, tyrosinase, trypsin, and the like, Carboxypeptidase, beta-glucuronidase, thymidine kinase and nitrosoreductase. In various embodiments, the activator is NADH dehydrogenase.

The activation of a generic compound targeting a mitochondrial reactive lipid material by NADH dehydrogenase in the central nervous system is shown above.

In the above figure, both compounds are useful. Due to its lipophilicity, the top compound can cross the BBB. The second compound cannot cross the BBB due to its positive charge and for the same reason it will target the Internal Mitochondrial Matrix (IMM). The four vinyl ether moieties increase the affinity of the compound for IMM. The compound does not directly affect MPTP; its products are all non-toxic.

The prodrug described above also targets lipid peroxides, but not MPTP, because it forms vanillin and glyceraldehyde upon reaction with reactive lipid species.

The upper molecule is a prodrug that will cross the BBB and skin, and the activated version shown below is intended to insert itself into the IMM. It has three reactive lipid species and reactive species sensitive groups, which will allow it to penetrate into the IMM and form glycerol, phenylglyoxal (MPTP inhibitor), glyceraldehyde, and triglycerol after the reaction. Thus, the compounds target and inhibit the opening of MPTP and target cardiolipin hydroperoxide and cardiolipin peroxy free radical.

The above compounds are activating molecules from one of the above indicated and can be inserted as such directly into the human body or topically treat the skin, or be enzymatically activated once the top prodrug form enters the tissue from the bloodstream.

In contrast to previous compounds, the above compounds do not use trigonelline prodrug moieties, but have a permanent cationic charge. The compounds can be administered intravenously, or topically to treat the skin without crossing the blood-brain barrier.

Consistent with the above example, the permanent and preformed charges on the prodrug do not cross the BBB, which is important for patients who only wish to treat mitochondrial dysfunction in non-neural tissue or need rapid treatment and protection (e.g., after myocardial infarction treatment) because the enzymatic transformations required by other compounds are not required.

The upper panel shows a long chain prodrug, which is designed to be soluble in water but highly lipophilic, so that it crosses the BBB, is activated in nervous tissue where the activated compound accumulates in the brain, targets the IMM, and has high activity with multiple vinyl ethers along its chain, resistant to hydroperoxides and peroxylipids, particularly cardiolipin. Upon reaction with the reactive species, the compound produces glyceraldehyde, pinecone and ethanol products, all of which are metabolized. The compounds can be easily modified to produce alcohols other than ethanol. MPTP is not targeted because it does not produce α -dicarbonyl.

The following compounds are similar to the above compounds except that the compounds can produce a food flavoring product instead of ethanol.

The above molecules and mechanisms produce 4-hydroxyphenyl glyoxal after both reactive species and enzymatic activation. The 4-hydroxyphenyl group promotes the opening of MPTP, causes mitochondrial dysfunction, and is useful for treating diseases requiring apoptosis, such as cancer. Because the apical compound can cross the BBB, the compound is useful for treating cancers of the nervous system, such as brain cancer.

The above prodrug will also activate MPTP, but since the α -dicarbonyl is not bound, this helps make arginine binding irreversible, which can be used as a reversible MPTP open molecule designed for the treatment of brain tumors under chemical and enzymatic activation.

The panel below provides compounds to prevent compounds targeting the Central Nervous System (CNS) from affecting mitochondria in non-CNS locations

Also provided herein are any of the compounds described above formulated in a pharmaceutical excipient. Such pharmaceutical formulations are discussed extensively in WO2017/049305, pages 22-26 and WO2018/102463, pages 53-59, both of which are incorporated herein by reference.

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In view of the above, it will be seen that the several objects of the invention are achieved and other advantages attained.

As various changes could be made in the above methods and compositions without departing from the scope of the invention, it is intended that all matter contained in the above description and shown in the accompanying drawings shall be interpreted as illustrative and not in a limiting sense.

All references cited in this specification are incorporated herein by reference. The discussion of the references herein is intended merely to summarize the assertions made by the authors and no admission is made that any reference constitutes prior art. Applicants reserve the right to challenge the accuracy and pertinency of the cited references.