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Ramireddy AR, Behara DK. QbD Based Formulation Development and Optimisation of Ozenoxacin Topical Nano-Emulgel and Efficacy Evaluation Using Impetigo Mice Model. AAPS PharmSciTech 2024; 25:90. [PMID: 38649513 DOI: 10.1208/s12249-024-02805-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024] Open
Abstract
To formulate and optimize Ozenoxacin nano-emulsion using Quality by Design (QbD) concept by means of Box-Behnken Design (BBD) and converting it to a gel to form Ozenoxacin nano-emulgel followed by physico-chemical, in-vitro, ex-vivo and in-vivo evaluation. This study demonstrates the application of QbD methodology for the development and optimization of an effective topical nanoemulgel formulation for the treatment of Impetigo focusing on the selection of appropriate excipients, optimization of formulation and process variables, and characterization of critical quality attributes. BBD was used to study the effect of "% of oil, % of Smix and homogenization speed" on critical quality attributes "globule size and % entrapment efficiency" for the optimisation of Ozenoxacin Nano-emulsion. Ozenoxacin loaded nano-emulgel was characterized for "description, identification, pH, specific gravity, amplitude sweep, viscosity, assay, organic impurities, antimicrobial effectiveness testing, in-vitro release testing, ex-vivo permeation testing, skin retention and in-vivo anti-bacterial activity". In-vitro release and ex-vivo permeation, skin retention and in-vivo anti-bacterial activity were found to be significantly (p < 0.01) higher for the nano-emulgel formulation compared to the innovator formulation (OZANEX™). Antimicrobial effectiveness testing was performed and found that even at 70% label claim of benzoic acid is effective to inhibit microbial growth in the drug product. The systematic application of QbD principles facilitated the successful development and optimization of a Ozenoxacin Nano-Emulsion. Optimised Ozenoxacin Nano-Emulgel can be considered as an effective alternative and found to be stable at least for 6 months at 40 °C / 75% RH and 30 °C / 75% RH.
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Affiliation(s)
- Amarnath Reddy Ramireddy
- Department of Pharmaceutical Sciences, Jawaharlal Nehru Technological University Anantapur (JNTUA), Ananthapuramu, Andhra Pradesh, 515002, India.
| | - Dilip Kumar Behara
- Chemical Engineering, JNTUA College of Engineering (Autonomous), Jawaharlal Nehru Technological University Anantapur (JNTUA), Ananthapuramu, Andhra Pradesh, 515002, India
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Zhang C, Li J, Lu R, Wang S, Fu Z, Yao Z. Efficacy of a Novel Antibacterial Agent Exeporfinium Chloride, (XF-73), Against Antibiotic-Resistant Bacteria in Mouse Superficial Skin Infection Models. Infect Drug Resist 2023; 16:4867-4879. [PMID: 37520450 PMCID: PMC10386860 DOI: 10.2147/idr.s417231] [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: 05/12/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
Background The number of incidences of antimicrobial resistance is rising continually, necessitating new and effective antibacterial drugs. The present study aimed to assess the in vitro and in vivo activity of XF-73 against antibiotic-resistant Staphylococcus aureus (S. aureus) isolates and to investigate the potential mechanism of action of XF-73. Methods The in vitro antibacterial activity of XF-73 and comparator antibacterial drugs, (mupirocin, fusidine, retapamulin, vancomycin, erythromycin, linezolid and daptomycin), against S. aureus (both antibiotic sensitive and resistant strains) was assessed using a broth microdilution method. Two different superficial Staphylococcal skin infection murine models were established to study the in vivo efficacy of XF-73 against antibiotic-resistant strains. The effect of XF-73 on the ultrastructure and cellular morphology of S. aureus was studied using transmission electron microscopy (TEM) and scanning electron microscopy (SEM). Results The MICs (minimum inhibitory concentration) determined by the broth microdilution method for XF-73 demonstrated that the compound had a high potency against S. aureus isolates with varying susceptibility to the study drugs. Also, the antibacterial activity of XF-73 was superior or similar to most of the tested antibacterial drugs. We also found that the XF-73 dermal formulation significantly inhibited S. aureus survival in both the murine skin tape-stripping and suture superficial skin infection models, maintained a consistently high inhibitory capacity against the antibiotic-resistant strains tested and was significantly more effective than mupirocin ointment, a commonly used antibiotic for the treatment of skin infections. The morphological studies using TEM suggest that XF-73 had a rapid (2 minute) bacterial cell wall disruption activity, with longer incubation (10 minute) subsequently causing membrane damage. SEM analysis demonstrated that this cell wall and cell membrane disruption did not lead to disintegration of the plasma membrane, and did not cause bacterial cell lysis. Conclusion Therefore, XF-73 may be an effective drug alternative to combat multi-drug-resistant skin infections in the clinical setting.
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Affiliation(s)
- Chenrui Zhang
- Department of Immunology, Key Laboratory of Immune Microenvironment and Disease of the Educational Ministry of China, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Jinping Li
- Kangzhe Pharmaceutical Technology Development Company, Ltd., Tianjin, People’s Republic of China
| | - Rong Lu
- Kangzhe Pharmaceutical Technology Development Company, Ltd., Tianjin, People’s Republic of China
| | - Song Wang
- Kangzhe Pharmaceutical Technology Development Company, Ltd., Tianjin, People’s Republic of China
| | - Zheng Fu
- Kangzhe Pharmaceutical Technology Development Company, Ltd., Tianjin, People’s Republic of China
| | - Zhi Yao
- Department of Immunology, Key Laboratory of Immune Microenvironment and Disease of the Educational Ministry of China, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, People’s Republic of China
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3
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Zhang Y, Håkansson J, Fan Y, Andrén OCJ, San Jacinto García J, Qin L, Umerska A, Hutchinson DJ, Lüchow M, Mahlapuu M, Malkoch M. Dendritic Nanogels Directed Dual-Encapsulation Topical Delivery System of Antimicrobial Peptides Targeting Skin Infections. Macromol Biosci 2023; 23:e2200433. [PMID: 36639138 DOI: 10.1002/mabi.202200433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/15/2022] [Indexed: 01/15/2023]
Abstract
Antimicrobial peptides (AMPs) are promising antibacterial agents in the fight against multidrug resistant pathogens. However, their application to skin infections is limited by the absence of a realizable topical delivery strategy. Herein, a hybrid hierarchical delivery system for topical delivery of AMPs is accomplished through the incorporation of AMPs into dendritic nanogels (DNGs) and their subsequent embedding into poloxamer gel. The high level of control over the crosslink density and the number of chosen functionalities makes DNGs ideal capsules with tunable loading capacity for DPK-060, a human kininogen-derived AMP. Once embedded into the poloxamer gel, DPK-060 encapsulated in DNGs displays a slower release rate compared to those entrapped directly in the gels. In vitro EpiDerm Skin Irritation Tests show good biocompatibility, while MIC and time-kill curves reveal the potency of the peptide toward Staphylococcus aureus. Anti-infection tests on ex vivo pig skin and in vivo mouse infection models demonstrate that formulations with 0.5% and 1% AMPs significantly inhibit the growth of S. aureus. Similar outcomes are observed for an in vivo mouse surgical site infection model. Importantly, when normalizing the bacteria inhibition to released/free DPK-060 at the wound site, all formulations display superior efficacy compared to DPK-060 in solution.
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Affiliation(s)
- Yuning Zhang
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, SE-100 44, Sweden.,Key Laboratory of Organ Regeneration and Transplantation of Ministry of Education, Institute of Immunology, The First Hospital, Jilin University, Changchun, 130061, P. R. China
| | - Joakim Håkansson
- Biological Function Unit, RISE Research Institutes of Sweden, Methodology, Textile and Medical Devices, Borås, SE-501 15, Sweden.,Department of Laboratory Medicine, Institute of Biomedicine, University of Gothenburg, P.O. Box 440, Gothenburg, SE-40530, Sweden
| | - Yanmiao Fan
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, SE-100 44, Sweden
| | - Oliver C J Andrén
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, SE-100 44, Sweden
| | - Jorge San Jacinto García
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, SE-100 44, Sweden
| | - Liguo Qin
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, SE-100 44, Sweden.,Institute of Design Science and Basic Components, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, 710049, P. R. China
| | - Anita Umerska
- Biological Function Unit, RISE Research Institutes of Sweden, Methodology, Textile and Medical Devices, Borås, SE-501 15, Sweden
| | - Daniel J Hutchinson
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, SE-100 44, Sweden
| | - Mads Lüchow
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, SE-100 44, Sweden
| | | | - Michael Malkoch
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, SE-100 44, Sweden
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Saeed S, Martins-Green M. Animal models for the study of acute cutaneous wound healing. Wound Repair Regen 2023; 31:6-16. [PMID: 36153666 DOI: 10.1111/wrr.13051] [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: 05/26/2021] [Revised: 08/29/2022] [Accepted: 09/12/2022] [Indexed: 01/25/2023]
Abstract
The process of wound healing is critical to maintaining homeostasis after injury. Although a considerable amount has been learned about this complex process, much remains unknown. Whereas, studies with human volunteers are ideal given the unique nature of the human skin anatomy and immune system, the lack of such clinical access has made animal models prime candidates for use in preclinical studies. This review aims to discuss the strengths and limitations of the commonly used mammalian species in wound healing studies: murine, rabbit and porcine. Thereafter, a survey of models of various acute wounds such as cutaneous, ear, and implant are presented and representative studies that use them are described. This review is intended to acquaint readers with the vast spectrum of models available, each of which has a distinct utility. At the same time, it highlights the importance of utilising clinical samples to complement investigations conducted in animal models. Through this strategy, it is hoped that forthcoming research may be more reflective of the acute wound healing process as it occurs in humans.
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Affiliation(s)
- Shayan Saeed
- Department of Molecular, Cell, and Systems Biology, University of California, Riverside, Riverside, California, USA
| | - Manuela Martins-Green
- Department of Molecular, Cell, and Systems Biology, University of California, Riverside, Riverside, California, USA
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Luong AD, Buzid A, Luong JHT. Important Roles and Potential Uses of Natural and Synthetic Antimicrobial Peptides (AMPs) in Oral Diseases: Cavity, Periodontal Disease, and Thrush. J Funct Biomater 2022; 13:jfb13040175. [PMID: 36278644 PMCID: PMC9589978 DOI: 10.3390/jfb13040175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 01/10/2023] Open
Abstract
Numerous epithelial cells and sometimes leukocytes release AMPs as their first line of defense. AMPs encompass cationic histatins, defensins, and cathelicidin to encounter oral pathogens with minimal resistance. However, their concentrations are significantly below the effective levels and AMPs are unstable under physiological conditions due to proteolysis, acid hydrolysis, and salt effects. In parallel to a search for more effective AMPs from natural sources, considerable efforts have focused on synthetic stable and low-cytotoxicy AMPs with significant activities against microorganisms. Using natural AMP templates, various attempts have been used to synthesize sAMPs with different charges, hydrophobicity, chain length, amino acid sequence, and amphipathicity. Thus far, sAMPs have been designed to target Streptococcus mutans and other common oral pathogens. Apart from sAMPs with antifungal activities against Candida albicans, future endeavors should focus on sAMPs with capabilities to promote remineralization and antibacterial adhesion. Delivery systems using nanomaterials and biomolecules are promising to stabilize, reduce cytotoxicity, and improve the antimicrobial activities of AMPs against oral pathogens. Nanostructured AMPs will soon become a viable alternative to antibiotics due to their antimicrobial mechanisms, broad-spectrum antimicrobial activity, low drug residue, and ease of synthesis and modification.
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Affiliation(s)
- Albert Donald Luong
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University of Buffalo, Buffalo, NY 14215, USA
| | - Alyah Buzid
- Department of Chemistry, College of Science, King Faisal University, P.O. Box 380, Al-Ahsa 31982, Saudi Arabia
| | - John H. T. Luong
- School of Chemistry and Analytical & Biological Chemistry Research Facility (ABCRF), University College Cork, College Road, T12 YN60 Cork, Ireland
- Correspondence: or
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Combinatorial Therapeutic Strategy of Biogenics Derived from Lactobacillus fermentum PUM and Zingerone Against Pseudomonas aeruginosa PAO1-Induced Surgical Site Infection: an Experimental Study. Probiotics Antimicrob Proteins 2022; 14:712-726. [PMID: 35482245 DOI: 10.1007/s12602-022-09944-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2022] [Indexed: 10/18/2022]
Abstract
Pseudomonas aeruginosa, a WHO-prioritized multidrug-resistant Gram-negative bacteria, is one of the frequently implicated pathogen in surgical site infection (SSI) due to its virulence phenotypes and biofilm-forming ability. In the present study, cell-free supernatant (CFS) and biogenics (organic acids and precipitated protein fraction) of indigenous potential probiotic, Lactobacillus fermentum PUM both alone and in combination with zingerone were found to inhibit pyocyanin, pyochelin, protease, elastase, the virulence factors, and motility of P. aeruginosa PAO1. Furthermore, scanning electron microscopy indicated that biofilm formation was attenuated maximally by CFS of L. fermentum combined with zingerone. In vivo study revealed reduced P. aeruginosa burden, suppuration at surgical site vis-a-vis reduced levels of oxidants, pro-inflammatory cytokines, ameliorated anti-oxidants, and healed infected surgical site compared with counter controls. In totality, combination of L. fermentum PUM-derived biogenics and zingerone could be employed to treat P. aeruginosa-induced SSI that needs to be correlated clinically.
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Knutsen MF, Agrenius K, Ugland H, Petronis S, Haglerod C, Håkansson J, Chinga-Carrasco G. Oxygenated Nanocellulose-A Material Platform for Antibacterial Wound Dressing Devices. ACS APPLIED BIO MATERIALS 2021; 4:7554-7562. [PMID: 35006698 DOI: 10.1021/acsabm.1c00819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Both carboxylated cellulose nanofibrils (CNF) and dissolved oxygen (DO) have been reported to possess antibacterial properties. However, the combination for use as wound dressings against biofilm infections in chronic wounds is less known. The present study reports the development of oxygenated CNF dispersions that exhibit strong antibacterial effect. Carboxylated CNF dispersions with different oxidation levels were oxygenated by the OXY BIO System and tested for antibacterial activity against Pseudomonas aeruginosa and Staphylococcus aureus. The results reveal that the higher oxidation level of the CNFs, the better antibacterial effect. Scanning electron microscopy of bacterial biofilms revealed that a potential mechanism of action of the CNFs is the formation of a network surrounding and entrapping the bacteria. This effect is further potentiated by the oxygenation process. A CNF sample (concentration 0.6 wt %) that was oxygenated to a DO level of 46.4 mg/L demonstrated a strong antibacterial effect against S. aureus in vivo using a mouse model of surgical site infection. The oxygenated CNF dispersion reduced the bacterial survival by 71%, after 24 h treatment. The potent antibacterial effect indicates that oxygenated nanocellulose is a promising material for antibacterial wound dressings.
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Affiliation(s)
| | - Karin Agrenius
- Chemistry, Biomaterials and Textiles, RISE Research Institutes of Sweden, Box 857, SE-50115 Borås, Sweden
| | - Hege Ugland
- Oxy Solutions, Gaustadalléen 21, 0349 Oslo, Norway
| | - Sarunas Petronis
- Chemistry, Biomaterials and Textiles, RISE Research Institutes of Sweden, Box 857, SE-50115 Borås, Sweden
| | | | - Joakim Håkansson
- Chemistry, Biomaterials and Textiles, RISE Research Institutes of Sweden, Box 857, SE-50115 Borås, Sweden.,Department of Laboratory Medicine, Institute of Biomedicine, Gothenburg University, 405 30 Gothenburg, Sweden
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Momin M, Mishra V, Gharat S, Omri A. Recent advancements in cellulose-based biomaterials for management of infected wounds. Expert Opin Drug Deliv 2021; 18:1741-1760. [PMID: 34605347 DOI: 10.1080/17425247.2021.1989407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Chronic wounds are a substantial burden on the healthcare system. Their treatment requires advanced dressings, which can provide a moist wound environment, prevent bacterial infiltration, and act as a drug carrier. Cellulose is biocompatible, biodegradable, and can be functionalized according to specific requirements, which makes it a highly versatile biomaterial. Antimicrobial cellulose dressings are proving to be highly effective against infected wounds. AREAS COVERED This review briefly addresses the mechanism of wound healing and its pathophysiology. It also discusses wound infections, biofilm formation, and progressive emergence of drug-resistant bacteria in chronic wounds and the treatment strategies for such types of infected wounds. It also summarizes the general properties, method of production, and types of cellulose wound dressings. It explores recent studies and advancements regarding the use of cellulose and its derivatives in wound management. EXPERT OPINION Cellulose and its various functionalized derivatives represent a promising choice of wound dressing material. Cellulose-based dressings loaded with antimicrobials are very useful in controlling infection in a chronic wound. Recent studies showing its efficacy against drug-resistant bacteria make it a favorable choice for chronic wound infections. Further research and large-scale clinical trials are required for better clinical evidence of its efficiency.
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Affiliation(s)
- Munira Momin
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, India.,SVKM's C B Patel Research Center for Chemistry and Biological Sciences, Mumbai, India
| | - Varsha Mishra
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, India
| | - Sankalp Gharat
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, India
| | - Abdelwahab Omri
- The Novel Drug and Vaccine Delivery Systems Facility, Department of Chemistry and Biochemistry, Laurentian University, Sudbury, Canada
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9
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Chinga-Carrasco G, Johansson J, Heggset EB, Leirset I, Björn C, Agrenius K, Stevanic JS, Håkansson J. Characterization and Antibacterial Properties of Autoclaved Carboxylated Wood Nanocellulose. Biomacromolecules 2021; 22:2779-2789. [PMID: 34185505 DOI: 10.1021/acs.biomac.1c00137] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cellulose nanofibrils (CNFs) were obtained by applying a chemical pretreatment consisting of autoclaving the pulp fibers in sodium hydroxide, combined with 2,2,6,6-tetramethylpiperidinyl-1-oxyl-mediated oxidation. Three levels of sodium hypochlorite were applied (2.5, 3.8, and 6.0 mmol/g) to obtain CNF qualities (CNF_2.5, CNF_3.8, and CNF_6.0) with varying content of carboxyl groups, that is, 1036, 1285, and 1593 μmol/g cellulose. The cytotoxicity and skin irritation potential (indirect tests) of the CNFs were determined according to standardized in vitro testing for medical devices. We here demonstrate that autoclaving (121 °C, 20 min), which was used to sterilize the gels, caused a modification of the CNF characteristics. This was confirmed by a reduction in the viscosity of the gels, a morphological change of the nanofibrils, by an increase of the ultraviolet-visible absorbance maxima at 250 nm, reduction of the absolute zeta potential, and by an increase in aldehyde content and reducing sugars after autoclaving. Fourier-transform infrared spectroscopy and wide-angle X-ray scattering complemented an extensive characterization of the CNF gels, before and after autoclaving. The antibacterial properties of autoclaved carboxylated CNFs were demonstrated in vitro (bacterial survival and swimming assays) on Pseudomonas aeruginosa and Staphylococcus aureus. Importantly, a mouse in vivo surgical-site infection model on S. aureus revealed that CNF_3.8 showed pronounced antibacterial effect and performed as good as the antiseptic Prontosan wound gel.
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Affiliation(s)
| | - Jenny Johansson
- Chemistry, Biomaterials and Textiles, RISE Research Institutes of Sweden, P.O. Box 857, 501 15 Borås, Sweden
| | | | | | - Camilla Björn
- Chemistry, Biomaterials and Textiles, RISE Research Institutes of Sweden, P.O. Box 857, 501 15 Borås, Sweden
| | - Karin Agrenius
- Chemistry, Biomaterials and Textiles, RISE Research Institutes of Sweden, P.O. Box 857, 501 15 Borås, Sweden
| | - Jasna S Stevanic
- Material and Surface Design, RISE Research Institutes of Sweden, P.O. Box 5604, 114 86 Stockholm, Sweden
| | - Joakim Håkansson
- Chemistry, Biomaterials and Textiles, RISE Research Institutes of Sweden, P.O. Box 857, 501 15 Borås, Sweden.,Department of Laboratory Medicine, Institute of Biomedicine, Gothenburg University, 405 30 Gothenburg, Sweden
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10
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Håkansson J, Cavanagh JP, Stensen W, Mortensen B, Svendsen JS, Svenson J. In vitro and in vivo antibacterial properties of peptide AMC-109 impregnated wound dressings and gels. J Antibiot (Tokyo) 2021; 74:337-345. [PMID: 33495549 DOI: 10.1038/s41429-021-00406-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/16/2020] [Accepted: 12/24/2020] [Indexed: 02/06/2023]
Abstract
Synthetic mimics of antimicrobial peptides (AMPs) is a promising class of molecules for a variety of antimicrobial applications. Several hurdles must be passed before effective systemic infection therapies with AMPs can be achieved, but the path to effective topical treatment of skin, nail, and soft tissue infections appears less challenging to navigate. Skin and soft tissue infection is closely coupled to the emergence of antibiotic resistance and represents a major burden to the healthcare system. The present study evaluates the promising synthetic cationic AMP mimic, AMC-109, for treatment of skin infections in vivo. The compound is evaluated both in impregnated cotton wound dressings and in a gel formulation against skin infections caused by Staphylococcus aureus and methicillin resistant S. aureus. Both the ability to prevent colonization and formation of an infection, as well as eradicate an ongoing infection in vivo with a high bacterial load, were evaluated. The present work demonstrates that AMC-109 displays a significantly higher antibacterial activity with up to a seven-log reduction in bacterial loads compared to current clinical standard therapy; Altargo cream (1% retapamulin) and Fucidin cream (2% fusidic acid) in the in vivo wound models. It is thus concluded that AMC-109 represents a promising entry in the development of new and effective remedies for various skin infections.
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Affiliation(s)
- Joakim Håkansson
- Department of Chemistry, Biomaterial & Textile, RISE Research Institutes of Sweden, Borås, Sweden.,Department of Laboratory Medicine, Institute of Biomedicine, Gothenburg University, Gothenburg, Sweden
| | - Jorunn Pauline Cavanagh
- Amicoat A/S, Sandvika, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Wenche Stensen
- Department of Chemistry, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - John-Sigurd Svendsen
- Amicoat A/S, Sandvika, Norway.,Department of Chemistry, UiT The Arctic University of Norway, Tromsø, Norway
| | - Johan Svenson
- Department of Chemistry, Biomaterial & Textile, RISE Research Institutes of Sweden, Borås, Sweden. .,Cawthron Institute, Nelson, New Zealand.
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11
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Successful Development of Bacteriocins into Therapeutic Formulation for Treatment of MRSA Skin Infection in a Murine Model. Antimicrob Agents Chemother 2020; 64:AAC.00829-20. [PMID: 32958719 PMCID: PMC7674055 DOI: 10.1128/aac.00829-20] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 09/17/2020] [Indexed: 01/08/2023] Open
Abstract
The emergence of antibiotic-resistant pathogens has caused a serious worldwide problem in infection treatment in recent years. One of the pathogens is methicillin-resistant Staphylococcus aureus (MRSA), which is a major cause of skin and soft tissue infections. Alternative strategies and novel sources of antimicrobials to solve antibiotic resistance problems are urgently needed. In this study, we explored the potential of two broad-spectrum bacteriocins, garvicin KS and micrococcin P1, in skin infection treatments. The emergence of antibiotic-resistant pathogens has caused a serious worldwide problem in infection treatment in recent years. One of the pathogens is methicillin-resistant Staphylococcus aureus (MRSA), which is a major cause of skin and soft tissue infections. Alternative strategies and novel sources of antimicrobials to solve antibiotic resistance problems are urgently needed. In this study, we explored the potential of two broad-spectrum bacteriocins, garvicin KS and micrococcin P1, in skin infection treatments. The two bacteriocins acted synergistically with each other and with penicillin G in killing MRSA in vitro. The MICs of the antimicrobials in the three-component mixture were 40 ng/ml for micrococcin P1 and 2 μg/ml for garvicin KS and penicillin G, which were 62, 16, and at least 1,250 times lower than their MICs when assessed individually. To assess its therapeutic potential further, we challenged the three-component formulation in a murine skin infection model with the multidrug-resistant luciferase-tagged MRSA Xen31, a strain derived from the clinical isolate S. aureus ATCC 33591. Using the tagged-luciferase activity as a reporter for the presence of Xen31 in wounds, we demonstrated that the three-component formulation was efficient in eradicating the pathogen from treated wounds. Furthermore, compared to Fucidin cream, which is an antibiotic commonly used in skin infection treatments, our formulation was also superior in terms of preventing resistance development.
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12
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Impetigo Animal Models: A Review of Their Feasibility and Clinical Utility for Therapeutic Appraisal of Investigational Drug Candidates. Antibiotics (Basel) 2020; 9:antibiotics9100694. [PMID: 33066386 PMCID: PMC7602235 DOI: 10.3390/antibiotics9100694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 01/12/2023] Open
Abstract
Impetigo (school sores), a superficial skin infection commonly seen in children, is caused by the gram-positive bacteria Staphylococcus aureus and/or Streptococcus pyogenes. Antibiotic treatments, often topical, are used as the first-line therapy for impetigo. The efficacy of potential new antimicrobial compounds is first tested in in vitro studies and, if effective, followed by in vivo studies using animal models and/or humans. Animal models are critical means for investigating potential therapeutics and characterizing their safety profile prior to human trials. Although several reviews of animal models for skin infections have been published, there is a lack of a comprehensive review of animal models simulating impetigo for the selection of therapeutic drug candidates. This review critically examines the existing animal models for impetigo and their feasibility for testing the in vivo efficacy of topical treatments for impetigo and other superficial bacterial skin infections.
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Mercer DK, O'Neil DA. Innate Inspiration: Antifungal Peptides and Other Immunotherapeutics From the Host Immune Response. Front Immunol 2020; 11:2177. [PMID: 33072081 PMCID: PMC7533533 DOI: 10.3389/fimmu.2020.02177] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 08/10/2020] [Indexed: 12/17/2022] Open
Abstract
The purpose of this review is to describe antifungal therapeutic candidates in preclinical and clinical development derived from, or directly influenced by, the immune system, with a specific focus on antimicrobial peptides (AMP). Although the focus of this review is AMP with direct antimicrobial effects on fungi, we will also discuss compounds with direct antifungal activity, including monoclonal antibodies (mAb), as well as immunomodulatory molecules that can enhance the immune response to fungal infection, including immunomodulatory AMP, vaccines, checkpoint inhibitors, interferon and colony stimulating factors as well as immune cell therapies. The focus of this manuscript will be a non-exhaustive review of antifungal compounds in preclinical and clinical development that are based on the principles of immunology and the authors acknowledge the incredible amount of in vitro and in vivo work that has been conducted to develop such therapeutic candidates.
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Huss MK, Casey KM, Hu J, Moorhead RC, Chum HH. Evaluation of 3 Alcohol-based Agents for Presurgical Skin Preparation in Mice. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE : JAALAS 2020; 59:67-73. [PMID: 31753064 PMCID: PMC6978582 DOI: 10.30802/aalas-jaalas-19-000053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/15/2019] [Accepted: 05/31/2019] [Indexed: 11/05/2022]
Abstract
Appropriate aseptic technique is a crucial component of rodent survival surgery. Ease of technique, surgical space constraint, batch surgery, and cost are factors that may affect researcher compliance with appropriate aseptic technique. The first part of this study compared 3 antiseptic preparation agents with the standard triplicate application of povidone-iodine and alcohol. Euthanized mice (n = 40) were shaved on the dorsum, and culture swabs were taken for RODAC plating and bacterial identification. Shaved sites were prepared by using one of the 4 antiseptic preparation agents. Culture samples were obtained immediately and at 20 min after antiseptic preparation. In the 2nd part of the study, 8 mice (n = 2 per group) were prepared for a survival surgical procedure by using one of the 4 antiseptic preparation agents to evaluate whether the antiseptic preparation agents caused skin irritation or impaired healing. Results from this study indicated that all 3 of the antiseptic agents evaluated were equally effective at reducing bacterial populations immediately and at 20 min after preparation. Histopathologic examination of the incision sites revealed signs of normal healing without lesions adjacent to the incision site. We conclude that all 3 of the products evaluated are comparable to traditional povidone-iodine and alcohol as agents for aseptic preparation of surgical sites.
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Affiliation(s)
| | | | - Jing Hu
- Veterinary Service Center Diagnostic Laboratory, Stanford University, Stanford, California
| | - Roberta C Moorhead
- Veterinary Service Center Diagnostic Laboratory, Stanford University, Stanford, California
| | - Helen H Chum
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California
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15
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Ribeiro DML, Carvalho Júnior AR, Vale de Macedo GHR, Chagas VL, Silva LDS, Cutrim BDS, Santos DM, Soares BLL, Zagmignan A, de Miranda RDCM, de Albuquerque PBS, Nascimento da Silva LC. Polysaccharide-Based Formulations for Healing of Skin-Related Wound Infections: Lessons from Animal Models and Clinical Trials. Biomolecules 2019; 10:E63. [PMID: 31905975 PMCID: PMC7022374 DOI: 10.3390/biom10010063] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/08/2019] [Accepted: 11/15/2019] [Indexed: 12/17/2022] Open
Abstract
Skin injuries constitute a gateway for pathogenic bacteria that can be either part of tissue microbiota or acquired from the environmental. These microorganisms (such as Acinetobacter baumannii, Enterococcus faecalis,Pseudomonas aeruginosa, and Staphylococcus aureus) produce virulence factors that impair tissue integrity and sustain the inflammatory phase leading for establishment of chronic wounds. The high levels of antimicrobial resistance have limited the therapeutic arsenal for combatting skin infections. Thus, the treatment of non-healing chronic wounds is a huge challenge for health services worldwide, imposing great socio-economic damage to the affected individuals. This scenario has encouraged the use of natural polymers, such as polysaccharide, in order to develop new formulations (membranes, nanoparticles, hydrogels, scaffolds) to be applied in the treatment of skin infections. In this non-exhaustive review, we discuss the applications of polysaccharide-based formulations in the healing of infected wounds in animal models and clinical trials. The formulations discussed in this review were prepared using alginate, cellulose, chitosan, and hyaluronic acid. In addition to have healing actions per se, these polysaccharide formulations can act as transdermal drug delivery systems, controlling the release of active ingredients (such as antimicrobial and healing agents). The papers show that these polysaccharides-based formulations are efficient in controlling infection and improve the healing, even in chronic infected wounds. These data should positively impact the design of new dressings to treat skin infections.
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Affiliation(s)
- Diogo Marcelo Lima Ribeiro
- Programa de Pós-graduação, Universidade Ceuma, São Luís, Maranhão 65075–120, Brazil; (D.M.L.R.); (A.R.C.J.); (G.H.R.V.d.M.); (V.L.C.); (L.d.S.S.); (B.d.S.C.); (D.M.S.); (B.L.L.S.); (A.Z.); (R.d.C.M.d.M.)
| | - Alexsander Rodrigues Carvalho Júnior
- Programa de Pós-graduação, Universidade Ceuma, São Luís, Maranhão 65075–120, Brazil; (D.M.L.R.); (A.R.C.J.); (G.H.R.V.d.M.); (V.L.C.); (L.d.S.S.); (B.d.S.C.); (D.M.S.); (B.L.L.S.); (A.Z.); (R.d.C.M.d.M.)
| | - Gustavo Henrique Rodrigues Vale de Macedo
- Programa de Pós-graduação, Universidade Ceuma, São Luís, Maranhão 65075–120, Brazil; (D.M.L.R.); (A.R.C.J.); (G.H.R.V.d.M.); (V.L.C.); (L.d.S.S.); (B.d.S.C.); (D.M.S.); (B.L.L.S.); (A.Z.); (R.d.C.M.d.M.)
| | - Vitor Lopes Chagas
- Programa de Pós-graduação, Universidade Ceuma, São Luís, Maranhão 65075–120, Brazil; (D.M.L.R.); (A.R.C.J.); (G.H.R.V.d.M.); (V.L.C.); (L.d.S.S.); (B.d.S.C.); (D.M.S.); (B.L.L.S.); (A.Z.); (R.d.C.M.d.M.)
| | - Lucas dos Santos Silva
- Programa de Pós-graduação, Universidade Ceuma, São Luís, Maranhão 65075–120, Brazil; (D.M.L.R.); (A.R.C.J.); (G.H.R.V.d.M.); (V.L.C.); (L.d.S.S.); (B.d.S.C.); (D.M.S.); (B.L.L.S.); (A.Z.); (R.d.C.M.d.M.)
| | - Brenda da Silva Cutrim
- Programa de Pós-graduação, Universidade Ceuma, São Luís, Maranhão 65075–120, Brazil; (D.M.L.R.); (A.R.C.J.); (G.H.R.V.d.M.); (V.L.C.); (L.d.S.S.); (B.d.S.C.); (D.M.S.); (B.L.L.S.); (A.Z.); (R.d.C.M.d.M.)
| | - Deivid Martins Santos
- Programa de Pós-graduação, Universidade Ceuma, São Luís, Maranhão 65075–120, Brazil; (D.M.L.R.); (A.R.C.J.); (G.H.R.V.d.M.); (V.L.C.); (L.d.S.S.); (B.d.S.C.); (D.M.S.); (B.L.L.S.); (A.Z.); (R.d.C.M.d.M.)
| | - Bruno Luis Lima Soares
- Programa de Pós-graduação, Universidade Ceuma, São Luís, Maranhão 65075–120, Brazil; (D.M.L.R.); (A.R.C.J.); (G.H.R.V.d.M.); (V.L.C.); (L.d.S.S.); (B.d.S.C.); (D.M.S.); (B.L.L.S.); (A.Z.); (R.d.C.M.d.M.)
| | - Adrielle Zagmignan
- Programa de Pós-graduação, Universidade Ceuma, São Luís, Maranhão 65075–120, Brazil; (D.M.L.R.); (A.R.C.J.); (G.H.R.V.d.M.); (V.L.C.); (L.d.S.S.); (B.d.S.C.); (D.M.S.); (B.L.L.S.); (A.Z.); (R.d.C.M.d.M.)
| | - Rita de Cássia Mendonça de Miranda
- Programa de Pós-graduação, Universidade Ceuma, São Luís, Maranhão 65075–120, Brazil; (D.M.L.R.); (A.R.C.J.); (G.H.R.V.d.M.); (V.L.C.); (L.d.S.S.); (B.d.S.C.); (D.M.S.); (B.L.L.S.); (A.Z.); (R.d.C.M.d.M.)
| | | | - Luís Cláudio Nascimento da Silva
- Programa de Pós-graduação, Universidade Ceuma, São Luís, Maranhão 65075–120, Brazil; (D.M.L.R.); (A.R.C.J.); (G.H.R.V.d.M.); (V.L.C.); (L.d.S.S.); (B.d.S.C.); (D.M.S.); (B.L.L.S.); (A.Z.); (R.d.C.M.d.M.)
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16
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Antimicrobial efficacy and toxicity of novel CAMPs against P. aeruginosa infection in a murine skin wound infection model. BMC Microbiol 2019; 19:293. [PMID: 31842727 PMCID: PMC6915932 DOI: 10.1186/s12866-019-1657-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 11/20/2019] [Indexed: 01/08/2023] Open
Abstract
Background Treatment of P. aeruginosa wound infection is challenging due to its inherent and acquired resistance to many conventional antibiotics. Cationic antimicrobial peptides (CAMPs) with distinct modes of antimicrobial action have been considered as the next-generation therapeutic agents. In the present study, a murine skin surgical wound infection model was used to evaluate the in vivo toxicity and efficacy of two newly designed antimicrobial peptides (CAMP-A and CAMP-B), as chemotherapeutic agents to combat P. aeruginosa infection. Results In the first trial, topical application of CAMPs on the wounds at a dose equivalent to 4 × MIC for 7 consecutive days did not cause any significant changes in the physical activities, hematologic and plasma biochemical parameters, or histology of systemic organs of the treated mice. Daily treatment of infected wounds with CAMP-A and CAMP-B for 5 days at a dose equivalent to 2× MIC resulted in a significant reduction in wound bacterial burden (CAMP-A: 4.3 log10CFU/g of tissue and CAMP-B: 5.8 log10CFU/g of tissue), compared to that of the mock-treated group (8.1 log10CFU/g of tissue). Treatment with CAMPs significantly promoted wound closure and induced epidermal cell proliferation. Topical application of CAMP-A on wounds completely prevented systemic dissemination of P. aeruginosa while CAMP-B blocked systemic infection in 67% of mice and delayed the onset of systemic infection by at least 2 days in the rest of the mice (33%). In a second trial, daily application of CAMP-A at higher doses (5× MIC and 50× MIC) didn’t show any significant toxic effect on mice and the treatments with CAMP-A further reduced wound bacterial burden (5× MIC: 4.5 log10CFU/g of tissue and 50× MIC: 3.8 log10CFU/g of tissue). Conclusions The data collectively indicated that CAMPs significantly reduced wound bacterial load, promoted wound healing, and prevented hepatic dissemination. CAMP-A is a promising alternative to commonly used antibiotics to treat P. aeruginosa skin infection.
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Håkansson J, Ringstad L, Umerska A, Johansson J, Andersson T, Boge L, Rozenbaum RT, Sharma PK, Tollbäck P, Björn C, Saulnier P, Mahlapuu M. Characterization of the in vitro, ex vivo, and in vivo Efficacy of the Antimicrobial Peptide DPK-060 Used for Topical Treatment. Front Cell Infect Microbiol 2019; 9:174. [PMID: 31192163 PMCID: PMC6548878 DOI: 10.3389/fcimb.2019.00174] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/08/2019] [Indexed: 12/26/2022] Open
Abstract
Antimicrobial peptides, also known as host defense peptides, have recently emerged as a promising new category of therapeutic agents for the treatment of infectious diseases. This study evaluated the preclinical in vitro, ex vivo, and in vivo antimicrobial activity, as well as the potential to cause skin irritation, of human kininogen-derived antimicrobial peptide DPK-060 in different formulations designed for topical delivery. We found that DPK-060 formulated in acetate buffer or poloxamer gel caused a marked reduction of bacterial counts of Staphylococcus aureus in vitro (minimum microbicidal concentration <5 μg/ml). We also found that DPK-060 in poloxamer gel significantly suppressed microbial survival in an ex vivo wound infection model using pig skin and in an in vivo mouse model of surgical site infection (≥99 or ≥94% reduction in bacterial counts was achieved with 1% DPK-060 at 4 h post-treatment, respectively). Encapsulation of DPK-060 in different types of lipid nanocapsules or cubosomes did not improve the bactericidal potential of the peptide under the applied test conditions. No reduction in cell viability was observed in response to administration of DPK-060 in any of the formulations tested. In conclusion, the present study confirms that DPK-060 has the potential to be an effective and safe drug candidate for the topical treatment of microbial infections; however, adsorption of the peptide to nanocarriers failed to show any additional benefits.
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Affiliation(s)
- Joakim Håkansson
- Division of Bioscience and Materials, RISE Research Institutes of Sweden, Borås, Sweden
| | - Lovisa Ringstad
- Division of Bioscience and Materials, RISE Research Institutes of Sweden, Borås, Sweden
| | - Anita Umerska
- Université de Lorraine, CITHEFOR, Nancy, France.,INSERM 1066, CNRS 6021, Université Bretagne Loire, MINT, UNIV Angers, Angers, France
| | - Jenny Johansson
- Division of Bioscience and Materials, RISE Research Institutes of Sweden, Borås, Sweden
| | - Therese Andersson
- Division of Bioscience and Materials, RISE Research Institutes of Sweden, Borås, Sweden
| | - Lukas Boge
- Division of Bioscience and Materials, RISE Research Institutes of Sweden, Borås, Sweden
| | - René T Rozenbaum
- Department of Biomedical Engineering, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Prashant K Sharma
- Department of Biomedical Engineering, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Petter Tollbäck
- Division of Bioscience and Materials, RISE Research Institutes of Sweden, Borås, Sweden
| | - Camilla Björn
- Division of Bioscience and Materials, RISE Research Institutes of Sweden, Borås, Sweden
| | - Patrick Saulnier
- INSERM 1066, CNRS 6021, Université Bretagne Loire, MINT, UNIV Angers, Angers, France
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18
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Affiliation(s)
- Donald E. Fry
- MPA Healthcare Solutions, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, and Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico
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19
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Potuck A, Leming R, Lam S. Dynamic rheology as a quantitative method for real-time tracking of excipient solvation in non-aqueous hydroxypropylcellulose topical gels. Pharm Dev Technol 2018; 24:521-527. [PMID: 30035650 DOI: 10.1080/10837450.2018.1502319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This article describes a method to quantitatively track the solvation of HPC in a non-aqueous solvent system during topical gel manufacture. Where visual observation and microscopy could not establish a trend, straight-forward rheological profiling demonstrated a correlation between increased solvation of hydroxypropyl cellulose polymer (viscosity modifier) and decreased tan δ, indicating the formation of a viscoelastic gel network over time during processing. This correlation serves as a valuable tool for process optimization and HPC solvation tracking in non-aqueous topical gel formulations.
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Affiliation(s)
- Alicia Potuck
- a GSK Dermatology Unit , Topical Product Development , Collegeville , PA , USA
| | - Robert Leming
- a GSK Dermatology Unit , Topical Product Development , Collegeville , PA , USA
| | - Stephanie Lam
- a GSK Dermatology Unit , Topical Product Development , Collegeville , PA , USA
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20
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Conjugates and nano-delivery of antimicrobial peptides for enhancing therapeutic activity. J Drug Deliv Sci Technol 2018. [DOI: 10.1016/j.jddst.2017.12.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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21
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Current and Emerging Topical Antibacterials and Antiseptics: Agents, Action, and Resistance Patterns. Clin Microbiol Rev 2017; 30:827-860. [PMID: 28592405 DOI: 10.1128/cmr.00112-16] [Citation(s) in RCA: 188] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Bacterial skin infections represent some of the most common infectious diseases globally. Prevention and treatment of skin infections can involve application of a topical antimicrobial, which may be an antibiotic (such as mupirocin or fusidic acid) or an antiseptic (such as chlorhexidine or alcohol). However, there is limited evidence to support the widespread prophylactic or therapeutic use of topical agents. Challenges involved in the use of topical antimicrobials include increasing rates of bacterial resistance, local hypersensitivity reactions (particularly to older agents, such as bacitracin), and concerns about the indiscriminate use of antiseptics potentially coselecting for antibiotic resistance. We review the evidence for the major clinical uses of topical antibiotics and antiseptics. In addition, we review the mechanisms of action of common topical agents and define the clinical and molecular epidemiology of antimicrobial resistance in these agents. Moreover, we review the potential use of newer and emerging agents, such as retapamulin and ebselen, and discuss the role of antiseptic agents in preventing bacterial skin infections. A comprehensive understanding of the clinical efficacy and drivers of resistance to topical agents will inform the optimal use of these agents to preserve their activity in the future.
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22
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Piotrowska U, Sobczak M, Oledzka E. Current state of a dual behaviour of antimicrobial peptides-Therapeutic agents and promising delivery vectors. Chem Biol Drug Des 2017; 90:1079-1093. [DOI: 10.1111/cbdd.13031] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/14/2017] [Accepted: 05/18/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Urszula Piotrowska
- Chair of Inorganic and Analytical Chemistry; Department of Biomaterials Chemistry; Faculty of Pharmacy with the Laboratory Medicine Division; Medical University of Warsaw; Warsaw Poland
| | - Marcin Sobczak
- Chair of Inorganic and Analytical Chemistry; Department of Biomaterials Chemistry; Faculty of Pharmacy with the Laboratory Medicine Division; Medical University of Warsaw; Warsaw Poland
| | - Ewa Oledzka
- Chair of Inorganic and Analytical Chemistry; Department of Biomaterials Chemistry; Faculty of Pharmacy with the Laboratory Medicine Division; Medical University of Warsaw; Warsaw Poland
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23
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Sandreschi S, Piras AM, Batoni G, Chiellini F. Perspectives on polymeric nanostructures for the therapeutic application of antimicrobial peptides. Nanomedicine (Lond) 2016; 11:1729-44. [PMID: 27348155 DOI: 10.2217/nnm-2016-0057] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Antimicrobial peptides (AMPs) are a class of promising anti-infective molecules but their therapeutic application is opposed by their poor bioavailability, susceptibility to protease degradation and potential toxicity. The advancement of nanoformulation technologies offers encouraging perspectives for the development of novel therapeutic strategies based on AMPs to treat antibiotic resistant microbial infections. Additionally, the use of polymers endowed per-se with antibacterial properties, stands out as an innovative approach for the development of a new generation of drug delivery systems in which an enhanced antimicrobial action could be obtained by the synergic combination of bioactive polymer matrices and drugs. Herein, the latest AMPs drug delivery research is discussed.
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Affiliation(s)
- Stefania Sandreschi
- BIOlab Research Group, Department of Chemistry & Industrial Chemistry, University of Pisa, UdR INSTM Pisa, Via G. Moruzzi 13, 56124 Pisa, Italy
| | - Anna Maria Piras
- BIOlab Research Group, Department of Chemistry & Industrial Chemistry, University of Pisa, UdR INSTM Pisa, Via G. Moruzzi 13, 56124 Pisa, Italy
| | - Giovanna Batoni
- Department of Translational Research & New Technology in Medicine & Surgery, University of Pisa, Via S. Zeno 35-39, 56127 Pisa, Italy
| | - Federica Chiellini
- BIOlab Research Group, Department of Chemistry & Industrial Chemistry, University of Pisa, UdR INSTM Pisa, Via G. Moruzzi 13, 56124 Pisa, Italy
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Newly Developed Topical Cefotaxime Sodium Hydrogels: Antibacterial Activity and In Vivo Evaluation. BIOMED RESEARCH INTERNATIONAL 2016; 2016:6525163. [PMID: 27314033 PMCID: PMC4895050 DOI: 10.1155/2016/6525163] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 04/06/2016] [Accepted: 04/13/2016] [Indexed: 12/29/2022]
Abstract
In an attempt to reach better treatment of skin infections, gel formulations containing Cefotaxime (CTX) were prepared. The gel was formulated using Carbopol 934 (C934), Hydroxypropyl Methylcellulose 4000 (HPMC 4000), Carboxymethylcellulose Sodium (Na CMC), Pectin (PEC), Xanthan Gum (XG), or Guar Gum (GG). Thirteen different formulas were prepared and characterized physically in terms of color, syneresis, spreadability, pH, drug content, and rheological properties. Drug-excipients compatibility studies were confirmed by FTIR and then in vitro drug release study was conducted. In vitro and in vivo antibacterial activities of CTX were studied against wound pathogens such as, Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), and Pseudomonas aeruginosa (P. aeruginosa), using either pure drug or Fucidin® cream as control. F13 provides better spreadability compared to F1 (XG) or F11 (HPMC). Moreover, the release of the drug from hydrogel F13 containing C934 was slower and sustained for 8 h. Stability study revealed that, upon storage, there were no significant changes in pH, drug content, and viscosity of the gels. Also, F13 showed the larger inhibition zone and highest antibacterial activity among other formulations. Histological analysis demonstrated that after single treatment with F13 gel formulation, a noticeable reduction in microbial bioburden occurred in case of both Gram positive and Gram negative bacterial isolates.
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25
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Development and In Vivo Evaluation of a Novel Histatin-5 Bioadhesive Hydrogel Formulation against Oral Candidiasis. Antimicrob Agents Chemother 2015; 60:881-9. [PMID: 26596951 DOI: 10.1128/aac.02624-15] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 11/18/2015] [Indexed: 01/09/2023] Open
Abstract
Oral candidiasis (OC), caused by the fungal pathogen Candida albicans, is the most common opportunistic infection in HIV(+) individuals and other immunocompromised populations. The dramatic increase in resistance to common antifungals has emphasized the importance of identifying unconventional therapeutic options. Antimicrobial peptides have emerged as promising candidates for therapeutic intervention due to their broad antimicrobial properties and lack of toxicity. Histatin-5 (Hst-5) specifically has exhibited potent anticandidal activity indicating its potential as an antifungal agent. To that end, the goal of this study was to design a biocompatible hydrogel delivery system for Hst-5 application. The bioadhesive hydroxypropyl methylcellulose (HPMC) hydrogel formulation was developed for topical oral application against OC. The new formulation was evaluated in vitro for gel viscosity, Hst-5 release rate from the gel, and killing potency and, more importantly, was tested in vivo in our mouse model of OC. The findings demonstrated a controlled sustained release of Hst-5 from the polymer and rapid killing ability. Based on viable C. albicans counts recovered from tongues of treated and untreated mice, three daily applications of the formulation beginning 1 day postinfection with C. albicans were effective in protection against development of OC. Interestingly, in some cases, Hst-5 was able to clear existing lesions as well as associated tissue inflammation. These findings were confirmed by histopathology analysis of tongue tissue. Coupled with the lack of toxicity as well as anti-inflammatory and wound-healing properties of Hst-5, the findings from this study support the progression and commercial feasibility of using this compound as a novel therapeutic agent.
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26
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Björn C, Noppa L, Näslund Salomonsson E, Johansson AL, Nilsson E, Mahlapuu M, Håkansson J. Efficacy and safety profile of the novel antimicrobial peptide PXL150 in a mouse model of infected burn wounds. Int J Antimicrob Agents 2015; 45:519-24. [PMID: 25649371 DOI: 10.1016/j.ijantimicag.2014.12.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 12/05/2014] [Accepted: 12/10/2014] [Indexed: 11/16/2022]
Abstract
The urgent need to develop novel antimicrobial therapies has stimulated interest in antimicrobial peptides as therapeutic candidates for the treatment of infectious diseases. The aim of this study was to evaluate the anti-infectious effect of the synthetic antimicrobial peptide PXL150, formulated in hydroxypropyl cellulose (HPC) gel, on Pseudomonas aeruginosa in vitro and in an in vivo mouse model of infected burn wounds as well as to assess the in vivo safety profile of PXL150 in rats and rabbits. Minimal microbicidal concentration analysis showed prominent efficacy of PXL150 against P. aeruginosa in vitro, which was further enhanced in formulating the peptide in HPC gel. Application of 1.25, 2.5, 5, 10 and 20mg/g PXL150 in HPC gel twice daily for four consecutive days significantly reduced bacterial counts in the burn wounds compared with non-treated or placebo-treated controls. Continuous bioluminescence measurements of the bacteria revealed a pronounced anti-infective effect already at the first day post infection by PXL150 in concentrations of ≥2.5mg/g. In the non-clinical safety studies, PXL150 showed a favourable safety profile following repeated administration systemically and locally in rats and rabbits, respectively. In conclusion, these data support that PXL150 has the potential to be an effective and safe drug candidate for the treatment of infected burn wounds. The findings encourage the progression of PXL150 as a novel topical treatment of microbial infections.
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Affiliation(s)
- Camilla Björn
- Pergamum AB, Karolinska Institutet Science Park, Fogdevreten 2, SE-171 65 Solna, Sweden; SP Technical Research Institute of Sweden, Medical Device Technology, Box 857, SE-501 15 Borås, Sweden; The Lundberg Laboratory for Diabetes Research, Department of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, Blå stråket 5, SE-413 45 Gothenburg, Sweden
| | - Laila Noppa
- FOI Swedish Defence Research Agency, SE-901 82 Umeå, Sweden
| | | | | | - Elin Nilsson
- FOI Swedish Defence Research Agency, SE-901 82 Umeå, Sweden
| | - Margit Mahlapuu
- Pergamum AB, Karolinska Institutet Science Park, Fogdevreten 2, SE-171 65 Solna, Sweden; The Lundberg Laboratory for Diabetes Research, Department of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, Blå stråket 5, SE-413 45 Gothenburg, Sweden
| | - Joakim Håkansson
- Pergamum AB, Karolinska Institutet Science Park, Fogdevreten 2, SE-171 65 Solna, Sweden; SP Technical Research Institute of Sweden, Medical Device Technology, Box 857, SE-501 15 Borås, Sweden.
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27
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Carmona-Ribeiro AM, de Melo Carrasco LD. Novel formulations for antimicrobial peptides. Int J Mol Sci 2014; 15:18040-83. [PMID: 25302615 PMCID: PMC4227203 DOI: 10.3390/ijms151018040] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 08/30/2014] [Accepted: 09/16/2014] [Indexed: 12/22/2022] Open
Abstract
Peptides in general hold much promise as a major ingredient in novel supramolecular assemblies. They may become essential in vaccine design, antimicrobial chemotherapy, cancer immunotherapy, food preservation, organs transplants, design of novel materials for dentistry, formulations against diabetes and other important strategical applications. This review discusses how novel formulations may improve the therapeutic index of antimicrobial peptides by protecting their activity and improving their bioavailability. The diversity of novel formulations using lipids, liposomes, nanoparticles, polymers, micelles, etc., within the limits of nanotechnology may also provide novel applications going beyond antimicrobial chemotherapy.
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Affiliation(s)
- Ana Maria Carmona-Ribeiro
- Biocolloids Laboratory, Instituto de Química, Universidade de São Paulo, Av. Lineu Prestes 748, 05508-000 São Paulo, SP, Brazil.
| | - Letícia Dias de Melo Carrasco
- Biocolloids Laboratory, Instituto de Química, Universidade de São Paulo, Av. Lineu Prestes 748, 05508-000 São Paulo, SP, Brazil.
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