1
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Wang H, Li H, Liu Z, Zhu Z, Cao Y. Activity of thonningianin A against Candida albicans in vitro and in vivo. Appl Microbiol Biotechnol 2024; 108:96. [PMID: 38212967 PMCID: PMC10784352 DOI: 10.1007/s00253-023-12996-1] [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: 09/06/2023] [Revised: 12/17/2023] [Accepted: 12/26/2023] [Indexed: 01/13/2024]
Abstract
Fungal infections are increasing rapidly, and antifungal agents used in clinics are limited. Therefore, novel antifungal agents with high efficiency are urgently required. In this study, we investigated the antifungal activity of thonningianin A (THA), a natural compound that is widely found in plants. We first determined the activity of THA against Candida albicans, one of the most common fungal pathogens, and found that THA showed antifungal activity against all C. albicans tested, including several fluconazole-resistant isolates. THA also inhibits the growth of non-Candida albicans species. In addition, THA displayed antibiofilm activity and could not only inhibit biofilm formation but also destroy mature biofilms. The in vivo antifungal efficacy of THA was confirmed in a Galleria mellonella infection model. Further studies revealed that THA could enhance intracellular reactive oxygen species (ROS) production and regulate the transcription of several redox-related genes. Specifically, caspase activity and expression of CaMCA1, a caspase-encoding gene in C. albicans, were remarkably increased upon THA treatment. Consistent with this, in the presence of THA, the Camca1 null mutant displayed higher survival rates and reduced caspase activity compared to the wild-type or CaMCA1-reintroduced strains, indicating an important role of CaMCA1 in the antifungal activity of THA. Taken together, our results indicate that THA possesses excellent antifungal activity and may be a promising novel antifungal candidate. KEY POINTS: • THA exhibits activity against Candida species, including fluconazole-resistant isolates • THA inhibits biofilm formation and destroys mature biofilm • Elevated ROS production and CaMCA1-mediated caspase activity are involved in the antifungal mechanisms of THA.
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Affiliation(s)
- Hui Wang
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Hui Li
- Department of Dermatology, Changhai Hospital, Naval Medical University, Shanghai, 200438, China
| | - ZhiWei Liu
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - ZhenYu Zhu
- School of Pharmacy, Naval Medical University, Shanghai, 200433, China.
| | - YingYing Cao
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China.
- Shanghai Engineering Research Center for Topical Chinese Medicine, Shanghai, 200443, China.
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2
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Yu Y, Tang X, Zhou L, Xu F, Zhang Y, Zeng L, Li J, Liao G, Luo L. Cascade-targeting polymeric particles eliminate intracellular C. neoformans in fungal infection therapy. J Control Release 2024; 373:399-409. [PMID: 39033984 DOI: 10.1016/j.jconrel.2024.07.047] [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: 03/04/2024] [Revised: 07/18/2024] [Accepted: 07/18/2024] [Indexed: 07/23/2024]
Abstract
C. neoformans, a life-threatening invasive fungal pathogen, can hijack the pulmonary macrophages as 'Trojan horse', leading to cryptococcal meningitis and recurrence. Combatting these elusive fungi has posed a long-standing challenge. Here, we report an inhaled cascade-targeting drug delivery platform that can sequentially target host cells and intracellular fungi. The delivery system involves encapsulating amphotericin B (AMB) into polymeric particles decorated with AMB, creating a unique surface pattern, denoted as APP@AMB. The surface topology of APP@AMB guides the efficient macrophages internalization and intracellular drugs accumulation. Following endocytosis, the surface-functionalized AMB specifically targets intracellular fungi by binding to ergosterol in the fungal membrane, as demonstrated through co-localization studies using confocal microscopy. Through on-site AMB delivery, APP@AMB displays superior efficacy in eliminating C. neoformans in the lungs and brain compared to free AMB following inhalation in infected mice. Additionally, APP@AMB significantly alleviates the nephrotoxicity associated with free AMB inhalation therapy. Thus, this biocompatible delivery system enabling host cells and intracellular fungi targeting in a cascade manner, provides a new avenue for the therapy of fungal infection.
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Affiliation(s)
- Yinglan Yu
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
| | - Xuefeng Tang
- Department of Pathology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 401120, China
| | - Liya Zhou
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
| | - Fanshu Xu
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
| | - Ying Zhang
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
| | - Linggao Zeng
- NMPA Key Laboratory for Quality Monitoring of Narcotic Drugs and Psychotropic Substances, Chongqing Institute for Food and Drug Control, Chongqing 401121, China
| | - Jun Li
- School of Chemistry and Chemical Engineering, North University of China, Taiyuan 030051, China
| | - Guojian Liao
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China.
| | - Lei Luo
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China.
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3
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Cunha NFC, de Siqueira LBDO, Garcia AR, Rodrigues IA, Matos APDS, Júnior ER, Monteiro MSDSB. Nanoemulsions containing amphotericin b and paromomycin for the treatment of cutaneous leishmaniasis. Acta Trop 2024; 254:107189. [PMID: 38522630 DOI: 10.1016/j.actatropica.2024.107189] [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: 11/10/2023] [Revised: 03/01/2024] [Accepted: 03/14/2024] [Indexed: 03/26/2024]
Abstract
Cutaneous leishmaniasis (CL) is a vector-borne disease characterized by skin lesions that can evolve into high-magnitude ulcerated lesions. Thus, this study aimed to develop an innovative nanoemulsion (NE) with clove oil, Poloxamer® 407, and multiple drugs, such as amphotericin B (AmB) and paromomycin (PM), for use in the topical treatment of CL. METHODS Droplet size, morphology, drug content, stability, in vitro release profile, in vitro cytotoxicity on RAW 264.7 macrophages, and antileishmanial activity using axenic amastigotes of Leishmania amazonensis were assessed for NEs. RESULTS After optimizing the formulation parameters, such as the concentration of clove oil and drugs, using an experimental design, it was possible to obtain a NE with an average droplet size of 40 nm and a polydispersion index of 0.3, and these parameters were maintained throughout the 365 days. Furthermore, the NE showed stability of AmB and PM content for 180 days under refrigeration (4 °C), presented a pH compatible with the skin, and released modified AmB and PM. NE showed the same toxicity as free AmB and higher toxicity than free PM against RAW 264.7 macrophages. The same activity as free AmB, and higher activity than free PM against amastigotes L. amazonensis. CONCLUSION It is possible to develop a NE for the treatment of CL; however, complementary studies regarding the antileishmanial activity of NE should be carried out.
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Affiliation(s)
- Nicolas Fontenele Callipo Cunha
- Laboratório de Desenvolvimento Galênico, Departamento de Fármacos e Medicamentos, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro (FF/UFRJ), Rio de Janeiro, RJ, Brazil
| | - Luciana Betzler de Oliveira de Siqueira
- Laboratório de Desenvolvimento Galênico, Departamento de Fármacos e Medicamentos, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro (FF/UFRJ), Rio de Janeiro, RJ, Brazil
| | - Andreza Raposo Garcia
- Programa de Pós-graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Laboratório de Investigação de Substâncias Bioativas, Departamentos de Produtos Naturais e Alimentos, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Igor Almeida Rodrigues
- Laboratório de Investigação de Substâncias Bioativas, Departamentos de Produtos Naturais e Alimentos, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ana Paula Dos Santos Matos
- Laboratório de Desenvolvimento Galênico, Departamento de Fármacos e Medicamentos, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro (FF/UFRJ), Rio de Janeiro, RJ, Brazil
| | - Eduardo Ricci Júnior
- Laboratório de Desenvolvimento Galênico, Departamento de Fármacos e Medicamentos, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro (FF/UFRJ), Rio de Janeiro, RJ, Brazil
| | - Mariana Sato de Souza Bustamante Monteiro
- Laboratório de Desenvolvimento Galênico, Departamento de Fármacos e Medicamentos, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro (FF/UFRJ), Rio de Janeiro, RJ, Brazil.
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4
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Malykhina AI, Efimova SS, Andriianov VS, Ostroumova OS. The interaction of plant flavones with amphotericin B: Consequences for its pore-forming ability. Biomed Pharmacother 2024; 175:116723. [PMID: 38723514 DOI: 10.1016/j.biopha.2024.116723] [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: 03/12/2024] [Revised: 04/25/2024] [Accepted: 05/06/2024] [Indexed: 06/03/2024] Open
Abstract
The growth of antibiotic resistance to antifungal drugs contributes to the search for new ways to enhance their effectiveness and reduce toxicity. The undeniable advantage of polyene macrolide antibiotic amphotericin B (AmB) which ensures low pathogen resistance is its mechanism of action related to the formation of transmembrane pores in target lipid membranes. Here, we investigated the effects of plant flavones, chrysin, wogonin, baicalein, apigenin, scutellarein, luteolin, morin and fisetin on the pore-forming activity of AmB in the sterol-enriched membranes by electrophysiological assays. Сhrysin, wogonin, baicalein, apigenin, scutellarein, and luteolin were shown to decrease the AmB pore-forming activity in the bilayers composed of palmitoyloleylphosphocholine independently of their sterol composition. Morin and fisetin led to the increase and decrease in the AmB pore-forming activity in the ergosterol- and cholesterol-containing bilayers respectively. Differential scanning microcalorimetry of the gel-to-liquid crystalline phase transition of membrane forming lipids, molecular dynamics simulations, and absorbance spectroscopy revealed the possibility of direct interactions between AmB and some flavones in the water and/or in the lipid bilayer. The influence of these interactions on the antibiotic partitioning between aqueous solution and membrane and/or its transition between different states in the bilayer was discussed.
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Affiliation(s)
- Anna I Malykhina
- Laboratory of Membrane and Ion Channel Modeling, Institute of Cytology of Russian Academy of Sciences, Tikhoretsky 4, Saint Petersburg 194064, Russian Federation
| | - Svetlana S Efimova
- Laboratory of Membrane and Ion Channel Modeling, Institute of Cytology of Russian Academy of Sciences, Tikhoretsky 4, Saint Petersburg 194064, Russian Federation
| | - Vladimir S Andriianov
- Laboratory of Membrane and Ion Channel Modeling, Institute of Cytology of Russian Academy of Sciences, Tikhoretsky 4, Saint Petersburg 194064, Russian Federation
| | - Olga S Ostroumova
- Laboratory of Membrane and Ion Channel Modeling, Institute of Cytology of Russian Academy of Sciences, Tikhoretsky 4, Saint Petersburg 194064, Russian Federation.
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5
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Romanovska A, Schmidt M, Brandt V, Tophoven J, Tiller JC. Controlling the function of bioactive worm micelles by enzyme-cleavable non-covalent inter-assembly cross-linking. J Control Release 2024; 368:15-23. [PMID: 38346504 DOI: 10.1016/j.jconrel.2024.02.013] [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: 11/26/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 02/23/2024]
Abstract
Drugs that form self-assembled supramolecular structures to be most-active is a promising way of creating new highly specific and active pharmaceuticals. Controlling the activity of bioactive supramolecular structures such as drug-loaded micelles is possible by both core/shell and inter-assembly cross-linking. However, if the flexibility of the assembly is mandatory for the activity cross-linking is not feasible. Thus, such structures cannot be manipulated in their activity. The present study demonstrates a novel concept to control the activity of not drug-releasing, non-cross-linked bioactive superstructures. This is achieved by formation of nanostructured nanoparticles derived by non-covalent inter-assembly cross-linking of the superstructures. This is shown on the example of amphiphilic diblock-copolymers conjugated with the antibiotic ciprofloxacin (CIP). These polymer-antibiotic conjugates form worm micelles, which greatly activate the conjugated antibiotic without releasing it. Non-covalent inter-assembly cross-linking of these CIP-worm-micelles with amphiphilic triblock copolymers terminated with lipase-cleavable esters leads to nanostructured nanoparticles that resemble cross-linked worm micelles and show an up to 135-fold lower activity than the free worm micelles. The activity of the worm-micelles can be fully recovered by cleaving the end groups of the polymeric cross-linker with lipase.
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Affiliation(s)
- Alina Romanovska
- Biomaterials and Polymer Science, Department of Bio- and Chemical Engineering, TU Dortmund, Emil-Figge-Straße 66, 44227 Dortmund, Germany
| | - Martin Schmidt
- Biomaterials and Polymer Science, Department of Bio- and Chemical Engineering, TU Dortmund, Emil-Figge-Straße 66, 44227 Dortmund, Germany
| | - Volker Brandt
- Biomaterials and Polymer Science, Department of Bio- and Chemical Engineering, TU Dortmund, Emil-Figge-Straße 66, 44227 Dortmund, Germany
| | - Jonas Tophoven
- Biomaterials and Polymer Science, Department of Bio- and Chemical Engineering, TU Dortmund, Emil-Figge-Straße 66, 44227 Dortmund, Germany
| | - Joerg C Tiller
- Biomaterials and Polymer Science, Department of Bio- and Chemical Engineering, TU Dortmund, Emil-Figge-Straße 66, 44227 Dortmund, Germany.
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6
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Zuccari G, Villa C, Iurilli V, Barabino P, Zorzoli A, Marimpietri D, Caviglia D, Russo E. AmBisome ® Formulations for Pediatrics: Stability, Cytotoxicity, and Cost-Effectiveness Studies. Pharmaceutics 2024; 16:466. [PMID: 38675127 PMCID: PMC11054559 DOI: 10.3390/pharmaceutics16040466] [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: 02/24/2024] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
Liposomal amphotericin B (Ambisome®) is the gold standard for the treatment and prevention of fungal infections both in the adult and pediatric populations. The lyophilized dosage form has to be reconstituted and diluted by hospital staff, but its management can be challenging due to the spontaneous tendency of amphotericin B to form aggregates with different biological activity. In this study, the colloidal stability of the liposomes and the chemical stability of amphotericin B were investigated over time at storage conditions. Three liposomal formulations of amphotericin B at 4.0 mg/mL, 2.0 mg/mL, and 0.2 mg/mL were prepared and assayed for changes regarding the dimensional distribution, zeta potential, drug aggregation state, and onset of by-products. Our analyses highlighted that the most diluted formulation, kept at room temperature, showed the greatest changes in the aggregation state of the drug and accordingly the highest cytotoxicity. These findings are clinically relevant since the lower dosages are addressed to the more vulnerable patients. Therefore, the centralization of the dilution of AmBisome® at the pharmacy is of fundamental importance for assuring patient safety, and at the same time for reducing medication waste, as we demonstrated using the cost-saving analysis of drug expense per therapy carried out at the G. Gaslini children hospital.
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Affiliation(s)
- Guendalina Zuccari
- Department of Pharmacy, University of Genoa, Viale Benedetto XV, 16132 Genoa, Italy; (C.V.); (D.C.)
| | - Carla Villa
- Department of Pharmacy, University of Genoa, Viale Benedetto XV, 16132 Genoa, Italy; (C.V.); (D.C.)
| | - Valentina Iurilli
- UOC—Unità Operativa Complessa, IRCCS Istituto Giannina Gaslini, via Gerolamo Gaslini 5, 16147 Genoa, Italy; (V.I.); (P.B.)
| | - Paola Barabino
- UOC—Unità Operativa Complessa, IRCCS Istituto Giannina Gaslini, via Gerolamo Gaslini 5, 16147 Genoa, Italy; (V.I.); (P.B.)
| | - Alessia Zorzoli
- Stem Cell Laboratory and Cell Therapy Center, IRCCS Istituto Giannina Gaslini, via Gerolamo Gaslini 5, 16147 Genoa, Italy; (A.Z.); (D.M.)
| | - Danilo Marimpietri
- Stem Cell Laboratory and Cell Therapy Center, IRCCS Istituto Giannina Gaslini, via Gerolamo Gaslini 5, 16147 Genoa, Italy; (A.Z.); (D.M.)
| | - Debora Caviglia
- Department of Pharmacy, University of Genoa, Viale Benedetto XV, 16132 Genoa, Italy; (C.V.); (D.C.)
| | - Eleonora Russo
- Department of Pharmacy, University of Genoa, Viale Benedetto XV, 16132 Genoa, Italy; (C.V.); (D.C.)
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7
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Jiang C, Li F, Song P, Wen M, Yang S, Tian G, Shao D, Shi J, Shang L. Multifunctional Gold Nanozyme-Engineered Amphotericin B for Enhanced Antifungal Infection Therapy. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024:e2312253. [PMID: 38501846 DOI: 10.1002/smll.202312253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/01/2024] [Indexed: 03/20/2024]
Abstract
Chronic wounds of significant severity and acute injuries are highly vulnerable to fungal infections, drastically impeding the expected wound healing trajectory. The clinical use of antifungal therapeutic drug is hampered by poor solubility, high toxicity and adverse reactions, thereby necessitating the urgent development of novel antifungal therapy strategy. Herein, this study proposes a new strategy to enhance the bioactivity of small-molecule antifungal drugs based on multifunctional metal nanozyme engineering, using amphotericin B (AmB) as an example. AmB-decorated gold nanoparticles (AmB@AuNPs) are synthesized by a facile one-pot reaction strategy, and the AmB@AuNPs exhibit superior peroxidase (POD)-like enzyme activity, with maximal reaction rates (Vmax ) 3.4 times higher than that of AuNPs for the catalytic reaction of H2 O2 . Importantly, the enzyme-like activity of AuNPs significantly enhanced the antifungal properties of AmB, and the minimum inhibitory concentrations of AmB@AuNPs against Candida albicans (C. albicans) and Saccharomyces cerevisiae (S. cerevisiae) W303 are reduced by 1.6-fold and 50-fold, respectively, as compared with AmB alone. Concurrent in vivo studies conducted on fungal-infected wounds in mice underscored the fundamentally superior antifungal ability and biosafety of AmB@AuNPs. The proposed strategy of engineering antifungal drugs with nanozymes has great potential for enhanced therapy of fungal infections and related diseases.
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Affiliation(s)
- Chunmei Jiang
- Key Laboratory for Space Bioscience and Space Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi, 710072, China
| | - Fangping Li
- Key Laboratory for Space Bioscience and Space Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi, 710072, China
| | - Pei Song
- Key Laboratory for Space Bioscience and Space Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi, 710072, China
| | - Mengyao Wen
- State Key Laboratory of Solidification Processing, School of Materials Science and Engineering, Northwestern Polytechnical University, Xi'an, Shaanxi, 710072, China
| | - Saixue Yang
- Key Laboratory for Space Bioscience and Space Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi, 710072, China
| | - Geng Tian
- Key Laboratory for Space Bioscience and Space Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi, 710072, China
| | - Dongyan Shao
- Key Laboratory for Space Bioscience and Space Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi, 710072, China
| | - Junling Shi
- Key Laboratory for Space Bioscience and Space Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi, 710072, China
| | - Li Shang
- State Key Laboratory of Solidification Processing, School of Materials Science and Engineering, Northwestern Polytechnical University, Xi'an, Shaanxi, 710072, China
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8
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Marques Borges GS, Santos TT, Pinto CM, Frézard F, Blanco VF, Ondei R, Rumbelow S, Miranda Ferreira LA, Gontijo de Aguiar MM, Castro Goulart GA. Distearoyl phosphatidylglycerol and dioleoyl phosphatidylglycerol increase the retention and reduce the toxicity of amphotericin B-loaded in nanoemulsions. Nanomedicine (Lond) 2024; 19:383-396. [PMID: 38293893 DOI: 10.2217/nnm-2023-0256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Aim: To develop nanoemulsions (NEs) loading amphotericin B (AmB) and to evaluate the influence of different excipients on the stability and the supramolecular organization, retention and toxicity of AmB. Materials & methods: The NEs were developed from different oils, surfactants, external media and anionic lipids (disteaoryl phosphatidylglycerol [DSPG] and dioleoyl phosphatidylglycerol [DOPG]). Their impact on the size, pH, zeta potential, AmB encapsulation efficiency, AmB retention and hemolytic potential of the NEs was evaluated. Results & conclusion: The use of soybean oil (lipid matrix), Span 80 (surfactant), phosphate buffer (external phase) and DSPG or DOPG (hydrophobic ion pair) provided better NE stability, higher AmB retention within the NEs and a safer formulation profile in hemolysis tests.
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Affiliation(s)
- Gabriel Silva Marques Borges
- Departamento de Farmácia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, 39100-000, Brazil
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Brazil
| | - Thais Tunes Santos
- Departamento de Fisiologia e Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Brazil
| | - Cristiane Monteiro Pinto
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Brazil
| | - Frédéric Frézard
- Departamento de Fisiologia e Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Brazil
| | | | - Roberta Ondei
- Croda do Brasil, Rua Croda, 580, Campinas, 13054-710, Brazil
| | - Stephen Rumbelow
- Croda Inc, Building 2, Suite 200, 777 Scudders Mill Road, Plainsboro, NJ 08540, USA
| | - Lucas Antônio Miranda Ferreira
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Brazil
| | - Marta Marques Gontijo de Aguiar
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Brazil
| | - Gisele Assis Castro Goulart
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Brazil
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9
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Malec K, Mikołajczyk A, Marciniak D, Gawin-Mikołajewicz A, Matera-Witkiewicz A, Karolewicz B, Nawrot U, Khimyak YZ, Nartowski KP. Pluronic F-127 Enhances the Antifungal Activity of Fluconazole against Resistant Candida Strains. ACS Infect Dis 2024; 10:215-231. [PMID: 38109184 PMCID: PMC10795414 DOI: 10.1021/acsinfecdis.3c00536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/13/2023] [Accepted: 11/21/2023] [Indexed: 12/19/2023]
Abstract
Candida strains as the most frequent causes of infections, along with their increased drug resistance, pose significant clinical and financial challenges to the healthcare system. Some polymeric excipients were reported to interfere with the multidrug resistance mechanism. Bearing in mind that there are a limited number of marketed products with fluconazole (FLU) for the topical route of administration, Pluronic F-127 (PLX)/FLU formulations were investigated in this work. The aims of this study were to investigate (i) whether PLX-based formulations can increase the susceptibility of resistant Candida strains to FLU, (ii) whether there is a correlation between block polymer concentration and the antifungal efficacy of the FLU-loaded PLX formulations, and (iii) what the potential mode of action of PLX assisting FLU is. The yeast growth inhibition upon incubation with PLX formulations loaded with FLU was statistically significant. The highest efficacy of the azole agent was observed in the presence of 5.0 and 10.0% w/v of PLX. The upregulation of the CDR1/CDR2 genes was detected in the investigated Candida strains, indicating that the efflux of the drug from the fungal cell was the main mechanism of the resistance.
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Affiliation(s)
- Katarzyna Malec
- Department of Drug Form Technology, Faculty of
Pharmacy, Wroclaw Medical University, 211a Borowska Str, 50-556
Wroclaw, Poland
| | - Aleksandra Mikołajczyk
- Screening Biological Activity Assays and Collection of
Biological Material Laboratory, Wroclaw Medical University,
211a Borowska Str, 50-556 Wroclaw, Poland
| | - Dominik Marciniak
- Department of Drug Form Technology, Faculty of
Pharmacy, Wroclaw Medical University, 211a Borowska Str, 50-556
Wroclaw, Poland
| | - Agnieszka Gawin-Mikołajewicz
- Department of Drug Form Technology, Faculty of
Pharmacy, Wroclaw Medical University, 211a Borowska Str, 50-556
Wroclaw, Poland
| | - Agnieszka Matera-Witkiewicz
- Screening Biological Activity Assays and Collection of
Biological Material Laboratory, Wroclaw Medical University,
211a Borowska Str, 50-556 Wroclaw, Poland
| | - Bożena Karolewicz
- Department of Drug Form Technology, Faculty of
Pharmacy, Wroclaw Medical University, 211a Borowska Str, 50-556
Wroclaw, Poland
| | - Urszula Nawrot
- Department of Pharmaceutical Microbiology and
Parasitology, Wroclaw Medical University, 211a Borowska Str,
50-556 Wroclaw, Poland
| | - Yaroslav Z. Khimyak
- Department of Drug Form Technology, Faculty of
Pharmacy, Wroclaw Medical University, 211a Borowska Str, 50-556
Wroclaw, Poland
- School of Pharmacy, University of East
Anglia, Chancellors Drive, NR4 7TJ Norwich, U.K.
| | - Karol P. Nartowski
- Department of Drug Form Technology, Faculty of
Pharmacy, Wroclaw Medical University, 211a Borowska Str, 50-556
Wroclaw, Poland
- School of Pharmacy, University of East
Anglia, Chancellors Drive, NR4 7TJ Norwich, U.K.
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10
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Joyson N, Pathak A, Jain K. One Platform Comparison of Polymeric and Lipidic Nanoparticles for the Delivery of Amphotericin B. AAPS PharmSciTech 2023; 24:226. [PMID: 37945925 DOI: 10.1208/s12249-023-02672-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/03/2023] [Indexed: 11/12/2023] Open
Abstract
Amphotericin B (AmB) is a membrane-acting antibiotic used for the treatment of fungal and protozoal infections. AmB exists in various molecular forms, i.e., monomeric, super-aggregated, and oligomeric forms, where oligomeric forms are highly toxic because of their relative affinity toward cholesterol present over human cell membrane. Hence, the objective of our research work was to study the aggregation state of AmB in two different nanoformulations, i.e., solid lipid nanoparticles (SLNs) and zein-based nanoparticles (PNPs), with the aim of enhancing the fraction of less toxic form of AmB, and a comparative study was performed. The zein and glyceryl monostearate can intercalate the polyenic domain of AmB and thereby hinder the hydrophobic attractions between the AmB molecules, which allows their existence in monomeric forms. The particle size of AmB-SLNs and AmB-PNPs were 378.90 ± 9.50 nm and 184.90 ± 6.00 nm, while zeta potential was -34.97 ± 0.51 mV and +28.93 ± 2.29 mV, respectively. In vitro release studies showed more controlled release of AmB from PNPs (52.48 ± 1.07%) as compared to SLNs (86.33 ± 0.93%). The predominant aggregation state of AmB in both formulations was determined by UV-visible and circular dichroism spectrophotometry, where a higher degree of monomerization of AmB was reported in AmB-SLNs as compared to AmB-PNPs. Toxicity of the nanoformulations was evaluated through hemolysis test, where the results suggested that AmB-SLNs and AmB-PNPs were less hemolytic as compared to pure AmB. The nanoformulations demonstrated the predominant monomeric form of AmB, which may offer higher selectivity index toward microbial membrane.
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Affiliation(s)
- Nandha Joyson
- Drug Delivery and Nanomedicine Research Laboratory, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER) - Raebareli, Lucknow, Uttar Pradesh, 226002, India
| | - Anchal Pathak
- Drug Delivery and Nanomedicine Research Laboratory, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER) - Raebareli, Lucknow, Uttar Pradesh, 226002, India
| | - Keerti Jain
- Drug Delivery and Nanomedicine Research Laboratory, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER) - Raebareli, Lucknow, Uttar Pradesh, 226002, India.
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11
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Celi SS, Fernández-García R, Afonso-Urich AI, Ballesteros MP, Healy AM, Serrano DR. Co-Delivery of a High Dose of Amphotericin B and Itraconazole by Means of a Dry Powder Inhaler Formulation for the Treatment of Severe Fungal Pulmonary Infections. Pharmaceutics 2023; 15:2601. [PMID: 38004579 PMCID: PMC10675812 DOI: 10.3390/pharmaceutics15112601] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/27/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Over the past few decades, there has been a considerable rise in the incidence and prevalence of pulmonary fungal infections, creating a global health problem due to a lack of antifungal therapies specifically designed for pulmonary administration. Amphotericin B (AmB) and itraconazole (ITR) are two antifungal drugs with different mechanisms of action that have been widely employed in antimycotic therapy. In this work, microparticles containing a high dose of AmB and ITR (20, 30, and 40% total antifungal drug loading) were engineered for use in dry powder inhalers (DPIs) with an aim to improve the pharmacological effect, thereby enhancing the existing off-label choices for pulmonary administration. A Design of Experiment (DoE) approach was employed to prepare DPI formulations consisting of AmB-ITR encapsulated within γ-cyclodextrin (γ-CD) alongside functional excipients, such as mannitol and leucine. In vitro deposition indicated a favourable lung deposition pattern characterised by an upper ITR distribution (mass median aerodynamic diameter (MMAD) ~ 6 µm) along with a lower AmB deposition (MMAD ~ 3 µm). This offers significant advantages for treating fungal infections, not only in the lung parenchyma but also in the upper respiratory tract, considering that Aspergillus spp. can cause upper and lower airway disorders. The in vitro deposition profile of ITR and larger MMAD was related to the higher unencapsulated crystalline fraction of the drug, which may be altered using a higher concentration of γ-CD.
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Affiliation(s)
- Salomé S. Celi
- Departamento de Farmacia Galénica y Tecnología Alimentaria, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
| | - Raquel Fernández-García
- Departamento de Farmacia Galénica y Tecnología Alimentaria, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
| | - Andreina I. Afonso-Urich
- Departamento de Farmacia Galénica y Tecnología Alimentaria, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
| | - M. Paloma Ballesteros
- Departamento de Farmacia Galénica y Tecnología Alimentaria, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
- Facultad de Farmacia, Instituto Universitario de Farmacia Industrial, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040 Madrid, Spain
| | - Anne Marie Healy
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Dolores R. Serrano
- Departamento de Farmacia Galénica y Tecnología Alimentaria, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
- Facultad de Farmacia, Instituto Universitario de Farmacia Industrial, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040 Madrid, Spain
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12
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Marcelino HR, Solgadi A, Chéron M, do Egito EST, Ponchel G. Exploring the permeability of Amphotericin B trough serum albumin dispersions and lipid nanocarriers for oral delivery. Int J Pharm 2023; 646:123444. [PMID: 37757958 DOI: 10.1016/j.ijpharm.2023.123444] [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: 04/15/2023] [Revised: 08/12/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023]
Abstract
Amphotericin B (AmB) is a potent polyenic antifungal agent with leishmanicidal activity. Due to its low solubility and permeability in the gastrointestinal tract, AmB is usually administered intravenously. In this context, various approaches have been used to try to improve these properties. Some of the systems developed have shown proven successful, but there is still a lack of knowledge about the pathways AmB takes after oral administration. Therefore, the aim of this work was not only to obtain aqueous dispersions containing AmB at different aggregation states, but also to entrap this molecule in nanocarriers, and evaluate the influence of these conditions on the jejunal permeability of AmB. To observe the aggregation states of AmB, physicochemical characterization of AmB-albumin complexes and AmB-loaded formulations was performed. Different degrees of AmB aggregation states were obtained. Thus, permeability tests were performed in the Ussing chamber and a decrease in AmB concentration in the donor compartment was observed. Electrophysiological measurements showed different responses depending on the AmB formulation. In conclusion, although control of the AmB aggregation state was observed by physicochemical characterization, this approach does not seem to have a sufficient effect on AmB permeability, but on its toxicity. For a complete understanding of AmB-loaded nanocarriers, other pathways, such as lymphatic absorption, should also be investigated.
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Affiliation(s)
- Henrique Rodrigues Marcelino
- Graduate Program in Health Sciences (PPgCSa), Federal University of Rio Grande do Norte, Natal/RN 59012-570, Brazil; Institut Galien Paris-Saclay, CNRS UMR 8612, Université Paris-Saclay, Orsay 91190, France; College of Pharmacy, Federal University of Bahia, Salvador/BA 40170-115, Brazil (Recent affiliation)
| | - Audrey Solgadi
- SFR IPSIT (Paris-Saclay Institute of Therapeutic Innovation), University Paris-Saclay, Orsay 91190, France
| | - Monique Chéron
- College of Pharmacy, University Paris-Saclay, Orsay 91190, France
| | | | - Gilles Ponchel
- Institut Galien Paris-Saclay, CNRS UMR 8612, Université Paris-Saclay, Orsay 91190, France; College of Pharmacy, University Paris-Saclay, Orsay 91190, France
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13
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Vasconcelos I, Santos T. Nanotechnology Applications in Sepsis: Essential Knowledge for Clinicians. Pharmaceutics 2023; 15:1682. [PMID: 37376129 DOI: 10.3390/pharmaceutics15061682] [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: 05/04/2023] [Revised: 05/29/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Sepsis is a life-threatening condition caused by a dysregulated host response to an invading pathogen such as multidrug-resistant bacteria. Despite recent advancements, sepsis is a leading cause of morbidity and mortality, resulting in a significant global impact and burden. This condition affects all age groups, with clinical outcomes mainly depending on a timely diagnosis and appropriate early therapeutic intervention. Because of the unique features of nanosized systems, there is a growing interest in developing and designing novel solutions. Nanoscale-engineered materials allow a targeted and controlled release of bioactive agents, resulting in improved efficacy with minimal side effects. Additionally, nanoparticle-based sensors provide a quicker and more reliable alternative to conventional diagnostic methods for identifying infection and organ dysfunction. Despite recent advancements, fundamental nanotechnology principles are often presented in technical formats that presuppose advanced chemistry, physics, and engineering knowledge. Consequently, clinicians may not grasp the underlying science, hindering interdisciplinary collaborations and successful translation from bench to bedside. In this review, we abridge some of the most recent and most promising nanotechnology-based solutions for sepsis diagnosis and management using an intelligible format to stimulate a seamless collaboration between engineers, scientists, and clinicians.
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Affiliation(s)
- Inês Vasconcelos
- School of Medicine, University of Minho, 4710-057 Braga, Portugal
- Department of Surgery and Physiology, Cardiovascular Research and Development Center-UnIC, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Tiago Santos
- School of Medicine, University of Minho, 4710-057 Braga, Portugal
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14
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de Pablo E, O'Connell P, Fernández-García R, Marchand S, Chauzy A, Tewes F, Dea-Ayuela MA, Kumar D, Bolás F, Ballesteros MP, Torrado JJ, Healy AM, Serrano DR. Targeting lung macrophages for fungal and parasitic pulmonary infections with innovative amphotericin B dry powder inhalers. Int J Pharm 2023; 635:122788. [PMID: 36863544 DOI: 10.1016/j.ijpharm.2023.122788] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 03/04/2023]
Abstract
The incidence of fungal pulmonary infections is known to be on the increase, and yet there is an alarming gap in terms of marketed antifungal therapies that are available for pulmonary administration. Amphotericin B (AmB) is a highly efficient broad-spectrum antifungal only marketed as an intravenous formulation. Based on the lack of effective antifungal and antiparasitic pulmonary treatments, the aim of this study was to develop a carbohydrate-based AmB dry powder inhaler (DPI) formulation, prepared by spray drying. Amorphous AmB microparticles were developed by combining 39.7 % AmB with 39.7 % γ-cyclodextrin, 8.1 % mannose and 12.5 % leucine. An increase in the mannose concentration from 8.1 to 29.8 %, led to partial drug crystallisation. Both formulations showed good in vitro lung deposition characteristics (80 % FPF < 5 µm and MMAD < 3 µm) at different air flow rates (60 and 30 L/min) when used with a DPI, but also during nebulisation upon reconstitution in water.
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Affiliation(s)
- E de Pablo
- Pharmaceutics and Food Technology Department, School of Pharmacy, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
| | - P O'Connell
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, Ireland
| | - R Fernández-García
- Pharmaceutics and Food Technology Department, School of Pharmacy, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
| | - S Marchand
- UMR 1070, Université de PoitiersPôle Biologie Santé, 1, Rue Georges Bonnet, 86073 Poitiers, France; Laboratoire de Toxicologie-Pharmacocinétique, CHU de Poitiers, 2, Rue de la milétrie, 86021 Poitiers, France
| | - A Chauzy
- UMR 1070, Université de PoitiersPôle Biologie Santé, 1, Rue Georges Bonnet, 86073 Poitiers, France
| | - F Tewes
- UMR 1070, Université de PoitiersPôle Biologie Santé, 1, Rue Georges Bonnet, 86073 Poitiers, France; Laboratoire de Toxicologie-Pharmacocinétique, CHU de Poitiers, 2, Rue de la milétrie, 86021 Poitiers, France
| | - M A Dea-Ayuela
- Pharmacy Department, School of Life Sciences, Universidad Cardenal Herrera-CEU, Moncada 46113 Valencia, Spain
| | - D Kumar
- Department of Pharmaceutical Engineering & Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, India
| | - F Bolás
- Parasitology Department, School of Pharmacy, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
| | - M P Ballesteros
- Pharmaceutics and Food Technology Department, School of Pharmacy, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto Universitario de Farmacia Industrial, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - J J Torrado
- Pharmaceutics and Food Technology Department, School of Pharmacy, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto Universitario de Farmacia Industrial, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - A M Healy
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, Ireland
| | - D R Serrano
- Pharmaceutics and Food Technology Department, School of Pharmacy, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto Universitario de Farmacia Industrial, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain.
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15
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Ji X, Shi C, Guo D, Yang X, Suo L, Luo J. Engineering Telodendrimer Nanocarriers for Monomeric Amphotericin B Delivery. Mol Pharm 2023; 20:2138-2149. [PMID: 36877183 DOI: 10.1021/acs.molpharmaceut.2c01087] [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] [Indexed: 03/07/2023]
Abstract
Systemic fungal infections are an increasingly prevalent health problem. Amphotericin B (AmB), a hydrophobic polyene antibiotic, remains the drug of choice for life-threatening invasive fungal infections. However, it has dose-limiting side effects, including nephrotoxicity. The efficacy and toxicity of AmB are directly related to its aggregation state. Here, we report the preparation of a series of telodendrimer (TD) nanocarriers with the freely engineered core structures for AmB encapsulation to fine-tune AmB aggregation status. The reduced aggregation status correlates well with the optimized antifungal activity, attenuated hemolytic properties, and reduced cytotoxicity to mammalian cells. The optimized TD nanocarrier for monomeric AmB encapsulation significantly increases the therapeutic index, reduces the in vivo toxicity, and enhances antifungal effects in mouse models with Candida albicans infection in comparison to two common clinical formulations, i.e., Fungizone and AmBisome.
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Affiliation(s)
- Xiaotian Ji
- Department of Pharmacology, State University of New York Upstate Medical University, Syracuse, New York 13210, United States
| | - Changying Shi
- Department of Pharmacology, State University of New York Upstate Medical University, Syracuse, New York 13210, United States
| | - Dandan Guo
- Department of Pharmacology, State University of New York Upstate Medical University, Syracuse, New York 13210, United States
| | - Xiguang Yang
- Department of Pharmacology, State University of New York Upstate Medical University, Syracuse, New York 13210, United States
| | - Liye Suo
- Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York 13210, United States
| | - Juntao Luo
- Department of Pharmacology, Department of Surgery, Department of Microbiology and Immunology, Upstate Cancer Center, Upstate Sepsis Interdisciplinary Research Center, State University of New York Upstate Medical University, Syracuse, New York 13210, United States
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16
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Sawangchan P, Alexandrino Júnior F, Alencar ÉN, Egito EST, Kirsch LE. The role of aggregation and ionization in the chemical instability of Amphotericin B in aqueous methanol. Int J Pharm 2023; 632:122586. [PMID: 36623739 DOI: 10.1016/j.ijpharm.2023.122586] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/26/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
Amphotericin B (AmB) is a potent antimicrobial agent used in clinical practice. Nevertheless, the mechanism of its aqueous instability remains not yet fully understood, especially the role that its aggregation state plays in this process. Therefore, the current study used an aqueous methanol media to evaluate the AmB instability as a function of pH-, organic solvent- and concentration-dependent ionization and aggregation. To reach this goal, the aggregation status and instability were determined using UV-vis spectroscopy, LC-MS and HPLC. Moreover, not only the hydrolytic degradation products were identified by UV-vis spectroscopy and LC-MS, but also, the degradation rate constants were estimated by nonlinear regression. The results indicated that monomeric AmB was the predominant species under pH conditions, wherein the substrate was cationic (pH < 4) or anionic (pH > 9). On the other hand, aggregated AmB form was the predominant species for the zwitterionic substrate (at methanol concentration < 30 %(v/v)). Anionic substrate degraded by specific base-catalyzed lactone hydrolysis. Oxidation accounted for the loss of zwitterionic substrate. Aggregated zwitterionic AmB exhibited lower stability than monomeric zwitterionic AmB under neutral pH conditions. These studies are a step forward in comprehending the degradation kinetics of AmB in aqueous medium. In fact, along with our previous research on AmB instability in oils, it leads to a better understanding of the AmB stability in complex systems with an oil-water interface, such as disperse lipid systems.
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Affiliation(s)
- Phawanan Sawangchan
- The Division of Pharmaceutics and Translation Therapeutics, The University of Iowa, Iowa City, IA, USA
| | - Francisco Alexandrino Júnior
- The Division of Pharmaceutics and Translation Therapeutics, The University of Iowa, Iowa City, IA, USA; Graduate Program in Pharmaceutical Nanotechnology (PPGNanoFarma), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Éverton N Alencar
- The Division of Pharmaceutics and Translation Therapeutics, The University of Iowa, Iowa City, IA, USA; Graduate Program in Pharmaceutical Nanotechnology (PPGNanoFarma), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Eryvaldo S T Egito
- The Division of Pharmaceutics and Translation Therapeutics, The University of Iowa, Iowa City, IA, USA; Graduate Program in Pharmaceutical Nanotechnology (PPGNanoFarma), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil.
| | - Lee E Kirsch
- The Division of Pharmaceutics and Translation Therapeutics, The University of Iowa, Iowa City, IA, USA
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17
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Fernández-García R, Walsh D, O'Connell P, Slowing K, Raposo R, Paloma Ballesteros M, Jiménez-Cebrián A, Chamorro-Sancho MJ, Bolás-Fernández F, Healy AM, Serrano DR. Can amphotericin B and itraconazole be co-delivered orally? Tailoring oral fixed-dose combination coated granules for systemic mycoses. Eur J Pharm Biopharm 2023; 183:74-91. [PMID: 36623752 DOI: 10.1016/j.ejpb.2023.01.003] [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: 09/24/2022] [Revised: 12/06/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
The incidence and prevalence of invasive fungal infections have increased significantly over the last few years, leading to a global health problem due to the lack of effective treatments. Amphotericin B (AmB) and itraconazole (ITR) are two antifungal drugs with different mechanisms of action. In this work, AmB and ITR have been formulated within granules to elicit an enhanced pharmacological effect, while enhancing the oral bioavailability of AmB. A Quality by Design (QbD) approach was utilised to prepare fixed-dose combination (FDC) granules consisting of a core containing AmB with functional excipients, such as inulin, microcrystalline cellulose (MCC), chitosan, sodium deoxycholate (NaDC) and Soluplus® and polyvinyl pyrrolidone (PVP), coated with a polymeric layer containing ITR with Soluplus® or a combination of Poloxamer 188 and hydroxypropyl methyl cellulose-acetyl succinate (HPMCAS). A Taguchi design of experiments (DoE) with 7 factors and 2 levels was carried out to understand the key factors impacting on the physicochemical properties of the formulation followed by a Box-Behnken design with 3 factors in 3 levels chosen to optimise the formulation parameters. The core of the FDC granules was obtained by wet granulation and later coated using a fluidized bed. In vitro antifungal efficacy was demonstrated by measuring the inhibition halo against different species of Candida spp., including C. albicans (24.19-30.48 mm), C. parapsilosis (26.38-27.84 mm) and C. krusei (11.48-17.92 mm). AmB release was prolonged from 3 to 24 h when the AmB granules were coated. In vivo in CD-1 male mice studies showed that these granules were more selective towards liver, spleen and lung compared to kidney (up to 5-fold more selective in liver, with an accumulation of 8.07 µg AmB/g liver after twice-daily 5 days administration of granules coated with soluplus-ITR), resulting in an excellent oral administration option in the treatment of invasive mycosis. Nevertheless, some biochemical alterations were found, including a decrease in blood urea nitrogen (∼17 g/dl) and alanine aminotransferase (<30 U/l) and an increase in the levels of bilirubin (∼0.2 mg/dl) and alkaline phosphatase (<80 U/l), which could be indicative of a liver failure. Once-daily regimen for 10 days can be a promising therapy.
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Affiliation(s)
- Raquel Fernández-García
- Departamento de Farmacia Galénica y Tecnología Alimentaria, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain
| | - David Walsh
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, Ireland
| | - Peter O'Connell
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, Ireland
| | - Karla Slowing
- Departamento de Farmacología, Farmacognosia y Botánica, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain
| | - Rafaela Raposo
- Seccion Departamental de Fisiología, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
| | - M Paloma Ballesteros
- Departamento de Farmacia Galénica y Tecnología Alimentaria, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain; Instituto Universitario de Farmacia Industrial, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain
| | | | | | - Francisco Bolás-Fernández
- Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain
| | - Anne Marie Healy
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, Ireland
| | - Dolores R Serrano
- Departamento de Farmacia Galénica y Tecnología Alimentaria, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain; Instituto Universitario de Farmacia Industrial, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain.
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18
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Liu L, Liang Z, Zhou Y, Pan H, Liu H. Effect of Amphotericin B on the thermodynamic stability, aggregation state, hemolysis and antifungal activity of Amphotericin B-nonionic surfactant micellar system. J Mol Liq 2023. [DOI: 10.1016/j.molliq.2023.121486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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19
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Frézard F, Aguiar MMG, Ferreira LAM, Ramos GS, Santos TT, Borges GSM, Vallejos VMR, De Morais HLO. Liposomal Amphotericin B for Treatment of Leishmaniasis: From the Identification of Critical Physicochemical Attributes to the Design of Effective Topical and Oral Formulations. Pharmaceutics 2022; 15:pharmaceutics15010099. [PMID: 36678729 PMCID: PMC9864876 DOI: 10.3390/pharmaceutics15010099] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
The liposomal amphotericin B (AmB) formulation, AmBisome®, still represents the best therapeutic option for cutaneous and visceral leishmaniasis. However, its clinical efficacy depends on the patient's immunological status, the clinical manifestation and the endemic region. Moreover, the need for parenteral administration, its side effects and high cost significantly limit its use in developing countries. This review reports the progress achieved thus far toward the understanding of the mechanism responsible for the reduced toxicity of liposomal AmB formulations and the factors that influence their efficacy against leishmaniasis. It also presents the recent advances in the development of more effective liposomal AmB formulations, including topical and oral liposome formulations. The critical role of the AmB aggregation state and release rate in the reduction of drug toxicity and in the drug efficacy by non-invasive routes is emphasized. This paper is expected to guide future research and development of innovative liposomal formulations of AmB.
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Affiliation(s)
- Frédéric Frézard
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
- Correspondence: ; Tel.: +55-31-34092940
| | - Marta M. G. Aguiar
- Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Lucas A. M. Ferreira
- Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Guilherme S. Ramos
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Thais T. Santos
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Gabriel S. M. Borges
- Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Virgínia M. R. Vallejos
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Helane L. O. De Morais
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
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20
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Yan Y, Liao Z, Shen J, Zhu Z, Cao Y. Nicotinamide potentiates amphotericin B activity against Candida albicans. Virulence 2022; 13:1533-1542. [PMID: 36068709 PMCID: PMC9467617 DOI: 10.1080/21505594.2022.2119656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Amphotericin B (AmB) is a widely used antifungal agent especially for the therapy of systemic fungal infections. However, the severe side effects of AmB often leads to the premature termination of the treatment. So it is imperative to find the drugs that can both reduce the dosage and enhance the antifungal efficacy of AmB. Here we demonstrated that Nicotinamide (NAM), a cheap and safe vitamin, could enhance the antifungal activities of AmB. We demonstrated the synergistic interaction of NAM and AmB against Candida albicans as well as other Candida spp. and Cryptococcus neoformans. Moreover, NAM could enhance of the activity of AmB against biofilm. This enhancement was also observed in disseminated candidiasis in vivo. Our further study revealed that AmB could induce oxidative damage through the modification of histone acetylation. AmB could inhibit the expression of HST3, an H3K56 deacetylase in C. albicans. The immunoblotting test revealed excessive H3K56ac in AmB-treated fungal cells. Consistantly, the hst3Δ mutant displayed high sensitivity to AmB, while addition of NAM, an H3K56 deacetylation inhibitor, resulted in an even severe inhibition in the growth of this strain. These results indicated that AmB could execute antifungal activity via boosting H3K56ac which was mediated by HST3, and the mechanism for the synergistic interaction of NAM and AmB was based on exacerbating this process, which led to even excessive H3K56ac and oxidative damage. This finding provided theoretical basis for better understanding the antifungal mechanisms of AmB and clinical application of this drug.
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Affiliation(s)
- Yu Yan
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.,Shanghai Engineering Research Center for Topical Chinese Medicine, Shanghai, China
| | - ZeBin Liao
- School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Juan Shen
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.,Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - ZhenYu Zhu
- School of Pharmacy, Second Military Medical University, Shanghai, China
| | - YingYing Cao
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.,Shanghai Engineering Research Center for Topical Chinese Medicine, Shanghai, China
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21
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Wasan E, Mandava T, Crespo-Moran P, Nagy A, Wasan KM. Review of Novel Oral Amphotericin B Formulations for the Treatment of Parasitic Infections. Pharmaceutics 2022; 14:2316. [PMID: 36365135 PMCID: PMC9697626 DOI: 10.3390/pharmaceutics14112316] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/19/2022] [Accepted: 10/24/2022] [Indexed: 09/26/2023] Open
Abstract
Amphotericin B (AmpB) is a polyene macrolide antibiotic used in the treatment of blood-borne parasitic and fungal infections. However, its use, particularly in the developing world, has been limited by dose-dependent kidney toxicity, other systemic-related toxicity issues following injection, the inconvenience of parenteral administration, and accessibility. Oral formulation approaches have focused on the dual problem of solubility and permeability of AmpB, which is poorly water soluble, amphoteric and has extremely low oral bioavailability. Therefore, to enhance oral absorption, researchers have employed micellar formulations, polymeric nanoparticles, cochleates, pro-drugs, and self-emulsifying drug delivery systems (SEDDS). This paper will highlight current uses of AmpB against parasitic infections such as leishmaniasis, preclinical and clinical formulation strategies, applications in veterinary medicine and the importance of developing a cost-effective and safe oral AmpB formulation.
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Affiliation(s)
- Ellen Wasan
- College of Pharmacy and Nutrition, University of Saskatchewan, Health Sciences Building, Saskatoon, SK S7N 5E5, Canada
| | - Tavonga Mandava
- College of Pharmacy and Nutrition, University of Saskatchewan, Health Sciences Building, Saskatoon, SK S7N 5E5, Canada
| | - Pablo Crespo-Moran
- College of Pharmacy and Nutrition, University of Saskatchewan, Health Sciences Building, Saskatoon, SK S7N 5E5, Canada
| | - Adrienne Nagy
- College of Pharmacy and Nutrition, University of Saskatchewan, Health Sciences Building, Saskatoon, SK S7N 5E5, Canada
| | - Kishor M. Wasan
- Department of Urologic Sciences, Faculty of Medicine & the Neglected Global Diseases Initiative, University of British Columbia, Vancouver Campus, Vancouver, BC V5Z 1L8, Canada
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22
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Taniguchi H, Ishimime Y, Minamihata K, Santoso P, Komada T, Saputra H, Uchida K, Goto M, Taira T, Kamiya N. Liposomal Amphotericin B Formulation Displaying Lipid-Modified Chitin-Binding Domains with Enhanced Antifungal Activity. Mol Pharm 2022; 19:3906-3914. [PMID: 36066555 DOI: 10.1021/acs.molpharmaceut.2c00388] [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: 11/29/2022]
Abstract
Fungal infections affect more than one billion people worldwide and cause more than one million deaths per year. Amphotericin B (AmB), a polyene antifungal drug, has been used as the gold standard for many years because of its broad antifungal spectrum, high activity, and low tendency of drug resistance. However, the side effects of AmB, such as nephrotoxicity and hepatotoxicity, have hampered its widespread use, leading to the development of a liposome-type AmB formulation, AmBisome. Herein, we report a simple but highly effective strategy to enhance the antifungal activity of AmBisome with a lipid-modified protein. The chitin-binding domain (LysM) of the antifungal chitinase, Pteris ryukyuensis chitinase A (PrChiA), a small 5.3 kDa protein that binds to fungal cell wall chitin, was engineered to have a glutamine-containing peptide tag at the C-terminus for the microbial transglutaminase (MTG)-catalyzed crosslinking reaction (LysM-Q). LysM-Q was site-specifically modified with a lysine-containing lipid peptide substrate of MTG with a palmitoyl moiety (Pal-K). The resulting palmitoylated LysM (LysM-Pal) exhibited negligible cytotoxicity to mammalian cells and can be easily anchored to yield LysM-presenting AmBisome (LysM-AmBisome). LysM-AmBisome exhibited a dramatic enhancement of antifungal activity toward Trichoderma viride and Cryptococcus neoformans, demonstrating the marked impact of displaying a cell-wall binder protein on the targeting ability of antifungal liposomal formulations. Our simple strategy with enzymatic protein lipidation provides a potent approach to upgrade other types of lipid-based drug formulations.
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Affiliation(s)
- Hiromasa Taniguchi
- Department of Applied Chemistry, Graduate School of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - Yugo Ishimime
- Department of Bioscience and Biotechnology, Faculty of Agriculture, University of the Ryukyus, 1 Senbaru, Nishihara-cho, Okinawa 903-0213, Japan
| | - Kosuke Minamihata
- Department of Applied Chemistry, Graduate School of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - Pugoh Santoso
- Department of Applied Chemistry, Graduate School of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - Takuya Komada
- Department of Applied Chemistry, Graduate School of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - Hendra Saputra
- Department of Applied Chemistry, Graduate School of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - Kazuki Uchida
- Department of Applied Chemistry, Graduate School of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - Masahiro Goto
- Department of Applied Chemistry, Graduate School of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan.,Division of Biotechnology, Center for Future Chemistry, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - Toki Taira
- Department of Bioscience and Biotechnology, Faculty of Agriculture, University of the Ryukyus, 1 Senbaru, Nishihara-cho, Okinawa 903-0213, Japan
| | - Noriho Kamiya
- Department of Applied Chemistry, Graduate School of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan.,Division of Biotechnology, Center for Future Chemistry, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
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23
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Valentim-Silva JR, de Barros NB, Macedo SRA, Ferreira ADS, Silva RS, Dill LSM, Zanchi FB, do Nascimento JR, do Nascimento FRF, Lourenzoni MR, Soares AM, Calderon LDA, Nicolete R. Antileishmanial activity, cytotoxicity and cellular response of amphotericin B in combination with crotamine derived from Crotalus durissus terrificus venom using in vitro and in silico approaches. Toxicon 2022; 217:96-106. [PMID: 35977615 DOI: 10.1016/j.toxicon.2022.08.009] [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: 05/26/2022] [Revised: 08/03/2022] [Accepted: 08/10/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE To investigate the in vitro activity, synergism, cytotoxicity and cellular immunological response, as well as the molecular affinity between amphotericin B (AmB) and crotamine (CTA), derived from Crotalus durissus terrificus venom against Leishmania amazonensis. METHODS This study performed the inhibition of promastigotes and amastigotes' growth under different concentrations of the drug and pharmacological combinations (AmB + CTA) based on the Berimbaum method (synergism study). The lactate dehydrogenase (LDH) quantification method was used to determine the cytotoxicity of the drug and combinations employing four cell lines (J774, HepG2, VERO, and C2C12). Following, the levels of Tumour Necrose Factor-alpha (TNF-α) and Interleukin-12 (IL-12) cytokines, using enzyme-linked immunosorbent assay (ELISA) and nitrites, as an indirect measure of Nitric Oxide (NO), using the Griess reaction were assessed in the supernatants of infected macrophages. In silico approach (molecular docking and dynamics) and binding affinity (surface plasmon resonance) between the drug and toxin were also investigated. RESULTS CTA enhanced AmB effect against promastigote and amastigote forms of L. amazonensis, decreased the drug toxicity in different cell lines and induced the production of important Th1-like cytokines and NO by infected macrophages. The pharmacological combination also displayed consistent molecular interactions with low energy of coupling and a concentration-dependent profile. CONCLUSION Our data suggest that this pharmacological approach is a promising alternative treatment against L. amazonensis infection due to the improved activity (synergistic effect) achieved against the parasites' forms and to the decreased cytotoxic effect.
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Affiliation(s)
- João R Valentim-Silva
- Post-Doctoral Fellow in Health Sciences, Federal University of Acre (UFAC), Rio Branco, AC, Brazil; Physical Education Department of Federal University of Rondônia (UNIR), Porto Velho, RO, Brazil; Oswaldo Cruz Foundation (Fiocruz Rondônia), Porto Velho, RO, Brazil
| | | | | | | | - Rodrigo S Silva
- Center of Study of Biomolecules Applied in Medicine (CEBio), Oswaldo Cruz Foundation (Fiocruz Rondônia) and Federal University of Rondônia (UNIR), Porto Velho, RO, Brazil
| | - Leandro S M Dill
- Center of Study of Biomolecules Applied in Medicine (CEBio), Oswaldo Cruz Foundation (Fiocruz Rondônia) and Federal University of Rondônia (UNIR), Porto Velho, RO, Brazil
| | - Fernando B Zanchi
- Center of Study of Biomolecules Applied in Medicine (CEBio), Oswaldo Cruz Foundation (Fiocruz Rondônia) and Federal University of Rondônia (UNIR), Porto Velho, RO, Brazil
| | - Johnny R do Nascimento
- Immunophysiology Laboratory, Department of Pathology, Center for Biological and Health Sciences, Federal University of Maranhão (UFMA), São Luís, MA, Brazil
| | - Flávia R F do Nascimento
- Immunophysiology Laboratory, Department of Pathology, Center for Biological and Health Sciences, Federal University of Maranhão (UFMA), São Luís, MA, Brazil
| | | | - Andreimar M Soares
- Center of Study of Biomolecules Applied in Medicine (CEBio), Oswaldo Cruz Foundation (Fiocruz Rondônia) and Federal University of Rondônia (UNIR), Porto Velho, RO, Brazil; eCentro Universitário São Lucas (UniSL), Porto Velho, RO, Brazil
| | - Leonardo de A Calderon
- Center of Study of Biomolecules Applied in Medicine (CEBio), Oswaldo Cruz Foundation (Fiocruz Rondônia) and Federal University of Rondônia (UNIR), Porto Velho, RO, Brazil
| | - Roberto Nicolete
- Oswaldo Cruz Foundation (Fiocruz Rondônia), Porto Velho, RO, Brazil; Oswaldo Cruz Foundation (Fiocruz Ceará), Eusébio, CE, Brazil.
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24
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Recent trends in pharmaceutical analysis to foster modern drug discovery by comparative in-silico profiling of drugs and related substances. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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25
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Malebari AM, Kara A, Khayyat AN, Mohammad KA, Serrano DR. Development of Advanced 3D-Printed Solid Dosage Pediatric Formulations for HIV Treatment. Pharmaceuticals (Basel) 2022; 15:ph15040435. [PMID: 35455431 PMCID: PMC9025733 DOI: 10.3390/ph15040435] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 02/04/2023] Open
Abstract
The combination of lopinavir/ritonavir remains one of the first-line therapies for the initial antiretroviral regimen in pediatric HIV-infected children. However, the implementation of this recommendation has faced many challenges due to cold-chain requirements, high alcohol content, and unpalatability for ritonavir-boosted lopinavir syrup. In addition, the administration of crushed tablets has shown a detriment for the oral bioavailability of both drugs. Therefore, there is a clinical need to develop safer and better formulations adapted to children’s needs. This work has demonstrated, for the first time, the feasibility of using direct powder extrusion 3D printing to manufacture personalized pediatric HIV dosage forms based on 6 mm spherical tablets. H-bonding between drugs and excipients (hydroxypropyl methylcellulose and polyethylene glycol) resulted in the formation of amorphous solid dispersions with a zero-order sustained release profile, opposite to the commercially available formulation Kaletra, which exhibited marked drug precipitation at the intestinal pH.
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Affiliation(s)
- Azizah M. Malebari
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (A.M.M.); (A.N.K.); (K.A.M.)
| | - Aytug Kara
- Department of Pharmaceutics and Food Science, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Ahdab N. Khayyat
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (A.M.M.); (A.N.K.); (K.A.M.)
| | - Khadijah A. Mohammad
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (A.M.M.); (A.N.K.); (K.A.M.)
| | - Dolores R. Serrano
- Department of Pharmaceutics and Food Science, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain;
- Instituto de Farmacia Industrial y Galénica, School of Pharmacy, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-91-394-16-20
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