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Last Updated: March 28, 2024

Details for Patent: 6,803,357


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Title: Method of regulating glucose metabolism, and reagents related thereto
Abstract:The present invention provides methods and compositions for modification and regulation of GLP 1 metabolism, glucose and lipid metabolism, generally to reduce insulin resistance, hyperglycemia, hyperinsulinemia, obesity, hyperlipidemia, hyperlipoproteinemia (such as chylomicrons, VLDL and LDL), and to regulate body fat and more generally lipid stores, and, more generally, for the improvement of metabolism disorders, especially those associated with diabetes, obesity and/or atherosclerosis. The compositions described herein are high-affinity boronyl and non-boronyl peptidomimetic inhibitors of DPIV.
Inventor(s): Bachovchin; William A. (Melrose, MA), Plaut; Andrew G. (Lexington, MA), Drucker; Daniel (Toronto, CA)
Assignee: New England Medical Center Hospitals, Inc. (Boston, MA) Trustees of Tufts College (Medford, MA) 1149336 Ontario Inc. (Toronto, CA)
Filing Date:Jan 05, 2001
Application Number:09/601,432
Claims:1. A method for treating Type II diabetes, comprising administering to an animal a composition including one or more inhibitors of dipeptidylpeptidase IV (DPIV) represented by Formula I in an amount sufficient to treat Type II diabetes but not sufficient to suppress the immune system of the animal: ##STR39##

wherein A represents a 4-8 membered heterocycle including the N and a C.alpha. carbon; Z represents C or N; W represents --CH.dbd.NR.sub.5, ##STR40## R.sub.1 represents a C-terminally linked amino acid residue or amino acid analog, or a C-terminally linked peptide or peptide analog, or an amino-protecting group, or ##STR41## R.sub.2 is absent or represents one or more substitutions to the ring A, each of which can independently be a halogen, a lower alkyl, a lower alkenyl, a lower alkynyl, a carbonyl, a thiocarbonyl, an amino, an acylamino, an amido, a cyano, a nitro, an azido, a sulfate, a sulfonate, a sulfonamido, --(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --OH, --(CH.sub.2).sub.m --O-lower alkyl, --(CH.sub.2).sub.m --O-lower alkenyl, --(CH.sub.2).sub.n --O--(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --SH, --(CH.sub.2).sub.m --S-lower alkyl, --(CH.sub.2).sub.m --S-lower alkenyl, or --(CH.sub.2).sub.n --S--(CH.sub.2).sub.m --R.sub.7 ; if Z is N, R.sub.3 represents hydrogen, if Z is C, R.sub.3 represents hydrogen or a halogen, a lower alkyl, a lower alkenyl, a lower alkynyl, a carbonyl, a thiocarbonyl, an amino, an acylamino, an amido, a cyano, a nitro, an azido, a sulfate, a sulfonate, a sulfonamido, --(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --OH, --(CH.sub.2).sub.m --O-lower alkyl, --(CH.sub.2).sub.m --O-lower alkenyl, --(CH.sub.2).sub.n --O--(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --SH, --(CH.sub.2).sub.m --S-lower alkyl, --(CH.sub.2).sub.m --S-lower alkenyl, or --(CH.sub.2).sub.n --S--(CH.sub.2).sub.m --R.sub.7 ; R.sub.5 represents a hydrogen, an alkyl, an alkenyl, an alkynyl, --C(X.sub.1)(X.sub.2)X.sub.3, --(CH.sub.2), --R.sub.7, --(CH.sub.2).sub.n --OH, --(CH.sub.2).sub.n --O-alkyl, --(CH.sub.2), --O-alkenyl, --(CH.sub.2).sub.n --O-alkynyl, --(CH.sub.2).sub.n --O--(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.n --SH, --(CH.sub.2).sub.n --S-alkyl, --(CH.sub.2).sub.n --S-alkenyl, --(CH.sub.2).sub.n --S-alkynyl, --(CH.sub.2).sub.n --S--(CH.sub.2).sub.m --R.sub.7, --C(O)C(O)NH.sub.2, or --C(O)C(O)OR'.sub.7 ; R.sub.6 represents hydrogen, a halogen, an alkyl, an alkenyl, an alkynyl, an aryl, --(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --OH, --(CH.sub.2).sub.m --O-alkyl, --(CH.sub.2).sub.m --O-alkenyl, --(CH.sub.2).sub.m --O-alkynyl, --(CH.sub.2).sub.m --O--(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --SH, --(CH.sub.2).sub.m --S-alkyl, --(CH.sub.2).sub.m --S-alkenyl, --(CH.sub.2).sub.m --S-alkynyl, or --(CH.sub.2).sub.m --S--(CH.sub.2).sub.m --R.sub.7, ##STR42## R.sub.7 represents, for each occurrence, a substituted or unsubstituted aryl, aralkyl, cycloalkyl, cycloalkenyl, or heterocycle; R'.sub.7 represents, for each occurrence, hydrogen, or a substituted or unsubstituted alkyl, alkenyl, aryl, aralkyl, cycloalkyl, cycloalkenyl or heterocyclyl; R.sub.8 and R.sub.9 each independently represent hydrogen, alkyl, alkenyl, --(CH.sub.2).sub.m --R.sub.7, --C(.dbd.O)-alkyl, --C(.dbd.O)-alkenyl, --C(.dbd.O)alkynyl, or --C(.dbd.O)(CH.sub.2).sub.m --R.sub.7, or R.sub.8 and R.sub.9 taken together with the N atom to which they are attached complete a heterocyclic ring having from 4 to 8 atoms in the ring structure; R.sub.50 represents O or S; R.sub.51 represents N.sub.3, SH, NH.sub.2, NO.sub.2 or OR'.sub.7 ; R.sub.52 represents hydrogen, a lower alkyl, an amine, OR'.sub.7, or a pharmaceutically acceptable salt, or R.sub.51 and R.sub.52 taken together with the phosphorous atom to which they are attached complete a heterocyclic ring having from 5 to 8 atoms in the ring structure; Y.sub.1 and Y.sub.2 can independently or together be a group capable of being hydrolyzed to a hydroxyl group, or cyclic derivatives where Y.sub.1 and Y.sub.2 are connected via a ring having from 5 to 8 atoms in the ring structure; X.sub.1 represents a halogen; X.sub.2 and X.sub.3 each represent a hydrogen or a halogen; m is zero or an integer in the range of 1 to 8; and n is an integer in the range of 1 to 8.

2. The method of claim 1, wherein the animal is a mammal.

3. The method of claim 1, wherein the mammal is a human.

4. The method of claim 1, wherein the inhibitor has an EC.sub.50 for modification of glucose metabolism which is at least one order of magnitude less than its EC.sub.50 for immunosuppression.

5. The method of claim 1, wherein the inhibitor has an EC.sub.50 for inhibition of glucose intolerance in the nanomolar or less range.

6. The method of claim 4, wherein the inhibitor has an EC.sub.50 for immunosuppression in the micromolar or greater range.

7. The method of claim 1 or 3, wherein the inhibitor has a K.sub.i for DPIV inhibition of 1.0 nM or less.

8. The method of claim 1, wherein the inhibitor is peptidomimetic of a peptide selected from Pro-Pro, Ala-Pro, and (D)-Ala-(L)-Ala.

9. The method of claim 1, wherein the inhibitor has a molecular weight less than 7500 amu.

10. The method of claim 1, wherein the inhibitor is administered orally.

11. The method of claim 1, wherein W represents --CH.dbd.NR.sub.5, ##STR43## R.sub.5 represents H, an alkyl, an alkenyl, an alkynyl, --C(X.sub.1)(X.sub.2)X.sub.3, --(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.n --OH, --(CH.sub.2).sub.n --O-alkyl, --(CH.sub.2).sub.n --O-alkenyl, --(CH.sub.2).sub.n --O-alkynyl, -(CH.sub.2).sub.n --O--(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.n --SH, --(CH.sub.2).sub.n --S-alkyl, --(CH.sub.2).sub.n --S-alkenyl, --(CH.sub.2).sub.n --S-alkynyl, --(CH.sub.2).sub.n --S--(CH.sub.2).sub.m --R.sub.7, --C(O)C(O)NH.sub.2, or --C(O)C(O)OR'.sub.7 ; R.sub.7 represents, for each occurrence, a substituted or unsubstituted aryl, aralkyl, cycloalkyl, cycloalkenyl or heterocyclyl; R'.sub.7 represents, for each occurrence, hydrogen, or a substituted or unsubstituted alkyl, alkenyl, aryl, aralkyl, cycloalkyl, cycloalkenyl, or heterocycle; Y.sub.1 and Y.sub.2 can independently or together be a group capable of being hydrolyzed to a hydroxyl group, or cyclic derivatives where Y.sub.1 and Y.sub.2 are connected via a ring having from 5 to 8 atoms in the ring structure; R.sub.50 represents O or S; R.sub.51 represents N.sub.3, SH, NH.sub.2, NO.sub.2 or OR'.sub.7 ; R.sub.52 represents hydrogen, a lower alkyl, an amine, OR'.sub.7, or a pharmaceutically acceptable salt, or R.sub.51 and R.sub.52 taken together with the phosphorous atom to which they are attached complete a heterocyclic ring having from 5 to 8 atoms in the ring structure; X.sub.1 represents a halogen; X.sub.2 and X.sub.3 each represent a hydrogen or a halogen; m is zero or an integer in the range of 1 to 8; and n is an integer in the range of 1 to 8.

12. The method of claim 11, wherein the ring A is represented by the formula: ##STR44## wherein n is an integer of 1 or 2.

13. The method of claim 11, wherein W represents ##STR45##

14. The method of claim 11, wherein R.sub.1 represents ##STR46## R.sub.36 is a small hydrophobic group and R.sub.38 is hydrogen, or, R.sub.36 and R.sub.38 together form a 4-7 membered heterocycle including the N and the C.alpha. carbon, as defined for A above; and R.sub.40 represents a C-terminally linked amino acid residue or amino acid analog, or a C-terminally linked peptide or peptide analog, or an amino-protecting group.

15. The method of claim 11, wherein R.sub.2 is absent, or represents a small hydrophobic group.

16. The method of claim 11, wherein R.sub.3 is a hydrogen, or a small hydrophobic group.

17. The method of claim 11, wherein R.sub.5 is a hydrogen, or a halogenated lower alkyl.

18. The method of claim 11, wherein X.sub.1 is a fluorine, and X.sub.2 and X.sub.3, if halogens, are fluorine.

19. The method of claim 11, wherein the inhibitor is represented by the general formula: ##STR47##

wherein R.sub.1 represents a C-terminally linked amino acid residue or amino acid analog, or a C-terminally linked peptide or peptide analog, or an amino protecting group, or ##STR48## R.sub.6 represents hydrogen, a halogen, an alkyl, an alkenyl, an alkynyl, an aryl, --(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --OH, --(CH.sub.2).sub.m --O-alkyl, --(CH.sub.2).sub.m --O-alkenyl, --(CH.sub.2).sub.m --O-alkynyl, --(CH.sub.2).sub.m -O--(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --SH, --(CH.sub.2).sub.m --S-alkyl, --(CH.sub.2).sub.m --S-alkenyl, --(CH.sub.2).sub.m --S-alkynyl, --(CH.sub.2).sub.m --S--(CH.sub.2).sub.m --R.sub.7, ##STR49## R.sub.7 represents an aryl, a cycloalkyl, a cycloalkenyl, or a heterocycle; R.sub.8 and R.sub.9 each independently represent hydrogen, alkyl, alkenyl, --(CH.sub.2).sub.m --R.sub.7, --C(.dbd.O)-alkyl, --C(.dbd.O)-alkenyl, --C(.dbd.O)-alkynyl, or --C(.dbd.O)--(CH.sub.2).sub.m --R.sub.7, or R.sub.8 and R.sub.9 taken together with the N atom to which they are attached complete a heterocyclic ring having from 4 to 8 atoms in the ring structure; R.sub.11 and R.sub.12 each independently represent an alkyl, or a pharmaceutically acceptable salt, or R.sub.11 and R.sub.12 taken together with the O--B--O atoms to which they are attached complete a heterocyclic ring having from 5 to 8 atoms in the ring structure; m is zero or an integer in the range of 1 to 8; and n is an integer in the range of 1 to 8.

20. The method of claim 11, wherein the inhibitor is represented by the general formula ##STR50##

wherein R.sub.1 represents a C-terminally linked amino acid residue or amino acid analog, or a C-terminally linked peptide or peptide analog, or an amino protecting group, or ##STR51## R.sub.6 represents hydrogen, a halogen, an alkyl, an alkenyl, an alkynyl, an aryl, --(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --OH, --(CH.sub.2).sub.m --O-alkyl, --(CH.sub.2).sub.m --O-alkenyl, --(CH.sub.2).sub.m --O-alkynyl, --(CH.sub.2).sub.m --O--(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --SH, --(CH.sub.2).sub.m --S-alkyl, --(CH.sub.2).sub.m --S-alkenyl, --(CH.sub.2).sub.m --S-alkynyl, --(CH.sub.2).sub.m --S--(CH.sub.2).sub.m --R.sub.7, ##STR52## R.sub.7 represents an aryl, a cycloalkyl, a cycloalkenyl, or a heterocycle; R.sub.8 and R.sub.9 each independently represent hydrogen, alkyl, alkenyl, --(CH.sub.2).sub.m --R.sub.7, --C(.dbd.O)-alkyl, --C(.dbd.O)-alkenyl, --C(.dbd.O)-alkynyl, or --C(.dbd.O)--(CH.sub.2).sub.m --R.sub.7, or R.sub.8 and R.sub.9 taken together with the N atom to which they are attached complete a heterocyclic ring having from 4 to 8 atoms in the ring structure; m is zero or an integer in the range of 1 to 8; and n is an integer in the range of 1 to 8.

21. The method of claim 11, wherein the inhibitor is represented by the general formula: ##STR53##

wherein R.sub.1 represents a C-terminally linked amino acid residue or amino acid analog, or a C-terminally linked peptide or peptide analog, or an amino protecting group, or ##STR54## R.sub.6 represents hydrogen, a halogen, an alkyl, an alkenyl, an alkynyl, an aryl, --(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --OH, --(CH.sub.2).sub.m --O-alkyl, --(CH.sub.2).sub.m --O-alkenyl, --(CH.sub.2).sub.m --O-alkynyl, --(CH.sub.2).sub.m --O--(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --SH, --(CH.sub.2).sub.m --S-alkyl, --(CH.sub.2).sub.m --S-alkenyl, --(CH.sub.2).sub.m --S-alkynyl, --(CH.sub.2).sub.m --S--(CH.sub.2).sub.m --R.sub.7, ##STR55## R.sub.7 represents an aryl, a cycloalkyl, a cycloalkenyl, or a heterocycle; R.sub.8 and R.sub.9 each independently represent hydrogen, alkyl, alkenyl, --(CH.sub.2).sub.m --R.sub.7, --C(.dbd.O)alkyl, --C(.dbd.O)-alkenyl, --C(.dbd.O)-alkynyl, or --C(.dbd.O)--(CH.sub.2).sub.m --R.sub.7, or R.sub.8 and R.sub.9 taken together with the N atom to which they are attached complete a heterocyclic ring having from 4 to 8 atoms in the ring structure; X.sub.1, X.sub.2 and X.sub.3 each represent a halogen; m is zero or an integer in the range of 1 to 8; and n is an integer in the range of 1 to 8.

22. The method of claim 11, wherein the inhibitor is represented by the general formula: ##STR56##

wherein A represent a 4-8 membered heterocycle including an N and a C.alpha. carbon; W represents, ##STR57## R.sub.2 is absent or represents one or more substitutions to the ring A, each of which can independently be a halogen, a lower alkyl, a lower alkenyl, a lower alkynyl, a carbonyl, a thiocarbonyl, an amino, an acylamino, an amido, a cyano, a nitro, an azido, a sulfate, a sulfonate, a sulfonamido, --(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --OH, --(CH.sub.2).sub.m --O-lower alkyl, --(CH.sub.2).sub.m --O-lower alkenyl, --(CH.sub.2).sub.n --O--(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --SH, --(CH.sub.2).sub.m --S-lower alkyl, --(CH.sub.2).sub.m --S-lower alkenyl, or --(CH.sub.2).sub.n --S--(CH.sub.2).sub.m --R.sub.7 ; R.sub.3 represents a hydrogen or a halogen, a lower alkyl, a lower alkenyl, a lower alkynyl, a carbonyl, a thiocarbonyl, an amino, an acylamino, an amido, a cyano, a nitro, an azido, a sulfate, a sulfonate, a sulfonamido, --(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --OH, --(CH.sub.2).sub.m --O-lower alkyl, --(CH.sub.2).sub.m --O-lower alkenyl, --(CH.sub.2).sub.n --O--(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --SH, --(CH.sub.2).sub.m --S-lower alkyl, --(CH.sub.2).sub.m --S-lower alkenyl, or --(CH.sub.2).sub.n --S--(CH.sub.2).sub.m --R.sub.7 ; R.sub.5 represents a hydrogen, an alkyl, an alkenyl, an alkynyl, --C(X.sub.1)(X.sub.2)X.sub.3, --(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.n --OH, --(CH.sub.2).sub.n --O-alkyl, --(CH.sub.2).sub.n --O-alkenyl, --(CH.sub.2).sub.n --O-alkynyl, --(CH.sub.2).sub.n --O--(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.n --SH, (CH.sub.2).sub.n --S-alkyl, --(CH.sub.2).sub.n --S-alkenyl, --(CH.sub.2).sub.n --S-alkynyl, --(CH.sub.2).sub.n --S(CH.sub.2).sub.m --R.sub.7, --C(O)C(O)NH.sub.2, or --C(O)C(O)OR'.sub.7 ; R.sub.7 represents, for each occurrence, a substituted or unsubstituted aryl, aralkyl, cycloalkyl, cycloalkenyl or heterocyclyl; R'.sub.7 represents, for each occurrence, hydrogen, or a substituted or unsubstituted alkyl, alkenyl, aryl, aralkyl, cycloalkyl, cycloalkenyl or heterocyclyl; R.sub.32 is a small hydrophobic group; R.sub.30 represents a C-terminally linked amino acid residue or amino acid analog, or a C-terminally linked peptide or peptide analog, or an amino-protecting group or ##STR58## R.sub.50 represents O or S; R.sub.51 represents N.sub.3, SH, NH.sub.2, NO.sub.2 or OR'.sub.7 ; R.sub.52 represents hydrogen, a lower alkyl, an amine, OR'.sub.7, or a pharmaceutically acceptable salt, or R.sub.51 and R.sub.52 taken together with the phosphorous atom to which they are attached complete a heterocyclic ring having from 5 to 8 atoms in the ring structure; X.sub.1 represents a halogen; X.sub.2 and X.sub.3 each represent a hydrogen or a halogen; m is zero or an integer in the range of 1 to 8; and n is an integer in the range of 1 to 8.

23. A method for treating Type II diabetes in an animal, comprising administering to the animal a composition including a boronyl peptidomimetic of a peptide selected from Pro-Pro, Ala-Pro, or (D)-Ala-(L)-Ala in an amount sufficient to treat the Type II diabetes, but not sufficient to suppress the immune system of the animal.

24. The method of claim 23, wherein the boronyl peptidomimetic is represented in the general formula: ##STR59##

wherein each A independently represents a 4-8 membered heterocycle including the N and a C.alpha. carbon; R.sub.2 is absent or represents one or more substitutions to the ring A, each of which can independently be a halogen, a lower alkyl, a lower alkenyl, a lower alkynyl, a carbonyl, a thiocarbonyl, an amino, an acylamino, an amido, a cyano, a nitro, an azido, a sulfate, a sulfonate, a sulfonamido, --(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --OH, --(CH.sub.2).sub.m --O-lower alkyl, --(CH.sub.2).sub.m --O-lower alkenyl, --(CH.sub.2).sub.n --O--(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --SH, --(CH.sub.2).sub.m --S-lower alkyl, --(CH.sub.2).sub.m --S-lower alkenyl, or --(CH.sub.2).sub.n --S--(CH.sub.2).sub.m --R.sub.7 ; R.sub.3 represents hydrogen or a halogen, a lower alkyl, a lower alkenyl, a lower alkynyl, a carbonyl, a thiocarbonyl, an amino, an acylamino, an amido, a cyano, a nitro, an azido, a sulfate, a sulfonate, a sulfonamido, --(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --OH, --(CH.sub.2).sub.m --O-lower alkyl, --(CH.sub.2).sub.m --O-lower alkenyl, --(CH.sub.2).sub.n --O--(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --SH, --(CH.sub.2).sub.m --S-lower alkyl, --(CH.sub.2).sub.m --S-lower alkenyl, or --(CH.sub.2).sub.n --S--(CH.sub.2).sub.m --R.sub.7 ; R.sub.6 represents hydrogen, a halogen, an alkyl, an alkenyl, an alkynyl, an aryl, --(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --OH, --(CH.sub.2).sub.m --O-alkyl, --(CH.sub.2).sub.m --O-alkenyl, --(CH.sub.2).sub.m --O-alkynyl, --(CH.sub.2).sub.m --O--(CH.sub.2).sub.m --R.sub.7, --(CH.sub.2).sub.m --SH, --(CH.sub.2).sub.m --S-alkyl, --(CH.sub.2).sub.m --S-alkenyl, --(CH.sub.2).sub.m --S-alkynyl, or --(CH.sub.2).sub.m --S--(CH.sub.2).sub.m --R.sub.7 ; R.sub.7 represents, for each occurrence, a substituted or unsubstituted aryl, aralkyl, cycloalkyl, cycloalkenyl, or heterocycle; R.sub.30 represents a C-terminally linked amino acid residue or amino acid analog, or a C-terminally linked peptide or peptide analog, or an amino-protecting group, or ##STR60## R.sub.32 and R.sub.62, independently, represent small hydrophobic groups; Y.sub.1 and Y.sub.2 can independently or together be OH, or a group capable of being hydrolyzed to a hydroxyl group, or cyclic derivatives where Y.sub.1 and Y.sub.2 are connected via a ring having from 5 to 8 atoms in the ring structure; m is zero or an integer in the range of 1 to 8; and n is an integer in the range of 1 to 8.

25. The method of claim 24, wherein administering the boronyl peptidomimetic reduces one or more of insulin resistance, glucose intolerance, hyperglycemia, hyperinsulinemia, obesity, hyperlipidemia, or hyperlipoproteinemia.

26. The method of claim 24, wherein the boronyl peptidomimetic has an EC.sub.50 for modification of glucose metabolism which is at least one order of magnitude less than its EC.sub.50 for immunosuppression.

27. The method of claim 24, wherein the boronyl peptidomimetic has an EC.sub.50 for inhibition glucose tolerance in the nanomolar or less range.

28. The method of claim 24, wherein the boronyl peptidomimetic has an EC.sub.50 for immunosuppression in the .mu.M or greater range.

29. The method of claim 24, wherein the boronyl peptidomimetic is administered orally.

30. The method of claim 10, wherein the inhibitor is administered in a single dosage.

31. The method of claim 30, wherein the total daily dosage of the inhibitor is less than 2000 mg.

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