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Pereira-Oliveira GR, Gremião IDF, Corrêa ML, Caroline Dos Santos Honorato C, Gonçalves Viana P, Figueiredo ABF, Boechat JS, Guerino Dos Reis É, Oliveira RDVC, da Silva ACDA, Novotny TS, Guaraldo L, Pereira SA. Plasma itraconazole concentrations during treatment of feline sporotrichosis. Med Mycol 2024; 62:myae076. [PMID: 39049454 DOI: 10.1093/mmy/myae076] [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: 06/06/2024] [Revised: 07/12/2024] [Accepted: 07/23/2024] [Indexed: 07/27/2024] Open
Abstract
Itraconazole (ITZ) is the most used drug to treat feline sporotrichosis; however, little is known about its pharmacokinetics in cats with this mycosis. The aim of this study was to determine plasma ITZ concentrations in cats with sporotrichosis treated with ITZ as monotherapy or in combination with potassium iodide (KI). Cats diagnosed with sporotrichosis received orally ITZ (100 mg/cat/day) or combination therapy with ITZ (100 mg/cat/day) and KI (2.5-5 mg/kg/day) in the case of worsening or stagnation of the clinical condition. At each monthly visit, blood samples were collected at an interval of 4 h for analysis of trough and peak plasma ITZ concentrations by HPLC. Clinical features and laboratory parameters were evaluated during follow-up. Sixteen cats were included in the study. The median plasma ITZ concentration of all cats was 0.75 µg/mL. The median plasma ITZ concentration was 0.5 µg/mL in cats that received ITZ monotherapy (n = 12) and 1.0 µg/mL in those treated with ITZ + KI (n = 4). The clinical cure rate was 56.3% (n = 9) and the median treatment duration was 8 weeks. Nine cats (56.3%) developed adverse clinical reactions, and hyporexia was the most frequent (n = 8; 88.9%). Serum alanine aminotransferase was elevated in four cats (25%). The median plasma ITZ concentration detected in cats was considered to be therapeutic (>0.5 µg/mL) and was reached after 4 weeks of treatment. Plasma ITZ concentrations were higher in cats that received ITZ + KI compared to those treated only with ITZ, suggesting pharmacokinetic synergism between these drugs.
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Affiliation(s)
- Gabriela Reis Pereira-Oliveira
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Isabella Dib Ferreira Gremião
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Maria Lopes Corrêa
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | | | - Paula Gonçalves Viana
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | | | - Jéssica Sepúlveda Boechat
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Érica Guerino Dos Reis
- Biosafety Advisory, Quality Vice-Directory, The Institute of Technology on Immunobiologicals (Bio-Manguinhos), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | | | | | - Thiago Santana Novotny
- Medicines Sector, National Institute for Quality Control in Health (INCQS), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Lusiele Guaraldo
- Clinical Research Laboratory on Acute Febrile Illnesses, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Sandro Antonio Pereira
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
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2
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Sousa YV, Santiago MG, de Souza BM, Keller KM, Oliveira CSF, Mendoza L, Vilela RVR, Goulart GAC. Itraconazole in human medicine and veterinary practice. J Mycol Med 2024; 34:101473. [PMID: 38493607 DOI: 10.1016/j.mycmed.2024.101473] [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: 10/05/2023] [Revised: 02/03/2024] [Accepted: 03/08/2024] [Indexed: 03/19/2024]
Abstract
Diagnosis and management of fungal infections are challenging in both animals and humans, especially in immunologically weakened hosts. Due to its broad spectrum and safety profile when compared to other antifungals, itraconazole (ITZ) has been widely used in the treatment and prophylaxis of fungal infections, both in human and veterinary medicine. The dose and duration of management depend on factors such as the type of fungal pathogen, the site of infection, sensitivity to ITZ, chronic stages of the disease, the health status of the hosts, pharmacological interactions with other medications and the therapeutic protocol used. In veterinary practice, ITZ doses generally vary between 3 mg/kg and 50 mg/kg, once or twice a day. In humans, doses usually vary between 100 and 400 mg/day. As human and veterinary fungal infections are increasingly associated, and ITZ is one of the main medications used, this review addresses relevant aspects related to the use of this drug in both clinics, including case reports and different clinical aspects available in the literature.
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Affiliation(s)
- Yamara V Sousa
- Department of Pharmaceuticals, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Av Antônio Carlos, 6627, Belo Horizonte, MG 31270-901, Brazil
| | - Marie G Santiago
- Department of Pharmaceuticals, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Av Antônio Carlos, 6627, Belo Horizonte, MG 31270-901, Brazil
| | - Bianca M de Souza
- Department of Preventive Veterinary Medicine, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil
| | - Kelly M Keller
- Department of Preventive Veterinary Medicine, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil
| | - Camila S F Oliveira
- Department of Preventive Veterinary Medicine, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil
| | - Leonel Mendoza
- Biomedical Laboratory Diagnostics, Michigan State University, East Lansing, MI 48824, United States
| | - Raquel V R Vilela
- Biomedical Laboratory Diagnostics, Michigan State University, East Lansing, MI 48824, United States; Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil
| | - Gisele A C Goulart
- Department of Pharmaceuticals, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Av Antônio Carlos, 6627, Belo Horizonte, MG 31270-901, Brazil.
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3
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Cabañero-Resta GJ, Sánchez-Dengra B, Ruiz-Picazo A, Bermejo M, Merino V, Gonzalez-Alvarez I, Gonzalez-Alvarez M. Pharmaceutical Compounding in Veterinary Medicine: Suspension of Itraconazole. Pharmaceutics 2024; 16:576. [PMID: 38794238 PMCID: PMC11125331 DOI: 10.3390/pharmaceutics16050576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/09/2024] [Accepted: 04/19/2024] [Indexed: 05/26/2024] Open
Abstract
Itraconazole is a drug used in veterinary medicine for the treatment of different varieties of dermatophytosis at doses between 3-5 mg/kg/day in cats. Nevertheless, in Spain, it is only available in the market as a 52 mL suspension at 10 mg/mL. The lack of alternative formulations, which provide sufficient formulation to cover the treatment of large animals or allow the treatment of a group of them, can be overcome with compounding. For this purpose, it has to be considered that itraconazole is a weak base, class II compound, according to the Biopharmaceutics Classification System, that can precipitate when reaching the duodenum. The aim of this work is to develop alternative oral formulations of itraconazole for the treatment of dermatophytosis. Several oral compounds of itraconazole were prepared and compared, in terms of dissolution rate, permeability, and stability, in order to provide alternatives to the medicine commercialized. The most promising formulation contained hydroxypropyl methylcellulose and β-cyclodextrin. This combination of excipients was capable of dissolving the same concentration as the reference product and delaying the precipitation of itraconazole upon leaving the stomach. Moreover, the intestinal permeability of itraconazole was increased more than two-fold.
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Affiliation(s)
- Gema J. Cabañero-Resta
- Departamento de Farmacia y Tecnología Farmacéutica y Parasitología, Universitat de València, Vicente Andrés Estelles s/n, Burjassot, 46100 Valencia, Spain; (G.J.C.-R.); (V.M.)
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, 46100 Valencia, Spain
| | - Bárbara Sánchez-Dengra
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area, Miguel Hernandez University, 03550 San Juan de Alicante, Spain; (B.S.-D.); (A.R.-P.); (M.B.); (M.G.-A.)
| | - Alejandro Ruiz-Picazo
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area, Miguel Hernandez University, 03550 San Juan de Alicante, Spain; (B.S.-D.); (A.R.-P.); (M.B.); (M.G.-A.)
| | - Marival Bermejo
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area, Miguel Hernandez University, 03550 San Juan de Alicante, Spain; (B.S.-D.); (A.R.-P.); (M.B.); (M.G.-A.)
| | - Virginia Merino
- Departamento de Farmacia y Tecnología Farmacéutica y Parasitología, Universitat de València, Vicente Andrés Estelles s/n, Burjassot, 46100 Valencia, Spain; (G.J.C.-R.); (V.M.)
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, 46100 Valencia, Spain
| | - Isabel Gonzalez-Alvarez
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area, Miguel Hernandez University, 03550 San Juan de Alicante, Spain; (B.S.-D.); (A.R.-P.); (M.B.); (M.G.-A.)
| | - Marta Gonzalez-Alvarez
- Engineering: Pharmacokinetics and Pharmaceutical Technology Area, Miguel Hernandez University, 03550 San Juan de Alicante, Spain; (B.S.-D.); (A.R.-P.); (M.B.); (M.G.-A.)
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4
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Hunter RP, Madigan R. The effects of formulation on the pharmacokinetics of itraconazole and amiodarone in dogs after oral administration of a combination product, commercial products, and compounded products. J Vet Pharmacol Ther 2024; 47:65-72. [PMID: 37818972 DOI: 10.1111/jvp.13411] [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: 04/27/2023] [Revised: 09/07/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023]
Abstract
This study evaluated four different formulations of itraconazole and amiodarone. Formulation 1 was Vida's combination tablet containing both active pharmaceutical ingredients (APIs). Formulation 2 was separate, commercially available human generic capsules and tablets of itraconazole and amiodarone, respectively. Formulation 3 was separate, compounded suspensions of itraconazole and amiodarone. Formulation 4 was a compounded chewable tablet of itraconazole. Eight female dogs were dosed with 5 mg/kg of itraconazole and 15 mg/kg amiodarone (except for formulation 4, which only received 5 mg/kg itraconazole) once weekly for 4 weeks using a modified Latin Square design, ensuring that all dogs received all formulations with a 7-day washout between treatments. Animals were fasted overnight prior to each dose administration, with food returned to all animals 4 h post-dose. Blood samples (3 mL) were collected pre-treatment (0) and at appropriate time points over 72 h after each dose for a total of 14 samples per dog per treatment. There was high variability in the serum concentration data within treatment groups for itraconazole. The compounded suspensions were difficult to dose due to the nature of the formulations. The volumes dosed were accurate and consistent, but the suspension was thin and settled immediately when shaking was stopped for both itraconazole and amiodarone. All serum samples following itraconazole chewable tablet administration were not detectable or just above itraconazole's LOQ and thus did not allow for pharmacokinetic determination.
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Affiliation(s)
| | - Roy Madigan
- Vida Pharmacal, Inc., Spring Branch, Texas, USA
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5
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Nunes PD, Pinto JF, Bauer-Brandl A, Brandl M, Henriques J, Paiva AM. In vitro dissolution/permeation tools for amorphous solid dispersions bioavailability forecasting I: Experimental design for PermeaLoop™. Eur J Pharm Sci 2023; 188:106512. [PMID: 37423576 DOI: 10.1016/j.ejps.2023.106512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/11/2023] [Accepted: 06/29/2023] [Indexed: 07/11/2023]
Abstract
Along with the increasing demand for candidate-enabling formulations comes the need for appropriate in vitro bioavailability forecasting. Dissolution/permeation (D/P) systems employing cell-free permeation barriers are increasingly gaining interest, due to their low cost and easy application as passive diffusion bio-predictive profiling in drug product development, as this accounts for nearly 75% of new chemical entities (NCEs) absorption mechanism. To this end, this study comprises theoretical considerations on the design and experimental work towards the establishment and optimization of a PermeaLoop™ based dissolution/permeation assay to simultaneously evaluate the drug release and permeation using Itraconazole (ITZ)-based amorphous solid dispersions (ASD) formulations, with different drug loads, based on a solvent-shift approach. Alternative method conditions were tested such as: donor medium, acceptor medium and permeation barrier were screened using both PermeaPad® and PermeaPlain® 96-well plates. A range of solubilizers, namely Sodium Dodecyl Sulfate, Vitamin E-TPGS and hydroxypropyl-β-cyclodextrin, were screened as possible solubilizing additives to the acceptor medium, while donor medium was varied between blank FaSSIF (phosphate buffer) and FaSSIF. The method optimization also included the ITZ dose selection, being the ITZ single dose (100 mg) considered the most adequate to be used in further experiments to allow the comparison with in vivo studies. In the end, a standardized approach that may be applied to predict the bioavailability of weakly basic poorly soluble drug-based formulations is described, contributing to strengthening the analytical portfolio of in vitro pre-clinical drug product development.
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Affiliation(s)
- Patrícia D Nunes
- R&D Analytical Development, Hovione Farmaciência S.A., Campus do Lumiar, Building S, 1649-038 Lisboa, Portugal; R&D Oral Drug Product Development, Hovione Farmaciência S.A., Campus do Lumiar, Building S, 1649-038 Lisboa, Portugal; Research Institute for Medicines (iMed.Ulisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal
| | - João F Pinto
- Research Institute for Medicines (iMed.Ulisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal.
| | - Annette Bauer-Brandl
- Drug Transport and Delivery Group, Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, Odense DK, 5230, Denmark
| | - Martin Brandl
- Drug Transport and Delivery Group, Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, Odense DK, 5230, Denmark.
| | - João Henriques
- R&D Oral Drug Product Development, Hovione Farmaciência S.A., Campus do Lumiar, Building S, 1649-038 Lisboa, Portugal
| | - Ana Mafalda Paiva
- R&D Analytical Development, Hovione Farmaciência S.A., Campus do Lumiar, Building S, 1649-038 Lisboa, Portugal
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6
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Nunes PD, Ferreira AF, Pinto JF, Bauer-Brandl A, Brandl M, Henriques J, Paiva AM. In vitro dissolution/permeation tools for amorphous solid dispersions bioavailability forecasting II: Comparison and mechanistic insights. Eur J Pharm Sci 2023; 188:106513. [PMID: 37423577 DOI: 10.1016/j.ejps.2023.106513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/11/2023] [Accepted: 06/29/2023] [Indexed: 07/11/2023]
Abstract
Along with the increasing demand for complex formulations comes the need for appropriate in vitro methodologies capable of predicting their corresponding in vivo performance and the mechanisms controlling the drug release which can impact on in vivo drug absorption. In vitro dissolution-permeation (D/P) methodologies that can account for the effects of enabling formulations on the permeability of drugs are increasingly being used in performance ranking during early development stages. This work comprised the application of two different cell-free in vitro D/P setups: BioFLUX™ and PermeaLoop™ to evaluate the dissolution-permeation interplay upon drug release from itraconazole (ITZ)- HPMCAS amorphous solid dispersions (ASDs) of different drug loads. A solvent-shift approach was employed, from a simulated gastric environment to a simulated intestinal environment in the donor compartment. PermeaLoop™ was then combined with microdialysis sampling to separate the dissolved (free) drug from other species present in solution, like micelle-bound drug and drug-rich colloids, in real time. This setup was applied to clarify the mechanisms for drug release and permeation from these ASDs. In parallel, a pharmacokinetic study (dog model) was conducted to assess the drug absorption from these ASDs and to compare the in vivo results with the data obtained from each in vitro D/P setup, allowing to infer which would be the most adequate setup for ASD ranking. Even though both D/P systems resulted in the same qualitative ranking, BioFLUX™ overpredicted the difference between the in vivo AUC of two ASDs, whereas PermeaLoop™ permeation flux resulted in a good correlation with the AUC observed in pharmacokinetic studies (dog model) (R2 ≈ 0.98). Also, PermeaLoop™ combined with a microdialysis sampling probe clarified the mechanisms for drug release and permeation from these ASDs. It demonstrated that the free drug was the only driving force for permeation, while the drug-rich colloids kept permeation active for longer periods by acting as drug reservoirs and maintaining constant high levels of free drug in solution, which are then immediately able to permeate. Hence, the data obtained points BioFLUX™ and PermeaLoop™ applications to different momentums in the drug product development pipeline: while BioFLUX™, an automated standardized method, poses as a valuable tool for initial ASD ranking during the early development stages, PermeaLoop™ combined with microdialysis sampling allows to gain mechanistic understanding of the dissolution-permeation interplay, being crucial to fine tune and identify leading ASD candidates prior to in vivo testing.
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Affiliation(s)
- Patrícia D Nunes
- R&D Analytical Development, Hovione Farmaciência S.A., Campus do Lumiar, Building S, 1649-038 Lisboa, Portugal; R&D Oral Drug Product Development, Hovione Farmaciência S.A., Campus do Lumiar, Building S, 1649-038 Lisboa, Portugal; Research Institute for Medicines (iMed.Ulisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal
| | - Ana Filipa Ferreira
- R&D Analytical Development, Hovione Farmaciência S.A., Campus do Lumiar, Building S, 1649-038 Lisboa, Portugal
| | - João F Pinto
- Research Institute for Medicines (iMed.Ulisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal.
| | - Annette Bauer-Brandl
- Drug Transport and Delivery Group, Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, Odense DK-5230, Denmark
| | - Martin Brandl
- Drug Transport and Delivery Group, Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, Odense DK-5230, Denmark.
| | - João Henriques
- R&D Oral Drug Product Development, Hovione Farmaciência S.A., Campus do Lumiar, Building S, 1649-038 Lisboa, Portugal
| | - Ana Mafalda Paiva
- R&D Analytical Development, Hovione Farmaciência S.A., Campus do Lumiar, Building S, 1649-038 Lisboa, Portugal
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Grecu M, Minea B, Foia LG, Bostanaru-Iliescu AC, Miron L, Nastasa V, Mares M. Short Review on the Biological Activity of Cyclodextrin-Drug Inclusion Complexes Applicable in Veterinary Therapy. Molecules 2023; 28:5565. [PMID: 37513437 PMCID: PMC10383344 DOI: 10.3390/molecules28145565] [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: 06/21/2023] [Revised: 07/15/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Cyclodextrins (CDs) are a family of carrier molecules used to improve the pharmacokinetic parameters of therapeutic molecules. These cyclic oligosaccharides have medical and pharmaceutical applications by being able to form inclusion complexes with molecules that are poorly soluble in water. The benefits of these complexes are directed towards improving the chemical and biological properties-i.e., solubility, bioavailability, stability, non-toxicity and shelf life of drug molecules. Since the 1960s, the first inclusion complexes used in therapeutics were those with α-, β- and γ-CD, which proved their usefulness, but had certain degrees of particularly renal toxicity. Currently, to correct these deficiencies, β-CD derivatives are most frequently used, such as sulfobutylether-β-CD, hydroxypropyl-β-CD, etc. Therefore, it is of interest to bring to the attention of those interested the diversity of current and potential future clinical applications of inclusion complexes in veterinary medicine and to present the contribution of these inclusion complexes in improving drug efficacy. The most important biological activities of β-CD complexed molecules in the veterinary field are summarized in this short review.
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Affiliation(s)
- Mariana Grecu
- Laboratory of Antimicrobial Chemotherapy, Faculty of Veterinary Medicine, "Ion Ionescu de la Brad" University of Life Sciences of Iasi (IULS), 8 Mihail Sadoveanu Alley, 700489 Iasi, Romania
| | - Bogdan Minea
- Department of Surgery, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iași, Romania
| | - Liliana-Georgeta Foia
- Department of Surgery, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iași, Romania
| | - Andra-Cristina Bostanaru-Iliescu
- Laboratory of Antimicrobial Chemotherapy, Faculty of Veterinary Medicine, "Ion Ionescu de la Brad" University of Life Sciences of Iasi (IULS), 8 Mihail Sadoveanu Alley, 700489 Iasi, Romania
| | - Liviu Miron
- Laboratory of Antimicrobial Chemotherapy, Faculty of Veterinary Medicine, "Ion Ionescu de la Brad" University of Life Sciences of Iasi (IULS), 8 Mihail Sadoveanu Alley, 700489 Iasi, Romania
| | - Valentin Nastasa
- Laboratory of Antimicrobial Chemotherapy, Faculty of Veterinary Medicine, "Ion Ionescu de la Brad" University of Life Sciences of Iasi (IULS), 8 Mihail Sadoveanu Alley, 700489 Iasi, Romania
| | - Mihai Mares
- Laboratory of Antimicrobial Chemotherapy, Faculty of Veterinary Medicine, "Ion Ionescu de la Brad" University of Life Sciences of Iasi (IULS), 8 Mihail Sadoveanu Alley, 700489 Iasi, Romania
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Hanzlicek AS, KuKanich KS, Cook AK, Hodges S, Thomason JM, DeSilva R, Ramachandran A, Durkin MM. Clinical utility of fungal culture and antifungal susceptibility in cats and dogs with histoplasmosis. J Vet Intern Med 2023; 37:998-1006. [PMID: 37092675 DOI: 10.1111/jvim.16725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 04/08/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Culture can be used for diagnosis and antifungal susceptibility testing in animals with fungal infections. Limited information is available regarding the diagnostic performance of culture and the susceptibility patterns of Histoplasma spp. isolates. HYPOTHESIS/OBJECTIVES Describe the clinical utility of culture and the susceptibility patterns of Histoplasma spp. isolates causing histoplasmosis in cats and dogs. ANIMALS Seventy-one client-owned animals, including 33 cats and 19 dogs with proven or probable histoplasmosis. METHODS Culture was attempted from tissue or fluid samples. Diagnostic performance of culture, cytopathology, and antigen detection were compared with final diagnosis. Susceptibility to antifungal agents was determined for a subset (11 from dogs, 9 from cats) of culture isolates. RESULTS Culture had a diagnostic sensitivity of 17/33 (52%; 95% confidence interval [CI], 34%-69%) and 15/19 (79%; 95% CI, 61%-97%) and specificity of 6/6 (100%; 95% CI, 54%-100%) and 10/10 (100%; 95% CI, 69%-100%) in cats and dogs, respectively. Culture was not positive in any animal in which cytopathology and antigen testing were negative. Target drug exposure (area under the concentration curve [AUC]/minimum inhibitory concentration [MIC] >25) should be easily achieved for all isolates for itraconazole, voriconazole, or posaconazole. Five of 20 (25%) isolates had fluconazole MIC ≥32 μg/mL and achieving target drug exposure is unlikely. CONCLUSIONS AND CLINICAL IMPORTANCE Fungal culture did not improve diagnostic sensitivity when used with cytopathology and antigen detection. Susceptibility testing might help identify isolates for which fluconazole is less likely to be effective.
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Affiliation(s)
- Andrew S Hanzlicek
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, Oklahoma, USA
- MiraVista Diagnostics, Indianapolis, Indiana, USA
| | - Kate S KuKanich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Audrey K Cook
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Steven Hodges
- Oklahoma Veterinary Specialists, Tulsa, Oklahoma, USA
| | - John M Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Rupika DeSilva
- Oklahoma Animal Disease Diagnostic Laboratory, Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Akhilesh Ramachandran
- Oklahoma Animal Disease Diagnostic Laboratory, Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, Oklahoma, USA
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9
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KuKanich K, KuKanich B, Magnin G. Oral fluconazole has variable pharmacokinetics in dogs. J Vet Pharmacol Ther 2023; 46:71-76. [PMID: 36300550 DOI: 10.1111/jvp.13101] [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: 08/17/2022] [Revised: 09/23/2022] [Accepted: 10/07/2022] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to assess the effects of food and manufacturer on the oral bioavailability of fluconazole in dogs. We hypothesized feeding would decrease fluconazole bioavailability and large variability between manufacturers would occur. Six healthy purpose-bred dogs aged 2-3 years, weighing 9.5-13.7 kg, were enrolled. Each dog was administered a 100 mg fluconazole tablet from three FDA approved manufacturers (1-Glenmark, 2-Citron, 3-Harris) in a randomized crossover block study, fasted for 12 h (fasted) or 15 min after feeding (fed); each dog had 6 treatments. Blood was collected for 72 h after dosing with a 10-day washout between treatments. Fluconazole plasma concentrations were determined with mass spectrometry. Overall variability in dose-normalized drug exposure (AUC/dose) was large (range 1.9-2.9x) within each treatment, while the overall range across all treatments was 3.3-fold. The inter-dog variability in the terminal half-life was also large, 3.1-fold. The mean fed relative oral bioavailability was lower (82%-90%) compared to fasted for each formulation. Due to the large variability, the formulations were not bioequivalent. These data suggest the variability in the half-life was a major contributor to the large variability in fluconazole pharmacokinetics in dogs, while the feeding status and manufacturer were minor contributors.
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Affiliation(s)
- Kate KuKanich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Butch KuKanich
- Department of Anatomy & Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Geraldine Magnin
- Department of Anatomy & Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
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10
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Tonero ME, Li Z, Reinhart JM. Cytochrome P450 reaction phenotyping of itraconazole hydroxylation in the dog. J Vet Pharmacol Ther 2022; 45:255-264. [PMID: 35389533 DOI: 10.1111/jvp.13058] [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: 11/22/2021] [Revised: 02/21/2022] [Accepted: 03/28/2022] [Indexed: 11/30/2022]
Abstract
Itraconazole (ITZ) is an important drug in the treatment of superficial and deep mycoses in dogs. Its primary metabolite is hydroxy-itraconazole, which has antifungal activity similar to the parent compound. The purpose of this study was to identify the cytochrome P450 enzyme (CYP) isoform(s) responsible for ITZ hydroxylation in canine liver. Reaction kinetics for ITZ hydroxylation were determined in a panel of canine recombinant CYPs and dog liver microsomes (DLMs). Findings were confirmed using CYP isoform-specific inhibitors in rCYPs and DLMs. In rCYP experiments, CYP2D15 and CYP3A12 had highest activity for ITZ hydroxylation. In inhibitor experiments, quinidine and erythromycin inhibited ITZ hydroxylation in CYP2D15 and CYP3A12, respectively, in an isoform-specific manner. In DLMs, quinidine and erythromycin combined inhibited ITZ hydroxylation more than erythromycin alone but not quinidine alone. However, this may be related to inhibitor potency rather than the contribution of the individual CYP isoforms to the reaction. These findings support a role for CYP2D15 and CYP3A12 in ITZ biotransformation in canine liver.
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Affiliation(s)
- Matthew E Tonero
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Zhong Li
- Roy J. Carver Biotechnology Center, University of Illinois, Urbana, Illinois, USA
| | - Jennifer M Reinhart
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
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11
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Lim YY, Mansfield C, Stevenson M, Thompson M, Davies D, Whitney J, James F, Tebb A, Fry D, Buob S, Hambrook L, Boo G, Dandrieux JRS. A retrospective multi-center study of treatment, outcome, and prognostic factors in 34 dogs with disseminated aspergillosis in Australia. J Vet Intern Med 2022; 36:580-590. [PMID: 35085412 PMCID: PMC8965214 DOI: 10.1111/jvim.16366] [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] [Received: 03/01/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Disseminated aspergillosis (DA) in dogs has a guarded prognosis and there is a lack of a gold standard treatment protocol. OBJECTIVE To retrospectively assess survival times and factors influencing survival times. ANIMALS Dogs diagnosed with DA from January 2007 to June 2017. METHODS Disseminated aspergillosis case data were retrieved from 13 Australian veterinary referral centers, with a diagnosis confirmed with culture or PCR. Factors influencing survival time after diagnosis were quantified using a Cox proportional hazards regression model. RESULTS Thirty-four dogs met the study inclusion criteria. Twenty-two dogs were treated with antifungal treatment and 12 dogs received no antifungal treatment. Accounting for censoring of dogs that were either still alive on the date of data collection or were loss to follow-up, dogs treated with itraconazole alone (n = 8) had a median survival time (MST) of 63 (95% CI: 20-272) days compared to 830 (95% CI: 267-1259) days for the n = 14 dogs that received multimodal antifungal therapy ( χ 2 test statistic 8.6; df = 1; P < .01). The daily hazard of death (DHOD) for dogs with abnormally high serum creatinine concentration at the time of diagnosis was 7.4 (95% CI: 1.9-29) times that of dogs with serum creatinine within the reference interval. CONCLUSION AND CLINICAL IMPORTANCE Serum creatinine concentration at the time of diagnosis is a useful prognostic indicator for survival after a diagnosis of DA. The MST for dogs treated with multimodal antifungal therapy is longer than itraconazole alone and warrant further investigation (P < .01).
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Affiliation(s)
- Yi Yu Lim
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Caroline Mansfield
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mark Stevenson
- Asia-Pacific Centre for Animal Health, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mary Thompson
- School of Veterinary and Life Sciences, Murdoch University, Perth, Western Australia, Australia
| | - David Davies
- Adelaide Veterinary Specialist & Referral Centre, Adelaide, South Australia, Australia
| | - Joanna Whitney
- Faculty of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Fleur James
- Perth Veterinary Specialist, Perth, Western Australia, Australia
| | - Anna Tebb
- Western Australian Veterinary Emergency and Specialty, Perth, Western Australia, Australia
| | - Darren Fry
- Brisbane Veterinary Specialist Centre, Brisbane, Queensland, Australia
| | - Sibylle Buob
- Queensland Veterinary Specialists, Brisbane, Queensland, Australia
| | | | - Gladys Boo
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - Julien R S Dandrieux
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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12
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Profile of veterinary drugs in a specialized pharmacy for manual production of drugs in João Pessoa, Brazil. VETERINARSKI GLASNIK 2021. [DOI: 10.2298/vetgl210401008s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This is a cross-sectional study conducted in a veterinary pharmacy for manual
production of drugs located in the city of Jo?o Pessoa, Brazil. The data
collected comprised the period from January 2017 to December 2019, using the
records system present in the pharmacy itself. We are seeing a growing
demand for veterinary manipulated drugs, with a 40% increase in sales from
2017 to 2019. Among the pharmaceutical forms, capsules were the most
commonly requested, followed by solutions, and among the active ingredients,
itraconazole was the most frequent. With the diversity of pet species, the
manipulation pharmacies have arisen to supply market needs, enabling the
development of pharmaceutical forms that meet the physical characteristics
of each pet species.
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13
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Zalesak SM, Sanchez CR, Pich AA, Papich MG. Preliminary Pilot Study of Itraconazole After a Single Oral Dose of a Veterinary Formulation Solution in African Penguins ( Spheniscus demersus). J Avian Med Surg 2020; 34:52-56. [PMID: 32237682 DOI: 10.1647/1082-6742-34.1.52] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Aspergillosis is a common cause of morbidity and mortality in captive penguins. Itraconazole, an antifungal drug, is commonly used to treat aspergillosis infections in avian species; however, commercially available human formulations are costly, and studies have shown the effectiveness of compounded formulations to be unreliable. The US Food and Drug Administration (FDA) recently approved a veterinary formulation of itraconazole, Itrafungol, for use in cats. This study provides preliminary results from limited sampling evaluating whether this veterinary formulation is suitable for future studies in the African penguin (Spheniscus demersus). A 20 mg/kg PO itraconazole dose was administered to 9 African penguins. Blood samples were taken over the course of 24 hours; each sample was collected from a different bird to minimize stress to the animals. Plasma was analyzed by high-performance liquid chromatography for concentrations of itraconazole. The drug was absorbed in all penguins, and plasma concentrations in 5 of 9 penguins (56%) were found to be greater than the established therapeutic dose of 1.0 µg/ mL. To our knowledge, this is the first study that has investigated a 20 mg/kg dose of itraconazole in a penguin species. The small sample size limits the conclusions that can be drawn from this preliminary study. Nonetheless, we demonstrate encouraging evidence that the FDA-approved formulation of oral itraconazole solution should be considered for future study as a cost-effective treatment for aspergillosis in African penguins and other avian species.
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Affiliation(s)
- Selina M Zalesak
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA,
| | | | - Ashley A Pich
- College of Veterinary Medicine, Ohio State University, Columbus, OH 43210, USA
| | - Mark G Papich
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
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14
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Scott G, Field CL, Papich MG, Harms CA. Plasma concentrations of itraconazole following a single oral dose in juvenile California sea lions (Zalophus californianus). J Vet Pharmacol Ther 2020; 43:377-380. [PMID: 32286696 DOI: 10.1111/jvp.12865] [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: 12/17/2019] [Revised: 02/25/2020] [Accepted: 03/19/2020] [Indexed: 11/26/2022]
Abstract
The objective of this study was to establish a single-dose pharmacokinetic profile for orally administered itraconazole in California sea lions (Zalophus californianus). Twenty healthy rehabilitated juvenile California sea lions were included in this study. Itraconazole capsules were administered orally with food at a target dose of 5-10 mg/kg. Blood samples were collected from each animal at 0 hr and at two of the following timepoints: 0.5, 1, 2, 4, 6, 8, 12, 24, 48, and 72 hr. Quantitative analysis of itraconazole in plasma samples was performed by high-performance liquid chromatography. An average maximum concentration of 0.22 µg/ml ± 0.11 was detected 4 hr after administration. The average concentration fell to 0.12 µg/ml ± 0.11 by 6 hr and 0.02 µg/ml ± 0.02 at 12 hr. At no point did concentrations reach 0.5 µg/ml, the concentration commonly accepted for therapeutic efficacy. While this formulation was well tolerated by the sea lions, oral absorption was poor and highly variable among individuals. These data indicate that a single oral dose of itraconazole given as a capsule at 5-10 mg/kg, under the conditions used in this study, does not achieve therapeutic plasma concentrations in California sea lions.
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Affiliation(s)
- Gregory Scott
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.,Center for Marine Sciences and Technology, North Carolina State University, Morehead City, NC, USA
| | - Cara L Field
- Veterinary Science Department, The Marine Mammal Center, Sausalito, CA, USA
| | - Mark G Papich
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Craig A Harms
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.,Center for Marine Sciences and Technology, North Carolina State University, Morehead City, NC, USA
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15
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Yang W, Jones BR, Rossi G, Stephens N, Arthur I, Merritt A, Reese S, Langner K. First case of a dog infected with Aspergillus (Phialosimplex) caninus in Australasia. N Z Vet J 2020; 68:231-237. [PMID: 31852374 DOI: 10.1080/00480169.2019.1706659] [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: 10/25/2022]
Abstract
Case history: A 2-year-old Rottweiler dog from Perth (WA, Australia) was referred for assessment of a chronic productive cough and weight loss.Clinical findings: Severely enlarged bilateral superficial cervical lymph nodes and severely enlarged abdominal organs were present. The body condition score was poor and there was moderate muscle wasting. Thoracic and abdominal computed tomography images revealed severe diffuse enlargement of thoracic and abdominal lymph nodes, hepatomegaly and diffuse splenomegaly. A diffuse bronchial pattern with severe multifocal saccular bronchiectasis was identified in the lungs.Diagnostic findings: Fungal organisms were seen within macrophages on cytological preparations and on histopathological sections of biopsies of the superficial cervical lymph node. Macrophages contained intracytoplasmic, non-filamentous round-to-ovoid organisms, which varied in size from 5-30 µm in diameter with variable morphology. Budding was not observed, and no hyphae were present. Fungal culture of lymph node tissue resulted in growth of Aspergillus (Phialosimplex) caninus which was confirmed by amplification and sequencing of a segment of the 16S-23S rRNA internal transcribed spacer. Concurrent bacterial bronchitis was diagnosed on culture of broncho-alveolar fluid.Diagnosis: Disseminated aspergillosis caused by Aspergillus caninus.Clinical relevance: This is believed to be the first report of infection caused by A. caninus in a dog in Australasia. The dog was treated with itraconazole for 7 months and was still alive 7 months after the start of treatment.
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Affiliation(s)
- W Yang
- The Animal Hospital at Murdoch University, Murdoch, WA, Australia
| | - B R Jones
- The Animal Hospital at Murdoch University, Murdoch, WA, Australia
| | - G Rossi
- The Animal Hospital at Murdoch University, Murdoch, WA, Australia
| | - N Stephens
- The Animal Hospital at Murdoch University, Murdoch, WA, Australia
| | - I Arthur
- PathWest Department of Microbiology and Infectious Disease, Queen Elizabeth II Medical Centre, Nedlands, WA, Australia
| | - A Merritt
- PathWest Department of Microbiology and Infectious Disease, Queen Elizabeth II Medical Centre, Nedlands, WA, Australia
| | - S Reese
- Vet Imaging Specialists, Murdoch, WA, Australia
| | - Kfa Langner
- The Animal Hospital at Murdoch University, Murdoch, WA, Australia
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Dedeaux A, Grooters A, Wakamatsu-Utsuki N, Taboada J. Opportunistic Fungal Infections in Small Animals. J Am Anim Hosp Assoc 2018; 54:327-337. [DOI: 10.5326/jaaha-ms-6768] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
Opportunistic fungal infections have long been recognized as rare causes of disease in immunocompetent dogs and cats. Recently, the escalating use of multiagent immunosuppression protocols (especially those that include cyclosporine) has resulted in an increased number of patients with opportunistic fungal infection encountered by small animal practitioners and has altered the typical case phenotype. Based on histologic and cytologic features such as pigmentation, hyphal diameter, and distribution in tissue, these opportunistic mycoses can be placed into categories such as phaeohyphomycosis, hyalohyphomycosis, and eumycotic mycetoma. This review aims to summarize the clinical presentations, methods for diagnosis, treatment recommendations, and prognosis for both immunocompetent and immunosuppressed patients with opportunistic fungal infections. An example case description is included to illustrate the most common current clinical presentation.
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Affiliation(s)
- Andrea Dedeaux
- From the Department of Veterinary Clinical Sciences (A.D., A.G., J.T.) and Department of Pathobiological Sciences (N.W-U.), Louisiana State University, Baton Rouge, Louisiana
| | - Amy Grooters
- From the Department of Veterinary Clinical Sciences (A.D., A.G., J.T.) and Department of Pathobiological Sciences (N.W-U.), Louisiana State University, Baton Rouge, Louisiana
| | - Nobuko Wakamatsu-Utsuki
- From the Department of Veterinary Clinical Sciences (A.D., A.G., J.T.) and Department of Pathobiological Sciences (N.W-U.), Louisiana State University, Baton Rouge, Louisiana
| | - Joseph Taboada
- From the Department of Veterinary Clinical Sciences (A.D., A.G., J.T.) and Department of Pathobiological Sciences (N.W-U.), Louisiana State University, Baton Rouge, Louisiana
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17
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Sánchez CR, Zalesak S, Pich AA, Papich MG. Population pharmacokinetics of itraconazole solution after a single oral administration in captive lesser flamingos (Phoeniconaias minor). J Vet Pharmacol Ther 2018; 42:1-6. [PMID: 30302773 DOI: 10.1111/jvp.12721] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 08/02/2018] [Accepted: 08/27/2018] [Indexed: 12/15/2022]
Abstract
Aspergillosis is an infectious, non-contagious fungal disease of clinical importance in flamingo collections. Itraconazole is an antifungal drug commonly used in the treatment and prophylaxis of avian aspergillosis. Studies have shown that dosage regimes in birds vary based on different itraconazole presentation and administration methods. This investigation used a population pharmacokinetic approach to study itraconazole in lesser flamingos. Itraconazole was administered orally at 10 mg/kg to 17 flamingos. A sparse blood sampling was performed on the subjects, and samples were collected at 1, 2, 3, 5, 8, 12, 16, 21, and 24 hr post-drug administration. Twelve flamingos were sampled three times, three birds bled twice and two sampled once. Itraconazole in plasma was quantified using high-pressure liquid chromatography (HPLC). A one-compartment pharmacokinetic model with first order absorption was fitted to the data using nonlinear mixed effects modeling (NLME) to determine values for population parameters. We identified a long half-life (T½) of more than 75 hr and a maximum plasma concentration (CMAX ) of 1.69 µg/ml, which is above the minimal inhibitory concentrations for different aspergillus isolates. We concluded that plasma drug concentrations of itraconazole were maintained in a population of flamingos above 0.5 ug/ml for at least 24 hr after a single oral dose of 10 mg/kg of itraconazole solution.
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Affiliation(s)
| | - Selina Zalesak
- Texas A&M University College of Veterinary Medicine, College Station, Texas
| | - Ashley A Pich
- Veterinary Services, Fort Worth Zoo, Fort Worth, Texas
| | - Mark G Papich
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
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18
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Lee JS, Choi HJ, Song JH, Ko HJ, Yoon K, Seong JM. Antiviral Activity of Itraconazole against Echovirus 30 Infection In Vitro. Osong Public Health Res Perspect 2017; 8:318-324. [PMID: 29164043 PMCID: PMC5678193 DOI: 10.24171/j.phrp.2017.8.5.05] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 09/18/2017] [Accepted: 09/20/2017] [Indexed: 11/05/2022] Open
Abstract
Objectives Echovirus 30 is a major cause of meningitis in children and adults. The aim of this study was to investigate whether the antifungal drug itraconazole could exhibit antiviral activity against echovirus 30. Methods The cytopathic effect and viral RNA levels were assessed in RD cells as indicators of viral replication. The effects of itraconazole were compared to those of two known antiviral drugs, rupintrivir and pleconaril. The time course and time-of-addition assays were used to approximate the time at which itraconazole exerts its activity in the viral cycle. Results Itraconazole and rupintrivir demonstrated the greatest potency against echovirus 30, demonstrating concentration-dependent activity, whereas pleconaril showed no antiviral activity. Itraconazole did not directly inactivate echovirus 30 particles or impede viral uptake into RD cells, but did affect the initial stages of echovirus 30 infection through interference with viral replication. Conclusion Itraconazole can be considered a lead candidate for the development of antiviral drugs against echovirus 30 that may be used during the early stages of echovirus 30 replication.
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Affiliation(s)
- Jae-Sug Lee
- Department of Beauty Science, Kwangju Women's University, Gwangju, Korea
| | - Hwa-Jung Choi
- Department of Beauty Science, Kwangju Women's University, Gwangju, Korea
| | - Jae-Hyoung Song
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, Chuncheon, Korea
| | - Hyun-Jeong Ko
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, Chuncheon, Korea
| | - Kyungah Yoon
- Department of Clinical Pathology, Daejeon Health Institute of Technology, Daejeon, Korea
| | - Jeong-Min Seong
- Department of Dental Hygiene, College of Health Science, Kangwon National University, Samcheok, Korea
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