Clarithromycin ion pair in a liposomal membrane to improve its stability and reduce its irritation caused by intravenous administration

Kaempferia parviflora Extracellular Vesicle Loaded with Clarithromycin for the Treatment of Helicobacter pylori Infection

Purpose

Kaempferia parviflora extracellular vesicles (KPEVs) have been reported as promising nanovesicles for drug delivery. This study aimed to load clarithromycin (CLA) into KPEVs (KPEVS-CLA) and determine the physical properties, drug-releasing efficiency, gastric cell uptake, anti-H. pylori activities, and anti-inflammatory responses in comparison with free CLA and KPEVs.

Methods

The size and surface charge of KPEVs-CLA were evaluated using dynamic light scattering and visualized using a transmission electron microscope. The encapsulation efficiency (EE%), loading capacity (LC%), and drug release of KPEVs-CLA were examined using HPLC. Anti-H. pylori growth and anti-adhesion were evaluated. IL-8 gene expression, NF-κB signaling proteins, and anti-inflammatory profiles were examined using qRT-PCR, Western blotting, and Bio-Plex immunoassay, respectively. Anti-chemotaxis was then examined using a Transwell assay.

Results

KPEVs-CLA were intact and showed a negative surface charge similar to that of KPEVs. However, slightly enlarged KPEVs were observed. CLA was successfully loaded into KPEVs with EE of 93.45% ± 2.43%, LC of 9.3% ± 3.02%. CLA release in the PBS and gastric mimic buffer with Fickian diffusion (n ≤ 0.43) according to Korsmeyer-Peppas kinetic model (R2=0.98). KPEVs-CLA was localized in the gastric cells' cytoplasm and perinuclear region. Anti-H. pylori growth and anti-H. pylori adhesion of KPEVs-CLA were compared with those of free CLA with no cytotoxicity to adenocarcinoma gastric cells. KPEVs-CLA significantly reduced IL-8, G-CSF, MIP-1α, and MIP-1β levels. Moreover, KPEVs-CLA showed a superior effect over CLA in reducing G-CSF, MIP-1α, and NF-κB phosphorylation and monocyte chemotactic activities.

Conclusion

KPEVs serve as potential carriers of CLA. They exhibited a higher efficiency in inhibiting gastric cell inflammation mediated by H. pylori infection than free CLA. The establishment of KPEVs-CLA as a nanodrug delivery model for H. pylori treatment could be applied to other plant extracellular vesicles or loaded with other cancer drugs for gastric cancer treatment.

Probing Pharmaceutical Strategies to Promote the Skin Delivery of Asiatic Acid from Hydrogels: Enhancement Effects of Organic Amine Counterions, Chemical Enhancers, and Microneedle Pretreatment

Asiatic acid (AA) is a pentacyclic triterpene isolated from Centella asiatica, holding great promise for treating a variety of skin disorders. However, the dermal application of AA is limited by its poor solubility and permeability. This study aimed to identify a hydrogel formulation for AA and improve its skin penetration by various penetration enhancement methods. Four kinds of hydrogel bases were selected to prepare the AA hydrogel, in which different organic amines and chemical enhancers were incorporated in combination with microneedle pretreatment. The results showed that AA had good release profiles in the presence of hyaluronic acid as the hydrogel base and organic amines as the counter-ions. Diethylamine and Span 80 could promote drug penetration into the skin, and pretreatment with microneedles could further increase the drug permeability. In conclusion, the optimized hyaluronic acid hydrogel has great potential for use in the topical delivery of AA, and its penetration via the skin can be further improved by different pharmaceutical approaches.

Delivering macrolide antibiotics to heal a broken heart - And other inflammatory conditions

Drug carriers to deliver macrolide antibiotics, such as azithromycin, show promise as antibacterial agents. Macrolide drug carriers have largely focused on improving the drug stability and pharmacokinetics, while reducing adverse reactions and improving antibacterial activity. Recently, macrolides have shown promise in treating inflammatory conditions by promoting a reparative effect and limiting detrimental pro-inflammatory responses, which shifts the immunologic setpoint from suppression to balance. While macrolide drug carriers have only recently been investigated for their ability to modulate immune responses, the previous strategies that deliver macrolides for antibacterial therapy provide a roadmap for repurposing the macrolide drug carriers for therapeutic interventions targeting inflammatory conditions. This review describes the antibacterial and immunomodulatory activity of macrolides, while assessing the past in vivo evaluation of drug carriers used to deliver macrolides with the intention of presenting a case for increased effort to translate macrolide drug carriers into the clinic.

The Effect of Cold Application on Relieving Drug Infusion-Related Pain in Children: A Randomized Controlled Experimental Trial in Turkey

BACKGROUND

Parenteral IV drug administration in hospital environments can cause many complications at the infusion site. Nerve endings on the venous walls may be affected during antibiotic drug infusion, depending on the drug molecule, which results in pain.

PURPOSE

This study aims to assess the effect of cold application on relieving drug infusion-related pain (lincosamide class clindamycin phosphate) in children.

DESIGN & METHODS

This study included 120 pediatric patients (40 in the experimental, 40 in the placebo, and 40 in the control groups) aged 6 to 18 and hospitalized in a pediatric hospital. In the experimental group, a cold pack kept in the refrigerator was applied to the area above the IV catheter before drug infusion, while a cold pack kept at room temperature was applied in the placebo group. In the control group, drug infusion was routinely administered.

RESULTS

The experimental, placebo and control groups' 5th minute mean VAS scores were 0.98 ± 2.17, 3.95 ± 4.08, and 4.73 ± 3.89, respectively (p < 0.001), being higher in the control and placebo groups compared to the experimental group. No difference was found between the groups based on the VAS measurements at the 10th minute (p = 0.053). A difference was found between the groups based on the VAS measurements at the 15th minute (p=0.026). The VAS score of control group was higher than that of the placebo group (p = 0.032).

CONCLUSION

Cold application was effective in relieving drug infusion-related pain.

IMPLICATIONS FOR PRACTICE

This method may be recommended for general use in clinics since it is easy-to-use and economic. This method can ease the treatment process between nurses and children and increase patient satisfaction.

Aprepitant Intravenous Emulsion Based on Ion Pairing/Phospholipid Complex for Improving Physical and Chemical Stability During Thermal Sterilization

An aprepitant (APT) cholesteryl hemisuccinate (CHEMS) ion pair complex emulsion (AIPE) with high lecithin content was prepared to improve sterilization stability through the film dispersion homogenization method; therefore, it could be a promising delivery system of APT. Medium-chain triglycerides (MCT) was selected as the oil phase to improve the solubility and stability of APT in oil phase. DSC, XRD, FT-IR, and ¹H-NMR spectroscopies confirmed that the APT-CHEMS ion pair (AIP) was formed between CHEMS and APT. The formation of AIP significantly increased the hydrophobicity of APT, allowing it to be completely embedded in the oil phase core to improve chemical stability and decrease hydrolysis of APT in the water phase. Also, CHEMS had a strong affinity with lecithin and could stabilize lipid membranes, forming a stronger and thicker interface membrane to increase the physical stability of AIPE. As a result, AIPE could withstand autoclaving at 120°C for 8 min without any change of particle size or content. Furthermore, AIPE with a potential of - 53.4 mV remained stable through spatial repulsion during sterilization. The encapsulation efficiency of AIPE was over 90% and the particle size was 106.8 ± 65.62 nm(0.286). Pharmacokinetic study in rats was comparable with that of CINVANTI which yielded a relative bioavailability of 114.31% indicating that the AIPE had similar pharmacokinetic processes in vivo with the analog of CINVANTI®. The AUC0-t of the AIPE was 4.31-fold that of the APT solution.

The modulation of drug-loading stability within lipid membranes via medium chain triglycerides incorporation

The current research aimed to explore medium chain triglycerides (MCT) incorporation in liposomes to overcome stability challenges when drugs with high molecular weight and payload are loaded within lipid membranes. A model drug clarithromycin was loaded in lipid dispersions with various MCT/phospholipids ratios (R_M/P = 0, 0.5, 1.75 and 7.5 w/w). TEM images demonstrated a liposome-to-emulsion structural transformation by MCT incorporation to cause increased particle size (104.3-167.7 nm) but decreased zeta potential (-63.6 to -44.4 mV) of lipid particles. MCT incorporation produced biphasic release in PBS and accelerated released in plasma. The tolerance of liposomes for thermal sterilization, high temperature test and freeze-thaw cycles were significantly improved by MCT incorporation. However, MCT incorporation produced adverse effects on colloidal stability in plasma and pharmacokinetics behavior in vivo to some extent. MCT stabilizing mechanism attributes to the modulation of drug loading area and stability improvement of lipid carriers. MCT incorporated liposomes achieved 2-3 fold cellular uptake level than traditional liposomes without significant cytotoxicity. These results indicated that MCT incorporation could be a promising strategy to apply in liposome production to achieve stable drug loading.

Synthesis, characterization and in vitro evaluation of amphiphilic ion pairs of erythromycin and kanamycin antibiotics with liposaccharides

The hydrophilic ion paring strategy (HIP) is a method explored to improve the cell/tissue uptake of poorly adsorbed drugs and to optimize their physico-chemical characteristics. In this context, we here describe the synthesis of some ion pairs of two model cationic antibiotics, erythromycin (ERY) and kanamycin A (KAN), with liposaccharides having different levels of lipophilicity and charge. The formation of drug-liposaccharide complexes was confirmed by Fourier transform infrared spectroscopy (FT-IR), differential scanning calorimetry (DSC) and powder X-ray diffraction (PXRD) analysis. The effect of the amphiphilic liposaccharide moieties on the antimicrobial activity of ERY and KAN was assessed by measuring the minimal inhibitory concentration (MIC) of the compounds against a panel of bacterial strains that were susceptible or resistant to the parent antibiotics. The ion pairing did not depress the in vitro antibiotic activity, although no lowering of MIC values was registered. The experimental findings would motivate the future investigation of this ion pairing strategy in drug design, for instance allowing improvement of the encapsulation efficiency of hydrophilic antibiotics in lipid-based nanocarriers, or changing their in vivo biodistribution and pharmacokinetic profile.