1
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Islam N, Reid D. Inhaled antibiotics: A promising drug delivery strategies for efficient treatment of lower respiratory tract infections (LRTIs) associated with antibiotic resistant biofilm-dwelling and intracellular bacterial pathogens. Respir Med 2024; 227:107661. [PMID: 38729529 DOI: 10.1016/j.rmed.2024.107661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/12/2024]
Abstract
Antibiotic-resistant bacteria associated with LRTIs are frequently associated with inefficient treatment outcomes. Antibiotic-resistant Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, and Staphylococcus aureus, infections are strongly associated with pulmonary exacerbations and require frequent hospital admissions, usually following failed management in the community. These bacteria are difficult to treat as they demonstrate multiple adaptational mechanisms including biofilm formation to resist antibiotic threats. Currently, many patients with the genetic disease cystic fibrosis (CF), non-CF bronchiectasis (NCFB) and chronic obstructive pulmonary disease (COPD) experience exacerbations of their lung disease and require high doses of systemically administered antibiotics to achieve meaningful clinical effects, but even with high systemic doses penetration of antibiotic into the site of infection within the lung is suboptimal. Pulmonary drug delivery technology that reliably deliver antibacterials directly into the infected cells of the lungs and penetrate bacterial biofilms to provide therapeutic doses with a greatly reduced risk of systemic adverse effects. Inhaled liposomal-packaged antibiotic with biofilm-dissolving drugs offer the opportunity for targeted, and highly effective antibacterial therapeutics in the lungs. Although the challenges with development of some inhaled antibiotics and their clinicals trials have been studied; however, only few inhaled products are available on market. This review addresses the current treatment challenges of antibiotic-resistant bacteria in the lung with some clinical outcomes and provides future directions with innovative ideas on new inhaled formulations and delivery technology that promise enhanced killing of antibiotic-resistant biofilm-dwelling bacteria.
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Affiliation(s)
- Nazrul Islam
- Pharmacy Discipline, School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, QLD, Australia; Centre for Immunology and Infection Control (CIIC), Queensland University of Technology, Brisbane, Queensland, Australia; Centre for Materials Science, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - David Reid
- Lung Inflammation and Infection, QIMR Berghofer Medical Research Institute, Australia
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2
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Wang Q, Bu C, Dai Q, Chen J, Zhang R, Zheng X, Ren H, Xin X, Li X. Recent Progress in Nucleic Acid Pulmonary Delivery toward Overcoming Physiological Barriers and Improving Transfection Efficiency. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2309748. [PMID: 38460157 PMCID: PMC11095210 DOI: 10.1002/advs.202309748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/04/2024] [Indexed: 03/11/2024]
Abstract
Pulmonary delivery of therapeutic agents has been considered the desirable administration route for local lung disease treatment. As the latest generation of therapeutic agents, nucleic acid has been gradually developed as gene therapy for local diseases such as asthma, chronic obstructive pulmonary diseases, and lung fibrosis. The features of nucleic acid, specific physiological structure, and pathophysiological barriers of the respiratory tract have strongly affected the delivery efficiency and pulmonary bioavailability of nucleic acid, directly related to the treatment outcomes. The development of pharmaceutics and material science provides the potential for highly effective pulmonary medicine delivery. In this review, the key factors and barriers are first introduced that affect the pulmonary delivery and bioavailability of nucleic acids. The advanced inhaled materials for nucleic acid delivery are further summarized. The recent progress of platform designs for improving the pulmonary delivery efficiency of nucleic acids and their therapeutic outcomes have been systematically analyzed, with the application and the perspectives of advanced vectors for pulmonary gene delivery.
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Affiliation(s)
- Qiyue Wang
- School of Pharmaceutical ScienceNanjing Tech UniversityNanjing211816China
- NMPA Key Laboratory for Research and Evaluation of Pharmaceutical Preparation and ExcipientsNanjing210009China
| | - Chaozhi Bu
- Wuxi Maternity and Child Health Care HospitalAffiliated Women's Hospital of Jiangnan UniversityWuxi214002China
| | - Qihao Dai
- School of Pharmaceutical ScienceNanjing Tech UniversityNanjing211816China
| | - Jinhua Chen
- NMPA Key Laboratory for Research and Evaluation of Pharmaceutical Preparation and ExcipientsNanjing210009China
- Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs, Department of PharmaceuticsChina Pharmaceutical UniversityNanjing210009China
| | - Ruitao Zhang
- NMPA Key Laboratory for Research and Evaluation of Pharmaceutical Preparation and ExcipientsNanjing210009China
- Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs, Department of PharmaceuticsChina Pharmaceutical UniversityNanjing210009China
| | - Xiaomin Zheng
- Wuxi Maternity and Child Health Care HospitalAffiliated Women's Hospital of Jiangnan UniversityWuxi214002China
| | - Hao Ren
- School of Pharmaceutical ScienceNanjing Tech UniversityNanjing211816China
| | - Xiaofei Xin
- Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs, Department of PharmaceuticsChina Pharmaceutical UniversityNanjing210009China
| | - Xueming Li
- School of Pharmaceutical ScienceNanjing Tech UniversityNanjing211816China
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3
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Zhang L, Bera H, Guo Y, Shi C, Ulrik Lind J, Radeke C, Wang J, Wang H, Zhao X, Cun D, Yang M. Co-spray dried inhalable composite powders of ciprofloxacin and alginate oligosaccharide as anti-biofilm therapy. Int J Pharm 2024; 654:123949. [PMID: 38417723 DOI: 10.1016/j.ijpharm.2024.123949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 02/25/2024] [Accepted: 02/25/2024] [Indexed: 03/01/2024]
Abstract
The treatment of chronic respiratory infections caused by biofilm formation are extremely challenging owing to poor drug penetration into the complex biofilm structure and high drug resistance. Local delivery of an antibiotic together with a non-antibiotic adjuvant to the lungs could often enhance the therapeutic responses by targeting different bacterial growth pathways and minimizing drug resistance. In this study, we designed new inhalable dry powders containing ciprofloxacin (CIP) and OligoG (Oli, a low-molecular-weight alginate oligosaccharide impairing the mucoid biofilms by interacting with their cationic ions) to combat respiratory bacterial biofilm infections. The resulting powders were characterized with respect to their morphology, solid-state property, surface chemistry, moisture sorption behavior, and dissolution rate. The aerosol performance and storage stability of the dry powders were also evaluated. The results showed that inhalable dry powders composed of CIP and Oli could be readily accomplished via the wet milling and spray drying process. Upon the storage under 20 ± 2 °C/20 ± 2 % relative humidity (RH) for one month, there was no significant change in the in vitro aerosol performances of the dry powders. In contrast, the dry powders became non-inhalable following the storage at 20 ± 2 °C/53 ± 2 % RH for one month due to the hygroscopic nature of Oli, which could be largely prevented by incorporation of leucine. Collectively, this study suggests that the newly developed co-spray-dried powders composed of CIP and Oli might represent a promising and alternative treatment strategy against respiratory bacterial biofilm infections.
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Affiliation(s)
- Li Zhang
- Wuya College of Innovation, Shenyang Pharmaceutical University, Wenhua Road, No. 103, 110016 Shenyang, China; Joint International Research Laboratory of Intelligent Drug Delivery Systems, Ministry of Education, China; Lanzhou Institute of Biological Products Co., Ltd, Lanzhou, China
| | - Hriday Bera
- Dr. B.C. Roy College of Pharmacy & Allied Health Sciences, Durgapur, India
| | - Yi Guo
- Wuya College of Innovation, Shenyang Pharmaceutical University, Wenhua Road, No. 103, 110016 Shenyang, China; Joint International Research Laboratory of Intelligent Drug Delivery Systems, Ministry of Education, China; Taiyuan Health School, Taiyuan, China
| | - Changzhi Shi
- Wuya College of Innovation, Shenyang Pharmaceutical University, Wenhua Road, No. 103, 110016 Shenyang, China; Joint International Research Laboratory of Intelligent Drug Delivery Systems, Ministry of Education, China
| | - Johan Ulrik Lind
- Department of Health Technology (DTU Health Tech), Technical University of Denmark, Lyngby, Denmark
| | - Carmen Radeke
- Department of Health Technology (DTU Health Tech), Technical University of Denmark, Lyngby, Denmark
| | - Junwei Wang
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Hengzhuang Wang
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Henrik Harpestrengsvej 4A, DK-2100 Copenhagen, Denmark; Department of Immunology and Microbiology, University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen, Denmark
| | - Xia Zhao
- Key Laboratory of Marine Drugs, Ministry of Education, Shandong Provincial Key Laboratory of Glycoscience and Glycoengineering, School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China
| | - Dongmei Cun
- Wuya College of Innovation, Shenyang Pharmaceutical University, Wenhua Road, No. 103, 110016 Shenyang, China; Joint International Research Laboratory of Intelligent Drug Delivery Systems, Ministry of Education, China.
| | - Mingshi Yang
- Wuya College of Innovation, Shenyang Pharmaceutical University, Wenhua Road, No. 103, 110016 Shenyang, China; Joint International Research Laboratory of Intelligent Drug Delivery Systems, Ministry of Education, China; Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark.
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4
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Knap K, Reczyńska-Kolman K, Kwiecień K, Niewolik D, Płonka J, Ochońska D, Jeleń P, Mielczarek P, Kazek-Kęsik A, Jaszcz K, Brzychczy-Włoch M, Pamuła E. Poly(sebacic acid) microparticles loaded with azithromycin as potential pulmonary drug delivery system: Physicochemical properties, antibacterial behavior, and cytocompatibility studies. BIOMATERIALS ADVANCES 2023; 153:213540. [PMID: 37429048 DOI: 10.1016/j.bioadv.2023.213540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/12/2023]
Abstract
Recurrent bacterial infections are a common cause of death for patients with cystic fibrosis and chronic obstructive pulmonary disease. Herein, we present the development of the degradable poly(sebacic acid) (PSA) microparticles loaded with different concentrations of azithromycin (AZ) as a potential powder formulation to deliver AZ locally to the lungs. We characterized microparticle size, morphology, zeta potential, encapsulation efficiency, interaction PSA with AZ and degradation profile in phosphate buffered saline (PBS). The antibacterial properties were evaluated using the Kirby-Bauer method against Staphylococcus aureus. Potential cytotoxicity was evaluated in BEAS-2B and A549 lung epithelial cells by the resazurin reduction assay and live/dead staining. The results show that microparticles are spherical and their size, being in the range of 1-5 μm, should be optimal for pulmonary delivery. The AZ encapsulation efficiency is nearly 100 % for all types of microparticles. The microparticles degradation rate is relatively fast - after 24 h their mass decreased by around 50 %. The antibacterial test showed that released AZ was able to successfully inhibit bacteria growth. The cytotoxicity test showed that the safe concentration of both unloaded and AZ-loaded microparticles was equal to 50 μg/ml. Thus, appropriate physicochemical properties, controlled degradation and drug release, cytocompatibility, and antibacterial behavior showed that our microparticles may be promising for the local treatment of lung infections.
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Affiliation(s)
- Karolina Knap
- AGH University of Science and Technology, Faculty of Materials Science and Ceramics, Department of Biomaterials and Composites, Al. Mickiewicza 30, 30-059 Kraków, Poland
| | - Katarzyna Reczyńska-Kolman
- AGH University of Science and Technology, Faculty of Materials Science and Ceramics, Department of Biomaterials and Composites, Al. Mickiewicza 30, 30-059 Kraków, Poland
| | - Konrad Kwiecień
- AGH University of Science and Technology, Faculty of Materials Science and Ceramics, Department of Biomaterials and Composites, Al. Mickiewicza 30, 30-059 Kraków, Poland
| | - Daria Niewolik
- Silesian University of Technology, Faculty of Chemistry, Department of Physical Chemistry and Technology of Polymers, ul. M. Strzody 9, 44-100 Gliwice, Poland
| | - Joanna Płonka
- Silesian University of Technology, Faculty of Chemistry, Department of Inorganic Chemistry, Analytical Chemistry and Electrochemistry, ul. Krzywoustego 6, Gliwice 44-100, Poland
| | - Dorota Ochońska
- Jagiellonian University Medical College, Faculty of Medicine, Chair of Microbiology, Department of Molecular Medical Microbiology, ul. Św. Anny 12, 31-121 Kraków, Poland
| | - Piotr Jeleń
- AGH University of Science and Technology, Faculty of Materials Science and Ceramics, Department of Silicate Chemistry and Macromolecular Compounds, Al. Mickiewicza 30, 30-059 Kraków, Poland
| | - Przemysław Mielczarek
- AGH University of Science and Technology, Faculty of Materials Science and Ceramics, Department of Analytical Chemistry and Biochemistry, Al. Mickiewicza 30, 30-059 Kraków, Poland
| | - Alicja Kazek-Kęsik
- Silesian University of Technology, Faculty of Chemistry, Department of Inorganic Chemistry, Analytical Chemistry and Electrochemistry, ul. Krzywoustego 6, Gliwice 44-100, Poland
| | - Katarzyna Jaszcz
- Silesian University of Technology, Faculty of Chemistry, Department of Physical Chemistry and Technology of Polymers, ul. M. Strzody 9, 44-100 Gliwice, Poland
| | - Monika Brzychczy-Włoch
- Jagiellonian University Medical College, Faculty of Medicine, Chair of Microbiology, Department of Molecular Medical Microbiology, ul. Św. Anny 12, 31-121 Kraków, Poland
| | - Elżbieta Pamuła
- AGH University of Science and Technology, Faculty of Materials Science and Ceramics, Department of Biomaterials and Composites, Al. Mickiewicza 30, 30-059 Kraków, Poland.
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Wang Z, Hao A, Xing P. Halogen Interaction Effects on Chiral Self-Assemblies on Cyclodipeptide Scaffolds Across Hierarchy. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023; 19:e2302517. [PMID: 37165600 DOI: 10.1002/smll.202302517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/27/2023] [Indexed: 05/12/2023]
Abstract
How halogenation affects protein or peptide folding and self-assembly hierarchically? This study tries to answer this question by using the halogen bonding mediated self-assemblies on cyclodipeptide scaffolds. Single-functionalized cyclodipeptides (Cyclo-GX) based on para-halogenated phenylalanine in the solid state form homochiral helical nanotubes via consecutive X···O bonds (X = Cl, Br, and I) independent of halogen kinds. In contrast, double-functionalized cyclodipeptides (Cyclo-XX) feature versatile self-assembly architectures depending on the para-substituents (X = H, F, Cl, Br, and I), affording nanotubular, lamellar, and triple helical nanotubular architectures. Cyclo-BrBr exclusively adopts intramolecular Type-IV X···X interaction that alters the molecular folding and packing, which also gives rise to opposite chirality at molecular folding (secondary structure), stacking (tertiary structure), and self-assembled nanohelices (quarternary structure) at macroscopic scale. It unveils how halogenation impacts on the self-assembly and chirality at hierarchical levels in specific peptides. Clusteroluminescence is found for the cyclodipeptides, achieving high quantum yield up to 71%, whereby circularly polarized luminescence is realized with tunable handedness by controlling halogen substituents.
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Affiliation(s)
- Zhuoer Wang
- Key Laboratory of Colloid and Interface Chemistry of Ministry of Education, School of Chemistry and Chemical Engineering, Shandong University, Jinan, 250100, P. R. China
| | - Aiyou Hao
- Key Laboratory of Colloid and Interface Chemistry of Ministry of Education, School of Chemistry and Chemical Engineering, Shandong University, Jinan, 250100, P. R. China
| | - Pengyao Xing
- Key Laboratory of Colloid and Interface Chemistry of Ministry of Education, School of Chemistry and Chemical Engineering, Shandong University, Jinan, 250100, P. R. China
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6
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Ahmed S, Mansour M, Ishak RAH, Mortada ND. Customizable Resveratrol Spray-dried Micro-composites for Inhalation as a Promising Contender for Treatment of Idiopathic Pulmonary Fibrosis. Int J Pharm 2023:123117. [PMID: 37315636 DOI: 10.1016/j.ijpharm.2023.123117] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/16/2023]
Abstract
The past decades have witnessed tremendous expansion in utilization of plant-derived medicines as resveratrol (RES) in treating several diseases like idiopathic pulmonary fibrosis (IPF). RES can exhibit its role in treating IPF via its outstanding antioxidant and anti-inflammatory activities. The goal of this work was to formulate RES-loaded spray-dried composite microparticles (SDCMs) suitable for pulmonary delivery via dry powder inhaler (DPI). They were prepared by spray drying of a previously prepared RES-loaded bovine serum albumin nanoparticles (BSA NPs) dispersion using different carriers. RES-loaded BSA NPs, prepared by the desolvation technique, acquired suitable particle size of 177.67±0.95 nm and entrapment efficiency of 98.7±0.35% with perfectly uniform size distribution and high stability. Considering the attributes of the pulmonary route, NPs were co-spray dried with compatible carriers viz. mannitol, dextran, trehalose, leucine, glycine, aspartic acid, and glutamic acid to fabricate SDCMs. All formulations showed suitable mass median aerodynamic diameter less than 5 µm; that is suitable for deep lung deposition. However, the best aerosolization behavior was attained from using leucine with fine particle fraction (FPF) of 75.74%, followed by glycine with FPF of 54.7%. Finally, a pharmacodynamic study was conducted on bleomycin-induced mice, and it strongly revealed the role of the optimized formulations in alleviating PF through suppressing the levels of hydroxyproline, tumor necrosis factor-α and matrix metalloproteinase-9 with obvious improvements in the treated lung histopathology. These findings indicate that in addition to leucine, the glycine amino acid, which is not commonly used yet, is very promising in the formulation of DPIs.
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Affiliation(s)
- Sara Ahmed
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, Postal Code 11566, Cairo, Egypt
| | - Mai Mansour
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, Postal Code 11566, Cairo, Egypt
| | - Rania A H Ishak
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, Postal Code 11566, Cairo, Egypt.
| | - Nahed D Mortada
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, Postal Code 11566, Cairo, Egypt
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7
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Parveen S, Ali MS, Al-Lohedan HA, Hoti N, Tabassum S. Molecular interaction of lysozyme with therapeutic drug azithromycin: Effect of sodium dodecyl sulfate on binding profile. Int J Biol Macromol 2023; 242:124844. [PMID: 37210056 DOI: 10.1016/j.ijbiomac.2023.124844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/22/2023]
Abstract
This paper describes an inclusive biophysical study elucidating the interaction of therapeutic drug azithromycin (Azith) with hen egg white lysozyme (HEWL). Spectroscopic and computational tools have been employed to study the interaction of Azith with HEWL at pH 7.4. The fluorescence quenching constant values (Ksv) exhibited a decrease with the increase in temperature which revealed the occurrence of static quenching mechanism between Azith and HEWL. The thermodynamic data demonstrated that hydrophobic interactions were predominantly involved in the Azith-HEWL interaction. The negative value of standard Gibbs free energy (ΔG°) stated that the Azith-HEWL complex formed via spontaneous molecular interactions. The effect of sodium dodecyl sulfate (SDS) surfactant monomers on the binding propensity of Azith with HEWL was insignificant at lower concentrations however the binding significantly decreased at increased concentrations of the former. Far-UV CD data revealed alteration in the secondary structure of HEWL in the presence of Azith and the overall HEWL conformation changed. Molecular docking results revealed that the binding of Azith with HEWL takes place through hydrophobic interactions and hydrogen bonds.
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Affiliation(s)
- Sabiha Parveen
- Department of Chemistry, Aligarh Muslim University, Aligarh 202002, India
| | - Mohd Sajid Ali
- Department of Chemistry, College of Sciences, King Saud University, Riyadh 11451, the Kingdom of Saudi Arabia
| | - Hamad A Al-Lohedan
- Department of Chemistry, College of Sciences, King Saud University, Riyadh 11451, the Kingdom of Saudi Arabia
| | | | - Sartaj Tabassum
- Department of Chemistry, Aligarh Muslim University, Aligarh 202002, India.
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8
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Efficacy and Safety of Integrated Maxing Shigan Decoction and Azithromycin for Mycoplasma Pneumoniae Pneumonia in Children: A Systematic Review and Meta-Analysis. J Clin Pharm Ther 2023. [DOI: 10.1155/2023/2596562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background. The primary objective of this study was to thoroughly assess the effectiveness of treating pediatric mycoplasma pneumoniae pneumonia (MPP) with Maxing Shigan decoction (MSD) and azithromycin. Materials and Methods. We comprehensively reviewed the literature for randomized controlled trials research on MPP treated by MSD combined with azithromycin in children in the databases of Medicine, Embase, ClinicalTrials.gov, Cochrane Library, PubMed, CNKI, WangFang, and VIP from inception to April 2021. dds ratio (OR) was used for dichotomous data, while the mean difference (MD) was adopted for continuous variables as effect size, both of which were demonstrated in effect size and 95% confidence intervals (CI). Results. A total of 49 studies with 5704 patients were included in the meta-analysis. The results showed that MSD combined with azithromycin significantly improved the clinical efficacy (OR = 5.31, 95% CI: (4.35, 6.49), and
) and reduced the chest X-rays recovery time (MD = −2.25, 95% CI: (−2.86, −1.65), and
), cough duration (MD = −2.53, 95% CI: (−2.93. −2.12), and
), CRP (MD = −7.84, 95% CI: (−9.51, −6.17), and
), fever duration (MD = −1.53, 95% CI: (−1.78, −1.28), and
), hospital days (MD = −2.70, 95% CI: (−3.35, −2.06), and
), moist rales duration (MD = −2.00, 95% CI: (−2.33, −1.68), and
), and adverse effects (OR = 0.55, 95% CI: (0.41, 0.75), and
) when compared with azithromycin alone in the treatment of MPP in children. Meta-regression analysis demonstrated that the course of disease and duration of medication contribute to the heterogeneity across studies when comparing outcomes between groups. Conclusion. MSD and azithromycin worked better when used in conjunction to treat MPP in young patients. These findings require confirmation by additional high-quality, big sample RCTs.
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Wang Q, Liu J, Chen D, Miao S, Wen J, Liu C, Xue S, Liu Y, Zhang Q, Shen Y. "Cluster Bomb" Based Bismuth Nano-in-Micro Spheres Formed Dry Powder Inhalation for Thermo-Radio Sensitization Effects of Lung Metastatic Breast Cancer. Adv Healthc Mater 2023; 12:e2202622. [PMID: 36601733 DOI: 10.1002/adhm.202202622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/24/2022] [Indexed: 01/06/2023]
Abstract
Lung metastatic breast cancer (LMBC) is mainly diagnosed through CT imaging and radiotherapy could be the most common method in the clinic to inhibit tumor proliferation. While the sensitivity of radiotherapy is always limited due to the hypoxic tumor microenvironment and high doses of irradiation easily induce systemic cytotoxicity. Metal-based materials applied as radiosensitizers have been widely investigated to improve efficiency and reduce the doses of irradiation. Herein, it is aimed to overcome these problems by designing biodegradable lipid-camouflaged bismuth-based nanoflowers (DP-BNFs) as both a photo-thermo-radiosensitizer to develop a novel photothermal therapy (PTT) and radiotherapy combination strategy for LMBC treatment. To achieve effective lung deposition, "Cluster Bomb" structure-based DP-BNFs nano-in-micro dry powder inhalation (DP-BNF@Lat-MPs) are formulated through spray-dried technology. The DP-BNFs "cluster" in the microsphere to improve their tumor-targeted lung deposition with a high fine particle fraction followed by burst releasing of DP-BNFs for targeting delivery and LMBC therapy. The DP-BNF@Lat-MPs exhibit excellent photothermal conversion efficiency, radiotherapy enhancement, and CT imaging ability in vitro, which synergistically inhibit cell proliferation and metastasis. In vitro and in vivo data prove that combining PTT and radiotherapy with DP-BNF@Lat-MPs as a thermo-radio dual-sensitizer significantly enhances LMBC tumor metastasis inhibition with good biocompatibility and low toxicity.
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Affiliation(s)
- Qiyue Wang
- School of Pharmaceutical Science, Nanjing Tech University, Nanjing, 211816, China
| | - Ji Liu
- Department of Pharmaceutics, State Key Laboratory of Nature Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Daquan Chen
- School of Pharmacy, Yantai University, 30 Qingquan Road, Yantai, 264005, China
| | - Si Miao
- Department of Pharmaceutics, State Key Laboratory of Nature Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Jing Wen
- Department of Pharmaceutics, State Key Laboratory of Nature Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Chang Liu
- Department of Pharmaceutics, State Key Laboratory of Nature Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Shushu Xue
- Department of Pharmacy, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Yang Liu
- Department of Pharmaceutics, State Key Laboratory of Nature Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Qingjie Zhang
- Department of Pharmaceutics, State Key Laboratory of Nature Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Yan Shen
- Department of Pharmaceutics, State Key Laboratory of Nature Medicines, China Pharmaceutical University, Nanjing, 210009, China
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10
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Li G, Liu D, Zuo YY. Nano-bio Interactions in the Lung. Nanomedicine (Lond) 2023. [DOI: 10.1007/978-981-16-8984-0_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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11
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Zhang Y, Fei X, Zhang X, Bao W, Han L, Xue Y, Hao H, Zhou X, Zhang M. Adipose-derived mesenchymal stem cells suppress ozone-mediated airway inflammation in a mouse model of chronic obstructive pulmonary disease. Mol Immunol 2022; 151:95-102. [PMID: 36113365 DOI: 10.1016/j.molimm.2022.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/03/2022] [Accepted: 08/28/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE AND DESIGN Ozone exposure is an important risk factor for Chronic Obstructive Pulmonary Disease (COPD) which is a global public health concern. Until now, there is no effective approach to reverse airflow limitation and accelerated loss of lung function completely. Here, we delineate the efficacy of mouse allogeneic adipose-derived mesenchymal stem cells (mASCs) in the treatment of COPD mice by intratracheal and intravenous administration. METHODS In this study, we established ozone-exposed COPD model in mice and were administered intratracheally or intravenously with mASCs which were extracted, cultured, and identified in vitro. RESULTS We observed that exposure to ozone resulted in a marked lung neutrophilia with high levels of inflammatory cell counts, enhanced expression of cytokines IL-1β and TNF-α, reduced expression of IL-10, lung function and airspace enlargement. mASCs intratracheal administration rescured the lung neutrophilia, lung function and emphysema-like phenotype. Similar results were observed in mice with mASCs intravenous administration. But the altered levels of serum cytokines in mice with mASCs intratracheal administration appears more robust than those in mice with mASCs intravenous administration. CONCLUSIONS Collectively, these data indicate that intratracheal administration of mASCs appears more effective in treating ozone-induced COPD compared to intravenous administration of mASCs, although the two approaches can be comparable in safety. mASCs are expected to become a new potential intervention strategy for COPD.
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Affiliation(s)
- Yingying Zhang
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xia Fei
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xue Zhang
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wuping Bao
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Han
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yishu Xue
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huijuan Hao
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Zhou
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Zhang
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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12
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Purushotham M, Paul B. Iodinated Diketopiperazines: Synthesis and Biological Evaluation of Iodinated Analogues of Cyclo(L‐Tyrosine‐L‐Tyrosine) Peptides. ChemistrySelect 2022. [DOI: 10.1002/slct.202201120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Affiliation(s)
- Manasa Purushotham
- Department of Chemistry Jnana Bharathi Campus Bangalore University Bangalore 560056 India
| | - Bishwajit Paul
- Department of Chemistry Jnana Bharathi Campus Bangalore University Bangalore 560056 India
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13
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Kumar M, Jha A, Bharti K, Parmar G, Mishra B. Advances in lipid-based pulmonary nanomedicine for the management of inflammatory lung disorders. Nanomedicine (Lond) 2022; 17:913-934. [PMID: 35451334 DOI: 10.2217/nnm-2021-0389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Inflammatory lung disorders have become one of the fastest growing global healthcare concerns, with more than 500 million annual cases of disorders such as chronic obstructive pulmonary disease, asthma and pulmonary fibrosis. Owing to environmental changes and socioeconomic disparity, the numbers are expected to grow even more in years to come. The therapeutic strategies and approved drugs currently employed in the management of inflammatory lung disorders show dose-dependent resistance and pharmacokinetic limitations. This review comprehensively discusses lipid-based pulmonary nanomedicine as a potential platform to overcome these barriers while ensuring site-specific drug delivery and minimal side effects in nontargeted tissues for the management of noninfectious inflammatory lung disorders.
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Affiliation(s)
- Manish Kumar
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, Uttar Pradesh, 221005, India
| | - Abhishek Jha
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, Uttar Pradesh, 221005, India
| | - Kanchan Bharti
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, Uttar Pradesh, 221005, India
| | - Gourav Parmar
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, Uttar Pradesh, 221005, India
| | - Brahmeshwar Mishra
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, Uttar Pradesh, 221005, India
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14
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Combination and nanotechnology based pharmaceutical strategies for combating respiratory bacterial biofilm infections. Int J Pharm 2022; 616:121507. [PMID: 35085729 DOI: 10.1016/j.ijpharm.2022.121507] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/31/2021] [Accepted: 01/20/2022] [Indexed: 12/14/2022]
Abstract
Respiratory infections are one of the major global health problems. Among them, chronic respiratory infections caused by biofilm formation are difficult to treat because of both drug tolerance and poor drug penetration into the complex biofilm structure. A major part of the current research on combating respiratory biofilm infections have been focused on destroying the matrix of extracellular polymeric substance and eDNA of the biofilm or promoting the penetration of antibiotics through the extracellular polymeric substance via delivery technologies in order to kill the bacteria inside. There are also experimental data showing that certain inhaled antibiotics with simple formulations can effectively penetrate EPS to kill surficially located bacteria and centrally located dormant bacteria or persisters. This article aims to review recent advances in the pharmaceutical strategies for combating respiratory biofilm infections with a focus on nanotechnology-based drug delivery approaches. The formation and characteristics of bacterial biofilm infections in the airway mucus are presented, which is followed by a brief review on the current clinical approaches to treat respiratory biofilm infections by surgical removal and antimicrobial therapy, and also the emerging clinical treatment approaches. The current combination of antibiotics and non-antibiotic adjuvants to combat respiratory biofilm infections are also discussed.
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15
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Nano-Bio Interactions in the Lung. Nanomedicine (Lond) 2022. [DOI: 10.1007/978-981-13-9374-7_14-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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16
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Excipient-Free Inhalable Microparticles of Azithromycin Produced by Electrospray: A Novel Approach to Direct Pulmonary Delivery of Antibiotics. Pharmaceutics 2021; 13:pharmaceutics13121988. [PMID: 34959270 PMCID: PMC8704604 DOI: 10.3390/pharmaceutics13121988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/08/2021] [Accepted: 11/16/2021] [Indexed: 11/16/2022] Open
Abstract
Inhalation therapy offers several advantages in respiratory disease treatment. Azithromycin is a macrolide antibiotic with poor solubility and bioavailability but with a high potential to be used to fight lung infections. The main objective of this study was to generate a new inhalable dry powder azithromycin formulation. To this end, an electrospray was used, yielding a particle size around 2.5 µm, which is considered suitable to achieve total deposition in the respiratory system. The physicochemical properties and morphology of the obtained microparticles were analysed with a battery of characterization techniques. In vitro deposition assays were evaluated after aerosolization of the powder at constant flow rate (100 L/min) and the consideration of the simulation of two different realistic breathing profiles (healthy and chronic obstructive pulmonary disease (COPD) patients) into a next generation impactor (NGI). The formulation was effective in vitro against two types of bacteria, Staphylococcus aureus and Pseudomonas aeruginosa. Finally, the particles were biocompatible, as evidenced by tests on the alveolar cell line (A549) and bronchial cell line (Calu-3).
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17
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Su R, Zhang Y, Zhang J, Wang H, Luo Y, Chan HF, Tao Y, Chen Z, Li M. Nanomedicine to advance the treatment of bacteria-induced acute lung injury. J Mater Chem B 2021; 9:9100-9115. [PMID: 34672317 DOI: 10.1039/d1tb01770e] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Bacteria-induced acute lung injury (ALI) is associated with a high mortality rate due to the lack of an effective treatment. Patients often rely on supportive care such as low tidal volume ventilation to alleviate the symptoms. Nanomedicine has recently received much attention owing to its premium benefits of delivering drugs in a sustainable and controllable manner while minimizing the potential side effects. It can effectively improve the prognosis of bacteria-induced ALI through targeted delivery of drugs, regulation of multiple inflammatory pathways, and combating antibiotic resistance. Hence, in this review, we first discuss the pathogenesis of ALI and its potential therapeutics. In particular, the state-of-the-art nanomedicines for the treatment of bacteria-induced ALI are highlighted, including their administration routes, in vivo distribution, and clearance. Furthermore, the available bacteria-induced ALI animal models are also summarized. In the end, future perspectives of nanomedicine for ALI treatment are proposed.
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Affiliation(s)
- Ruonan Su
- Center for Nanomedicine, Department of Pediatrics and Department of Allergy, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China. .,Laboratory of Biomaterials and Translational Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| | - Yu Zhang
- Department of Biological and Environmental Engineering, Cornell University, Ithaca 14853, USA
| | - Jiabin Zhang
- Center for Nanomedicine, Department of Pediatrics and Department of Allergy, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.
| | - Haixia Wang
- Center for Nanomedicine, Department of Pediatrics and Department of Allergy, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China. .,Laboratory of Biomaterials and Translational Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| | - Yun Luo
- Department of Urology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
| | - Hon Fai Chan
- Institute for Tissue Engineering and Regenerative Medicine, School of Biomedical Science, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Yu Tao
- Center for Nanomedicine, Department of Pediatrics and Department of Allergy, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China. .,Laboratory of Biomaterials and Translational Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| | - Zhuanggui Chen
- Center for Nanomedicine, Department of Pediatrics and Department of Allergy, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.
| | - Mingqiang Li
- Center for Nanomedicine, Department of Pediatrics and Department of Allergy, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China. .,Laboratory of Biomaterials and Translational Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.,Guangdong Provincial Key Laboratory of Liver Disease Research, Guangzhou 510630, China
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18
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Monou PK, Andriotis EG, Bouropoulos N, Panteris E, Akrivou M, Vizirianakis IS, Ahmad Z, Fatouros DG. Engineered mucoadhesive microparticles of formoterol/budesonide for pulmonary administration. Eur J Pharm Sci 2021; 165:105955. [PMID: 34298141 DOI: 10.1016/j.ejps.2021.105955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 07/13/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
In the present study, a multi-component system comprised of dipalmitylphospatidylcholine (DPPC), Chitosan, Lactose, and L-Leucine was developed for pulmonary delivery. Microparticles were engineered by the spray drying process and the selection of the critical parameters was performed by applying experimental design. The microcarriers with the appropriate size and yield were co-formulated with two active pharmaceutical ingredients (APIs), namely, Formoterol fumarate and Budesonide, and they were further investigated. All formulations exhibited spherical shape, appropriate aerodynamic performance, satisfying entrapment efficiency, and drug load. Their physicochemical properties were evaluated using Scanning Electron Microscopy (SEM), Fourier Transform Infrared Spectroscopy (FT-IR), and Differential Scanning Calorimetry (DSC). The aerodynamic particle size characterization was determined using an eight-stage Andersen cascade impactor, whereas the release of the actives was monitored in vitro in simulated lung fluid. Additional evaluation of the microparticles' mucoadhesive properties was performed by ζ-potential measurements and ex vivo mucoadhesion study applying a falling liquid film method using porcine lung tissue. Cytotoxicity and cellular uptake studies in Calu-3 lung epithelial cell line were conducted to further investigate the safety and efficacy of the developed formulations.
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Affiliation(s)
- Paraskevi Kyriaki Monou
- Department of Pharmacy, Division of Pharmaceutical Technology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Eleftherios G Andriotis
- Department of Pharmacy, Division of Pharmaceutical Technology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
| | - Nikolaos Bouropoulos
- Department of Materials Science, University of Patras, 26504 Rio, Patras, Greece; Foundation for Research and Technology Hellas, Institute of Chemical Engineering and High Temperature Chemical Processes, 26504 Patras, Greece
| | - Emmanuel Panteris
- Department of Botany, School of Biology, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece
| | - Melpomeni Akrivou
- Department of Pharmacy, Division of Pharmacology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ioannis S Vizirianakis
- Department of Pharmacy, Division of Pharmacology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; Department of Life and Health Sciences, University of Nicosia, CY-1700 Nicosia, Cyprus
| | - Zeeshan Ahmad
- Leicester School of Pharmacy, De Montfort University, Leicester, LE1 9BH, UK
| | - Dimitrios G Fatouros
- Department of Pharmacy, Division of Pharmaceutical Technology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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19
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Balachandra C, Padhi D, Govindaraju T. Cyclic Dipeptide: A Privileged Molecular Scaffold to Derive Structural Diversity and Functional Utility. ChemMedChem 2021; 16:2558-2587. [PMID: 33938157 DOI: 10.1002/cmdc.202100149] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Indexed: 12/11/2022]
Abstract
Cyclic dipeptides (CDPs) are the simplest form of cyclic peptides with a wide range of applications from therapeutics to biomaterials. CDP is a versatile molecular platform endowed with unique properties such as conformational rigidity, intermolecular interactions, structural diversification through chemical synthesis, bioavailability and biocompatibility. A variety of natural products with the CDP core exhibit anticancer, antifungal, antibacterial, and antiviral activities. The inherent bioactivities have inspired the development of synthetic analogues as drug candidates and drug delivery systems. CDP plays a crucial role as conformation and molecular assembly directing core in the design of molecular receptors, peptidomimetics and fabrication of functional material architectures. In recent years, CDP has rapidly become a privileged scaffold for the design of advanced drug candidates, drug delivery agents, bioimaging, and biomaterials to mitigate numerous disease conditions. This review describes the structural diversification and multifarious biomedical applications of the CDP scaffold, discusses challenges, and provides future directions for the emerging field.
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Affiliation(s)
- Chenikkayala Balachandra
- Bioorganic Chemistry Laboratory, New Chemistry Unit and School of Advanced materials (SAMat), Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur P.O., Bangalore, 560064, India
| | - Dikshaa Padhi
- Bioorganic Chemistry Laboratory, New Chemistry Unit and School of Advanced materials (SAMat), Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur P.O., Bangalore, 560064, India
| | - Thimmaiah Govindaraju
- Bioorganic Chemistry Laboratory, New Chemistry Unit and School of Advanced materials (SAMat), Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur P.O., Bangalore, 560064, India
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20
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Chen X, Guo R, Wang C, Li K, Jiang X, He H, Hong W. On-demand pH-sensitive surface charge-switchable polymeric micelles for targeting Pseudomonas aeruginosa biofilms development. J Nanobiotechnology 2021; 19:99. [PMID: 33836750 PMCID: PMC8034112 DOI: 10.1186/s12951-021-00845-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 03/26/2021] [Indexed: 12/16/2022] Open
Abstract
Bacterial biofilm is the complicated clinical issues, which usually results in bacterial resistance and reduce the therapeutic efficacy of antibiotics. Although micelles have been drawn attention in treatment of the biofilms, the micelles effectively permeate and retain in biofilms still facing a big challenge. In this study, we fabricated on-demand pH-sensitive surface charge-switchable azithromycin (AZM)-encapsulated micelles (denoted as AZM-SCSMs), aiming to act as therapeutic agent for treating Pseudomonas aeruginosa (P. aeruginosa) biofilms. The AZM-SCSMs was composed of poly(l-lactide)-polyetherimide-hyd-methoxy polyethylene glycol (PLA-PEI-hyd-mPEG). It was noteworthy that the pH-sensitive acylhydrazone bond could be cleaved in acidic biofilm microenvironment, releasing the secondary AZM-loaded cationic micelles based on PLA-PEI (AZM-SCMs) without destroying the micellar integrity, which could tailor drug-bacterium interaction using micelles through electrostatic attraction. The results proved that positively charged AZM-SCMs could facilitate the enhanced penetration and retention inside biofilms, improved binding affinity with bacterial membrane, and added drug internalization, thus characterized as potential anti-biofilm agent. The excellent in vivo therapeutic performance of AZM-SCSMs was confirmed by the targeting delivery to the infected tissue and reduced bacterial burden in the abscess-bearing mice model. This study not only developed a novel method for construction non-depolymerized pH-sensitive SCSMs, but also provided an effective means for the treatment of biofilm-related infections. ![]()
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Affiliation(s)
- Xiangjun Chen
- School of Pharmacy, Shandong New Drug Loading & Release Technology and Preparation Engineering Laboratory, Binzhou Medical University, 346 Guanhai Road, Yantai, 264003, People's Republic of China
| | - Rong Guo
- School of Pharmacy, Shandong New Drug Loading & Release Technology and Preparation Engineering Laboratory, Binzhou Medical University, 346 Guanhai Road, Yantai, 264003, People's Republic of China
| | - Changrong Wang
- School of Pharmacy, Shandong New Drug Loading & Release Technology and Preparation Engineering Laboratory, Binzhou Medical University, 346 Guanhai Road, Yantai, 264003, People's Republic of China
| | - Keke Li
- School of Pharmacy, Shandong New Drug Loading & Release Technology and Preparation Engineering Laboratory, Binzhou Medical University, 346 Guanhai Road, Yantai, 264003, People's Republic of China
| | - Xinyu Jiang
- School of Pharmacy, Shandong New Drug Loading & Release Technology and Preparation Engineering Laboratory, Binzhou Medical University, 346 Guanhai Road, Yantai, 264003, People's Republic of China
| | - Huayu He
- School of Pharmacy, Shandong New Drug Loading & Release Technology and Preparation Engineering Laboratory, Binzhou Medical University, 346 Guanhai Road, Yantai, 264003, People's Republic of China
| | - Wei Hong
- School of Pharmacy, Shandong New Drug Loading & Release Technology and Preparation Engineering Laboratory, Binzhou Medical University, 346 Guanhai Road, Yantai, 264003, People's Republic of China.
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21
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Mansour BS, Salem NA, Kader GA, Abdel-Alrahman G, Mahmoud OM. Protective effect of Rosuvastatin on Azithromycin induced cardiotoxicity in a rat model. Life Sci 2021; 269:119099. [PMID: 33476632 PMCID: PMC7816566 DOI: 10.1016/j.lfs.2021.119099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/09/2021] [Accepted: 01/14/2021] [Indexed: 12/23/2022]
Abstract
AIMS Azithromycin is widely used broad spectrum antibiotic recently used in treatment protocol of COVID-19 for its antiviral and immunomodulatory effects combined with Hydroxychloroquine or alone. Rat models showed that Azithromycin produces oxidative stress, inflammation, and apoptosis of myocardial tissue. Rosuvastatin, a synthetic statin, can attenuate myocardial ischemia with antioxidant and antiapoptotic effects. This study aims to evaluate the probable protective effect of Rosuvastatin against Azithromycin induced cardiotoxicity. MAIN METHOD Twenty adult male albino rats were divided randomly into four groups, five rats each control, Azithromycin, Rosuvastatin, and Azithromycin +Rosuvastatin groups. Azithromycin 30 mg/kg/day and Rosuvastatin 2 mg/kg/day were administrated for two weeks by an intragastric tube. Twenty-four hours after the last dose, rats were anesthetized and the following measures were carried out; Electrocardiogram, Blood samples for Biochemical analysis of lactate dehydrogenase (LDH), and creatine phosphokinase (CPK). The animals sacrificed, hearts excised, apical part processed for H&E, immunohistochemical staining, and examined by light microscope. The remaining parts of the heart were collected for assessment of Malondialdehyde (MDA) and Reduced Glutathione (GSH). KEY FINDINGS The results revealed that Rosuvastatin significantly ameliorates ECG changes, biochemical, and Oxidative stress markers alterations of Azithromycin. Histological evaluation from Azithromycin group showed marked areas of degeneration, myofibers disorganization, inflammatory infiltrate, and hemorrhage. Immunohistochemical evaluation showed significant increase in both Caspase 3 and Tumor necrosis factor (TNF) immune stain. Rosuvastatin treated group showed restoration of the cardiac muscle fibers in H&E and Immunohistochemical results. SIGNIFICANCE We concluded that Rosuvastatin significantly ameliorates the toxic changes of Azithromycin on the heart.
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Affiliation(s)
- Basma S Mansour
- Anatomy Department, Faculty of Medicine, Suez Canal University, Egypt
| | - Noha A Salem
- Anatomy Department, Faculty of Medicine, Suez Canal University, Egypt
| | - Ghada Abdel Kader
- Anatomy Department, Faculty of Medicine, Suez Canal University, Egypt
| | | | - Omayma M Mahmoud
- Anatomy Department, Faculty of Medicine, Suez Canal University, Egypt.
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22
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Scolari IR, Volpini X, Fanani ML, La Cruz-Thea BD, Natali L, Musri MM, Granero GE. Exploring the Toxicity, Lung Distribution, and Cellular Uptake of Rifampicin and Ascorbic Acid-Loaded Alginate Nanoparticles as Therapeutic Treatment of Lung Intracellular Infections. Mol Pharm 2021; 18:807-821. [PMID: 33356316 DOI: 10.1021/acs.molpharmaceut.0c00692] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Nanotechnology is a very promising technological tool to combat health problems associated with the loss of effectiveness of currently used antibiotics. Previously, we developed a formulation consisting of a chitosan and tween 80-decorated alginate nanocarrier that encapsulates rifampicin and the antioxidant ascorbic acid (RIF/ASC), intended for the treatment of respiratory intracellular infections. Here, we investigated the effects of RIF/ASC-loaded NPs on the respiratory mucus and the pulmonary surfactant. In addition, we evaluated their cytotoxicity for lung cells in vitro, and their biodistribution on rat lungs in vivo after their intratracheal administration. Findings herein demonstrated that RIF/ASC-loaded NPs display a favorable lung biocompatibility profile and a uniform distribution throughout lung lobules. RIF/ASC-loaded NPs were mainly uptaken by lung macrophages, their primary target. In summary, findings show that our novel designed RIF/ASC NPs could be a suitable system for antibiotic lung administration with promising perspectives for the treatment of pulmonary intracellular infections.
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Affiliation(s)
- Ivana R Scolari
- UNITEFA, CONICET and Departamento de Ciencias Farmacéuticas, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba X5000HUA, Argentina
| | - Ximena Volpini
- Instituto de Investigación Médica Mercedes y Martín Ferreyra, Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional de Córdoba (INIMEC-CONICET-UNC), Córdoba X5000HUA, Argentina
| | - María L Fanani
- Departamento de Química Biológica Ranwel Caputto, Facultad de Ciencias Químicas. Universidad Nacional de Córdoba, Córdoba X5000HUA, Argentina
- Centro de Investigaciones en Química Biológica de Córdoba (CIQUIBIC), CONICET, Córdoba X5000HUA, Argentina
| | - Benjamín De La Cruz-Thea
- Instituto de Investigación Médica Mercedes y Martín Ferreyra, Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional de Córdoba (INIMEC-CONICET-UNC), Córdoba X5000HUA, Argentina
| | - Lautaro Natali
- Instituto de Investigación Médica Mercedes y Martín Ferreyra, Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional de Córdoba (INIMEC-CONICET-UNC), Córdoba X5000HUA, Argentina
| | - Melina M Musri
- Instituto de Investigación Médica Mercedes y Martín Ferreyra, Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional de Córdoba (INIMEC-CONICET-UNC), Córdoba X5000HUA, Argentina
- Facultad de Ciencias Exactas Físicas y Naturales, Universidad Nacional de Córdoba, Córdoba X5000HUA, Argentina
| | - Gladys E Granero
- UNITEFA, CONICET and Departamento de Ciencias Farmacéuticas, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba X5000HUA, Argentina
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23
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Thubelihle Ndebele R, Yao Q, Shi YN, Zhai YY, Xu HL, Lu CT, Zhao YZ. Progress in the Application of Nano- and Micro-based Drug Delivery Systems in Pulmonary Drug Delivery. BIO INTEGRATION 2021. [DOI: 10.15212/bioi-2021-0028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Nanotechnology is associated with the development of particles in the nano-size range that can be used in a wide range of applications in the medical field. It has gained more importance in the pharmaceutical research field particularly in drug delivery, as it results in enhanced therapeutic drug performance, improved drug solubility, targeted drug delivery to the specific sites, minimized side effects, and prolonged drug retention time in the targeted site. To date, the application of nanotechnology continues to offer several benefits in the treatment of various chronic diseases and results in remarkable improvements in treatment outcomes. The use of nano-based delivery systems such as liposomes, micelles, and nanoparticles in pulmonary drug delivery have shown to be a promising strategy in achieving drug deposition and maintained controlled drug release in the lungs. They have been widely used to minimize the risks of drug toxicity in vivo. In this review, recent advances in the application of nano- and micro-based delivery systems in pulmonary drug delivery for the treatment of various pulmonary diseases, such as lung cancer, asthma, and chronic obstructive pulmonary disease, are highlighted. Limitations in the application of these drug delivery systems and some key strategies in improving their formulation properties to overcome challenges encountered in drug delivery are also discussed.
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Affiliation(s)
| | - Qing Yao
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - Yan-Nan Shi
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - Yuan-Yuan Zhai
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - He-Lin Xu
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - Cui-Tao Lu
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - Ying-Zheng Zhao
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou 325035, China
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24
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Bianchera A, Buttini F, Bettini R. Micro/nanosystems and biomaterials for controlled delivery of antimicrobial and anti-biofilm agents. Expert Opin Ther Pat 2020; 30:983-1000. [PMID: 33078643 DOI: 10.1080/13543776.2020.1839415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Microbial resistance is a severe problem for clinical practice due to misuse of antibiotics that promotes the development of surviving strategies by bacteria and fungi. Microbial cells surrounded by a self-produced polymer matrix, defined as biofilms, are inherently more difficult to eradicate. Biofilms endow bacteria with a unique resistance against antibiotics and other anti-microbial agents and play a crucial role in chronic infection. AREAS COVERED Biofilm-associated antimicrobial resistance in the lung and wounds. Existing inhaled therapies for treatment of biofilm-associated lung infections. Role of pharmaceutical nanotechnologies to fight resistant microbes and biofilms. EXPERT OPINION The effectiveness of antibiotics has gradually decreased due to the onset of resistance phenomena. The formation of biofilms represents one of the most important steps in the development of resistance to antimicrobial treatment. The most obvious solution for overcoming this criticality would be the discovery of new antibiotics. However, the number of new molecules with antimicrobial activity brought into clinical development has considerably decreased. In the last decades the development of innovative drug delivery systems, in particular those based on nanotechnological platforms, has represented the most effective and economically affordable approach to optimize the use of available antibiotics, improving their effectiveness profile. Abbreviations AZT: Aztreonam; BAT: Biofilm antibiotic tolerance; CF: Cystic Fibrosis; CIP: Ciprofloxacin; CRS: Chronic Rhinosinusitis; DPPG: 1,2-dipalmytoyl-sn-glycero-3-phosphoglycerol; DSPC: 1,2-distearoyl-sn-glycero-phosphocholine sodium salt; EPS: extracellular polymeric substance; FEV1: Forced Expiratory Volume in the first second; GSNO: S-nitroso-glutathione; LAE: lauroyl arginate ethyl; MIC: Minimum inhibitory Concentration; NCFB: Non-Cystic Fibrosis Bronchiectasis; NTM: Non-Tuberculous Mycobacteria; NTM-LD: Non-tuberculous mycobacteria Lung Disease PA: Pseudomonas aeruginosa; pDMAEMA: poly(dimethylaminoethyl methacrylate);pDMAEMA-co-PAA-co-BMA: poly(dimethylaminoethyl methacrylate)-co-propylacrylic acid-co-butyl methacrylate; PEG: polyethylene glycol; PEGDMA: polyethylene glycol dimethacrylate;PCL: Poly-ε-caprolactone; PLA: poly-lactic acid; PLGA: poly-lactic-co-glycolic acid; PVA: poli-vinyl alcohol; SA: Staphylococcus aureus; TIP: Tobramycin Inhalation Powder; TIS: Tobramycin Inhalation Solution; TPP: Tripolyphosphate.
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Affiliation(s)
| | | | - Ruggero Bettini
- Food and Drug Department, University of Parma , Parma, Italy
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Gao Y, Wang J, Chai M, Li X, Deng Y, Jin Q, Ji J. Size and Charge Adaptive Clustered Nanoparticles Targeting the Biofilm Microenvironment for Chronic Lung Infection Management. ACS NANO 2020; 14:5686-5699. [PMID: 32320228 DOI: 10.1021/acsnano.0c00269] [Citation(s) in RCA: 154] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Chronic lung infection caused by bacterial biofilms is an extremely serious clinical problem, which can lead to the failure of antibiotic therapy. Although nanoparticles have shown great potential in the treatment of biofilms, the efficient penetration and retention of nanoparticles in biofilms is still a big challenge. To address this issue, we herein fabricate size and charge adaptive azithromycin (AZM)-conjugated clustered nanoparticles (denoted as AZM-DA NPs) as therapeutic agents for treating biofilms. The AZM-DA NPs are prepared by electrostatic complexation between AZM conjugated amino-ended poly(amidoamine) dendrimer (PAMAM) and 2,3-dimethyl maleic anhydride (DA) modified poly(ethylene glycol)-block-polylysine (PEG-b-PLys). It is noteworthy that the AZM-DA NPs can disassemble in an acidic biofilm microenvironment (pH 6.0), leading to the release of secondary AZM-conjugated PAMAM nanoparticles (PAMAM-AZM NPs). PAMAM-AZM NPs with small size and positive charge are beneficial for improved penetration and retention inside biofilms, enhanced permeabilization of the bacterial membrane, and increased internalization of AZM, thus exhibiting excellent antibiofilm activities. AZM-DA NPs are also favorable as long-term antibacterial agents due to the reduced occurrence of drug resistance. In vivo therapeutic performance is confirmed by the reduced bacterial burden and the alleviated inflammation in the chronic lung infection model. This research not only develops an innovative strategy for antibiotic delivery in vivo but also provides an effective way for the management of biofilm-associated infections, including chronic lung infection.
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Affiliation(s)
- Yifan Gao
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, P. R. China
| | - Jing Wang
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, P. R. China
| | - Mengying Chai
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, P. R. China
| | - Xu Li
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, P. R. China
| | - Yongyan Deng
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, P. R. China
| | - Qiao Jin
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, P. R. China
| | - Jian Ji
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, P. R. China
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Tatara AM. Role of Tissue Engineering in COVID-19 and Future Viral Outbreaks. Tissue Eng Part A 2020; 26:468-474. [PMID: 32272857 PMCID: PMC7249458 DOI: 10.1089/ten.tea.2020.0094] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 02/06/2023] Open
Abstract
In light of the current novel coronavirus (COVID-19) pandemic, as well as other viral outbreaks in the 21st century, there is a dire need for new diagnostic and therapeutic strategies to combat infectious diseases worldwide. As a convergence science, tissue engineering has traditionally focused on the application of engineering principles to biological systems, collaboration across disciplines, and rapid translation of technologies from the benchtop to the bedside. Given these strengths, tissue engineers are particularly well suited to apply their skill set to the current crisis and viral outbreaks in general. This work introduces the basics of virology and epidemiology for tissue engineers, and highlights important developments in the field of tissue engineering relevant to the current pandemic, including in vitro model systems, vaccine technology, and small-molecule drug delivery. COVID-19 serves as a call to arms for scientists across all disciplines, and tissue engineers are well trained to be leaders and contributors in this time of need. Impact statement Given the steep mortality caused by the recent novel coronavirus (COVID-19) pandemic, there is clear need for advances in diagnostics and therapeutics for viral outbreaks. Tissue engineering has the potential for critical impact on clinical outcomes in viral outbreaks. Tissue engineers, if mobilized, could play key roles as leaders in the outbreak, given their ability to apply engineering principles to biological processes, experience in collaborative environments, and penchant for technological translation from benchtop to bedside. In this work, three areas pioneered by tissue engineers that could be applied to the current COVID-19 crisis and future viral outbreaks are highlighted.
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Affiliation(s)
- Alexander M. Tatara
- Department of Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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Pontes JF, Grenha A. Multifunctional Nanocarriers for Lung Drug Delivery. NANOMATERIALS 2020; 10:nano10020183. [PMID: 31973051 PMCID: PMC7074870 DOI: 10.3390/nano10020183] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/15/2020] [Accepted: 01/17/2020] [Indexed: 12/14/2022]
Abstract
Nanocarriers have been increasingly proposed for lung drug delivery applications. The strategy of combining the intrinsic and more general advantages of the nanostructures with specificities that improve the therapeutic outcomes of particular clinical situations is frequent. These include the surface engineering of the carriers by means of altering the material structure (i.e., chemical modifications), the addition of specific ligands so that predefined targets are reached, or even the tuning of the carrier properties to respond to specific stimuli. The devised strategies are mainly directed at three distinct areas of lung drug delivery, encompassing the delivery of proteins and protein-based materials, either for local or systemic application, the delivery of antibiotics, and the delivery of anticancer drugs-the latter two comprising local delivery approaches. This review addresses the applications of nanocarriers aimed at lung drug delivery of active biological and pharmaceutical ingredients, focusing with particular interest on nanocarriers that exhibit multifunctional properties. A final section addresses the expectations regarding the future use of nanocarriers in the area.
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Affiliation(s)
- Jorge F. Pontes
- Centre for Marine Sciences (CCMAR), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal;
- Drug Delivery Laboratory, Centre for Biomedical Research (CBMR), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - Ana Grenha
- Centre for Marine Sciences (CCMAR), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal;
- Drug Delivery Laboratory, Centre for Biomedical Research (CBMR), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
- Department of Chemistry and Pharmacy, Faculty of Sciences and Technology, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
- Correspondence: ; Tel.: +351-289-244-441; Fax: +351-289-800-066
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Xia Y, Su Y, Wang Q, Yang C, Tang B, Zhang Y, Tu J, Shen Y. Preparation, characterization, and pharmacodynamics of insulin-loaded fumaryl diketopiperazine microparticle dry powder inhalation. Drug Deliv 2019; 26:650-660. [PMID: 31257946 PMCID: PMC6609328 DOI: 10.1080/10717544.2019.1631408] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose: With the increase of population aging and the proportion of overweight and obese, a growing number of people are suffering from diabetes. Insulin (INS) as the most widely used hypoglycemic agent was always chosen as the most effective treatment method of diabetes. In this study, fumaryl diketopiperazine (FDKP) was used as a carrier for the pulmonary delivery of insulin. Patients and methods: The INS-loaded FDKP microspheres (INS@FDKP-MPs) were prepared by spray drying and physicochemical properties (drug loading, particle size, flowability, moisture content, morphology, and crystalline state) were further investigated. Pharmacodynamics was investigated on diabetic model rats administrated by intratracheal insufflation. Results: The INS-loaded FDKP microspheres show satisfied flowability and in vitro deposition with FPF 50.2% and MMAD 3.45 ± 0.13 μm, and the blood glucose level was significantly decreased. Moreover, no inflammatory reaction was observed during the safety study. Conclusion: To sum up, the aim was to develop a non-injection system for insulin, INS@FDKP-MPs powder inhalation with high dose, low toxicity, and good lung deposition inhalation could rapidly decrease the blood glucose level without immune stimulation, which shows remarkably potential on diabetes treatment by pulmonary delivery route.
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Affiliation(s)
- Yun Xia
- a Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs , China Pharmaceutical University , Nanjing , China.,b State Key Laboratory of Nature Medicines, Department of Pharmaceutics , China Pharmaceutical University , Nanjing , China
| | - Yipeng Su
- a Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs , China Pharmaceutical University , Nanjing , China.,b State Key Laboratory of Nature Medicines, Department of Pharmaceutics , China Pharmaceutical University , Nanjing , China
| | - Qiyue Wang
- a Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs , China Pharmaceutical University , Nanjing , China.,b State Key Laboratory of Nature Medicines, Department of Pharmaceutics , China Pharmaceutical University , Nanjing , China
| | - Chen Yang
- a Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs , China Pharmaceutical University , Nanjing , China
| | - Baoqiang Tang
- a Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs , China Pharmaceutical University , Nanjing , China.,b State Key Laboratory of Nature Medicines, Department of Pharmaceutics , China Pharmaceutical University , Nanjing , China
| | - Yue Zhang
- a Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs , China Pharmaceutical University , Nanjing , China.,b State Key Laboratory of Nature Medicines, Department of Pharmaceutics , China Pharmaceutical University , Nanjing , China
| | - Jiasheng Tu
- a Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs , China Pharmaceutical University , Nanjing , China.,b State Key Laboratory of Nature Medicines, Department of Pharmaceutics , China Pharmaceutical University , Nanjing , China
| | - Yan Shen
- a Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs , China Pharmaceutical University , Nanjing , China.,b State Key Laboratory of Nature Medicines, Department of Pharmaceutics , China Pharmaceutical University , Nanjing , China
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Balachandra C, Govindaraju T. Cyclic Dipeptide-Guided Aggregation-Induced Emission of Naphthalimide and Its Application for the Detection of Phenolic Drugs. J Org Chem 2019; 85:1525-1536. [DOI: 10.1021/acs.joc.9b02580] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Chenikkayala Balachandra
- Bioorganic Chemistry Laboratory, New Chemistry Unit and School of Advanced Materials (SAMat), Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur P.O., Bengaluru, Karnataka 560064, India
| | - Thimmaiah Govindaraju
- Bioorganic Chemistry Laboratory, New Chemistry Unit and School of Advanced Materials (SAMat), Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur P.O., Bengaluru, Karnataka 560064, India
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Kong Y, Cai H, Xing H, Ren C, Kong D, Ning C, Li N, Zhao D, Chen X, Lu Y. Pulmonary delivery alters the disposition of raloxifene in rats. ACTA ACUST UNITED AC 2019; 72:185-196. [PMID: 31730290 DOI: 10.1111/jphp.13201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/26/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Pulmonary delivery is an effective way to improve the bioavailability of drugs with extensive metabolism. This research was designed to study the different pharmacokinetic behaviours of small molecule drug after pulmonary delivery and intragastric (i.g) administration. METHODS Raloxifene, a selective estrogen receptor modulator with low oral bioavailability (~2%), was chosen as the model drug. Studies were conducted systematically in rats, including plasma pharmacokinetics, excretion, tissue distribution and metabolism. KEY FINDINGS Results showed that raloxifene solution dosed by intratracheal (i.t) administration exhibited relatively quick plasma elimination (t1/2 = 1.78 ± 0.14 h) and undetected absorption process, which was similar with intravenous injection. Compared with i.g administration, the bioavailability increased by 58 times, but the major route of excretion remained faecal excretion. Drug concentration on the bone and the target efficiency were improved by 49.6 times and five times, respectively. Benefited from quick elimination in the lung, chronic toxicity might be ignored. CONCLUSIONS Pulmonary administration improved the bioavailability of raloxifene and further increased the distribution on the target organ (bone), with no obvious impact on its excretory pattern.
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Affiliation(s)
- Ying Kong
- Clinical Pharmacokinetics Laboratory, China Pharmaceutical University, Nanjing, China.,Yantai Key Laboratory of Nanomedicine & Advanced Preparations, Yantai Institute of Materia Medica, Shandong, China
| | - Hui Cai
- Clinical Pharmacokinetics Laboratory, China Pharmaceutical University, Nanjing, China
| | - Han Xing
- Clinical Pharmacokinetics Laboratory, China Pharmaceutical University, Nanjing, China
| | - Chang Ren
- Clinical Pharmacokinetics Laboratory, China Pharmaceutical University, Nanjing, China
| | - Dexuan Kong
- Clinical Pharmacokinetics Laboratory, China Pharmaceutical University, Nanjing, China
| | - Chen Ning
- Clinical Pharmacokinetics Laboratory, China Pharmaceutical University, Nanjing, China
| | - Ning Li
- Clinical Pharmacokinetics Laboratory, China Pharmaceutical University, Nanjing, China
| | - Di Zhao
- Clinical Pharmacokinetics Laboratory, China Pharmaceutical University, Nanjing, China
| | - Xijing Chen
- Clinical Pharmacokinetics Laboratory, China Pharmaceutical University, Nanjing, China
| | - Yang Lu
- Clinical Pharmacokinetics Laboratory, China Pharmaceutical University, Nanjing, China
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Fumaryl diketopiperazine based effervescent microparticles to escape macrophage phagocytosis for enhanced treatment of pneumonia via pulmonary delivery. Biomaterials 2019; 228:119575. [PMID: 31677394 DOI: 10.1016/j.biomaterials.2019.119575] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/18/2019] [Accepted: 10/18/2019] [Indexed: 11/20/2022]
Abstract
The treatment of pulmonary infections with antibiotics administered via pulmonary delivery provides for higher local therapeutic efficacy rather than through systemic administration. Pneumonia is globally considered a major cause of death due to a lack of proper medication. The treatment of pneumonia with inhalable antibiotics (such as azithromycin (AZM)) can provide a maximum pulmonary therapeutic effect without significant systemic side effects. Compared to non-effervescent microparticles, effervescent microparticles can provide an active driving force to release loaded antibiotics for subsequent distribution deep into the lung by virtue of its smaller size. In this study, N-fumaroylated diketopiperazine (FDKP) was used as a carrier to prepare effervescent inhalable microparticles loaded with AZM (AZM@FDKP-E-MPs). This effervescent dry powder was characterized for both in vitro and in vivo deposition in the lung and the results obtained showed significant improvement in lung deposition and anti-bacterial efficiency, suggesting a strong potential application for pneumonia treatment.
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Altube MJ, Martínez MMB, Malheiros B, Maffía PC, Barbosa LRS, Morilla MJ, Romero EL. Fast Biofilm Penetration and Anti-PAO1 Activity of Nebulized Azithromycin in Nanoarchaeosomes. Mol Pharm 2019; 17:70-83. [DOI: 10.1021/acs.molpharmaceut.9b00721] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Maria Julia Altube
- Nanomedicine Research and Development Centre, Science and Technology Department, National University of Quilmes, 1876 Bernal, Buenos Aires, Argentina
| | - Melina M. B. Martínez
- Laboratorio de Microbiología Molecular, Instituto de Microbiología Básica y Aplicada, Universidad Nacional de Quilmes, 1876 Bernal, Buenos Aires, Argentina
| | - Barbara Malheiros
- Institute of Physics, University of São Paulo (USP), 05508-900 São Paulo, Brazil
| | - Paulo C. Maffía
- Laboratorio de Microbiología Molecular, Instituto de Microbiología Básica y Aplicada, Universidad Nacional de Quilmes, 1876 Bernal, Buenos Aires, Argentina
| | | | - Maria Jose Morilla
- Nanomedicine Research and Development Centre, Science and Technology Department, National University of Quilmes, 1876 Bernal, Buenos Aires, Argentina
| | - Eder Lilia Romero
- Nanomedicine Research and Development Centre, Science and Technology Department, National University of Quilmes, 1876 Bernal, Buenos Aires, Argentina
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Duan X, Wang K, Wu J, Zhang D, Liu X, Ni M, Liu S, Meng Z. Comparative efficacy of Chinese herbal injections combined with azithromycin for mycoplasma pneumonia in children: A Bayesian network meta-analysis of randomized controlled trials. J Clin Pharm Ther 2019; 44:675-684. [PMID: 31119782 PMCID: PMC6852301 DOI: 10.1111/jcpt.12855] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 02/06/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE An increasing macrolide resistance leads to complex clinical treatment schemes in mycoplasma pneumonia in children. Chinese herbal injection (CHI) is widely used to treat it and may provide a new treatment regimen. This study was conducted to systematically evaluate the efficacy of CHIs combined with azithromycin for treating mycoplasma pneumonia in children by Bayesian network meta-analysis. METHODS Randomized controlled trials (RCTs) of CHIs combined with azithromycin for mycoplasma pneumonia in children were searched in electronic databases and related references from initiation to 30 October 2018. Two researchers conducted data extraction and risk of bias assessment. WinBUGS software and STATA software were adopted to analyse the data. RESULTS A total of 167 RCTs were included with 5 CHIs involving 16 144 patients. All CHIs combined with azithromycin had superior effects than azithromycin only among overall outcomes. Yanhuning injection combined with azithromycin ranked highest in four different outcomes and second in two based on surface under the cumulative ranking probabilities (SUCRA). Meanwhile, the results of MD and 95% CIs of concerned outcomes indicated that only Yanhuning injection combined with azithromycin had better response than other CHIs combined with azithromycin. Moreover, cluster analysis results revealed Reduning injection combined with azithromycin was associated with a positive effect on the three group outcomes. Similarly, it was found to be the top three ranking in all outcomes based on SUCRA. WHAT IS NEW AND CONCLUSION Yanhuning injection combined with azithromycin and Reduning injection combined with azithromycin were found to be preferable treatments based on the data of this study.
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Affiliation(s)
- Xiaojiao Duan
- Department of Clinical Chinese Pharmacy, School of Chinese Materia MedicaBeijing University of Chinese MedicineBeijingChina
| | - Kaihuan Wang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia MedicaBeijing University of Chinese MedicineBeijingChina
| | - Jiarui Wu
- Department of Clinical Chinese Pharmacy, School of Chinese Materia MedicaBeijing University of Chinese MedicineBeijingChina
| | - Dan Zhang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia MedicaBeijing University of Chinese MedicineBeijingChina
| | - Xinkui Liu
- Department of Clinical Chinese Pharmacy, School of Chinese Materia MedicaBeijing University of Chinese MedicineBeijingChina
| | - Mengwei Ni
- Department of Clinical Chinese Pharmacy, School of Chinese Materia MedicaBeijing University of Chinese MedicineBeijingChina
| | - Shuyu Liu
- Department of Clinical Chinese Pharmacy, School of Chinese Materia MedicaBeijing University of Chinese MedicineBeijingChina
| | - Ziqi Meng
- Department of Clinical Chinese Pharmacy, School of Chinese Materia MedicaBeijing University of Chinese MedicineBeijingChina
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Zhao Y, Guo Q, Dai X, Wei X, Yu Y, Chen X, Li C, Cao Z, Zhang X. A Biomimetic Non-Antibiotic Approach to Eradicate Drug-Resistant Infections. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2019; 31:e1806024. [PMID: 30589118 PMCID: PMC6634980 DOI: 10.1002/adma.201806024] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 11/26/2018] [Indexed: 05/19/2023]
Abstract
The chronic infections by pathogenic Pseudomonas aeruginosa (P. aeruginosa) remain to be properly addressed. In particular, for drug-resistant strains, limited medication is available. An in vivo pneumonia model induced by a clinically isolated aminoglycoside resistant strain of P. aeruginosa is developed. Tobramycin clinically treating P. aeruginosa infections is found to be ineffective to inhibit or eliminate this drug-resistant strain. Here, a newly developed non-antibiotics based nanoformulation plus near-infrared (NIR) photothermal treatment shows a remarkable antibacterial efficacy in treating this drug-resistant pneumonia. The novel formulation contains 50-100 nm long nanorods decorated with two types of glycomimetic polymers to specifically block bacterial LecA and LecB lectins, respectively, which are essential for bacterial biofilm development. Such a 3D display of heteromultivalent glycomimetics on a large scale is inspired by the natural strengthening mechanism for the carbohydrate-lectin interaction that occurs when bacteria initially infects the host. This novel formulation shows the most efficient bacteria inhabitation and killing against P. aeruginosa infection, through lectin blocking and the near-infrared-light-induced photothermal effect of gold nanorods, respectively. Collectively, the novel biomimetic design combined with the photothermal killing capability is expected to be an alternative treatment strategy against the ever-threatening drug-resistant infectious diseases when known antibiotics have failed.
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Affiliation(s)
- Yu Zhao
- Key Laboratory of Functional Polymer Materials of Ministry Education, Institute of Polymer Chemistry, College of Chemistry, Nankai University, Tianjin 300071, China
| | - Qianqian Guo
- Key Laboratory of Functional Polymer Materials of Ministry Education, Institute of Polymer Chemistry, College of Chemistry, Nankai University, Tianjin 300071, China
| | - Xiaomei Dai
- Key Laboratory of Functional Polymer Materials of Ministry Education, Institute of Polymer Chemistry, College of Chemistry, Nankai University, Tianjin 300071, China
| | - Xiaosong Wei
- Key Laboratory of Functional Polymer Materials of Ministry Education, Institute of Polymer Chemistry, College of Chemistry, Nankai University, Tianjin 300071, China
| | - Yunjian Yu
- Key Laboratory of Functional Polymer Materials of Ministry Education, Institute of Polymer Chemistry, College of Chemistry, Nankai University, Tianjin 300071, China
| | - Xuelei Chen
- Key Laboratory of Functional Polymer Materials of Ministry Education, Institute of Polymer Chemistry, College of Chemistry, Nankai University, Tianjin 300071, China
| | - Chaoxing Li
- Key Laboratory of Functional Polymer Materials of Ministry Education, Institute of Polymer Chemistry, College of Chemistry, Nankai University, Tianjin 300071, China
| | - Zhiqiang Cao
- Department of Chemical Engineering and Materials Science, Wayne State University, Detroit, Michigan 48202, USA
| | - Xinge Zhang
- Key Laboratory of Functional Polymer Materials of Ministry Education, Institute of Polymer Chemistry, College of Chemistry, Nankai University, Tianjin 300071, China
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Chaurasiya B, Zhou M, Tu J, Sun C. Design and validation of a simple device for insufflation of dry powders in a mice model. Eur J Pharm Sci 2018; 123:495-501. [PMID: 30098390 DOI: 10.1016/j.ejps.2018.08.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 08/04/2018] [Accepted: 08/08/2018] [Indexed: 01/08/2023]
Abstract
Delivery of inhalational dry powders (DPs) to the lung of mice is pivotal for pre-clinical pharmacokinetic and pharmacodynamic investigations. Although several devices have been reported, their application is always limited by many factors, including complicated design, high price, commercially discontinued status, as well as requirement of special skills. Here, we have introduced a simple device for non-invasive and precise delivery of DPs in mice. We set up the self-made device using a 20 G cannula tube and a 1 mL syringe. Subsequently, it was validated in terms for proper installation, delivery of dry powder and safety. Taken together, we believe that this device will be helpful in pre-clinical studies, especially in laboratory experiments, for respiratory drug delivery in small animal models.
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Affiliation(s)
- Birendra Chaurasiya
- Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, China; State Key Laboratory of Natural Medicines, Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, China
| | - Muye Zhou
- Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, China; State Key Laboratory of Natural Medicines, Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, China
| | - Jiasheng Tu
- Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, China; State Key Laboratory of Natural Medicines, Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, China.
| | - Chunmeng Sun
- Center for Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, China; State Key Laboratory of Natural Medicines, Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, China.
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Ding W, Zhou Y, Qu Q, Cui W, God'spower BO, Liu Y, Chen X, Chen M, Yang Y, Li Y. Azithromycin Inhibits Biofilm Formation by Staphylococcus xylosus and Affects Histidine Biosynthesis Pathway. Front Pharmacol 2018; 9:740. [PMID: 30042679 PMCID: PMC6048454 DOI: 10.3389/fphar.2018.00740] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 06/18/2018] [Indexed: 11/13/2022] Open
Abstract
Staphylococcus xylosus, a coagulase-negative, non-pathogenic bacterium, responsible for opportunistic infections in humans and bovine mastitis, has the ability to form biofilms, which are responsible for persistent infections and antibiotic resistance. In our study, azithromycin significantly inhibited biofilm formation by altering protein expression. Of the 1764 proteins measured by the isobaric Tag for Relative and Absolute Quantification (iTRAQ) technique, only 148 proteins showed significantly different expression between the azithromycin-treated and untreated cells. Most ribosomal proteins were markedly up-regulated, and the expression of the proteins involved in histidine biosynthesis, which, in turn, influence biofilm formation, was down-regulated, particularly imidazole glycerophosphate dehydratase (IGPD). Previously, we had observed that IGPD plays an important role in biofilm formation by S. xylosus. Therefore, hisB expression was studied by real-time PCR, and the interactions between azithromycin and IGPD were predicted by molecular docking analysis. hisB was found to be significantly down-regulated, and six bond interactions were observed between azithromycin and IGPD. Many active atoms of azithromycin did not interact with the biologically active site of IGPD. Surface plasmon resonance analysis used to further study the relationship between IGPD and azithromycin showed minimum interaction between them. Histidine content in the azithromycin-treated and untreated groups was determined. We noted a slight difference, which was not consistent with the expression of the proteins involved in histidine biosynthesis. Therefore, histidine degradation into glutamate was also studied, and we found that all proteins were down-regulated. This could be the reason why histidine content showed little change between the treated and untreated groups. In summary, we found that azithromycin is a potential inhibitor of S. xylosus biofilm formation, and the underlying mechanism was preliminarily elucidated in this study.
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Affiliation(s)
- Wenya Ding
- Department of Veterinary Medicine, Northeast Agricultural University, Harbin, China.,Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical Development, Harbin, China
| | - Yonghui Zhou
- Department of Veterinary Medicine, Northeast Agricultural University, Harbin, China.,Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical Development, Harbin, China
| | - Qianwei Qu
- Department of Veterinary Medicine, Northeast Agricultural University, Harbin, China.,Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical Development, Harbin, China
| | - Wenqiang Cui
- Department of Veterinary Medicine, Northeast Agricultural University, Harbin, China.,Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical Development, Harbin, China
| | - Bello Onaghise God'spower
- Department of Veterinary Medicine, Northeast Agricultural University, Harbin, China.,Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical Development, Harbin, China
| | - Yanyan Liu
- Department of Veterinary Medicine, Northeast Agricultural University, Harbin, China.,Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical Development, Harbin, China
| | - Xueying Chen
- Department of Veterinary Medicine, Northeast Agricultural University, Harbin, China.,Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical Development, Harbin, China
| | - Mo Chen
- Department of Veterinary Medicine, Northeast Agricultural University, Harbin, China.,Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical Development, Harbin, China
| | - Yanbei Yang
- Department of Veterinary Medicine, Northeast Agricultural University, Harbin, China.,Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical Development, Harbin, China
| | - Yanhua Li
- Department of Veterinary Medicine, Northeast Agricultural University, Harbin, China.,Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical Development, Harbin, China
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