1
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Wang C, Jiang H, Zhu J, Jin Y. A new agent for contrast-enhanced intravascular ultrasound imaging in vitro: polybutylcyanoacrylate nanoparticles with drug-carrying capacity. ARTIFICIAL CELLS, NANOMEDICINE, AND BIOTECHNOLOGY 2024; 52:218-228. [PMID: 38646876 DOI: 10.1080/21691401.2024.2334713] [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: 08/17/2023] [Accepted: 03/20/2024] [Indexed: 04/23/2024]
Abstract
This study prepared and evaluated polymeric polybutylcyanoacrylate (PBCA) nanoparticles (NPs) that can be used as a new agent for contrast-enhanced intravascular ultrasound (IVUS) imaging with drug delivery capacity. The nanoformulation was successfully developed using suspension polymerisation and characterised in terms of size, size distribution, zeta potential, morphology, stability, toxicity effects, imaging effects and drug release study. The results showed that the nanoparticles were round and hollow, with a particle diameter of 215.8 ± 25.3 nm and a zeta potential of -22.2 ± 4.1 mV. In vitro experiments, the nanoparticles were safe, non-toxic, and stable in nature with the capacity to carry and release drug (ant-miR-126). Moreover, the nanoparticles can match the high-frequency probe of commercially IVUS as a contrast agent to improve the resolution of imaging (the mean echo intensity ratio in the vascular wall increased significantly from 10.89 ± 1.10 at baseline, to 24.51 ± 1.91 during injection and 43.70 ± 0.88 after injection, respectively p < .0001). Overall, a new nano agent with drug-carrying capacity was prepared, which can be used in combination with IVUS for simultaneous diagnosis and targeted therapy of coronary atherosclerosis.
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Affiliation(s)
- Congying Wang
- The Department of Cardiology, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Haodong Jiang
- The Department of Cardiology, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Jia Zhu
- The Department of Cardiology, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Yunpeng Jin
- The Department of Cardiology, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, Zhejiang, China
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2
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Liu F, Chen Y, Huang Y, Jin Q, Ji J. Nanomaterial-based therapeutics for enhanced antifungal therapy. J Mater Chem B 2024. [PMID: 39192670 DOI: 10.1039/d4tb01484g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
The application of nanotechnology in antifungal therapy is gaining increasing attention. Current antifungal drugs have significant limitations, such as severe side effects, low bioavailability, and the rapid development of resistance. Nanotechnology offers an innovative solution to address these issues. This review discusses three key strategies of nanotechnology to enhance antifungal efficacy. Firstly, nanomaterials can enhance their interaction with fungal cells via ingenious surface tailoring of nanomaterials. Effective adhesion of nanoparticles to fungal cells can be achieved by electrostatic interaction or specific targeting to the fungal cell wall and cell membrane. Secondly, stimuli-responsive nanomaterials are developed to realize smart release of drugs in the specific microenvironment of pathological tissues, such as the fungal biofilm microenvironment and inflammatory microenvironment. Thirdly, nanomaterials can be designed to cross different physiological barriers, effectively addressing challenges posed by skin, corneal, and blood-brain barriers. Additionally, some new nanomaterial-based strategies in treating fungal infections are discussed, including the development of fungal vaccines, modulation of macrophage activity, phage therapy, the application of high-throughput screening in drug discovery, and so on. Despite the challenges faced in applying nanotechnology to antifungal therapy, its significant potential and innovation open new possibilities for future clinical antifungal applications.
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Affiliation(s)
- Fang Liu
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China.
| | - Yongcheng Chen
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China.
| | - Yue Huang
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China.
| | - Qiao Jin
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China.
| | - Jian Ji
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China.
- State Key Laboratory of Transvascular Implantation Devices, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Rd, Hangzhou, 310009, China
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3
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Aderibigbe BA. Nanotherapeutics for the delivery of antifungal drugs. Ther Deliv 2024. [PMID: 38174574 DOI: 10.4155/tde-2023-0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
The treatment of fungal infections is challenging with high death rates reported among immunocompromised patients. The currently available antifungals suffer from poor bioavailability and solubility, pharmacokinetics, and drug resistance, with limited cellular uptake. The clinical pipeline of new antifungals is dry. The incorporation of antifungal drugs into polymer-based nanocarriers to form nanotherapeutics is a promising approach to enhance the therapeutic outcomes of the available antifungal drugs. This review summarizes different polymer-based nanotherapeutics strategies that have been explored for the delivery of antifungals, resulting in enhanced therapeutic outcomes, such as improved pharmacokinetics, targeted/sustained delivery, prolonged drug circulation, retention of the drugs at the localized site of action, and overcoming drug resistance when compared with the free antifungal drugs.
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4
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Wu S, Song R, Liu T, Li C. Antifungal therapy: Novel drug delivery strategies driven by new targets. Adv Drug Deliv Rev 2023; 199:114967. [PMID: 37336246 DOI: 10.1016/j.addr.2023.114967] [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: 01/23/2023] [Revised: 05/22/2023] [Accepted: 06/14/2023] [Indexed: 06/21/2023]
Abstract
In patients with compromised immunity, invasive fungal infections represent a significant cause of mortality. Given the limited availability and drawbacks of existing first-line antifungal drugs, there is a growing interest in exploring novel targets that could facilitate the development of new antifungal agents or enhance the effectiveness of conventional ones. While previous studies have extensively summarized new antifungal targets inherent in fungi for drug development purposes, the exploration of potential targets for novel antifungal drug delivery strategies has received less attention. In this review, we provide an overview of recent advancements in new antifungal drug delivery strategies that leverage novel targets, including those located in the physio-pathological barrier at the site of infection, the infection microenvironment, fungal-host interactions, and the fungal pathogen itself. The objective is to enhance therapeutic efficacy and mitigate toxic effects in fungal infections, particularly in challenging cases such as refractory, recurrent, and drug-resistant invasive fungal infections. We also discuss the current challenges and future prospects associated with target-driven antifungal drug delivery strategies, offering important insights into the clinical implementation of these innovative approaches.
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Affiliation(s)
- Shuang Wu
- State Key Laboratory of Resource Insects, Medical Research Institute, Southwest University, Chongqing 400716, PR China
| | - Ruiqi Song
- State Key Laboratory of Resource Insects, Medical Research Institute, Southwest University, Chongqing 400716, PR China
| | - Tongbao Liu
- State Key Laboratory of Resource Insects, Medical Research Institute, Southwest University, Chongqing 400716, PR China.
| | - Chong Li
- State Key Laboratory of Resource Insects, Medical Research Institute, Southwest University, Chongqing 400716, PR China; College of Pharmaceutical Sciences, Southwest University, Chongqing 400715, PR China.
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5
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Liu J, Li Y, Liu S, Zhang Y, Luo Y, Yang Y, Zhuang X, Wang X, Zhao B, Xu T, Xu L. Alkoxy cyanoacrylate-based nanoparticles with stealth and brain-targeting properties. J Drug Target 2021; 30:219-231. [PMID: 34319831 DOI: 10.1080/1061186x.2021.1961790] [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] [Indexed: 01/04/2023]
Abstract
Nanoparticles (NPs) with 'stealth' properties have been designed to decrease the phagocytosis of such particles by mononuclear phagocytes and to protect them from enzymatic degradation, thus improving circulation time and bioavailability after intravenous administration. Brain-targeting modifications endow NPs with the capacity to cross the blood-brain barrier, facilitating chemotherapy for brain diseases such as glioma. In this study, newly designed alkoxy cyanoacrylate (CA)-based NPs with stealth and brain-targeting properties were synthesised and evaluated. The monomers for NP core polymerisation were chemically modified to hydrophilic short alkoxy structure for stealth purposes and coated with polysorbate-80 for brain targeting. Two monomers (2-methoxyethyl CA and 2-(2-methoxyethyl)ethyl CA) were used to create NP2 and NP3, respectively. Both NPs were successfully loaded with anti-sense oligonucleotide (ASON) of transforming growth factor beta 2. Compared to traditional n-butyl CA-based ASON-NP1, ASON-NP3 was found to decrease phagocytosis by mononuclear macrophages (RAW264.7) and to increase cellular uptake by cancer cells. ASON-NP3 showed definite brain targeting and anti-cancer effects. This work provides a potential new strategy for preparing stealth NPs core, providing a new NP vehicle for clinical drug delivery that may be targeted to the brain and circulates in the blood for an extended period of time.
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Affiliation(s)
- Jimin Liu
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Yunfeng Li
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Shan Liu
- Department of Pathology, General Hospital of the PLA Rocket Force, Beijing, China
| | - Yi Zhang
- Department of Precision Medicine and Healthcare, Tsinghua-Berkeley Shenzhen Institute, Shenzhen, China.,East China Institute of Digital Medical Engineering, Shangrao, China
| | - Yuan Luo
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Yang Yang
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Xiaomei Zhuang
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Xuanzhi Wang
- East China Institute of Digital Medical Engineering, Shangrao, China.,Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, China
| | - Baoquan Zhao
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Tao Xu
- Department of Precision Medicine and Healthcare, Tsinghua-Berkeley Shenzhen Institute, Shenzhen, China.,Department of Mechanical Engineering, Biomanufacturing Center, Tsinghua University, Beijing, China
| | - Liang Xu
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
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6
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Azhari H, Younus M, Hook SM, Boyd BJ, Rizwan SB. Cubosomes enhance drug permeability across the blood-brain barrier in zebrafish. Int J Pharm 2021; 600:120411. [PMID: 33675926 DOI: 10.1016/j.ijpharm.2021.120411] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/09/2021] [Accepted: 02/16/2021] [Indexed: 12/22/2022]
Abstract
The potential of cubosomes to improve delivery of incorporated cargo to the brain was explored in zebrafish. Cubosomes were formulated with one of three stabilisers, Pluronic F68, Pluronic F127 or Tween 80, with the hypothesis that coating with Tween 80 will enable brain targeting of cubosomes as has been previously shown for polymeric nanoparticles. The physiochemical properties and the ability of the cubosomes to facilitate delivery of the model drug lissamine rhodamine (RhoB) into the brain was investigated. Distribution of cubosomes in the midbrain was also investigated by ultrastructural analysis via incorporation of octanethiol-functionalized gold nanoparticles. Cubosomes were typically 165-195 nm in size with a Pn3m (Pluronics) or Im3m (Tween 80) cubic phase internal structure. Cubosomes were injected intravenously into zebrafish larvae (12-14 days post fertilization) and the concentration of RhoB in the midbrain was determined by quantifying its fluorescence intensity. Uptake of RhoB was significantly greater in larvae injected with Tween 80 stabilized cubosomes as compared to a control suspension of RhoB or cubosomes stabilized with Pluronics. Collectively, we show for the first time that cubosomes can be functionalized to deliver drug across the BBB, offering new opportunities to overcome drug delivery issues across this formidable biological barrier.
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Affiliation(s)
- H Azhari
- School of Pharmacy, University of Otago, PO Box 56, Dunedin 9054 Dunedin, New Zealand
| | - Mohammad Younus
- School of Pharmacy, University of Otago, PO Box 56, Dunedin 9054 Dunedin, New Zealand
| | - Sarah M Hook
- School of Pharmacy, University of Otago, PO Box 56, Dunedin 9054 Dunedin, New Zealand
| | - Ben J Boyd
- Drug Delivery, Disposition and Dynamics and ARC Centre of Excellence in Convergent Bio-Nano Science and Technology, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Shakila B Rizwan
- School of Pharmacy, University of Otago, PO Box 56, Dunedin 9054 Dunedin, New Zealand.
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7
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Drug delivery platforms for neonatal brain injury. J Control Release 2021; 330:765-787. [PMID: 33417984 DOI: 10.1016/j.jconrel.2020.12.056] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 12/18/2022]
Abstract
Hypoxic-ischemic encephalopathy (HIE), initiated by the interruption of oxygenated blood supply to the brain, is a leading cause of death and lifelong disability in newborns. The pathogenesis of HIE involves a complex interplay of excitotoxicity, inflammation, and oxidative stress that results in acute to long term brain damage and functional impairments. Therapeutic hypothermia is the only approved treatment for HIE but has limited effectiveness for moderate to severe brain damage; thus, pharmacological intervention is explored as an adjunct therapy to hypothermia to further promote recovery. However, the limited bioavailability and the side-effects of systemic administration are factors that hinder the use of the candidate pharmacological agents. To overcome these barriers, therapeutic molecules may be packaged into nanoscale constructs to enable their delivery. Yet, the application of nanotechnology in infants is not well examined, and the neonatal brain presents unique challenges. Novel drug delivery platforms have the potential to magnify therapeutic effects in the damaged brain, mitigate side-effects associated with high systemic doses, and evade mechanisms that remove the drugs from circulation. Encouraging pre-clinical data demonstrates an attenuation of brain damage and increased structural and functional recovery. This review surveys the current progress in drug delivery for treating neonatal brain injury.
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8
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Khatoon R, Alam MA, Sharma PK. Current approaches and prospective drug targeting to brain. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2020.102098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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9
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Barani M, Mukhtar M, Rahdar A, Sargazi G, Thysiadou A, Kyzas GZ. Progress in the Application of Nanoparticles and Graphene as Drug Carriers and on the Diagnosis of Brain Infections. Molecules 2021; 26:molecules26010186. [PMID: 33401658 PMCID: PMC7795866 DOI: 10.3390/molecules26010186] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/24/2020] [Accepted: 12/29/2020] [Indexed: 12/12/2022] Open
Abstract
The blood–brain barrier (BBB) is the protective sheath around the brain that protects the sensitive microenvironments of the brain. However, certain pathogens, viruses, and bacteria disrupt the endothelial barrier and cause infection and hence inflammation in meninges. Macromolecular therapeutics are unable to cross the tight junctions, thereby limiting their bioavailability in the brain. Recently, nanotechnology has brought a revolution in the field of drug delivery in brain infections. The nanostructures have high targeting accuracy and specificity to the receptors in the case of active targeting, which have made them the ideal cargoes to permeate across the BBB. In addition, nanomaterials with biomimetic functions have been introduced to efficiently cross the BBB to be engulfed by the pathogens. This review focuses on the nanotechnology-based drug delivery approaches for exploration in brain infections, including meningitis. Viruses, bacteria, fungi, or, rarely, protozoa or parasites may be the cause of brain infections. Moreover, inflammation of the meninges, called meningitis, is presently diagnosed using laboratory and imaging tests. Despite attempts to improve diagnostic instruments for brain infections and meningitis, due to its complicated and multidimensional nature and lack of successful diagnosis, meningitis appears almost untreatable. Potential for overcoming the difficulties and limitations related to conventional diagnostics has been shown by nanoparticles (NPs). Nanomedicine now offers new methods and perspectives to improve our knowledge of meningitis and can potentially give meningitis patients new hope. Here, we review traditional diagnosis tools and key nanoparticles (Au-NPs, graphene, carbon nanotubes (CNTs), QDs, etc.) for early diagnosis of brain infections and meningitis.
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Affiliation(s)
- Mahmood Barani
- Department of Chemistry, Shahid Bahonar University of Kerman, Kerman 76169-14111, Iran;
| | - Mahwash Mukhtar
- Faculty of Pharmacy, Institute of Pharmaceutical Technology and Regulatory Affairs, University of Szeged, 6720 Szeged, Hungary;
| | - Abbas Rahdar
- Department of Physics, Faculty of Science, University of Zabol, Zabol 538-98615, Iran
- Correspondence: (A.R.); (G.Z.K.); Tel.: +30-2510-462218 (G.Z.K.)
| | - Ghasem Sargazi
- Noncommunicable Diseases Research Center, Bam University of Medical Science, Bam 5166-15731, Iran;
| | - Anna Thysiadou
- Department of Chemistry, International Hellenic University, 65404 Kavala, Greece;
| | - George Z. Kyzas
- Department of Chemistry, International Hellenic University, 65404 Kavala, Greece;
- Correspondence: (A.R.); (G.Z.K.); Tel.: +30-2510-462218 (G.Z.K.)
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10
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Rana SS, Bhatt S, Kumar M, Malik A, Sharma JB, Arora D, Saini V. Design and Optimization of Itraconazole Loaded SLN for Intranasal Administration Using Central Composite Design. ACTA ACUST UNITED AC 2020. [DOI: 10.2174/2210681209666191111113112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Introduction:
Solid Lipid nanoparticles (SLN) are comprising of a solid lipid core with
a mean diameter between 50 and 1000 nm. SLN is an advanced carrier system to traditional colloidal
carriers such as emulsion, liposomes, and polymeric microparticles.
Objective:
The objective of this study was to formulate SLN of Itraconazole (ITZ) for intranasal
administration.
Methods:
ITZ-loaded SLN were prepared by high pressure homogenization technique using the
Central Composite Design (CCD). The concentration of surfactant (X1) and drug to lipid ratio
(X2) was considered as independent variables, whereas particle size (Y1) and percentage entrapment
efficiency (Y2) were considered as a response. The compatibility of ingredients with the drug
was tested using differential scanning calorimetry. SLN were characterized for their particle size,
entrapment efficiency, transmission electron microscopy, in vitro drug release, and ex vivo study.
Results:
The solid lipid nanoparticles were successfully prepared using high pressure homogenization
technique and glyceryl monostearate was used as solid lipid. The lipid ratio significantly increases
the particle size as well as entrapment efficiency. The particle size and (%) entrapment efficiency
of optimized formulation were found to be 29 nm and 78.9%, respectively. The differential
scanning calorimetry confirmed that the drug existed in amorphous form. Nasal histopathology
study on sheep mucosa revealed that the developed SLN was non-toxic and safe to use for intranasal
administration. The results of ex vivo study showed that the Higuchi pattern of drug release
was followed. The in vitro release studies showed the significant difference in drug release from
ITZ-loaded SLN compared to plain ITZ-solution.
Conclusion:
ITZ-loaded SLN were successfully prepared and validated. The best batch was selected
based on the desired particle size, and EE which is an important characteristic for SLN formulations.
The developed formulations were nontoxic as determined by histo-pathological studies.
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Affiliation(s)
- Sarvjeet S. Rana
- MM College of Pharmacy, MM (Deemed to be University), Mullana, Ambala, Haryana, India
| | - Shailendra Bhatt
- MM College of Pharmacy, MM (Deemed to be University), Mullana, Ambala, Haryana, India
| | - Manish Kumar
- MM College of Pharmacy, MM (Deemed to be University), Mullana, Ambala, Haryana, India
| | - Anuj Malik
- MM College of Pharmacy, MM (Deemed to be University), Mullana, Ambala, Haryana, India
| | - Jai B. Sharma
- MM College of Pharmacy, MM (Deemed to be University), Mullana, Ambala, Haryana, India
| | - Deepshi Arora
- Guru Gobind Singh College of Pharmacy, Yamuna Naga, India
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11
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Kischkel B, Rossi SA, Santos SR, Nosanchuk JD, Travassos LR, Taborda CP. Therapies and Vaccines Based on Nanoparticles for the Treatment of Systemic Fungal Infections. Front Cell Infect Microbiol 2020; 10:463. [PMID: 33014889 PMCID: PMC7502903 DOI: 10.3389/fcimb.2020.00463] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 07/28/2020] [Indexed: 12/11/2022] Open
Abstract
Treatment modalities for systemic mycoses are still limited. Currently, the main antifungal therapeutics include polyenes, azoles, and echinocandins. However, even in the setting of appropriate administration of antifungals, mortality rates remain unacceptably high. Moreover, antifungal therapy is expensive, treatment periods can range from weeks to years, and toxicity is also a serious concern. In recent years, the increased number of immunocompromised individuals has contributed to the high global incidence of systemic fungal infections. Given the high morbidity and mortality rates, the complexity of treatment strategies, drug toxicity, and the worldwide burden of disease, there is a need for new and efficient therapeutic means to combat invasive mycoses. One promising avenue that is actively being pursued is nanotechnology, to develop new antifungal therapies and efficient vaccines, since it allows for a targeted delivery of drugs and antigens, which can reduce toxicity and treatment costs. The goal of this review is to discuss studies using nanoparticles to develop new therapeutic options, including vaccination methods, to combat systemic mycoses caused by Candida sp., Cryptococcus sp., Paracoccidioides sp., Histoplasma sp., Coccidioides sp., and Aspergillus sp., in addition to providing important information on the use of different types of nanoparticles, nanocarriers and their corresponding mechanisms of action.
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Affiliation(s)
- Brenda Kischkel
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.,Laboratory of Medical Mycology-Institute of Tropical Medicine of São Paulo/LIM53/Medical School, University of São Paulo, São Paulo, Brazil
| | - Suélen A Rossi
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.,Laboratory of Medical Mycology-Institute of Tropical Medicine of São Paulo/LIM53/Medical School, University of São Paulo, São Paulo, Brazil
| | - Samuel R Santos
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.,Laboratory of Medical Mycology-Institute of Tropical Medicine of São Paulo/LIM53/Medical School, University of São Paulo, São Paulo, Brazil
| | - Joshua D Nosanchuk
- Departments of Medicine [Division of Infectious Diseases], Microbiology and Immunology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States
| | - Luiz R Travassos
- Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo, São Paulo, Brazil
| | - Carlos P Taborda
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.,Laboratory of Medical Mycology-Institute of Tropical Medicine of São Paulo/LIM53/Medical School, University of São Paulo, São Paulo, Brazil
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12
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Spadari CDC, Wirth F, Lopes LB, Ishida K. New Approaches for Cryptococcosis Treatment. Microorganisms 2020; 8:E613. [PMID: 32340403 PMCID: PMC7232457 DOI: 10.3390/microorganisms8040613] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 02/06/2023] Open
Abstract
Cryptococcosis is an important opportunistic infection and a leading cause of meningitis in patients with HIV infection. The antifungal pharmacological treatment is limited to amphotericin B, fluconazole and 5- flucytosine. In addition to the limited pharmacological options, the high toxicity, increased resistance rate and difficulty of the currently available antifungal molecules to cross the blood-brain barrier hamper the treatment. Thus, the search for new alternatives for the treatment of cryptococcal meningitis is extremely necessary. In this review, we describe the therapeutic strategies currently available, discuss new molecules with antifungal potential in different phases of clinical trials and in advanced pre-clinical phase, and examine drug nanocarriers to improve delivery to the central nervous system.
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Affiliation(s)
- Cristina de Castro Spadari
- Laboratory of Antifungal Chemotherapy, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, Brazil; (C.d.C.S.); (F.W.)
| | - Fernanda Wirth
- Laboratory of Antifungal Chemotherapy, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, Brazil; (C.d.C.S.); (F.W.)
| | - Luciana Biagini Lopes
- Laboratory of Nanomedicine and Drug Delivery Systems, Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, Brazil;
| | - Kelly Ishida
- Laboratory of Antifungal Chemotherapy, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, Brazil; (C.d.C.S.); (F.W.)
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13
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Güven UM, Yenilmez E. Olopatadine hydrochloride loaded Kollidon® SR nanoparticles for ocular delivery: Nanosuspension formulation and in vitro–in vivo evaluation. J Drug Deliv Sci Technol 2019. [DOI: 10.1016/j.jddst.2019.03.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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14
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Sharma G, Sharma AR, Lee SS, Bhattacharya M, Nam JS, Chakraborty C. Advances in nanocarriers enabled brain targeted drug delivery across blood brain barrier. Int J Pharm 2019; 559:360-372. [DOI: 10.1016/j.ijpharm.2019.01.056] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/31/2019] [Accepted: 01/31/2019] [Indexed: 01/13/2023]
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15
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Obinu A, Rassu G, Corona P, Maestri M, Riva F, Miele D, Giunchedi P, Gavini E. Poly (ethyl 2-cyanoacrylate) nanoparticles (PECA-NPs) as possible agents in tumor treatment. Colloids Surf B Biointerfaces 2019; 177:520-528. [PMID: 30822627 DOI: 10.1016/j.colsurfb.2019.02.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/29/2019] [Accepted: 02/19/2019] [Indexed: 01/04/2023]
Abstract
Tumor eradication has many challenges due to the difficulty of selectively delivering anticancer drugs to malignant cells avoiding contact with healthy tissues/organs. The improvement of antitumor efficacy and the reduction of systemic side effects can be achieved using drug loaded nanoparticles. In this study, poly (ethyl 2-cyanoacrylate) nanoparticles (PECA-NPs) were prepared using an emulsion polymerization method and their potential for cancer treatment was investigated. The size, polydispersity index and zeta potential of prepared nanoparticles are about 80 nm, 0.08 and -39.7 mV, respectively. The stability test shows that the formulation is stable for 15 days, while an increase in particle size occurs after 30 days. TEM reveals the spherical morphology of nanoparticles; furthermore, FTIR and 1H NMR analyses confirm the structure of PECA-NPs and the complete polymerization. The nanoparticles demonstrate an in vitro concentration-dependent cytotoxicity against human epithelial colorectal adenocarcinoma cell lines (Caco-2), as assessed by MTT assay. The anticancer activity of PECA-NPs was studied on 3D tumor spheroids models of hepatocellular carcinoma (HepG2) and kidney adenocarcinoma cells (A498) to better understand how the nanoparticles could interact with a complex structure such as a tumor. The results confirm the antitumor activity of PECA-NPs. Therefore, these systems can be considered good candidates in tumor treatment.
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Affiliation(s)
- Antonella Obinu
- Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Giovanna Rassu
- Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy
| | - Paola Corona
- Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy
| | - Marcello Maestri
- IRCCS Policlinico San Matteo Foundation and Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Federica Riva
- Department of Public Health, Experimental and Forensic Medicine-Histology and Embryology Unit, University of Pavia, Pavia, Italy
| | - Dalila Miele
- Department of Drug Sciences, University of Pavia, Pavia, Italy
| | - Paolo Giunchedi
- Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy.
| | - Elisabetta Gavini
- Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy.
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16
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Crecente‐Campo J, Alonso MJ. Engineering, on-demand manufacturing, and scaling-up of polymeric nanocapsules. Bioeng Transl Med 2019; 4:38-50. [PMID: 30680317 PMCID: PMC6336665 DOI: 10.1002/btm2.10118] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/04/2018] [Accepted: 09/09/2018] [Indexed: 12/14/2022] Open
Abstract
Polymeric nanocapsules are versatile delivery systems with the capacity to load lipophilic drugs in their oily nucleus and hydrophilic drugs in their polymeric shell. The objective of this work was to expand the technological possibilities to prepare customized nanocapsules. First, we adapted the solvent displacement technique to modulate the particle size of the resulting nanocapsules in the 50-500 nm range. We also produced nanosystems with a shell made of one or multiple polymer layers i.e. chitosan, dextran sulphate, hyaluronate, chondroitin sulphate, and alginate. In addition, we identified the conditions to translate the process into a miniaturized high-throughput tailor-made fabrication that enables massive screening of formulations. Finally, the production of the nanocapsules was scaled-up both in a batch production, and also using microfluidics. The versatility of the properties of these nanocapsules and their fabrication technologies is expected to propel their advance from bench to clinic.
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Affiliation(s)
- José Crecente‐Campo
- Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Campus VidaUniversidade de Santiago de CompostelaSantiago de CompostelaSpain
| | - María José Alonso
- Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Campus VidaUniversidade de Santiago de CompostelaSantiago de CompostelaSpain
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17
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Domingues Bianchin M, Borowicz SM, da Rosa Monte Machado G, Pippi B, Stanisçuaski Guterres S, Raffin Pohlmann A, Meneghello Fuentefria A, Clemes Külkamp-Guerreiro I. Lipid core nanoparticles as a broad strategy to reverse fluconazole resistance in multiple Candida species. Colloids Surf B Biointerfaces 2018; 175:523-529. [PMID: 30579053 DOI: 10.1016/j.colsurfb.2018.12.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 12/11/2022]
Abstract
Fungal resistance is the major problem related to fluconazole treatments. This study aims to develop innovative lipid core nanocapsules and nanostructured lipid carriers containing fluconazole, to study in vitro antifungal activity and to assess the possibility of resistance reversion in Candida albicans, C. glabrata, C. krusei, and C. tropicalis isolates. The action mechanism of nanoparticles was investigated through efflux pumps and scanning electron microscopy studies. The lipid core nanocapsules and nanostructured lipid carriers were prepared by interfacial deposition of preformed polymer and high-pressure homogenization methods, respectively. Both nanostructures presented sizes below 250 nm, SPAN < 1.6, negative zeta potential, pH slightly acid, high drug content and controlled drug release. The nanostructured lipid carriers were unable to reverse the fungal resistance. Lipid core nanoparticles displayed advantages such as a reduction in the effective dose of fluconazole and resistance reversion in all isolates tested - with multiple mechanisms of resistance. The main role of the supramolecular structure and the composition of the nanoparticles on antifungal mechanisms of action were discussed. The results achieved through this study have an impact on clinical therapy, with a potential application in the treatment of fungal infections caused by resistant isolates of Candida spp.
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Affiliation(s)
- Mariana Domingues Bianchin
- Programa de Pós-Graduação em Farmacologia e Terapêutica, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500, Centro, Porto Alegre, RS, 90050-170, Brazil
| | - Sílvia Maria Borowicz
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Av Ipiranga, 2752, Santana, Porto Alegre, RS, 90610-000, Brazil
| | - Gabriella da Rosa Monte Machado
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500, Centro, Porto Alegre, RS, 90050-170, Brazil
| | - Bruna Pippi
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500, Centro, Porto Alegre, RS, 90050-170, Brazil
| | - Sílvia Stanisçuaski Guterres
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Av Ipiranga, 2752, Santana, Porto Alegre, RS, 90610-000, Brazil
| | - Adriana Raffin Pohlmann
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Av Ipiranga, 2752, Santana, Porto Alegre, RS, 90610-000, Brazil; Departamento de Química Orgânica, Instituto de química, Universidade Federal do Rio Grande do Sul, CP15003, Av. Bento Gonçalves, 9500, Agronomia, Porto Alegre, RS, 91501-970, Brazil
| | - Alexandre Meneghello Fuentefria
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Av Ipiranga, 2752, Santana, Porto Alegre, RS, 90610-000, Brazil; Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500, Centro, Porto Alegre, RS, 90050-170, Brazil
| | - Irene Clemes Külkamp-Guerreiro
- Programa de Pós-Graduação em Farmacologia e Terapêutica, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500, Centro, Porto Alegre, RS, 90050-170, Brazil; Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Av Ipiranga, 2752, Santana, Porto Alegre, RS, 90610-000, Brazil.
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18
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Khan AR, Yang X, Fu M, Zhai G. Recent progress of drug nanoformulations targeting to brain. J Control Release 2018; 291:37-64. [DOI: 10.1016/j.jconrel.2018.10.004] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 02/08/2023]
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19
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Masood MT, Zahid M, Goldoni L, Ceseracciu L, Athanassiou A, Bayer IS. Highly Transparent Polyethylcyanoacrylates from Approved Eco-Friendly Fragrance Materials Demonstrating Excellent Fog-Harvesting and Anti-Wear Properties. ACS APPLIED MATERIALS & INTERFACES 2018; 10:34573-34584. [PMID: 30199218 DOI: 10.1021/acsami.8b10717] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Superglue monomers belong to a family of cyanoacrylates that are known for their very rapid polymerization upon contact with moist surfaces. Their biodegradation and low toxicity make them attractive as medical and veterinary adhesives. Although the fast-acting polymerization characteristics have been successfully utilized to design nanoscale polymeric particles that can carry drugs or other inorganic nanoparticles, it constitutes a significant drawback if one desires to produce other forms of functional biodegradable acrylics, such as coatings, sheets, or nanocomposites. This is because rapid polymerization in air creates highly porous and brittle structures. Here, we address this drawback by reporting a simple and inexpensive method of fabricating highly transparent (>92%) polyethylcyanoacrylate (PECA) coatings by dispersing the monomer in a fragrance-classified green liquid, cyclopentanone. The resulting transparent coatings were hydrophilic but with slippery wetting characteristics, suitable as efficient fog-harvesting templates. Furthermore, another fragrance liquid, benzyl alcohol, is introduced as a plasticizer and co-solvent to overcome its brittleness while retaining its transparency. The same plasticized monomer solutions, dispersing low concentrations of graphene (<0.5 wt %), were allowed to self-assemble on stainless steel surfaces, forming low-friction and anti-wear dry lubricants by decreasing the steel friction coefficient and wear rate by 6- and 10-fold, respectively.
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Affiliation(s)
- Muhammad Tamoor Masood
- Dipartimento di Informatica, Bioingegneria, Robotica e Ingegneria dei Sistemi (DIBRIS) , Università degli studi di Genova , Via Opera Pia 13 , 16145 Genoa , Italy
| | - Muhammad Zahid
- Dipartimento di Informatica, Bioingegneria, Robotica e Ingegneria dei Sistemi (DIBRIS) , Università degli studi di Genova , Via Opera Pia 13 , 16145 Genoa , Italy
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20
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Zhang T, Tang Y, Zhang W, Liu S, Zhao Y, Wang W, Wang J, Xu L, Liu K. Sustained drug release and cancer treatment by an injectable and biodegradable cyanoacrylate-based local drug delivery system. J Mater Chem B 2018; 6:1216-1225. [PMID: 32254182 DOI: 10.1039/c7tb03066e] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Sustained drug release at specific sites is clinically favorable for the treatment of many diseases. The discovery of new polymeric materials suitable for prolonging drug release, improving therapeutic efficiency, and decreasing systemic toxicity is always of great interest in local sustained-release drug delivery systems (LSRDDSs). In this study, a new cross-linked cyanoacrylate (CA)-based LSRDDS is developed, in which the drug depot consists of a formulation of methoxyethyl cyanoacrylate (MOE-CA) with the cross-linking agent CA-PEG-CA. The MOE-CA endowed the CA polymer with good degradability. The drug-release profile could be affected by the structure and composition ratio of the MOE-CA/CA-PEG-CA monomer. The liquid CA monomer could dissolve the drug without using other solvents, and could polymerize into a solid glue just in a few seconds after injection. An optimal formulation loaded with 5-fluorouracil (J-Fu-1.25) showed excellent anticancer activity both in vitro and in vivo, with 50% survival of the mice and no significant systemic toxicity detected during the experiment. The CA depot might affect the blood flow in microvessels of tumors, thus contributing to the synergetic anticancer effect of 5-fluorouracil. We believe that this work provides a practical, biodegradable, and biocompatible LSRDDS for chemotherapeutic drug delivery that can also be applied universally with various drugs for certain therapeutic aims.
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Affiliation(s)
- Tao Zhang
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, 27 Taiping Road, Beijing, 100850, China.
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21
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Bharadwaj VN, Nguyen DT, Kodibagkar VD, Stabenfeldt SE. Nanoparticle-Based Therapeutics for Brain Injury. Adv Healthc Mater 2018; 7:10.1002/adhm.201700668. [PMID: 29034608 PMCID: PMC5903677 DOI: 10.1002/adhm.201700668] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 07/06/2017] [Indexed: 12/18/2022]
Abstract
Brain injuries affect a large patient population with major physical and emotional suffering for patients and their relatives; at a significant cost to the society. Effective diagnostic and therapeutic options available for brain injuries are limited by the complex brain injury pathology involving blood-brain barrier (BBB). Brain injuries, including ischemic stroke and brain trauma, initiate BBB opening for a short period of time, which is followed by a second reopening for an extended time. The leaky BBB and/or the alterations in the receptor expression on BBB may provide opportunities for therapeutic delivery via nanoparticles (NPs). The approaches for therapeutic interventions via NP delivery are aimed at salvaging the pericontusional/penumbra area for possible neuroprotection and neurovascular unit preservation. The focus of this progress report is to provide a survey of NP strategies employed in cerebral ischemia and brain trauma and finally provide insights for improved NP-based diagnostic/treatment approaches.
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Affiliation(s)
- Vimala N. Bharadwaj
- School of Biological and Health Systems Engineering, Arizona State University, PO Box 879709, Tempe, AZ 85287, United States
| | - Duong T. Nguyen
- School of Biological and Health Systems Engineering, Arizona State University, PO Box 879709, Tempe, AZ 85287, United States
| | - Vikram D. Kodibagkar
- School of Biological and Health Systems Engineering, Arizona State University, PO Box 879709, Tempe, AZ 85287, United States
| | - Sarah E. Stabenfeldt
- School of Biological and Health Systems Engineering, Arizona State University, PO Box 879709, Tempe, AZ 85287, United States
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22
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Korde JM, Kandasubramanian B. Biocompatible alkyl cyanoacrylates and their derivatives as bio-adhesives. Biomater Sci 2018; 6:1691-1711. [DOI: 10.1039/c8bm00312b] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Cyanoacrylate adhesives and their homologues have elicited interest over the past few decades owing to their applications in the biomedical sector, extending from tissue adhesives to scaffolds to implants to dental material and adhesives, because of their inherent biocompatibility and ability to polymerize solely with moisture, thanks to which they adhere to any substrate containing moisture such as the skin.
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Affiliation(s)
- Jay M. Korde
- Biocomposite Fabrication Lab
- Department of Metallurgical and Materials Engineering
- DIAT (DU)
- Ministry of Defence
- Pune-411025
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23
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Varghese NM, Senthil V, Saxena SK. Nanocarriers for brain specific delivery of anti-retro viral drugs: challenges and achievements. J Drug Target 2017; 26:195-207. [PMID: 28866957 DOI: 10.1080/1061186x.2017.1374389] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
HIV/AIDS is a global pandemic and the deleterious effects of human immunodeficiency virus in the brain cannot be overlooked. Though the current anti-retro viral therapy is able to reduce the virus load in the peripheral tissues of the body, the inability of the anti-retro viral drugs to cross the blood brain barrier, as such, limits its therapeutic effect in the brain. The development of newer, successful nanoparticulate drug delivery systems to enhance the feasibility of the anti-retro viral drugs to the brain, offers a novel strategy to treat the AIDS-related neuronal degradation. This review summarised the neuropathogenesis of neuroAIDS, the challenges and achievements made in the delivery of therapeutics across the BBB and the use of nanocarriers as a safe and effective way for delivering anti-retro viral drugs to the brain.
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Affiliation(s)
- Nila Mary Varghese
- a Department of Pharmaceutics, JSS College of Pharmacy, Ootacamund , Jagadguru Sri Shivarathreeswara University , Mysuru , India
| | - Venkatachalam Senthil
- a Department of Pharmaceutics, JSS College of Pharmacy, Ootacamund , Jagadguru Sri Shivarathreeswara University , Mysuru , India
| | - Shailendra K Saxena
- b Centre for Advance Research (CFAR) , King George's Medical University (KGMU) , Lucknow , India
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