Poly(lactic-co-glycolic) Acid-Lipid Hybrid Microparticles Enhance the Intracellular Uptake and Antibacterial Activity of Rifampicin

An urgent demand exists for the development of effective carrier systems that systematically enhance the cellular uptake and localization of antibiotic drugs for the treatment of intracellular pathogens. Commercially available antibiotics suffer from poor cellular penetration, restricting their efficacy against pathogens hosted and protected within phagocytic cells. In this study, the potency of the antibiotic rifampicin against intracellular small colony variants of Staphylococcus aureus was improved through encapsulation within a strategically engineered cell-penetrant delivery system, composed of lipid nanoparticles encapsulated within a poly(lactic-co-glycolic) acid (PLGA) nanoparticle matrix. PLGA-lipid hybrid (PLH) microparticles were synthesized through the process of spray drying, whereby rifampicin was loaded within both the polymer and lipid phases, to create a nanoparticle-in-microparticle system capable of efficient redispersion in aqueous biorelevant media and with programmable release kinetics. The ability of PLH particles to disintegrate into nanoscale agglomerates of the precursor nanoparticles was shown to be instrumental in optimizing rifampicin uptake in RAW264.7 macrophages, with a 7.2- and 1.6-fold increase in cellular uptake, when compared to the pure drug and PLGA microparticles (of an equivalent initial particle size), respectively. The enhanced phagocytosis and extended drug release mechanism (under the acidic macrophage environment) associated with PLH particles induced a 2.5-log reduction in colony forming units compared to initial colonies at 2.50 μg/mL rifampicin dose. Thus, the ability of PLH particles to reduce the intracellular viability of S. aureus, without demonstrating significant cellular toxicity, satisfies the requirements necessary for the safe and efficacious delivery of antibiotics to macrophages for the treatment of intracellular infections.

Doxorubicin-Loaded Delta Inulin Conjugates for Controlled and Targeted Drug Delivery: Development, Characterization, and In Vitro Evaluation

Delta inulin, also known as microparticulate inulin (MPI), was modified by covalently attaching doxorubicin to its nanostructured surface for use as a targeted drug delivery vehicle. MPI is readily endocytosed by monocytes, macrophages, and dendritic cells and in this study, we sought to utilize this property to develop a system to target anti-cancer drugs to lymphoid organs. We investigated, therefore, whether MPI could be used as a vehicle to deliver doxorubicin selectively, thereby reducing the toxicity of this antibiotic anthracycline drug. Doxorubicin was covalently attached to the surface of MPI using an acid–labile linkage to enable pH-controlled release. The MPI-doxorubicin conjugate was characterized using FTIR and SEM, confirming covalent attachment and indicating doxorubicin coupling had no obvious impact on the physical nanostructure, integrity, and cellular uptake of the MPI particles. To simulate the stability of the MPI-doxorubicin in vivo, it was stored in artificial lysosomal fluid (ALF, pH 4.5). Although the MPI-doxorubicin particles were still visible after 165 days in ALF, 53% of glycosidic bonds in the inulin particles were hydrolyzed within 12 days in ALF, reflected by the release of free glucose into solution. By contrast, the fructosidic bonds were much more stable. Drug release studies of the MPI-doxorubicin in vitro, demonstrated a successful pH-dependent controlled release effect. Confocal laser scanning microscopy studies and flow cytometric analysis confirmed that when incubated with live cells, MPI-doxorubicin was efficiently internalized by immune cells. An assay of cell metabolic activity demonstrated that the MPI carrier alone had no toxic effects on RAW 264.7 murine monocyte/macrophage-like cells, but exhibited anti-cancer effects against HCT116 human colon cancer cells. MPI-doxorubicin had a greater anti-cancer cell effect than free doxorubicin, particularly when at lower concentrations, suggesting a drug-sparing effect. This study establishes that MPI can be successfully modified with doxorubicin for chemotherapeutic drug delivery.

An update on polymer-lipid hybrid systems for improving oral drug delivery

INTRODUCTION

A promising approach that has recently emerged to overcome the complex biobarriers and interrelated challenges associated with oral drug absorption is to combine the benefits of polymeric and lipid-based nanocarriers within one hybrid system. This multifaceted formulation strategy has given rise to a plethora of polymer-lipid hybrid (PLH) systems with varying nanostructures and biological activities, all of which have demonstrated the ability to improve the biopharmaceutical performance of a wide range of challenging therapeutics.

AREAS COVERED

The multitude of polymers that can be combined with lipids to exert a synergistic effect for oral drug delivery have been identified, reviewed and critically evaluated. Specific focus is attributed to preclinical studies performed within the past 5 years that have elucidated the role and mechanism of the polymer phase in altering the oral absorption of encapsulated therapeutics.

EXPERT OPINION

The potential of PLH systems has been clearly identified; however, improved understanding of the structure-activity relationship between PLH systems and oral absorption is fundamental for translating this promising delivery approach into a clinically relevant formulation. Advancing research within this field to identify optimal polymer, lipid combinations and engineering conditions for specific therapeutics are therefore encouraged.

Solidification to improve the biopharmaceutical performance of SEDDS: Opportunities and challenges

Self-emulsifying drug delivery systems (SEDDS) offer potential for overcoming the inherent slow dissolution and poor oral absorption of hydrophobic drugs by retaining them in a solubilised state during gastrointestinal transit. However, the promising biopharmaceutical benefits of liquid lipid formulations has not translated into widespread commercial success, due to their susceptibility to long term storage and in vivo precipitation issues. One strategy that has emerged to overcome such limitations, is to combine the solubilisation and dissolution enhancing properties of lipids with the stabilising effects of solid carrier materials. The development of intelligent hybrid drug formulations has presented new opportunities to harness the potential of emulsified lipids in optimising oral bioavailability for lipophilic therapeutics. Specific emphasis of this review is placed on the impact of solidification approaches and excipients on the biopharmaceutical performance of self-emulsifying lipids, with findings highlighting the key design considerations that should be implemented when developing hybrid lipid-based formulations.

Engineering intelligent particle-lipid composites that control lipase-mediated digestion

Nanostructured particle-lipid composites have emerged as state-of-the-art carrier systems for poorly water-soluble bioactive molecules due to their ability to control and enhance the lipase-mediated hydrolysis of encapsulated triglycerides, leading to a subsequent improvement in the solubilisation and absorption of encapsulated species. The first generation of particle-lipid composites (i.e. silica-lipid hybrid (SLH) microparticles) were designed and fabricated by spray drying a silica nanoparticle-stabilised Pickering emulsion, to create a novel three-dimensional architecture, whereby lipid droplets were encapsulated within a porous matrix support. The development of SLH microparticles has acted as a solid foundation for the synthesis of several next generation particle-lipid composites, including polymer-lipid hybrid (PLH) and clay-lipid hybrid systems (CLH), which present lipase with unique lipid microenvironments for optimised lipolysis. This review details the methods utilised to engineer lipid hybrid particles and the strategic investigations that have been performed to determine the influence of key material characteristics on digestion enzyme activity. In doing so, this provides insight into manipulating the mechanism of lipase action through the intelligent design of lipid-based biomaterials for their use in drug delivery formulations and novel functional foods.

Selecting among three basic fitness landscape models: Additive, multiplicative and stickbreaking

Fitness landscapes map genotypes to organismal fitness. Their topographies depend on how mutational effects interact - epistasis - andare important for understanding evolutionary processes such as speciation, the rate of adaptation, the advantage of recombination, and the predictability versus stochasticity of evolution. The growing amount of data has made it possible to better test landscape models empirically. We argue that this endeavor will benefit from the development and use of meaningful basic models against which to compare more complex models. Here we develop statistical and computational methods for fitting fitness data from mutation combinatorial networks to three simple models: additive, multiplicative and stickbreaking. We employ a Bayesian framework for doing model selection. Using simulations, we demonstrate that our methods work and we explore their statistical performance: bias, error, and the power to discriminate among models. We then illustrate our approach and its flexibility by analyzing several previously published datasets. An R-package that implements our methods is available in the CRAN repository under the name Stickbreaker.

Ten month outcome of cognitive behavioural therapy v. interpersonal psychotherapy in patients with major depression: a randomised trial of acute and maintenance psychotherapy

BACKGROUND

Cognitive behaviour therapy (CBT) and interpersonal psychotherapy (IPT) are the most studied psychotherapies for treatment of depression, but they are rarely directly compared particularly over the longer term. This study compares the outcomes of patients treated with CBT and IPT over 10 months and tests whether there are differential or general predictors of outcome.

METHODS

A single centre randomised controlled trial (RCT) of depressed outpatients treated with weekly CBT or IPT sessions for 16 weeks and then 24 weeks of maintenance CBT or IPT. The principle outcome was depression severity measured using the MADRS. Pre-specified predictors of response were in four domains: demographic depression, characteristics, comorbidity and personality. Data were analysed over 16 weeks and 40 weeks using general linear mixed effects regression models.

RESULTS

CBT was significantly more effective than IPT in reducing depressive symptoms over the 10 month study largely because it appeared to work more quickly. There were no differential predictors of response to CBT v. IPT at 16 weeks or 40 weeks. Personality variables were most strongly associated with overall outcome at both 16 weeks and 40 weeks. The number of personality disorder symptoms and lower self-directness and reward dependence scores were associated with poorer outcome for both CBT and IPT at 40 weeks.

CONCLUSIONS

CBT and IPT are effective treatments for major depression over the longer term. CBT may work more quickly. Personality variables are the most relevant predictors of outcome.

Medical student attitudes towards complementary and alternative medicine (CAM) in medical education: a critical review

Background This paper aims to remedy a gap in the knowledge by presenting the first critical review of the literature on major themes relating to medical students perceptions and attitudes towards the exponentially growing field of complementary and alternative medicine (CAM). MethodsAfter a comprehensive database search of the literature, 21 papers were chosen as suitable for the review. The results from these papers were tabled and discussed. ResultsThe results indicated that medical students lacked knowledge of CAM and are generally positive towards CAM education (especially in the preclinical years, if it provided evidence of efficacy and post-placement). Medical students thought that CAM should generally be incorporated into the medical curriculum mainly so they can confidently undertake referral to CAM practitioners. Being able to communicate with future patients about their CAM use was a major motivation for medical students to learn about CAM and a factor for medical student support of further incorporation of CAM content in the medical curricula. Educational exposure to CAM in many forms and in many papers was shown to significantly affect medical student attitudes to CAM. This may be reflective of the fact that, outside direct CAM training, there may be limited accessible opportunities for medical students and if integration is to occur, educational exposure is most important. ConclusionsThe rise of CAM as a social and clinical phenomenon necessitates consideration of further inclusion of these topics in the medical curriculum, if future physicians are to be able to fully discharge their role as care providers in an increasingly medically pluralistic world. However, the inclusion of CAM needs to be done in an objective and critical manner, which is relevant to the learner.

Nanostructured Montmorillonite Clay for Controlling the Lipase-Mediated Digestion of Medium Chain Triglycerides

Biocompatible lipid hybrid particles composed of montmorillonite and medium chain triglycerides were engineered for the first time by spray drying oil-in-water emulsions stabilized by montmorillonite platelets to form montmorillonite-lipid hybrid (MLH) microparticles containing up to 75% w/w lipid. In vitro lipolysis studies under simulated intestinal conditions indicated that the specific porous nanoarchitecture and surface chemistry of MLH particles significantly increased the rate (>10-fold) and extent of lipase-mediated digestion compared to that of coarse and homogenized submicrometer triglyceride emulsions. Proton nuclear magnetic resonance studies verified the rapid and enhanced production of fatty acids for MLH particles; these are electrostatically repelled by the negatively charged montmorillonite platelet faces and avoid the "interfacial poisoning" caused by incomplete digestion that retards lipid droplet digestion. MLH particles are a novel biomaterial and encapsulation system that optimize lipase enzyme efficiency and have excellent potential as a smart delivery system for lipophilic biomolecules owing to their exceptional physicochemical and biologically active properties. These particles can be readily fabricated with varying lipid loads and thus may be tailored to optimize the solubilization of specific bioactive molecules requiring reformulation.

Planning horizon affects prophylactic decision-making and epidemic dynamics

The spread of infectious diseases can be impacted by human behavior, and behavioral decisions often depend implicitly on a planning horizon—the time in the future over which options are weighed. We investigate the effects of planning horizons on epidemic dynamics. We developed an epidemiological agent-based model (along with an ODE analog) to explore the decision-making of self-interested individuals on adopting prophylactic behavior. The decision-making process incorporates prophylaxis efficacy and disease prevalence with the individuals’ payoffs and planning horizon. Our results show that for short and long planning horizons individuals do not consider engaging in prophylactic behavior. In contrast, individuals adopt prophylactic behavior when considering intermediate planning horizons. Such adoption, however, is not always monotonically associated with the prevalence of the disease, depending on the perceived protection efficacy and the disease parameters. Adoption of prophylactic behavior reduces the epidemic peak size while prolonging the epidemic and potentially generates secondary waves of infection. These effects can be made stronger by increasing the behavioral decision frequency or distorting an individual’s perceived risk of infection.

Love the one you're with: replicate viral adaptations converge on the same phenotypic change

Parallelism is important because it reveals how inherently stochastic adaptation is. Even as we come to better understand evolutionary forces, stochasticity limits how well we can predict evolutionary outcomes. Here we sought to quantify parallelism and some of its underlying causes by adapting a bacteriophage (ID11) with nine different first-step mutations, each with eight-fold replication, for 100 passages. This was followed by whole-genome sequencing five isolates from each endpoint. A large amount of variation arose—281 mutational events occurred representing 112 unique mutations. At least 41% of the mutations and 77% of the events were adaptive. Within wells, populations generally experienced complex interference dynamics. The genome locations and counts of mutations were highly uneven: mutations were concentrated in two regulatory elements and three genes and, while 103 of the 112 (92%) of the mutations were observed in ≤4 wells, a few mutations arose many times. 91% of the wells and 81% of the isolates had a mutation in the D-promoter. Parallelism was moderate compared to previous experiments with this system. On average, wells shared 27% of their mutations at the DNA level and 38% when the definition of parallel change is expanded to include the same regulatory feature or residue. About half of the parallelism came from D-promoter mutations. Background had a small but significant effect on parallelism. Similarly, an analyses of epistasis between mutations and their ancestral background was significant, but the result was mostly driven by four individual mutations. A second analysis of epistasis focused on de novo mutations revealed that no isolate ever had more than one D-promoter mutation and that 56 of the 65 isolates lacking a D-promoter mutation had a mutation in genes D and/or E. We assayed time to lysis in four of these mutually exclusive mutations (the two most frequent D-promoter and two in gene D) across four genetic backgrounds. In all cases lysis was delayed. We postulate that because host cells were generally rare (i.e., high multiplicity of infection conditions developed), selection favored phage that delayed lysis to better exploit their current host (i.e., ‘love the one you’re with’). Thus, the vast majority of wells (at least 64 of 68, or 94%) arrived at the same phenotypic solution, but through a variety of genetic changes. We conclude that answering questions about the range of possible adaptive trajectories, parallelism, and the predictability of evolution requires attention to the many biological levels where the process of adaptation plays out.

Partition structures and sufficient statistics

Is the Ewens distribution the only one-parameter family of partition structures where the total number of types sampled is a sufficient statistic? In general, the answer is no. It is shown that all counterexamples can be generated via an urn scheme. The urn scheme need only satisfy two general conditions. In fact, the conditions are both necessary and sufficient. However, in particular, for a large class of partition structures that naturally arise in the infinite alleles theory of population genetics, the Ewens distribution is the only one in this class where the total number of types is sufficient for estimating the mutation rate. Finally, asymptotic sufficiency for parametric families of partition structures is discussed.

Robustness of the Ewens sampling formula

Under the assumptions of the neutral infinite alleles model,K(the total number of alleles present in a sample) is sufficient for estimatingθ(the mutation rate). This is a direct result of the Ewens sampling formula, which gives a consistent, asymptotically normal estimator forθbased onK. It is shown that the same estimator used to estimateθunder neutrality is consistent and asymptotically normal, even when the assumption of selective neutrality is violated.

Likelihood ratios for the infinite alleles model

The stationary distribution for the population frequencies under an infinite alleles model is described as a random sequence (x1,x2, · ··) such that Σxi= 1. Likelihood ratio theory is developed for random samples drawn from such populations. As a result of the theory, it is shown that any parameter distinguishing an infinite alleles model with selection from the neutral infinite alleles model cannot be consistently estimated based on gene frequencies at a single locus. Furthermore, the likelihood ratio (neutral versus selection) converges to a non-trivial random variable under both hypotheses. This shows that if one wishes to test a completely specified infinite alleles model with selection against neutrality, the test will not obtain power 1 in the limit.

A convergence theorem for symmetric functionals of random partitions

This paper gives general conditions under which symmetric functionals of random partitions of the integer m converge in distribution as m → ∞. The main result is used to settle a conjecture of Donnelly et al. (1991) to the effect that the mean of the sum of the square roots of the relative sizes of the components of a random mapping of m integers converges to π/2 as m → ∞.

Estimating the frequency of the oldest allele: a bayesian approach

In this paper we calculate posterior distributions associated with a version of the Poisson–Dirichlet distribution called the GEM. The GEM has been shown (by several authors) to be the limiting stationary distribution for allele frequencies listed in age order associated with the neutral infinite alleles model. In view of this result, we use our posterior distributions to calculate Bayes estimators for the frequency of the oldest allele given a sample.

Consistent ordered sampling distributions: characterization and convergence

This paper is concerned with models for sampling from populations in which there exists a total order on the collection of types, but only the relative ordering of types which actually appear in the sample is known. The need for consistency between different sample sizes limits the possible models to what are here called ‘consistent ordered sampling distributions'. We give conditions under which weak convergence of population distributions implies convergence of sampling distributions and conversely those under which population convergence may be inferred from convergence of sampling distributions. A central result exhibits a collection of ‘ordered sampling functions', none of which is continuous, which separates measures in a certain class. More generally, we characterize all consistent ordered sampling distributions, proving an analogue of de Finetti's theorem in this context. These results are applied to an unsolved problem in genetics where it is shown that equilibrium age-ordered population allele frequencies for a wide class of exchangeable reproductive models converge weakly, as the population size becomes large, to the so-called GEM distribution. This provides an alternative characterization which is more informative and often more convenient than Kingman's (1977) characterization in terms of the Poisson–Dirichlet distribution.

Genetically Determined Variation in Lysis Time Variance in the Bacteriophage φX174

Researchers in evolutionary genetics recently have recognized an exciting opportunity in decomposing beneficial mutations into their proximal, mechanistic determinants. The application of methods and concepts from molecular biology and life history theory to studies of lytic bacteriophages (phages) has allowed them to understand how natural selection sees mutations influencing life history. This work motivated the research presented here, in which we explored whether, under consistent experimental conditions, small differences in the genome of bacteriophage φX174 could lead to altered life history phenotypes among a panel of eight genetically distinct clones. We assessed the clones' phenotypes by applying a novel statistical framework to the results of a serially sampled parallel infection assay, in which we simultaneously inoculated each of a large number of replicate host volumes with ∼1 phage particle. We sequentially plated the volumes over the course of infection and counted the plaques that formed after incubation. These counts served as a proxy for the number of phage particles in a single volume as a function of time. From repeated assays, we inferred significant, genetically determined heterogeneity in lysis time and burst size, including lysis time variance. These findings are interesting in light of the genetic and phenotypic constraints on the single-protein lysis mechanism of φX174. We speculate briefly on the mechanisms underlying our results, and we discuss the potential importance of lysis time variance in viral evolution.