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Zhong HL, Li PZ, Li D, Guan CX, Zhou Y. The role of vasoactive intestinal peptide in pulmonary diseases. Life Sci 2023; 332:122121. [PMID: 37742737 DOI: 10.1016/j.lfs.2023.122121] [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: 05/14/2023] [Revised: 09/12/2023] [Accepted: 09/21/2023] [Indexed: 09/26/2023]
Abstract
Vasoactive intestinal peptide (VIP) is an abundant neurotransmitter in the lungs and other organs. Its discovery dates back to 1970. And VIP gains attention again due to the potential application in COVID-19 after a research wave in the 1980s and 1990s. The diverse biological impacts of VIP extend beyond its usage in COVID-19 treatment, encompassing its involvement in various pulmonary and systemic disorders. This review centers on the function of VIP in various lung diseases, such as pulmonary arterial hypertension, chronic obstructive pulmonary disease, asthma, cystic fibrosis, acute lung injury/acute respiratory distress syndrome, pulmonary fibrosis, and lung tumors. This review also outlines two main limitations of VIP as a potential medication and gathers information on extended-release formulations and VIP analogues.
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Affiliation(s)
- Hong-Lin Zhong
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha, Hunan 410078, China
| | - Pei-Ze Li
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha, Hunan 410078, China
| | - Di Li
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha, Hunan 410078, China
| | - Cha-Xiang Guan
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha, Hunan 410078, China.
| | - Yong Zhou
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha, Hunan 410078, China.
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Lian S, Liu Y, Xu L, Wang F, Zhang M, Salunke S, Walsh J, Zhao M. Survey-based investigation into the current use of paediatric medicines and administration devices in China. Eur J Pharm Biopharm 2023; 191:290-302. [PMID: 37689320 DOI: 10.1016/j.ejpb.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
The accurate, rapid and convenient administration of medicines to children is not possible without the use of appropriate administration devices. However, due to the unique nature of this patient population, inappropriate paediatric medication administration has been widely observed worldwide. According to previous surveys carried out in other countries including the UK and Japan, there has been a wide variation in the handling of paediatric devices among children. To date, little is known about the current situation in China where the variety of available paediatric administration devices is more limited than in Europe and the UK. The aim of this study was therefore to conduct a China-wide survey to gain a better understanding of the perspectives of children and their caregivers on paediatric medicines and devices. This study was conducted throughout China with 215 children as well as 749 caregivers of paediatric year groups from 1 to less than 18 years old. The majority of participants (83%) took oral dosage forms where granules, syrup and tablets were ranked as the Top 3 commonly used oral dosage forms. The most commonly used devices, i.e., measuring cups (47.3%) and household spoons (41.1%) were both well accepted by the vast majority of children. More instruction and demonstration by the healthcare professionals were provided to inhalation devices users with the nebuliser and facemask being the most commonly used. In particular, the role of pharmacists in China is expected to be better defined, which may in turn help with the education provided to paediatric users in operating medical devices. The data collected varied considerably with the age of children but not statistically significantly with the region in which the survey was conducted.
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Affiliation(s)
- Shangjie Lian
- School of Pharmacy, Queen's University Belfast, Belfast, UK
| | - Yixiao Liu
- China Medical University-Queen's University Belfast Joint College (CQC), China Medical University, Shenyang, China
| | - Luomeng Xu
- China Medical University-Queen's University Belfast Joint College (CQC), China Medical University, Shenyang, China
| | - Fengjing Wang
- China Medical University-Queen's University Belfast Joint College (CQC), China Medical University, Shenyang, China
| | - Meng Zhang
- School of Pharmacy, Queen's University Belfast, Belfast, UK
| | - Smita Salunke
- University College London School of Pharmacy, London, UK
| | | | - Min Zhao
- School of Pharmacy, Queen's University Belfast, Belfast, UK; China Medical University-Queen's University Belfast Joint College (CQC), China Medical University, Shenyang, China.
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Liu T, Tong S, Liao Q, Pan L, Cheng M, Rantanen J, Cun D, Yang M. Role of dispersion enhancer selection in the development of novel tratinterol hydrochloride dry powder inhalation formulations. Int J Pharm 2023; 635:122702. [PMID: 36773729 DOI: 10.1016/j.ijpharm.2023.122702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
Tratinterol hydrochloride (TH) is a new long-acting bronchodilator with strong β2 adrenoceptor stimulation activity. The aim of this study was to design a new carrier-based dry powder inhalation (DPI) formulation for TH and to investigate the effect of dispersion enhancers on the aerosol performance of TH in vitro. To this end, coarse lactose was used as a carrier. TH was micronized by using a jet mill and blended with the carrier to obtain a reference DPI formulation. Commercial magnesium stearate (MgSt) as received, micronized MgSt (MgSt-M), and fine lactose (FL) were used as the dispersion enhancers and formulated with the micronized TH (TH-M) and the carrier as DPI formulations. The obtained DPI formulations were characterized using dynamic light scattering (DLS), X-ray powder diffraction (XRPD), thermal analysis, powder rheometer, and Raman microscopy. A next generation pharmaceutical impactor (NGI) was used to evaluate the aerodynamic performance of the dry powders. The results showed that TH-M was in an inhalable particle size range, and based on the XRPD and thermal analysis, the solid form of TH-M did not change compared to the starting materials. The NGI results showed that the fine particle fraction (FPF) of TH could be increased with the addition of MgSt and FL as dispersion enhancers in the reference formulation. In addition, the FPF of TH could be increased with a decrease in the particle size of MgSt or an increase in the amount of FL. A combination of MgSt-M and FL could further improve the aerosol performance of TH. Raman spectroscopic imaging confirmed the spatial location of MgSt and TH at the surface of the carrier. This study demonstrates that TH could be formulated into carrier-based dry powder formulation for inhalation using coarse lactose as the carrier. The dual strategy based on using both MgSt and FL as dispersion enhancers improved the aerosol performance of a novel TH dry powder formulation.
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Affiliation(s)
- Tingting Liu
- Wuya College of Innovation, Shenyang Pharmaceutical University, Wenhua Road No. 103, 110016 Shenyang, China
| | - Shiqing Tong
- Wuya College of Innovation, Shenyang Pharmaceutical University, Wenhua Road No. 103, 110016 Shenyang, China
| | - Qianqian Liao
- Wuya College of Innovation, Shenyang Pharmaceutical University, Wenhua Road No. 103, 110016 Shenyang, China
| | - Li Pan
- Department of Medicinal Chemistry, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Wenhua Road No. 103, 110016 Shenyang, China
| | - Maosheng Cheng
- Department of Medicinal Chemistry, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Wenhua Road No. 103, 110016 Shenyang, China
| | - Jukka Rantanen
- Department of Pharmacy, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Dongmei Cun
- Wuya College of Innovation, Shenyang Pharmaceutical University, Wenhua Road No. 103, 110016 Shenyang, China
| | - Mingshi Yang
- Wuya College of Innovation, Shenyang Pharmaceutical University, Wenhua Road No. 103, 110016 Shenyang, China; Department of Pharmacy, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark.
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Chandel A, Goyal AK, Ghosh G, Rath G. Recent advances in aerosolised drug delivery. Biomed Pharmacother 2019; 112:108601. [PMID: 30780107 DOI: 10.1016/j.biopha.2019.108601] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 01/10/2019] [Accepted: 01/18/2019] [Indexed: 10/27/2022] Open
Abstract
Pulmonary route is extensively studied for the diagnosis and treatment of pulmonary and extra pulmonary disease conditions such as asthma, tuberculosis, emphysema, and bronchitis. Formulation design, inhalation device and particle size play key role in determining the aerosol performance. The lack of desired clinical outcome along with the problem regarding efficacy or any adverse drug effect may arise due to improper training and education in use of the device to control the actuation and aerosol inhalation. This review summarizes the difference in the mechanistic features of current marketed aerosol delivery devices with respect to mechanism of aerosol generation with possible advancements in the aerosol design. The delivery options in the pulmonary route and its merits together with the limitations are also discussed. An update is provided regarding the current research and clinical outcome of the use of inhalational technology.
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Affiliation(s)
- Akshay Chandel
- Department of pharmaceutics, I.S.F. College of Pharmacy, Moga, Punjab, India
| | - Amit K Goyal
- National Institute of Animal Biotechnology, Hyderabad, India
| | - Goutam Ghosh
- Siksha 'O' Anusandhan (Deemed to be University), Kalinga Nagar, Bhubaneswar, Odisha, India
| | - Goutam Rath
- Department of pharmaceutics, I.S.F. College of Pharmacy, Moga, Punjab, India.
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Rangaraj N, Pailla SR, Sampathi S. Insight into pulmonary drug delivery: Mechanism of drug deposition to device characterization and regulatory requirements. Pulm Pharmacol Ther 2018; 54:1-21. [PMID: 30447295 DOI: 10.1016/j.pupt.2018.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/09/2018] [Accepted: 11/13/2018] [Indexed: 02/07/2023]
Affiliation(s)
- Nagarjun Rangaraj
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER-HYD), Balanagar, Telangana, 500037, India
| | - Sravanthi Reddy Pailla
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER-HYD), Balanagar, Telangana, 500037, India
| | - Sunitha Sampathi
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER-HYD), Balanagar, Telangana, 500037, India.
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Lee YH, Kwon GY, Park DY, Bang JY, Jang DM, Lee SH, Lee EK, Choi BM, Noh GJ. Efficiency of a New Mesh-Type Nebulizer (NE-SM1 NEPLUS) for Intrapulmonary Delivery of Ipratropium Bromide in Surgical Patients. Basic Clin Pharmacol Toxicol 2015; 118:313-9. [DOI: 10.1111/bcpt.12499] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 09/29/2015] [Indexed: 11/24/2022]
Affiliation(s)
- Yong-Hun Lee
- Department of Anaesthesiology and Pain Medicine; Asan Medical Centre; University of Ulsan College of Medicine; Seoul Korea
| | - Gu-Youn Kwon
- Ulsan Graduate School of Medicine and Science; Seoul Korea
| | - Do-Yang Park
- Department of Clinical Pharmacology and Therapeutics; Asan Medical Centre; University of Ulsan College of Medicine; Seoul Korea
| | - Ji-Yeon Bang
- Department of Anaesthesiology and Pain Medicine; Asan Medical Centre; University of Ulsan College of Medicine; Seoul Korea
| | - Dong-Min Jang
- Department of Anaesthesiology and Pain Medicine; Asan Medical Centre; University of Ulsan College of Medicine; Seoul Korea
| | - Soo-Han Lee
- Department of Veterinary Internal Medicine; College of Veterinary Medicine; Konkuk University; Seoul Korea
| | - Eun-Kyung Lee
- Department of Statistics; Ewha Womans University; Seoul Korea
| | - Byung-Moon Choi
- Department of Anaesthesiology and Pain Medicine; Asan Medical Centre; University of Ulsan College of Medicine; Seoul Korea
| | - Gyu-Jeong Noh
- Department of Anaesthesiology and Pain Medicine; Asan Medical Centre; University of Ulsan College of Medicine; Seoul Korea
- Department of Clinical Pharmacology and Therapeutics; Asan Medical Centre; University of Ulsan College of Medicine; Seoul Korea
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Yeo LY, Friend JR, McIntosh MP, Meeusen ENT, Morton DAV. Ultrasonic nebulization platforms for pulmonary drug delivery. Expert Opin Drug Deliv 2010; 7:663-79. [PMID: 20459360 DOI: 10.1517/17425247.2010.485608] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
IMPORTANCE OF THE FIELD Since the 1950s, ultrasonic nebulizers have played an important role in pulmonary drug delivery. As the process in which aerosol droplets are generated is independent and does not require breath-actuation, ultrasonic nebulizers, in principle, offer the potential for instantaneously fine-tuning the dose administered to the specific requirements of a patient, taking into account the patient's breathing pattern, physiological profile and disease state. Nevertheless, owing to the difficulties and limitations associated with conventional designs and technologies, ultrasonic nebulizers have never been widely adopted, and have in recent years been in a state of decline. AREAS COVERED IN THIS REVIEW An overview is provided on the advances in new miniature ultrasonic nebulization platforms in which large increases in lung dose efficiency have been reported. WHAT THE READER WILL GAIN In addition to a discussion of the underlying mechanisms governing ultrasonic nebulization, in which there appears to be widely differing views, the advantages and shortcomings of conventional ultrasonic nebulization technology are reviewed and advanced state-of-the-art technologies that have been developed recently are discussed. TAKE HOME MESSAGE Recent advances in ultrasonic nebulization technology demonstrate significant potential for the development of smart, portable inhalation therapy platforms for the future. Nevertheless, there remain considerable challenges that need to be addressed before such personalized delivery systems can be realized. These have to be addressed across the spectrum from fundamental physics through to in vivo device testing and dealing with the relevant regulatory framework.
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Affiliation(s)
- Leslie Y Yeo
- Monash University, Department of Mechanical and Aerospace Engineering, Micro/Nanophysics Research Laboratory, Clayton, VIC 3800, Australia.
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Affiliation(s)
- Michael J Welch
- From the Allergy and Asthma Medical Group and Research Center, San Diego, California 92123, USA.
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Onoue S, Yamada S, Yajima T. Bioactive analogues and drug delivery systems of vasoactive intestinal peptide (VIP) for the treatment of asthma/COPD. Peptides 2007; 28:1640-50. [PMID: 17537541 DOI: 10.1016/j.peptides.2007.04.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2007] [Revised: 04/04/2007] [Accepted: 04/13/2007] [Indexed: 01/11/2023]
Abstract
Vasoactive intestinal peptide (VIP) is one of the major peptide transmitters in the central and peripheral nervous systems, being involved in a wide range of biological functions. In an airway system where VIP-immunoreactive nerve fibers are present, VIP acts as neurotransmitter or neuromodulator of the inhibitory non-adrenergic and non-cholinergic airway nervous system and influences many aspects of pulmonary biology. A clinical application of VIP has been believed to offer potential benefits in the treatment of chronic inflammatory lung diseases such as asthma and chronic obstructive pulmonary disease (COPD), however, its clinical application has been limited in the past for a number of reasons, including its extremely short plasma half-life after intravenous administration and difficulty in administration routes. The development of long-acting VIP analogues, in combination with appropriate drug delivery systems, may provide clinically useful agents for the treatment of asthma/COPD. In this review, development of efficacious VIP derivatives, drug delivery systems designed for VIPs and the potential application for asthma/COPD are discussed. We also include original data from our chemical modification experiments and formulation studies, which led to successful development of [R(15, 20, 21), L(17)]-VIP-GRR (IK312532), a potent VIP analogue, and a VIPs-based dry powder inhaler system.
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Affiliation(s)
- Satomi Onoue
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences, Toho University, Funabashi, Chiba 274-8510, Japan.
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Berger WE, Milgrom H, Skoner DP, Tripp K, Parsey MV, Baumgartner RA. Evaluation of levalbuterol metered dose inhaler in pediatric patients with asthma: a double-blind, randomized, placebo- and active-controlled trial. Curr Med Res Opin 2006; 22:1217-26. [PMID: 16846555 DOI: 10.1185/030079906x112534] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of levalbuterol metered dose inhaler (MDI) in children aged 4-11 years (n = 173). RESEARCH DESIGN AND METHODS Multicenter, randomized, double-blind 28-day study of QID levalbuterol 90 microg, racemic albuterol 180 mug, and placebo (2:1:1 ratio). Serial spirometry was performed on Days 0, 14, and 28. The primary endpoint was the double-blind average peak percent (%) change in FEV(1) from visit pre-dose; the primary comparison was with placebo. Secondary endpoints included the area under the FEV(1) percent change from pre-dose curve and peak % predicted FEV(1). Safety endpoints included adverse events, laboratory tests, rescue medication use, and electrocardiograms. RESULTS Levalbuterol significantly improved the least square mean peak percent change in FEV(1) compared with placebo (levalbuterol 25.6% +/- 1.3% [p < 0.001]; racemic albuterol 21.8% +/- 1.8% [p = ns]; placebo 16.8% +/- 1.9%). Results for levalbuterol were similar for the other spirometry endpoints (p < 0.05 vs. placebo). No levalbuterol-treated patients had a peak percent change in FEV(1) < 10% (compared with 15.8% of racemic albuterol-treated patients and 30.3% of placebo-treated patients). The incidence of adverse events was 43.4% for levalbuterol, 56.4% for racemic albuterol, and 51.4% for placebo. The rate of discontinuation was 1.3% for levalbuterol, 2.6% for racemic albuterol, and 8.6% for placebo. The rate of asthma attacks (10.5%, 12.8%, 14.3%, respectively) was similar among treatments. Levalbuterol and racemic albuterol both reduced rescue medication use (p < 0.01 vs. placebo) and produced changes in ventricular heart rate and QT(c-F) that were similar to placebo. CONCLUSIONS In this study, levalbuterol administered via MDI significantly improved airway function in comparison with placebo in asthmatic children aged 4-11 years with a safety profile that was similar to placebo.
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Affiliation(s)
- William E Berger
- Allergy and Asthma Associates of Southern California, Mission Viejo, CA, USA
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