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Zadeh Mehrizi T, Mosaffa N, Vodjgani M, Ebrahimi Shahmabadi H. Advances in nanotechnology for improving the targeted delivery and activity of amphotericin B (2011-2023): a systematic review. Nanotoxicology 2024:1-28. [PMID: 38646931 DOI: 10.1080/17435390.2024.2340467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024]
Abstract
Amphotericin B (AmB) is a broad-spectrum therapeutic and effective drug, but it has serious side effects of toxicity and solubility. Therefore, reducing its toxicity should be considered in therapeutic applications. Nanotechnology has paved the way to improve drug delivery systems and reduce toxicity. The present study, for the first time, comprehensively reviews the studies from 2011 to 2023 on reducing the in vitro toxicity of AmB. The findings showed that loading AmB with micellar structures, nanostructured lipid carriers, liposomes, emulsions, poly lactide-co-glycolide acid, chitosan, dendrimers, and other polymeric nanoparticles increases the biocompatibility and efficacy of the drug and significantly reduces toxicity. In addition, modified carbon nanoparticles (including graphene, carbon nanotubes, and carbon dots) with positively charged amine groups, PEI, and other components showed favorable drug delivery properties. Uncoated and coated magnetic nanoparticles and silver NPs-AmB composites had less cytotoxicity and more antifungal activity than free AmB. Citrate-reduced GNPs and lipoic acid-functionalized GNPs were also effective nanocarriers to reduce AmB cytotoxicity and improve anti-leishmania efficacy. In addition, zinc oxide-NPs and PEGylated zinc oxide-NPs showed favorable antifungal activity and negligible toxicity. According to a review study, carbon-based nanoparticles, metal nanoparticles, and especially polymer nanoparticles caused some reduction in the toxicity and improved solubility of AmB in water. Overall, considering the discussed nanocarriers, further research on the application of nanotechnology as a cost-effective candidate to improve the efficiency and reduce the cytotoxicity of AmB is recommended.
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Affiliation(s)
| | - Nariman Mosaffa
- Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Vodjgani
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hasan Ebrahimi Shahmabadi
- Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Mahfud MAS, Syahirah NA, Akram M, Mahfufah U, Saputra MD, Elim D, Andi MNF, Sultan NAF, Himawan A, Domínguez-Robles J, Pamornpathomkul B, Mir M, Permana AD. Solid Dispersion Incorporated into Dissolving Microneedles for Improved Antifungal Activity of Amphotericin B: In Vivo Study in a Fungal Keratitis Model. Mol Pharm 2023; 20:6246-6261. [PMID: 37975721 DOI: 10.1021/acs.molpharmaceut.3c00647] [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] [Indexed: 11/19/2023]
Abstract
Fungal keratitis (FK) is a fungal infection of the cornea, which is part of the eye and causes corneal ulcers and an increased risk of permanent blindness, which is often found in Candida albicans species. Amphotericin B (AMB), which is a group of polyenes as the first-line treatment of FK, is effective in annihilating C. albicans. However, AMB preparations such as eye drops and ointments have major drawbacks, for instance, requiring more frequent administrations, loss of the drug by the drainage process, and rapid elimination in the precornea, which result in low bioavailability of the drug. An ocular dissolving microneedle containing the solid dispersion amphotericin B (DMN-SD-AMB) had been developed using a mixture of poly(vinyl alcohol) (PVA) and poly(vinylpyrrolidone) (PVP) polymers, while the solid dispersion AMB (SD-AMB) was contained in the needle as a drug. This study aims to determine the most optimal and safest DMN-SD-AMB formula for the treatment of FK in the eye as well as a solution to overcome the low bioavailability of AMB eye drops and ointment preparations. SD-AMB had been successfully developed, which was characterized by increased antifungal activity and drug release in vitro compared to other treatments. Furthermore, DMN-SD-AMB studies had also been successfully performed with the best formulation, which exhibited the best ex vivo corneal permeation profile and antifungal activity as well as being safe from eye irritation. In addition, an in vivo antifungal activity using a rabbit infection model shows that the number of fungal colonies was 0.98 ± 0.11 log10 CFU/mL (F3), 5.76 ± 0.32 log10 CFU/mL (AMB eye drops), 4.01 ± 0.28 log10 CFU/mL (AMB ointments), and 9.09 ± 0.65 log10 CFU/mL (control), which differed significantly (p < 0.05). All of these results evidence that DMN-SD-AMB is a new approach to developing intraocular preparations for the treatment of FK.
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Affiliation(s)
| | | | - Muhammad Akram
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia
| | - Ulfah Mahfufah
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia
| | | | - Diany Elim
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia
| | | | | | - Achmad Himawan
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia
| | - Juan Domínguez-Robles
- Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, Universidad de Sevilla, Seville 41012, Spain
| | | | - Maria Mir
- Department of Pharmacy, Iqra University Islamabad Campus, Islamabad 45320, Pakistan
| | - Andi Dian Permana
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia
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Zhong X, Yang J, Liu H, Yang Z, Luo P. Potential lipid-based strategies of amphotericin B designed for oral administration in clinical application. Drug Deliv 2023; 30:2161671. [PMID: 36601799 PMCID: PMC9828648 DOI: 10.1080/10717544.2022.2161671] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Amphotericin B (AmB) is regarded as a first-line therapy against life-threatening invasive fungal infections. Due to its poor oral bioavailability, AmB is restricted to intravenous administration in clinical practice. As science continues to move forward, two lipid-based formulations are successfully developed for oral AmB administration, currently undergoing phase I clinical trials. Encouragingly, lipid-AmB conjugates with emulsions also exhibit a better bioavailability, which may be another strategy to design oral AmB formulation in clinical practice. Thus, this review mainly focused on the two lipid-based formulations in clinical trials, and discussed the potential perspectives of AmB-lipid conjugation-loaded nanocochleates and emulsions.
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Affiliation(s)
- Xiaoming Zhong
- Department of Oncology Radiotherapy, Jiangxi Cancer Hospital, Nanchang, China
| | - Jianqiong Yang
- Department of Clinical Medicine Research Center, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China;
| | - Hongyan Liu
- Department of Pharmacy, Shanghai Songjiang District Central Hospital, Shanghai, China
| | - Zhiwen Yang
- Department of Pharmacy, Shanghai Songjiang District Central Hospital, Shanghai, China
| | - Ping Luo
- Department of Breast surgery, Nanchang Third Hospital, Nanchang, China,CONTACT Ping Luo Department of Breast surgery, Nanchang Third Hospital, Nanchang, China
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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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Chen Z, Feng Q, Wang X, Tian F. Prophylactic use amphotericin B use in patients with hematologic disorders complicated by neutropenia: a systematic review and meta-analysis. Sci Rep 2023; 13:14008. [PMID: 37635176 PMCID: PMC10460793 DOI: 10.1038/s41598-023-41268-1] [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: 08/29/2022] [Accepted: 08/24/2023] [Indexed: 08/29/2023] Open
Abstract
The purpose of this study is to evaluate the efficacy of prophylactic use amphotericin B in patients with hematologic disorders complicated by neutropenia. We searched the PubMed, EMBASE, The Cochrane Library, CBM, CNKI, VIP and WanFang Data database and the China Clinical Trials Registry ( www.chictr.org.cn ) to collect randomized controlled trials (RCTs) of amphotericin B for patients with hematologic disorders complicated by neutropenia from inception to May 2023. The Cochrane risk-of-bias tool for RCTs was used to assess the bias risk of the included studies. The meta-analysis was performed using RevMan 5.3 software. A total of 6 studies with a total of 1019 patients were included. The results of the meta-analysis showed that the treatment group was superior to the control group in terms of the fungal infection rate, and the differences were statistically significant [RR = 0.47, 95% CI (0.32, 0.69), P < 0.0001]. There was no significant difference between the two groups in terms of the mortality [RR = 0.87, 95% CI (0.61, 1.23), P = 0.43] and the incidence of colonization [OR = 0.51, 95% CI (0.25, 1.03), P = 0.06]. The evidence shows that amphotericin B prophylactic use for patients with hematologic disorders complicated by neutropenia can decrease the fungal infection rate. However, there was no significant difference in reducing mortality or the incidence of colonization. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
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Affiliation(s)
- Zhaoyan Chen
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Qiyi Feng
- Sichuan Provincial Key Laboratory of Precision Medicine and National Clinical Research Center for Geriatrics, Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Xiaoxing Wang
- Department of Pharmacy, China-Japan Friendship Hospital, Beijing, 100029, China.
| | - Fangyuan Tian
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
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Khan S, Sharma A, Jain V. An Overview of Nanostructured Lipid Carriers and its Application in Drug Delivery through Different Routes. Adv Pharm Bull 2023; 13:446-460. [PMID: 37646052 PMCID: PMC10460807 DOI: 10.34172/apb.2023.056] [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: 01/16/2022] [Revised: 07/24/2022] [Accepted: 09/09/2022] [Indexed: 09/01/2023] Open
Abstract
Nanostructured Lipid Carriers (NLC) are nano-sized colloidal drug delivery system that contains a lipid mixture consisting of both solid and liquid lipids in their core. This Lipid-Based Nanosystem is introduced as a biocompatible, non-toxic, and safe nano-drug delivery system as compared to polymeric or metallic nanoparticles. Due to its safety, stability, and high drug loading capacity compared to other lipid-based nanocarriers, NLC gained the attention of researchers to formulate safe and effective drug carriers. The ability to increase drug solubility and permeability while encapsulating the drug in a lipidic shell makes them an ideal carrier for drug delivery through difficult-to-achieve routes. Surface modification of NLC and the use of various additives result in drug targeting and increased residence time. With such qualities, NLCs can be used to treat a variety of diseases such as cancer, infections, neurodegenerative diseases, hypertension, diabetes, and pain management. This review focuses on the recent developments being made to deliver the drugs and genes through different routes via these nanocarriers. Here, we also discuss about historical background, structure, types of NLC and commonly employed techniques for manufacturing lipid-based nanocarriers.
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Affiliation(s)
- Shadab Khan
- Mahakal Institute of Pharmaceutical Studies, Ujjain, India
| | | | - Vikas Jain
- Mahakal Institute of Pharmaceutical Studies, Ujjain, India
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Maw PD, Jansook P. Cyclodextrin-based Pickering nanoemulsions containing amphotericin B: Part I. evaluation of oil/cyclodextrin and amphotericin B/cyclodextrin inclusion complexes. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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El-Dakroury WA, Zewail MB, Elsabahy M, Shabana ME, Asaad GF. Famotidine-loaded solid self-nanoemulsifying drug delivery system demonstrates exceptional efficiency in amelioration of peptic ulcer. Int J Pharm 2022; 611:121303. [PMID: 34798155 DOI: 10.1016/j.ijpharm.2021.121303] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/02/2021] [Accepted: 11/12/2021] [Indexed: 12/12/2022]
Abstract
Famotidine (FMD) is a highly potent H2-receptor antagonist used in peptic ulcer treatment. However, the drug possesses poor aqueous solubility and permeability. FMD-loaded solid self-nanoemulsifying drug delivery system (FMD-S-SNEDDS) comprised of Labrafil® M 1944 CS, Tween® 20 and PEG 400, adsorbed on Aerosil® 200, has been developed. FMD-S-SNEDDS has demonstrated acceptable micromeritic properties, and upon reconstitution in water, spherical nanosized particles were released, as demonstrated by dynamic light scattering studies and transmission electron microscopy imaging. High encapsulation efficiency of FMD in the developed SNEDDS has been attained, and the saturated solubility of the drug has increased by 20-fold when it was incorporated in the SNEDDS. Several in vitro characterizations have been carried out, including, Fourier transform-infrared spectroscopy, differential scanning calorimetry, scanning electron microscopy, and drug dissolution studies. In vivo, upon administration of the free drug suspension, marketed product (FAMOTIN®) and FMD-S-SNEDDS (40 mg/kg) in peptic ulcer rat models, FMD-S-SNEDDS and the marketed FMD demonstrated 12.5- and 4.7-fold reduction in ulcers number, and 28.7- and 7.2-fold reduction in ulcer severity, respectively, compared to the control untreated animals. FMD-S-SNEDDS showed a significant (p < 0.05) increase in the levels of depleted glutathione and endothelial nitric oxide synthase, and significantly (p < 0.05) reduced the elevated level of malondialdehyde, as compared to the free and marketed FMD. Only FMD-S-SNEDDS could restore the elevated proton pump activity and cyclic adenosine monophosphate RNA expression to their normal levels. Hence, FMD-S-SNEDDS provides a great potential as a nanotherapeutic system for treatment of peptic ulcer.
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Affiliation(s)
- Walaa A El-Dakroury
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Badr University in Cairo, Badr City, Cairo 11829, Egypt
| | - Moataz B Zewail
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Badr University in Cairo, Badr City, Cairo 11829, Egypt
| | - Mahmoud Elsabahy
- School of Biotechnology, Badr University in Cairo, Badr City, Cairo 11829, Egypt; Department of Chemistry, Texas A&M University, College Station, TX 77842, USA.
| | - Marwa E Shabana
- Department of Pathology, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo 12622, Egypt
| | - Gihan F Asaad
- Department of Pharmacology, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo 12622, Egypt
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