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Yadaorao Raut S, Fu K, Taichun H, Gahane A, Chaudhari D, Kushwah V, Suresh Managuli R, Hegde AR, Jain S, Kalthur G, Bandu Joshi M, Chang HI, Dai NT, Mutalik S. Engineered Nano-carrier Systems for the oral targeted delivery of Follicle Stimulating Hormone: Development, characterization, and, assessment of in vitro and in vivo performance and targetability. Int J Pharm 2023; 637:122868. [PMID: 36958606 DOI: 10.1016/j.ijpharm.2023.122868] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/27/2023] [Accepted: 03/15/2023] [Indexed: 03/25/2023]
Abstract
Follicle stimulating hormone (FSH) is widely used for the treatment of female infertility, where the level of FSH is suboptimal due to which arrest in follicular development and anovulation takes place. Currently, only parenteral formulations are available for FSH in the market. Due to the drawbacks of parenteral administration and the high market shares of FSH, there is a need for easily accessible oral formulation. Therefore, enteric coated capsules filled with FSH loaded nanostructured lipid carriers (NLCs) or liposomes were prepared. Preliminary studies such as circular dichroism, SDS-PAGE, FTIR and ELISA were conducted to analyze FSH. Prepared formulations were optimized with respect to the size, polydispersity index, zeta potential, and entrapment efficiency using the design of experiments. Optimized formulations were subjected to particle counts and distribution analysis, TEM analysis, in vitro drug release, dissolution of enteric coated capsules, cell line studies, everted sac rat's intestinal uptake study, pharmacokinetics, pharmacodynamics, and stability studies. In the case of liposomes, RGD conjugation was done by carbodiimide chemistry and conjugation was confirmed by FTIR, 1HNMR and Raman spectroscopy. The prepared formulations were discrete and spherical. The release of FSH from enteric coated capsules was slow and sustained. The increased permeability of nano-formulations was observed in Caco-2 monoculture as well as in Caco-2 and Raji-B co-culture models. NLCs and liposomes showed an improvement in oral bioavailability and efficacy of FSH in rats. This may be due to mainly chylomicron-assisted lymphatic uptake of NLCs; whereas, in the case of liposomes, RGD-based targeting of β1 integrins of M cells on Peyer's patches may be the main reason for the better effect by FSH. FSH was found to be stable chemically and conformationally. Overall, the study reveals the successful development and evaluation of FSH loaded NLCs and liposomes.
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Affiliation(s)
- Sushil Yadaorao Raut
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka State, India
| | - Kengyen Fu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan 114
| | - Huang Taichun
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan 114
| | - Avinash Gahane
- Department of Biological Sciences & Bioengineering, Indian Institute of Technology Kanpur 208016, Uttar Pradesh State, India
| | - Dasharath Chaudhari
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, S.A.S. Nagar 160062, Punjab State, India
| | - Varun Kushwah
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, S.A.S. Nagar 160062, Punjab State, India
| | - Renuka Suresh Managuli
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka State, India
| | - Aswathi R Hegde
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka State, India; Department of Pharmaceutics, Faculty of Pharmacy, M.S. Ramaiah University of Applied Sciences, Gnanagangothri Campus, New B.E.L. Road, M.S.R. Nagar, M.S.R.I.T Post, Bengaluru 560054, Karnataka State, India
| | - Sanyog Jain
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, S.A.S. Nagar 160062, Punjab State, India
| | - Guruprasad Kalthur
- Division of Reproductive Biology, Department of Reproductive Science, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal 576 104, Karnataka State, India
| | - Manjunath Bandu Joshi
- Department of Aging Research, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka State, India
| | - Hsin-I Chang
- Department of Biochemical Sciences and Technology, National Chiayi University, 300 Syuefu Road, Chiayi City, 60004, Taiwan
| | - Niann-Tzyy Dai
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan 114
| | - Srinivas Mutalik
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka State, India.
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Ni Y, Tong C, Xu L, Qian W, Huang L, Zhang A, Fang Q. Prevalence and associated factors of medication adherence among infertile women undergoing frozen-thawed embryo transfer cycle: A cross-sectional study. Front Pharmacol 2023; 14:1148867. [PMID: 37007001 PMCID: PMC10064053 DOI: 10.3389/fphar.2023.1148867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/09/2023] [Indexed: 03/19/2023] Open
Abstract
Objective: This study aimed to explore the prevalence and associated factors of medication adherence among infertile women undergoing frozen-thawed embryo transfer (FET) cycle.Methods: A cross-sectional study was conducted with 556 infertile women undergoing FET cycle in total. The Self-efficacy for Appropriate Medication Use Scale (SEAMS), Herth Hope Index (HHI) scale, and Social Support Rating Scale (SSRS) were used to evaluate the patients. Data were described by univariate and multivariate analyses. Logistic regression method was performed to analyse the factors potentially associated with medication adherence.Results: The average score of Self-efficacy for Appropriate Medication Use Scale (SEAMS) was 30.38 ± 6.65, and 65.3% of participants showed non-adherence. Multiple regression analysis indicated that first-time FET cycle, treatment stage, methods of daily medication, social support and hope level were the main associated factors of the medication adherence among infertile women undergoing FET cycle (p < 0.001).Conclusion: This study revealed the medication adherence is at medium level among infertile women undergoing FET cycle, especially in patients with repeated FET cycles. The study also suggested that improving the hope level and social support of infertile women undergoing FET cycle may increase medication adherence.
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Affiliation(s)
- Ying Ni
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenye Tong
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lianying Xu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Qian
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Limin Huang
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Aijun Zhang
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Qiong Fang, ; Aijun Zhang,
| | - Qiong Fang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Qiong Fang, ; Aijun Zhang,
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Öztürk R, Herbell K, Morton J, Bloom T. "The worst time of my life": Treatment-related stress and unmet needs of women living with infertility. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:1121-1133. [PMID: 33616236 PMCID: PMC8324009 DOI: 10.1002/jcop.22527] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 05/11/2023]
Abstract
Approximately 12% of women in the United States have difficulty getting pregnant or carrying a pregnancy to term (i.e., infertility). Infertility permeates women's lives and is psychologically, socially and financially burdensome. This study aimed to describe women's experiences regarding infertility and explore factors that women find helpful to alleviate their fertility-related stressors. Using purposive sample, we conducted in-depth qualitative interviews with infertile women. Participants reported multiple infertility treatment-related stressors including (a) difficulty accessing infertility treatment due to financial issues, geographic disparities, and healthcare provider factors; (b) challenges during infertility treatment related to painful, embarrassing, confusing treatments, side effects, and healthcare providers' failures to fully address women's needs. The stories and findings add to a body of literature that elucidate significant stressors that women encounter in their fertility journey including a desire for empathetic, understandable, and effective treatment and support, and the crucial role of healthcare providers.
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Affiliation(s)
- Ruşen Öztürk
- Women Health and Diseases Nursing Department, Ege University Nursing Faculty, izmir, Turkey
| | - Kayla Herbell
- Ohio State University College of Nursing, Ohio State University, 1585 Neil Ave, Columbus, Ohio, USA
| | - Jamie Morton
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA
| | - Tina Bloom
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA
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Hutcherson NEC, Harris JB, Karaoui LR, Lakdawala L, Lodise NM, Stone RH, Vernon V. Infertility Management and Pharmacotherapy: What Every Pharmacist Should Know. J Pharm Pract 2020; 34:635-647. [PMID: 32588713 DOI: 10.1177/0897190020930969] [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: 11/17/2022]
Abstract
Infertility is a significant public health concern in the United States. As such, utilization of infertility services, including pharmacotherapeutic treatments, is prevalent, and the role of the pharmacist as part of the health care team is essential. Pharmacists can assist patients by providing education on infertility causes, risk factor mitigation, referrals, nonpharmacologic and pharmacologic management options, navigation of the prescription process, and resource availability for the significant financial burden accompanying infertility treatment. In-depth pharmacotherapeutic information may not be readily available to pharmacists dispensing and counseling on these medications, and infertility management regimens are often varied and complicated requiring more in-depth counseling on use and administration. Given the complexity of infertility management, pharmacists are a valuable patient support and education resource. This article provides an in-depth review of infertility management strategies, both nonpharmacologic and pharmacologic.
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Affiliation(s)
- Nicole E Cieri- Hutcherson
- Department of Pharmacy Practice, 15497University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, NY, USA
| | | | - Lamis R Karaoui
- Department of Pharmacy Practice, School of Pharmacy, 114792Lebanese American University, Byblos, Lebanon
| | - Lauren Lakdawala
- 1466Johns Hopkins Outpatient Pharmacy, Specialty Services, Baltimore, MD, USA
| | - Nicole M Lodise
- 1091Albany College of Pharmacy and Health Sciences, Albany, NY, USA
| | - Rebecca H Stone
- 1355University of Georgia College of Pharmacy, Athens, GA, USA
| | - Veronica Vernon
- Pharamcy Practice, 15461Butler University College of Pharmacy and Health Sciences, Indianapolis, IN, USA
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El-Ibiary SY, Azizoddin A, Petrossian L, Gurney MK. Implementation and evaluation of a women's reproductive health pharmacy elective. CURRENTS IN PHARMACY TEACHING & LEARNING 2018; 10:1087-1096. [PMID: 30314545 DOI: 10.1016/j.cptl.2018.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 02/27/2018] [Accepted: 05/10/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND PURPOSE To create, implement and evaluate an elective course for pharmacy students focusing on women's reproductive health topics. EDUCATIONAL ACTIVITY AND SETTING A course was developed that included lectures discussing contraception, infertility, preconception care, pregnancy, and postpartum health. Active learning provided in the forms of journal article review and review of drug information resources for medication use in pregnancy were utilized. Workshops provided hands-on experiences with prescription contraceptives and over-the-counter fertility products. Knowledge and skills were assessed with in-class quizzes, journal article presentations, class participation, patient cases, and a final exam. A 46-item survey was administered to students pre- and post-course to assess self-perceived knowledge and confidence in women's reproductive health. FINDINGS A total of 33 students were enrolled in the course. The response rate for the pre-course survey was 100% (n = 33) and for the post-course survey was 91% (n = 30). Students' confidence in counseling on women's reproductive health topics significantly increased after the course (mean scores 2.62 pre-course and 3.75 post-course, p < 0.0001). Similar results were seen in students' self-perceptions of their overall knowledge in women's health (mean scores 2.63 pre-course and 3.92 post-course, p < 0.0001). Preferred methods of learning included product workshops, and journal club presentations were the least preferred learning method. DISCUSSION AND SUMMARY A women's reproductive health course was well received by students and increased their self-perceived knowledge and confidence in the areas of prescription contraceptives and over-the-counter fertility products.
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Affiliation(s)
- Shareen Y El-Ibiary
- Midwestern University College of Pharmacy - Glendale, 19555 N. 59th Ave., Glendale, AZ 85308, United States.
| | - Asal Azizoddin
- Midwestern University College of Pharmacy - Glendale, 19555 N. 59th Ave., Glendale, AZ 85308, United States
| | - Lara Petrossian
- Midwestern University College of Pharmacy - Glendale, 19555 N. 59th Ave., Glendale, AZ 85308, United States
| | - Mary K Gurney
- Midwestern University College of Pharmacy - Glendale, 19555 N. 59th Ave., Glendale, AZ 85308, United States
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Ma F, Deng L, Secrest P, Shi L, Zhao J, Gagneux P. A Mouse Model for Dietary Xenosialitis: ANTIBODIES TO XENOGLYCAN CAN REDUCE FERTILITY. J Biol Chem 2016; 291:18222-31. [PMID: 27382056 PMCID: PMC5000070 DOI: 10.1074/jbc.m116.739169] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 06/28/2016] [Indexed: 12/18/2022] Open
Abstract
Humans can incorporate the xenoglycan N-glycolylneuraminic acid (Neu5Gc) from the diet into reproductive tissues and secretions. Most humans also have circulating antibodies specific for this dietary xenoglycan. The potential for inflammation induced by incorporated Neu5Gc and circulating anti-Neu5Gc antibodies, termed xenosialitis, has been discussed as a factor influencing several human diseases. Potential effects of xenosialitis on human fertility remain unknown. Here, we investigate possible adverse effects of the presence of Neu5Gc on sperm or endometrium combined with anti-Neu5Gc antibodies in semen or uterine secretions in a mouse model. We use Cmah(-/-) mice, humanized for Neu5Gc deficiency. We find that the viability, migration, and capacitation of sperm with incorporated Neu5Gc are negatively affected when these are exposed to anti-Neu5Gc antibodies. In addition, we find that after copulation, activated uterine neutrophils and macrophages show increased phagocytosis of sperm in the presence of anti-Neu5Gc antibodies via the complement receptor 3 (C3R) and Fcγ I/II/III (Fc receptor). Furthermore, Neu5Gc in endometrial cells combined with the presence of anti-Neu5Gc antibodies alters the receptivity and decidualization of endometrial explants. These studies provide mechanistic insights on how Neu5Gc on sperm and/or endometrium combined with anti-Neu5Gc antibodies in semen and uterine fluid might contribute to unexplained human infertility.
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Affiliation(s)
- Fang Ma
- From the Sichuan University - The Chinese University of Hong Kong Joint Laboratory for Reproductive Medicine, Key Laboratory of Obstetric, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, and Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, China and
| | - Liwen Deng
- the Glycobiology Research and Training Center and Department of Pathology
| | - Patrick Secrest
- the Glycobiology Research and Training Center and Department of Pathology
| | | | - June Zhao
- Transgenic Mouse Core, University of California - San Diego, La Jolla, California 92093
| | - Pascal Gagneux
- the Glycobiology Research and Training Center and Department of Pathology,
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