Stabilizing vaccines via drying: Quality by design considerations

Pandemics and epidemics are continually challenging human beings' health and imposing major stresses on the societies particularly over the last few decades, when their frequency has increased significantly. Protecting humans from multiple diseases is best achieved through vaccination. However, vaccines thermal instability has always been a hurdle in their widespread application, especially in less developed countries. Furthermore, insufficient vaccine processing capacity is also a major challenge for global vaccination programs. Continuous drying of vaccine formulations is one of the potential solutions to these challenges. This review highlights the challenges on implementing the continuous drying techniques for drying vaccines. The conventional drying methods, emerging technologies and their adaptation by biopharmaceutical industry are investigated considering the patented technologies for drying of vaccines. Moreover, the current progress in applying Quality by Design (QbD) in each of the drying techniques considering the critical quality attributes (CQAs), critical process parameters (CPPs) are comprehensively reviewed. An expert advice is presented on the required actions to be taken within the biopharmaceutical industry to move towards continuous stabilization of vaccines in the realm of QbD.

Formation of Ciprofloxacin–Isonicotinic Acid Cocrystal Using Mechanochemical Synthesis Routes—An Investigation into Critical Process Parameters

The mechanochemical synthesis of cocrystals has been introduced as a promising approach of formulating poorly water-soluble active pharmaceutical ingredients (APIs). In this study, hot-melt extrusion (HME) as a continuous process and grinding and ball milling as batch processes were employed to explore the feasibility of cocrystallization. Ciprofloxacin (CIP) and isonicotinic acid (INCA) were selected as the model API and coformer. CIP–INCA cocrystal was produced in all techniques. It was revealed that higher cocrystal content could be achieved at longer durations of grinding and ball milling. However, milling for more than 10 min led to increased co-amorphous content instead of cocrystal. A design of experiment (DoE) approach was used for deciphering the complex correlation of screw configuration, screw speed, and temperature as HME process parameters and their respective effect on final relative cocrystal yield. Statistical analysis showed that screw configuration, temperature, and their interaction were the most critical factors affecting cocrystallization. Interestingly, screw speed had minimal impact on the relative cocrystallization yield. Cocrystallization led to increased dissolution rate of CIP in phosphate buffer up to 2.5-fold. Overall, this study shed a light on the potential of mechanochemical synthesis techniques with special focus on HME as a continuous process for producing cocrystals.

Controlled isolation and stabilisation of pure metastable carbamazepine form IV by droplet-confinement via a continuous manufacturing route

This study outlines a systematic approach to control the polymorphism of carbamazepine (CBZ) and isolate the metastable polymorph CBZ form IV as a function of droplet size using spray drying as a continuous method of manufacture.

Impact of polymeric excipient on cocrystal formation via hot-melt extrusion and subsequent downstream processing

Pharmaceutical cocrystals have gained increasing interest due to their potential to modify the physicochemical properties of drugs. Herein, a 1:1 cocrystal of ibuprofen (IBU) as a BCS class II active pharmaceutical ingredient (API) and nicotinamide as coformer was produced using a hot-melt extrusion (HME) process. The effect of process parameters such as barrel temperature and screw speed were studied. It was shown that the addition of polymeric excipient such as soluplus (Sol) decreases the cocrystallization temperature by enhancing the interaction between API and coformer. In order to study the effect of cocrystallization on the tableting properties of IBU-NIC cocrystal, 5 different formulations of pure IBU, IBU-NIC cocrystal, IBU-NIC physical mixture, IBU-NIC-Sol physical mixture and IBU-NIC-Sol cocrystal were tableted by a compaction simulator. Tabletability, compactibility and compressibility were investigated. The sample with IBU-NIC-Sol cocrystal formulation outperformed all the other formulations in terms of tabletability, compactibility and compressibility. Interestingly, this sample was even superior to the IBU-NIC cocrystal sample which verified the advantageous effect of the presence of an excipient. Moreover, dissolution test confirmed a noticeable increase in the dissolution of not only the cocrystal samples but even the physical mixtures of IBU and NIC compared with pure IBU.

Co-crystal polymorphic control by nanodroplet and electrical confinement

The polymorphic control of the co-crystal carbamazepine–saccharin (CBZ–SAC) metastable form II was achieved by nano-droplet confinement in tandem with droplet surface charging induced by electrospraying the precursor solution.

Identification of Mucorales isolates from soil using morphological and molecular methods

Background and Purpose:

Soil is the main habitat of saprophytic and pathogenic fungi. Mucoromycotina constitutes a large group of soil fungi, with certain opportunistic members causing systemic infections in immunocompromised hosts. The majority of human and animal infections are caused by the members of the genera Rhizopus, Mucor, Rhizomucor, Lichtheimia (Absidia), Cunninghamella, and Mortierella. Accordingly, in the present study, we aimed to isolate and identify the main genera of the order Mucorales, using molecular assays and morphological features.

Materials and Methods:

In total, 340 soil samples were collected from seven public parks throughout the city and sidewalk gardens in 14 municipal districts in Isfahan, Iran. All the samples were cultured on the appropriate media, incubated at 27°C for 2- 4 days, and examined daily for visible fungal growth. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was applied and macroscopic, microscopic, and physiological characteristics were assessed to identify fungal colonies.

Results:

400 pure colonies, belonging to the orders Mucorales and Mortierellales, including the genera Lichtheimia, Rhizopus, Rhizomucor, Mucor, Cunninghamella, and Mortierella, were identified. The genus Rhizopus (35.5%) was the most frequent isolate, followed by Mucor (32.25%) and Rhizomucor (27.5%).

Conclusion:

The results emphasize the importance of opportunistic fungi in public areas and indicate the risk of exposure for immunocompromised individuals.

Association of metabolic syndrome components with insulin resistance in normal weight population: the Qazvin Metabolic Diseases study

PURPOSE

Metabolically obese but normal weight (MONW) is associated with higher risk of type 2 diabetes, dyslipidemia, and hypertension. The aim of this study was to evaluate the association of metabolic syndrome components with MONW in each sex in Iranian population.

METHODS

This cross-sectional study was performed on 417 normal weight subjects in Qazvin, Iran between September 2010 and April 2011. MONW was defined by insulin resistance (IR) using the homeostatic model assessment (HOMA). Cut off point for IR was defined as the lower limit of top quintile of HOMA-IR values in normal weight population without any metabolic risk factors. Data were analyzed using T test, Mann-Whitney U test, and multi-variant logistic regression analysis.

RESULTS

Of 417 subjects, 44.3 % were female. The prevalence of MONW was 33.8 % in men and 39.8 % in women. Triglycerides levels were significantly higher in both men and women with MONW. Waist circumference was significantly higher in men with MONW, while high-density lipoprotein cholesterol levels were significantly lower in women with MONW. In logistic regression analysis, hypertriglyceridemia in women (OR 3.398; 95 % CI 1.306-8.846) and waist circumference (per 5 cm increment) in men (OR 1.653; 95 % CI 1.279-2.136) had independent association with MONW.

CONCLUSION

Association of metabolic syndrome components with MONW is different in men and women. Waist circumference had an independent association with IR in men but not in women. IR and its complications should be considered in lean women with hypertriglyceridemia.

Association between health-related quality of life and impaired glucose metabolism in Iran: the Qazvin Metabolic Diseases Study

AIM

To evaluate the association between health-related quality of life and glucose metabolism status in a study population in Qazvin, Iran.

METHODS

This cross-sectional study was conducted in 1044 people (aged 20-78 years old) between September 2010 and April 2011 in Qazvin, Iran. An oral glucose tolerance test was performed for each participant who had never been diagnosed with diabetes. Participants were characterized as having normal glucose metabolism, pre-diabetes or diabetes according to American Diabetes Association criteria. The short-form 36 questionnaire was used to measure quality of life. Data were analysed using a chi-squared test, anova and ancova.

RESULTS

A total of 530 (51.7%) of the participants were women, and 24.1 and 11.6% of the participants were categorized as having prediabetes and diabetes mellitus, respectively. Except for the role emotional domain, there was a gradual decrease in the mean scores of every domain of the short-form 36 scale across the three study groups. The mean scores in the physical domains were significantly different among the participants with normal glucose metabolism and those with diabetes. After adding age as covariate, there were no significant differences between the categories in any of the domains.

CONCLUSION

There is no association between quality of life domains and glucose metabolism status in Iranian subjects. More longitudinal studies are necessary to investigate the natural history of pre-diabetes, diabetes and quality of life.

Prevalence of metabolic syndrome in Qazvin Metabolic Diseases Study (QMDS), Iran: a comparative analysis of six definitions

OBJECTIVE

The aim of the present study was to compare the prevalence of metabolic syndrome (MS) according to six definitions and evaluate the agreement between them in an urban sample in Qazvin, Iran.

METHODS

In a cross sectional study, 529 men and 578 women in age of 20-78 years were attended from September 2010 to April 2011 in Qazvin, Iran. Standardized measurements were available for waist circumference, blood pressure, fasting serum high-density lipoprotein cholesterol, triglycerides, glucose, and insulin. The diagnostic criteria proposed by World Health Organization (WHO), National cholesterol education program third Adult Treatment Panel (ATPIII 2001, 2004), International Diabetes Federation (IDF), American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI), and new Joint Interim Societies (JIS) were applied. The degree of agreement between different definitions was assessed by kappa statistic.

RESULTS

The prevalence of MS was found to be 28% (WHO), 26.2% (ATPIII 2001), 30.6% (ATPIII 2004), 34.2% (IDF), 33% (AHA/NHLBI), and 39.3% (JIS). With regards to the gender, the prevalence of MS according to ATPIII 2001 and IDF was significantly greater in women than men. However, using other definitions, the prevalence of MS was similar in both genders. The agreement of JIS criteria with IDF and AHA/NHLBI definitions was excellent (IDF: 0.902; AHA/NHLBI: 0.862), while the agreement of IDF criteria with ATPIII 2004 and AHA/NHLBI was good (ATPIII 2004:0.719; AHA/NHLBI: 0.756).

CONCLUSIONS

Although JIS definition resulted in a higher prevalence of MS than other definitions, an excellent agreement has been seen between these criteria. Widespread acceptance of JIS definition may lead to management and therapy in a greater part of the population.

Collateral vessel physiology and functional impact–in vivo assessment of collateral channels

The existence and recruitment of collateral vessels within the coronary circulation may account for the tremendous variability in presentation, symptoms and outcome in patients with coronary atherosclerosis. Multiple episodes of ischemia have been found to produce the stimuli necessary for the growth of new vessels which result in collateral blood flow. Furthermore, there is also a subset of patients with readily recruitable collateral vessels that function to limit myocardial necrosis during an acute ischemic event. Promising early studies have utilized angiogenic growth factors as a means to stimulate collateral growth, bringing a renewal interest in their assessment and significance. We review, in brief, the significance and understanding of the development of coronary collaterals as well as the available means to assess them.