Pharmaceutical compositions for the treatment of ischemic brain damage

0001The present invention relates to a pharmaceutical composition for the treatment of ischemic brain damage. More particularly, the invention relates to a pharmaceutical composition comprising as an active ingredient a specific guanidine derivative having a Na⁺/H⁺ exchange system inhibition activity, which is particularly useful for the prevention of death at the acute phase and sequelae following ischemia, brain edema, cerebral microcirculatory disorder and for neuroprotective purpose.

0002The mortality rate from cerebrovascular disorders has been decreasing in these years but is still very high. Even now the number of patients with ischemic sequela or who receive treatment in hospital or attend a hospital is increasing. When ischemia in the brain continues for a certain time of period, various irreversible changes occur to cause necrosis in the brain tissue, namely, cerebral infarction, which induces various neural symptoms. Appropriate treatments during the acute phase will contribute to reduction in the mortality rate at the initial phase and to alleviation of sequelae.

0003Na⁺/H⁺ exchangers are plasma membrane proteins, which release H⁺ ion outside cells concomitant with uptake of Na⁺ ion into cells. Since the migration of Na⁺ ion is known to be accompanied by water transfer, it is considered that Na⁺/H⁺ exchangers will regulate intracellular pH level and a cell volume. There is evidence to suggest that the Na⁺/H⁺ exchangers will be activated by ischemia and reperfusion in the tissue to increase the level of Na⁺ ion in the cells and in turn Ca²⁺ ion via Na⁺/Ca²⁺ exchangers, which eventually cause various cytotoxic states.

0004It is reported that the infarcted area in the heart caused by ischemia and reperfusion was reduced in ischemia model animals by inhibiting Na⁺/H⁺ exchangers. As far as ischemic brain damage is concerned, no report is made on any animal experiments. It is reported on a cellular level that amiloride attenuated cell swelling induced by acid loading on the cultured glial cells (Kempski, O., et al., Stroke, 19, 385-392, 1988). However, this report does not explain any correlation between brain edema and Na⁺/H⁺ exchange inhibitors, because amiloride has many other actions due to its low specificity, although it has a Na⁺/H⁺ exchange inhibition action. Rather, amiloride is used as an Na⁺/Ca²⁺ exchange inhibitor in some papers. Thus, the causal relation is unclear if the cell swelling was prevented by inhibiting the Na⁺/H⁺ exchange system.

0005Another reason to deny the reasoning that the results obtained with the cultured glial cells will explain the relationship between brain edema and Na⁺/H⁺ exchangers, is the fact that cell swelling was prevented by acetazolamide in the reported experiments. Acetazolamide is known as a diuretic agent. In fact, no significant effect of preventing cerebral edema was noted with ischemic animal models <u>in</u><u>vivo</u> (Goto et al., NO-SOTCHU JIKKEN HANDBOOK (Experimental Handbook of Ischemic Insult), chapter 7, "Vascular permeability and brain edema", pages 629-733, published by IPC Co., Ltd.; Neurosurgery, 6, 149-154, 1980; Stroke, 2, 456-460, 1971). Reasonable reading of these reports indicates that the experimental data obtained with the cultured glial cells cannot be used as reflecting on the prevention of brain edema <u>in vivo</u>.

0006Compounds having a Na⁺/H⁺ exchange inhibitory activity are mentioned in, e.g., Japanese Patent KOKAI (Laid-Open) No. 9-67340, for use in the prevention or treatment of cerebral infarction. However, no pharmacological data was presented to support the alleged use. Indeed, there was no report to suggest that the Na⁺/H⁺ exchange inhibitory activity in association with the prevention of ischemic cerebrovascular disorders <u>in</u><u>vivo</u>.

0007Main drugs currently employed for the clinical treatment of cerebral apoplexy in the acute phase are compounds like glycerol, which are considered to act through a mechanism to diminish edema by their high permeability or to prevent the blood coagulation mechanism. However, those drugs are not satisfactorily effective. A more serious problem is that anti-blood coagulants contraindicate hemorrhagic conditions or cerebral embolism. Thus, pre-tests for diagnosis become necessary, which disadvantageously retards the onset of immediate treatment required for the acute phase of ischemia. It is therefore desired to provide a drug effectively applicable to the acute phase of any conditions without requiring pre-test for diagnosis.

0008The present inventors have made extensive studies to develop compounds effective for the prevention of ischemic brain damage. As a result it has been found that compounds having a Na⁺/H⁺ exchange inhibitory activity exhibit an excellent effect of improving cerebral infarction and cerebral edema. Therefore the present invention has been attained. In view of the report as stated hereinabove on the experiments using the cultured glial cells <u>in</u><u>vitro</u>, candidate compounds was elucidated <u>in</u><u>vivo</u> in the present invention to find compounds effective for ischemic edema and infarction. It is quite likely that the Na⁺/H⁺ exchange system inhibitors will be drugs effective for the treatment of ischemic cerebrovascular disorders, especially in the acute phase, and available for the type of brain damage concomitant with hemorrhage, since Na⁺/H⁺ exchangers do not significantly affect either the blood coagulation cycle or the fibrinolytic system.

0009Accordingly, the present invention thus provides a pharmaceutical composition for the treatment of ischemic brain damage comprising as an active ingredient a compound having the Na⁺/H⁺ exchange system inhibition activity or a salt thereof, together with a pharmaceutically acceptable carrier.

0010In the preferred embodiment, said ischemic brain damage is cerebral infarction, cerebral embolism, or cerebral thrombus.

0011Further, the present invention provides a method for treating ischemic brain damage, which comprises administering into a patient a compound having a Na⁺/H⁺ exchange system inhibition activity or a salt thereof in a pharmacologically effective amount.

0012Further, the present invention provides use of a compound having a Na⁺/H⁺ exchange system inhibition activity in the manufacture of a pharmaceutical composition for the treatment of ischemic brain damage. <ul id="ul0001" list-style="none" compact="compact"><li>Fig. 1 is a graph showing the percentage of infarcted area observed in the vehicle group and the group treated with Compound 1, which was induced in rats with transient ischemia in Example 1.</li><li>Fig. 2 is a graph showing the percentage of infarcted area observed in the vehicle group and the group treated with Compound 2, which was induced in rats with transient ischemia in Example 2.</li><li>Fig. 3 is a graph showing the percentage of infarcted area observed in the vehicle group and the group treated with Compound 3, which was induced in rats with transient ischemia in Example 3.</li><li>Fig. 4 is a graph showing the brain water content in rats with transient brain ischemia, observed in the normal control group, the vehicle group and the groups treated with 0.3 mg/kg and 1 mg/kg of Compound 1 in Example 4.</li><li>Fig. 5 is a graph showing the brain water content in rats with transient brain ischemia, observed in the normal control group, the vehicle group and the groups treated with 3 mg/kg of Compound 2 in Example 5.</li><li>Fig. 6 is a graph showing the brain water content in rats with transient brain ischemia, observed in the normal control group, the vehicle group and the groups treated with 0.3 mg/kg and 1 mg/kg of Compound 3 in Example 6.</li></ul>

0013The compounds used in the present invention as the Na⁺/H⁺ exchange system inhibitors are described below in detail.

0014As the Na⁺/H⁺ exchange system inhibitors or salts thereof used in the pharmaceutical compositions according to the present invention, any compounds may be used without particular restriction, so long as these compounds have an activity of inhibiting the Na⁺/H⁺ exchange system. The invention includes the following embodiments. <ul id="ul0002" list-style="none" compact="compact"><li>(a) The present invention relates to a pharmaceutical composition comprising an indoloylguanidine derivative described in Japanese Patent KOKAI (Laid-Open) No. 8-208602, which is represented by the following general formula (1): <chemistry id="chem0001" num="0001"><img file="EP0937459A2_D0001.tif" /></chemistry> wherein: <ul id="ul0003" list-style="none" compact="compact"><li>R₁ represents one or more, the same or different, substituent(s) which is selected from the group consisting of a hydrogen atom, a C₁-C₈ alkyl group, a substituted C₁-C₈ alkyl group, a C₂-C₆ alkenyl group, a C₂-C₆ alkynyl group, a C₃-C₇ cycloalkyl group, a halogen atom, nitro, a C₂-C₈ alkanoyl group, an arylalkanoyl group having carbon atoms up to 10, an aroyl group having carbon atoms up to 11, carboxyl, a C₂-C₆ alkoxycarbonyl group, an aromatic group, a group shown by formula: -OR₃, -NR₆R₇, -SO₂NR₆R₇ or -S(O)_nR₄₀, and a group shown by formula: <chemistry id="chem0002" num="0002"><img file="EP0937459A2_D0002.tif" /></chemistry> wherein A represents an oxygen atom or a group shown by formula: -S(O)_n- or -N(R₅₀)- wherein R₅₀ is a hydrogen atom or a C₁-C₈ alkyl group, R' represents a hydrogen atom, a C₁-C₈ alkyl group or a substituted C₁-C₈ alkyl group; and the ring represents a saturated 3 to 8-membered hetero ring containing one nitrogen atom;</li><li>R₂ represents a hydrogen atom, a C₁-C₈ alkyl group, a substituted C_1-C₈ alkyl group, a C₃-C₇ cycloalkyl group, hydroxy, a C₁-C₆ alkoxy group, an aromatic group or a group shown by formula: -CH₂R₂₀;</li><li>R₃ represents a hydrogen atom, a C₁-C₈ alkyl group, a substituted C₁-C₈ alkyl group, a C₃-C₇ cycloalkyl group, an aromatic group or a group shown by formula: -CH₂R₃₀, in which R₃₀ represents an C₂-C₆ alkenyl group or an C₂-C₆ alkynyl group;</li><li>each of R₆ and R₇ independently represents a hydrogen atom, a C₁-C₈ alkyl group, a substituted C₁-C₈ alkyl group, a C₃-C₇ cycloalkyl group, a C₂-C₈ alkanoyl group, an arylalkanoyl group having carbon atoms up to 10, an aroyl group having carbon atoms up to 11, an aromatic group or a group shown by formula: -CH₂R₆₀ wherein R₆₀ represents a C₂-C₆ alkenyl group or a C₂-C₆ alkynyl group; or R₆ and R₇ are combined together to form a saturated 5- to 7-membered cyclic amino group which may contain other hetero atom(s) in the ring thereof;</li><li>R₄₀ represents a C₁-C₈ alkyl group, a substituted C₁-C₈ alkyl group or an aromatic group;</li><li>n represents 0, 1 or 2; and,</li><li>R₂₀ represents a C₂-C₆ alkenyl group or a C₂-C₆ alkynyl group; in which:</li><li>the substituent (s) of the substituted C₁-C₈ alkyl group means a halogen atom, hydroxy, a C₁-C₆ alkoxy group, cyano, carboxyl, a C₂-C₆ alkoxycarbonyl group, a C₂-C₈ alkanoyl group, an arylalkanoyl group having carbon atoms up to 10, an aroyl group having carbon atoms up to 11, an aromatic group, and -CONR₄R₅ in which each of R₄ and R₅ independently represents a hydrogen atom or a C₁-C₈ alkyl group or R₄ and R₅ are combined together to form a saturated 5- to 7-membered cyclic amino group which may contain other hetero atom(s) in the ring; -NR₆R₇; or a group shown by: <chemistry id="chem0003" num="0003"><img file="EP0937459A2_D0003.tif" /></chemistry> in which:</li><li>E represents a nitrogen atom or a CH group and</li><li>R'' represents a hydrogen atom, a C₁-C₈ alkyl group or a substituted C₁-C₈ alkyl group substituted with hydroxy, a C₁-C₆ alkoxy group, cyano, carboxyl, a C₂-C₆ alkoxycarbonyl group, a C₂-C₈ alkanoyl group, an arylalkanoyl group having carbon atoms up to 10, an aroyl group having carbon atoms up to 11, an aromatic group, a group shown by -NR₆R₇, or a group shown by - CONR₄R₅, in which each of R₄ and R₅ independently represents a hydrogen atom or a C₁-C₈ alkyl group or R₄ and R₅ are combined together to form a saturated 5- to 7-membered cyclic amino group which may contain other hetero atom(s) therein; and the ring of <chemistry id="chem0004" num="0004"><img file="EP0937459A2_D0004.tif" /></chemistry> is a 3-to 8-membered saturated aliphatic ring or saturated hetero ring containing one nitrogen atom;</li><li>all of the aromatic groups hereinabove means an aryl group having carbon atoms up to 10, a 5- or 6-membered heteroaryl group containing 1 to 4 nitrogen atom(s), a 5- or 6-membered hetero-aryl group containing 1 to 2 nitrogen atom(s) and one oxygen atom or one sulfur atom, or furyl; and,</li><li>all of the aromatic groups hereinabove may be substituted with a substituent selected from the group consisting of a C₁-C₈ alkyl group, a substituted C₁-C₈ alkyl group, a halogen atom, nitro, a C₂-C₆ alkoxycarbonyl group, carboxyl and a group selected from the group shown by formulae: -OR₃, -NR₆R₇, -CONR₆R₇, -SO₂NR₆R₇ and -S(O)_nR₄₀;</li><li>provided that R₁ and the guanidinocarbonyl group may be substituted at any one of the 5- and 6-membered rings of the indole nucleus; or,</li><li>a pharmaceutically acceptable acid addition salt thereof.</li></ul> The respective groups in the indoloylguanidine derivatives of the general formula (1) are described below in detail. The alkyl group refers to a linear or branched alkyl group having 8 or less carbon atoms, for example, methyl, ethyl, propyl, 2-propyl, butyl, 2-butyl, 2-methylpropyl, 1,1-dimethylethyl, pentyl, hexyl, heptyl and octyl. The alkenyl group includes, for example, alkenyl groups of 6 or less carbon atoms, such as vinyl, allyl, propenyl, 2-propenyl, butenyl, pentenyl and hexenyl. The alkynyl group includes, for example, alkynyl groups of 6 or less carbon atoms, such as ethynyl, propargyl, butynyl and pentynyl. The cycloalkyl group refers to a cycloalkyl group having 3 to 7 carbon atoms, e.g., cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl and cycloheptyl. Typical examples of the halogen atom include fluorine, chlorine and bromine. The acyl group refers to a linear or branched alkanoyl group having carbon atoms up to 8, e.g., acetyl, propanoyl and 2-methylpropanoyl; an arylalkanoyl group having carbon atoms up to 10, e.g., phenylacetyl and phenylpropanoyl; and an aroyl group having 11 or less carbon atoms, e.g., benzoyl, 1-naphthoyl and 2-naphthoyl. The alkoxycarbonyl group refers to a linear or branched alkoxycarbonyl group having carbon atoms up to 6, e.g., methoxycarbonyl, ethoxycarbonyl, propoxycarbonyl and 2-propoxycarbonyl. The aromatic group refers to an aryl or hetero-aryl group which may have a substituent. Examples of the aryl group are those having carbon atoms up to 10, e.g., phenyl, tolyl or naphthyl, and examples of the hetero-aryl group are a 5- or 6-membered aromatic group containing 1 to 4 nitrogen atoms or a 5- or 6-membered aromatic ring containing 1 to 2 nitrogen atoms and one oxygen atom or one sulfur atom, e.g., 2-, 3- or 4-pyridyl, imidazolyl, triazolyl, tetrazolyl, 2- or 3-furyl, 2- or 3-thienyl, 1-, 3- or 4-oxazolyl, and 3-, 4-or 5-isoxazolyl. Examples of the substituent in the substituted aryl or hetero-aryl group include an alkyl group, a substituted alkyl group, a halogen atom, nitro, an alkoxycarbonyl group, carboxyl and a group shown by formula: -0R₃, -NR₆R₇, -CONR₆R₇, -SO₂NR₆R₇ or -S(O)_nR₄₀. Where R₁ is a group shown by formula: -OR₃ wherein R₃ is an aromatic group, representative examples of the -OR₃ group include phenoxy and a substituted phenoxy group. Examples of the substituted phenoxy group are a phenoxy group substituted with nitro, -NR₆R₇ wherein R₆ and R₇ are typically a hydrogen atom or an alkyl group, or a substituted alkyl group, the substituent of which is exemplified by hydroxy or -NR₆R₇. Specific examples of the substituted phenoxy group are o-, m- or p-nitrophenoxy, o-, m- or p-aminophenoxy, o-, m- or p-(dimethylamino)phenoxy, o-, m- or p-(aminomethyl)phenoxy and o-, m- or p-(dimethylaminomethyl)phenoxy. The alkoxy group refers to a linear or branched alkoxy group having carbon atoms up to 6, e.g., methoxy, ethoxy, isopropoxy and tert-butoxy. As the saturated 5- to 7-membered cyclic amino group which is formed by combining R₆ and R₇ together and may contain other hetero atoms therein, there are, for example, a 5- to 7-membered cyclic group containing 1 to 3 nitrogen atoms and a 5- to 7-membered cyclic group containing one nitrogen atom and one oxygen atom. Specific examples of such cyclic amino group include 1-pyrrolidinyl, piperidino, 1-piperazinyl, morpholino, 4-methylmorpholino and 4-methylpiperazinyl. Examples of the substituent in the substituted alkyl group include a cycloalkyl group, a halogen atom, hydroxy, an alkoxy group, cyano, carboxyl, an alkoxycarbonyl group, an acyl group, an aromatic group, or a group shown by formula: -CONR₄R₅, wherein each of R₄ and R₅ independently represents hydrogen atom or an alkyl group, or R₄ and R₅ are combined together to form a saturated 5- to 7-membered cyclic amino group which may contain other hetero atoms in the ring; -NR₆R₇; or a group shown by formula: <chemistry id="chem0005" num="0005"><img file="EP0937459A2_D0005.tif" /></chemistry> wherein: <ul id="ul0004" list-style="none" compact="compact"><li>E represents a nitrogen atom or a CH group and</li><li>R'' represents a hydrogen atom, an alkyl group or a substituted alkyl group substituted with hydroxy, a C₁-C₆ alkoxy group, cyano, carboxyl, a C₂-C₆ alkoxycarbonyl group, a C₂-C₈ alkanoyl group, an arylalkanoyl group having carbon atoms up to 10, an aroyl group having carbon atoms up to 11, an aromatic group, a group shown by -NR₆R₇, or a group shown by -CONR₄R₅, in which each of R₄ and R₅ independently represents a hydrogen atom or a C₁-C₈ alkyl group or R₄ and R₅ are combined together to form a saturated 5- to 7-membered cyclic amino group which may contain other hetero atom(s) therein; and the ring of <chemistry id="chem0006" num="0006"><img file="EP0937459A2_D0006.tif" /></chemistry> is a 3- to 8-membered saturated aliphatic ring or saturated hetero ring containing one nitrogen atom. Particularly where R₁, R₂ and R₃ represent a substituted alkyl group, examples of the substituent include a cycloalkyl group, a halogen atom, hydroxy, an alkoxy group, carboxyl, an alkoxycarbonyl group, an acyl group, an aromatic group or a group shown by formula: -CONR₄R₅ or -NR₆R₇. Where R₆ and R₇ represent a substituted alkyl group, examples of the substituent include a cycloalkyl group, hydroxy, an alkoxy group, carboxyl, an alkoxycarbonyl group, an acyl group, an aryl group or a group shown by formula: -CONR₄R₅ or -NR₄R₅. As the alkyl moiety in the substituted alkyl group, the same examples as those for the alkyl group described above are given.</li></ul> As such a substituted alkyl group, there are, for example, an alkyl group having 1 to 5 carbon atoms which is substituted with a cycloalkyl having 3 to 6 carbon atoms, a polyhaloalkyl group having 1 to 5 carbon atoms, a hydroxyalkyl group having 1 to 6 carbon atoms, an alkoxyalkyl group having 2 to 6 carbon atoms, a cyanoalkyl group having 2 to 6 carbon atoms, a carboxyalkyl group having 2 to 6 carbon atoms, an alkoxycarbonylalkyl group having 3 to 8 carbon atoms, an alkanoylalkyl group having 3 to 8 carbon atoms, an aralkyl group having carbon atoms up to 16, a phenyl- or naphthyl-C₁ to C₅ alkyl group which may be substituted, a carbamoyl-C₁ to C₃ alkyl group in which the nitrogen atom may be substituted with one or two C₁ to C₃ alkyl, an amino-C₁ to C₅ alkyl group in which the nitrogen atom may be substituted with one or two C₁ to C₃ alkyl or C₇ to C₁₁ aralkyl, and a saturated 5- to 7-membered cyclic amino-C₁ to C₃ alkyl group. Representative examples of the substituted alkyl group include: <ul id="ul0005" list-style="none" compact="compact"><li>in the case of R₁: a polyhaloalkyl group having 1 to 3 carbon atoms such as trifluoromethyl, trifluoroethyl or trichloromethyl; a hydroxyalkyl group having 1 to 6 carbon atoms such as hydroxymethyl, hydroxyethyl or 1-hydroxyethyl; and an aminoalkyl group having 1 to 5 carbon atoms such as aminomethyl, aminoethyl or 1-aminoethyl;</li><li>in the case of R₂: a hydroxyalkyl group having 1 to 6 carbon atoms such as hydroxyethyl, hydroxypropyl, hydroxybutyl, 2-hydroxypropyl or 3,4-dihydroxybutyl; an alkoxyalkyl group having 1 to 6 carbon atoms such as methoxyethyl, ethoxyethyl or methoxypropyl; a carboxyalkyl group having 2 to 6 carbon atoms such as carboxyethyl or carboxypropyl; an alkoxycarbonylalkyl group having 3 to 7 carbon atoms such as methoxycarbonylmethyl, ethoxycarbonylmethyl or methoxycarbonylethyl; a phenyl- or naphthyl-C₁ to C₅ alkyl group, wherein a phenyl or naphthyl group may be substituted with a substituent, e.g., a C₁ to c₃ alkyl group, a halogen atom, nitro, amino, hydroxy or a C₁ to C₃ alkoxy group, such as benzyl, phenylethyl, phenylpropyl, phenylbutyl or, 1- or 2-naphthylmethyl; a carbamoyl-C₁ to c₃ alkyl group in which the nitrogen atom may be substituted with one or two C₁ to C₃ alkyl groups, such as carbamoylmethyl, carbamoylethyl or dimethylcarbamoylmethyl; or, an amino-C₁ to C₅ alkyl group in which the nitrogen atom may be substituted with one or two C₁ to C₃ alkyl, such as aminoethyl, aminopropyl, dimethylaminoethyl, dimethylaminopropyl or diethylaminoethyl;</li><li>in the case of R₃ and R₄₀: a hydroxyalkyl group having 1 to 6 carbon atoms such as hydroxyethyl, hydroxypropyl, 2-hydroxypropyl, hydroxybutyl or 2,3-dihydroxybutyl; a carboxyalkyl group having 2 to 6 carbon atoms such as carboxymethyl or carboxyethyl; a phenyl-C₁ to C₅ alkyl group such as benzyl, phenylethyl or phenylpropyl; a carbamoyl-C₁ to C₃ alkyl group such as carbamoylmethyl or carbamoylethyl; an amino-C₁ to C₅ alkyl group containing one or two nitrogen atoms in which the nitrogen atom may be substituted with one or two C₁ to C₃ alkyl or C₇ to C₁₁ aralkyl groups, such as aminoethyl, aminopropyl, dimethylaminoethyl, dimethylaminopropyl or benzylmethyl-aminoethyl; or a saturated 5- to 7-membered cyclic amino-C₁ to C₃ alkyl group such as 1-pyrrolidinyl-ethyl or piperidinoethyl; and,</li><li>in the case of R₆ and R₇: a phenyl-C₁ to C₅ alkyl group such as phenylethyl.</li></ul> Examples of the saturated 5- to 7-membered cyclic amino group which is formed by combining R₄ and R₅ together and may contain other hetero atoms in the ring thereof include the same groups as exemplified for the aforesaid cyclic amino group formed by R₆ and R₇. Examples of the group shown by formula: -S(O)_nR₄₀ include an alkylsulfonyl group having carbon atoms up to 8, such as methylsulfonyl, ethylsulfonyl, propylsulfonyl or isopropylsulfonyl; and the corresponding alkylsulfinyl and alkylthio groups. Examples of the group of include the following groups: <chemistry id="chem0007" num="0007"><img file="EP0937459A2_D0007.tif" /></chemistry><chemistry id="chem0008" num="0008"><img file="EP0937459A2_D0008.tif" /></chemistry> Among the above groups, there are preferred (piperidin-3-yl)oxy, (piperidin-4-yl)oxy, (1-methylpiperidin-3-yl)oxy, (1-methylpiperidin-4-yl)oxy, (pyrrolidin-3-yl)oxy, (1-methylpyrrolidin-3-yl)oxy, (piperidin-3-yl)thio, (piperidin-4-yl)thio, (1-methylpiperidin-3-yl)thio, (1-methylpiperidin-4-yl)thio, (pyrrolidin-3-yl)thio, (1-methylpyrrolidin-3-yl)thio, (piperidin-3-yl)amino, (piperidin-4-yl)amino, (1-methylpiperidin-3-yl)amino, (1-methylpiperidin-4-yl)amino, (pyrrolidin-3-yl)amino and (1-methylpyrrolidin-3-yl)amino. </li><li>(b) The present invention relates to a pharmaceutical composition comprising a substituted guanidine derivative described in EP 787,728, which is represented by the general formula (1b): <chemistry id="chem0009" num="0009"><img file="EP0937459A2_D0009.tif" /></chemistry> wherein: <ul id="ul0006" list-style="none" compact="compact"><li>R_1b, R_2b, R_3b and R_4b are independently a hydrogen atom, an unsubstituted alkyl group, a substituted alkyl group, a cycloalkyl group, a cycloalkenyl group, a saturated heterocyclic group, a halogen atom, a nitro group, a carboxyl group, an alkoxycarbonyl group, an aromatic group, an acyl group, -OR_5b, -N(R_6b)R_7b, - CON(R_6b)R_7b, -SO₂N(R_6b)R_7b, -S(O)_nR_8b wherein R_8b is an unsubstituted alkyl group, a substituted alkyl group or an aromatic group, and n is 0, 1 or 2, -Q_b-R_ab, or <chemistry id="chem0010" num="0010"><img file="EP0937459A2_D0010.tif" /></chemistry> wherein A_b is an oxygen atom or -S(O)_n- wherein n is as defined above or -N(R_10b)-, R_9b is a hydrogen atom, an unsubstituted alkyl group, a substituted alkyl group, an acyl group or -Q_b-R_ab, and the ring is a 3- to 8-membered saturated heterocyclic group composed of a nitrogen atom and carbon atoms;</li><li>Y_1b, Y_2b, Y_3b, Y_4b, Y_5b, Y_6b and Y_7b, which may be the same or different, are independently a single bond, -CH₂-, -O-, -CO-, -C(=C(R_11b)R_12b)-, -S(O)_n- or -N(R_10b)-, adjacent members of a group consisting of Y_1b through Y_7b being able to be taken together to represent -CH=CH-, and at least two of Y_1b through Y_7b being independently a group other than a single bond;</li><li>Z_b may be absent, or one or more Z_bs may be present and are, the same or different, independently the following substituent for a hydrogen atom bonded to any of the carbon atoms constituting the ring formed by Y_1b through Y_7b; an unsubstituted alkyl group, a substituted alkyl group, an alkenyl group, an alkynyl group, a cycloalkyl group, a cycloalkenyl group, a substituted heterocyclic group, a halogen atom, a carboxyl group, an alkoxycarbonyl group, an aromatic group, an acyl group, -OR_5b, -N(R_6b)R_7b, -S(O)_nR_8b, -C(O)N(R_6b)R_7b, or -Q_b-R_ab, provided that when Z_b is a substituent for the hydrogen atom of -CH=CH-, Z_b is not -N(R_6b)R_7b or -S(O)_nR_8b;</li><li>Q_b is a substituted or unsubstituted lower alkylene group;</li><li>R_ab is a substituted or unsubstituted vinyl group, or a substituted or unsubstituted ethynyl group;</li><li>R_5b is a hydrogen atom, an unsubstituted alkyl group, a substituted alkyl group, a cycloalkyl group, a cycloalkenyl group, a saturated heterocyclic group or an aromatic group;</li><li>R_6b and R_7b are independently a hydrogen atom, an unsubstituted alkyl group, a substituted alkyl group, a cycloalkyl group, a cycloalkenyl group, a saturated heterocyclic group, an aromatic group, an acyl group or -Q_b-R_ab, or R_6b and R_7b, when taken together with the nitrogen atom to which they are bonded, form a saturated 5- to 7-membered cyclic amino group which may contain an oxygen atom or a sulfur atom in the ring and may be substituted by one or more unsubstituted alkyl groups, substituted alkyl groups, hydroxyl groups or -OR_5b groups;</li><li>R_8b is an unsubstituted alkyl group, a substituted alkyl group or an aromatic group;</li><li>R_10b is a hydrogen atom, an unsubstituted alkyl group, a substituted alkyl group, a cycloalkyl group, a saturated heterocyclic group, an aromatic group, an acyl group or -Q_b-R_ab; and,</li><li>R_11b and R_12b are independently a hydrogen atom, an unsubstituted alkyl group, a substituted alkyl group, an alkenyl group, an alkynyl group, a cycloalkyl group, a cycloalkenyl group, a saturated heterocyclic group, a halogen atom, a carboxyl group, an alkoxycarbonyl group, an aromatic group, an acyl group, -OR_5b, -N(R_6b)R_7b, - C(O)N(R_6b)R_7b, -S(O)_nR_8b or -Q_bR_ab; and n is 0, 1 or 2; or a pharmaceutically acceptable acid addition salt thereof.</li></ul> The various groups in the compounds of general formula (1b) are explained below. The alkyl group includes, for example, linear or branched alkyl groups of 8 or less carbon atoms, such as methyl, ethyl, propyl, 2-propyl, butyl, 2-butyl, 2-methylpropyl, 1,1-dimethylethyl, pentyl, hexyl, heptyl and octyl. The cycloalkyl group may be unsubstituted or may be substituted by 1 to 4 unsubstituted alkyl groups, substituted alkyl groups, hydroxyl groups or groups of the formula -OR_5b, and includes, for example, 3- to 8-membered cycloalkyl groups such as cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, 2-methylcyclopentyl, 3-methylcyclopentyl, 2-methylcyclohexyl, 3-methylcyclohexyl, 4-methylcyclohexyl, 2-hydroxycyclopentyl, 3-hydroxycyclopentyl, 2-hydroxycyclohexyl, 3-hydroxycyclohexyl, 4-hydroxycyclohexyl, 2-(hydroxymethyl)cyclopentyl, 3-(hydroxymethyl)cyclopentyl, 2-(hydroxymethyl)cyclohexyl, 3-(hydroxymethyl)-cyclohexyl, 4-(hydroxymethyl)cyclohexyl, 2-(aminomethyl)cyclopentyl, 3-(aminomethyl)cyclopentyl, 2-(aminomethyl)cyclohexyl, 3-(aminomethyl)cyclohexyl, 4-(aminomethyl)cyclohexyl, 2-(methoxymethyl)cyclopentyl, 3-(methoxymethyl)cyclopentyl, 2-(methoxymethyl)cyclohexyl, 3-(methoxymethyl)cyclohexyl, 4-(methoxymethyl)-cyclohexyl, etc. The cycloalkenyl group may be unsubstituted or may be substituted by 1 to 4 unsubstituted alkyl groups, substituted alkyl groups, hydroxyl groups or groups of the formula, -OR_5b, and includes, for example, 3- to 8-membered cycloalkenyl groups having a double bond, such as 1-cyclopentenyl, 2-cyclopentenyl, 3-cyclopentenyl 1-cyclohexenyl, 2-cyclohexenyl, 3-cyclohexenyl, etc. The saturated heterocyclic group may be unsubstituted or may be substituted by 1 to 4 unsubstituted alkyl groups, substituted alkyl groups, hydroxyl groups or group of the formula -OR_5b, and includes, for example, 3- to 8-membered saturated heterocyclic groups having an oxygen atom or a sulfur atom, such as 2-tetrahydrofuranyl, 3-tetrahydrofuranyl, 2-tetrahydro-2H-pyranyl, 4-tetrahydro-4H-pyranyl, etc. The halogen atom includes, for example, fluorine, chlorine and bromine atoms. The alkoxycarbonyl group includes, for example, linear or branched alkoxycarbonyl group of 6 or less carbon atoms, such as methoxycarbonyl, ethoxycarbonyl, propoxycarbonyl and 2-propoxycarbonyl. The aromatic group includes substituted or unsubstituted aryl groups and substituted or unsubstituted heteroaryl groups. As the aryl groups, there may be exemplified aryl groups of 10 or less carbon atoms, such as phenyl, naphthyl, etc. As the heteroaryl groups, there may be exemplified 5- or 6-membered heteroaryl groups containing 1 to 4 nitrogen atoms, such as 2-, 3- or 4-pyridyl, imidazolyl, triazolyl, tetrazolyl, etc.; and 5- or 6-membered heteroaryl groups containing 0 to 2 nitrogen atoms and one oxygen atom or one sulfur atom, such as 2- or 3-furyl, 2- or 3-thienyl, 1-, 3- or 4-oxazolyl, 3-, 4- or 5-isoxazolyl, etc. The substituent of each of the substituted aryl group and the substituted heteroaryl group includes unsubstituted alkyl groups, substituted alkyl groups, halogen atoms, nitro group, carboxyl groups, alkoxycarbonyl groups, and groups represented by the formula - OR_5b, -N(R_6b)R_7b, -CON(R_6b)R_7b, -SO₂N(R_6b)R_7b or -S(O)_nR_8b. When R_1b, R_2b, R_3b and R_4b are independently a group represented by the formula -OR_5b wherein R_5b is an aromatic group, typical examples of the -OR_5b group are unsubstituted phenoxy groups and substituted phenoxy groups. Examples of the substituted phenoxy groups are those having as the substituent, for example, a nitro group, a -N(R_6b)R_7b group wherein R_6b and R_7b are independently, for instance, a hydrogen atom or an unsubstituted alkyl group, or a substituted alkyl group having as the substituent, for example, a hydroxyl group or a -N(R_6b)R_7b group. More specific examples of the substituted phenoxy group are o-, m- or p-nitrophenoxy, o-, m- or p-aminophenoxy, o-, m- or p-(dimethylamino)-phenoxy, o-, m- or p-(aminomethyl)phenoxy, and o-, m- or p-(dimethylaminomethyl)phenoxy. The alkoxy group includes, for example, linear or branched alkoxy groups of 6 or less carbon atoms, such as methoxy, ethoxy, isopropoxy and tert-butoxy. As the cyclic amino group which R_6b and R_7b form when taken together with the nitrogen atom to which they are bonded, i.e., the saturated 5- to 7-membered cyclic amino group which may contain another hetero atom in the ring, there may be exemplified 5- to 7-membered cyclic groups containing 1 to 3 nitrogen atoms and 5- to 7-membered cyclic groups containing one nitrogen atom and one oxygen atom. More specific examples of the saturated 5- to 7-membered cyclic amino group are 1-pyrrolidinyl, 1-piperidino, 1-piperazinyl, morpholino and 1-(4-methyl)piperazinyl. The substituent on the substituted alkyl group include halogen atoms, hydroxy group, alkoxy groups, cycloalkyl groups, cyano group, carboxyl group, alkoxycarbonyl groups, acyl groups, aromatic groups, and groups shown by the formula -CONR_pbR_qb (wherein R_pb and R_qb are independently a hydrogen atom or an unsubstituted alkyl group, or R_pb and R_qb being able to be taken together to represent a saturated 5- to 7-membered cyclic amino group which may contain another hetero atom in the ring), -NR_6bR_7b or a group shown by formula: <chemistry id="chem0011" num="0011"><img file="EP0937459A2_D0011.tif" /></chemistry> wherein R'' is a hydrogen atom, an unsubstituted alkyl group or a substituted alkyl group, and the ring is a 3-to 8-membered saturated heterocyclic group containing one nitrogen atom. Particularly when R_1b, R_2b, R_3b, R_4b, R_5b, R_8b, R_11b, R_12b, or Z_b is a substituted alkyl group, the substituent includes, for example, cycloalkyl groups, halogen atoms, hydroxyl group, alkoxy groups, carboxyl group, alkoxycarbonyl groups, acyl groups, aromatic groups and groups shown by formula -CONR_pbR_qb or -NR_6bR_7b. When R_6b, R_7b, R_9b or R_10b is a substituted alkyl group, the substituent includes, for example, cycloalkyl groups, hydroxyl group, alkoxy groups, carboxyl group, alkoxycarbonyl groups, acyl groups, aryl groups and groups shown by the formula -CONR_pbR_qb or -NR_pbR_qb. As the alkyl portion of the substituted alkyl group, there may be exemplified the same groups as those exemplified above as the alkyl group. As such substituted alkyl groups, there may be exemplified substituted alkyl groups of 1 to 5 carbon atoms having as the substituent a cycloalkyl group of 3 to 6 carbon atoms, polyhaloalkyl groups of 1 to 5 carbon atoms, hydroxyalkyl groups of 1 to 6 carbon atoms, alkoxyalkyl groups of 2 to 6 carbon atoms, cyanoalkyl groups of 2 to 6 carbon atoms, carboxyalkyl groups of 2 to 6 carbon atoms, alkoxycarbonylalkyl groups of 3 to 8 carbon atoms, alkanoylalkyl groups of 3 to 8 carbon atoms, aroylalkyl groups of 16 or less carbon atoms, substituted or unsubstituted phenyl- or naphthyl-C₁-C₅ alkyl groups, carbamoyl-C₁-C₃ alkyl groups which may have one or two C₁-C₃ alkyl groups as a substituent(s) on the nitrogen atom, amino-C₁-C₅ alkyl groups which may have one or two C₁-C₃ alkyl or C₇-C₁₁ aralkyl groups as a substituent(s) on the nitrogen atom, and saturated 5- to 7-membered cyclic amino-C₁-C₃ alkyl groups. Typical examples of the substituted alkyl group are polyhaloalkyl groups of 1 to 3 carbon atoms, such as trifluoromethyl, trifluoroethyl or trichloromethyl; hydroxyalkyl groups of 1 to 6 carbon atoms, such as hydroxymethyl, hydroxyethyl or 1-hydroxyethyl; aminoalkyl groups of 1 to 5 carbon atoms, such as aminomethyl, aminoethyl or 1-aminoethyl; alkoxyalkyl groups of 1 to 6 carbon atoms, such as methoxyethyl, ethoxyethyl or methoxypropyl; carboxyalkyl groups of 2 to 6 carbon atoms, such as carboxyethyl or carboxypropyl; alkoxycarbonylalkyl groups of 3 to 7 carbon atoms, such as methoxycarbonylmethyl, ethoxycarbonylmethyl or methoxycarbonylethyl; phenyl- or naphthyl-C₁-C₅ alkyl groups (which may have in the phenyl or naphthyl portion a substituent such as a C₁-C₃ alkyl group, halogen atom, nitro group, amino group, hydroxyl group, C₁-C₃ alkoxy group or the like) such as benzyl, phenylethyl, phenylpropyl, phenylbutyl or, 1- or 2-naphthylmethyl; carbamoyl-C₁-C₃ alkyl groups which may have one or two C₁-C₃ alkyl groups as a substituent(s) on the nitrogen atom, for example, carbamoylmethyl, carbamoylethyl or dimethylcarbamoyl-methyl; amino-C₁-C₅ alkyl groups which may have one or two C₁-C₃ alkyl groups or C₇-C₁₁ aralkyl groups as a substituent(s) on the nitrogen atom, for example, aminoethyl, aminopropyl, dimethylaminoethyl, dimethylaminopropyl, diethylaminoethyl or N-methyl-N-benzylaminoethyl; and saturated 5- to 7-membered cyclic amino-C₁-C₃ alkyl groups such as 1-pyrrolidinyl-ethyl or piperidinoethyl. In the case of R_6b and R_7b, typical examples of the substituted alkyl group are phenyl-C₁-C₅ alkyl groups such as phenylethyl. As the substituent on the lower alkylene group for Q_b and the substituent on the vinyl or ethynyl group for R_ab, there may be exemplified unsubstituted alkyl groups, substituted alkyl groups, cycloalkyl groups, cycloalkenyl groups, saturated heterocyclic groups, carboxyl group, alkoxycarbonyl groups, aromatic groups, and groups represented by the formula -CON(R_6b)R_7b. The lower alkylene group includes, for example, alkylene groups of 6 or less carbon atoms, such as methylene, ethylene, trimethylene, tetramethylene, pentamethylene, hexamethylene, etc. The acyl group includes, for example, formyl group; alkanoyl groups of 2 to 6 carbon atoms, such as acetyl, propanoyl, etc.; cycloalkanecarbonyl groups of 3 to 6 carbon atoms, such as cyclopropanecarbonyl, cyclobutanecarbonyl, cyclopentanecarbonyl, cyclohexanecarbonyl, etc.; cycloalkenecarbonyl groups of 3 to 6 carbon atoms, such as cyclopentenecarbonyl, cyclohexenecarbonyl, etc.; aroyl groups of 6 to 10 carbon atoms, such as benzoyl, toluoyl, naphthoyl, etc.; saturated heterocyclic ring-carbonyl groups having a 5- or 6-membered saturated heterocyclic group containing one or two hetero atoms selected from the group consisting of nitrogen atom, oxygen atom and sulfur atom, for example, 2-piperidinecarbonyl, 3-morpholinecarbonyl, etc.; and heteroaryl acyl groups having a 5- or 6-membered heteroaryl ring containing one or two hetero atoms selected from the group consisting of nitrogen atom, oxygen atom and sulfur atom, for example, furoyl, thenoyl, nicotinoyl, isonicotinoyl, etc. As the cyclic amino group which R_pb and R_bq form when taken together, i.e., the saturated 5- to 7-membered cyclic amino group which may contain another hetero atom in the ring, there may be exemplified the same groups as those exemplified above as the cyclic amino group formed by R_6b and R_7b. The group represented by the formula -S(O)_nR_8b includes, for example, alkylsulfonyl groups of 8 or less carbon atoms, such as methylsulfonyl, ethylsulfonyl, propylsulfonyl or isopropylsulfonyl; and the corresponding alkylsulfinyl groups and alkylthio groups. As the group represented by the formula: <chemistry id="chem0012" num="0012"><img file="EP0937459A2_D0012.tif" /></chemistry> there may be exemplified groups represented by the following formulas: <chemistry id="chem0013" num="0013"><img file="EP0937459A2_D0013.tif" /></chemistry> Preferred examples of the aforesaid group are (piperidin-3-yl)oxy, (piperidin-4-yl)oxy, (1-methylpiperidin-3-yl)oxy, (1-methylpiperidin-4-yl)oxy, (pyrrolidin-3-yl)oxy, (1-methylpyrrolidin-3-yl)oxy, (piperidin-3-yl)thio, (piperidin-4-yl)thio, (1-methylpiperidin-3-yl)thio, (1-methylpiperidin-4-yl)thio, (pyrrolidin-3-yl)thio, (1-methylpyrrolidin-3-yl)thio, (piperidin-3-yl)amino, (piperidin-4-yl)amino, (1-methylpiperidin-3-yl)amino, (1-methylpiperidin-4-yl)amino, (pyrrolidin-3-yl)amino and (1-methylpyrrolidin-3-yl)amino. The alkenyl group includes, for example, alkenyl groups of 6 or less carbon atoms, such as vinyl, allyl, propenyl, 2-propenyl, butenyl, pentenyl and hexenyl. The alkynyl group includes, for example, alkynyl groups of 6 or less carbon atoms, such as ethynyl, propargyl, butynyl and pentynyl. As Y_1b, Y_2b, Y_3b, Y_4b, Y_5b, Y_6b and Y_7b, the following may be exemplified. <ul id="ul0007" list-style="none" compact="compact"><li>1. One of Y_1b through Y_7b is -CH₂-, -O-, -CO-, -C(=C(R_11b)R_12b)-, -S(O)_n- or -N(R_10b)-, another is -CH₂-, and the five others, which may be the same or different, are independently a single bond or -CH₂-. More specific examples of Y_1b through Y_7b are as follows. <ul id="ul0008" list-style="none" compact="compact"><li>1-1. Y_1b is -CH₂-, -O-, -CO-, -C(=C(R_11b)R_12b)-, -S(O)_n- or -N(R_10b)-, Y_2b is -CH₂-, and Y_3b through Y_7b, which may be the same or different, are independently a single bond or -CH₂-.</li><li>1-2. Y_7b is -O-, -CO-, -C(=C(R_11b)R_12b)-, Y_6b is -CH₂-, and Y_1b through Y_5b, which may be the same or different, are independently a single bond or -CH₂-.</li><li>1-3. Y_1b and Y_7b are -CH₂-, one of Y_2b, Y_3b, Y_4b, Y_5b and Y_6b is -CH₂-, -O-, -C(=C(R_11b)R_12b)-, -S(O)_n- or - N(R_10b)-, and the four others, which may be the same or different, are independently a single bond or -CH₂-.</li><li>1-4. Y_1b is -CH₂-, -O-, -CO-, -C(=C(R_11b)R_12b)-, -S(O)_n- or -N(R_10b)-, Y_2b through Y_4b are independently - CH₂-, and Y_5b and Y_6b are independently a single bond.</li></ul></li><li>2. Any adjacent two members of a group consisting of Y_1b through Y_7b are taken together to represent -CH=CH-, the four others, which may be the same or different, are independently a single bond or - CH₂-, and Y_7b is a single bond, -O-, -CO-, -C(=C(R_11b)R_12b)-or -CH₂-. More specific examples of Y_1b through Y_7b are as follows. <ul id="ul0009" list-style="none" compact="compact"><li>2-1. -Y_1b-Y_2b- is -CH=CH-.</li><li>2-2. Y_1b is -CH₂-, and -Y_2b-Y_3b- is -CH=CH-.</li><li>2-3. Y_1b and Y_2b are independently -CH₂-, and - Y_3b-Y_4b- is -CH=CH-.</li><li>2-4. Y_1b, Y_2b and Y_3b are -CH₂-, and -Y_4b-Y_5b- is -CH=CH-.</li></ul></li><li>3. Y_1b is -O- or -N(R_10b)-, one of Y_2b through Y_7b is -CO-, and the five others, which may be the same or different, are independently a single bond or -CH₂-. More specific examples of Y_1b through Y_7b are as follows. <ul id="ul0010" list-style="none" compact="compact"><li>3-1. Y_2b is -CO-.</li><li>3-2. Y_2b is -CH₂-, and Y_3b is -CO-.</li><li>3-3. Y_2b and Y_3b are -CH₂-, and Y_4b is -CO-.</li><li>3-4. Y_2b, Y_3b and Y_4b are -CH₂-, and Y_5b is -CO-.</li><li>3-5. Y_2b, Y_3b, Y_4b and Y_5b are -CH₂-, and Y_6b is - CO-.</li></ul></li></ul> Preferred examples of Y_1b through Y_7b are such that two of five, in particular, two to four, of Y_1b through Y_7b are independently a single bond and the others independently a group other than a single bond. More preferably, two or three of Y_1b through Y_7b are independently a single bond, and the others are groups other than a single bond. </li><li>(c) The present invention relates to a pharmaceutical composition comprising a substituted guanidine derivative described in Japanese Patent KOKAI (Laid-Open) No. 9-291076, which is represented by the general formula (1c): <chemistry id="chem0014" num="0014"><img file="EP0937459A2_D0014.tif" /></chemistry> wherein <ul id="ul0011" list-style="none" compact="compact"><li>R_1c is a hydrogen atom, an unsubstituted alkyl group, a substituted alkyl group, a cycloalkyl group, a cycloalkenyl group, a saturated heterocyclic group, an aromatic group, -OR_5c, an acyl group or -Q_c-R_ac;</li><li>R_2c, R_3c and R_4c are independently a hydrogen atom, an unsubstituted alkyl group, a substituted alkyl group, a cycloalkyl group, a cycloalkenyl group, a saturated heterocyclic group, a halogen atom, a nitro group, a carboxyl group, an alkoxycarbonyl group, an aromatic group, -OR_5c, -N(R_6c)R_7c, -CON(R_6c)R_7c, - SO₂N(R_6c)R_7c, -S(O)_nR_8c, an acyl group, -Q_c-R_ac, or <chemistry id="chem0015" num="0015"><img file="EP0937459A2_D0015.tif" /></chemistry> wherein the ring is a 3- to 8-membered saturated heterocyclic group composed of a nitrogen atom and carbon atoms;</li><li>Y_1c, Y_2c, Y_3c and Y_4c are as follows: <ul id="ul0012" list-style="none" compact="compact"><li>(1) one of Y_1c, Y_2c, Y_3c and Y_4c is a methylene group, a carbonyl group, an oxygen atom, -S(O)_n-, - N(R_10c)- or -C(=C(R_11c)(R_12c))-, two others are independently a methylene group, and the remaining one is a single bond or a methylene group, or,</li><li>(2) any adjacent two members of a group consisting of Y_1c, Y_2c, Y_3c, and Y_4c are taken together to represent a vinylene group (-CH=CH-) or -CON(R_10c)-, another is a methylene group, a carbonyl group, an oxygen atom, -S(O)_n-, -N(R_10c) - or -C(=C(R_11c)(R_12c))-, and the remaining one is a single bond or a methylene group, provided that the oxygen atom, nitrogen atom and sulfur atom are not directly bonded to the vinylene group; <ul id="ul0013" list-style="none" compact="compact"><li>Z_c is a substituent which may be substituted for at least one hydrogen atom (for example, one or two hydrogen atoms) bonded to any of the carbon atoms constituting the ring formed by Y_1c, Y_2c, Y_3c, and Y_4c, namely, Z_c may be absent, or one or more Zs may be present and are independently a substituent selected from the group consisting of unsubstituted alkyl groups, substituted alkyl groups, alkenyl groups, alkynyl groups, cycloalkyl groups, cycloalkenyl groups, saturated heterocyclic groups, halogen atoms, carboxyl groups, alkoxycarbonyl groups, aromatic groups, -OR_5c, - N(R_6c)R_7c, -CON(R_6c)R_7c, -S(O)_nR_8c, acyl groups and -Q_c-R_ac-;</li><li>A_c is an oxygen atom, -S(O)_n- or -N(R_10c)-;</li><li>Q_c is a substituted or unsubstituted lower alkylene group;</li><li>R_ac is a substituted or unsubstituted vinyl group, or a substituted or unsubstituted ethynyl group;</li><li>R_5c is a hydrogen atom, an unsubstituted alkyl group, a substituted alkyl group, a cycloalkyl group, a cycloalkenyl group, a saturated heterocyclic group or an aromatic group;</li><li>R_6c and R_7c are independently a hydrogen atom, an unsubstituted alkyl group, a substituted alkyl group, a cycloalkyl group, a cycloalkenyl group, a saturated heterocyclic group, an aromatic group, an acyl group or -Q_c-R_ac, or R_6c and R_7c, when taken together with the nitrogen atom to which they are bonded, form a saturated 5- to 7-membered cyclic amino group which may contain an oxygen atom or a sulfur atom in the ring and may be substituted by one or more (for example, two) unsubstituted alkyl groups, substituted alkyl groups, hydroxyl groups or -OR_5c groups;</li><li>R_8c is an unsubstituted alkyl group, a substituted alkyl group or an aromatic group;</li><li>R_9c is a hydrogen atom, an unsubstituted alkyl group, a substituted alkyl group, an acyl group or -Q_c-R_ac,</li><li>R_10c is a hydrogen atom, an unsubstituted alkyl group, a substituted alkyl group, a cycloalkyl group, a saturated heterocyclic group, an aromatic group, an acyl group or -Q_c-R_ac; and,</li><li>R_11c and R_12c are independently a hydrogen atom, an unsubstituted alkyl group, a substituted alkyl group, an alkenyl group, an alkynyl group, a cycloalkyl group, a cycloalkenyl group, a saturated heterocyclic group, a halogen atom, a carboxyl group, an alkoxycarbonyl group, an aromatic group, -OR_5c, -N(R_6c)R_7c, -CON(R_6c)R_7c, -S(O)_nR_8c, an acyl group or -Q_c-R_ac-; and,</li><li>n is 0, 1 or 2; or a pharmaceutically acceptable acid addition salt thereof.</li></ul></li></ul></li></ul> The various groups in the compounds of general formula (1c) are explained below. The alkyl group includes, for example, linear or branched alkyl groups of 8 or less carbon atoms, such as methyl, ethyl, propyl, 2-propyl, butyl, 2-butyl, 2-methylpropyl, 1,1-dimethylethyl, pentyl, hexyl, heptyl and octyl. The cycloalkyl group may be unsubstituted or may be substituted by 1 to 4 unsubstituted alkyl groups, substituted alkyl groups, hydroxyl groups or groups of the formula -OR_5c, and includes, for example, 3- to 8-membered cycloalkyl groups such as cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, 2-methylcyclopentyl, 3-methylcyclopentyl, 2-methylcyclohexyl, 3-methylcyclohexyl, 4-methylcyclohexyl, 2-hydroxycyclopentyl, 3-hydroxycyclopentyl, 2-hydroxycyclohexyl, 3-hydroxycyclohexyl, 4-hydroxycyclohexyl, 2-(hydroxymethyl)cyclopentyl, 3-(hydroxymethyl)cyclopentyl, 2-(hydroxymethyl)cyclohexyl, 3-(hydroxymethyl)-cyclohexyl, 4-(hydroxymethyl)cyclohexyl, 2-(aminomethyl)cyclopentyl, 3-(aminomethyl)cyclopentyl, 2-(aminomethyl)cyclohexyl, 3-(aminomethyl)cyclohexyl, 4-(aminomethyl)cyclohexyl, 2-(methoxymethyl)cyclopentyl, 3-(methoxymethyl)cyclopentyl, 2-(methoxymethyl)cyclohexyl, 3-(methoxymethyl)cyclohexyl, 4-(methoxymethyl)-cyclohexyl, etc. The cycloalkenyl group may be unsubstituted or may be substituted by 1 to 4 unsubstituted alkyl groups, substituted alkyl groups, hydroxyl groups or groups of the formula, -OR_5c, and includes, for example, 3- to 8-membered cycloalkenyl groups having a double bond, such as 1-cyclopentenyl, 2-cyclopentenyl, 3-cyclopentenyl 1-cyclohexenyl, 2-cyclohexenyl, 3-cyclohexenyl, etc. The saturated heterocyclic group may be unsubstituted or may be substituted by 1 to 4 unsubstituted alkyl groups, substituted alkyl groups, hydroxyl groups or group of the formula -OR_5c, and includes, for example, 3- to 8-membered saturated heterocyclic groups having an oxygen atom or a sulfur atom, such as 2-tetrahydrofuranyl, 3-tetrahydrofuranyl, 2-tetrahydro-2H-pyranyl, 4-tetrahydro-4H-pyranyl, etc. The halogen atom includes, for example, fluorine, chlorine and bromine atoms. The alkoxycarbonyl group includes, for example, linear or branched alkoxycarbonyl group of 6 or less carbon atoms, such as methoxycarbonyl, ethoxycarbonyl, propoxycarbonyl and 2-propoxycarbonyl. The aromatic group includes substituted or unsubstituted aryl groups and substituted or unsubstituted heteroaryl groups. As the aryl groups, there may be exemplified aryl groups of 10 or less carbon atoms, such as phenyl, naphthyl, etc. As the heteroaryl groups, there may be exemplified 5- or 6-membered heteroaryl groups containing 1 to 4 nitrogen atoms, such as 2-, 3- or 4-pyridyl, pyrrolyl, imidazolyl, triazolyl, tetrazolyl, etc.; and 5- or 6-membered heteroaryl groups containing 0 to 2 nitrogen atoms and one oxygen atom or one sulfur atom, such as 2- or 3-furyl, 2- or 3-thienyl, 1-, 3- or 4-oxazolyl, 3-, 4- or 5-isoxazolyl, etc. The substituent of each of the substituted aryl group and the substituted heteroaryl group includes unsubstituted alkyl groups, substituted alkyl groups, halogen atoms, nitro group, carboxyl groups, alkoxycarbonyl groups, and groups represented by the formula - OR_5c, -N(R_6c)R_7c, -CONR_6cR_7c, -SO₂NR_6cR_7c or -S(O)_nR_8c. When R_1c, R_2c, R_3c and R_4c are independently a group represented by the formula -OR_5c wherein R_5c is an aromatic group, typical examples of the -OR_5c group are unsubstituted phenoxy groups and substituted phenoxy groups. Examples of the unsubstituted phenoxy groups are those having as the substituent, for example, a nitro group, a -NR_6cR_7c group (wherein R_6c and R_7c are independently, for instance, a hydrogen atom or an unsubstituted alkyl group), or a substituted alkyl group having as the substituent, for example, a hydroxyl group or a -NR_6cR_7c group. More specific examples of the substituted phenoxy groups are o-, m- or p-nitrophenoxy, o-, m- or p-aminophenoxy, o-, m- or p-(dimethylamino)phenoxy, o-, m- or p-(aminomethyl)phenoxy, and o-, m- or p-(dimethylaminomethyl)phenoxy. The alkoxy group includes, for example, linear or branched alkoxy groups of 6 or less carbon atoms, such as methoxy, ethoxy, isopropoxy, tert-butoxy, etc. As the cyclic amino group which R_6c and R_7c form when taken together with the nitrogen atom to which they are bonded, i.e., the saturated 5- to 7-membered cyclic amino group which may contain another hetero atom in the ring, there may be exemplified 5- to 7-membered cyclic groups containing 1 to 3 nitrogen atoms and 5- to 7-membered cyclic groups containing one nitrogen atom and one oxygen atom. More specific examples of the saturated 5- to 7-membered cyclic amino group are 1-pyrrolidinyl, 1-piperidino, 1-piperazinyl, 4-morpholino and 1-(4-methyl)piperazinyl. The substituent on the substituted alkyl group include halogen atoms, hydroxy group, alkoxy groups, cycloalkyl groups, cyano group, carboxyl group, alkoxycarbonyl groups, aromatic groups, acyl groups and groups shown by the formula -CONR_pcR_qc, wherein R_pc and R_qc are independently a hydrogen atom or an unsubstituted alkyl group, or R_pc and R_qc being able to be taken together to represent a saturated 5- to 7-membered cyclic amino group which may contain another hetero atom in the ring, -NR_6cR_7c or a group shown by formula: <chemistry id="chem0016" num="0016"><img file="EP0937459A2_D0016.tif" /></chemistry> wherein R_13c is a hydrogen atom, an unsubstituted alkyl group or a substituted alkyl group, and the ring is a 3-to 8-membered saturated heterocyclic group containing one nitrogen atom. Particularly when any of R_1c, R_2c, R_3c, R_4c, R_5c, R_8c, R_9c, R_12c and Z_c is a substituted alkyl group, the substituent includes, for example, cycloalkyl groups, halogen atoms, hydroxyl group, alkoxy groups, carboxyl group, alkoxycarbonyl groups, acyl groups, aromatic groups and groups shown by the formula -CONR_pcR_qc or -NR_6cR_7c. When any of R_6c, R_7c, R_10c, R_11c and R_13c is a substituted alkyl group, the substituent includes, for example, cycloalkyl groups, hydroxyl group, alkoxy groups, carboxyl group, alkoxycarbonyl groups, acyl groups, aryl groups, and groups shown by the formula - CONR_pcR_qc or -NR_pcR_qc. As the alkyl portion of the substituted alkyl group, there may be exemplified the same groups as those exemplified above as the alkyl group. As such substituted alkyl groups, there may be exemplified substituted alkyl groups of 1 to 5 carbon atoms having as the substituent a cycloalkyl group of 3 to 6 carbon atoms, polyhaloalkyl groups of 1 to 5 carbon atoms, hydroxyalkyl groups of 1 to 6 carbon atoms, alkoxyalkyl groups of 2 to 6 carbon atoms, cyanoalkyl groups of 2 to 6 carbon atoms, carboxyalkyl groups of 2 to 6 carbon atoms, alkoxycarbonylalkyl groups of 3 to 8 carbon atoms, alkanoylalkyl groups of 3 to 8 carbon atoms, aroylalkyl groups of 16 or less carbon atoms, substituted or unsubstituted phenyl- or naphthyl-C₁-C₅ alkyl groups, carbamoyl-C₁-C₃ alkyl groups which may have one or two C₁-C₃ alkyl groups as a substituent(s) on the nitrogen atom, amino-C₁-C₅ alkyl groups which may have one or two C₁-C₃ alkyl or C₇-C₁₁ aralkyl groups as a substituent(s) on the nitrogen atom, and saturated 5- to 7-membered cyclic amino-C₁-C₃ alkyl groups. Typical examples of the substituted alkyl group are polyhaloalkyl groups of 1 to 3 carbon atoms, such as trifluoromethyl, trifluoroethyl or trichloromethyl; hydroxyalkyl groups of 1 to 6 carbon atoms, such as hydroxymethyl, hydroxyethyl or 1-hydroxyethyl; aminoalkyl groups of 1 to 5 carbon atoms, such as aminomethyl, aminoethyl or 1-aminoethyl; alkoxyalkyl groups of 1 to 6 carbon atoms, such as methoxyethyl, ethoxyethyl or methoxypropyl; carboxyalkyl groups of 2 to 6 carbon atoms, such as carboxyethyl or carboxypropyl; alkoxycarbonylalkyl groups of 3 to 7 carbon atoms, such as methoxycarbonylmethyl, ethoxycarbonylmethyl or methoxycarbonylethyl; phenyl- or naphthyl-C₁-C₅ alkyl groups (which may have in the phenyl or naphthyl portion a substituent such as a C₁-C₃ alkyl group, halogen atom, nitro group, amino group, hydroxyl group, C₁-C₃ alkoxy group or the like) such as benzyl, phenylethyl, phenylpropyl, phenylbutyl or, 1- or 2-naphthylmethyl; carbamoyl-C₁-C₃ alkyl groups which may have one or two C₁-C₃ alkyl groups as a substituent(s) on the nitrogen atom, for example, carbamoylmethyl, carbamoylethyl or dimethylcarbamoylmethyl; amino-C₁-C₅ alkyl groups which may have one or two C₁-C₃ alkyl groups or C₇-C₁₁ aralkyl groups as a substituent(s) on the nitrogen atom, for example, aminoethyl, aminopropyl, dimethylaminoethyl, dimethylaminopropyl, diethylaminoethyl or N-methyl-N-benzylaminoethyl; and saturated 5-to 7-membered cyclic amino-C₁-C₃ alkyl groups such as 1-pyrrolidinylethyl or piperidinoethyl. In the case of R_6c and R_7c, typical examples of the substituted alkyl group are phenyl-C₁-C₅ alkyl groups such as phenylethyl. As the substituent on the lower alkylene group for Q_c and the substituent on the vinyl or ethynyl group for R_ac, there may be exemplified unsubstituted alkyl groups, substituted alkyl groups, cycloalkyl groups, cycloalkenyl groups, saturated heterocyclic groups, carboxyl group, alkoxycarbonyl groups, aromatic groups, and groups represented by the formula -CON(R_6c)R_7c. The lower alkylene group includes, for example, alkylene groups of 6 or less carbon atoms, such as methylene, ethylene, trimethylene, tetramethylene, pentamethylene, hexamethylene, etc. The acyl group includes, for example, formyl group; alkanoyl groups of 2 to 6 carbon atoms, such as acetyl, propanoyl, etc.; cycloalkanecarbonyl groups of 3 to 6 carbon atoms, such as cyclopropanecarbonyl, cyclobutanecarbonyl, cyclopentanecarbonyl, cyclohexanecarbonyl, etc.; cycloalkenecarbonyl groups of 3 to 6 carbon atoms, such as cyclopentenecarbonyl, cyclohexenecarbonyl, etc.; aroyl groups of 6 to 10 carbon atoms, such as benzoyl, toluoyl, naphthoyl, etc.; saturated heterocyclic ring-carbonyl groups having a 5- or 6-membered saturated heterocyclic group containing one or two hetero atoms selected from the group consisting of nitrogen atom, oxygen atom and sulfur atom, for example, 2-piperidinecarbonyl, 3-morpholinecarbonyl, etc.; and heteroaromatic acyl groups having a 5- or 6-membered heteroaromatic ring containing one or two hetero atoms selected from the group consisting of nitrogen atom, oxygen atom and sulfur atom, for example, furoyl, thenoyl, nicotinoyl, isonicotinoyl, etc. As the cyclic amino group which R_pc and R_qc form when taken together, i.e., the saturated 5- to 7-membered cyclic amino group which may contain another hetero atom in the ring, there may be exemplified the same groups as those exemplified above as the cyclic amino group formed by R_6c and R_7c. The group represented by the formula -S(O)_nR_8c includes, for example, alkylsulfonyl groups of 8 or less carbon atoms, such as methylsulfonyl, ethylsulfonyl, propylsulfonyl or isopropylsulfonyl; and alkylsulfinyl groups and alkylthio groups, which correspond to the alkylsulfonyl groups. As the group represented by the formula: <chemistry id="chem0017" num="0017"><img file="EP0937459A2_D0017.tif" /></chemistry> there may be exemplified groups represented by the following formulas: <chemistry id="chem0018" num="0018"><img file="EP0937459A2_D0018.tif" /></chemistry> Preferred examples of the aforesaid group are (piperidin-3-yl)oxy, (piperidin-4-yl)oxy, (1-methylpiperidin-3-yl)oxy, (1-methylpiperidin-4-yl)oxy, (pyrrolidin-3-yl)oxy, (1-methylpyrrolidin-3-yl)oxy, (piperidin-3-yl)thio, (piperidin-4-yl)thio, (1-methylpiperidin-3-yl)thio, (1-methylpiperidin-4-yl)thio, (pyrrolidin-3-yl)thio, (1-methylpyrrolidin-2-yl)thio, (piperidin-3-yl)amino, (piperidin-4-yl)amino, (1-methylpiperidin-3-yl)amino, (1-methylpiperidin-4-yl)amino, (pyrrolidin-3-yl)amino and (1-methylpyrrolidin-3-yl)amino. The alkenyl group includes, for example, alkenyl groups of 6 or less carbon atoms, such as vinyl, allyl, propenyl, 2-propenyl, butenyl, pentenyl and hexenyl. The alkynyl group includes, for example, alkynyl groups of 6 or less carbon atoms, such as ethynyl, propargyl, butynyl and pentynyl. </li><li>(d) The present invention relates to pharmaceutical compositions comprising Compound (d) represented by formula (1d): <chemistry id="chem0019" num="0019"><img file="EP0937459A2_D0019.tif" /></chemistry> or pharmaceutically acceptable acid addition salts thereof, in particular, the methanesulfonate (Code No. HOE-642, cariporide, namely, 4-isopropyl-3-methylsulfonylbenzoylguanidine methanesulfonate).</li><li>(e) The present invention relates to pharmaceutical compositions comprising Compound (e) represented by formula (1e): <chemistry id="chem0020" num="0020"><img file="EP0937459A2_D0020.tif" /></chemistry> or pharmaceutically acceptable acid addition salts thereof, in particular, the dihydrochloride (Code No. FR183998).</li><li>(f) The present invention relates to pharmaceutical compositions comprising Compound (f) represented by formula (1f): <chemistry id="chem0021" num="0021"><img file="EP0937459A2_D0021.tif" /></chemistry> or pharmaceutically acceptable acid addition salts thereof, in particular, the methanesulfonate (Code No. KBR-9032). Of the compounds described above, particularly preferred are Compounds (g) and (h) shown below. </li><li>(g) 1-Methyl-2-indoloylguanidine represented by the formula (1g) described in Japanese Patent KOKAI (Laid-Open) No. 8-208602: <chemistry id="chem0022" num="0022"><img file="EP0937459A2_D0022.tif" /></chemistry> or salts thereof, more preferably the methanesulfonate thereof.</li><li>(h) N-(Aminoiminomethyl)-5,6,7,8-tetrahydro11-chloro-8-oxo-4H-azocino[3,2,1-hi]indole-2-carboxamide of the formula (1h) described in EP 787,728: <chemistry id="chem0023" num="0023"><img file="EP0937459A2_D0023.tif" /></chemistry> or salt thereof, more preferably, the methanesulfonate thereof.</li></ul>

0015Throughout the present specification, the compounds represented by the general formulas (1), (1b) and (1c) and the compounds of the formulas (1d), (1e), (1f), (1g) and (1h) are described using the formulas (1), (1b), (1c), (1d), (1e), (1f), (1g) and (1h) but tautomers of these compounds are also present since the guanidine portions are tautomeric. More specifically, the tautomer of acylguanidine group: -C(O)N=C(NH₂)₂ in which the guanidine portion takes diaminomethyleneamino as well as that of -C(O)NH-C(=NH)NH₂ in which the guanidine portion takes aminoiminomethylamino are present in the respective compounds. These tautomeric compounds are different only in their chemical formation state but have the same pharmacological effects. Therefore, the compounds which may be used in the pharmaceutical compositions of the present invention include these tautomeric isomers.

0016The compounds of the general formulas (1), (1b) and (1c) also include those having optically asymmetric centers. Thus, these compounds may be obtained in the racemic form, or can be obtained in the optically active form in the case that optically active starting materials are employed. If necessary and desired, the racemic compounds thus obtained may resolved chemically or physically into enantiomers by known methods. Preferably, the racemic compounds are subjected to a reaction using an optically active resolving agent to convert into the diastereomers. The diastereomers in different configurations may be resolved in a conventional manner, for example, by fractional crystallization.

0017The compounds represented by the general formulas (1), (1b) and (1c) and the compounds represented by the formulas (1d), (1e), (1f), (1g) and (1h) may be converted into acid addition salts with pharmaceutically acceptable inorganic acids or organic acids, if necessary and desired. Examples of such acid addition salts are salts with inorganic acids such as hydrochloric acid, hydrobromic acid, sulfuric acid or phosphoric acid; salts with organic acids such as formic acid, acetic acid, fumaric acid, maleic acid, oxalic acid, citric acid, malic acid, tartaric acid, aspartic acid or glutamic acid; salts with sulfonic acids such as methanesulfonic acid, benzenesulfonic acid, p-toluenesulfonic acid, hydroxybenzenesulfonic acid, dihydroxybenzenesulfonic acid, etc.

0018The compounds represented by the general formulas (1), (1b) and (1c) and the compounds represented by the formulas (1d), (1e), (1f), (1g) and (1h), and acid addition salts thereof may take the form of the anhydrides, hydrates and solvates thereof.

0019As the Na⁺/H⁺ exchanger inhibitors which can be used in the pharmaceutical compositions of the present invention, compounds described in a publication, such as the one described in the following publications may also be used to achieve the objects of the present invention, which publications are, for example:

0020Japanese Patent KOKAI (Laid-Open) Nos. 7-10839, 8-208602, 9-268172, 9-291076, 9-227496, 9-221465, 9-169719, 9-169718, 9-169721, 9-169723, 9-124584, 9-52823, 9-31045, 8-319226, 8-311012, 8-259515, 8-225514, 8-99950, 8-92215, 8-12643, 8-27093, 7-304729, 7-291927, 7-224022, 7-109251, 7-76566, 7-89938, 6-345715, 6-345643, 6-256291, 6-234730, 6-256290, 6-239828, 6-228082, 6-116230, 5-339228, 8-291131, 8-41028, 7-206823, 7-82234, 7-145149, 9-124583, 9-52876, 8-311011, 8-245560, 8-269001, 8-283232, 8-73427, 8-59598, 8-59602, 8-188568, 8-27113, 7-267926, 8-225513, 9-77753, 9-59245, 9-67332, 9-67340 and 8-277269; PCT KOKAI (Laid-Open) Nos. 6-509798, 9-505035, 9-504535, 8-511243 and 9-500895; European Patent (EP) Nos. 794172, 794171, 790245, 765868 and 787728; German Patent (DE) Nos. 19548708 and 19601303, WO Nos. 9711055, 9640728, 9604241, 9725310 and 9727183.

0021The compounds having the Na⁺/H⁺ exchange system inhibition activity and salts thereof, which are used in the present invention, may be prepared by the methods described in the patent publications <u>supra</u>, etc.

0022The pharmaceutical composition of the present invention, useful for the treatment of ischemic brain damage, comprises as the active ingredient the compound having the Na⁺/H⁺ exchange system inhibition activity or salt thereof. These compounds having the Na⁺/H⁺ exchange system inhibition activity or salt thereof may freely take optional forms in the pharmaceutical composition without any restriction. This compound or salt thereof may be formulated into a pharmaceutical preparation suitable for oral or parenteral administration. The compound or salt thereof described above may also be employed in the pharmaceutical preparation after the compound or salt is dissolved in distilled water or a buffer solution. In the case that the active compound is used in the form of injection, a solution, suspension or emulsion of the compounds is prepared, using conventional substances for this purpose, for example, a solubilizer, an emulsifier or other additives. Solvents available for the purpose of the present invention are, for example, water, physiological saline, an alcohol such as ethanol or propanol, or a sugar solution such as a glucose solution or a mannitol solution, and a mixture of the various solvents described above. The pharmaceutical composition of the present invention may further contain, if necessary and desired, other pharmaceutical additives, such as a surfactant, an emulsifier and a stabilizer. The pharmaceutical composition of the present invention contains the active compound in a concentration of, for example, approximately 0.1 to 10 wt%. The composition in a non-parenteral preparation may be prepared, for example, by mixing the active compound with appropriate carriers conventionally acceptable for this purpose, for example, an excipient, a stabilizer, a diluent, a binder, etc. and then treating the resulting mixture in a conventional manner into an appropriate dosage mode, such as tablets, coated tablets, capsules, granules, powders, syrup or suspensions. The excipient that may be used in the pharmaceutical composition of the present invention are, for example, gum arabic, magnesia, magnesium carbonate, calcium phosphate, lactose, glucose or starch, especially corn starch.

0023The dosage and frequency of administration may vary and may be determined preferably depending upon the age, body weight, condition and administration route. In general, the composition of the present invention is administered in a daily dose of 0.1 to 2000 mg, preferably 1 to 200 mg, per day for adult in a single dose or by multiple dose.

0024The present invention is described below more specifically with reference to Examples but is not deemed to be limited thereto.

0025Compound 1 used in Examples 1 and 4 is 1-methyl-2-indoloylguanidine methanesulfonate, which is described in Example 240 of Japanese Patent KOKAI (Laid-Open) No. 8-208602, namely, the methanesulfonate of the compound represented by the formula (1g); Compound 2 used in Examples 2 and 5 is 1,4-dimethyl-2-indoloylguanidine methanesulfonate, which is described in Example 241 of Japanese Patent KOKAI (Laid-Open) No. 8-208602, and Compound 3 used in Examples 3 and 6 is N-(aminoiminomethyl)-5,6,7,8-tetrahydro-11-chloro-8-oxo-4H-azocino[3,2,1-hi]indole-2-carboxamide methanesulfonate monohydrate, which is described in Example 22 of Japanese Patent KOKAI (Laid-Open) No. 10-237073, namely, the methanesulfonate of the compound represented by the formula (1h).

Example 1

Effect of Na

<u>+</u>

/H

<u>+</u>

exchanger inhibitor on the infarcted area induced in transient ischemic rats

0026Male rats were anesthetized with halothane mixed with nitrous oxide. The cervical region was dissected to ligate the left external carotid artery and the left common carotid artery. Occlusion was induced for 2 hours in the control section at the origin of the middle cerebral artery by inserting a nylon thread through the left internal carotid artery to reach the left middle deutocerebral artery. Reperfusion through the middle cerebral artery was established by withdrawing the nylon thread. The test compound was intravenously given to the animals in a volume of 1 ml/kg at 30 minutes after the occlusion. As the test compound, a solution of Compound 1 (1 mg/ml) in 8% polyethylene glycol #400 was used. For control, the vehicle (8% polyethylene glycol #400) containing no active compound was used. The animals were decapitated 22 hours after reperfusion and the brain was removed. Coronal sections of 2 mm thick were prepared in the ipsilateral hemisphere from 3 mm anterior to 5 mm posterior of the bregma. The sections were stained with 2,3,5-triphenyltetrazolium chloride for photographing. The photographs were scanned with a scanner (GT-8000, Epson) for computer-based image analysis (software used, Ep Scan Mac 1. 40). The rate of the infarcted area of each section in the left hemisphere was analyzed by a computer (software used, NIH image 1.59). The pharmacological effect was evaluated by mean percentage of the infarcted areas in the five sections obtained in one rat.

0027By the left middle cerebral artery occlusion for 2 hours, mean infarcted area of 47.9 ± 3.6% in each section (mean ± standard error in 9 cases) was observed 22 hours after reperfusion in the control group. In the group treated with Compound 1, mean infarcted area observed in each section was only 35.4 ± 3.1% (mean ± standard error in 8 cases, p&lt;5%, Student's t-test). The data reveals that the infarcted area was significantly reduced in the Compound 1-treated group, as compared to the control group. The infarcted area of each section in the left hemisphere is expressed by mean ± standard error, which is shown in Fig. 1.

Example 2

Effect of Na

<u>+</u>

/H

<u>+</u>

exchanger inhibitor on the infarcted area induced in transient ischemic rats

0028Compound 2 was elucidated for the effect on the infarcted area in a manner similar to that of Example 1. The test compound was intraperitoneally given 30 minutes before the occlusion to the animals in a volume of 1 ml/kg. As the test compound, a solution of Compound 2 (1 mg/ml) in 8% polyethylene glycol #400 was used. For control, the vehicle (8% polyethylene glycol #400) containing no active compound was used.

0029In the control group, the mean percentage of the infarcted area in each section was 49.5 ± 4.1% (mean ± standard error in 6 cases). In the drug-treated group, the infarcted area observed in each section was only 26.6 ± 3.1% (mean ± standard error in 5 cases). The data reveals that the infarcted area was significantly reduced in the drug-treated group with p&lt;1% (by Student's t-test), as compared to the control group. The infarcted area of each section in the left hemisphere is expressed by mean percentage with standard error, which is shown in Fig. 2.

Example 3

Effect of Na

<u>+</u>

/H

<u>+</u>

exchanger inhibitor on the infarcted area induced in transient ischemic rats

0030Compound 3 was elucidated for the effect on the infarcted area in a manner similar to that of Example 1. The test compound was intraperitoneally given immediately after the occlusion to the animals in a volume of 1 ml/kg. As the test compound, a solution of Compound 3 (1 mg/ml) in 8% polyethylene glycol #400 was used. For control, the vehicle (8% polyethylene glycol #400) containing no active compound was used.

0031In the control group, the mean percentage of the infarcted area in each section was 55.4 ± 2.1% (mean ± standard error in 14 cases). In the drug-treated group, the infarcted area observed in each section was only 45.2 ± 2.2% (mean ± standard error in 13 cases). The data reveals that the infarcted area was significantly reduced in the drug-treated group with p&lt;5% (by Student's t-test), as compared to the control group. The infarcted area of each section in the left hemisphere is expressed by mean percentage with standard error, which is shown in Fig. 3.

Example 4

Effect of Na

<u>+</u>

/H

<u>+</u>

exchanger inhibitor on brain edema induced in rats with transient ischemia

0032Male rats were anesthetized with halothane mixed with nitrous oxide. The cervical region was dissected to ligate the left external carotid artery and the left common carotid artery. Occlusion was induced for 2 hours in the control section at the origin of the middle cerebral artery by inserting a nylon thread through the left internal carotid artery to reach the left middle deutocerebral artery. Reperfusion through the middle cerebral artery was established by withdrawing the nylon thread. The test compound was intravenously given to the animals an hour after the occlusion in a volume of 1 ml/kg. As the test compound, a solution of Compound 1 (0.3 mg/ml or 1 mg/ml) in 8% polyethylene glycol #400 was used. For control, the vehicle alone (8% polyethylene glycol #400) containing no active compound was used. The animals were decapitated 4 hours after reperfusion and the brain was removed. Coronal sections of 4 mm thick were prepared in the ipsilateral hemisphere from 1 mm anterior to 3 mm posterior of the bregma. After the wet weight (W) of each section was weighed, the section was dried in an oven at 110°C for 24 hours and then its dry weight (D) was weighed. The brain water content (WC) was calculated according to the following equation.<maths id="math0001" num=""><math display="block"><mrow><mtext>WC = (W - D) / W x 100</mtext></mrow></math><img file="EP0937459A2_D0024.tif" /></maths> In the normal control group, the brain water content was 79.9 ± 0.1% (mean ± standard error in 15 cases); however, by reperfusion following the occlusion, the brain water content in the control group increased to 83.3 ± 0.3% (mean + standard error in 15 cases). The drug-treated groups showed the brain water content of 82.6 ± 0.3% and 82.2 ± 0.3% in 0.3 mg/kg and 1 mg/kg, respectively (mean ± standard error both in 16 cases). The results indicate that the drug-treated groups significantly prevented the increase in water content with p&lt;1%, when compared to the control group (by Williams' multiple comparison). The results of mean brain water content with standard error obtained in the respective groups are shown in Fig. 4.

Example 5

Effect of Na

<u>+</u>

/H

<u>+</u>

exchanger inhibitor on brain edema induced in rats with transient ischemia

0033Compound 2 was elucidated for the effect on brain edema in a manner similar to that of Example 4. The test compound was intravenously given immediately after the reperfusion to the animals in a volume of 1 ml/kg. As the test compound, a solution of Compound 2 (1 mg/ml) in 8% polyethylene glycol #400 was used. For control, the vehicle (8% polyethylene glycol #400) containing no active compound was used.

0034In the normal control group, the brain water content was found to be 78.7 ± 0.1% (mean ± standard error in 8 cases). By reperfusion following the ischemia, the brain water content in the control group increased to 81.9 ± 0.4% (mean ± standard error in 11 cases). In the drug-treated group, the brain water content was found to be 82.0 ± 0.4% (mean ± standard error in 11 cases); no significant effect of preventing the increase in brain water content was noted. The results of mean brain water content with standard error in each section are shown in Fig. 5.

Example 6

Effect of Na

<u>+</u>

/H

<u>+</u>

exchanger inhibitor an brain edema induced in rats with transient ischemia

0035Compound 3 was elucidated for the effect on brain edema in a manner similar to that of Example 4. The test compound was intravenously given immediately after the reperfusion to the animals in a volume of 1 ml/kg. As the test compound, a solution of Compound 3 (0.3 mg/ml or 1 mg/ml) in 8% polyethylene glycol #400 was used. For control, the vehicle alone (8% polyethylene glycol #400) containing no active compound was used.

0036In the normal control group, the brain water content was found to be 79.2 ± 0.2% (mean ± standard error in 7 cases). By reperfusion following the ischemia, the brain water content in the control group increased to 82.8 ± 0.3% (mean ± standard error in 10 cases). In the drug-treated groups, the brain water content was found to be 82.4 ± 0.3% and 81.7 ± 0.4%, respectively, in 0.3 mg/kg and 1 mg/kg (mean ± standard error in 9 cases and 11 cases, respectively). The data reveal the tendency that the drug-treated groups prevented the increase in brain water content, as compared to the control group. The results of mean brain water content with standard error in each section are shown in Fig. 6.

0037It is established by these experiments in the Examples above that the Na⁺/H⁺ exchanger inhibitors exhibit good effects on ischemia-induced brain edema and cerebral infarction and therefore, effective for the treatment of ischemic brain damage.

0038The present invention thus provides the pharmaceutical compositions comprising the Na⁺/H⁺ exchanger inhibitors which are effective for the treatment of ischemic brain damage.