WO2022010778A1 - Uridine phosphorylase inhibitors to treat or prevent pulmonary disease - Google Patents

Uridine phosphorylase inhibitors to treat or prevent pulmonary disease Download PDF

Info

Publication number
WO2022010778A1
WO2022010778A1 PCT/US2021/040290 US2021040290W WO2022010778A1 WO 2022010778 A1 WO2022010778 A1 WO 2022010778A1 US 2021040290 W US2021040290 W US 2021040290W WO 2022010778 A1 WO2022010778 A1 WO 2022010778A1
Authority
WO
WIPO (PCT)
Prior art keywords
anhydro
benzoyl
anhydropyrimidine
derivative
substituted
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2021/040290
Other languages
French (fr)
Inventor
William A. Garland
Philip LIAW
Brian D. Frenzel
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Tosk Inc
Original Assignee
Tosk Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Tosk Inc filed Critical Tosk Inc
Priority to EP21837558.2A priority Critical patent/EP4178581A4/en
Priority to CN202180054634.3A priority patent/CN116096422A/en
Priority to AU2021306230A priority patent/AU2021306230A1/en
Priority to IL299703A priority patent/IL299703A/en
Priority to CA3185126A priority patent/CA3185126A1/en
Publication of WO2022010778A1 publication Critical patent/WO2022010778A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7042—Compounds having saccharide radicals and heterocyclic rings
    • A61K31/7052—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
    • A61K31/706—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
    • A61K31/7064—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
    • A61K31/7068—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines having oxo groups directly attached to the pyrimidine ring, e.g. cytidine, cytidylic acid
    • A61K31/7072—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines having oxo groups directly attached to the pyrimidine ring, e.g. cytidine, cytidylic acid having two oxo groups directly attached to the pyrimidine ring, e.g. uridine, uridylic acid, thymidine, zidovudine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00—Drugs for disorders of the respiratory system

Definitions

  • INTRODUCTION Fibrosis (Rockey DC, Bell PD, Hill JA, Fibrosis — A Common Pathway to Organ Injury and Failure, N Engl J Med 2015; 372:1138-1149) is pathological wound healing where connective tissue replaces normal parenchymal tissue leading to tissue re-modelling and the formation of permanent scar tissue (fibrotic scarring). Fibrosis is a sequela of impaired wound healing from repetitive, extensive, epithelial injury. Normal, healthy wound healing is a natural restorative process in which an organ repairs itself after injury.
  • Fibrotic disorders encompass a wide spectrum of clinical entities including, systemic fibrotic diseases such as systemic sclerosis (SSc), sclerodermatous graft vs. host disease, and nephrogenic systemic fibrosis, and numerous organ-specific disorders including, radiation- induced fibrosis and cardiac, pulmonary, liver, and kidney fibrosis.
  • SSc systemic sclerosis
  • sclerodermatous graft vs. host disease sclerodermatous graft vs. host disease
  • nephrogenic systemic fibrosis nephrogenic systemic fibrosis
  • organ-specific disorders including, radiation- induced fibrosis and cardiac, pulmonary, liver, and kidney fibrosis.
  • the causative mechanisms of fibrotic disorders are diverse, and, in many cases, unknown. These diseases share the common feature of an uncontrolled and progressive accumulation of fibrotic tissue in affected organs causing their dysfunction and ultimate failure.
  • TGF- ⁇ transforming growth factor- ⁇
  • Pulmonary fibrosis is a particularly injurious manifestation of impaired wound healing. Pulmonary conditions with fibrosis as part of the underlying pathophysiology are often collected under the term Interstitial Lung Diseases (ILDs).
  • ILDs Interstitial Lung Diseases
  • ILDs include a large and diverse group of more than 200 lung diseases and respiratory conditions characterized by inflammation and fibrosis of the interstitium, the tissue located between the air sacs of the lung.
  • ILD connective tissue disease-associated ILD
  • SSc-ILD systemic sclerosis-ILD
  • RA-ILD rheumatoid arthritis-ILD
  • i SIP idiopathic non-specific interstitial pneumonia
  • CHP chronic hypersensitivity pneumonitis
  • IIP interstitial pneumonia with autoimmune features
  • IPF environmental/occupational fibrosing lung diseases such as those caused by asbestosis and silica.
  • IPF Idiopathic pulmonary fibrosis
  • Glass DS Grossfeld D, Renna HA, Agarwala P, Spiegler P, Kasselman LJ, Glass AD, DeLeon J, Reiss AB, Idiopathic pulmonary fibrosis: Molecular mechanisms and potential treatment approaches, Respiratory Investigation 2020; 58(5): 320-335; Richeldi L, Collard HR, Jones MG, Idiopathic pulmonary fibrosis, Lancet. 2017 May 13;389(10082):1941-1952).
  • IPF is characterized by progressive fibrosis of the interstitium of the lung, leading to decreasing lung volume as determined by forced vital capacity (FVC) and progressive pulmonary insufficiency.
  • FVC forced vital capacity
  • pulmonary insufficiency The decline in lung function caused by IPF often manifests as exertional dyspnea and cough.
  • Symptoms result from a fibrotic process driven by alveolar epithelial cells that leads to increased migration, proliferation, and differentiation of lung fibroblasts.
  • the differentiation of fibroblasts into myofibroblasts which synthesize excessive amounts of extracellular matrix proteins, destroys the lung architecture.
  • the factors that induce the fibrotic process are unclear, and diagnosis can be difficult. Practical biomarkers to improve diagnostic and prognostic accuracy are lacking.
  • High-resolution computed tomography typically shows interstitial pneumonia with basal and peripheral honeycombing. Gas exchange and diffusion capacity are impaired. Treatments are limited. Lung transplantation is often contraindicated because of age and comorbidities, but it improves survival when successful.
  • Two drugs recently approved to treat IPF, pirfenidone (Gulati S, Luckhardt TR, Updated Evaluation of the Safety, Efficacy and Tolerability of Pirfenidone in the Treatment of Idiopathic Pulmonary Fibrosis, Drug Healthc Patient Saf.
  • ARDS Acute respiratory distress syndrome
  • Bos LD Martin-Loeches I, Schultz MJ, ARDS: challenges in patient care and frontiers in research, Eur Respir Rev. 2018;27 (147):170107
  • Fluid leaks from small blood vessels and collects in tiny air sacs in lungs preventing the sacs from filling with air.
  • ARDS can advance quickly and can be life-threatening.
  • ARDS causes of ARDS include, sepsis, accidents, breathing in harmful things such as dense smoke or chemical fumes, pneumonia, transfusion, inflamed pancreas, reactions to certain medications like amiodarone, (Papiris SA, Triantafillidou C, Kolilekas L, Markoulaki D, Manali ED, Amiodarone: review of pulmonary effects and toxicity, Drug Saf. 2010; 33(7): 539-58) drug overdose, near-drowning, burns, and aspiration of food. Symptoms include shortness of breath, low blood pressure, unusually fast breathing, fast heartbeat, cough, fever, chest pain, especially when breathing deeply, confusion and exhaustion, blue-tinted lips or nails from lack of arterial oxygen, and dizziness.
  • ARDS ARDS fibrosis .
  • Treatments include a breathing tube or a ventilator. Most treatment of ARDS is done in the ICU, where the overall hospital mortality rate is typically about 40%.
  • the pathophysiology of ARDS involves interactions among multiple mechanisms, including, immune cell infiltration, cytokine storm, alveolar-capillary barrier disruption, and cell apoptosis.
  • SUMMARY Methods are provided for treating patients suffering from pulmonary disease having fibrosis as the pathologic endpoint, such as IPF, ARDS, virus induced fibrosis, etc., using a UPase inhibitor. Aspects of the methods include administering an effective amount of a UPase inhibitor, with or without supplemental UR, to the subject.
  • the agent is a 2,2'- anhydropyrimidine, or a derivative thereof.
  • compositions for use in practicing the subject methods The subject methods and compositions find use in a variety of different pulmonary conditions. BRIEF DESCRIPTION OF THE DRAWINGS Figure 1.
  • Figure provides a regression analysis of plasma UR concentration versus plasma Compound 1 concentrations determined following continuous infusion of various amounts of TK- 112690 to mice.
  • R2 for the line is 0.95, and the slope and intercept values for the line are 0.010 and 0.051, respectively.
  • TK-112690 is seen to elevate plasma UR in a linear fashion.
  • Figure is a chart providing histology scores for pulmonary tissue from mice all treated with bleomycin (a well characterized lung toxin) and either dosing vehicle, UR or TK-112690. Mice treated with TK-112690 showed a statistically significant 30% less fibrosis than mice treated with the dosing vehicle.
  • FIG. 3A-D Figure provides representative lung sections from each of the four experimental groups from the bleomycin/pulmonary fibrosis study summarized in Figure 2. The lung sections were stained by Masson’s trichrome.
  • Figure 4. Figure provides a correlation between fibrosis scores and TGF- ⁇ levels in BAL fluid from the mice participating in the bleomycin/pulmonary fibrosis study whose results are shown in Figure 2. Although, considerable variability in TGF ⁇ concentrations are observed, a statistically significant correlation between fibrosis scores and TGF- ⁇ concentrations are observed.
  • Acylamino refers to a radical -NR'C(O)R, where R' is hydrogen, alkyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroalkyl, heteroaryl, heteroarylalkyl and R is hydrogen, alkyl, alkoxy, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroalkyl, heteroaryl or heteroarylalkyl, as defined herein.
  • Representative examples include, but are not limited to, formylamino, acetylamino, cyclohexylcarbonylamino, cyclohexylmethyl-carbonylamino, benzoylamino, benzylcarbonylamino and the like.
  • “Acyloxy” refers to the group -OC(O)H, -OC(O)-alkyl, -OC(O)-aryl or -OC(O)- cycloalkyl.
  • Aliphatic refers to hydrocarbyl organic compounds or groups characterized by a straight, branched or cyclic arrangement of the constituent carbon atoms and an absence of aromatic unsaturation.
  • Aliphatics include, without limitation, alkyl, alkylene, alkenyl, alkynyl and alkynylene. Aliphatic groups typically have from 1 or 2 to 6 or 12 carbon atoms. "Alkenyl” refers to monovalent olefinically unsaturated hydrocarbyl groups having up to about 11 carbon atoms, particularly, from 2 to 8 carbon atoms, and more particularly, from 2 to 6 carbon atoms, which can be straight-chained or branched and having at least 1 and particularly from 1 to 2 sites of olefinic unsaturation.
  • Alkoxy refers to the group -O-alkyl. Particular alkoxy groups include, by way of example, methoxy, ethoxy, n-propoxy, isopropoxy, n-butoxy, tert-butoxy, sec-butoxy, n-pentoxy, n-hexoxy, 1,2-dimethylbutoxy, and the like.
  • Alkoxycarbonyl refers to a radical -C(O)-alkoxy where alkoxy is as defined herein.
  • Alkoxycarbonylamino refers to the group -NRC(O)OR' where R is hydrogen, alkyl, aryl or cycloalkyl, and R' is alkyl or cycloalkyl.
  • Alkyl refers to monovalent saturated aliphatic hydrocarbyl groups particularly having up to about 12 or 18 carbon atoms, more particularly as a lower alkyl, from 1 to 8 carbon atoms and still more particularly, from 1 to 6 carbon atoms.
  • the hydrocarbon chain may be either straight-chained or branched.
  • alkyl also includes “cycloalkyls” as defined herein. Structures for a few exemplary alkyl groups are provided in Table 1 below.
  • Alkylene refers to divalent saturated aliphatic hydrocarbyl groups particularly having up to about 12 or 18 carbon atoms and more particularly 1 to 6 carbon atoms which can be straight-chained or branched.
  • Alkynyl refers to acetylenically unsaturated hydrocarbyl groups particularly having up to about 12 or 18 carbon atoms and more particularly 2 to 6 carbon atoms which can be straight-chained or branched and having at least 1 and particularly from 1 to 2 sites of alkynyl unsaturation.
  • alkynyl groups include acetylenic, ethynyl (-C ⁇ CH), propargyl (-CH 2 C ⁇ CH), and the like.
  • Amino refers to the radical -NH 2 .
  • Amino acid refers to any of the naturally occurring amino acids (eg Ala, Arg, Asn, Asp, Cys, Glu, Gln, Gly, His, Hyl, Hyp, Ile, Leu, Lys, Met, Phe, Pro, Ser, Thr, Trp, Tyr, and Val) in D, L, or DL form.
  • side chains of naturally occurring amino acids include, for example, hydrogen (eg, as in glycine), alkyl (eg, as in alanine, valine, leucine, isoleucine, proline), substituted alkyl (eg, as in threonine, serine, methionine, cysteine, aspartic acid, asparagine, glutamic acid, glutamine, arginine, and lysine), alkaryl (eg, as in phenylalanine and tryptophan), substituted arylalkyl (eg, as in tyrosine), and heteroarylalkyl (eg, as in histidine).
  • hydrogen eg, as in glycine
  • alkyl eg, as in alanine, valine, leucine, isoleucine, proline
  • substituted alkyl eg, as in threonine, serine, methionine, cysteine, aspartic acid, asparagine
  • Aminocarbonyl refers to the group -C(O)NRR where each R is independently hydrogen, alkyl, aryl or cycloalkyl, or where the R groups are joined to form an alkylene group.
  • Aminocarbonylamino refers to the group -NRC(O)NRR where each R is independently hydrogen, alkyl, aryl or cycloalkyl, or where two R groups are joined to form an alkylene group.
  • Aminocarbonyloxy refers to the group -OC(O)NRR where each R is independently hydrogen, alkyl, aryl or cycloalky, or where the R groups are joined to form an alkylene group.
  • Amino-containing saccharide group refers to a saccharide group having an amino substituent.
  • Representative amino-containing saccharide include L-vancosamine, 3-desmethyl-vancosamine, 3-epi-vancosamine, 4-epi-vancosamine, acosamine, actinosamine, daunosamine, 3-epi- daunosamine, ristosamine, N-methyl-D-glucamine and the like.
  • ARDS refers to acute respiratory distress
  • an ILD "Aralkyl” or “arylalkyl” refers to an alkyl group, as defined above, substituted with one or more aryl groups, as defined above.
  • Aryl refers to a monovalent aromatic hydrocarbon group derived by the removal of one hydrogen atom from a single carbon atom of a parent aromatic ring system.
  • Typical aryl groups include, but are not limited to, groups derived from aceanthrylene, acenaphthylene, acephenanthrylene, anthracene, azulene, benzene, chrysene, coronene, fluoranthene, fluorene, hexacene, hexaphene, hexalene, as-indacene, s-indacene, indane, indene, naphthalene, octacene, octaphene, octalene, ovalene, penta-2,4-diene, pentacene, pentalene, pentaphene, perylene, phenalene, phenanthrene, picene, pleiadene,
  • an aryl group comprises from 6 to 14 carbon atoms.
  • the structures of a few exemplary aryl groups are provided in Table 2.
  • “Aryloxy” refers to -O-aryl groups wherein “aryl” is as defined herein.
  • Autoimmune disease” or “autoimmune condition” refers an illness that occurs when the body tissues are attacked by its own immune system. Examples of autoimmune disease or conditions include multiple sclerosis, ankylosing spondylitis, Crohn’s disease, arthritis, psoriasis, Behçet's disease and psoriatic arthritis. Azido” refers to the radical -N 3 .
  • “BAL” refers to Bronchoalveolar lavage also known as bronchoalveolar washing.
  • BALF refers to BAL fluid.
  • Carbohydrate means a mono-, di-, tri-, or polysaccharide, wherein the polysaccharide can have a molecular weight of up to about 20,000, for example, hydroxypropyl-methylcellulose or chitosan.
  • Carbohydrate also encompasses oxidized, reduced or substituted saccharide monoradical covalently attached to the anhydropyrimidine (eg, anhydrothymidine or anhydrouridine), or derivative thereof any atom of the saccharide moiety, eg, via the aglycone carbon atom.
  • the “mono-, di-, tri-, or polysaccharide” can also include amino-containing saccharide groups.
  • Carbohydrate include, by way of illustration, hexoses such as D-glucose, D-mannose, D-xylose, D-galactose, vancosamine, 3-desmethyl-vancosamine, 3-epi- vancosamine, 4-epi-vancosamine, acosamine, actinosamine, daunosamine, 3-epi-daunosamine, ristosamine, D-glucamine, N-methyl-D-glucamine, D-glucuronic acid, N-acetyl-D-glucosamine, N- acetyl-D-galactosamine, sialyic acid, iduronic acid, L-fucose, and the like; pentoses such as D- ribose or D-arabinose; ketoses such as D-ribulose or D-fructose; disaccharides such as 2-O-( ⁇ - L-vancosaminyl)- ⁇ -D-glucopyr
  • the saccharides can be either in their open, r pyranose or furanose forms.
  • Carboxyl refers to the radical -C(O)OH.
  • CHP refers to chronic hypersensitivity pneumonitis, an ILD.
  • CTD-ILD refers to connective tissue disease-associated ILD.
  • Cyano refers to the radical -CN.
  • Cycloalkenyl refers to cyclic hydrocarbyl groups having from 3 to 10 carbon atoms and having a single cyclic ring or multiple condensed rings, including fused and bridged ring systems and having at least one and particularly from 1 to 2 sites of olefinic unsaturation.
  • Such cycloalkenyl groups include, by way of example, single ring structures such as cyclohexenyl, cyclopentenyl, cyclopropenyl, and the like.
  • Cycloalkyl refers to cyclic hydrocarbyl groups having from 3 to about 10 carbon atoms and having a single cyclic ring or multiple condensed rings, including fused and bridged ring systems, which optionally can be substituted with from 1 to 3 alkyl groups.
  • Such cycloalkyl groups include, by way of example, single ring structures such as cyclopropyl, cyclobutyl, cyclopentyl, cyclooctyl, 1-methylcyclopropyl, 2-methylcyclopentyl, 2-methylcyclooctyl, and the like, and multiple ring structures such as adamantanyl, and the like.
  • FVC refers to forced vital capacity.
  • Heterocycloalkyl refers to a stable heterocyclic non-aromatic ring and fused rings containing one or more heteroatoms independently selected from N, O and S.
  • a fused heterocyclic ring system may include carbocyclic rings and need only include one heterocyclic ring. Examples of heterocyclic rings include, but are not limited to, piperazinyl, homopiperazinyl, piperidinyl and morpholinyl. The structures of a few exemplary heterocyclyls are shown in Table 3.
  • Halo or “halogen” refers to fluoro, chloro, bromo and iodo. Halo groups can be either fluoro or chloro.
  • HDL refers to high density lipoprotein.
  • Hetero when used to describe a compound or a group present on a compound means that one or more carbon atoms in the compound or group have been replaced by a nitrogen, oxygen, or sulfur heteroatom.
  • Hetero may be applied to any of the hydrocarbyl groups described above such as alkyl, eg heteroalkyl, cycloalkyl, eg heterocycloalkyl, aryl, eg heteroaryl, cycloalkenyl, eg, heterocycloalkenyl, cycloheteroalkenyl, eg, heterocycloheteroalkenyl and the like having from 1 to 5, and particularly from 1 to 3 heteroatoms.
  • a heteroatom is any atom other than carbon or hydrogen and is typically, but not exclusively, nitrogen, oxygen, sulfur, phosphorus, boron, chlorine, bromine, or iodine.
  • heteroaryl refers to a monovalent heteroaromatic group derived by the removal of one hydrogen atom from a single atom of a parent heteroaromatic ring system.
  • Typical heteroaryl groups include, but are not limited to, groups derived from acridine, arsindole, carbazole, ⁇ -carboline, chromane, chromene, cinnoline, furan, imidazole, indazole, indole, indoline, indolizine, isobenzofuran, isochromene, isoindole, isoindoline, isoquinoline, isothiazole, isoxazole, naphthyridine, oxadiazole, oxazole, perimidine, phenanthridine, phenanthroline, phenazine, phthalazine, pteridine, purine, pyran, pyrazine, pyrazole, pyridazine, pyridine, pyrimidine, pyrrole, pyrrolizine, quinazoline, quinoline, quinolizine, quinoxaline, te
  • the heteroaryl group can be a 5-20 membered heteroaryl, or 5-10 membered heteroaryl. Particular heteroaryl groups are those derived from thiophen, pyrrole, benzothiophene, benzofuran, indole, pyridine, quinoline, imidazole, oxazole and pyrazine.
  • “Hydroxyl” refers to the radical -OH.
  • IIP refers to unclassifiable idiopathic interstitial pneumonia.
  • ILDs refers interstitial lung disease.
  • I-PAF refers to interstitial pneumonia with autoimmune features.
  • IPF refers to Interstitial pulmonary fibrosis, an ILD.
  • i SIP refers to idiopathic non-specific interstitial pneumonia, an ILD.
  • KO refers to knockout as used in the phrase knockout animals.
  • MCD methionine-choline deficient diet
  • Ni refers to the radical -NO 2 .
  • Peptide refers to a polyamino acid containing up to 2, 5, 10, or about 100 amino acid residues.
  • Polypeptide means polyamino acid containing from about 100 amino acid units to about 1,000 amino acid units, from about 100 amino acid units to about 750 amino acid units, or from about 100 amino acid units to about 500 amino acid units.
  • RA-ILD refers to rheumatoid arthritis-ILD.
  • ROP refers to an eye condition in infant’s retinopathy of prematurity.
  • SEM refers to standard error of the mean “Side-effect” means an undesirable adverse consequence of drug administration such as mucositis associated with administration of cancer therapy.
  • SSc refers to systemic sclerosis, an ILD.
  • Stepoisomer as it relates to a given compound is well understood in the art, and refers to another compound having the same molecular formula, wherein the atoms making up the other compound differ in the way they are oriented in space, but wherein the atoms in the other compound are like the atoms in the given compound with respect to which atoms are joined to which other atoms (eg an enantiomer, a diastereomer, or a geometric isomer).
  • enantiomer e.g., a diastereomer, or a geometric isomer.
  • Substituted refers to a group in which one or more hydrogen atoms are each independently replaced with the same or different substituent(s).
  • “Substituted” groups particularly refer to groups having 1 or more substituents, for instance from 1 to 5 substituents, and particularly from 1 to 3 substituents, selected from the group consisting of acyl, acylamino, acyloxy, alkoxy, substituted alkoxy, alkoxycarbonyl, alkoxycarbonylamino, amino, substituted amino, aminocarbonyl, aminocarbonylamino, aminocarbonyloxy, aryl, aryloxy, aralkyl, azido, carboxyl, cyano, cycloalkyl, substituted cycloalkyl, halogen, hydroxyl, imidate, keto, nitro, thioalkoxy, substituted thioalkoxy, thioaryloxy, thioketo, thiol, alkylthio, (substituted al
  • Substituted amino includes those groups recited in the definition of "substituted” herein, and particularly refers to the group -N(R) 2 where each R is independently selected from the group consisting of hydrogen, alkyl, substituted alkyl, alkenyl, substituted alkenyl, alkynyl, substituted alkynyl, aryl, cycloalkyl, substituted cycloalkyl, and where both R groups are joined to form an alkylene group.
  • SSc-ILD refers to systemic sclerosis-ILD.
  • T2D refers to type 2 diabetes.
  • TG refers to transgenic
  • Thioalkoxy refers to the group -S-alkyl.
  • Thioaryloxy refers to the group -S-aryl.
  • Thiol refers to the group -SH.
  • UR refers to uridine.
  • UPase (Uridine phosphorylase)” refers in enzymology to a phosphorylase (EC 2.4.2.3) that catalyzes the chemical reaction: uridine + phosphate ⁇ uracil + alpha-D-ribose 1-phosphate. The two substrates of this enzyme are uridine and phosphate, whereas its two products are uracil and alpha-D-ribose 1-phosphate.
  • This enzyme belongs to the family of glycosyltransferases, specifically the pentosyltransferases.
  • the systematic name of this enzyme class is uridine phosphate alpha-D-ribosyltransferase.
  • Other names in common use include pyrimidine phosphorylase, UrdPase, UPH, and UPase.
  • UrdPase UPH
  • UPase This enzyme participates in pyrimidine metabolism.
  • “Uridine Supplement” refers to either a formulated product containing UR or a formulated product containing a UR precursor such as UR monophosphate or acetylated UR that converts to UR in the body.
  • the formulated product could be a solution, a capsule, a tablet or a cream.
  • the product could be administered po, ip, sc, or iv.
  • the UR supplement could be administered as part of a more complex mixture such as a nutritional supplement.
  • ip, po and sc are intraperitoneal, oral or subcutaneous dosing, respectfully.
  • H&E Haematoxylin & Eosin, a dye used to stain tissues.
  • SD is standard deviation.
  • SE is standard error.
  • PBS is phosphate buffered saline. qd. and bid are daily and twice-a-day, respectfully.
  • a heterocyclic ring may have one to four heteroatoms so long as the heteroaromatic ring is chemically feasible and stable.
  • DETAILED DESCRIPTION Methods for treating a subject for pulmonary conditions are provided. Aspects of the methods include administering an effective amount of a UR plasma level modulator to a subject. In certain embodiments, the therapy is a 2,2'-anhydropyrimidine, or a derivative thereof. Also provided are compositions for use in practicing the subject methods.
  • anhydronucleosides are employed in combination with UR, a UR pro-drug, or a UR mimetic.
  • Anhydronucleosides are analogs of natural nucleosides, often finding use as intermediates in the synthesis of nucleoside derivatives. They are characterized by having, in addition to the N-glycoside linkage, a covalent linkage either directly or via bridging atoms between the 2', 3', or 5' carbons of the sugar and a carbon, oxygen or nitrogen atom (other than the nitrogen of the glycoside bond) of the base.
  • the anhydropyrimidines are characterized by a pyrimidine base that is covalently linked either directly or via bridging atoms between the 2', 3', or 5' carbons of the sugar and a carbon, oxygen or nitrogen atom (other than the nitrogen of the glycoside bond) of the pyrimidine base.
  • compositions e.g., formulations and kits
  • methods of treating a subject for pulmonary conditions are provided.
  • An aspect of the subject methods is administration to the subject of an effective amount of a UR plasma level modulator.
  • the treatment is a 2,2'-anhydropyrimidine, such as a 2,2'-anhydrouridine or analogue/derivative thereof.
  • the UR plasma level modulator e.g., UR elevation agent
  • UR may be used in combination with UR, a UR pro-drug, or UR mimetic.
  • the UR, UR pro-drug or UR mimetic are administered simultaneously with the UR elevating agent.
  • the UR elevating agent e.g., an 2,2'- anhydropyrimidine
  • the UR, UR pro-drug or UR mimetic are administered sequentially.
  • the UR elevating agent and the UR, UR pro-drug or UR mimetic can be administered at the same time as two separate formulations or are combined into a single composition that is administered to the subject.
  • uridine elevating agent and UR plasma level modulator are administered sequentially or simultaneously, or any effective variation thereof, the agents are considered to be administered together or in combination for purposes of the present invention. Routes of administration of the two agents may vary. Representative routes of administration are described below.
  • an effective amount of a UR plasma level modulator e.g., UR elevating agent
  • a UR plasma level modulator is an agent that changes the plasma UR level of a subject following administration to the subject.
  • a UR plasma level modulator enhances the plasma UR level in the subject.
  • Plasma UR level enhancing agents include, but are not limited to, UR and sources thereof, UR precursors as sources thereof, and UR degradation inhibitors, such as UPase inhibitors, UR secretion inhibiting compounds and UR renal transport competitors. Of particular interest are 2,2'-anhydropyrimidines and derivatives thereof that are inhibitors of UPase.
  • UPase (UPh; EC 2.4.2.3) is a member of the pyrimidine nucleoside phosphorylase family of enzymes which catalyzes the phosphorolytic cleavage of the C-N glycoside bond of UR, with the formation of ribose 1-phosphate and uracil.
  • UPase UPh; EC 2.4.2.3
  • the UR elevating agent is 2,2'-anhydropyrimidines or a derivative thereof.
  • the 2,2'-anhydropyrimidine or derivative thereof is a compound of formula (I): or the pharmaceutically acceptable salts, solvates, hydrates, and prodrug forms thereof, and stereoisomers thereof; wherein: each R 1 , R 2 , R 3 and R 4 is independently selected from the group consisting of hydrogen, substituted or unsubstituted heteroatom, substituted or unsubstituted alkyl, substituted or unsubstituted cycloalkyl, substituted or unsubstituted heterocycloalkyl, substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted aralkyl, hydroxyl, halogen, azido, amino, substituted amino, carbohydrate, nucleic acid, amino acid, peptide, dye, fluorophore and polypeptide.
  • the compound is of formula (I), R 1 , R 2 , R 3 and R 4 are independently hydrogen, hydroxyl, heteroatom, C 1 -C 18 alkyl, C 1 -C 18 substituted alkyl, C 1 -C 18 alkenyl, C 1 -C 18 acyl, amino, substituted amino, wherein the alkyl, alkenyl or acyl is linear or branched, and optionally substituted with a hydroxyl, an ester and its derivatives, a carboxyl and its derivatives, a cycloalkyl, a heterocycloalkyl, an aryl, a heteroaryl, an aralkyl, a heteroatom, and possibly containing in chain or bridging heteroatoms such as nitrogen, oxygen and sulfur.
  • R 1 , R 2 , R 3 and R 4 are independently hydrogen, hydroxyl, heteroatom, C 1 -C 18 alkyl, C 1 -C 18 substituted alkyl, C 1 -C 18 alkenyl,
  • R 1 constituents of interest include, but are not limited to: hydrogen; hydroxyl; sulfyhydryl; halogen such as fluorine, chlorine, bromine or iodine, as well as pseudohalogen such as a lower alkylsulfonyl group of 1 to 5 carbons such as methyl-, ethyl-, propyl-, isopropyl-, butyl- , isobutyl-, tert-butyl-, and pentasulfonyl or arylsulfonyl such as benzene, p-toluene, p- nitrobenzenesulfonyl groups; lower alkyl containing 1 to 20 carbons such as methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl, pentyl and the like, including substituted lower alkyl such as aminomethyl, hydroxymethyl, methoxy,
  • R 1 is hydrogen, hydroxyl, sulfyhydryl, amino, substituted amino, hydroxymethyl, monomethoxy, halogen, pseudohalogen, or a lower hydrocarbon (which hydrocarbon can be substituted or unsubstituted) containing from 1 to 20 atoms.
  • R 1 is a lower hydrocarbon selected from alkyl, substituted alkyl, alkenyl, alkanoyl, aryl, aroyl, aralkyl, or alkylamino.
  • R 1 is a lower hydrocarbon substituted with alkoxy, substituted alkoxy, imidate, arylthio, or (substituted aryl) thio.
  • R 1 is a lower alkyl selected from methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl and pentyl. In other embodiments, R 1 is a lower alkenyl selected from vinyl, substituted vinyl, ethynyl, or substituted ethynyl.
  • R 1 is a lower alkanoyl selected from formyl, acetyl, propionyl, isopropionyl, butyryl, isobutyryl, tert-butyryl, valeryl, pivaloyl, caproyl, capryl, lauryl, myristyl, palmityl, stearyl, arachidyl, stilligyl, palmitoyl, oleyl, linolenyl, and arachidonyl.
  • R 1 is lower aryl selected from phenyl, p-tolyl, p-chlorophenyl, p-aminophenyl, p-nitrophenyl, p-anisyl.
  • R 1 is a lower aroyl selected from benzoyl and naphthoyl.
  • R 1 is a lower aralkyl selected from benzyl, benzhydryl, p-chlorobenzyl, m-chlorobenzyl, p-nitrobenzyl, benzyloxybenzyl, or pentaflourobenzyl.
  • R 1 is a lower alkylamino is selected from monoalkylamino, monoaralkylamino, dialkylamino, diaralkylamino, and benzylamino.
  • Compounds of interest include, but are not limited to, those of formula (I) where R 1 is selected from hydrogen, fluorine, trifluoromethyl, methyl, ethyl, propyl, butyl, isopropyl, isobutyl, acetyl, propionyl, butyryl, 2-bromovinyl, phenyl, benzyl, benzoyl, benzyloxybenzyl, benzylamino, alkyloxyalkyl, benzyloxyalkyl, imidatealkyl, arylthio, and (substituted aryl) thio.
  • R 2 constituents of interest include, but are not limited to: hydrogen; hydroxyl; sulfyhydryl; halogen such as fluorine, chlorine, bromine or iodine, as well as pseudohalogen such as a lower alkylsulfonyl group of 1 to 5 carbons such as methyl-, ethyl-, propyl-, isopropyl-, butyl- , isobutyl-, tert-butyl-, and pentasulfonyl or arylsulfonyl such as benzene, p-toluene, p- nitrobenzenesulfonyl groups; lower alkyl containing 1 to 20 carbons such as methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl, pentyl and the like, including substituted lower alkyl such as aminomethyl, hydroxymethyl, methoxy,
  • R 2 is hydrogen, hydroxyl, sulfyhydryl, amino, hydroxymethyl, monomethoxy, halogen, pseudohalogen, or a lower hydrocarbon (which hydrocarbon can be substituted or unsubstituted) containing from 1 to 20 atoms, and esters thereof.
  • R 2 is a lower hydrocarbon selected from alkyl, alkenyl, alkanoyl, aryl, aroyl, aryloxy, aroyloxy, aralkyl, or alkylamino.
  • R 2 is a lower alkyl selected from methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl and pentyl.
  • R 2 is a lower alkenyl selected from vinyl, substituted vinyl, ethynyl, or substituted ethynyl.
  • R 2 is a lower alkanoyl selected from formyl, acetyl, propionyl, isopropionyl, butyryl, isobutyryl, tert-butyryl, valeryl, pivaloyl, caproyl, capryl, lauryl, myristyl, palmityl, stearyl, arachidyl, stilligyl, palmitoyl, oleyl, linolenyl, and arachidonyl.
  • R 2 is lower aryl selected from phenyl, p-tolyl, p-chlorophenyl, p-aminophenyl, p-nitrophenyl, p-anisyl.
  • R 2 is a lower aroyl selected from benzoyl and naphthoyl.
  • R 2 is a lower aralkyl selected from benzyl, benzhydryl, p-chlorobenzyl, m-chlorobenzyl, p-nitrobenzyl, benzyloxybenzyl, or pentaflourobenzyl.
  • R 2 is a lower aryloxy selected from phenyloxy, benzyloxy, benzhydryloxy, p-chlorobenzyloxy, m-chlorobenzyloxy, p-nitrobenzyloxy, (4-benzyloxybenzyl)-oxy, or pentaflourobenzyloxy.
  • R 2 is a lower aroyloxy selected from benzoyloxy, diphenylacetyloxy, p-chlorobenzoyloxy, m-chlorobenzoyloxy, p- nitrobenzoyloxy, (4-benzyloxybenzoyl)-oxy, or pentaflourobenzoyloxy.
  • R 2 is a lower alkylamino is selected from monoalkylamino, monoaralkylamino, dialkylamino, and diaralkylamino.
  • R 2 can not only be hydrogen or hydroxyl, but also an O-acyl, alkoxy, alkoxycarbonyl, alkoxycarbonylamino, O-alkyl, O-alkylene, O-alkynyl, O-aralkyl, O-aryl, O-aryloxy, O-carbohydrate, O-cycloalkenyl, O-cycloalkyl, O- heterocycloalkyl, O-heteroaryl.
  • an S can substitute for the O.
  • Compounds of interest include, but are not limited to, those of formula (I) where R 2 is selected from hydrogen, fluorine, trifluoromethyl, methyl, ethyl, propyl, butyl, isopropyl, isobutyl, acetyl, propionyl, butyryl, 2-bromovinyl, phenyl, phenyloxy, benzyl, benzoyl, benzoyloxy and benzyloxybenzyl.
  • R 2 is selected from hydrogen, fluorine, trifluoromethyl, methyl, ethyl, propyl, butyl, isopropyl, isobutyl, acetyl, propionyl, butyryl, 2-bromovinyl, phenyl, phenyloxy, benzyl, benzoyl, benzoyloxy and benzyloxybenzyl.
  • the compound is of formula (I), and R 2 is hydrogen, hydroxyl, or an O-linked substituent. This includes compounds of formula (I), where R 2 is H, OH or C 6 H 5 C(O)O.
  • R 3 of interest examples include, but are not limited to: hydrogen; hydroxyl; azido; sulfyhydryl; halogen; pseudohalogen; lower alkyl containing 1 to 20 carbons such as methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl, pentyl and the like, including a substituted lower alkyl such as aminomethyl, hydroxymethyl, methoxy, ethyloxy, propyloxy, and the like; lower alkanoyl (acyl) including esters thereof of a main chain of 1 to 20 carbon atoms such as formyl, acetyl, propionyl, isopropionyl, butyryl, isobutyryl, tert-butyryl, valeryl, pivaloyl, caproyl, capryl, lauryl, myristyl, palmityl, stearyl, arachidyl, stilligyl, palm
  • R 3 may also be adamantoyl, or substituted adamantoyl.
  • R 3 is hydrogen, hydroxyl, azido, sulfyhydryl, hydroxymethyl, halogen, or pseudohalogen.
  • R 3 is a lower hydrocarbon selected from alkyl, alkanoyl, aryl, aroyl, aryloxy, aroyloxy, or aralkyl.
  • R 3 is a lower alkyl selected from methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl and pentyl.
  • R 3 is a lower alkanoyl selected from formyl, acetyl, propionyl, isopropionyl, butyryl, isobutyryl, tert-butyryl, valeryl, pivaloyl, caproyl, capryl, lauryl, myristyl, palmityl, stearyl, arachidyl, stilligyl, palmitoyl, oleyl, linolenyl, and arachidonyl.
  • R 3 is a lower aryl selected from phenyl, p-tolyl, p-chlorophenyl, p-aminophenyl, p-nitrophenyl, p-anisyl and the like.
  • R 3 is a lower aroyl selected from benzoyl and naphthoyl.
  • R 3 is a lower aralkyl selected from benzyl, benzhydryl, p-chlorobenzyl, m- chlorobenzyl, p-nitrobenzyl, benzyloxybenzyl, or pentaflourobenzyl.
  • R 3 is a lower aryloxy selected from phenyloxy, benzyloxy, benzhydryloxy, p-chlorobenzyloxy, m- chlorobenzyloxy, p-nitrobenzyloxy, (4-benzyloxybenzyl)-oxy, or pentaflourobenzyloxy.
  • R 3 is a lower aroyloxy selected from benzoyloxy, diphenylacetyloxy, p- chlorobenzoyloxy, m-chlorobenzoyloxy, p-nitrobenzoyloxy, (4-benzyloxybenzoyl)-oxy, or pentaflourobenzoyloxy.
  • R 3 can not only be hydrogen or hydroxyl, but also an O-acyl, alkoxy, alkoxycarbonyl, alkoxycarbonylamino, O-alkyl, O-alkylene, O-alkynyl, O-aralkyl, O-aryl, O-aryloxy, O-carbohydrate, O-cycloalkenyl, O-cycloalkyl, O-heterocycloalkyl, O-heteroaryl.
  • an S can substitute for the O.
  • Compounds of interest are those of formula (I) where R 3 is hydrogen, hydroxyl, halogen, azido, or an O-linked substituent.
  • R 3 is selected from hydrogen, hydroxyl, n-butoxy, isobutyloxy, t-butyloxy, phenyloxy, benzyloxy, benzoyloxy, and pentafluorobenzoyloxy.
  • the compound is of formula (I), and R 3 is selected from H, OH, CH 3 CH 2 CH 2 CH 2 O, (CH 3 ) 2 CH 2 CH 2 O, (CH 3 ) 3 CO, C 6 H 5 O, benzoyloxy, and pentafluorobenzoyloxy.
  • the compound is of formula (I), where R 3 is H, OH, F, Cl, Br, I, N 3 , or C 6 H 5 C(O)O.
  • R 3 is H, OH, F, Cl, Br, I, N 3 , or C 6 H 5 C(O)O.
  • R 3 is OH, or O-acyl (for example, an ester such as C 6 H 5 C(O)O).
  • R 4 include but are not limited to: hydrogen; hydroxyl; sulfhydryl; halogen such as fluorine, chlorine, bromine or iodine; amino or lower alkylamino.
  • R 4 also is exemplified by lower alkyl, with acyl groups which may be lower alkanoyl groups of 1 to 7 carbon atoms such as formyl, acetyl, propionyl, isopropionyl, butyryl, isobutyryl, tert-butyryl and the like, and esters thereof.
  • acyl groups which may be lower alkanoyl groups of 1 to 7 carbon atoms such as formyl, acetyl, propionyl, isopropionyl, butyryl, isobutyryl, tert-butyryl and the like, and esters thereof.
  • R 4 can also be aroyl (and esters thereof such as O-linked aroyls, ie, O-arolys or arolyoxy) such as benzoyl and naphthoyl wherein the aromatic group may be additionally substituted by alkyl, alkoxy, halo, or nitro moieties such as p-tolnoyl, p-anisoyl, p-chlorobenzoyl, p-nitrobenzoyl or 2,4-dinitrobenzoyl and the like.
  • aroyl and esters thereof such as O-linked aroyls, ie, O-arolys or arolyoxy
  • benzoyl and naphthoyl wherein the aromatic group may be additionally substituted by alkyl, alkoxy, halo, or nitro moieties such as p-tolnoyl, p-anisoyl, p-chlorobenzoyl, p-nitrobenzoy
  • R 4 can not only be hydrogen or hydroxyl, but also an O-acyl, alkoxy, alkoxycarbonyl, alkoxycarbonylamino, O-alkyl, O-alkylene, O-alkynyl, O-aralkyl, O-aryl, O-aryloxy, O-carbohydrate, O-cycloalkenyl, O-cycloalkyl, O-heterocycloalkyl, O-heteroaryl.
  • an S can substitute for the O.
  • R 4 is hydrogen; hydroxyl; sulfhydryl; halogen, amino aminomethyl, or aminodimethyl.
  • R 4 is a lower alkyl, acyl, aroyl, or aroyloxy.
  • the compound of formula (I) is one where R 4 is hydrogen, flourine, hydroxyl, amino, aminomethyl, aminodimethyl, t-butyloxy, phenyloxy or benzoyloxy (for example, a compound of formula (I), where R 4 is H, F, OH, NH 2 , NHCH 3 , N(CH 3 ) 2 , (CH 3 ) 3 CO, C 6 H 5 O or C 6 H 5 C(O)O).
  • R 4 is hydrogen, hydroxyl, or an O-linked substituent.
  • the compound is of formula (I), where R 4 is H, OH or C 6 H 5 C(O)O.
  • R 4 is OH, or O-acyl (for example, an ester such as C 6 H 5 C(O)O).
  • 2,2'-anhydropyrimidine compounds of the invention may be in compositions that contain single stereoisomers, mixtures of stereoisomers, as well various derivatives thereof that can occur as equilibrium mixtures of tautomers.
  • 2,2'-anhydropyrimidines according to formula (I) include four stereo centers with respect to the furano ring, which includes the a and ⁇ anomers, and the L or D mirror image configurations.
  • stereoisomers of the 2,2'- anhydropyrimidine compounds of the invention are the ⁇ -D-isomer, ⁇ -L-isomer, ⁇ -D-isomer, and ⁇ -L-isomer, as well as tautomers and mixtures including ⁇ , ⁇ -D-isomers, ⁇ , ⁇ -L-isomers, ⁇ -DL- isomers, and ⁇ -DL-isomers.
  • compositions are provided that consists essentially of a stereoisomer of a 2,2'-anhydropyrimidine that is a ⁇ -D-isomer, ⁇ -L-isomer, ⁇ -D- isomer, or an ⁇ -L-isomer.
  • Stereoisomers exhibiting improved activity on a molar basis or improved specificity with respect to interfering with cancer therapy efficacy are of special interest.
  • Stereoisomers of particular interest include: 2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)uracil; 2,2′- anhydro-1-( ⁇ -D-arabinofuranosyl)-5-fluorouracil; 2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)-5- trifluoromethyluracil; 2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)-5-methyluracil; 2,2′-anhydro-1-( ⁇ -D- arabinofuranosyl)-5-ethyluracil; 2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)-5-n-propyluracil; 2,2′- anhydro-1-( ⁇ -D-arabinofuranosyl)-5-
  • stereoisomers of interest include: 3'-O-benzoyl-2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)uracil; 3'-O-benzoyl-2,2′- anhydro-1-( ⁇ -D-arabinofuranosyl)-5-fluororacil; 3'-O-benzoyl-2,2′-anhydro-1-( ⁇ -D- arabinofuranosyl)-5-trifluoromethyluracil; 3'-O-benzoyl-2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)-5- methyluracil; 3'-O-benzoyl-2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)-5-ethyluracil; 3'-O-benzoyl- 2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)-5-n-propyluracil; 3'
  • Additional stereoisomers of interest include: 5'-O-benzoyl-2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)uracil; 5'-O- benzoyl-2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)-5-fluorouracil; 5'-O-benzoyl-2,2′-anhydro-1-( ⁇ -D- arabinofuranosyl)-5-trifluoromethyluracil; 5'-O-benzoyl-2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)-5- methyluracil; 5'-O-benzoyl-2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)-5-ethyluracil; 5'-O-benzoyl- 2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)-5-n-propyluracil; 5
  • Examples of other analogs or derivatives of the 2,2'-anhydropyrimidines of the invention, and stereoisomers thereof include: 3′-O-acetyl-2,2′-anhydro-5-propyluridine (3′-O-acetyl-2,2'- anhydro-1-( ⁇ -D-arabinofuranosyl)-5-propyluracil); and 3′-O-acetyl-2,2′-anhydro-5- isopropyluridine (3′-O-acetyl-2,2'-anhydro-1-( ⁇ -D-arabinofuranosyl)-5-isopropyluracil); as well as the 2,2′-anhydrocytidines, and analogs and derivatives thereof, of which the stereoisomer 2,2′- anhydro-1-( ⁇ -D-arabinofuranosyl)cytosine is one example.
  • stereoisomers and the various 2,2'-anhydropyrimidines of particular interest are those which exhibit improved activity on a molar basis, or improved specificity with respect to not interfering with cancer therapy efficacy.
  • Such compounds can be readily selected for this purpose by comparing against a matrix of compounds of particular interest, such as those illustrated in Table 1 (where the compound is of formula (I)).
  • R 4 can be not only hydroxyl, but also an O-acyl, alkoxy, alkoxycarbonyl, alkoxycarbonylamino, O- alkyl, O-alkylene, O-alkynyl, O-aralkyl, O-aryl, O-aryloxy, O-carbohydrate, O-cycloalkenyl, O- cycloalkyl, O-heterocycloalkyl, O-heteroaryl.
  • an S can substitute for the O and other combinations of the structural elements such as described herein, as well as other streochemical orientations, are also possible.
  • acyl derivatives of the 2,2’-anyhydropyrimidines of formula (I) are of interest.
  • compounds of formula (I) include those in which R 1 , R 2 , R 3 and R 4 are as defined above, wherein at least one of R 2 , R 3 and R 4 is an acyl derivative.
  • acyl derivative is intended a derivative of a 2,2’-anyhydropyrimidine of formula (I) in which at least one of R 2 , R 3 and R 4 is a substantially nontoxic organic acyl substituent obtainable from a carboxylic acid that is attached to a hydroxyl group on the ribose or pyrimidine ring of formula (I) through an ester linkage.
  • Acyl derivatives of a 2,2’-anyhydropyrimidine compound of formula (I) include those in which R 1 is as defined above, and each R 2 , R 3 and R 4 is independently hydrogen, hydroxyl or an acyl radical, with the proviso that at least one of R 2 , R 3 and R 4 is not hydrogen.
  • the acyl derivative of a 2,2’-anyhydropyrimidine is a compound of formula (I) in which R 1 and R 2 are as defined above, with the proviso that R 2 is other than hydrogen, and each R 3 and R 4 is independently hydroxyl or an acyl radical.
  • the acyl derivative of a 2,2’- anyhydropyrimidine is a compound of formula (I) in which R 1 is as defined above, R 2 is hydrogen, and each R 3 and R 4 is independently hydroxyl or an acyl radical.
  • R 1 is as defined above
  • R 2 is hydrogen
  • each R 3 and R 4 is independently hydroxyl or an acyl radical.
  • R 1 is methyl
  • R 2 is hydrogen
  • each R 3 and R 4 is independently hydroxyl or an acyl radical.
  • an acyl derivative of a 2,2’-anyhydropyrimidine compound of formula (I) wherein R 1 is methyl, R 2 is hydrogen, and each R 3 and R 4 is an acyl radical.
  • ester linkage(s) of an acyl derivative of formula (I) are cleavable under physiological conditions, either in vitro, such as in a cell-based system, and/or in vivo, such as through metabolism in a body.
  • the acyl radical is a radical of a metabolite.
  • acyl substituents include, but are not limited to, those derived from acetic acid, fatty acids, amino acids, lipoic acid, glycolic acid, lactic acid, enolpyruvic acid, pyruvic acid, orotic acid, acetoacetic acid, beta-hydroxybutyric acid, creatinic acid, succinic acid, fumaric acid, adipic acid, benzoic acid and p-aminobenzoic acid.
  • Particular acyl substituents of interest are compounds which are normally present in the body, either as dietary constituents or as intermediary metabolites, and which are essentially nontoxic when cleaved from the 2,2’- anyhydropyrimidine compound of interest in vivo.
  • compositions comprising a 3'-O-acyl-2,2'-anhydropyrimidine or derivative thereof.
  • acyl derivatives of interest are those that include a 2,2’- anyhydropyrimidine compound of formula (I), where each R 1 , R 2 and R 3 is independently selected from selected from hydrogen, hydroxyl, sulfyhydryl, amino, hydroxymethyl, methoxy, halogen, pseudohalogen, and a substituted or unsubstituted lower hydrocarbon containing 1 to 20 carbons, such as a lower hydrocarbon selected from alkyl, alkenyl, alkanoyl, aryl, aroyl, aralkyl and alkylamino, and esters thereof, and where R 4 is an O-acyl radical.
  • the acyl derivatives include a 2,2’-anyhydropyrimidine compound of formula (I), where R 4 is an O-acyl radical, and where the O-acyl radical comprises 1 to 10 carbon atoms, such as an O-acyl radical selected from aroyloxy, aralkoyloxy, heteroaroyloxy, and cycloalkoyloxy.
  • acyl derivatives of a 2,2’-anyhydropyrimidine compound of formula (I) include 3’-O- acyl-2,2’-anyhdropyrimidines, 5’-O-acyl-2,2’-anyhdropyrimidines, 3’,5’-O-acyl-2,2’- anyhdropyrimidines, and derivatives thereof.
  • 3'-O-acyl-2,2'-anhydropyrimidines or derivatives thereof include 3'-O-aroyl-2,2'-anhydropyrimidines, such as a 3'-O-aroyl-2,2'- anhydrouridine or derivative thereof.
  • 3'-O-benzoyl-2,2'-anhydro-5-methyluridine is the stereoisomer 3'-O-benzoyl-2,2'-anhydro-1-( ⁇ -D-arabinofuranosyl)-5-methyluracil.
  • compounds according to formula (I) of specific interest are those where R 1 and R 4 are as defined above, and R 2 and/or R 3 is a cyclic hydrocarbyl.
  • cyclic hydrocarbyl is intended a hydrocarbon-based ring structure having from 3 to about 10 carbon atoms and having a single cyclic ring or multiple condensed rings that may be substituted.
  • Cyclic hydrocarbyls of interest are selected from aryl, aralkyl, aryloxy, aroyl, aroyloxy, heteroaryl, heteroaryloxy, heteroaroyloxy, cylcoalkyl, cycloalkyloxy and cycloalkoyloxy.
  • cyclic hydrocarbyls of special interest are O-linked to the ribose or pyrimidine ring of formula (I).
  • Compounds where R 2 and/or R 3 is a cyclic hydrocarbyl exhibit improved activity on a molar basis, or improved specificity with respect to not interfering with cancer therapy efficacy.
  • certain compounds of the invention comprise a 5'-O-(cyclic hydrocarbyl)-2,2'- anhydropyrimidine or derivative thereof.
  • a compound of interest is 5'-O-aryl-2,2'-anhydropyrimidine or derivative thereof, of which various 2,2'-anhydrouridine derivatives are of included.
  • compounds that exhibit improved activity on a molar basis or improved specificity with respect to not interfering with fluorouracil therapy efficacy are the 5'-O-aryl-2,2'- anhydrouridines, 5'-O-aroyl-2,2'-anhydrouridines, and derivatives thereof, such as 5'-O-aryl-2,2'- anhydro-5(R 4 )-uridine, 5'-O-aroyl-2,2'-anhydro-5(R 4 )-uridine, and their derivatives.
  • Examples include 5'-O-aryl-2,2'-anhydro-5-methyl-uridine; 5'-O-aryl-2,2'-anhydro-5-ethyl-uridine; 5'-O-aryl- 2,2'-anhydro-5-propyl-uridine; 5'-O-aryl-2,2'-anhydro-5-benzyl-uridine; and 5'-O-aryl-2,2'- anhydro-5-(2-bromovinyl)-uridine; and derivatives thereof.
  • Examples also include 5'-O-aroyl-2,2'- anhydro-5-methyl-uridine; 5'-O-aroyl-2,2'-anhydro-5-ethyl-uridine; 5'-O-aroyl-2,2'-anhydro-5- propyl-uridine; 5'-O-aroyl-2,2'-anhydro-5-benzyl-uridine; and 5'-O-aroyl-2,2'-anhydro-5-(2- bromovinyl)-uridine; and derivatives thereof.
  • Compounds of specific interest include 5'-O-benzoyl- 2,2'-anhydro-5(R 4 )-uridines, such as 5'-O-benzoyl-2,2'-anhydro-5-methyl-uridine; 5'-O-benzoyl- 2,2'-anhydro-5-ethyl-uridine; 5'-O-benzoyl-2,2'-anhydro-5-propyl-uridine; 5'-O-benzoyl-2,2'- anhydro-5-benzyl-uridine; and 5'-O-benzoyl-2,2'-anhydro-5-(2-bromovinyl)-uridine.
  • 5'-O-benzoyl- 2,2'-anhydro-5(R 4 )-uridines such as 5'-O-benzoyl-2,2'-anhydro-5-methyl-uridine; 5'-O-benzoyl- 2,2'-anhydro-5-ethyl-uridine;
  • Stereoisomers of interest include the 5'-O-(cyclic hydrocarbyl)-2,2'-anhydropyrimidines which are the ⁇ -D-isomers.
  • Examples include, but are not limited to: 5'-O-benzoyl-2,2′-anhydro-1-( ⁇ -D- arabinofuranosyl)uracil; 5'-O-benzoyl-2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)-5-fluorouracil; 5'-O- benzoyl-2,2′-anhydro-1-( ⁇ -D-arabinofuranosyl)-5-trifluoromethyluracil; 5'-O-benzoyl-2,2′- anhydro-1-( ⁇ -D-arabinofuranosyl)-5-methyluracil; 5'-O-benzoyl-2,2′-anhydro-1-( ⁇ -D- arabinofuranosyl)-5-ethylurac
  • analogues/derivatives of the above compounds where such analogs/derivatives reduce cancer therapy toxicity, such that cancer therapy toxicity is reduced when the compounds are administered in conjunction with a cancer therapy according to the subject invention.
  • an effective amount of cancer therapy toxicity-reducing adjuvant is employed in the subject methods.
  • the 2,2'-anhydropyrimidine and derivatives thereof described above are commercially available or can be conventionally prepared by techniques known to one of skill in the art.
  • representative patents describing various 2,2'-anhydropyrimidine and derivatives, including intermediates and precursors, analysis, as well as the synthesis/preparation thereof include U.S. Patent Nos.
  • UR and sources thereof include, but are not limited to: meat products, such as fish, pig and cow liver and pancreas, and the like; fungi related products, such as brewer’s yeast, beer, mushrooms, and the like; vegetable products, such as sugarcane, tomatoes, oats, algae, broccoli and the like; salts, such as UR phosphates, acylated UR, and the like.
  • UR and sources thereof which may be employed in embodiments of the invention include, but are not limited to, those described in U.S. Patent Nos.: 9,579,337; 6,316,426; and 5,470,838; the disclosures of which compounds are incorporated herein by reference.
  • UR precursors and sources thereof include, but are not limited to: prodrugs of UR, such as triphenyluridine, orotic acid and the like; prodrugs of uridine 5’-monophosphate, such as mono- and di-alkyl esters, acyloxyalkyl esters, alkoxycarbonylmethyl esters, substituted ethyl and propyl esters, amidomethyl esters, benzyl esters phenyl esters, phosphonamidates, cyclophosphate esters and the like; UR prodrugs containing mono-, di- or tri-esters of UR, such as mono-, di-, and triacetyl UR and the like; UR prodrugs containing mono, di- or tri-phosphates of UR, such as UR monophosphate, UR diphosphate, UR triphosphate and the like; UR homodimers and their esters, such as U-P-U and the like; heterodimers of dideoxynu
  • Uridine precursors and sources thereof which may be employed in embodiments of the invention include, but are not limited to, those described in U.S. Patent Nos.: 5,723,449 and 7,737,128; the disclosures of which compounds are incorporated herein by reference.
  • Uridine phosphorylase (UPase) inhibitors include, but are not limited to: benzylacyclouridine, benzyloxyacylouridine, aminomethyl-benzylacylouridine, aminomethyl- benzyloxybenzylacyclouridine, hydroxymethyl-benzylacyclouridine, hydroxymethyl- benzyloxybenzyl acyclouridine, and the like; derivatives of 5-benzylbarbiturate, such as 5- benzyloxybenzyl barbiturate; 5-benzyloxybenzyl-1-(1-hydroxy-2-ethoxy)methyl) barbiturate; 5- benzyloxybenzylacetyl-1-(1-hydroxy-2-ethoxy) methyl) barbiturate; 5-benzy
  • Upase inhibitors which may be employed in embodiments of the invention include, but are not limited to, those described in U.S. Patent Nos.: 5,723,449; 5,141,943; 5,077,280; and 4,613,604; the disclosures of which compounds are incorporated herein by reference.
  • UR secretion inhibiting compounds include, but are not limited to: drugs, such as dilazep, hexobendine.
  • UR secretion inhibiting compounds which may be employed in embodiments of the invention include, but are not limited to, those described in U.S. Patent Nos.: 6,989,376 and 5,567,689; the disclosures of which compounds are incorporated herein by reference.
  • UR renal transport competitors include, but are not limited to drugs, such as L-uridine, L-2',3'- dideoxyuridine, D-2',3'-dideoxyuridine.
  • UR renal transport competitors which may be employed in embodiments of the invention include, but are not limited to, those described in U.S. Patent Nos.: 6,989,376; 5,723,449 and 5,567,689; the disclosures of which compounds are incorporated herein by reference.
  • Subjects that are treated according to methods of the invention may be subjects suffering a pulmonary condition, such as a severe pulmonary condition, e.g., IPF, ARDS, etc. Treatment according to the disclosed methods can begin prophylactically for subjects at risk for lung disease or post diagnosis of a serious lung condition.
  • Treatment can be carried out at intervals determined to be appropriate by those of skill in the art.
  • the administration can be carried out 1, 2, 3, 4 or more times/day.
  • treatment is expected to be qd chronically.
  • Treatment can also be started before or at or near the same time as a drug associated with serious lung conditions.
  • FORMULATIONS Also provided are pharmaceutical compositions containing the UR plasma level modulator employed in the subject methods.
  • the plasma UR level modulator may be present in pharmaceutical compositions, e.g., in the form of a pharmaceutically acceptable salt, and can be formulated for oral, topical or parenteral administration for use in the subject methods, as described above.
  • UR plasma level modulator and if needed the UR pro-drug or UR mimetic can be admixed with conventional pharmaceutically acceptable carriers and excipients (ie, vehicles) and used in the form of aqueous solutions, tablets, capsules, elixirs, suspensions, syrups, wafers, and the like.
  • Such pharmaceutical compositions contain, in certain embodiments, from about 0.1% to about 90% by weight of the active compound, and more generally from about 1% to about 30% by weight of the active compound.
  • compositions may contain common carriers and excipients, such as corn starch or gelatin, lactose, dextrose, sucrose, microcrystalline cellulose, kaolin, mannitol, dicalcium phosphate, sodium chloride, and alginic acid.
  • Disintegrators commonly used in the formulations of this invention include croscarmellose, microcrystalline cellulose, corn starch, sodium starch glycolate and alginic acid.
  • a liquid composition will generally consist of a suspension or solution of the compound or pharmaceutically acceptable salt in a suitable liquid carrier(s), for example, ethanol, glycerine, sorbitol, non-aqueous solvent such as polyethylene glycol, oils or water, with a suspending agent, preservative, surfactant, wetting agent, flavoring or coloring agent.
  • a liquid formulation can be prepared from a reconstitutable powder.
  • a powder containing active compound, suspending agent, sucrose and a sweetener can be reconstituted with water to form a suspension; and a syrup can be prepared from a powder containing active ingredient, sucrose and a sweetener.
  • a composition in the form of a tablet can be prepared using any suitable pharmaceutical carrier(s) routinely used for preparing solid compositions.
  • suitable pharmaceutical carrier(s) include magnesium stearate, starch, lactose, sucrose, microcrystalline cellulose and binders, for example, polyvinylpyrrolidone.
  • the tablet can also be provided with a color film coating, or color included as part of the carrier(s).
  • active compound can be formulated in a controlled release dosage form as a tablet comprising a hydrophilic or hydrophobic matrix.
  • a composition in the form of a capsule can be prepared using routine encapsulation procedures, for example, by incorporation of active compound and excipients into a hard gelatin capsule.
  • a semi-solid matrix of active compound and high molecular weight polyethylene glycol can be prepared and filled into a hard gelatin capsule; or a solution of active compound in polyethylene glycol or a suspension in edible oil, for example, liquid paraffin or fractionated coconut oil can be prepared and filled into a soft gelatin capsule.
  • Tablet binders that can be included are acacia, methylcellulose, sodium carboxymethylcellulose, poly-vinylpyrrolidone (Povidone), hydroxypropyl methylcellulose, sucrose, starch and ethylcellulose.
  • Lubricants that can be used include magnesium stearate or other metallic stearates, stearic acid, silicone fluid, talc, waxes, oils and colloidal silica.
  • Flavoring agents such as peppermint, oil of wintergreen, cherry flavoring or the like can also be used. Additionally, it may be desirable to add a coloring agent to make the dosage form more attractive in appearance or to help identify the product.
  • the compounds of the invention and their pharmaceutically acceptable salts that are active when given parenterally can be formulated for intramuscular, intrathecal, or intravenous administration.
  • a typical composition for intramuscular or intrathecal administration will be of a suspension or solution of active ingredient in an oil, for example, arachis oil or sesame oil.
  • a typical composition for intravenous or intrathecal administration will be a sterile isotonic aqueous solution containing, for example, active ingredient and dextrose or sodium chloride, or a mixture of dextrose and sodium chloride.
  • Other examples are lactated Ringer's injection, lactated Ringer's plus dextrose injection, Normosol-M and dextrose, Isolyte E, acylated Ringer's injection, and the like.
  • a co-solvent for example, polyethylene glycol, a chelating agent, for example, ethylenediamine tetracetic acid, and an anti-oxidant, for example, sodium metabisulphite may be included in the formulation.
  • the solution can be freeze dried and then reconstituted with a suitable solvent just prior to administration.
  • the compounds of the invention and their pharmaceutically acceptable salts which are active on rectal administration can be formulated as suppositories.
  • a typical suppository formulation will generally consist of active ingredient with a binding and/or lubricating agent such as a gelatin or cocoa butter or other low melting vegetable or synthetic wax or fat.
  • the compounds of this invention and their pharmaceutically acceptable salts which are active on topical administration can be formulated as transdermal compositions or transdermal delivery devices ("patches").
  • Such compositions include, for example, a backing, active compound reservoir, a control membrane, liner and contact adhesive.
  • transdermal patches may be used to provide continuous or discontinuous infusion of the compounds of the present invention in controlled amounts.
  • the construction and use of transdermal patches for the delivery of pharmaceutical agents is well known in the art. See, eg, U.S. Patent No. 5,023,252, herein incorporated by reference in its entirety.
  • Such patches may be constructed for continuous, pulsatile, or on demand delivery of pharmaceutical agents.
  • the cancer therapy toxicity-reducing adjuvant and UR plasma level modulator are administered as a single pharmaceutical formulation, that, in addition to including an effective amount of the cancer therapy toxicity-reducing adjuvant and UR plasma level modulator, includes other suitable compounds and carriers, and may also be used in combination with other active agents.
  • the present invention also includes pharmaceutical compositions comprising pharmaceutically acceptable excipients.
  • the pharmaceutically acceptable excipients include, for example, any suitable vehicles, adjuvants, carriers or diluents, and are readily available to the public.
  • the pharmaceutical compositions of the present invention may further contain other active agents that are well known in the art.
  • suitable methods of administering a formulation of the present invention to a subject or host, eg, patient, in need thereof are available, and, although more than one route can be used to administer a particular formulation, a particular route can provide a more immediate and more effective reaction than another route.
  • Pharmaceutically acceptable excipients are also well-known to those who are skilled in the art and are readily available.
  • Formulations suitable for oral administration can consist of (a) liquid solutions, such as an effective amount of the compound dissolved in diluents, such as water, saline, or orange juice; (b) capsules, sachets or tablets, each containing a predetermined amount of the active ingredient, as solids or granules; (c) suspensions in an appropriate liquid; and (d) suitable emulsions.
  • Tablet forms can include one or more of lactose, mannitol, corn starch, potato starch, microcrystalline cellulose, acacia, gelatin, colloidal silicon dioxide, croscarmellose sodium, talc, magnesium stearate, stearic acid, and other excipients, colorants, diluents, buffering agents, moistening agents, preservatives, flavoring agents, and pharmacologically compatible excipients.
  • Lozenge forms can comprise the active ingredient in a flavor, usually sucrose and acacia or tragacanth, as well as pastilles comprising the active ingredient in an inert base, such as gelatin and glycerin, or sucrose and acacia, emulsions, gels, and the like containing, in addition to the active ingredient, such excipients as are known in the art.
  • the subject formulations of the present invention can be made into aerosol formulations to be administered via inhalation. These aerosol formulations can be placed into pressurized acceptable propellants, such as dichlorodifluoromethane, propane, nitrogen, and the like.
  • Formulations suitable for parenteral administration include aqueous and non-aqueous, isotonic sterile injection solutions, which can contain anti-oxidants, buffers, bacteriostats, and solutes that render the formulation isotonic with the blood of the intended recipient, and aqueous and non- aqueous sterile suspensions that can include suspending agents, solubilizers, thickening agents, stabilizers and preservatives.
  • the formulations can be presented in unit-dose or multi-dose sealed containers, such as ampules and vials, and can be stored in a freeze-dried (lyophilized) condition requiring only the addition of the sterile liquid excipient, for example, water, for injections, immediately prior to use.
  • sterile liquid excipient for example, water
  • Extemporaneous injection solutions and suspensions can be prepared from sterile powders, granules, and tablets of the kind previously described.
  • Formulations suitable for topical administration may be presented as creams, gels, pastes, or foams, containing, in addition to the active ingredient, and other such carriers that are known in the art to be appropriate.
  • Suppository formulations are also provided by mixing with a variety of bases such as emulsifying bases or water-soluble bases.
  • Formulations suitable for vaginal administration may be presented as pessaries, tampons, creams, gels, pastes, foams.
  • Unit dosage forms for oral or rectal administration such as syrups, elixirs, and suspensions may be provided wherein each dosage unit, for example, teaspoonful, tablespoonful, tablet or suppository, contains a predetermined amount of the composition containing one or more inhibitors.
  • unit dosage forms for injection or intravenous administration may comprise the inhibitor(s) in a composition as a solution in sterile water, normal saline or another pharmaceutically acceptable carrier.
  • unit dosage form refers to physically discrete units suitable as unitary dosages for human and animal subjects, each unit containing a predetermined quantity of compounds of the present invention calculated in an amount sufficient to produce the desired effect in association with a pharmaceutically acceptable diluent, carrier or vehicle.
  • the specifications for the novel unit dosage forms of the present invention depend on the particular compound employed and the effect to be achieved, and the pharmacodynamics associated with each compound in the host. Those of skill in the art will readily appreciate that dose levels can vary as a function of the specific compound, the nature of the delivery vehicle, and the like. Suitable dosages for a given compound are readily determinable by those of skill in the art by a variety of means.
  • the dose administered to an animal, particularly a human, in the context of the present invention should be sufficient to cause a prophylactic or therapeutic response in the animal over a reasonable time frame.
  • dosage will depend on a variety of factors including the strength of the particular compound employed, the condition of the animal, and the body weight of the animal, as well as the severity of the illness and the stage of the disease.
  • the size of the dose will also be determined by the existence, nature, and extent of any adverse side-effects that might accompany the administration of a particular compound. Suitable doses and dosage regimens can be determined by comparisons to anticancer or immunosuppressive agents that are known to cause the desired growth inhibitory or immunosuppressive response.
  • the pharmaceutical composition may contain other pharmaceutically acceptable components, such as buffers, surfactants, antioxidants, viscosity modifying agents, preservatives and the like.
  • these components are well-known in the art. For example, see U.S. Patent No.5,985,310, the disclosure of which is herein incorporated by reference.
  • Other components suitable for use in the formulations of the present invention can be found in Remington's Pharmaceutical Sciences, Mace Publishing Company, Philadelphia, Pa., 17th ed. (1985).
  • the aqueous solution of cyclodextrin also contains dextrose, e.g., about 5% dextrose.
  • the subject methods find use in the treatment of hepatic diseases that feature fibrosis, or the accumulation of extracellular matrix molecules that make up scar tissue as the toxic endpoint as well as other diseases such as, inter alia, pulmonary fibrosis, renal fibrosis, systemic sclerosis (SSc), sclerodermatous graft vs. host disease, radiation-induced fibrosis and cardiac fibrosis.
  • SSc systemic sclerosis
  • sclerodermatous graft vs. host disease radiation-induced fibrosis and cardiac fibrosis.
  • Several eye conditions such as ARMD, DR, ROP, and neovascular glaucoma also feature fibrosis as an endpoint. In aggregate, mitigating fibrosis represent a huge unmet clinical need.
  • treatment is meant that at least an amelioration of the symptoms associated with the condition afflicting the host is achieved, where amelioration is used in a broad sense to refer to at least a reduction in the magnitude of a parameter, eg, a symptom associated with the condition being treated or an side effect resulting from administration of a drug.
  • amelioration also includes situations where the pathological condition, or at least symptoms associated therewith, are completely inhibited, eg, prevented from happening, or stopped, eg terminated, such that the host no longer suffers from the condition, or at least the symptoms that characterize the condition.
  • a variety of subjects are treatable according to the subject methods.
  • Such hosts are "mammals” or “mammalian,” where these terms are used broadly to describe organisms which are within the class mammalia, including the orders carnivore (eg, dogs and cats), rodentia (eg, mice, guinea pigs, and rats), and primates (eg, humans, chimpanzees, and monkeys).
  • the subjects will be humans.
  • the subjects will be subjects that have been diagnosed for and are, therefore, in need of administration of the active agent.
  • the methods may include diagnosing the subject for the presence of the disease condition to be treated by administration of the active agent.
  • the methods may include diagnosing the subject for risk of a disease condition (eg, fibrosis) whose downstream severity could be modulated or entirely prevented by administration of the active agent.
  • a disease condition eg, fibrosis
  • the dose administered to an animal, particularly a human, in the context of the present invention should be sufficient to affect a prophylactic or therapeutic response in the animal over a reasonable time frame.
  • dosage will depend on a variety of factors including the strength of the particular compound employed and the dosing regimen used, the condition of the animal, and the body weight of the animal, as well as the severity of the illness and the stage of the disease.
  • the size of the dose will also be determined by the existence, nature, and extent of any adverse side-effects that might accompany the administration of a particular compound.
  • kits and systems that find use in practicing the subject methods, eg, as described above.
  • kits and systems for practicing the subject methods may include one or more pharmaceutical formulations, which include the UR plasma level modulator and perhaps UR, a UR prodrug, or a UR mimetic.
  • the kits may include a single pharmaceutical composition, present as one or more unit dosages, where the composition includes both a plasma UR level modulator and perhaps UR, a UR prodrug, or a UR mimetic.
  • kits may include two or more separate pharmaceutical compositions, each containing the plasma UR level modulator and perhaps UR, a UR prodrug, or a UR mimetic.
  • the subject kits may further include instructions for practicing the subject methods. These instructions may be present in the subject kits in a variety of forms, one or more of which may be present in the kit.
  • One form in which these instructions may be present is as printed information on a suitable medium or substrate, eg, a piece or pieces of paper on which the information is printed, in the packaging of the kit, in a package insert, etc.
  • Yet another means would be a computer readable medium, eg, diskette, CD, etc., on which the information has been recorded.
  • kits include as a first component (a) instructions for using a plasma UR level modulator, and as a second component (b) a pharmaceutical composition comprising a uridine, an UR prodrug, or an UR mimetic.
  • Kits of specific interest are those that include a 2, 2’-anhydropyrimidine pharmaceutical composition of the invention and suitable for practicing the subject methods of the invention, such as for mitigating serious pulmonary disease.
  • system refers to a collection of a plasma UR level modulator, and perhaps UR, an UR prodrug or an UR mimetic present in a single or disparate composition, that are brought together for the purpose of practicing the subject methods.
  • a plasma UR level modulator active agent and perhaps a UR, UR prodrug or UR mimetic dosage forms brought together and co-administered to a subject, according to the present invention are a system according to the present invention.
  • the following examples further illustrate the present invention but should not be construed in any way as limiting its scope.
  • Figure provides a regression analysis of plasma UR concentration versus plasma Compound 1 concentrations determined following continuous infusion of various amounts of Compound 1 (TK-112690) to mice.
  • R2 for the line is 0.95, and the slope and intercept values for the line are 0.010 and 0.051, respectively.
  • Compound 1 is seen to elevate plasma UR in a linear fashion.
  • Animals were anesthetized with 100 mg/kg ketamine prior to pump implantation.
  • Surgical scissors were used to make an approximately 1 cm incision on the dorsal surface near the shoulder blade of animals.
  • a hemostat was used to carve out a subcutaneous tunnel toward the anterior end of animal.
  • Osmotic pumps were placed inside the subcutaneous tunnel. Incision was sealed with wound clips. Blood collections were performed on animals anesthetized with ketamine (ip 100 mg/kg).
  • Blood samples from animals treated with a constant-rate infusion of TK-112690 were collected at 72 hours for 667 mg/kg/day and 833 mg/kg/day and 24 hours for 3000 mg/kg/day after pump implantation.
  • Whole blood ( ⁇ 0.8 mL) was drawn through the retro-orbital sinus using a heparin coated micro-hematocrit tube and collected into an EDTA microtainer tube.
  • Blood samples were transferred into fresh 1.5 mL microcentrifuge tubes and centrifuged for 10 minutes at 14,000 x g using an Eppendorf Minispin Plus stored in a 4oC refrigerator.
  • Exactly 0.4 mL of plasma was transferred into fresh microcentrifuge tubes containing 2 ⁇ L of 10 mM 5-FU and vortexed at highest setting for approximately 5 seconds. The final 50 ⁇ M concentration of 5-FU served as an internal standard. Animals were sacrificed by cervical dislocation and properly disposed. Blood samples from animals treated with a constant-rate infusion of compound I were collected at 72 hours for 667 mg/kg/day and 833 mg/kg/day and 24 hours for 3000 mg/kg/day after pump implantation. Whole blood ( ⁇ 0.8 mL) was drawn through the retro-orbital sinus using a heparin coated micro-hematocrit tube and collected into an EDTA microtainer tube.
  • Plasma samples were transferred into fresh 1.5 mL microcentrifuge tubes and centrifuged for 10 minutes at 14,000 x g using an Eppendorf Minispin Plus stored in a 4oC refrigerator. Exactly 0.4 mL of plasma was transferred into fresh microcentrifuge tubes containing 2 ⁇ L of 10 mM 5-FU and vortexed at highest setting for approximately 5 seconds. The final 50 ⁇ M concentration of 5-FU served as an internal standard. Animals were sacrificed by cervical dislocation and properly disposed. A solid-phase extraction (SPE) of analytes (UR, Compound I and 5-FU) from plasma was conducted before HPLC analysis. Supelco C8 SPE columns were used for extraction process.
  • SPE solid-phase extraction
  • FIG. 1 HPLC responses for compound I and UR were divided by the 5-FU response. Calibration curves were used to convert these ratios into concentrations of Compound 1.
  • a regression analysis (UR concentration vs. Compound 1 concentration) for data from the study is provided in Figure 1.
  • Higher concentration of TK-112690 (Compound 1) are seen to be associated with higher levels of UR.
  • Figure is a chart providing histology scores for pulmonary tissue from mice treated with bleomycin (a well characterized lung toxin) and either dosing vehicle, UR, or TK-112690. Thirty-three C57BL/6 male mice, 10-14 weeks at study initiation, were acclimatized for least 3 days. The mouse has been selected as is referenced in the literature as a representative species of choice for this experimental animal model.
  • mice were housed within a limited access rodent facility and kept in groups of a maximum of 4 mice per cage. Mice were housed in polypropylene cages with solid bottoms and wood shavings or corn cobb as bedding material. Animals were provided ad libitum with a commercial rodent diet and had free access to drinking water that is supplied to each cage via polyethylene bottles.
  • the automatically controlled environmental conditions was set to maintain temperature at 20-26°C with a relative humidity (RH) of 30-70%, a 12:12 hour light: dark cycle, and 10-15 air changes/hour in the study room. Animals were given a unique animal identification tail mark as a means of identification.
  • RH relative humidity
  • the cage card also contains the study and group numbers, route of administration, gender, study director and arrival date. Animals were randomly assigned to cages on arrival. Animals were assigned to treatment groups prior to treatment initiation. At study termination, surviving animals were weighed prior to euthanasia. Euthanasia was performed via anesthesia overdose and exsanguination. The table below lists the experimental group(s) comprising the study. *Dosing volume is based on average body weight per group, typically approx.20g/mouse. Disease Induction.75uL of Bleomycin (section 4.5.) was administered on day 0 via oropharyngeal aspiration (O.A.).
  • mice were anesthetized via isoflurane/oxygen and suspended by their cranial incisors on a thin wire from an angled stand.
  • the tongue was be gently held from the mouth using blunt forceps to visualize the base of the tongue and the pharynx.
  • Bleomycin/saline suspension was pipetted onto posterior pharynx. Nostrils will be held gently closed. Respiration was monitored to ensure the suspension is fully aspirated.
  • Treatment. Groups 3 and 4 were treated via intraperitoneal (IP) injection at a dosing volume of 10ml/kg twice daily, 6-8 hours between doses, from days 7 through 20. Observations and Examinations.
  • IP intraperitoneal
  • Clinical signs, humane endpoints, and palliative care Changes in skin, fur, eyes, mucus membranes, occurrence of secretions and excretions, autonomic activity, gait, posture, and response to handling, Bizarre behavior, tremors, convulsions, sleep and coma. Laboring breathing and adventitious lung sounds. The bleomycin administration induced a severe pulmonary inflammation resulting in lethargy, dehydration, and death of diseased animals. Animals in all diseased groups were given fresh diet gel daily beginning on Day 7 and through the remainder of the study. Body weight measurements were performed 3x weekly starting on Day 0 and throughout the rest of the study. Termination: BALF and tissue collection. Animals were euthanized via isoflurane overdose.
  • angiocatheter was inserted into the trachea. 1ml of PBS was instilled into the lungs and allowed to flow back out into the syringe twice. The resulting BALF was centrifuged at 500 ⁇ g for 5 mins and the non-cellular portion of the BALF was stored at -80 °C for potential subsequent analyses. Histology. Following BALF collection, lungs were inflated and fixed with formalin for histological analysis. Analysis included Masson’s Trichrome stain for presence of collagen. Disease severity and collagen levels were assessed by the Ashcroft fibrosis grading system. The resulting data were analyzed by SPSS, version 20.
  • FIG. 1 provides a chart correlating TGF- ⁇ 1 concentration in BAL fluid from the mice participating in the bleomycin/pulmonary fibrosis study whose results are shown in Figure 2 and fibrosis scores.
  • Each BAL sample was 60 ⁇ l of BALF in 1.5ml Eppendorf tubes. Prior to analysis the samples were stored at -80°C. The samples were run at a single concentration without any dilutions. Duplicates of each calibration standard were run, so that the CV values could also be evaluated for the panel. Samples were analyzed using a Luminex® MagPixTM system. Analysis of the raw data was performed using MilliplexTM Analyst software. The Luminex technology used color-code microspheres with fluorescent dyes which were coated with a specific capture antibody.
  • each range discussed herein can be readily broken down into a lower third, middle third and upper third, etc.
  • all language such as “up to,” “at least,” “greater than,” “less than,” and the like include the number recited and refer to ranges which can be subsequently broken down into sub-ranges as discussed above.
  • a range includes each individual member.
  • a group having 1-3 articles refers to groups having 1, 2, or 3 articles.
  • a group having 1-5 articles refers to groups having 1, 2, 3, 4, or 5 articles, and so forth.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Chemical & Material Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Epidemiology (AREA)
  • Engineering & Computer Science (AREA)
  • Molecular Biology (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Pulmonology (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • General Chemical & Material Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Organic Chemistry (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)

Abstract

The present invention relates to compositions, formulations, and methods for treating pulmonary disorders having fibrosis as part of the underlying pathology, such as IPF and ARDS, by administration of a UPase inhibitor, with or without supplemental UR, a UR prodrug, or a UR mimetic to a subject in need thereof.

Description

URIDINE PHOSPHORYLASE INHIBITORS TO TREAT OR PREVENT PULMONARY DISEASE CROSS-REFERENCE TO RELATED APPLICATIONS Pursuant to 35 U.S.C. §119(e), this application claims priority to the filing date of United States Provisional Patent Application Serial No. 63/048,850 filed July 7, 2020; the disclosure of which application is herein incorporated by reference INTRODUCTION Fibrosis (Rockey DC, Bell PD, Hill JA, Fibrosis — A Common Pathway to Organ Injury and Failure, N Engl J Med 2015; 372:1138-1149) is pathological wound healing where connective tissue replaces normal parenchymal tissue leading to tissue re-modelling and the formation of permanent scar tissue (fibrotic scarring). Fibrosis is a sequela of impaired wound healing from repetitive, extensive, epithelial injury. Normal, healthy wound healing is a natural restorative process in which an organ repairs itself after injury. Impaired wound healing occurs when the wound healing process enters a state of pathologic inflammation and scar formation because of a postponed, incomplete, or uncoordinated healing process. Fibrosis is the final, common pathological outcome of many chronic inflammatory diseases affecting organ tissues. (Wynn TA, Ramalingam TR, Mechanisms of fibrosis: therapeutic translation for fibrotic disease, Nature Medicine 2012; 18:1028–1040). Impaired wound healing followed by resulting pathologic fibrosis constitute a major health problem worldwide (fibrotic diseases; Rosenbloom J, Macarak E, Piera-Velazquez S, Jimenez SA, Human Fibrotic Diseases: Current Challenges in Fibrosis Research, Fibrosis, Part of the Methods in Molecular Biology book series, MIMB, Vol.1627, pg.1-23) because of: · The large number of affected individuals, · The limited knowledge of the pathogenesis of the fibrotic process, · The marked heterogeneity in fibrotic etiologies and clinical manifestations, · The absence of appropriate and fully validated biomarkers, and, · Most importantly, the lack of effective, preventative and disease-modifying therapeutic agents available to patients suffering from, or at risk for, fibrosis. Fibrotic disorders encompass a wide spectrum of clinical entities including, systemic fibrotic diseases such as systemic sclerosis (SSc), sclerodermatous graft vs. host disease, and nephrogenic systemic fibrosis, and numerous organ-specific disorders including, radiation- induced fibrosis and cardiac, pulmonary, liver, and kidney fibrosis. The causative mechanisms of fibrotic disorders are diverse, and, in many cases, unknown. These diseases share the common feature of an uncontrolled and progressive accumulation of fibrotic tissue in affected organs causing their dysfunction and ultimate failure. Despite the remarkable heterogeneity in the etiologic mechanisms responsible for the development of fibrotic diseases and their clinical manifestations, numerous studies have identified activated myofibroblasts as a common cellular element ultimately responsible for the replacement of normal tissues with nonfunctional, fibrotic tissue. The therapeutic targets most investigated to mitigate pathologic fibrosis are those initiated by transforming growth factor-β (TGF-β). (Meng XM, Nikolic-Paterson DJ, Lan HY, TGF-β: the master regulator of fibrosis, Nature Reviews Nephrology 2016; 12:325–338). Other approaches studied include numerous cytokines and signaling molecules, which stimulate profibrotic reactions in myofibroblasts. (Weiskirchen R, Weiskirchen S, Tacke F, Organ and tissue fibrosis: Molecular signals, cellular mechanisms and translational implications, Molecular Aspects of Medicine 2019; 65:2-15). Pulmonary fibrosis is a particularly injurious manifestation of impaired wound healing. Pulmonary conditions with fibrosis as part of the underlying pathophysiology are often collected under the term Interstitial Lung Diseases (ILDs). (du Bois RM, Strategies for treating idiopathic pulmonary fibrosis, Nature Reviews Drug Discovery 2010; 9:129-140). ILDs include a large and diverse group of more than 200 lung diseases and respiratory conditions characterized by inflammation and fibrosis of the interstitium, the tissue located between the air sacs of the lung. Two of the most common types of ILD are idiopathic pulmonary fibrosis (IPF) and acute respiratory disease (ARDS). Other ILDs with similar pathological fibrotic alterations in the lung interstitium and a progressive fibrosis include, connective tissue disease-associated ILD (CTD- ILD), which is mainly systemic sclerosis-ILD (SSc-ILD), rheumatoid arthritis-ILD (RA-ILD), idiopathic non-specific interstitial pneumonia (i SIP), chronic hypersensitivity pneumonitis (CHP), unclassifiable idiopathic interstitial pneumonia (IIP), interstitial pneumonia with autoimmune features (IPAF), and environmental/occupational fibrosing lung diseases such as those caused by asbestosis and silica. The most prominent ILDs are IPF and ARDS. ● Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive disease with high mortality that commonly occurs in middle-aged and older adults. (Glass DS, Grossfeld D, Renna HA, Agarwala P, Spiegler P, Kasselman LJ, Glass AD, DeLeon J, Reiss AB, Idiopathic pulmonary fibrosis: Molecular mechanisms and potential treatment approaches, Respiratory Investigation 2020; 58(5): 320-335; Richeldi L, Collard HR, Jones MG, Idiopathic pulmonary fibrosis, Lancet. 2017 May 13;389(10082):1941-1952). IPF is characterized by progressive fibrosis of the interstitium of the lung, leading to decreasing lung volume as determined by forced vital capacity (FVC) and progressive pulmonary insufficiency. The decline in lung function caused by IPF often manifests as exertional dyspnea and cough. Symptoms result from a fibrotic process driven by alveolar epithelial cells that leads to increased migration, proliferation, and differentiation of lung fibroblasts. Ultimately, the differentiation of fibroblasts into myofibroblasts, which synthesize excessive amounts of extracellular matrix proteins, destroys the lung architecture. However, the factors that induce the fibrotic process are unclear, and diagnosis can be difficult. Practical biomarkers to improve diagnostic and prognostic accuracy are lacking. High-resolution computed tomography typically shows interstitial pneumonia with basal and peripheral honeycombing. Gas exchange and diffusion capacity are impaired. Treatments are limited. Lung transplantation is often contraindicated because of age and comorbidities, but it improves survival when successful. Two drugs recently approved to treat IPF, pirfenidone (Gulati S, Luckhardt TR, Updated Evaluation of the Safety, Efficacy and Tolerability of Pirfenidone in the Treatment of Idiopathic Pulmonary Fibrosis, Drug Healthc Patient Saf. 2020 May 7; 12:85-94) and nintedanib, (Rodríguez-Portal JA, Efficacy and Safety of Nintedanib for the Treatment of Idiopathic Pulmonary Fibrosis: An Update, Drugs R D. 2018; 18: 19-25) only slow the progression of the disease. The incidence and prevalence of IPF has been increasing, and there is an urgent need for improved therapies. (Martinez FJ, Collard HR, Pardo A, Raghu G, Richeldi L, Selman M, Swigris JJ, Taniguchi H, Wells AU, Idiopathic pulmonary fibrosis, Nat Rev Dis Primers. 2017; 3: 17074). ● Acute respiratory distress syndrome (ARDS) (Bos LD, Martin-Loeches I, Schultz MJ, ARDS: challenges in patient care and frontiers in research, Eur Respir Rev. 2018;27 (147):170107) is a condition that causes fluid to build up in a patient’s lungs so oxygen cannot reach the patient’s organs. Fluid leaks from small blood vessels and collects in tiny air sacs in lungs preventing the sacs from filling with air. ARDS can advance quickly and can be life-threatening. Causes of ARDS include, sepsis, accidents, breathing in harmful things such as dense smoke or chemical fumes, pneumonia, transfusion, inflamed pancreas, reactions to certain medications like amiodarone, (Papiris SA, Triantafillidou C, Kolilekas L, Markoulaki D, Manali ED, Amiodarone: review of pulmonary effects and toxicity, Drug Saf. 2010; 33(7): 539-58) drug overdose, near-drowning, burns, and aspiration of food. Symptoms include shortness of breath, low blood pressure, unusually fast breathing, fast heartbeat, cough, fever, chest pain, especially when breathing deeply, confusion and exhaustion, blue-tinted lips or nails from lack of arterial oxygen, and dizziness. There is no test to identify ARDS. Treatments include a breathing tube or a ventilator. Most treatment of ARDS is done in the ICU, where the overall hospital mortality rate is typically about 40%. The pathophysiology of ARDS involves interactions among multiple mechanisms, including, immune cell infiltration, cytokine storm, alveolar-capillary barrier disruption, and cell apoptosis. These are followed by an organizing phase with alveolar septal fibrosis and vastly diminished lung function (Cardinal-Fernández P, Lorente JA, Ballén-Barragán A, Matute-Bello G, Acute Respiratory Distress Syndrome and Diffuse Alveolar Damage: New Insights on a Complex Relationship, Ann Am Thorac Soc.2017; 14(6): 844-850). COVID-19 and Lung Fibrosis. (George PM, Wells AU, Jenkins RG, Pulmonary fibrosis and COVID-19: the potential role for antifibrotic therapy, Lancet Respir Med. 2020 May 15: S2213- 2600(20)30225-3; Spagnolo P, Balestro E, Aliberti S, Cocconcelli E, Biondine D, Cas GD, Sverzellati N, Maher, TM, Pulmonary fibrosis secondary to COVID-19: a call to arms?, Lancet Respir Med. 2020. 15;S2213-2600(20)30222-8). To date, millions of people worldwide been infected with Covid-19 and hundreds of thousands have died. Despite many efforts to develop vaccines and antiviral therapies for Covid-19, most virologists expect there will be no quick solution to this pandemic, and that Covid-19 will continue to be a serious, global health threat for the foreseeable future. Almost all COVID-19 patients with severe disease present with pneumonia featuring lung abnormalities including, lower lobe glass opacities with, or without, consolidation, noticeable on x-ray. Many patients are diagnosed with ARDS with associated pulmonary fibrosis. The mechanisms by which COVID-19 causes lung damage are not completely understood. The most plausible contributor is the cytokine release syndrome/storm triggered by the SARS Cov-2 antigen. Other proposed contributors include, drug-induced pulmonary toxicity, high airway pressure, and hyperoxia induced acute lung injury secondary to mechanical ventilation. In addition to the immediate contribution of lung dysfunction to the lethality of COVID-19, long- term impairment of lung function, post infection, is a serious concern for the millions of individuals who survive COVID-19. SUMMARY Methods are provided for treating patients suffering from pulmonary disease having fibrosis as the pathologic endpoint, such as IPF, ARDS, virus induced fibrosis, etc., using a UPase inhibitor. Aspects of the methods include administering an effective amount of a UPase inhibitor, with or without supplemental UR, to the subject. In certain embodiments, the agent is a 2,2'- anhydropyrimidine, or a derivative thereof. Also provided are compositions for use in practicing the subject methods. The subject methods and compositions find use in a variety of different pulmonary conditions. BRIEF DESCRIPTION OF THE DRAWINGS Figure 1. Figure provides a regression analysis of plasma UR concentration versus plasma Compound 1 concentrations determined following continuous infusion of various amounts of TK- 112690 to mice. R2 for the line is 0.95, and the slope and intercept values for the line are 0.010 and 0.051, respectively. TK-112690 is seen to elevate plasma UR in a linear fashion. Figure 2. Figure is a chart providing histology scores for pulmonary tissue from mice all treated with bleomycin (a well characterized lung toxin) and either dosing vehicle, UR or TK-112690. Mice treated with TK-112690 showed a statistically significant 30% less fibrosis than mice treated with the dosing vehicle. Mice treated with UR showed only a 7% decrease in fibrosis compared to the dosing vehicle, and the result was not statistically significant. Figure 3A-D. Figure provides representative lung sections from each of the four experimental groups from the bleomycin/pulmonary fibrosis study summarized in Figure 2. The lung sections were stained by Masson’s trichrome. Figure 4. Figure provides a correlation between fibrosis scores and TGF-β levels in BAL fluid from the mice participating in the bleomycin/pulmonary fibrosis study whose results are shown in Figure 2. Although, considerable variability in TGFβ concentrations are observed, a statistically significant correlation between fibrosis scores and TGF-β concentrations are observed. DEFINITIONS The following terms have the following meanings unless otherwise indicated when describing the compounds, pharmaceutical compositions containing such compounds, methods of using such compounds and compositions, and the description of the biology and pharmacology for use of the compounds, It should also be understood that any of the moieties defined forth below may be substituted with a variety of substituents, and that the respective definitions are intended to include such substituted moieties within their scope. "Acyl" refers to a radical -C(O)R, where R is hydrogen, alkyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroalkyl, or heteroaryl as defined herein. Representative examples include, but are not limited to, formyl, acetyl, cylcohexylcarbonyl, cyclohexylmethylcarbonyl, benzoyl, benzylcarbonyl and the like. "Acylamino" refers to a radical -NR'C(O)R, where R' is hydrogen, alkyl, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroalkyl, heteroaryl, heteroarylalkyl and R is hydrogen, alkyl, alkoxy, cycloalkyl, heterocycloalkyl, aryl, arylalkyl, heteroalkyl, heteroaryl or heteroarylalkyl, as defined herein. Representative examples include, but are not limited to, formylamino, acetylamino, cyclohexylcarbonylamino, cyclohexylmethyl-carbonylamino, benzoylamino, benzylcarbonylamino and the like. "Acyloxy" refers to the group -OC(O)H, -OC(O)-alkyl, -OC(O)-aryl or -OC(O)- cycloalkyl. "Aliphatic" refers to hydrocarbyl organic compounds or groups characterized by a straight, branched or cyclic arrangement of the constituent carbon atoms and an absence of aromatic unsaturation. Aliphatics include, without limitation, alkyl, alkylene, alkenyl, alkynyl and alkynylene. Aliphatic groups typically have from 1 or 2 to 6 or 12 carbon atoms. "Alkenyl" refers to monovalent olefinically unsaturated hydrocarbyl groups having up to about 11 carbon atoms, particularly, from 2 to 8 carbon atoms, and more particularly, from 2 to 6 carbon atoms, which can be straight-chained or branched and having at least 1 and particularly from 1 to 2 sites of olefinic unsaturation. Particular alkenyl groups include ethenyl (-CH=CH2), n-propenyl (-CH2CH=CH2), isopropenyl (-C(CH3) =CH2), vinyl and substituted vinyl, and the like. "Alkoxy" refers to the group -O-alkyl. Particular alkoxy groups include, by way of example, methoxy, ethoxy, n-propoxy, isopropoxy, n-butoxy, tert-butoxy, sec-butoxy, n-pentoxy, n-hexoxy, 1,2-dimethylbutoxy, and the like. "Alkoxycarbonyl" refers to a radical -C(O)-alkoxy where alkoxy is as defined herein. "Alkoxycarbonylamino" refers to the group -NRC(O)OR' where R is hydrogen, alkyl, aryl or cycloalkyl, and R' is alkyl or cycloalkyl. "Alkyl" refers to monovalent saturated aliphatic hydrocarbyl groups particularly having up to about 12 or 18 carbon atoms, more particularly as a lower alkyl, from 1 to 8 carbon atoms and still more particularly, from 1 to 6 carbon atoms. The hydrocarbon chain may be either straight-chained or branched. This term is exemplified by groups such as methyl, ethyl, n-propyl, isopropyl, n-butyl, iso-butyl, tert-butyl, n-hexyl, n-octyl, tert-octyl and the like. The term "alkyl" also includes "cycloalkyls" as defined herein. Structures for a few exemplary alkyl groups are provided in Table 1 below.
Figure imgf000008_0001
"Alkylene" refers to divalent saturated aliphatic hydrocarbyl groups particularly having up to about 12 or 18 carbon atoms and more particularly 1 to 6 carbon atoms which can be straight-chained or branched. This term is exemplified by groups such as methylene (-CH2-), ethylene (-CH2CH2- ), the propylene isomers (eg, -CH2CH2CH2- and -CH(CH3) CH2-) and the like. "Alkynyl" refers to acetylenically unsaturated hydrocarbyl groups particularly having up to about 12 or 18 carbon atoms and more particularly 2 to 6 carbon atoms which can be straight-chained or branched and having at least 1 and particularly from 1 to 2 sites of alkynyl unsaturation. Particular non-limiting examples of alkynyl groups include acetylenic, ethynyl (-C≡CH), propargyl (-CH2C≡CH), and the like. "Amino" refers to the radical -NH2. "Amino acid" refers to any of the naturally occurring amino acids (eg Ala, Arg, Asn, Asp, Cys, Glu, Gln, Gly, His, Hyl, Hyp, Ile, Leu, Lys, Met, Phe, Pro, Ser, Thr, Trp, Tyr, and Val) in D, L, or DL form. The side chains of naturally occurring amino acids are well known in the art and include, for example, hydrogen (eg, as in glycine), alkyl (eg, as in alanine, valine, leucine, isoleucine, proline), substituted alkyl (eg, as in threonine, serine, methionine, cysteine, aspartic acid, asparagine, glutamic acid, glutamine, arginine, and lysine), alkaryl (eg, as in phenylalanine and tryptophan), substituted arylalkyl (eg, as in tyrosine), and heteroarylalkyl (eg, as in histidine). "Aminocarbonyl" refers to the group -C(O)NRR where each R is independently hydrogen, alkyl, aryl or cycloalkyl, or where the R groups are joined to form an alkylene group. "Aminocarbonylamino" refers to the group -NRC(O)NRR where each R is independently hydrogen, alkyl, aryl or cycloalkyl, or where two R groups are joined to form an alkylene group. "Aminocarbonyloxy" refers to the group -OC(O)NRR where each R is independently hydrogen, alkyl, aryl or cycloalky, or where the R groups are joined to form an alkylene group. “Amino-containing saccharide group” refers to a saccharide group having an amino substituent. Representative amino-containing saccharide include L-vancosamine, 3-desmethyl-vancosamine, 3-epi-vancosamine, 4-epi-vancosamine, acosamine, actinosamine, daunosamine, 3-epi- daunosamine, ristosamine, N-methyl-D-glucamine and the like. “ “ARDS” refers to acute respiratory distress, an ILD "Aralkyl" or "arylalkyl" refers to an alkyl group, as defined above, substituted with one or more aryl groups, as defined above. "Aryl" refers to a monovalent aromatic hydrocarbon group derived by the removal of one hydrogen atom from a single carbon atom of a parent aromatic ring system. Typical aryl groups include, but are not limited to, groups derived from aceanthrylene, acenaphthylene, acephenanthrylene, anthracene, azulene, benzene, chrysene, coronene, fluoranthene, fluorene, hexacene, hexaphene, hexalene, as-indacene, s-indacene, indane, indene, naphthalene, octacene, octaphene, octalene, ovalene, penta-2,4-diene, pentacene, pentalene, pentaphene, perylene, phenalene, phenanthrene, picene, pleiadene, pyrene, pyranthrene, rubicene, triphenylene, trinaphthalene and the like. Particularly, an aryl group comprises from 6 to 14 carbon atoms. The structures of a few exemplary aryl groups are provided in Table 2.
Figure imgf000010_0001
"Aryloxy" refers to -O-aryl groups wherein "aryl" is as defined herein. “Autoimmune disease” or “autoimmune condition" refers an illness that occurs when the body tissues are attacked by its own immune system. Examples of autoimmune disease or conditions include multiple sclerosis, ankylosing spondylitis, Crohn’s disease, arthritis, psoriasis, Behçet's disease and psoriatic arthritis. Azido" refers to the radical -N3. “BAL” refers to Bronchoalveolar lavage also known as bronchoalveolar washing. “BALF refers to BAL fluid. “Carbohydrate” means a mono-, di-, tri-, or polysaccharide, wherein the polysaccharide can have a molecular weight of up to about 20,000, for example, hydroxypropyl-methylcellulose or chitosan. “Carbohydrate” also encompasses oxidized, reduced or substituted saccharide monoradical covalently attached to the anhydropyrimidine (eg, anhydrothymidine or anhydrouridine), or derivative thereof any atom of the saccharide moiety, eg, via the aglycone carbon atom. The “mono-, di-, tri-, or polysaccharide” can also include amino-containing saccharide groups. Representative “carbohydrate” include, by way of illustration, hexoses such as D-glucose, D-mannose, D-xylose, D-galactose, vancosamine, 3-desmethyl-vancosamine, 3-epi- vancosamine, 4-epi-vancosamine, acosamine, actinosamine, daunosamine, 3-epi-daunosamine, ristosamine, D-glucamine, N-methyl-D-glucamine, D-glucuronic acid, N-acetyl-D-glucosamine, N- acetyl-D-galactosamine, sialyic acid, iduronic acid, L-fucose, and the like; pentoses such as D- ribose or D-arabinose; ketoses such as D-ribulose or D-fructose; disaccharides such as 2-O-(α- L-vancosaminyl)-β-D-glucopyranose- , 2-O-(3-desmethyl-α -L-vancosaminyl)-β -D- glucopyranose, sucrose, lactose, or maltose; derivatives such as acetals, amines, acylated, sulfated and phosphorylated sugars; oligosaccharides having from 2 to 10 saccharide units. The saccharides can be either in their open, r pyranose or furanose forms. "Carboxyl" refers to the radical -C(O)OH. “CHP” refers to chronic hypersensitivity pneumonitis, an ILD. “CTD-ILD” refers to connective tissue disease-associated ILD. "Cyano" refers to the radical -CN. "Cycloalkenyl" refers to cyclic hydrocarbyl groups having from 3 to 10 carbon atoms and having a single cyclic ring or multiple condensed rings, including fused and bridged ring systems and having at least one and particularly from 1 to 2 sites of olefinic unsaturation. Such cycloalkenyl groups include, by way of example, single ring structures such as cyclohexenyl, cyclopentenyl, cyclopropenyl, and the like. "Cycloalkyl" refers to cyclic hydrocarbyl groups having from 3 to about 10 carbon atoms and having a single cyclic ring or multiple condensed rings, including fused and bridged ring systems, which optionally can be substituted with from 1 to 3 alkyl groups. Such cycloalkyl groups include, by way of example, single ring structures such as cyclopropyl, cyclobutyl, cyclopentyl, cyclooctyl, 1-methylcyclopropyl, 2-methylcyclopentyl, 2-methylcyclooctyl, and the like, and multiple ring structures such as adamantanyl, and the like. “FVC” refers to forced vital capacity. “Heterocycloalkyl” refers to a stable heterocyclic non-aromatic ring and fused rings containing one or more heteroatoms independently selected from N, O and S. A fused heterocyclic ring system may include carbocyclic rings and need only include one heterocyclic ring. Examples of heterocyclic rings include, but are not limited to, piperazinyl, homopiperazinyl, piperidinyl and morpholinyl. The structures of a few exemplary heterocyclyls are shown in Table 3.
Figure imgf000012_0001
Figure imgf000013_0001
“Halo" or "halogen" refers to fluoro, chloro, bromo and iodo. Halo groups can be either fluoro or chloro. “HDL” refers to high density lipoprotein. "Hetero" when used to describe a compound or a group present on a compound means that one or more carbon atoms in the compound or group have been replaced by a nitrogen, oxygen, or sulfur heteroatom. Hetero may be applied to any of the hydrocarbyl groups described above such as alkyl, eg heteroalkyl, cycloalkyl, eg heterocycloalkyl, aryl, eg heteroaryl, cycloalkenyl, eg, heterocycloalkenyl, cycloheteroalkenyl, eg, heterocycloheteroalkenyl and the like having from 1 to 5, and particularly from 1 to 3 heteroatoms. A heteroatom is any atom other than carbon or hydrogen and is typically, but not exclusively, nitrogen, oxygen, sulfur, phosphorus, boron, chlorine, bromine, or iodine. An unsubstituted heteroatom refers to a pendant heteroatom such as an amine, hydroxyl and thiol. A substituted heteroatom refers to a heteroatom that is other than a pendant heteroatom. "Heteroaryl" refers to a monovalent heteroaromatic group derived by the removal of one hydrogen atom from a single atom of a parent heteroaromatic ring system. Typical heteroaryl groups include, but are not limited to, groups derived from acridine, arsindole, carbazole, β-carboline, chromane, chromene, cinnoline, furan, imidazole, indazole, indole, indoline, indolizine, isobenzofuran, isochromene, isoindole, isoindoline, isoquinoline, isothiazole, isoxazole, naphthyridine, oxadiazole, oxazole, perimidine, phenanthridine, phenanthroline, phenazine, phthalazine, pteridine, purine, pyran, pyrazine, pyrazole, pyridazine, pyridine, pyrimidine, pyrrole, pyrrolizine, quinazoline, quinoline, quinolizine, quinoxaline, tetrazole, thiadiazole, thiazole, thiophene, triazole, xanthene, and the like. The heteroaryl group can be a 5-20 membered heteroaryl, or 5-10 membered heteroaryl. Particular heteroaryl groups are those derived from thiophen, pyrrole, benzothiophene, benzofuran, indole, pyridine, quinoline, imidazole, oxazole and pyrazine. “Hydroxyl” refers to the radical -OH. “IIP” refers to unclassifiable idiopathic interstitial pneumonia. “ILDs” refers interstitial lung disease. “I-PAF” refers to interstitial pneumonia with autoimmune features. “IPF” refers to Interstitial pulmonary fibrosis, an ILD. “i SIP” refers to idiopathic non-specific interstitial pneumonia, an ILD. “KO” refers to knockout as used in the phrase knockout animals. “MCD” refers to methionine-choline deficient diet “Nitro” refers to the radical -NO2. “Peptide” refers to a polyamino acid containing up to 2, 5, 10, or about 100 amino acid residues. “Polypeptide” means polyamino acid containing from about 100 amino acid units to about 1,000 amino acid units, from about 100 amino acid units to about 750 amino acid units, or from about 100 amino acid units to about 500 amino acid units. “RA-ILD” refers to rheumatoid arthritis-ILD. “ROP refers to an eye condition in infant’s retinopathy of prematurity. “SEM” refers to standard error of the mean “Side-effect” means an undesirable adverse consequence of drug administration such as mucositis associated with administration of cancer therapy. “SSc” refers to systemic sclerosis, an ILD. “Stereoisomer” as it relates to a given compound is well understood in the art, and refers to another compound having the same molecular formula, wherein the atoms making up the other compound differ in the way they are oriented in space, but wherein the atoms in the other compound are like the atoms in the given compound with respect to which atoms are joined to which other atoms (eg an enantiomer, a diastereomer, or a geometric isomer). For example, Morrison and Boyd, Organic Chemistry, 1983, 4th ed., Allyn and Bacon, Inc., Boston, MA, p123. "Substituted" refers to a group in which one or more hydrogen atoms are each independently replaced with the same or different substituent(s). "Substituted” groups particularly refer to groups having 1 or more substituents, for instance from 1 to 5 substituents, and particularly from 1 to 3 substituents, selected from the group consisting of acyl, acylamino, acyloxy, alkoxy, substituted alkoxy, alkoxycarbonyl, alkoxycarbonylamino, amino, substituted amino, aminocarbonyl, aminocarbonylamino, aminocarbonyloxy, aryl, aryloxy, aralkyl, azido, carboxyl, cyano, cycloalkyl, substituted cycloalkyl, halogen, hydroxyl, imidate, keto, nitro, thioalkoxy, substituted thioalkoxy, thioaryloxy, thioketo, thiol, alkylthio, (substituted alkyl)thio, arylthio, (substituted aryl)thio, alkyl- S(O)-, aryl-S(O)-, alkyl-S(O)2- and aryl-S(O)2. Typical substituents include, but are not limited to, -X, -R8 (with the proviso that R8 is not hydrogen), -O-, =O, -OR8, -SR8, -S-, =S, -NR8R9, =NR8, - CX3, -CF3, -CN, -OCN, -SCN, -NO, -NO2, =N2, -N3, -S(O)2O-, -S(O)2OH, -S(O)2R8, -OS(O2)O-, - OS(O)2R8, -P(O)(O-)2, -P(O)(OR8)(O-), -OP(O)(OR8)(OR9), -C(O)R8, -C(S)R8, -C(O)OR8, - C(O)NR8R9, -C(O)O-, -C(S)OR8, -NR10C(O)NR8R9, -NR10C(S)NR8R9, -NR11C(NR10)NR8R9 and - C(NR10)NR8R9, where X is independently a halogen. "Substituted amino" includes those groups recited in the definition of "substituted" herein, and particularly refers to the group -N(R)2 where each R is independently selected from the group consisting of hydrogen, alkyl, substituted alkyl, alkenyl, substituted alkenyl, alkynyl, substituted alkynyl, aryl, cycloalkyl, substituted cycloalkyl, and where both R groups are joined to form an alkylene group. “SSc-ILD” refers to systemic sclerosis-ILD. “T2D” refers to type 2 diabetes. “TG” refers to transgenic "Thioalkoxy" refers to the group -S-alkyl. "Thioaryloxy" refers to the group -S-aryl. "Thioketo" refers to the group =S. "Thiol" refers to the group -SH. “UR” refers to uridine. “UPase (Uridine phosphorylase)” refers in enzymology to a phosphorylase (EC 2.4.2.3) that catalyzes the chemical reaction: uridine + phosphate → uracil + alpha-D-ribose 1-phosphate. The two substrates of this enzyme are uridine and phosphate, whereas its two products are uracil and alpha-D-ribose 1-phosphate. This enzyme belongs to the family of glycosyltransferases, specifically the pentosyltransferases. The systematic name of this enzyme class is uridine phosphate alpha-D-ribosyltransferase. Other names in common use include pyrimidine phosphorylase, UrdPase, UPH, and UPase. This enzyme participates in pyrimidine metabolism. “Uridine Supplement” refers to either a formulated product containing UR or a formulated product containing a UR precursor such as UR monophosphate or acetylated UR that converts to UR in the body. The formulated product could be a solution, a capsule, a tablet or a cream. The product could be administered po, ip, sc, or iv. The UR supplement could be administered as part of a more complex mixture such as a nutritional supplement. ip, po and sc are intraperitoneal, oral or subcutaneous dosing, respectfully. H&E is Haematoxylin & Eosin, a dye used to stain tissues. SD is standard deviation. SE is standard error. PBS is phosphate buffered saline. qd. and bid are daily and twice-a-day, respectfully. One having ordinary skill in the art will recognize that the maximum number of heteroatoms in a stable, chemically feasible heterocyclic ring, whether it is aromatic or non-aromatic, is determined by the size of the ring, the degree of unsaturation and the valence of the heteroatoms. In general, a heterocyclic ring may have one to four heteroatoms so long as the heteroaromatic ring is chemically feasible and stable. DETAILED DESCRIPTION Methods for treating a subject for pulmonary conditions are provided. Aspects of the methods include administering an effective amount of a UR plasma level modulator to a subject. In certain embodiments, the therapy is a 2,2'-anhydropyrimidine, or a derivative thereof. Also provided are compositions for use in practicing the subject methods. The subject methods and compositions find use in a variety of different applications to treat serious pulmonary conditions. In some instances, anhydronucleosides are employed in combination with UR, a UR pro-drug, or a UR mimetic. Anhydronucleosides are analogs of natural nucleosides, often finding use as intermediates in the synthesis of nucleoside derivatives. They are characterized by having, in addition to the N-glycoside linkage, a covalent linkage either directly or via bridging atoms between the 2', 3', or 5' carbons of the sugar and a carbon, oxygen or nitrogen atom (other than the nitrogen of the glycoside bond) of the base. The anhydropyrimidines are characterized by a pyrimidine base that is covalently linked either directly or via bridging atoms between the 2', 3', or 5' carbons of the sugar and a carbon, oxygen or nitrogen atom (other than the nitrogen of the glycoside bond) of the pyrimidine base. Before the present invention is described in greater detail, it is to be understood that this invention is not limited to particular embodiments described, as such may, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting, since the scope of the present invention will be limited only by the appended claims. Where a range of values is provided, it is understood that each intervening value, to the tenth of the unit of the lower limit unless the context clearly dictates otherwise, between the upper and lower limit of that range and any other stated or intervening value in that stated range, is encompassed within the invention. The upper and lower limits of these smaller ranges may independently be included in the smaller ranges and are also encompassed within the invention, subject to any specifically excluded limit in the stated range. Where the stated range includes one or both of the limits, ranges excluding either or both of those included limits are also included in the invention. Certain ranges are presented herein with numerical values being preceded by the term "about." The term "about" is used herein to provide literal support for the exact number that it precedes, as well as a number that is near to or approximately the number that the term precedes. In determining whether a number is near to or approximately a specifically recited number, the near or approximating unrecited number may be a number which, in the context in which it is presented, provides the substantial equivalent of the specifically recited number. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although any methods and materials similar or equivalent to those described herein can also be used in the practice or testing of the present invention, representative illustrative methods and materials are now described. All publications and patents cited in this specification are herein incorporated by reference as if each individual publication or patent were specifically and individually indicated to be incorporated by reference and are incorporated herein by reference to disclose and describe the methods and/or materials in connection with which the publications are cited. The citation of any publication is for its disclosure prior to the filing date and should not be construed as an admission that the present invention is not entitled to antedate such publication by virtue of prior invention. Further, the dates of publication provided may be different from the actual publication dates which may need to be independently confirmed. It is noted that, as used herein and in the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the context clearly dictates otherwise. It is further noted that the claims may be drafted to exclude any optional element. As such, this statement is intended to serve as antecedent basis for use of such exclusive terminology as “solely,” “only” and the like in connection with the recitation of claim elements or use of a “negative” limitation. As will be apparent to those of skill in the art upon reading this disclosure, each of the individual embodiments described and illustrated herein has discrete components and features which may be readily separated from or combined with the features of any of the other several embodiments without departing from the scope or spirit of the present invention. Any recited method can be carried out in the order of events recited or in any other order which is logically possible. While the apparatus and method has or will be described for the sake of grammatical fluidity with functional explanations, it is to be expressly understood that the claims, unless expressly formulated under 35 U.S.C. §112, are not to be construed as necessarily limited in any way by the construction of "means" or "steps" limitations, but are to be accorded the full scope of the meaning and equivalents of the definition provided by the claims under the judicial doctrine of equivalents, and in the case where the claims are expressly formulated under 35 U.S.C. §112 are to be accorded full statutory equivalents under 35 U.S.C. §112. In further describing the subject invention, the subject methods are described first in greater detail, followed by a review of the various compositions, e.g., formulations and kits, that may find use in the subject methods, as well as a discussion of various representative applications in which the subject methods and compositions find use. METHODS As summarized above, methods of treating a subject for pulmonary conditions are provided. An aspect of the subject methods is administration to the subject of an effective amount of a UR plasma level modulator. In certain embodiments, the treatment is a 2,2'-anhydropyrimidine, such as a 2,2'-anhydrouridine or analogue/derivative thereof. The UR plasma level modulator, e.g., UR elevation agent, may be used in combination with UR, a UR pro-drug, or UR mimetic. In one embodiment, the UR, UR pro-drug or UR mimetic are administered simultaneously with the UR elevating agent. In yet other embodiments, the UR elevating agent, e.g., an 2,2'- anhydropyrimidine, and the UR, UR pro-drug or UR mimetic are administered sequentially. The UR elevating agent and the UR, UR pro-drug or UR mimetic can be administered at the same time as two separate formulations or are combined into a single composition that is administered to the subject. Regardless of whether the uridine elevating agent and UR plasma level modulator are administered sequentially or simultaneously, or any effective variation thereof, the agents are considered to be administered together or in combination for purposes of the present invention. Routes of administration of the two agents may vary. Representative routes of administration are described below. In the subject methods, an effective amount of a UR plasma level modulator, e.g., UR elevating agent, is administered to a subject, optionally in combination with one or more of UR, UR pro- drug, or a UR mimetic. A UR plasma level modulator is an agent that changes the plasma UR level of a subject following administration to the subject. A UR plasma level modulator enhances the plasma UR level in the subject. While the magnitude of any enhancement may vary, in some instances the magnitude of enhancement is 2-fold or greater, such as 5-fold or greater, 10-fold or greater, 15-fold or greater, 20-fold or greater, 25-fold or greater, or 50-fold or greater. A variety of different types of plasma UR level enhancing agents may be employed. Plasma UR level enhancing agents include, but are not limited to, UR and sources thereof, UR precursors as sources thereof, and UR degradation inhibitors, such as UPase inhibitors, UR secretion inhibiting compounds and UR renal transport competitors. Of particular interest are 2,2'-anhydropyrimidines and derivatives thereof that are inhibitors of UPase. UPase (UPh; EC 2.4.2.3) is a member of the pyrimidine nucleoside phosphorylase family of enzymes which catalyzes the phosphorolytic cleavage of the C-N glycoside bond of UR, with the formation of ribose 1-phosphate and uracil. (Pizzorno G, Cao D, Leffert JJ, Russell RL, Zhang D, Handschumacher RE, Homeostatic control of uridine and the role of uridine phosphorylase: a biological and clinical update, Biochim Biophys Acta. 2002;1587(2-3):133-44). In some instances, the UR elevating agent is 2,2'-anhydropyrimidines or a derivative thereof. In some embodiments, the 2,2'-anhydropyrimidine or derivative thereof is a compound of formula (I):
Figure imgf000020_0001
or the pharmaceutically acceptable salts, solvates, hydrates, and prodrug forms thereof, and stereoisomers thereof; wherein: each R1, R2, R3 and R4 is independently selected from the group consisting of hydrogen, substituted or unsubstituted heteroatom, substituted or unsubstituted alkyl, substituted or unsubstituted cycloalkyl, substituted or unsubstituted heterocycloalkyl, substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted aralkyl, hydroxyl, halogen, azido, amino, substituted amino, carbohydrate, nucleic acid, amino acid, peptide, dye, fluorophore and polypeptide. In certain embodiments, the compound is of formula (I), R1, R2, R3 and R4 are independently hydrogen, hydroxyl, heteroatom, C1-C18 alkyl, C1-C18 substituted alkyl, C1-C18 alkenyl, C1-C18 acyl, amino, substituted amino, wherein the alkyl, alkenyl or acyl is linear or branched, and optionally substituted with a hydroxyl, an ester and its derivatives, a carboxyl and its derivatives, a cycloalkyl, a heterocycloalkyl, an aryl, a heteroaryl, an aralkyl, a heteroatom, and possibly containing in chain or bridging heteroatoms such as nitrogen, oxygen and sulfur. Examples of R1 constituents of interest include, but are not limited to: hydrogen; hydroxyl; sulfyhydryl; halogen such as fluorine, chlorine, bromine or iodine, as well as pseudohalogen such as a lower alkylsulfonyl group of 1 to 5 carbons such as methyl-, ethyl-, propyl-, isopropyl-, butyl- , isobutyl-, tert-butyl-, and pentasulfonyl or arylsulfonyl such as benzene, p-toluene, p- nitrobenzenesulfonyl groups; lower alkyl containing 1 to 20 carbons such as methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl, pentyl and the like, including substituted lower alkyl such as aminomethyl, hydroxymethyl, methoxy, ethyloxy, propyloxy, benzyloxy, imidate, alkylthio, (substituted alkyl)thio, arylthio, (substituted aryl)thio and the like; lower alkenyl containing 1 to 20 carbons such as vinyl and substituted vinyl, ethynyl and substituted ethynyl, where the substituted vinyl or substituted ethynyl designates substitution of the b position of vinyl or ethynyl by a halogen such as bromine, chlorine, fluorine or iodine, or substitution by an alkyl of 1 to 5 carbon atoms such as methyl, ethyl, propyl, butyl, pentyl and the like, or aralkyl such as benzyl, p-chlorobenzyl, p-nitrobenzyl and the like, or aryl such as phenyl, p-nitrophenyl, p-tolyl, p-anisyl, naphtyl and the like; lower alkanoyl (acyl groups) containing 1 to 20 carbons such as formyl, acetyl, propionyl, isopropionyl, butyryl, isobutyryl, tert-butyryl, valeryl, pivaloyl, caproyl, capryl, lauryl, myristyl, palmityl, stearyl, arachidyl, stilligyl, palmitoyl, oleyl, linolenyl, arachidonyl and the like; lower aryl containing 1 to 20 carbons such as phenyl, p-tolyl, p-chlorophenyl, p-aminophenyl, p-nitrophenyl, p-anisyl and the like; lower aroyl containing 1 to 20 carbons such as benzoyl and naphthoyl, where the aromatic group may be additionally substituted by alkyl, alkoxy, halo, or nitro moieties such as p-tolnoyl, p-anisoyl, p-chlorobenzoyl, p-nitrobenzoyl or 2,4-dinitrobenzoyl, pentafluorobenzoyl and the like, or another aroyl such as benzyloxybenzoyl and the like; lower aralkyl containing 1 to 20 carbons such as benzyl, benzhydryl, p-chlorobenzyl, m-chlorobenzyl, p-nitrobenzyl, benzyloxybenzyl, pentaflourobenzyl and the like; amino or alkylamino containing 1 to 20 carbons such as a monoalkyl- or monoaralkylamino groups like methylamino, ethylamino, propylamino or benzylamino and the like, dialkylamino such as dimethylamino, diethylamino, dibenzylamino, pyrrolidino, piperidino or molpholino and the like. Thus, in certain embodiments, R1 is hydrogen, hydroxyl, sulfyhydryl, amino, substituted amino, hydroxymethyl, monomethoxy, halogen, pseudohalogen, or a lower hydrocarbon (which hydrocarbon can be substituted or unsubstituted) containing from 1 to 20 atoms. In a particular embodiment, R1 is a lower hydrocarbon selected from alkyl, substituted alkyl, alkenyl, alkanoyl, aryl, aroyl, aralkyl, or alkylamino. In a particular embodiment, R1 is a lower hydrocarbon substituted with alkoxy, substituted alkoxy, imidate, arylthio, or (substituted aryl) thio. In other embodiments, R1 is a lower alkyl selected from methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl and pentyl. In other embodiments, R1 is a lower alkenyl selected from vinyl, substituted vinyl, ethynyl, or substituted ethynyl. In other embodiments, R1 is a lower alkanoyl selected from formyl, acetyl, propionyl, isopropionyl, butyryl, isobutyryl, tert-butyryl, valeryl, pivaloyl, caproyl, capryl, lauryl, myristyl, palmityl, stearyl, arachidyl, stilligyl, palmitoyl, oleyl, linolenyl, and arachidonyl. In other embodiments, R1 is lower aryl selected from phenyl, p-tolyl, p-chlorophenyl, p-aminophenyl, p-nitrophenyl, p-anisyl. In yet other embodiments, R1 is a lower aroyl selected from benzoyl and naphthoyl. In other embodiments, R1 is a lower aralkyl selected from benzyl, benzhydryl, p-chlorobenzyl, m-chlorobenzyl, p-nitrobenzyl, benzyloxybenzyl, or pentaflourobenzyl. In certain other embodiments, R1 is a lower alkylamino is selected from monoalkylamino, monoaralkylamino, dialkylamino, diaralkylamino, and benzylamino. Compounds of interest include, but are not limited to, those of formula (I) where R1 is selected from hydrogen, fluorine, trifluoromethyl, methyl, ethyl, propyl, butyl, isopropyl, isobutyl, acetyl, propionyl, butyryl, 2-bromovinyl, phenyl, benzyl, benzoyl, benzyloxybenzyl, benzylamino, alkyloxyalkyl, benzyloxyalkyl, imidatealkyl, arylthio, and (substituted aryl) thio. Thus, in certain embodiments, the compound is of formula (I), and R1 is H, F, CF3, CH3, CH3CH2, CH3CH2CH2, (CH3)2CH, (CH3)2CH2CH2, CH3(O)CCH2, CH3(O)CCH2CH2, Br-CH=CH, phenyl, benzyl, benzoyl, benzyloxybenzyl, benzyl-NH-, CH3CH2OCH2, benzyl-O-CH2, CH3OCH2, CH3C(NH)-O-CH2, or CH3-phenyl-O-CH2. Examples of R2 constituents of interest include, but are not limited to: hydrogen; hydroxyl; sulfyhydryl; halogen such as fluorine, chlorine, bromine or iodine, as well as pseudohalogen such as a lower alkylsulfonyl group of 1 to 5 carbons such as methyl-, ethyl-, propyl-, isopropyl-, butyl- , isobutyl-, tert-butyl-, and pentasulfonyl or arylsulfonyl such as benzene, p-toluene, p- nitrobenzenesulfonyl groups; lower alkyl containing 1 to 20 carbons such as methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl, pentyl and the like, including substituted lower alkyl such as aminomethyl, hydroxymethyl, methoxy, ethyloxy, propyloxy, and the like; lower alkenyl containing 1 to 20 carbons such as vinyl and substituted vinyl, ethynyl and substituted ethynyl, where the substituted vinyl or substituted ethynyl designates substitution of the ß position of vinyl or ethynyl by a halogen such as bromine, chlorine, fluorine or iodine, or substitution by an alkyl of 1 to 5 carbon atoms such as methyl, ethyl, propyl, butyl, pentyl and the like, or aralkyl such as benzyl, p-chlorobenzyl, p-nitrobenzyl and the like, or aryl such as phenyl, p-nitrophenyl, p-tolyl, p-anisyl, naphtyl and the like; lower alkanoyl (acyl groups) and esters thereof of a main chain containing 1 to 20 carbons such as formyl, acetyl, propionyl, isopropionyl, butyryl, isobutyryl, tert-butyryl, valeryl, pivaloyl, caproyl, capryl, lauryl, myristyl, palmityl, stearyl, arachidyl, stilligyl, palmitoyl, oleyl, linolenyl, arachidonyl and the like; lower aryl containing 1 to 20 carbons such as phenyl, p- tolyl, p-chlorophenyl, p-aminophenyl, p-nitrophenyl, p-anisyl and the like; lower aroyl containing 1 to 20 carbons such as benzoyl and naphthoyl, where the aromatic group may be additionally substituted by alkyl, alkoxy, halo, or nitro moieties such as p-tolnoyl, p-anisoyl, p-chlorobenzoyl, p-nitrobenzoyl or 2,4-dinitrobenzoyl, pentafluorobenzoyl and the like, or another aroyl such as benzyloxybenzoyl and the like; lower aralkyl containing 1 to 20 carbons such as benzyl, benzhydryl, p-chlorobenzyl, m-chlorobenzyl, p-nitrobenzyl, benzyloxybenzyl, pentaflourobenzyl and the like; lower aryloxy containing 1 to 20 carbons such as phenyloxy (ie, O-phenyl), benzyloxy (ie, O-benzyl), benzhydryloxy (ie, O-benzylhydryl), p-chlorobenzyloxy (ie, O-(p-chlorobenzyl)), m- chlorobenzyloxy (ie, O-(m-chlorobenzyl)), p-nitrobenzyloxy (ie, O-(p-nitrobenzyl)), (4- benzyloxybenzyl)-oxy (ie, O-benzyloxybenzyl), or pentaflourobenzyloxy (ie, O- pentaflourobenzyl); esters of aryloxys, such as lower aroyloxy (ie, O-aroyl) containing 1 to 20 carbons such as benzoyloxy (ie, O-benzoyl), diphenylacetyloxy (ie, O-diphenylacetyl), p- chlorobenzoyloxy (ie, O-(p-chlorobenzoyl)), m-chlorobenzoyloxy (ie, O-(m-chlorobenzoyl)), p- nitrobenzoyloxy (ie, O-(p-nitrobenzoyl)), (4-benzyloxybenzoyl)-oxy (ie, O-benzyloxybenzoyl), or pentaflourobenzoyloxy (ie, O-pentaflourobenzoyl); amino or alkylamino containing 1 to 20 carbons such as a monoalkyl- or monoaralkylamino groups like methylamino, ethylamino, propylamino or benzylamino and the like, dialkylamino such as dimethylamino, diethylamino, dibenzylamino, pyrrolidino, piperidino or molpholino and the like. Thus, in certain embodiments, R2 is hydrogen, hydroxyl, sulfyhydryl, amino, hydroxymethyl, monomethoxy, halogen, pseudohalogen, or a lower hydrocarbon (which hydrocarbon can be substituted or unsubstituted) containing from 1 to 20 atoms, and esters thereof. In a particular embodiment, R2 is a lower hydrocarbon selected from alkyl, alkenyl, alkanoyl, aryl, aroyl, aryloxy, aroyloxy, aralkyl, or alkylamino. In other embodiments, R2 is a lower alkyl selected from methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl and pentyl. In other embodiments, R2 is a lower alkenyl selected from vinyl, substituted vinyl, ethynyl, or substituted ethynyl. In other embodiments, R2 is a lower alkanoyl selected from formyl, acetyl, propionyl, isopropionyl, butyryl, isobutyryl, tert-butyryl, valeryl, pivaloyl, caproyl, capryl, lauryl, myristyl, palmityl, stearyl, arachidyl, stilligyl, palmitoyl, oleyl, linolenyl, and arachidonyl. In other embodiments, R2 is lower aryl selected from phenyl, p-tolyl, p-chlorophenyl, p-aminophenyl, p-nitrophenyl, p-anisyl. In yet other embodiments, R2 is a lower aroyl selected from benzoyl and naphthoyl. In other embodiments, R2 is a lower aralkyl selected from benzyl, benzhydryl, p-chlorobenzyl, m-chlorobenzyl, p-nitrobenzyl, benzyloxybenzyl, or pentaflourobenzyl. In other embodiments, R2 is a lower aryloxy selected from phenyloxy, benzyloxy, benzhydryloxy, p-chlorobenzyloxy, m-chlorobenzyloxy, p-nitrobenzyloxy, (4-benzyloxybenzyl)-oxy, or pentaflourobenzyloxy. In other embodiments, R2 is a lower aroyloxy selected from benzoyloxy, diphenylacetyloxy, p-chlorobenzoyloxy, m-chlorobenzoyloxy, p- nitrobenzoyloxy, (4-benzyloxybenzoyl)-oxy, or pentaflourobenzoyloxy. In certain other embodiments, R2 is a lower alkylamino is selected from monoalkylamino, monoaralkylamino, dialkylamino, and diaralkylamino. Thus, in certain embodiments, R2 can not only be hydrogen or hydroxyl, but also an O-acyl, alkoxy, alkoxycarbonyl, alkoxycarbonylamino, O-alkyl, O-alkylene, O-alkynyl, O-aralkyl, O-aryl, O-aryloxy, O-carbohydrate, O-cycloalkenyl, O-cycloalkyl, O- heterocycloalkyl, O-heteroaryl. In addition, an S can substitute for the O. Compounds of interest include, but are not limited to, those of formula (I) where R2 is selected from hydrogen, fluorine, trifluoromethyl, methyl, ethyl, propyl, butyl, isopropyl, isobutyl, acetyl, propionyl, butyryl, 2-bromovinyl, phenyl, phenyloxy, benzyl, benzoyl, benzoyloxy and benzyloxybenzyl. Thus, in certain embodiments, the compound is of formula (I), and R2 is H, F, CF3, CH3, CH3CH2, CH3CH2CH2, (CH3)2CH, (CH3)2CH2CH2, CH3(O)CCH2, CH3(O)CCH2CH2, Br- CH=CH, phenyl, phenyloxy, benzyl, benzoyl, benzoyloxy, or benzyloxybenzyl. In specific embodiments of interest, the compound is of formula (I), and R2 is hydrogen, hydroxyl, or an O-linked substituent. This includes compounds of formula (I), where R2 is H, OH or C6H5C(O)O. Examples of R3 of interest include, but are not limited to: hydrogen; hydroxyl; azido; sulfyhydryl; halogen; pseudohalogen; lower alkyl containing 1 to 20 carbons such as methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl, pentyl and the like, including a substituted lower alkyl such as aminomethyl, hydroxymethyl, methoxy, ethyloxy, propyloxy, and the like; lower alkanoyl (acyl) including esters thereof of a main chain of 1 to 20 carbon atoms such as formyl, acetyl, propionyl, isopropionyl, butyryl, isobutyryl, tert-butyryl, valeryl, pivaloyl, caproyl, capryl, lauryl, myristyl, palmityl, stearyl, arachidyl, stilligyl, palmitoyl, oleyl, linolenyl, arachidonyl and the like; lower aryl such as phenyl, p-nitrophenyl, p-tolyl, p-anisyl, naphtyl and the like; lower aroyl (acyl radical of an aromatic acid) of 1 to 20 carbons such as benzoyl and naphthoyl, where the aromatic group may be additionally substituted by alkyl, alkoxy, halo, or nitro moieties such as p-tolnoyl, p-anisoyl, p- chlorobenzoyl, p-nitrobenzoyl or 2,4-dinitrobenzoyl, pentafluorobenzoyl and the like; lower aryloxy of 1 to 20 carbons such as phenyloxy, benzyloxy, benzhydryloxy, p-chlorobenzyloxy, m- chlorobenzyloxy, p-nitrobenzyloxy, (4-benzyloxybenzyl)-oxy, or pentaflourobenzyloxy and the like; as well as esters of aryloxys, such as lower aroyloxy (O-aroyls) of 1 to 20 carbons such as benzoyloxy, diphenylacetyloxy, p-chlorobenzoyloxy, m-chlorobenzoyloxy, p-nitrobenzoyloxy, (4- benzyloxybenzoyl)-oxy, or pentaflourobenzoyloxy and the like. R3 may also be adamantoyl, or substituted adamantoyl. Thus, in certain embodiments, R3 is hydrogen, hydroxyl, azido, sulfyhydryl, hydroxymethyl, halogen, or pseudohalogen. In other embodiments, R3 is a lower hydrocarbon selected from alkyl, alkanoyl, aryl, aroyl, aryloxy, aroyloxy, or aralkyl. In other embodiments, R3 is a lower alkyl selected from methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl and pentyl. In other embodiments, R3 is a lower alkanoyl selected from formyl, acetyl, propionyl, isopropionyl, butyryl, isobutyryl, tert-butyryl, valeryl, pivaloyl, caproyl, capryl, lauryl, myristyl, palmityl, stearyl, arachidyl, stilligyl, palmitoyl, oleyl, linolenyl, and arachidonyl. In other embodiments, R3 is a lower aryl selected from phenyl, p-tolyl, p-chlorophenyl, p-aminophenyl, p-nitrophenyl, p-anisyl and the like. In other embodiments, R3 is a lower aroyl selected from benzoyl and naphthoyl. In yet other certain embodiments, R3 is a lower aralkyl selected from benzyl, benzhydryl, p-chlorobenzyl, m- chlorobenzyl, p-nitrobenzyl, benzyloxybenzyl, or pentaflourobenzyl. In other embodiments, R3 is a lower aryloxy selected from phenyloxy, benzyloxy, benzhydryloxy, p-chlorobenzyloxy, m- chlorobenzyloxy, p-nitrobenzyloxy, (4-benzyloxybenzyl)-oxy, or pentaflourobenzyloxy. In other embodiments, R3 is a lower aroyloxy selected from benzoyloxy, diphenylacetyloxy, p- chlorobenzoyloxy, m-chlorobenzoyloxy, p-nitrobenzoyloxy, (4-benzyloxybenzoyl)-oxy, or pentaflourobenzoyloxy. Thus, in certain embodiments, R3 can not only be hydrogen or hydroxyl, but also an O-acyl, alkoxy, alkoxycarbonyl, alkoxycarbonylamino, O-alkyl, O-alkylene, O-alkynyl, O-aralkyl, O-aryl, O-aryloxy, O-carbohydrate, O-cycloalkenyl, O-cycloalkyl, O-heterocycloalkyl, O-heteroaryl. In addition, an S can substitute for the O. Compounds of interest are those of formula (I) where R3 is hydrogen, hydroxyl, halogen, azido, or an O-linked substituent. This includes compounds of formula (I) where R3 is selected from hydrogen, hydroxyl, n-butoxy, isobutyloxy, t-butyloxy, phenyloxy, benzyloxy, benzoyloxy, and pentafluorobenzoyloxy. Thus, in certain embodiments, the compound is of formula (I), and R3 is selected from H, OH, CH3CH2CH2CH2O, (CH3)2CH2CH2O, (CH3)3CO, C6H5O, benzoyloxy, and pentafluorobenzoyloxy. In specific embodiments of interest, the compound is of formula (I), where R3 is H, OH, F, Cl, Br, I, N3, or C6H5C(O)O. Of special interest is a compound of formula (I), where R3 is OH, or O-acyl (for example, an ester such as C6H5C(O)O). Examples of R4 include but are not limited to: hydrogen; hydroxyl; sulfhydryl; halogen such as fluorine, chlorine, bromine or iodine; amino or lower alkylamino. R4 also is exemplified by lower alkyl, with acyl groups which may be lower alkanoyl groups of 1 to 7 carbon atoms such as formyl, acetyl, propionyl, isopropionyl, butyryl, isobutyryl, tert-butyryl and the like, and esters thereof. Thus, R4 can also be aroyl (and esters thereof such as O-linked aroyls, ie, O-arolys or arolyoxy) such as benzoyl and naphthoyl wherein the aromatic group may be additionally substituted by alkyl, alkoxy, halo, or nitro moieties such as p-tolnoyl, p-anisoyl, p-chlorobenzoyl, p-nitrobenzoyl or 2,4-dinitrobenzoyl and the like. Accordingly, in certain embodiments, R4 can not only be hydrogen or hydroxyl, but also an O-acyl, alkoxy, alkoxycarbonyl, alkoxycarbonylamino, O-alkyl, O-alkylene, O-alkynyl, O-aralkyl, O-aryl, O-aryloxy, O-carbohydrate, O-cycloalkenyl, O-cycloalkyl, O-heterocycloalkyl, O-heteroaryl. In addition, an S can substitute for the O. Thus, in certain embodiments, R4 is hydrogen; hydroxyl; sulfhydryl; halogen, amino aminomethyl, or aminodimethyl. In other embodiments, R4 is a lower alkyl, acyl, aroyl, or aroyloxy. This includes a specific embodiment, where the compound of formula (I) is one where R4 is hydrogen, flourine, hydroxyl, amino, aminomethyl, aminodimethyl, t-butyloxy, phenyloxy or benzoyloxy (for example, a compound of formula (I), where R4 is H, F, OH, NH2, NHCH3, N(CH3)2, (CH3)3CO, C6H5O or C6H5C(O)O). Compounds of particular interest are those of formula (I) where R4 is hydrogen, hydroxyl, or an O-linked substituent. In specific embodiments, the compound is of formula (I), where R4 is H, OH or C6H5C(O)O. Of special interest is a compound of formula (I), where R4 is OH, or O-acyl (for example, an ester such as C6H5C(O)O). Of interest are compounds of formula (I) where: R1 is H, F, CF3, CH3, CH3CH2, CH3CH2CH2, (CH3)2CH, (CH3)2CH2CH2, CH3(O)CCH2, CH3(O)CCH2CH2, Br-CH=CH, phenyl, benzyl, benzoyl, or benzyloxybenzyl, R2 is H, OH, F, CF3, CH3, CH3CH2, CH3CH2CH2, (CH3)2CH, (CH3)2CH2CH2, CH3(O)CCH2, CH3(O)CCH2CH2, Br-CH=CH, phenyl, phenyloxy, benzyl, benzoyl, benzoyloxy, or benzyloxybenzyl, and where R3 and R4 are each hydroxyl. These include the compounds: 2,2′- anhydrouridine; 2,2′-anhydro-5-fluorouridine; 2,2'-anhydro-5-trifluoromethyluridine; 2,2′-anhydro- 5-methyluridine; 2,2′-anhydro-5-ethyluridine; 2,2′-anhydro-5-propyluridine; 2,2′-anhydro-5- isopropyluridine; 2,2'-anhydro-5-isobutyluridine; 2,2'-anhydro-5-methylacyluridine; 2,2'-anhydro- 5-propylacyluridine; 2,2'-anhydro-5-(2-bromovinyl)-uridine; 2,2'-anhydro-5-phenylluridine; 2,2'- anhydro-5-benzyluridine; 2,2'-anhydro-5-benzyoluridine; and 2,2'-anhydro-5-(benzyloxybenzyl)- uridine. Of special interest is 2,2′-anhydro-5-methyluridine, or the pharmaceutically acceptable salts, solvates, hydrates, and prodrug forms thereof, and stereoisomers thereof. Additional compounds of interest are compounds of formula (I) where: R1 is H, F, CF3, CH3, CH3CH2, CH3CH2CH2, (CH3)2CH, (CH3)2CH2CH2, CH3(O)CCH2, CH3(O)CCH2CH2, Br-CH=CH, phenyl, benzyl, benzoyl, or benzyloxybenzyl, R2 is H, OH, F, CF3, CH3, CH3CH2, CH3CH2CH2, (CH3)2CH, (CH3)2CH2CH2, CH3(O)CCH2, CH3(O)CCH2CH2, Br-CH=CH, phenyl, phenyloxy, benzyl, benzyloxy, benzoyl, benzoyloxy, or benzyloxybenzyl, and where R3 is hydroxyl, and R4 is benzoyloxy. These include the compounds: 3'-O-benzoyl-2,2′-anhydrouridine; 3'-O-benzoyl-2,2′- anhydro-5-fluorouridine; 3'-O-benzoyl-2,2'-anhydro-5-trifluoromethyluridine; 3'-O-benzoyl-2,2′- anhydro-5-methyluridine; 3'-O-benzoyl-2,2′-anhydro-5-ethyluridine; 3'-O-benzoyl-2,2′-anhydro-5- propyluridine; 3'-O-benzoyl-2,2′-anhydro-5-isopropyluridine; 3'-O-benzoyl-2,2'-O-anhydro-5- isobutyluridine; 3'-O-benzoyl-2,2'-anhydro-5-methylacyluridine; 3'-O-benzoyl-2,2'-anhydro-5- propylacyluridine; 3'-O-benzoyl-2,2'-anhydro-5-(2-bromovinyl)-uridine; 3'-O-benzoyl-2,2'- anhydro-5-phenylluridine; 3'-O-benzoyl-2,2'-anhydro-5-benzyluridine; 3'-O-benzoyl-2,2'-anhydro- 5-benzyoluridine; and 3'-O-benzoyl-2,2'-anhydro-5-(benzyloxybenzyl)-uridine. Of specific interest is 3'-O-benzoyl-2,2′-anhydro-5-methyluridine, or the pharmaceutically acceptable salts, solvates, hydrates, and prodrug forms thereof, and stereoisomers thereof. Also of interest are compounds of formula (I) where: R1 is H, F, CF3, CH3, CH3CH2, CH3CH2CH2, (CH3)2CH, (CH3)2CH2CH2, CH3(O)CCH2, CH3(O)CCH2CH2, Br-CH=CH, phenyl, benzyl, benzoyl, or benzyloxybenzyl, R2 is H, OH, F, CF3, CH3, CH3CH2, CH3CH2CH2, (CH3)2CH, (CH3)2CH2CH2, CH3(O)CCH2, CH3(O)CCH2CH2, Br-CH=CH, phenyl, phenyloxy, benzyl, benzyloxy, benzoyl, benzoyloxy, or benzyloxybenzyl, and where R3 is benzoyloxy, and R4 is hydroxyl. These include the compounds: 5'-O-benzoyl-2,2′-anhydrouridine; 5'-O-benzoyl-2,2′-anhydro-5-fluorouridine; 5'- O-benzoyl-2,2'-anhydro-5-trifluoromethyluridine; 5'-O-benzoyl-2,2′-anhydro-5-methyluridine; 5'- O-benzoyl-2,2′-anhydro-5-ethyluridine; 5'-O-benzoyl-2,2′-anhydro-5-propyluridine; 5'-O-benzoyl- 2,2′-anhydro-5-isopropyluridine; 5'-O-benzoyl-2,2'-O-anhydro-5-isobutyluridine; 5'-O-benzoyl- 2,2'-anhydro-5-methylacyluridine; 5'-O-benzoyl-2,2'-anhydro-5-propylacyluridine; 5'-O-benzoyl- 2,2'-anhydro-5-(2-bromovinyl)-uridine; 5'-O-benzoyl-2,2'-anhydro-5-phenylluridine; 5'-O-benzoyl- 2,2'-anhydro-5-benzyluridine; 5'-O-benzoyl-2,2'-anhydro-5-benzyoluridine; and 5'-O-benzoyl- 2,2'-anhydro-5-(benzyloxybenzyl)-uridine. Of specific interest is 5'-O-benzoyl-2,2′-anhydro-5- methyluridine, or the pharmaceutically acceptable salts, solvates, hydrates, and prodrug forms thereof, and stereoisomers thereof. The 2,2'-anhydropyrimidine compounds of the invention may be in compositions that contain single stereoisomers, mixtures of stereoisomers, as well various derivatives thereof that can occur as equilibrium mixtures of tautomers. For instance, 2,2'-anhydropyrimidines according to formula (I) include four stereo centers with respect to the furano ring, which includes the a and β anomers, and the L or D mirror image configurations. Examples of stereoisomers of the 2,2'- anhydropyrimidine compounds of the invention are the β-D-isomer, β-L-isomer, α-D-isomer, and α-L-isomer, as well as tautomers and mixtures including α,β-D-isomers, α,β-L-isomers, α-DL- isomers, and β-DL-isomers. Thus, in one embodiment, compositions are provided that consists essentially of a stereoisomer of a 2,2'-anhydropyrimidine that is a β-D-isomer, β-L-isomer, α-D- isomer, or an α-L-isomer. Stereoisomers exhibiting improved activity on a molar basis or improved specificity with respect to interfering with cancer therapy efficacy are of special interest. Stereoisomers of particular interest include: 2,2′-anhydro-1-(β-D-arabinofuranosyl)uracil; 2,2′- anhydro-1-(β-D-arabinofuranosyl)-5-fluorouracil; 2,2′-anhydro-1-(β-D-arabinofuranosyl)-5- trifluoromethyluracil; 2,2′-anhydro-1-(β-D-arabinofuranosyl)-5-methyluracil; 2,2′-anhydro-1-(β-D- arabinofuranosyl)-5-ethyluracil; 2,2′-anhydro-1-(β-D-arabinofuranosyl)-5-n-propyluracil; 2,2′- anhydro-1-(β-D-arabinofuranosyl)-5-isopropyluracil; 2,2′-anhydro-1-(β-D-arabinofuranosyl)-5- isobutyluracil; 2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-methyacyluracil; 2,2'-anhydro-1-(β-D- arabinofuranosyl)-5-propylacyluracil; 2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-(2- bromovinyl)uracil; 2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-phenyluracil; 2,2'-anhydro-1-(β-D- arabinofuranosyl)-5-benzyluracil; 2,2’-anhydro-1-(β-D-arabinofuranosyl)-5-benzyoluracil; and 2,2’-anhydro-1-(β-D-arabinofuranosyl)-5-(3-benzyoxybenzyl)uracil. Further stereoisomers of interest include: 3'-O-benzoyl-2,2′-anhydro-1-(β-D-arabinofuranosyl)uracil; 3'-O-benzoyl-2,2′- anhydro-1-(β-D-arabinofuranosyl)-5-fluororacil; 3'-O-benzoyl-2,2′-anhydro-1-(β-D- arabinofuranosyl)-5-trifluoromethyluracil; 3'-O-benzoyl-2,2′-anhydro-1-(β-D-arabinofuranosyl)-5- methyluracil; 3'-O-benzoyl-2,2′-anhydro-1-(β-D-arabinofuranosyl)-5-ethyluracil; 3'-O-benzoyl- 2,2′-anhydro-1-(β-D-arabinofuranosyl)-5-n-propyluracil; 3'-O-benzoyl-2,2′-anhydro-1-(β-D- arabinofuranosyl)-5-isopropyluracil; 3'-O-benzoyl-2,2′-anhydro-1-(β-D-arabinofuranosyl)-5- isobutyluracil; 3'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-methyacyluracil; 3'-O- benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-propylacyluracil; 3'-O-benzoyl-2,2'-anhydro-1- (β-D-arabinofuranosyl)-5-(2-bromovinyl)uracil; 3'-O-benzoyl-2,2'-anhydro-1-(β-D- arabinofuranosyl)-5-phenyluracil; 3'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5- benzyluracil; 3'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-benzyoluracil; and 3'-O- benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-(3-benzyoxybenzyl)uracil. Additional stereoisomers of interest include: 5'-O-benzoyl-2,2′-anhydro-1-(β-D-arabinofuranosyl)uracil; 5'-O- benzoyl-2,2′-anhydro-1-(β-D-arabinofuranosyl)-5-fluorouracil; 5'-O-benzoyl-2,2′-anhydro-1-(β-D- arabinofuranosyl)-5-trifluoromethyluracil; 5'-O-benzoyl-2,2′-anhydro-1-(β-D-arabinofuranosyl)-5- methyluracil; 5'-O-benzoyl-2,2′-anhydro-1-(β-D-arabinofuranosyl)-5-ethyluracil; 5'-O-benzoyl- 2,2′-anhydro-1-(β-D-arabinofuranosyl)-5-n-propyluracil; 5'-O-benzoyl-2,2′-anhydro-1-(β-D- arabinofuranosyl)-5-isopropyluracil; 5'-O-benzoyl-2,2′-anhydro-1-(β-D-arabinofuranosyl)-5- isobutyluracil; 5'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-methyacyluracil; 5'-O- benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-propylacyluracil; 5'-O-benzoyl-2,2'-anhydro-1- (β-D-arabinofuranosyl)-5-(2-bromovinyl)uracil; 5'-O-benzoyl-2,2'-anhydro-1-(β-D- arabinofuranosyl)-5-phenyluracil; 5'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5- benzyluracil; 5'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-benzyoluracil; and 5'-O- benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-(3-benzyoxybenzyl)uracil. Examples of other analogs or derivatives of the 2,2'-anhydropyrimidines of the invention, and stereoisomers thereof include: 3′-O-acetyl-2,2′-anhydro-5-propyluridine (3′-O-acetyl-2,2'- anhydro-1-(β-D-arabinofuranosyl)-5-propyluracil); and 3′-O-acetyl-2,2′-anhydro-5- isopropyluridine (3′-O-acetyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-isopropyluracil); as well as the 2,2′-anhydrocytidines, and analogs and derivatives thereof, of which the stereoisomer 2,2′- anhydro-1-(β-D-arabinofuranosyl)cytosine is one example. As noted above, stereoisomers and the various 2,2'-anhydropyrimidines of particular interest are those which exhibit improved activity on a molar basis, or improved specificity with respect to not interfering with cancer therapy efficacy. Such compounds can be readily selected for this purpose by comparing against a matrix of compounds of particular interest, such as those illustrated in Table 1 (where the compound is of formula (I)).
Figure imgf000029_0001
Figure imgf000030_0001
Figure imgf000031_0001
Figure imgf000032_0001
As mentioned above, the compounds in Table I are illustrative but not limiting. For example, R4 can be not only hydroxyl, but also an O-acyl, alkoxy, alkoxycarbonyl, alkoxycarbonylamino, O- alkyl, O-alkylene, O-alkynyl, O-aralkyl, O-aryl, O-aryloxy, O-carbohydrate, O-cycloalkenyl, O- cycloalkyl, O-heterocycloalkyl, O-heteroaryl. In addition, an S can substitute for the O and other combinations of the structural elements such as described herein, as well as other streochemical orientations, are also possible. In certain embodiments, acyl derivatives of the 2,2’-anyhydropyrimidines of formula (I) are of interest. Thus, compounds of formula (I) include those in which R1, R2, R3 and R4 are as defined above, wherein at least one of R2, R3 and R4 is an acyl derivative. By “acyl derivative" is intended a derivative of a 2,2’-anyhydropyrimidine of formula (I) in which at least one of R2, R3 and R4 is a substantially nontoxic organic acyl substituent obtainable from a carboxylic acid that is attached to a hydroxyl group on the ribose or pyrimidine ring of formula (I) through an ester linkage. Acyl derivatives of a 2,2’-anyhydropyrimidine compound of formula (I) include those in which R1 is as defined above, and each R2, R3 and R4 is independently hydrogen, hydroxyl or an acyl radical, with the proviso that at least one of R2, R3 and R4 is not hydrogen. In another embodiment, the acyl derivative of a 2,2’-anyhydropyrimidine is a compound of formula (I) in which R1 and R2 are as defined above, with the proviso that R2 is other than hydrogen, and each R3 and R4 is independently hydroxyl or an acyl radical. In one embodiment, the acyl derivative of a 2,2’- anyhydropyrimidine is a compound of formula (I) in which R1 is as defined above, R2 is hydrogen, and each R3 and R4 is independently hydroxyl or an acyl radical. Of particular interest, is an acyl derivative of a 2,2’-anyhydropyrimidine compound of formula (I), wherein R1 is methyl, R2 is hydrogen, and each R3 and R4 is independently hydroxyl or an acyl radical. Also of interest is an acyl derivative of a 2,2’-anyhydropyrimidine compound of formula (I), wherein R1 is methyl, R2 is hydrogen, and each R3 and R4 is an acyl radical. In general, the ester linkage(s) of an acyl derivative of formula (I) are cleavable under physiological conditions, either in vitro, such as in a cell-based system, and/or in vivo, such as through metabolism in a body. Thus, in certain embodiments, the acyl radical is a radical of a metabolite. Such acyl substituents include, but are not limited to, those derived from acetic acid, fatty acids, amino acids, lipoic acid, glycolic acid, lactic acid, enolpyruvic acid, pyruvic acid, orotic acid, acetoacetic acid, beta-hydroxybutyric acid, creatinic acid, succinic acid, fumaric acid, adipic acid, benzoic acid and p-aminobenzoic acid. Particular acyl substituents of interest are compounds which are normally present in the body, either as dietary constituents or as intermediary metabolites, and which are essentially nontoxic when cleaved from the 2,2’- anyhydropyrimidine compound of interest in vivo. Of particular interest are compositions comprising a 3'-O-acyl-2,2'-anhydropyrimidine or derivative thereof. For example, acyl derivatives of interest are those that include a 2,2’- anyhydropyrimidine compound of formula (I), where each R1, R2 and R3 is independently selected from selected from hydrogen, hydroxyl, sulfyhydryl, amino, hydroxymethyl, methoxy, halogen, pseudohalogen, and a substituted or unsubstituted lower hydrocarbon containing 1 to 20 carbons, such as a lower hydrocarbon selected from alkyl, alkenyl, alkanoyl, aryl, aroyl, aralkyl and alkylamino, and esters thereof, and where R4 is an O-acyl radical. In certain embodiments, the acyl derivatives include a 2,2’-anyhydropyrimidine compound of formula (I), where R4 is an O-acyl radical, and where the O-acyl radical comprises 1 to 10 carbon atoms, such as an O-acyl radical selected from aroyloxy, aralkoyloxy, heteroaroyloxy, and cycloalkoyloxy. Accordingly, acyl derivatives of a 2,2’-anyhydropyrimidine compound of formula (I) include 3’-O- acyl-2,2’-anyhdropyrimidines, 5’-O-acyl-2,2’-anyhdropyrimidines, 3’,5’-O-acyl-2,2’- anyhdropyrimidines, and derivatives thereof. For example, 3'-O-acyl-2,2'-anhydropyrimidines or derivatives thereof include 3'-O-aroyl-2,2'-anhydropyrimidines, such as a 3'-O-aroyl-2,2'- anhydrouridine or derivative thereof. An example of particular interest is 3'-O-benzoyl-2,2'- anhydrouridine or derivative thereof, such as 3'-O-benzoyl-2,2'-anhydro-5-methyluridine. Also of interest is a compound in which the 3'-O-benzoyl-2,2'-anhydro-5-methyluridine is the stereoisomer 3'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-methyluracil. In some embodiments, acyl derivatives of a 2,2’-anyhydropyrimidine compound of formula (I) include those where: R1 is H, F, CF3, CH3, CH3CH2, CH3CH2CH2, (CH3)2CH, (CH3)2CH2CH2, CH3(O)CCH2, CH3(O)CCH2CH2, Br-CH=CH, phenyl, benzyl, benzoyl, or benzyloxybenzyl, R2 is H, OH, F, CF3, CH3, CH3CH2, CH3CH2CH2, (CH3)2CH, (CH3)2CH2CH2, CH3(O)CCH2, CH3(O)CCH2CH2, Br-CH=CH, phenyl, phenyloxy, benzyl, benzyloxy, benzoyl, benzyloxybenzyl, or acyl radical, and where each R3 and R4 is independently hydroxyl or an acyl radical. These include the compounds: 3'-O-benzoyl-2,2′-anhydrouridine; 3'-O-benzoyl-2,2′-anhydro-5- fluorouridine; 3'-O-benzoyl-2,2'-anhydro-5-trifluoromethyluridine; 3'-O-benzoyl-2,2′-anhydro-5- methyluridine; 3'-O-benzoyl-2,2′-anhydro-5-ethyluridine; 3'-O-benzoyl-2,2′-anhydro-5- propyluridine; 3'-O-benzoyl-2,2′-anhydro-5-isopropyluridine; 3'-O-benzoyl-2,2'-O-anhydro-5- isobutyluridine; 3'-O-benzoyl-2,2'-anhydro-5-methylacyluridine; 3'-O-benzoyl-2,2'-anhydro-5- propylacyluridine; 3'-O-benzoyl-2,2'-anhydro-5-(2-bromovinyl)-uridine; 3'-O-benzoyl-2,2'- anhydro-5-phenylluridine; 3'-O-benzoyl-2,2'-anhydro-5-benzyluridine; 3'-O-benzoyl-2,2'-anhydro- 5-benzyoluridine; and 3'-O-benzoyl-2,2'-anhydro-5-(benzyloxybenzyl)-uridine; 5'-O-benzoyl-2,2′- anhydrouridine; 5'-O-benzoyl-2,2′-anhydro-5-fluorouridine; 5'-O-benzoyl-2,2'-anhydro-5- trifluoromethyluridine; 5'-O-benzoyl-2,2′-anhydro-5-methyluridine; 5'-O-benzoyl-2,2′-anhydro-5- ethyluridine; 5'-O-benzoyl-2,2′-anhydro-5-propyluridine; 5'-O-benzoyl-2,2′-anhydro-5- isopropyluridine; 5'-O-benzoyl-2,2'-O-anhydro-5-isobutyluridine; 5'-O-benzoyl-2,2'-anhydro-5- methylacyluridine; 5'-O-benzoyl-2,2'-anhydro-5-propylacyluridine; 5'-O-benzoyl-2,2'-anhydro-5- (2-bromovinyl)-uridine; 5'-O-benzoyl-2,2'-anhydro-5-phenylluridine; 5'-O-benzoyl-2,2'-anhydro-5- benzyluridine; 5'-O-benzoyl-2,2'-anhydro-5-benzyoluridine; and 5'-O-benzoyl-2,2'-anhydro-5- (benzyloxybenzyl)-uridine; 3’,5'-O-benzoyl-2,2′-anhydrouridine; 3’,5'-O-benzoyl-2,2′-anhydro-5- fluorouridine; 3’,5'-O-benzoyl-2,2'-anhydro-5-trifluoromethyluridine; 3’,5'-O-benzoyl-2,2′-anhydro- 5-methyluridine; 3’,5'-O-benzoyl-2,2′-anhydro-5-ethyluridine; 3’,5'-O-benzoyl-2,2′-anhydro-5- propyluridine; 3’,5'-O-benzoyl-2,2′-anhydro-5-isopropyluridine; 3’,5'-O-benzoyl-2,2'-O-anhydro-5- isobutyluridine; 3’,5'-O-benzoyl-2,2'-anhydro-5-methylacyluridine; 3’,5'-O-benzoyl-2,2'-anhydro- 5-propylacyluridine; 3’,5'-O-benzoyl-2,2'-anhydro-5-(2-bromovinyl)-uridine; 3’,5'-O-benzoyl-2,2'- anhydro-5-phenylluridine; 3’,5'-O-benzoyl-2,2'-anhydro-5-benzyluridine; 3’,5'-O-benzoyl-2,2'- anhydro-5-benzyoluridine; and 3’,5'-O-benzoyl-2,2'-anhydro-5-(benzyloxybenzyl)-uridine; or the pharmaceutically acceptable salts, solvates, hydrates, and prodrug forms thereof, and stereoisomers thereof. Of specific interest is 3'-O-benzoyl-2,2′-anhydro-5-methyluridine, 5'-O-benzoyl-2,2′-anhydro-5- methyluridine, and 3’,5'-O-benzoyl-2,2′-anhydro-5-methyluridine, or the pharmaceutically acceptable salts, solvates, hydrates, and prodrug forms thereof, and stereoisomers thereof. Of specific interest are the β-D-arabinofuranosyl isomers of these compounds, or the pharmaceutically acceptable salts, solvates, hydrates, and prodrug forms thereof. In another embodiment, compounds according to formula (I) of specific interest are those where R1 and R4 are as defined above, and R2 and/or R3 is a cyclic hydrocarbyl. By “cyclic hydrocarbyl” is intended a hydrocarbon-based ring structure having from 3 to about 10 carbon atoms and having a single cyclic ring or multiple condensed rings that may be substituted. Cyclic hydrocarbyls of interest are selected from aryl, aralkyl, aryloxy, aroyl, aroyloxy, heteroaryl, heteroaryloxy, heteroaroyloxy, cylcoalkyl, cycloalkyloxy and cycloalkoyloxy. Thus, cyclic hydrocarbyls of special interest are O-linked to the ribose or pyrimidine ring of formula (I). Compounds where R2 and/or R3 is a cyclic hydrocarbyl exhibit improved activity on a molar basis, or improved specificity with respect to not interfering with cancer therapy efficacy. Accordingly, certain compounds of the invention comprise a 5'-O-(cyclic hydrocarbyl)-2,2'- anhydropyrimidine or derivative thereof. This embodiment includes 5'-O-(cyclic hydrocarbyl)-2,2'- anhydro-5(R5)-uridine or derivatives thereof, where R5 is R1 (eg, R5 = R1 where “5(R5)” refers to, and is the same as, R1 of formula (I)). A compound of interest is 5'-O-aryl-2,2'-anhydropyrimidine or derivative thereof, of which various 2,2'-anhydrouridine derivatives are of included. This includes compounds where the 5'-O-aryl- 2,2'-anhydropyrimidine is a 5'-O-aroyl-2,2'-anhydropyrimidine, such as: 5'-O-benzoyl-2,2'- anhydropyrimidine; 5'-O-chlorobenzyl-2,2'-anhydropyrimidine; 5'-O-nitrobenzyl-2,2'- anhydropyrimidine; 5'-O-hydroxybenzyl-2,2'-anhydropyrimidine, and the like. In one embodiment, compounds that exhibit improved activity on a molar basis or improved specificity with respect to not interfering with fluorouracil therapy efficacy are the 5'-O-aryl-2,2'- anhydrouridines, 5'-O-aroyl-2,2'-anhydrouridines, and derivatives thereof, such as 5'-O-aryl-2,2'- anhydro-5(R4)-uridine, 5'-O-aroyl-2,2'-anhydro-5(R4)-uridine, and their derivatives. Examples include 5'-O-aryl-2,2'-anhydro-5-methyl-uridine; 5'-O-aryl-2,2'-anhydro-5-ethyl-uridine; 5'-O-aryl- 2,2'-anhydro-5-propyl-uridine; 5'-O-aryl-2,2'-anhydro-5-benzyl-uridine; and 5'-O-aryl-2,2'- anhydro-5-(2-bromovinyl)-uridine; and derivatives thereof. Examples also include 5'-O-aroyl-2,2'- anhydro-5-methyl-uridine; 5'-O-aroyl-2,2'-anhydro-5-ethyl-uridine; 5'-O-aroyl-2,2'-anhydro-5- propyl-uridine; 5'-O-aroyl-2,2'-anhydro-5-benzyl-uridine; and 5'-O-aroyl-2,2'-anhydro-5-(2- bromovinyl)-uridine; and derivatives thereof. Compounds of specific interest include 5'-O-benzoyl- 2,2'-anhydro-5(R4)-uridines, such as 5'-O-benzoyl-2,2'-anhydro-5-methyl-uridine; 5'-O-benzoyl- 2,2'-anhydro-5-ethyl-uridine; 5'-O-benzoyl-2,2'-anhydro-5-propyl-uridine; 5'-O-benzoyl-2,2'- anhydro-5-benzyl-uridine; and 5'-O-benzoyl-2,2'-anhydro-5-(2-bromovinyl)-uridine. Stereoisomers of interest include the 5'-O-(cyclic hydrocarbyl)-2,2'-anhydropyrimidines which are the β-D-isomers. Examples include, but are not limited to: 5'-O-benzoyl-2,2′-anhydro-1-(β-D- arabinofuranosyl)uracil; 5'-O-benzoyl-2,2′-anhydro-1-(β-D-arabinofuranosyl)-5-fluorouracil; 5'-O- benzoyl-2,2′-anhydro-1-(β-D-arabinofuranosyl)-5-trifluoromethyluracil; 5'-O-benzoyl-2,2′- anhydro-1-(β-D-arabinofuranosyl)-5-methyluracil; 5'-O-benzoyl-2,2′-anhydro-1-(β-D- arabinofuranosyl)-5-ethyluracil; 5'-O-benzoyl-2,2′-anhydro-1-(β-D-arabinofuranosyl)-5-n- propyluracil; 5'-O-benzoyl-2,2′-anhydro-1-(β-D-arabinofuranosyl)-5-isopropyluracil; 5'-O-benzoyl- 2,2′-anhydro-1-(β-D-arabinofuranosyl)-5-isobutyluracil; 5'-O-benzoyl-2,2'-anhydro-1-(β-D- arabinofuranosyl)-5-methyacyluracil; 5'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5- propylacyluracil; 5'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-(2-bromovinyl)uracil; 5'- O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-phenyluracil; 5'-O-benzoyl-2,2'-anhydro-1- (β-D-arabinofuranosyl)-5-benzyluracil; 5'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5- benzyoluracil; and 5'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-(3- benzyoxybenzyl)uracil. As noted above, also of interest are analogues/derivatives of the above compounds, where such analogs/derivatives reduce cancer therapy toxicity, such that cancer therapy toxicity is reduced when the compounds are administered in conjunction with a cancer therapy according to the subject invention. As also indicated above, an effective amount of cancer therapy toxicity-reducing adjuvant is employed in the subject methods. The 2,2'-anhydropyrimidine and derivatives thereof described above are commercially available or can be conventionally prepared by techniques known to one of skill in the art. For example, representative patents describing various 2,2'-anhydropyrimidine and derivatives, including intermediates and precursors, analysis, as well as the synthesis/preparation thereof, include U.S. Patent Nos. 3,975,367; 4,145,531; 4,230,698; 4,247,544; 4,544,740; 4,604,382; 4,613,604; 4,681,933; 4,841,039; 4,916,122; 4,987,224; 5,008,384; 5,077,280; 5,084,445; 5,141,943; 5,190,926; 5,212,293; 5,278,167; 5,384,396; 5,455,339; 5,476,855; 5,596,093; 5,610,292; 5,721,241; 5,723,449; 5,739,314; 5,760,202; 5,889,013; 5,861,493; 6,060,592; 6,090,932; 6,222,025; 6,369,040; 6,642,367; 6,670,461; 6,867,290; and 7,176,295; the disclosures of which are herein incorporated by reference. UR and sources thereof include, but are not limited to: meat products, such as fish, pig and cow liver and pancreas, and the like; fungi related products, such as brewer’s yeast, beer, mushrooms, and the like; vegetable products, such as sugarcane, tomatoes, oats, algae, broccoli and the like; salts, such as UR phosphates, acylated UR, and the like. UR and sources thereof which may be employed in embodiments of the invention include, but are not limited to, those described in U.S. Patent Nos.: 9,579,337; 6,316,426; and 5,470,838; the disclosures of which compounds are incorporated herein by reference. UR precursors and sources thereof include, but are not limited to: prodrugs of UR, such as triphenyluridine, orotic acid and the like; prodrugs of uridine 5’-monophosphate, such as mono- and di-alkyl esters, acyloxyalkyl esters, alkoxycarbonylmethyl esters, substituted ethyl and propyl esters, amidomethyl esters, benzyl esters phenyl esters, phosphonamidates, cyclophosphate esters and the like; UR prodrugs containing mono-, di- or tri-esters of UR, such as mono-, di-, and triacetyl UR and the like; UR prodrugs containing mono, di- or tri-phosphates of UR, such as UR monophosphate, UR diphosphate, UR triphosphate and the like; UR homodimers and their esters, such as U-P-U and the like; heterodimers of dideoxynucleoside compounds and UR or UPase inhibitors, such as AZT-P-U and AZT-P-BAU; etc. Uridine precursors and sources thereof which may be employed in embodiments of the invention include, but are not limited to, those described in U.S. Patent Nos.: 5,723,449 and 7,737,128; the disclosures of which compounds are incorporated herein by reference. Uridine phosphorylase (UPase) inhibitors include, but are not limited to: benzylacyclouridine, benzyloxyacylouridine, aminomethyl-benzylacylouridine, aminomethyl- benzyloxybenzylacyclouridine, hydroxymethyl-benzylacyclouridine, hydroxymethyl- benzyloxybenzyl acyclouridine, and the like; derivatives of 5-benzylbarbiturate, such as 5- benzyloxybenzyl barbiturate; 5-benzyloxybenzyl-1-(1-hydroxy-2-ethoxy)methyl) barbiturate; 5- benzyloxybenzylacetyl-1-(1-hydroxy-2-ethoxy) methyl) barbiturate; 5-benzyloxybenzyl-1-(1,3- dihydroxy 2-propoxy)methyl barbiturate; 5-benzyloxybenzyl-1-1- hydroxy, 3-amino-2- propoxy)methyl) barbiturate; 5-benzyloxybenzyl-1-(2-(3-carboxypropionyloxy)ethoxy) methyl) barbiturate; 5-benzyl-1-(1-hydroxy-2-ethoxy) methyl) barbiturate; 5-methoxybenzylacetyl barbiturate; 5-benzyl-1-(1,3-dihydroxy-2-propoxy)methyl) barbiturate; 5-benzyl-1-(1-hydroxy, 3- amino-2-propoxy)methyl) barbiturate; and 5-benzyl-1-(2-(3-carboxypropionyloxy)ethoxy) methyl) barbiturate, and the like. Upase inhibitors which may be employed in embodiments of the invention include, but are not limited to, those described in U.S. Patent Nos.: 5,723,449; 5,141,943; 5,077,280; and 4,613,604; the disclosures of which compounds are incorporated herein by reference. UR secretion inhibiting compounds include, but are not limited to: drugs, such as dilazep, hexobendine. UR secretion inhibiting compounds which may be employed in embodiments of the invention include, but are not limited to, those described in U.S. Patent Nos.: 6,989,376 and 5,567,689; the disclosures of which compounds are incorporated herein by reference. UR renal transport competitors include, but are not limited to drugs, such as L-uridine, L-2',3'- dideoxyuridine, D-2',3'-dideoxyuridine. UR renal transport competitors which may be employed in embodiments of the invention include, but are not limited to, those described in U.S. Patent Nos.: 6,989,376; 5,723,449 and 5,567,689; the disclosures of which compounds are incorporated herein by reference. Subjects that are treated according to methods of the invention may be subjects suffering a pulmonary condition, such as a severe pulmonary condition, e.g., IPF, ARDS, etc. Treatment according to the disclosed methods can begin prophylactically for subjects at risk for lung disease or post diagnosis of a serious lung condition. Treatment can be carried out at intervals determined to be appropriate by those of skill in the art. For example, the administration can be carried out 1, 2, 3, 4 or more times/day. Ideally, treatment is expected to be qd chronically. Treatment can also be started before or at or near the same time as a drug associated with serious lung conditions. FORMULATIONS Also provided are pharmaceutical compositions containing the UR plasma level modulator employed in the subject methods. Accordingly, the plasma UR level modulator may be present in pharmaceutical compositions, e.g., in the form of a pharmaceutically acceptable salt, and can be formulated for oral, topical or parenteral administration for use in the subject methods, as described above. In certain embodiments, e.g., where the UR elevation agent and UR, UR pro- drug or an UR mimetic are used together perhaps in a common formulation. By way of illustration, UR plasma level modulator and if needed the UR pro-drug or UR mimetic (separately or in combination) can be admixed with conventional pharmaceutically acceptable carriers and excipients (ie, vehicles) and used in the form of aqueous solutions, tablets, capsules, elixirs, suspensions, syrups, wafers, and the like. Such pharmaceutical compositions contain, in certain embodiments, from about 0.1% to about 90% by weight of the active compound, and more generally from about 1% to about 30% by weight of the active compound. The pharmaceutical compositions may contain common carriers and excipients, such as corn starch or gelatin, lactose, dextrose, sucrose, microcrystalline cellulose, kaolin, mannitol, dicalcium phosphate, sodium chloride, and alginic acid. Disintegrators commonly used in the formulations of this invention include croscarmellose, microcrystalline cellulose, corn starch, sodium starch glycolate and alginic acid. A liquid composition will generally consist of a suspension or solution of the compound or pharmaceutically acceptable salt in a suitable liquid carrier(s), for example, ethanol, glycerine, sorbitol, non-aqueous solvent such as polyethylene glycol, oils or water, with a suspending agent, preservative, surfactant, wetting agent, flavoring or coloring agent. Alternatively, a liquid formulation can be prepared from a reconstitutable powder. For example, a powder containing active compound, suspending agent, sucrose and a sweetener can be reconstituted with water to form a suspension; and a syrup can be prepared from a powder containing active ingredient, sucrose and a sweetener. A composition in the form of a tablet can be prepared using any suitable pharmaceutical carrier(s) routinely used for preparing solid compositions. Examples of such carriers include magnesium stearate, starch, lactose, sucrose, microcrystalline cellulose and binders, for example, polyvinylpyrrolidone. The tablet can also be provided with a color film coating, or color included as part of the carrier(s). In addition, active compound can be formulated in a controlled release dosage form as a tablet comprising a hydrophilic or hydrophobic matrix. A composition in the form of a capsule can be prepared using routine encapsulation procedures, for example, by incorporation of active compound and excipients into a hard gelatin capsule. Alternatively, a semi-solid matrix of active compound and high molecular weight polyethylene glycol can be prepared and filled into a hard gelatin capsule; or a solution of active compound in polyethylene glycol or a suspension in edible oil, for example, liquid paraffin or fractionated coconut oil can be prepared and filled into a soft gelatin capsule. Tablet binders that can be included are acacia, methylcellulose, sodium carboxymethylcellulose, poly-vinylpyrrolidone (Povidone), hydroxypropyl methylcellulose, sucrose, starch and ethylcellulose. Lubricants that can be used include magnesium stearate or other metallic stearates, stearic acid, silicone fluid, talc, waxes, oils and colloidal silica. Flavoring agents such as peppermint, oil of wintergreen, cherry flavoring or the like can also be used. Additionally, it may be desirable to add a coloring agent to make the dosage form more attractive in appearance or to help identify the product. The compounds of the invention and their pharmaceutically acceptable salts that are active when given parenterally can be formulated for intramuscular, intrathecal, or intravenous administration. A typical composition for intramuscular or intrathecal administration will be of a suspension or solution of active ingredient in an oil, for example, arachis oil or sesame oil. A typical composition for intravenous or intrathecal administration will be a sterile isotonic aqueous solution containing, for example, active ingredient and dextrose or sodium chloride, or a mixture of dextrose and sodium chloride. Other examples are lactated Ringer's injection, lactated Ringer's plus dextrose injection, Normosol-M and dextrose, Isolyte E, acylated Ringer's injection, and the like. Optionally, a co-solvent, for example, polyethylene glycol, a chelating agent, for example, ethylenediamine tetracetic acid, and an anti-oxidant, for example, sodium metabisulphite may be included in the formulation. Alternatively, the solution can be freeze dried and then reconstituted with a suitable solvent just prior to administration. The compounds of the invention and their pharmaceutically acceptable salts which are active on rectal administration can be formulated as suppositories. A typical suppository formulation will generally consist of active ingredient with a binding and/or lubricating agent such as a gelatin or cocoa butter or other low melting vegetable or synthetic wax or fat. The compounds of this invention and their pharmaceutically acceptable salts which are active on topical administration can be formulated as transdermal compositions or transdermal delivery devices ("patches"). Such compositions include, for example, a backing, active compound reservoir, a control membrane, liner and contact adhesive. Such transdermal patches may be used to provide continuous or discontinuous infusion of the compounds of the present invention in controlled amounts. The construction and use of transdermal patches for the delivery of pharmaceutical agents is well known in the art. See, eg, U.S. Patent No. 5,023,252, herein incorporated by reference in its entirety. Such patches may be constructed for continuous, pulsatile, or on demand delivery of pharmaceutical agents. In certain embodiments of interest, the cancer therapy toxicity-reducing adjuvant and UR plasma level modulator are administered as a single pharmaceutical formulation, that, in addition to including an effective amount of the cancer therapy toxicity-reducing adjuvant and UR plasma level modulator, includes other suitable compounds and carriers, and may also be used in combination with other active agents. The present invention, therefore, also includes pharmaceutical compositions comprising pharmaceutically acceptable excipients. The pharmaceutically acceptable excipients include, for example, any suitable vehicles, adjuvants, carriers or diluents, and are readily available to the public. The pharmaceutical compositions of the present invention may further contain other active agents that are well known in the art. One skilled in the art will appreciate that a variety of suitable methods of administering a formulation of the present invention to a subject or host, eg, patient, in need thereof, are available, and, although more than one route can be used to administer a particular formulation, a particular route can provide a more immediate and more effective reaction than another route. Pharmaceutically acceptable excipients are also well-known to those who are skilled in the art and are readily available. The choice of excipient will be determined in part by the particular compound, as well as by the particular method used to administer the composition. Accordingly, there are a wide variety of suitable formulations of the pharmaceutical composition of the present invention. The following methods and excipients are merely exemplary and are in no way limiting. Formulations suitable for oral administration can consist of (a) liquid solutions, such as an effective amount of the compound dissolved in diluents, such as water, saline, or orange juice; (b) capsules, sachets or tablets, each containing a predetermined amount of the active ingredient, as solids or granules; (c) suspensions in an appropriate liquid; and (d) suitable emulsions. Tablet forms can include one or more of lactose, mannitol, corn starch, potato starch, microcrystalline cellulose, acacia, gelatin, colloidal silicon dioxide, croscarmellose sodium, talc, magnesium stearate, stearic acid, and other excipients, colorants, diluents, buffering agents, moistening agents, preservatives, flavoring agents, and pharmacologically compatible excipients. Lozenge forms can comprise the active ingredient in a flavor, usually sucrose and acacia or tragacanth, as well as pastilles comprising the active ingredient in an inert base, such as gelatin and glycerin, or sucrose and acacia, emulsions, gels, and the like containing, in addition to the active ingredient, such excipients as are known in the art. The subject formulations of the present invention can be made into aerosol formulations to be administered via inhalation. These aerosol formulations can be placed into pressurized acceptable propellants, such as dichlorodifluoromethane, propane, nitrogen, and the like. They may also be formulated as pharmaceuticals for non-pressured preparations such as for use in a nebulizer or an atomizer. Formulations suitable for parenteral administration include aqueous and non-aqueous, isotonic sterile injection solutions, which can contain anti-oxidants, buffers, bacteriostats, and solutes that render the formulation isotonic with the blood of the intended recipient, and aqueous and non- aqueous sterile suspensions that can include suspending agents, solubilizers, thickening agents, stabilizers and preservatives. The formulations can be presented in unit-dose or multi-dose sealed containers, such as ampules and vials, and can be stored in a freeze-dried (lyophilized) condition requiring only the addition of the sterile liquid excipient, for example, water, for injections, immediately prior to use. Extemporaneous injection solutions and suspensions can be prepared from sterile powders, granules, and tablets of the kind previously described. Formulations suitable for topical administration may be presented as creams, gels, pastes, or foams, containing, in addition to the active ingredient, and other such carriers that are known in the art to be appropriate. Suppository formulations are also provided by mixing with a variety of bases such as emulsifying bases or water-soluble bases. Formulations suitable for vaginal administration may be presented as pessaries, tampons, creams, gels, pastes, foams. Unit dosage forms for oral or rectal administration such as syrups, elixirs, and suspensions may be provided wherein each dosage unit, for example, teaspoonful, tablespoonful, tablet or suppository, contains a predetermined amount of the composition containing one or more inhibitors. Similarly, unit dosage forms for injection or intravenous administration may comprise the inhibitor(s) in a composition as a solution in sterile water, normal saline or another pharmaceutically acceptable carrier. The term “unit dosage form,” as used herein, refers to physically discrete units suitable as unitary dosages for human and animal subjects, each unit containing a predetermined quantity of compounds of the present invention calculated in an amount sufficient to produce the desired effect in association with a pharmaceutically acceptable diluent, carrier or vehicle. The specifications for the novel unit dosage forms of the present invention depend on the particular compound employed and the effect to be achieved, and the pharmacodynamics associated with each compound in the host. Those of skill in the art will readily appreciate that dose levels can vary as a function of the specific compound, the nature of the delivery vehicle, and the like. Suitable dosages for a given compound are readily determinable by those of skill in the art by a variety of means. The dose administered to an animal, particularly a human, in the context of the present invention should be sufficient to cause a prophylactic or therapeutic response in the animal over a reasonable time frame. One skilled in the art will recognize that dosage will depend on a variety of factors including the strength of the particular compound employed, the condition of the animal, and the body weight of the animal, as well as the severity of the illness and the stage of the disease. The size of the dose will also be determined by the existence, nature, and extent of any adverse side-effects that might accompany the administration of a particular compound. Suitable doses and dosage regimens can be determined by comparisons to anticancer or immunosuppressive agents that are known to cause the desired growth inhibitory or immunosuppressive response. Optionally, the pharmaceutical composition may contain other pharmaceutically acceptable components, such as buffers, surfactants, antioxidants, viscosity modifying agents, preservatives and the like. Each of these components is well-known in the art. For example, see U.S. Patent No.5,985,310, the disclosure of which is herein incorporated by reference. Other components suitable for use in the formulations of the present invention can be found in Remington's Pharmaceutical Sciences, Mace Publishing Company, Philadelphia, Pa., 17th ed. (1985). In an embodiment, the aqueous solution of cyclodextrin also contains dextrose, e.g., about 5% dextrose. UTILITY The subject methods find use in the treatment of hepatic diseases that feature fibrosis, or the accumulation of extracellular matrix molecules that make up scar tissue as the toxic endpoint as well as other diseases such as, inter alia, pulmonary fibrosis, renal fibrosis, systemic sclerosis (SSc), sclerodermatous graft vs. host disease, radiation-induced fibrosis and cardiac fibrosis. Several eye conditions such as ARMD, DR, ROP, and neovascular glaucoma also feature fibrosis as an endpoint. In aggregate, mitigating fibrosis represent a huge unmet clinical need. By treatment, is meant that at least an amelioration of the symptoms associated with the condition afflicting the host is achieved, where amelioration is used in a broad sense to refer to at least a reduction in the magnitude of a parameter, eg, a symptom associated with the condition being treated or an side effect resulting from administration of a drug. As such, treatment also includes situations where the pathological condition, or at least symptoms associated therewith, are completely inhibited, eg, prevented from happening, or stopped, eg terminated, such that the host no longer suffers from the condition, or at least the symptoms that characterize the condition. A variety of subjects are treatable according to the subject methods. Generally such hosts are "mammals" or "mammalian," where these terms are used broadly to describe organisms which are within the class mammalia, including the orders carnivore (eg, dogs and cats), rodentia (eg, mice, guinea pigs, and rats), and primates (eg, humans, chimpanzees, and monkeys). In many embodiments, the subjects will be humans. In certain embodiments, the subjects will be subjects that have been diagnosed for and are, therefore, in need of administration of the active agent. In certain embodiments, the methods may include diagnosing the subject for the presence of the disease condition to be treated by administration of the active agent. In certain embodiments, the methods may include diagnosing the subject for risk of a disease condition (eg, fibrosis) whose downstream severity could be modulated or entirely prevented by administration of the active agent. The dose administered to an animal, particularly a human, in the context of the present invention should be sufficient to affect a prophylactic or therapeutic response in the animal over a reasonable time frame. One skilled in the art will recognize that dosage will depend on a variety of factors including the strength of the particular compound employed and the dosing regimen used, the condition of the animal, and the body weight of the animal, as well as the severity of the illness and the stage of the disease. The size of the dose will also be determined by the existence, nature, and extent of any adverse side-effects that might accompany the administration of a particular compound. KITS & SYSTEMS Also provided are kits and systems that find use in practicing the subject methods, eg, as described above. For example, kits and systems for practicing the subject methods may include one or more pharmaceutical formulations, which include the UR plasma level modulator and perhaps UR, a UR prodrug, or a UR mimetic. As such, in certain embodiments the kits may include a single pharmaceutical composition, present as one or more unit dosages, where the composition includes both a plasma UR level modulator and perhaps UR, a UR prodrug, or a UR mimetic. In yet other embodiments, the kits may include two or more separate pharmaceutical compositions, each containing the plasma UR level modulator and perhaps UR, a UR prodrug, or a UR mimetic. In addition to the above components, the subject kits may further include instructions for practicing the subject methods. These instructions may be present in the subject kits in a variety of forms, one or more of which may be present in the kit. One form in which these instructions may be present is as printed information on a suitable medium or substrate, eg, a piece or pieces of paper on which the information is printed, in the packaging of the kit, in a package insert, etc. Yet another means would be a computer readable medium, eg, diskette, CD, etc., on which the information has been recorded. Yet another means that may be present is a website address which may be used via the internet to access the information at a removed site. Any convenient means may be present in the kits. For example, a kit according to one embodiment includes as a first component (a) instructions for using a plasma UR level modulator, and as a second component (b) a pharmaceutical composition comprising a uridine, an UR prodrug, or an UR mimetic. Kits of specific interest are those that include a 2, 2’-anhydropyrimidine pharmaceutical composition of the invention and suitable for practicing the subject methods of the invention, such as for mitigating serious pulmonary disease. The term "system" as employed herein refers to a collection of a plasma UR level modulator, and perhaps UR, an UR prodrug or an UR mimetic present in a single or disparate composition, that are brought together for the purpose of practicing the subject methods. For example, separately obtained plasma UR level modulator active agent and perhaps a UR, UR prodrug or UR mimetic dosage forms brought together and co-administered to a subject, according to the present invention, are a system according to the present invention. The following examples further illustrate the present invention but should not be construed in any way as limiting its scope. EXAMPLES Figure 1. Figure provides a regression analysis of plasma UR concentration versus plasma Compound 1 concentrations determined following continuous infusion of various amounts of Compound 1 (TK-112690) to mice. R2 for the line is 0.95, and the slope and intercept values for the line are 0.010 and 0.051, respectively. Compound 1 is seen to elevate plasma UR in a linear fashion. Because UR is cleared so rapidly, elimination t1/2 only a few minutes, (Deng Y, Wang ZV, Gordillo R, An Y, Zhang C, Liang Q, Yoshino J, Cautivo KM, De Brabander J, Elmquist JK, Horton JD, Hill JA, Klein S, Scherer PE, An adipo-biliary-uridine axis that regulates energy homeostasis, Science 2017, 17;355(6330) and the elimination t1/2 of Compound 1 in mice is only 1-2 hours, it is very challenging to measure UR concentrations elevations post discrete doses of Compound I, such as used for ip dosing. For this reason continuous infusion of compound I (authentic TK-112690, Batch TCY90108) to BDF-1 ǁ mice were administered via a sc implanted osmotic pumps and
Figure imgf000046_0001
the UR plasma concentration measured. Solutions of Compound I were prepared at a concentration of 500 mg/mL in sterile PBS. Osmotic pumps (ALZET® micro-osmotic pump 2001D and 1003D, Alza Co) were loaded with 200 µL (2001D osmotic pump) and/or 100 µL (1003D osmotic pump) of TK-112690 solution. BDF-1 male mice (n=6) were treated with a constant-rate infusion of 667, 833 or 3000 mg/kg/day doses of Compound I delivered via subcutaneously implanted osmotic pumps. Animals were anesthetized with 100 mg/kg ketamine prior to pump implantation. Surgical scissors were used to make an approximately 1 cm incision on the dorsal surface near the shoulder blade of animals. A hemostat was used to carve out a subcutaneous tunnel toward the anterior end of animal. Osmotic pumps were placed inside the subcutaneous tunnel. Incision was sealed with wound clips. Blood collections were performed on animals anesthetized with ketamine (ip 100 mg/kg). Blood samples from animals treated with a constant-rate infusion of TK-112690 were collected at 72 hours for 667 mg/kg/day and 833 mg/kg/day and 24 hours for 3000 mg/kg/day after pump implantation. Whole blood (~0.8 mL) was drawn through the retro-orbital sinus using a heparin coated micro-hematocrit tube and collected into an EDTA microtainer tube. Blood samples were transferred into fresh 1.5 mL microcentrifuge tubes and centrifuged for 10 minutes at 14,000 x g using an Eppendorf Minispin Plus stored in a 4ºC refrigerator. Exactly 0.4 mL of plasma was transferred into fresh microcentrifuge tubes containing 2 μL of 10 mM 5-FU and vortexed at highest setting for approximately 5 seconds. The final 50 μM concentration of 5-FU served as an internal standard. Animals were sacrificed by cervical dislocation and properly disposed. Blood samples from animals treated with a constant-rate infusion of compound I were collected at 72 hours for 667 mg/kg/day and 833 mg/kg/day and 24 hours for 3000 mg/kg/day after pump implantation. Whole blood (~0.8 mL) was drawn through the retro-orbital sinus using a heparin coated micro-hematocrit tube and collected into an EDTA microtainer tube. Blood samples were transferred into fresh 1.5 mL microcentrifuge tubes and centrifuged for 10 minutes at 14,000 x g using an Eppendorf Minispin Plus stored in a 4ºC refrigerator. Exactly 0.4 mL of plasma was transferred into fresh microcentrifuge tubes containing 2 μL of 10 mM 5-FU and vortexed at highest setting for approximately 5 seconds. The final 50 μM concentration of 5-FU served as an internal standard. Animals were sacrificed by cervical dislocation and properly disposed. A solid-phase extraction (SPE) of analytes (UR, Compound I and 5-FU) from plasma was conducted before HPLC analysis. Supelco C8 SPE columns were used for extraction process. All solutions were pushed through SPE columns using positive pressure generated from a Vacuum- Pressure Pump (Barnant Company Model 400-1901). The flow rate through the SPE column was approximately 2 drops per second. Pre-washing of SPE columns was done with a total of 2.4 mL of sterile PBS (room temp; pH = 7.4). Exactly 0.6 mL PBS was added to the SPE column four separate times and pushed through the column. Immediately after pre-wash, all 0.4 mL of the plasma sample (with added 5-FU internal standard) was transferred onto the column and pushed through the column. Analytes were disassociated from SPE column by pushing through exactly 0.5 mL of 5 M NaCl (room temp; pH ~ 5). Eluted samples were collected into fresh 1.5 mL micro- centrifuge tubes. Samples were transferred into fresh HPLC vials and analyzed. HPLC analysis was done at room temperature (RT) using a ThermoFinnigan Spectra System equipped with degasser, pump, autosampler and UV detector. Chromatograms were constructed from a chart recorder equipped with a pen. Analytes were separated using a Phenomenex C18 Reverse-Phase column (250 x 4.6 mm). Two separate mobile phase gradients were employed for the HPLC analysis: (1) 5% methanol in nano water with 0.1% formic acid (2) 5% methanol in acetonitrile with 0.1% formic acid (flow rate = 0.5 mL per minute). HPLC responses for compound I and UR were divided by the 5-FU response. Calibration curves were used to convert these ratios into concentrations of Compound 1. A regression analysis (UR concentration vs. Compound 1 concentration) for data from the study is provided in Figure 1. Higher concentration of TK-112690 (Compound 1) are seen to be associated with higher levels of UR. Figure 2. Figure is a chart providing histology scores for pulmonary tissue from mice treated with bleomycin (a well characterized lung toxin) and either dosing vehicle, UR, or TK-112690. Thirty-three C57BL/6 male mice, 10-14 weeks at study initiation, were acclimatized for least 3 days. The mouse has been selected as is referenced in the literature as a representative species of choice for this experimental animal model. During acclimation and throughout the entire study duration, animals were housed within a limited access rodent facility and kept in groups of a maximum of 4 mice per cage. Mice were housed in polypropylene cages with solid bottoms and wood shavings or corn cobb as bedding material. Animals were provided ad libitum with a commercial rodent diet and had free access to drinking water that is supplied to each cage via polyethylene bottles. The automatically controlled environmental conditions was set to maintain temperature at 20-26°C with a relative humidity (RH) of 30-70%, a 12:12 hour light: dark cycle, and 10-15 air changes/hour in the study room. Animals were given a unique animal identification tail mark as a means of identification. This number also appeared on a cage card, which is visible on the front of each cage. The cage card also contains the study and group numbers, route of administration, gender, study director and arrival date. Animals were randomly assigned to cages on arrival. Animals were assigned to treatment groups prior to treatment initiation. At study termination, surviving animals were weighed prior to euthanasia. Euthanasia was performed via anesthesia overdose and exsanguination. The table below lists the experimental group(s) comprising the study.
Figure imgf000049_0001
*Dosing volume is based on average body weight per group, typically approx.20g/mouse. Disease Induction.75uL of Bleomycin (section 4.5.) was administered on day 0 via oropharyngeal aspiration (O.A.). The mice were anesthetized via isoflurane/oxygen and suspended by their cranial incisors on a thin wire from an angled stand. The tongue was be gently held from the mouth using blunt forceps to visualize the base of the tongue and the pharynx. Bleomycin/saline suspension was pipetted onto posterior pharynx. Nostrils will be held gently closed. Respiration was monitored to ensure the suspension is fully aspirated. Treatment. Groups 3 and 4 were treated via intraperitoneal (IP) injection at a dosing volume of 10ml/kg twice daily, 6-8 hours between doses, from days 7 through 20. Observations and Examinations. Clinical signs, humane endpoints, and palliative care: Changes in skin, fur, eyes, mucus membranes, occurrence of secretions and excretions, autonomic activity, gait, posture, and response to handling, Bizarre behavior, tremors, convulsions, sleep and coma. Laboring breathing and adventitious lung sounds. The bleomycin administration induced a severe pulmonary inflammation resulting in lethargy, dehydration, and death of diseased animals. Animals in all diseased groups were given fresh diet gel daily beginning on Day 7 and through the remainder of the study. Body weight measurements were performed 3x weekly starting on Day 0 and throughout the rest of the study. Termination: BALF and tissue collection. Animals were euthanized via isoflurane overdose. Following euthanasia an angiocatheter was inserted into the trachea. 1ml of PBS was instilled into the lungs and allowed to flow back out into the syringe twice. The resulting BALF was centrifuged at 500 ×g for 5 mins and the non-cellular portion of the BALF was stored at -80 °C for potential subsequent analyses. Histology. Following BALF collection, lungs were inflated and fixed with formalin for histological analysis. Analysis included Masson’s Trichrome stain for presence of collagen. Disease severity and collagen levels were assessed by the Ashcroft fibrosis grading system. The resulting data were analyzed by SPSS, version 20. The mice treated with TK-112690 showed a statistically significant 30% less fibrosis than mice treated with the dosing vehicle. Mice treated with UR showed only a 7% decrease in fibrosis compared to the dosing vehicle, and the result was not statistically significant. Figure 3. Figure provides representative H&E images of lung sections from each experimental group for the bleomycin/pulmonary fibrosis study shown in Figure 2. Total lung was weighed, formalin fixed and stained. Analysis used Masson’s Trichrome stain to detect presence of collagen. The histopathologic measurement of fibrosis was performed by an experienced histopathologist. Figure 4. Figure provides a chart correlating TGF-β1 concentration in BAL fluid from the mice participating in the bleomycin/pulmonary fibrosis study whose results are shown in Figure 2 and fibrosis scores. Each BAL sample was 60µl of BALF in 1.5ml Eppendorf tubes. Prior to analysis the samples were stored at -80°C. The samples were run at a single concentration without any dilutions. Duplicates of each calibration standard were run, so that the CV values could also be evaluated for the panel. Samples were analyzed using a Luminex® MagPix™ system. Analysis of the raw data was performed using Milliplex™ Analyst software. The Luminex technology used color-code microspheres with fluorescent dyes which were coated with a specific capture antibody. After incubation of the analyte with captured beads, a biotinylated detection secondary antibody is introduced followed by a reporter molecule (Streptavidin-PE conjugate). The analyte concentration was quantified based on the fluorescent reporter signal. The best-fit standard curve was determined by regression analysis using five-parameter logistic curve-fit. SPSS, version 20, was used to perform the correlation evaluation. The observed correlation coefficient, 0.66, was significant at the 0.01 level (2-tailed). The green line in the plot is the regression line for the data. The curved black lines in the plot are the 95% confidence limits for the regression. In at least some of the previously described embodiments, one or more elements used in an embodiment can interchangeably be used in another embodiment unless such a replacement is not technically feasible. It will be appreciated by those skilled in the art that various other omissions, additions and modifications may be made to the methods and structures described above without departing from the scope of the claimed subject matter. All such modifications and changes are intended to fall within the scope of the subject matter, as defined by the appended claims. It will be understood by those within the art that, in general, terms used herein, and especially in the appended claims (e.g., bodies of the appended claims) are generally intended as “open” terms (e.g., the term “including” should be interpreted as “including but not limited to,” the term “having” should be interpreted as “having at least,” the term “includes” should be interpreted as “includes but is not limited to,” etc.). It will be further understood by those within the art that if a specific number of an introduced claim recitation is intended, such an intent will be explicitly recited in the claim, and in the absence of such recitation no such intent is present. For example, as an aid to understanding, the following appended claims may contain usage of the introductory phrases “at least one” and “one or more” to introduce claim recitations. However, the use of such phrases should not be construed to imply that the introduction of a claim recitation by the indefinite articles “a” or “an” limits any particular claim containing such introduced claim recitation to embodiments containing only one such recitation, even when the same claim includes the introductory phrases “one or more” or “at least one” and indefinite articles such as “a” or “an” (e.g., “a” and/or “an” should be interpreted to mean “at least one” or “one or more”); the same holds true for the use of definite articles used to introduce claim recitations. In addition, even if a specific number of an introduced claim recitation is explicitly recited, those skilled in the art will recognize that such recitation should be interpreted to mean at least the recited number (e.g., the bare recitation of “two recitations,” without other modifiers, means at least two recitations, or two or more recitations). Furthermore, in those instances where a convention analogous to “at least one of A, B, and C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “ a system having at least one of A, B, and C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). In those instances where a convention analogous to “at least one of A, B, or C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “ a system having at least one of A, B, or C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). It will be further understood by those within the art that virtually any disjunctive word and/or phrase presenting two or more alternative terms, whether in the description, claims, or drawings, should be understood to contemplate the possibilities of including one of the terms, either of the terms, or both terms. For example, the phrase “A or B” will be understood to include the possibilities of “A” or “B” or “A and B.” In addition, where features or aspects of the disclosure are described in terms of Markush groups, those skilled in the art will recognize that the disclosure is also thereby described in terms of any individual member or subgroup of members of the Markush group. As will be understood by one skilled in the art, for any and all purposes, such as in terms of providing a written description, all ranges disclosed herein also encompass any and all possible sub-ranges and combinations of sub-ranges thereof. Any listed range can be easily recognized as sufficiently describing and enabling the same range being broken down into at least equal halves, thirds, quarters, fifths, tenths, etc. As a non-limiting example, each range discussed herein can be readily broken down into a lower third, middle third and upper third, etc. As will also be understood by one skilled in the art all language such as “up to,” “at least,” “greater than,” “less than,” and the like include the number recited and refer to ranges which can be subsequently broken down into sub-ranges as discussed above. Finally, as will be understood by one skilled in the art, a range includes each individual member. Thus, for example, a group having 1-3 articles refers to groups having 1, 2, or 3 articles. Similarly, a group having 1-5 articles refers to groups having 1, 2, 3, 4, or 5 articles, and so forth. Although the foregoing invention has been described in some detail by way of illustration and example for purposes of clarity of understanding, it is readily apparent to those of ordinary skill in the art in light of the teachings of this invention that certain changes and modifications may be made thereto without departing from the spirit or scope of the appended claims. Accordingly, the preceding merely illustrates the principles of the invention. It will be appreciated that those skilled in the art will be able to devise various arrangements which, although not explicitly described or shown herein, embody the principles of the invention and are included within its spirit and scope. Furthermore, all examples and conditional language recited herein are principally intended to aid the reader in understanding the principles of the invention and the concepts contributed by the inventors to furthering the art, and are to be construed as being without limitation to such specifically recited examples and conditions. Moreover, all statements herein reciting principles, aspects, and embodiments of the invention as well as specific examples thereof, are intended to encompass both structural and functional equivalents thereof. Additionally, it is intended that such equivalents include both currently known equivalents and equivalents developed in the future, i.e., any elements developed that perform the same function, regardless of structure. Moreover, nothing disclosed herein is intended to be dedicated to the public regardless of whether such disclosure is explicitly recited in the claims. The scope of the present invention, therefore, is not intended to be limited to the exemplary embodiments shown and described herein. Rather, the scope and spirit of present invention is embodied by the appended claims. In the claims, 35 U.S.C. §112(f) or 35 U.S.C. §112(6) is expressly defined as being invoked for a limitation in the claim only when the exact phrase "means for" or the exact phrase "step for" is recited at the beginning of such limitation in the claim; if such exact phrase is not used in a limitation in the claim, then 35 U.S.C. § 112 (f) or 35 U.S.C. §112(6) is not invoked.

Claims

What is claimed is: 1. A method of treating a subject for a pulmonary condition having a toxic lung pathology, the method comprising: administering to the subject an effective amount of a 2,2'-anhydropyrimidine or derivative thereof to treat the subject for the pulmonary condition. 2. The method according to Claim 1, wherein the 2,
2'-anhydropyrimidine or derivative thereof is a compound of formula (I):
Figure imgf000054_0001
(I) or the pharmaceutically acceptable salts, solvates, hydrates, and prodrug forms thereof, and stereoisomers thereof; wherein: each R1, R2, R3 and R4 is independently selected from the group consisting of hydrogen, substituted or unsubstituted heteroatom, substituted or unsubstituted alkyl, substituted or unsubstituted cycloalkyl, substituted or unsubstituted heterocycloalkyl, substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted aralkyl, carbohydrate, nucleic acid, amino acid, peptide, dye, fluorophore and polypeptide.
3. The method according to Claim 2, wherein each R1, R2, R3 and R4 is independently selected from the group consisting of hydrogen, hydroxyl, sulfyhydryl, amino, hydroxymethyl, methoxy, halogen, pseudohalogen, and a substituted or unsubstituted lower hydrocarbon containing 1 to 20 carbons.
4. The method according to Claim 2, wherein the lower hydrocarbon is selected from the group consisting of alkyl, alkenyl, alkanoyl, aryl, aroyl, aralkyl and alkylamino, and esters thereof.
5. The method according to Claim 2, wherein R1 is hydrogen, fluorine, methyl, ethyl, propyl, benzyl, or 2-bromovinyl; R2 is hydrogen, hydroxyl fluorine, methyl, ethyl, propyl, benzyl, benzoyl, benzoyloxy, or 2-bromovinyl; and each R3 and R4 is independently selected from the group consisting of hydroxyl and benzoyloxy.
6. The method according to Claim 5, wherein R1 is hydrogen or methyl; R2 is hydrogen; and each R3 and R4 is independently selected from the group consisting of hydroxyl and benzoyloxy.
7. The method according to Claim 1, wherein the 2,2'-anhydropyrimidine or derivative thereof is selected from the group consisting of: 2,2'-anhydro-5-methyluridine; 3'-O- benzoyl-2,2'-anhydrouridine; 3'-O-benzoyl-2,2'-anhydro-5-methyluridine; 5'-O-benzoyl- 2,2'-anhydrouridine; and 5'-O-benzoyl-2,2'-anhydro-5-methyluridine.
8. The method according to Claim 7, wherein the 2,2'-anhydropyrimidine or derivative thereof is 2,2'-anhydro-5-methyluridine.
9. The method according to Claim 7, wherein the 2,2'-anhydropyrimidine or derivative thereof is 3'-O-benzoyl-2,2'-anhydro-5-methyluridine.
10. The method according to Claim 7, wherein the 2,2'-anhydropyrimidine or derivative thereof is 5'-O-benzoyl-2,2'-anhydro-5-methyluridine.
11. The method according to Claim 1, wherein the 2,2'-anhydropyrimidine or derivative thereof comprises a stereoisomer.
12. The method according to Claim 11, wherein the stereoisomer is selected from the group consisting of 2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-methyluracil; 3'-O-benzoyl- 2,2'-anhydro-1-(β-D-arabinofuranosyl)-uracil; 3'-O-benzoyl-2,2'-anhydro-1-(β-D- arabinofuranosyl)-5-methyluracil; 5'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)- uracil; and 5'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-methyluracil.
13. The method according to Claim 1, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering NAFLD.
14. The method according to Claim 1, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering NASH.
15. The method according to Claim 1, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering a DILI.
16. The method according to Claim 11, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject likely to suffer a DILI because of planned treatment.
17 A method of treating a subject for pulmonary condition having a toxic hepatic pathology, the method comprising: administering to the subject an effective amount of a 2,2'-anhydropyrimidine or derivative thereof in combination with one or more of UR, an UR prodrug and an UR mimetic to treat the subject for the pulmonary condition.
18. The method according to Claim 17, wherein the 2,2'-anhydropyrimidine or derivative thereof is a compound of formula (I):
Figure imgf000057_0001
or the pharmaceutically acceptable salts, solvates, hydrates, and prodrug forms thereof, and stereoisomers thereof; wherein: each R1, R2, R3 and R4 is independently selected from the group consisting of hydrogen, substituted or unsubstituted heteroatom, substituted or unsubstituted alkyl, substituted or unsubstituted cycloalkyl, substituted or unsubstituted heterocycloalkyl, substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted aralkyl, carbohydrate, nucleic acid, amino acid, peptide, dye, fluorophore and polypeptide.
19. The method according to Claim 18, wherein each R1, R2, R3 and R4 is independently selected from the group consisting of hydrogen, hydroxyl, sulfyhydryl, amino, hydroxymethyl, methoxy, halogen, pseudohalogen, and a substituted or unsubstituted lower hydrocarbon containing 1 to 20 carbons.
20. The method according to Claim 18, wherein the lower hydrocarbon is selected from the group consisting of alkyl, alkenyl, alkanoyl, aryl, aroyl, aralkyl and alkylamino, and esters thereof.
21. The method according to Claim 18, wherein R1 is hydrogen, fluorine, methyl, ethyl, propyl, benzyl, or 2-bromovinyl; R2 is hydrogen, hydroxyl fluorine, methyl, ethyl, propyl, benzyl, benzoyl, benzoyloxy, or 2-bromovinyl; and each R3 and R4 is independently selected from the group consisting of hydroxyl and benzoyloxy.
22. The method according to Claim 21, wherein R1 is hydrogen or methyl; R2 is hydrogen; and each R3 and R4 is independently selected from the group consisting of hydroxyl and benzoyloxy.
23. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is selected from the group consisting of: 2,2'-anhydro-5-methyluridine; 3'-O-benzoyl-2,2'-anhydrouridine; 3'-O-benzoyl-2,2'-anhydro-5-methyluridine; 5'-O- benzoyl-2,2'-anhydrouridine; and 5'-O-benzoyl-2,2'-anhydro-5-methyluridine.
24. The method according to Claim 23, wherein the 2,2'-anhydropyrimidine or derivative thereof is 2,2'-anhydro-5-methyluridine.
25. The method according to Claim 23, wherein the 2,2'-anhydropyrimidine or derivative thereof is 3'-O-benzoyl-2,2'-anhydro-5-methyluridine.
26. The method according to Claim 23, wherein the 2,2'-anhydropyrimidine or derivative thereof is 5'-O-benzoyl-2,2'-anhydro-5-methyluridine.
27. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof comprises a stereoisomer.
28. The method according to Claim 27, wherein the stereoisomer is selected from the group consisting of 2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-methyluracil; 3'-O-benzoyl- 2,2'-anhydro-1-(β-D-arabinofuranosyl)-uracil; 3'-O-benzoyl-2,2'-anhydro-1-(β-D- arabinofuranosyl)-5-methyluracil; 5'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)- uracil; and 5'-O-benzoyl-2,2'-anhydro-1-(β-D-arabinofuranosyl)-5-methyluracil.
29. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering an interstitial lung disease (ILDs).
30. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering IPF, an ILD.
31. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering ARDS, an ILD.
32. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering systemic fibrotic diseases such as systemic sclerosis (SSc), an ILD.
33. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering systemic fibrotic diseases such as sclerodermatous graft vs. host disease, an ILD.
34. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering systemic fibrotic diseases such as sclerodermatous graft vs. host disease, an ILD.
35. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering systemic fibrotic diseases such as sclerodermatous graft vs. host disease, an ILD.
36. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering connective tissue disease-associated ILD (CTD-ILD) which is mainly systemic sclerosis-ILD (SSc-ILD) and rheumatoid arthritis-ILD (RA-ILD).
37. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering idiopathic non-specific interstitial pneumonia (i SIP), an ILD.
38. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering chronic hypersensitivity pneumonitis (CHP), an ILD.
39. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering unclassifiable idiopathic interstitial pneumonia (IIP).
40. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering interstitial pneumonia with autoimmune features (IPAF).
41. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering environmental/occupational fibrosing lung diseases like asbestosis and silicosis.
42. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering nephrogenic systemic fibrosis.
43. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering radiation-induced fibrosis.
44. The method according to Claim 18, wherein the 2,2'-anhydropyrimidine or derivative thereof is administered to the subject suffering kidney fibrosis.
PCT/US2021/040290 2020-07-07 2021-07-02 Uridine phosphorylase inhibitors to treat or prevent pulmonary disease Ceased WO2022010778A1 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
EP21837558.2A EP4178581A4 (en) 2020-07-07 2021-07-02 Uridine phosphorylase inhibitors to treat or prevent pulmonary disease
CN202180054634.3A CN116096422A (en) 2020-07-07 2021-07-02 Uridine phosphorylase inhibitors for treating or preventing pulmonary diseases
AU2021306230A AU2021306230A1 (en) 2020-07-07 2021-07-02 Uridine phosphorylase inhibitors to treat or prevent pulmonary disease
IL299703A IL299703A (en) 2020-07-07 2021-07-02 Uridine phosphorylase inhibitors to treat or prevent pulmonary disease
CA3185126A CA3185126A1 (en) 2020-07-07 2021-07-02 Uridine phosphorylase inhibitors to treat or prevent pulmonary disease

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US202063048850P 2020-07-07 2020-07-07
US63/048,850 2020-07-07

Publications (1)

Publication Number Publication Date
WO2022010778A1 true WO2022010778A1 (en) 2022-01-13

Family

ID=79171945

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2021/040290 Ceased WO2022010778A1 (en) 2020-07-07 2021-07-02 Uridine phosphorylase inhibitors to treat or prevent pulmonary disease

Country Status (7)

Country Link
US (2) US12194043B2 (en)
EP (1) EP4178581A4 (en)
CN (1) CN116096422A (en)
AU (1) AU2021306230A1 (en)
CA (1) CA3185126A1 (en)
IL (1) IL299703A (en)
WO (1) WO2022010778A1 (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP4301398A4 (en) * 2021-03-05 2025-01-22 Tosk, Inc. Uridine phosphorylase inhibitors to prevent or treat drug-induced pulmonary dysfunction

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2020036982A1 (en) 2018-08-14 2020-02-20 Tosk, Inc. Methods and compositions for treating mucositis
WO2020036974A1 (en) 2018-08-14 2020-02-20 Tosk, Inc. Methods and compositions for reducing radiation induced toxicity
WO2020036975A1 (en) * 2018-08-14 2020-02-20 Tosk, Inc. Methods and compositions for reducing fluorouracil induced toxicity
EP4178581A4 (en) 2020-07-07 2024-06-05 Tosk, Inc. Uridine phosphorylase inhibitors to treat or prevent pulmonary disease

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040220134A1 (en) * 1987-10-28 2004-11-04 Pro-Neuron, Inc. Pyrimidine nucleotide precursors for treatment of systemic inflammation and inflammatory hepatitis
WO2009114325A2 (en) * 2008-03-03 2009-09-17 Tosk, Incorporated Methotrexate adjuvants to reduce toxicity and methods for using the same
US20140323427A1 (en) * 2011-08-12 2014-10-30 Universitaetsklinikum Freiburg Uridine and uridine analogues for treatment of specific lung diseases, namely copd and pulmonary fibrosis
WO2020036975A1 (en) * 2018-08-14 2020-02-20 Tosk, Inc. Methods and compositions for reducing fluorouracil induced toxicity
WO2020036974A1 (en) * 2018-08-14 2020-02-20 Tosk, Inc. Methods and compositions for reducing radiation induced toxicity

Family Cites Families (29)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5306509A (en) 1987-03-17 1994-04-26 Turner Robert E Prevention and treatment of oral lesions
US5470838A (en) * 1987-10-28 1995-11-28 Pro-Neuron, Inc. Method of delivering exogenous uridine or cytidine using acylated uridine or cytidine
US5736531A (en) 1987-10-28 1998-04-07 Pro-Neuron, Inc. Compositions of chemotherapeutic agent or antiviral agent with acylated pyrimidine nucleosides
US7776838B1 (en) 1987-10-28 2010-08-17 Wellstat Therapeutics Corporation Treatment of chemotherapeutic agent and antiviral agent toxicity with acylated pyrimidine nucleosides
US5968914A (en) 1987-10-28 1999-10-19 Pro-Neuron, Inc. Treatment of chemotherapeutic agent and antiviral agent toxicity with acylated pyrimidine nucleosides
CA2111571C (en) 1991-07-05 2005-08-23 Reid W. Von Borstel Treatment of chemotherapeutic agent and antiviral agent toxicity with acylated pyrimidine nucleosides
WO1994026761A1 (en) 1993-05-14 1994-11-24 Pro-Neuron, Inc. Treatment of chemotherapeutic agent and antiviral agent toxicity with acylated pyrimidine nucleosides
EP0767657A4 (en) 1994-06-22 1999-01-20 Nexstar Pharmaceuticals Inc NEW METHOD FOR THE PRODUCTION OF KNOWN AND NEW 2'-MODIFIED NUCLEOSIDES BY INTRAMOLECULAR NUCLEOPHILE SUBSTITUTION
JP4408450B2 (en) 1994-07-01 2010-02-03 ウェルスタット セラピューティクス コーポレイション Pyrimidine nucleotide precursors for the treatment of systemic inflammation and inflammatory hepatitis
HUT77534A (en) 1994-12-28 1998-05-28 Kowa Co. Ltd. Pyrimidine derivatives and pharmaceutical compositions containing them
US20040029823A1 (en) 1997-08-13 2004-02-12 Mckay Robert Antisense oligonucleotide compositions and methods for the modulation of JNK proteins
WO2002032920A2 (en) 2000-10-18 2002-04-25 Pharmasset Limited Modified nucleosides for treatment of viral infections and abnormal cellular proliferation
DE10110355A1 (en) 2001-03-03 2002-09-12 Ulrich Walker Combating side effects
US20030236217A1 (en) 2002-05-21 2003-12-25 Shalwitz Robert A. Treatment of mucositis
EP1572095B1 (en) 2002-09-13 2015-06-10 Novartis AG Beta-l-2'-deoxynucleosides for use in the treatment of resistant hbv strains
WO2005020885A2 (en) * 2003-05-21 2005-03-10 Isis Pharmaceuticals, Inc. Compositions and methods for the treatment of severe acute respiratory syndrome (sars)
WO2005026186A1 (en) 2003-09-12 2005-03-24 Max-Delbrück-Centrum für Molekulare Medizin Β-l-nucleosides and use thereof as pharmaceutical agents for treating viral diseases
US20050090551A1 (en) 2003-10-27 2005-04-28 Board Of Trustees Of Southern Illinois University Therapeutic use of methionine for the treatment or prevention of mucositis
WO2006021341A1 (en) 2004-08-23 2006-03-02 F. Hoffmann-La Roche Ag Antiviral 4’-azido-nucleosides
ES2725023T3 (en) 2006-10-12 2019-09-18 Galera Labs Llc Methods for the treatment of oral mucositis
WO2008083465A1 (en) 2007-01-08 2008-07-17 University Health Network Pyrimidine derivatives as anticancer agents
CA2744388A1 (en) 2008-11-21 2010-05-27 The Johns Hopkins University Compositions and methods for treating or preventing radiation injury
CA2818813C (en) 2010-11-23 2020-10-06 Alder Biopharmaceuticals, Inc. Anti-il-6 antibodies for the treatment of oral mucositis
US20120294869A1 (en) * 2011-05-16 2012-11-22 Nevada Cancer Institute Methods for Treating Fatty Liver Disease
BR102013022567B1 (en) 2013-09-03 2021-09-21 Uniao Brasileira De Educacão E Assistência USE OF 6-HYDROXY-2-PYRIDONES AND ITS DERIVATIVES IN THE PREPARATION OF A PHARMACEUTICAL COMPOSITION THAT ACT BY INHIBITING THE HUMAN PHOSPHORYLASE ENZYME
EP2845607A1 (en) 2013-09-09 2015-03-11 University of Vienna Antisense oligonucleotides with improved pharmacokinetic properties
WO2020036982A1 (en) 2018-08-14 2020-02-20 Tosk, Inc. Methods and compositions for treating mucositis
US11446303B2 (en) 2019-06-21 2022-09-20 Tosk, Inc. Uridine phosphorylase (UPase) inhibitors for treatment of liver conditions
EP4178581A4 (en) 2020-07-07 2024-06-05 Tosk, Inc. Uridine phosphorylase inhibitors to treat or prevent pulmonary disease

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040220134A1 (en) * 1987-10-28 2004-11-04 Pro-Neuron, Inc. Pyrimidine nucleotide precursors for treatment of systemic inflammation and inflammatory hepatitis
WO2009114325A2 (en) * 2008-03-03 2009-09-17 Tosk, Incorporated Methotrexate adjuvants to reduce toxicity and methods for using the same
US20140323427A1 (en) * 2011-08-12 2014-10-30 Universitaetsklinikum Freiburg Uridine and uridine analogues for treatment of specific lung diseases, namely copd and pulmonary fibrosis
WO2020036975A1 (en) * 2018-08-14 2020-02-20 Tosk, Inc. Methods and compositions for reducing fluorouracil induced toxicity
WO2020036974A1 (en) * 2018-08-14 2020-02-20 Tosk, Inc. Methods and compositions for reducing radiation induced toxicity

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of EP4178581A4 *

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP4301398A4 (en) * 2021-03-05 2025-01-22 Tosk, Inc. Uridine phosphorylase inhibitors to prevent or treat drug-induced pulmonary dysfunction

Also Published As

Publication number Publication date
US12194043B2 (en) 2025-01-14
AU2021306230A1 (en) 2023-03-02
CN116096422A (en) 2023-05-09
CA3185126A1 (en) 2022-01-13
IL299703A (en) 2023-03-01
US20250222000A1 (en) 2025-07-10
EP4178581A1 (en) 2023-05-17
US20220008422A1 (en) 2022-01-13
EP4178581A4 (en) 2024-06-05

Similar Documents

Publication Publication Date Title
US20250222000A1 (en) Uridine Phosphorylase Inhibitors to Treat or Prevent Pulmonary Disease
CN114450009B (en) Uridine phosphorylase (UPASE) inhibitors for the treatment of liver diseases
US12109222B2 (en) Methods and compositions for treating mucositis
CN104667279B (en) Methotrexate adjuvants to reduce toxicity and methods of use thereof
US20240091228A1 (en) Uridine Phosphorylase Inhibitors to Prevent or Treat Drug-Induced Pulmonary Dysfunction
US12419893B2 (en) Methods and compositions for maximizing the prevention and/or reduction of various maladies and drug side-effects using uridine
CN112770760A (en) Methods and compositions for reducing radiation-induced toxicity
TWI920032B (en) Uridine phosphorylase (upase) inhibitors for treatment of liver conditions

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 21837558

Country of ref document: EP

Kind code of ref document: A1

ENP Entry into the national phase

Ref document number: 3185126

Country of ref document: CA

WWE Wipo information: entry into national phase

Ref document number: 202317007012

Country of ref document: IN

NENP Non-entry into the national phase

Ref country code: DE

ENP Entry into the national phase

Ref document number: 2021837558

Country of ref document: EP

Effective date: 20230207

ENP Entry into the national phase

Ref document number: 2021306230

Country of ref document: AU

Date of ref document: 20210702

Kind code of ref document: A