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Akhuemokhan P, Green NA, Haddrell A, Lewis D, Reid JP, Forbes B. How to engineer aerosol particle properties and biopharmaceutical performance of propellant inhalers. Int J Pharm 2023; 634:122676. [PMID: 36738807 PMCID: PMC10685293 DOI: 10.1016/j.ijpharm.2023.122676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
Given the environmental compulsion to reformulate pressurised metered dose inhalers (pMDI) using new propellants with lower global warming potential, this study investigated how non-volatile excipients can be used to engineer aerosol particle microphysics and drug release. The dynamics of change in particle size, wetting and physical state were measured for single particles (glycerol/ethanol/beclomethasone dipropionate; BDP) in the aerosol phase at different relative humidity (RH) using an electrodynamic balance. BDP dissolution rates were compared for aerosols from pMDI containing different ratios of BDP:glycerol or BDP:isopropyl myristate (IPM). In 45 % RH, ethanol loss was followed by evaporation of condensed water to generate spherical particles with solid inclusions or compact irregular-shaped solid particles, according to the presence or absence of glycerol. In RH > 95 %, condensed water did not evaporate and BDP formed solid inclusions in water/glycerol or water droplets. Varying the non-volatile component, 0-50 % w/w, in pMDI resulted in a concentration-dependent 4-8-fold reduction in BDP dissolution rate. These findings demonstrate that non-volatile excipients provide a means of engineering aerosol properties and, modifying the rate of drug release from aerosol medicines. We also demonstrated differences between particles formed in vitro in ambient humidity versus higher humidity, more like that encountered during oral inhalation.
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Affiliation(s)
| | | | - Allen Haddrell
- School of Chemistry, University of Bristol, Bristol BS8 1TS, UK
| | - David Lewis
- Oz-UK Limited, Corsham, Wiltshire SN13 9BY, UK
| | - Jonathan P Reid
- School of Chemistry, University of Bristol, Bristol BS8 1TS, UK
| | - Ben Forbes
- Institute of Pharmaceutical Science, King's College London, London SE1 9NH, UK
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2
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Matera MG, Rinaldi B, Belardo C, Calzetta L, Cazzola M. Pharmacokinetic considerations surrounding triple therapy for uncontrolled asthma. Expert Opin Drug Metab Toxicol 2023; 19:345-355. [PMID: 37376964 DOI: 10.1080/17425255.2023.2230130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/12/2023] [Accepted: 06/23/2023] [Indexed: 06/29/2023]
Abstract
INTRODUCTION Solid pharmacological rationale and clinical evidence support the use of a combination of an inhaled corticosteroid (ICS), a long-acting β2-agonist, and a long-acting muscarinic antagonist in severe asthma, which clinically results in increased lung function, improved symptoms, and decreased exacerbation rates. AREAS COVERED We examined the pharmacokinetic issues associated with triple therapy for uncontrolled asthma. We considered the pharmacokinetic characteristics of the three drug classes, the role of inhalers in influencing their pharmacokinetic behavior, and the impact of severe asthma on the pharmacokinetics of inhaled drugs. EXPERT OPINION The pharmacokinetics of ICSs and bronchodilators are not affected to a great extent by severe asthma, according to a detailed review of the currently accessible literature. Compared to healthy people, patients with severe asthma show only minor variations in a few pharmacokinetic characteristics, which are unlikely to have therapeutic significance and do not require particular attention. However, the difficulty of obtaining pharmacokinetic profiles of the three drugs included in a triple therapy suggests that the clinical response should be followed over time, which can be considered a good surrogate indicator of whether the drugs have reached sufficient concentrations in the lung to exert a valid pharmacological action.
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Affiliation(s)
- Maria Gabriella Matera
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Barbara Rinaldi
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Carmela Belardo
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Luigino Calzetta
- Unit of Respiratory Disease and Lung Function, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Mario Cazzola
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome 'Tor Vergata', Rome, Italy
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3
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Martínez-García MÁ, Oscullo G, García-Ortega A, Matera MG, Rogliani P, Cazzola M. Inhaled Corticosteroids in Adults with Non-cystic Fibrosis Bronchiectasis: From Bench to Bedside. A Narrative Review. Drugs 2022; 82:1453-1468. [PMID: 36264441 PMCID: PMC9626424 DOI: 10.1007/s40265-022-01785-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2022] [Indexed: 11/06/2022]
Abstract
Due to their potent anti-inflammatory capacity (particularly in predominantly eosinophilic inflammation) and immunosuppressive properties, inhaled corticosteroids (ICSs) are widely used in asthmatic patients and also in individuals with chronic obstructive pulmonary disease (COPD) who suffer multiple exacerbations or have peripheral eosinophilia. However, there is little evidence for their use in non-cystic fibrosis bronchiectasis (hereafter, bronchiectasis). According to data extracted from large databases of bronchiectasis in adults, ICSs are used in more than 50% of patients without any scientific evidence to justify their efficacy and contrary to the recommendations of international guidelines on bronchiectasis that generally advise against their use. Indeed, bronchiectasis is a disease with predominantly neutrophilic inflammation and a high likelihood of chronic bacterial bronchial infection. Furthermore, it is known that due to their immunosuppressive properties, ICSs can induce an increase in bacterial infections. This manuscript aims to review the basic properties of ICSs, how they impact bronchiectasis in adults, the current position of international guidelines on this treatment, and the current indications and future challenges related to ICS use in bronchiectasis.
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Affiliation(s)
- Miguel Ángel Martínez-García
- Respiratory Department, Politechnic and University La Fe Hospital, Valencia, Spain.,CIBERES de Enfermedades Respiratorias, Madrid, Spain
| | - Grace Oscullo
- Respiratory Department, Politechnic and University La Fe Hospital, Valencia, Spain
| | | | - Maria Gabriella Matera
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paola Rogliani
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Mario Cazzola
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.
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4
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Selo MA, Sake JA, Kim KJ, Ehrhardt C. In vitro and ex vivo models in inhalation biopharmaceutical research - advances, challenges and future perspectives. Adv Drug Deliv Rev 2021; 177:113862. [PMID: 34256080 DOI: 10.1016/j.addr.2021.113862] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/02/2021] [Accepted: 07/06/2021] [Indexed: 12/11/2022]
Abstract
Oral inhalation results in pulmonary drug targeting and thereby reduces systemic side effects, making it the preferred means of drug delivery for the treatment of respiratory disorders such as asthma, chronic obstructive pulmonary disease or cystic fibrosis. In addition, the high alveolar surface area, relatively low enzymatic activity and rich blood supply of the distal airspaces offer a promising pathway to the systemic circulation. This is particularly advantageous when a rapid onset of pharmacological action is desired or when the drug is suffering from stability issues or poor biopharmaceutical performance following oral administration. Several cell and tissue-based in vitro and ex vivo models have been developed over the years, with the intention to realistically mimic pulmonary biological barriers. It is the aim of this review to critically discuss the available models regarding their advantages and limitations and to elaborate further which biopharmaceutical questions can and cannot be answered using the existing models.
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5
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Matera MG, Rinaldi B, Calzetta L, Rogliani P, Cazzola M. Pharmacokinetics and pharmacodynamics of inhaled corticosteroids for asthma treatment. Pulm Pharmacol Ther 2019; 58:101828. [PMID: 31349002 DOI: 10.1016/j.pupt.2019.101828] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/07/2019] [Accepted: 07/22/2019] [Indexed: 11/27/2022]
Abstract
The differences in the pharmacokinetic (PK) characteristics of inhaled corticosteroids (ICSs) critically influence the profile of each of them, but also the significant differences in glucocorticoid receptor selectivity, potency, and physicochemical properties are critical in defining the pharmacodynamic (PD) profile of an ICS. The PK and PD properties of ICSs used in asthma and the importance of their interrelationship have been reviewed. The differences among the ICSs in PK and PD must be considered when an ICS should be prescribed to an asthmatic patient because a better understanding of the PK/PD interrelationship of ICSs could be important to better fit with the between-patient variability and within-patient repeatability in the response to ICSs that often complicate the therapeutic approach to the asthmatic patient. The role of the device in influencing the PK profile of an ICS must be always considered because it is crucial. Also patient-related factors and disease severity affect pulmonary deposition of ICS.
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Affiliation(s)
- Maria Gabriella Matera
- University of Campania "Luigi Vanvitelli", Department of Experimental Medicine, Naples, Italy
| | - Barbara Rinaldi
- University of Campania "Luigi Vanvitelli", Department of Experimental Medicine, Naples, Italy
| | - Luigino Calzetta
- University of Rome "Tor Vergata", Department of Experimental Medicine, Rome, Italy
| | - Paola Rogliani
- University of Rome "Tor Vergata", Department of Experimental Medicine, Rome, Italy
| | - Mario Cazzola
- University of Rome "Tor Vergata", Department of Experimental Medicine, Rome, Italy.
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6
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Sambandan E, Kathavarayan T, Sellappan S, Shiea J, Ponnusamy VK. Identification and characterization of unknown degradation impurities in beclomethasone dipropionate cream formulation using HPLC, ESI-MS and NMR. J Pharm Biomed Anal 2019; 167:123-131. [PMID: 30771645 DOI: 10.1016/j.jpba.2019.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 02/07/2019] [Accepted: 02/08/2019] [Indexed: 11/25/2022]
Abstract
The present study focuses on identifying the degradation profile and pathways of unknown impurities from beclomethasone dipropionate (BDP) topical cream formulation reported under accelerated stability conditions. Six degradation impurities were observed during the accelerated stability testing of BDP topical cream formulation, and these thermally labile degradation impurities were primarily identified using a simple, effective and mass compatible isocratic reversed-phase high-performance liquid chromatography with ultraviolet detection method. The degradation impurities found in this sample were of very low concentration levels, thus the concentration of these impurities in the sample was enriched by mimicking the thermal degradation conditions to structurally elucidate the unknown impurities. These BDP thermal degradation impurities were isolated using preparative liquid chromatography and followed by pre-concentration using rota-vapour. Further, the collected thermal degradation impurities were characterized using ESI-MS, and the major impurity was identified using 1H and C13 NMR spectroscopy, and DEPT technique. Plausible degradation pathway and mechanism of each impurity from BDP has been proposed based on the obtained mass and NMR spectral data. Thus, the present method is simple and suitable to be applied towards BDP assay in various formulations, and also to investigate the thermal stability and degradation kinetics of the final drug product.
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Affiliation(s)
- Elumalai Sambandan
- Department of Chemistry, School of Advanced Sciences, Vellore Institute of Technology, Vellore, 632014, India
| | - Thenmozhi Kathavarayan
- Department of Chemistry, School of Advanced Sciences, Vellore Institute of Technology, Vellore, 632014, India
| | - Senthilkumar Sellappan
- Department of Chemistry, School of Advanced Sciences, Vellore Institute of Technology, Vellore, 632014, India.
| | - Jentaie Shiea
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan; Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Vinoth Kumar Ponnusamy
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung City, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
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7
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Dry powder inhalers: An overview of the in vitro dissolution methodologies and their correlation with the biopharmaceutical aspects of the drug products. Eur J Pharm Sci 2018; 113:18-28. [DOI: 10.1016/j.ejps.2017.09.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/30/2017] [Accepted: 09/04/2017] [Indexed: 11/17/2022]
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8
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Gerde P, Malmlöf M, Havsborn L, Sjöberg CO, Ewing P, Eirefelt S, Ekelund K. DissolvIt: An In Vitro Method for Simulating the Dissolution and Absorption of Inhaled Dry Powder Drugs in the Lungs. Assay Drug Dev Technol 2017; 15:77-88. [DOI: 10.1089/adt.2017.779] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Per Gerde
- Inhalation Sciences Sweden AB, Novum, Sweden
- Division of Physiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maria Malmlöf
- Inhalation Sciences Sweden AB, Novum, Sweden
- Division of Physiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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9
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Craparo E, Di Gioia S, Trapani A, Cellamare S, Belgiovine G, Mandracchia D, Giammona G, Cavallaro G, Conese M. Realization of polyaspartamide-based nanoparticles and in vivo lung biodistribution evaluation of a loaded glucocorticoid after aerosolization in mice. Int J Pharm 2016; 510:263-70. [DOI: 10.1016/j.ijpharm.2016.06.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/13/2016] [Accepted: 06/16/2016] [Indexed: 10/21/2022]
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10
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Schultz I, Vollmers F, Lühmann T, Rybak JC, Wittmann R, Stank K, Steckel H, Kardziev B, Schmidt M, Högger P, Meinel L. Pulmonary Insulin-like Growth Factor I Delivery from Trehalose and Silk-Fibroin Microparticles. ACS Biomater Sci Eng 2015. [DOI: 10.1021/ab500101c] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Isabel Schultz
- Institute
for Pharmacy and Food Chemistry, University of Wuerzburg, Am Hubland, DE-97074 Wuerzburg, Germany
| | - Frederic Vollmers
- Institute
for Pharmacy and Food Chemistry, University of Wuerzburg, Am Hubland, DE-97074 Wuerzburg, Germany
| | - Tessa Lühmann
- Institute
for Pharmacy and Food Chemistry, University of Wuerzburg, Am Hubland, DE-97074 Wuerzburg, Germany
| | - Jens-Christoph Rybak
- Institute
for Pharmacy and Food Chemistry, University of Wuerzburg, Am Hubland, DE-97074 Wuerzburg, Germany
| | - Ronja Wittmann
- Institute
for Pharmacy, University of Kiel, Grasweg 9a, DE-24118 Kiel, Germany
| | - Katharina Stank
- Institute
for Pharmacy, University of Kiel, Grasweg 9a, DE-24118 Kiel, Germany
| | - Hartwig Steckel
- Institute
for Pharmacy, University of Kiel, Grasweg 9a, DE-24118 Kiel, Germany
| | | | - Michael Schmidt
- Medical
Clinic and Polyclinic I, University of Wuerzburg, DE-97080, Germany
| | - Petra Högger
- Institute
for Pharmacy and Food Chemistry, University of Wuerzburg, Am Hubland, DE-97074 Wuerzburg, Germany
| | - Lorenz Meinel
- Institute
for Pharmacy and Food Chemistry, University of Wuerzburg, Am Hubland, DE-97074 Wuerzburg, Germany
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11
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Bodzenta-Łukaszyk A, Kokot M. Pharmacological consequences of inhaled drug delivery to small airways in the treatment of asthma. Adv Ther 2014; 31:803-16. [PMID: 25116888 DOI: 10.1007/s12325-014-0143-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Indexed: 11/29/2022]
Abstract
Small peripheral airways are an important target for the anti-inflammatory treatment of asthma. To make anti-inflammatory drugs (inhaled corticosteroids [ICS]) effectively reach small airways, they should be delivered using inhalation techniques containing high proportions of fine or super-fine particles. Higher proportions of fine particles are associated with higher systemic absorption of ICS leading to an increased risk of endogenous cortisol suppression. Ciclesonide, despite the highest proportion of fine and super-fine particle fractions, is the only ICS not associated with an increased risk of systemic adverse effects, including cortisol suppression. In contrary to ICS, bronchodilators should not be administered to peripheral airways. This does not improve their efficacy and may increase their risk of cardiotoxicity. Thus, from a pharmacological point of view and the theory of aerosols' deposition, fixed combinations of ICS and long-acting beta agonists are always suboptimal. In many cases, the best solution may be to use fine-particle ciclesonide and a non-fine particle beta agonist administered from separate inhalers.
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Affiliation(s)
- Anna Bodzenta-Łukaszyk
- Clinical Department of Allergic and Internal Diseases, Medical University of Białystok, Bialystok, Poland,
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12
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Buttini F, Miozzi M, Balducci AG, Royall PG, Brambilla G, Colombo P, Bettini R, Forbes B. Differences in physical chemistry and dissolution rate of solid particle aerosols from solution pressurised inhalers. Int J Pharm 2014; 465:42-51. [PMID: 24491530 DOI: 10.1016/j.ijpharm.2014.01.033] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 01/22/2014] [Accepted: 01/24/2014] [Indexed: 11/29/2022]
Abstract
Solution composition alters the dynamics of beclomethasone diproprionate (BDP) particle formation from droplets emitted by pressurised metered dose inhalers (pMDIs). The hypothesis that differences in inhaler solutions result in different solid particle physical chemistry was tested using a suite of complementary calorimetric techniques. The atomisation of BDP-ethanol solutions from commercial HFA-pMDI produced aerodynamically-equivalent solid particle aerosols. However, differences in particle physico-chemistry (morphology and solvate/clathrate formation) were detected by differential scanning calorimetry (DSC), thermogravimetric analysis (TGA) and supported by hot stage microscopy (HSM). Increasing the ethanol content of the formulation from 8 to 12% (w/w), which retards the evaporation of propellant and slows the increase in droplet surface viscosity, enhanced the likelihood of particles drying with a smooth surface. The dissolution rate of BDP from the 12% (w/w) ethanol formulation-derived particles (63% dissolved over 120 min) was reduced compared to the 8% (w/w) ethanol formulation-derived particles (86% dissolved over 120 min). The addition of 0.01% (w/w) formoterol fumarate or 1.3% (w/w) glycerol to the inhaler solution modified the particles and reduced the BDP dissolution rate further to 34% and 16% dissolved in 120 min, respectively. These data provide evidence that therapeutic aerosols from apparently similar inhaler products, including those with similar aerodynamic performance, may behave non-equivalently after deposition in the lungs.
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Affiliation(s)
- Francesca Buttini
- Department of Pharmacy, University of Parma, Viale delle Scienze 27/a, 43124 Parma, Italy.
| | - Michele Miozzi
- Department of Pharmacy, University of Parma, Viale delle Scienze 27/a, 43124 Parma, Italy
| | - Anna Giulia Balducci
- Interdepartmental Center, Biopharmanet-TEC, University of Parma, Viale delle Scienze 27/a, 43124 Parma, Italy
| | - Paul G Royall
- King's College London, Institute of Pharmaceutical Science, London SE1 9NH, UK
| | | | - Paolo Colombo
- Department of Pharmacy, University of Parma, Viale delle Scienze 27/a, 43124 Parma, Italy
| | - Ruggero Bettini
- Department of Pharmacy, University of Parma, Viale delle Scienze 27/a, 43124 Parma, Italy
| | - Ben Forbes
- King's College London, Institute of Pharmaceutical Science, London SE1 9NH, UK
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13
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Haghi M, Bebawy M, Colombo P, Forbes B, Lewis DA, Salama R, Traini D, Young PM. Towards the bioequivalence of pressurised metered dose inhalers 2. Aerodynamically equivalent particles (with and without glycerol) exhibit different biopharmaceutical profiles in vitro. Eur J Pharm Biopharm 2013; 86:38-45. [PMID: 23528797 DOI: 10.1016/j.ejpb.2013.02.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Revised: 02/22/2013] [Accepted: 02/26/2013] [Indexed: 11/17/2022]
Abstract
Two solution-based pressurised metered dose inhaler (pMDI) formulations were prepared such that they delivered aerosols with identical mass median aerodynamic diameters, but contained either beclomethasone dipropionate (BDP) alone (glycerol-free formulation) or BDP and glycerol in a 1:1 mass ratio (glycerol-containing formulation). The two formulations were deposited onto Calu-3 respiratory epithelial cell layers cultured at an air interface. Equivalent drug mass (∼1000ng or ∼2000ng of the formulation) or equivalent particle number (1000ng of BDP in the glycerol-containing versus 2000ng of BDP in the glycerol-free formulation) were deposited as aerosolised particles on the air interfaced surface of the cell layers. The transfer rate of BDP across the cell layer after deposition of the glycerol-free particles was proportional to the mass deposited. In comparison, the transfer of BDP from the glycerol-containing formulation was independent of the mass deposited, suggesting that the release of BDP is modified in the presence of glycerol. The rate of BDP transfer (and the extent of metabolism) over 2h was faster when delivered in glycerol-free particles, 465.01ng±95.12ng of the total drug (20.99±4.29%; BDP plus active metabolite) transported across the cell layer, compared to 116.17ng±3.07ng (6.07±0.16%) when the equivalent mass of BDP was deposited in glycerol-containing particles. These observations suggest that the presence of glycerol in the maturated aerosol particles may influence the disposition of BDP in the lungs.
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Affiliation(s)
- M Haghi
- Respiratory Technology, The Woolcock Institute of Medical Research, The University of Sydney, Australia; Discipline of Pharmacology, Faculty Medicine, The University of Sydney, Australia
| | - M Bebawy
- Graduate School of Pharmacy Health-Pharmacy, University of Technology Sydney, Sydney, Australia
| | - P Colombo
- Department of Pharmacy, University of Parma, Parma, Italy
| | - B Forbes
- Institute of Pharmaceutical Science, King's College London, London, UK
| | | | - R Salama
- Respiratory Technology, The Woolcock Institute of Medical Research, The University of Sydney, Australia; Discipline of Pharmacology, Faculty Medicine, The University of Sydney, Australia
| | - D Traini
- Respiratory Technology, The Woolcock Institute of Medical Research, The University of Sydney, Australia; Discipline of Pharmacology, Faculty Medicine, The University of Sydney, Australia
| | - P M Young
- Respiratory Technology, The Woolcock Institute of Medical Research, The University of Sydney, Australia; Discipline of Pharmacology, Faculty Medicine, The University of Sydney, Australia.
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14
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Liu X, Jin L, Upham JW, Roberts MS. The development of models for the evaluation of pulmonary drug disposition. Expert Opin Drug Metab Toxicol 2013; 9:487-505. [DOI: 10.1517/17425255.2013.754009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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15
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Costa-Katz CL, Livnat G, Hakim F, Vilozni D, Bentur Y, Bentur L. The effect of beclomethasone dipropionate in ultrafine particles on bronchial hyper-reactivity in young children. Acta Paediatr 2012; 101:e219-24. [PMID: 22214276 DOI: 10.1111/j.1651-2227.2012.02590.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Bronchial hyper-reactivity (BHR) provides a tool for asthma diagnosis, assessment of severity and response to treatment. The effect of beclomethasone dipropionate in ultrafine particles (BDP-HFA) on BHR as measured by the adenosine challenge test in young children has not yet been determined. Our aim was to determine the effect of BDP-HFA (100 μg twice daily) on BHR as evaluated by a reduction of 20% from baseline FEV1 (PC20-FEV1) values in young asthmatic children. METHODS Twenty-one young children (13 males), mean age 4.95 ± 1.05 years, with partially controlled or controlled asthma completed a double-blind randomized, placebo-controlled, cross-over study. Each child received 4 weeks of treatment with either 100 μg BDP-HFA twice daily or placebo, and after a 2-week washout period the other way around. Primary outcomes were PC20-FEV1 concentration, and the stage number at which FEV1 values dropped by 20%. RESULTS Following 4 weeks of treatment, median PC20-FEV1 was 81.28 mg/mL while on BDP-HFA, compared with 9.64 mg/mL on placebo (p < 0.001). The median increase in stages required to achieve PC20 on BDP-HFA compared with placebo was three (95% CI 2.28-4.86). CONCLUSION Four weeks of treatment with BDP-HFA resulted in significantly decreased BHR in young children.
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Affiliation(s)
- Claudia L Costa-Katz
- Pediatric Pulmonary Unit, Meyer Children's Hospital, The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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16
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Gnadt M, Trammer B, Kardziev B, Bayliss MK, Edwards CD, Schmidt M, Högger P. Comparison of the bronchodilating effects of inhaled β₂-agonists after methacholine challenge in a human lung reperfusion model. Eur J Pharm Biopharm 2012; 81:617-26. [PMID: 22561952 DOI: 10.1016/j.ejpb.2012.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 04/07/2012] [Accepted: 04/18/2012] [Indexed: 10/28/2022]
Abstract
The aim of the present investigation was to compare the onset of action and intrinsic activity of the long-acting β(2)-agonist GW597901 with the fast- and short-acting salbutamol as model compounds using an isolated human lung reperfusion model. Twelve resected human lung lobes were challenged with methacholine (MCh) and subsequently nebulised with either GW597901 or salbutamol. Prostaglandin E(2) (PGE(2)) concentrations in the perfusion fluid were compared with the dose of MCh that was required to induce a bronchoconstriction. After successful MCh provocation, nebulisation of GW597901 and salbutamol fully reversed any observed bronchoconstriction. The bronchodilating effect was more pronounced for GW597901. Salbutamol revealed an immediate onset of action while the effect of GW597901 was observed with an approximate delay of 6 min. Higher doses of MCh were required for a successful bronchial challenge in the presence of elevated PGE(2) levels (r=0.8171, p ≤ 0.05). For the first time, an isolated perfused human lung model has been established for comparing the onset of action and potency of a short- and long-acting β(2)-agonist. We therefore conclude that it is an alternative for determination of drug effect characteristics and suitable for supplementing or predicting clinical data.
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Affiliation(s)
- Mirjam Gnadt
- Institut für Pharmazie und Lebensmittelchemie, Universität Würzburg, Würzburg, Germany
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Sahib MN, Darwis Y, Peh KK, Abdulameer SA, Fung Tan YT. Incorporation of Beclomethasone Dipropionate into Polyethylene Glycol-Diacyl Lipid Micelles as a Pulmonary Delivery System. Drug Dev Res 2012. [DOI: 10.1002/ddr.21000] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Mohanad Naji Sahib
- School of Pharmaceutical Sciences; Universiti Sains Malaysia; Penang; Malaysia
| | - Yusrida Darwis
- School of Pharmaceutical Sciences; Universiti Sains Malaysia; Penang; Malaysia
| | - Kok Khiang Peh
- School of Pharmaceutical Sciences; Universiti Sains Malaysia; Penang; Malaysia
| | | | - Yvonne Tze Fung Tan
- School of Pharmaceutical Sciences; Universiti Sains Malaysia; Penang; Malaysia
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18
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Surfactant protein A (SP-A) and angiotensin converting enzyme (ACE) as early biomarkers for pulmonary edema formation in ventilated human lung lobes. Lung 2012; 190:431-40. [PMID: 22466057 DOI: 10.1007/s00408-012-9386-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Accepted: 03/13/2012] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Ex vivo perfused and ventilated lung lobes frequently develop pulmonary edema. We were looking for a suitable and early detectable biomarker in the perfusion fluid indicating lung cell damage and loss of tissue integrity in ventilated human lung lobes. Therefore, we elucidated whether surfactant protein A (SP-A) and angiotensin-converting enzyme (ACE) were measurable in the perfusion fluid and whether they were suitable indicators for edema formation occurring within the experimental time frame of 1-2 h. METHODS Patients (n = 39) undergoing a lobectomy, bilobectomy or pneumonectomy due to primary bronchial cell carcinoma were included in the studies. Lung lobes were extracorporally ventilated and perfused for up to 2 h. Two different perfusion fluids were used, plain perfusion buffer and perfusion buffer containing packed erythrocytes or buffy coats. Perfusion fluid samples were analyzed for SP-A and ACE using immunoassays served as perfusion fluids. RESULTS SP-A and ACE concentrations were analyzed in fluid sample sets of 39 and 33 perfusion experiments, respectively. Degrees of edema formation were arbitrarily classified into three groups (≤ 29, 30-59, ≥ 60 % weight gain). The maximum increase of SP-A and ACE concentrations in the perfusate was significantly higher for more pronounced edemas in case of perfusions using a mixture of blood components and buffer. Interestingly, the time courses of ACE and SP-A were highly similar. CONCLUSION We suggest that SP-A and ACE are promising early biochemical markers for the development for pulmonary edema formation in the ex vivo lung lobe perfusion.
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19
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Grainger CI, Saunders M, Buttini F, Telford R, Merolla LL, Martin GP, Jones SA, Forbes B. Critical Characteristics for Corticosteroid Solution Metered Dose Inhaler Bioequivalence. Mol Pharm 2012; 9:563-9. [DOI: 10.1021/mp200415g] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C. I. Grainger
- Institute of Pharmaceutical Science, King’s College London, 150 Stamford Street,
London, SE1 9NH, U.K
| | - M. Saunders
- Kuecept Ltd, 16/17 Station Close, Potters Bar, Hertfordshire,
EN7 1TL, U.K
| | - F. Buttini
- Department
of Pharmacy, University of Parma, Parma,
Italy
| | - R. Telford
- Analytical Centre, University of Bradford, BD7 1DP, U.K
| | - L. L. Merolla
- Safety and Environmental Assurance Centre, Unilever Colworth, Sharnbrook, MK44 1LQ, U.K
| | - G. P. Martin
- Institute of Pharmaceutical Science, King’s College London, 150 Stamford Street,
London, SE1 9NH, U.K
| | - S. A. Jones
- Institute of Pharmaceutical Science, King’s College London, 150 Stamford Street,
London, SE1 9NH, U.K
| | - B. Forbes
- Institute of Pharmaceutical Science, King’s College London, 150 Stamford Street,
London, SE1 9NH, U.K
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20
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Gnadt M, Trammer B, Freiwald M, Kardziev B, Bayliss MK, Edwards CD, Schmidt M, Friedel G, Högger P. Methacholine delays pulmonary absorption of inhaled β2-agonists due to competition for organic cation/carnitine transporters. Pulm Pharmacol Ther 2012; 25:124-34. [DOI: 10.1016/j.pupt.2011.12.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 12/19/2011] [Accepted: 12/30/2011] [Indexed: 01/11/2023]
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21
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Forbes B, Asgharian B, Dailey LA, Ferguson D, Gerde P, Gumbleton M, Gustavsson L, Hardy C, Hassall D, Jones R, Lock R, Maas J, McGovern T, Pitcairn GR, Somers G, Wolff RK. Challenges in inhaled product development and opportunities for open innovation. Adv Drug Deliv Rev 2011; 63:69-87. [PMID: 21144875 DOI: 10.1016/j.addr.2010.11.004] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 11/19/2010] [Accepted: 11/25/2010] [Indexed: 11/26/2022]
Abstract
Dosimetry, safety and the efficacy of drugs in the lungs are critical factors in the development of inhaled medicines. This article considers the challenges in each of these areas with reference to current industry practices for developing inhaled products, and suggests collaborative scientific approaches to address these challenges. The portfolio of molecules requiring delivery by inhalation has expanded rapidly to include novel drugs for lung disease, combination therapies, biopharmaceuticals and candidates for systemic delivery via the lung. For these drugs to be developed as inhaled medicines, a better understanding of their fate in the lungs and how this might be modified is required. Harmonized approaches based on 'best practice' are advocated for dosimetry and safety studies; this would provide coherent data to help product developers and regulatory agencies differentiate new inhaled drug products. To date, there are limited reports describing full temporal relationships between pharmacokinetic (PK) and pharmacodynamic (PD) measurements. A better understanding of pulmonary PK and PK/PD relationships would help mitigate the risk of not engaging successfully or persistently with the drug target as well as identifying the potential for drug accumulation in the lung or excessive systemic exposure. Recommendations are made for (i) better industry-academia-regulatory co-operation, (ii) sharing of pre-competitive data, and (iii) open innovation through collaborative research in key topics such as lung deposition, drug solubility and dissolution in lung fluid, adaptive responses in safety studies, biomarker development and validation, the role of transporters in pulmonary drug disposition, target localisation within the lung and the determinants of local efficacy following inhaled drug administration.
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22
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Patton JS, Brain JD, Davies LA, Fiegel J, Gumbleton M, Kim KJ, Sakagami M, Vanbever R, Ehrhardt C. The Particle has Landed—Characterizing the Fate of Inhaled Pharmaceuticals. J Aerosol Med Pulm Drug Deliv 2010; 23 Suppl 2:S71-87. [DOI: 10.1089/jamp.2010.0836] [Citation(s) in RCA: 164] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
| | | | - Lee A. Davies
- Gene Medicine Group, University of Oxford, Oxford, United Kingdom
| | - Jennifer Fiegel
- Colleges of Pharmacy and Engineering, University of Iowa, Iowa City, Iowa
| | - Mark Gumbleton
- Welsh School of Pharmacy, Cardiff University, Cardiff, Wales, United Kingdom
| | - Kwang-Jin Kim
- Will Rogers Institute Pulmonary Research Center, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Masahiro Sakagami
- School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia
| | - Rita Vanbever
- Unité de Pharmacie Galénique, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium
| | - Carsten Ehrhardt
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
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23
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Bosquillon C. Drug transporters in the lung--do they play a role in the biopharmaceutics of inhaled drugs? J Pharm Sci 2010; 99:2240-55. [PMID: 19950388 DOI: 10.1002/jps.21995] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The role of transporters in drug absorption, distribution and elimination processes as well as in drug-drug interactions is increasingly being recognised. Although the lungs express high levels of both efflux and uptake drug transporters, little is known of the implications for the biopharmaceutics of inhaled drugs. The current knowledge of the expression, localisation and functionality of drug transporters in the pulmonary tissue and the few studies that have looked at their impact on pulmonary drug absorption is extensively reviewed. The emphasis is on transporters most likely to affect the disposition of inhaled drugs: (1) the ATP-binding cassette (ABC) superfamily which includes the efflux pumps P-glycoprotein (P-gp), multidrug resistance associated proteins (MRPs), breast cancer resistance protein (BCRP) and (2) the solute-linked carrier (SLC and SLCO) superfamily to which belong the organic cation transporter (OCT) family, the peptide transporter (PEPT) family, the organic anion transporter (OAT) family and the organic anion transporting polypeptide (OATP) family. Whenever available, expression and localisation in the intact human tissue are compared with those in animal lungs and respiratory epithelial cell models in vitro. The influence of lung diseases or exogenous agents on transporter expression is also mentioned.
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Affiliation(s)
- Cynthia Bosquillon
- Centre for Biomolecular Sciences, School of Pharmacy, University of Nottingham, University Park, Nottingham NG72RD, United Kingdom.
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24
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In Vitro Aqueous Fluid-Capacity-Limited Dissolution Testing of Respirable Aerosol Drug Particles Generated from Inhaler Products. Pharm Res 2010; 27:786-95. [DOI: 10.1007/s11095-010-0070-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 01/13/2010] [Indexed: 10/19/2022]
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25
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Tolman JA, Williams RO. Advances in the pulmonary delivery of poorly water-soluble drugs: influence of solubilization on pharmacokinetic properties. Drug Dev Ind Pharm 2010; 36:1-30. [DOI: 10.3109/03639040903092319] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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26
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Trammer B, Amann A, Haltner-Ukomadu E, Tillmanns S, Keller M, Högger P. Comparative permeability and diffusion kinetics of cyclosporine A liposomes and propylene glycol solution from human lung tissue into human blood ex vivo. Eur J Pharm Biopharm 2008; 70:758-64. [DOI: 10.1016/j.ejpb.2008.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Revised: 07/03/2008] [Accepted: 07/03/2008] [Indexed: 11/25/2022]
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