Research progresses on carboxymethyl xanthan gum: Review of synthesis, physicochemical properties, rheological characterization and applications in drug delivery

Xanthan gum is a nonionic polysaccharide widely explored in biomedical, nutraceutical, and pharmaceutical fields. XG suffers from several drawbacks like poor dissolution, lower bioavailability and an inability to form hydrogels. The carboxymethyl derivative of XG, CMX, has better solubility, dissolution, and bioavailability characteristics. Moreover, due to its anionic character, it forms water insoluble hydrogels upon crosslinking with metal cations. CMX hydrogels are used to prepare matrix tablets, microparticles, beads, and films. CMX hydrogels has been used in drug delivery and tissue engineering fields. CMX hydrogels are used for sustained gastrointestinal, colon targeted, and transdermal delivery of drugs. CMX nanoparticles have been used for targeted delivery of anticancer drugs to tumor cells. CMX hydrogels have already made significant strides in drug delivery and tissue engineering fields. Further understanding of the physicochemical properties and rheological characteristics of CMX would enable researchers to explore newer applications of CMX. This review article thus aims to discuss the synthesis, physicochemical properties, and rheological characteristics of CMX. The article also gives critical insights on the versatility of CMX as a drug delivery carrier and presents prospective trends on applications of CMX.

H-ras-targeted genetic therapy remarkably surpassed docetaxel treatment in inhibiting chemically induced hepatic tumors in rats

AIMS

Hepatocellular carcinoma (HCC) is still a leading cause of cancer-related death worldwide. But its chemotherapeutic options are far from expectation. We here compared H-ras targeted genetic therapy to a commercial docetaxel formulation (DXT) in inhibiting HCC in rats.

MAIN METHODS

After the physicochemical characterization of phosphorothioate-antisense oligomer (PS-ASO) against H-ras mutated gene, the PS-ASO-mediated in vitro hemolysis, in vivo hepatic uptake, its pharmacokinetic profile, tissue distribution in some highly perfused organs, its effect in normal rats, antineoplastic efficacy in carcinogen-induced HCC in rats were evaluated and compared against DXT treatment. Mutated H-ras expression by in situ hybridization, hep-par-I, CK-7, CD-15, p53 expression patterns by immunohistochemical methods, scanning electron microscopic evaluation of hepatic architecture, various hepatic marker enzyme levels and caspase-3/9 apoptotic enzyme activities were also carried out in the experimental rats.

KEY FINDINGS

PS-ASO showed low in vitro hemolysis (<3 %), and had a sustained PS-ASO blood residence time in vivo compared to DTX, with a time-dependent hepatic uptake. It showed no toxic manifestations in normal rats. PS-ASO distribution was although initially less in the lung than liver and kidney, but at 8 h it accumulated more in lung than kidney. Antineoplastic potential of PS-ASO (treated for 6 weeks) excelled in inhibiting chemically-induced tumorigenesis compared to DTX in rats, by inhibiting H-ras gene expression, some immonohistochemical modulations, and inducing caspase-3/9-mediated apoptosis. It prevented HCC-mediated lung metastatic tumor in the experimental rats.

SIGNIFICANCE

PS-ASO genetic therapy showed potential to inhibit HCC far more effectively than DXT in rats.

Effect of intragranular/extragranular tara gum on sustained gastrointestinal drug delivery from semi-IPN hydrogel matrices

The present research was undertaken to develop semi-IPN hydrogel matrix tablets of tara gum (TG) and carboxymethyl TG (CMTG) for sustained gastrointestinal delivery of highly water soluble tramadol hydrochloride (TH). The matrix tablets were developed by a hybrid process of wet granulation and direct compression technique. Carboxymethyl TG was crosslinked with dual cross-linking ions (Al3+/Ca2+). The uncross-linked component of the semi-IPN matrix was either incorporated within the granules (intragranular TG) or incorporated outside the granules (extragranular TG), prior to compression. The effect of intragranular/extragranular TG on the swelling, erosion and TH release characteristics from the semi-IPN hydrogel matrix tablets was investigated. The key finding of the investigation indicated that intragranular TG expedited TH release, while extragranular TG sustained TH release. Moreover, the effect of cross-linking ions on viscosity, rigidity, cross-link density and TH release behavior from hydrogel matrices was investigated. In-vivo pharmacokinetic performance of the optimized extragranular TG semi-IPN hydrogel matrix (F15) indicated sustained TH release in gastrointestinal milieu.

Carboxymethylated Gums and Derivatization: Strategies and Significance in Drug Delivery and Tissue Engineering

Natural polysaccharides have been widely exploited in drug delivery and tissue engineering research. They exhibit excellent biocompatibility and fewer adverse effects; however, it is challenging to assess their bioactivities to that of manufactured synthetics because of their intrinsic physicochemical characteristics. Studies showed that the carboxymethylation of polysaccharides considerably increases the aqueous solubility and bioactivities of inherent polysaccharides and offers structural diversity, but it also has some limitations that can be resolved by derivatization or the grafting of carboxymethylated gums. The swelling ratio, flocculation capacity, viscosity, partition coefficient, metal absorption properties, and thermosensitivity of natural polysaccharides have been improved as a result of these changes. In order to create better and functionally enhanced polysaccharides, researchers have modified the structures and properties of carboxymethylated gums. This review summarizes the various ways of modifying carboxymethylated gums, explores the impact that molecular modifications have on their physicochemical characteristics and bioactivities, and sheds light on various applications for the derivatives of carboxymethylated polysaccharides.

Al3+/Ca2+ cross-linked hydrogel matrix tablet of etherified tara gum for sustained delivery of tramadol hydrochloride in gastrointestinal milieu

Tara gum (TG) was derivatized to carboxymethyl TG (CMTG) and then cross-linked with Al³⁺/Ca²⁺ ions to prepare Al/Ca cross-linked CMTG matrices for sustained delivery of Tramadol Hydrochloride (TH), a highly water-soluble drug. The effect of Al³⁺/Ca²⁺ ions concentration on swelling, erosion, and drug release behavior from Al/Ca-CMTG matrices was investigated. Al-CMTG matrices had greater cross-linking density, produced a more rigid and denser hydrogel layer than Ca-CMTG matrices. The rate of swelling, erosion, and in vitro drug release from Al-CMTG matrices was slower than from Ca-CMTG matrices. The most important finding of our study indicated that at the same concentration of cross-linking ions, the release of TH from Al-CMTG matrices was slower compared to Ca-CMTG matrices. The optimized formulation containing 9 % w/w AlCl₃ in CMTG matrices released TH in a sustained manner up to 12 h in the gastrointestinal milieu. Moreover, it was observed that the prepared optimized formulation exhibited a more sustained release of TH compared to the marketed product.

A review on challenges and issues with carboxymethylation of natural gums: The widely used excipients for conventional and novel dosage forms

Diverse properties of natural gums have made them quite useful for various pharmaceutical applications. However, they suffer from various problems, including unregulated hydration rates, microbial degradation, and decline in viscosity during warehousing. Among various chemical procedures for modification of gums, carboxymethylation has been widely studied due to its simplicity and efficiency. Despite the availability of numerous research articles on natural gums and their uses, a comprehensive review on carboxymethylation of natural gums and their applications in the pharmaceutical and other biomedical fields is not published until now. This review outlines the classification of gums and their derivatization methods. Further, we have discussed various techniques of carboxymethylation, process of determination of degree of substitution, and functionalization pattern of substituted gums. Detailed information about the application of carboxymethyl gums as drug delivery carriers has been described. The article also gives a brief account on tissue engineering and cell delivery potential of carboxymethylated gums.

Enhanced Floating and Intragastric Release of 5-Flourouracil through Sesame Oil Entrapped Gellan Composite Hydrogel Beads

Background:

5-Fluorouracil is an anti-metabolite compound used for several years as an anti-tumor drug. The development of a gastroretentive drug delivery system of 5-Fluorouracil may have advantages since they retain in the stomach for an extended time and release the drug in a sustained manner, which ultimately enhances the absorption of the drug and consequently the bioavailability.

Objective:

The objective of the present work was to prepare a sesame oil-entrapped gellan gum hydrogel bead for controlled stomach specific delivery of 5-Fluorouracil.

Methods:

Sesame oil-entrapped gellan gum hydrogel bead was prepared by ionotropic gelation method. The developed hydrogels were characterized by SEM, FTIR, DSC, and XRD. The entrapment efficiency, floating ability, swelling and drug release in vitro were also determined.

Results:

Electrostatic interaction between the carboxylic group of polymers and Ca++ was confirmed by FTIR analysis. The SEM photograph of the hydrogel beads portrayed an approximately spherical shaped structure. DSC thermogram and XRD spectra exhibited the molecular dispersion of the drug inside the hydrogel beads. The developed beads of 5-Fluorouracil floated in pH 1.2 buffer solutions for a prolonged time period and the duration of floating was improved significantly with increasing the concentration of oil. The developed formulations showed controlled release of drug and incorporation of oil retarded the release of the drug. Fickian and non-Fickian mechanism of drug transport was observed from the prepared hydrogel beads.

Conclusion:

Overall, the oil-entrapped gellan matrices could be used for the intragastric delivery of 5-Fluorouracil to treat stomach cancer.

Moringa gum and its modified form as a potential green polymer used in biomedical field

Over the past few decades, natural gums are extensively investigated by the researchers due to their beneficial physicochemical properties. Among them, the polysaccharide exudates obtained from the stem of the plant Moringa oleifera, known as moringa gum, is investigated widely in the food, pharmaceutical, and other areas. The moringa gum is used in the form of dried powder as a pharmaceutical excipient in various formulations. It is also derivatized either by grafting or by other chemical modifications for enhancing its properties. The research on moringa gum and modified moringa gum has diversified in numerous biomedical fields. However, summarization of these progress are not available in the literature. This article gives an overview of the collection, purification, structural elucidation, and modification of moringa gum. Moreover, the present review furnishes complete information on the various aspects of moringa gum and its applications in various industrial and biomedical fields.

Formulation and Characterization of Solid Dispersion Containing Capsaicin for the Treatment of Diabetes

Background:

Chili peppers are widely used in many cuisines as a spice, and capsaicin is the main component. It has been reported that capsaicin acts as an antihyperglycemic agent. However, it shows poor aqueous solubility and bioavailability.

Objective:

The is to enhance the aqueous solubility and antihyperglycemic activity of capsaicin through solid dispersion formulation.

Methods:

Solid dispersions were prepared by the solvent evaporation method using polyethylene glycol 6000 (PEG 6000) as a hydrophilic carrier. Polymer-drug miscibility and drug crystallinity were characterized through the differential thermal analysis and X-ray powder patterns analysis. Solid dispersions were evaluated for solubility, in vitro drug dissolution and in vivo animal study in rats.

Results:

Results of x-ray powder patterns analysis showed a considerable reduction of drug crystallinity in solid dispersion. Differential thermal analysis result revealed a complete disappearance of capsaicin melting onset temperature in solid dispersion. From the phase solubility data, it was observed that the aqueous solubility of capsaicin was increased with increasing concentration of PEG 6000. Solid dispersion formulation showed considerable enhancement of in vitro release of drugs in comparison to pure capsaicin. In vivo animal study in rats shows that the solid dispersion containing capsaicin significantly reduced the blood glucose level in comparison to the free capsaicin.

Conclusion:

Higher anti-hyperglycemic effect of capsaicin loaded solid dispersion in comparison to the pure drug may be due to the enhancement of aqueous solubility of capsaicin. Thus, the solid dispersion of capsaicin showed a simple approach for capsaicin delivery with improved antidiabetic activity.

Xyloglucan as green renewable biopolymer used in drug delivery and tissue engineering

Xyloglucan is a mucoadhesive polysaccharide which is extracted from the cell wall of vascular plants. Tamarind seeds are the abundant source of xyloglucan and commercially more popular. It is biocompatible, biodegradable, and nontoxic in nature. It is approved by the FDA for use as a food additive, stabilizing and thickening agent or gelling agent. Recently, many researchers are giving attention to xyloglucan for drug delivery through various routes and regeneration of the number of tissues. However, the findings of tissue regeneration and drug delivery in combination are not collected and represented in a simple and comprehensive way. The aim of this review is to find and represent these missing links. This review presents current researches on xyloglucan in drug delivery and regeneration of tissue.

Breaking the Barrier of Cancer through Papaya Extract and their Formulation

Background:

In the last decade, many new avenues of cancer treatment have opened up but the costs of treatment have sky-rocketed too. Hence, screening of indigenously available plant and animal resources for anti-carcinogenic potential is an important branch of anticancer research. The effort has been made through this comprehensive review to highlight the recent developments of anticancer therapies using different parts of papaya plant extract.

Methods:

In search of the naturally existing animals and plants for anticarcinogenic potential, papaya plant has been exploited by the scientist working in this research field. A widespread literature search was performed for writing this review.

Results:

Different constituents of Carica papaya responsible for anticancer activities have been discussed. Papaya extract for the treatment of breast, liver, blood, pancreas, skin, prostate, and colon cancer have also been reported. Finally, the various formulation approach using Carica papaya extract have been highlighted.

Conclusion:

The information provided in this review might be useful for researchers in designing of novel formulation of Carica papaya extract for the treatment of cancer.

Current Status of Stem Cell Therapies in Tissue Repair and Regeneration

Tissue engineering is a multi-disciplinary field such as material science, life science, and bioengineering that are necessary to make artificial tissue or rejuvenate damaged tissue. Numerous tissue repair techniques and substitute now exist even though it has several shortcomings; these shortcomings give a good reason for the continuous research for more acceptable tissue-engineered substitutes. The search for and use of a suitable stem cell in tissue engineering is a promising concept. Stem cells have a distinctive capability to differentiate and self-renew that make more suitable for cell-based therapies in tissue repair and regeneration. This review article focuses on stem cell for tissue engineering and their methods of manufacture with their application in nerve, bone, skin, cartilage, bladder, cardiac, liver tissue repair and regeneration.

Non-Invasive Extraction of Gabapentin for Therapeutic Drug Monitoring by Reverse Iontophoresis: Effect of pH, Ionic Strength, and Polyethylene Glycol 400 in the Receiving Medium

Background:

Monitoring of plasma concentrations is a necessity for narrow therapeutic index potent drugs. Development of non-invasive methods can save the patients from the trauma of needles and hence is considered as a research priority.

Introduction:

Gabapentin, an anti-epileptic drug requires therapeutic monitoring because of its narrow therapeutic index. The objective of the study was to develop a suitable method for the non-invasive extraction of gabapentin for the same.

Methods:

Transdermal reverse iontophoresis was performed using pig ear skin as a barrier membrane. Three compartment iontophoretic cells were used for the extraction study. Extractions were carried out under low intensity electric field (current intensity- 0.5 mA/cm2, electrical field approximately 5 V). The donor compartment was charged with aqueous gabapentin (10 µg/ml in phosphate buffer of pH 7.4). For studying the effect of receiving vehicle (pH, ionic strength, and enhancer) on the extraction efficiency of gabapentin, the two receiver chambers were charged with media having varying concentration of these factors. Drug content was determined by HPLC.

Results:

Compared to other pHs, cumulative extraction of gabapentin at pH 5 was significantly higher at both anode and cathode (p<0.001). At low ionic strength, extraction of gabapentin increased linearly with the increase in concentration of ions up to a certain value but at very high ionic strength the pattern reversed. Similar results were obtained with enhancer (polyethylene glycol 400). Extraction increased with increase in polyethylene glycol 400 up to 3% and then decreased.

Conclusion:

Extraction flux can be optimized by manipulation of the receiver media.

Development of Capsaicin Loaded Hydrogel Beads for In vivo Lipid Lowering Activities of Hyperlipidemic Rats

Objective:

The presence of capsaicin in the diet has been revealed to enhance energy expenditure and it has been used in anti-obesity therapy. The present work investigated the potential antihyperlipidemic effect of capsaicin loaded hydrogel beads on hyperlipidemic rats. Hydrogels are three dimensional, hydrophilic, polymeric networks capable of imbibing large amounts of water or biological fluids.

Methods:

Capsaicin loaded hydrogel beads were prepared by the ionotropic gelation method using Aluminium Chloride (AlCl₃) as a cross-linking agent. The characterization of hydrogel beads was carried out by X-ray Diffraction (XRD), Differential Scanning Calorimetry (DSC), and Scanning Electron Microscopic (SEM) analysis.

Results:

The surface morphology revealed that the prepared beads were spherical in shape. XRD and DSC study of the hydrogel beads revealed that the drug was homogeneously dispersed in the hydrogel matrix. The beads showed pH sensitive behavior and when the medium pH was changed from 1.2 to 7.4, the capsaicin release was considerably increased. 100mg/kg body weight of Triton was injected intraperitoneally in rats to induce hyperlipidemia and it showed elevated levels of serum cholesterol and triglyceride. Capsaicin loaded hydrogel beads were administered to normal and hyperlipidemic rats for 7 days and the prepared hydrogel beads were significantly reduced high lipid profile in comparison to free capsaicin.

Conclusion:

The results clearly demonstrated that hydrogel beads can be used as a potential carrier for delivery of capsaicin to reduce lipid profile.

An in vitro study to compare the influence of different all-ceramic systems on the polymerization of dual-cure resin cement

Aim:

The aim of the study is to compare the effect of composition of three different all-ceramic systems on the polymerization of dual-cure resin cement, using different curing cycles and evaluated immediately within 15 min and after 24 h.

Materials and Methods:

Resin cement disc samples were fabricated by polymerization through three different all-ceramic disc, namely: lithium disilicate discs – IPS e.max (Group B), leucitereinforced discs – IPS Empress (Group C), zirconia discs – Cercon (Group D), and without an intervening ceramic disc, as control (Group A). A total of 80 resin cement disc samples were fabricated for fur groups (n = 20). Each group further consisted of two subgroups (n = 10), t10 and t20 according to two different exposure times of 10 and 20 s, respectively. Each of the 80 resin disc samples was evaluated for their degree of polymerization achieved, by measuring the microhardness(Vickers hardness number) of the samples immediately within 15 min and after 24 h, giving us a total of 160 readings. Oneway analysis of variance test, ttest, and paired ttest were used for multiple group comparisons followed by Tukey's post hoc for groupwise comparison.

Results:

Direct activation of the resin cement samples of control (Group A) showed statistically significant higher mean microhardness values followed by Groups C then B and D, both immediately and after 24 h. The mean microhardness for immediate post-activation was always inferior to the 24 h post-activation test. For both 10 and 20 s curing cycle, there was a significant increase in the microhardness of the resin cement discs cured for 20 s through the different ceramics.

Conclusion:

Ceramic composition affected the polymerization of dual cured resin cement. Doubling the light irradiation time or curing cycle significantly increased mean microhardness value. Greater degree of conversion leading to an increase in hardness was observed when the resin cement discs were evaluated after 24 h.

Extraction of levetiracetam for therapeutic drug monitoring by transdermal reverse iontophoresis

Recently, transdermal reverse iontophoresis across the skin has been investigated as a novel technology for the purpose of diagnosis as well as therapeutic drug monitoring. Accordingly, the objective of this study was to investigate ex vivo and in vivo transdermal extraction of levetiracetam, an antiepileptic drug, across the pig ear skin by reverse iontophoresis. Reverse iontophoresis experiments were performed using three chambered diffusion cells. Extractions profiles were generated in phosphate buffers at different current intensities, pH and ionic strength as well donor drug concentrations. This was followed by ex vivo extraction in gels and in vivo extractions using New Zealand rabbits. Results indicate that levetiracetam was extracted at both anode and cathode. Flux values were unaffected by increase in current intensities (0.5 mA and 0.6 mA) but affected by pH and ionic strength. Neither in cathodal nor in anodal extraction, flux values did show a proportional relationship with the donor drug concentration. At low and medium concentration levels, flux values did not show any major change but the extraction flux at high donor concentration was much higher. In contrast, in vivo experiment with rabbits resulted in wide variation of fluxes with very high fluxes recorded at the cathodal end. Reasons attributed to this difference may include lower current intensity, and species variation. The most significant finding of this study is that measurable amounts of the levetiracetam were extracted at both the ends indicating its feasibility for non-invasive drug monitoring.

Transdermal reverse iontophoresis: A novel technique for therapeutic drug monitoring

Application of transdermal reverse iontophoresis for diagnostic purpose is a relatively new concept but its short span of research is full of ups and downs. In early nineties, when the idea was floated, it received a dubious welcome by the scientific community. Yet to the disbelief of many, 2001 saw the launching of GlucoWatch® G2 Biographer, the first device that could measure the blood sugar level noninvasively. Unfortunately, the device failed to match the expectation and was withdrawn in 2007. However, the concept stayed on. Research on reverse iontophoresis has diversified in many fields. Numerous in vitro and in vivo experiments confirmed the prospect of reverse iontophoresis as a noninvasive tool in therapeutic drug monitoring and clinical chemistry. This review provides an overview about the recent developments in reverse iontophoresis in the field of therapeutic drug monitoring.

Recent expansions in an emergent novel drug delivery technology: Emulgel

Emulgel is an emerging topical drug delivery system to which if more effort is paid towards its formulation & development with more number of topically effective drugs it will prove a boon for derma care & cosmetology. Emulgels are either emulsion of oil in water or water in oil type, which is gelled by mixing it with gelling agent. Incorporation of emulsion into gel increases its stability & makes it a dual control release system. Due to lack of excess oily bases & insoluble excipients, it shows better drug release as compared to other topical drug delivery system. Presence of gel phase makes it a non greasy & favors good patient compliance. These reviews give knowledge about Emulgel including its properties, advantages, formulation considerations, and its recent advances in research field. All factors such as selection of gelling agent, oil agent, emulsifiers influencing the stability and efficacy of Emulgel are discussed. All justifications are described in accordance with the research work carried out by various scientists. These brief reviews on formulation method have been included. Current research works that carried out on Emulgel are also discussed and highlighted the wide utility of Emulgel in topical drug delivery system. After the vast study, it can be concluded that the Emulgels appear better & effective drug delivery system as compared to other topical drug delivery system. The comprehensive analysis of rheological and release properties will provide an insight into the potential usage of Emulgel formulation as drug delivery system.

Biodegradable IPN hydrogel beads of pectin and grafted alginate for controlled delivery of diclofenac sodium

A novel diclofenac sodium (DS) loaded interpenetrating polymer network (IPN) beads of pectin and hydrolyzed polyacrylamide-graft-sodium alginate (PAAm-g-SA) was developed through ionotropic gelation and covalent cross-linking. The graft copolymer was synthesized by free radical polymerization under the nitrogen atmosphere followed by alkaline hydrolysis. The grafting, alkaline hydrolysis, and characterization of beads were confirmed by Fourier transforms infrared spectroscopy. The crystalline structure of drug after encapsulation into IPN beads were evaluated by differential scanning colorimetry and X-ray diffraction analyses. DS encapsulation was up to 96.45 %. The effect of hydrolyzed graft copolymer/pectin ratios and glutaraldehyde concentration on drug release in acidic and phosphate buffer solutions were investigated. The release of drug was significantly increased with increase of pH. The release of drug depends on the extent of cross-linking. The results indicated that IPN beads of hydrolyzed PAAm-g-SA and pectin could be used for sustained release of DS.

Advancement in stimuli triggered in situ gelling delivery for local and systemic route

INTRODUCTION

Current research efforts focused on the design and evaluation of drug delivery systems that are easy to administer require decreased administration frequency, and provide sustained drug release in order to increase clinical efficacy and compliance of the patients. The gel forming smart polymeric formulations offer numerous applications resemble sustained and prolonged action in contrast to conventional drug delivery systems.

AREAS COVERED

Article summarizes type of bioactive, sol-gel triggering factors, dose, rationales, and polymers involved in gelation with respect to their route of administration. A lot of work has been done with smart polymeric gelling system taking the advantage of stimuli (temperature and pH) triggered sol-gel phase-transition in the administered area that have great prospective in biomedical and pharmaceutical applications, particularly in target-specific controlled drug delivery systems.

EXPERT OPINION

Although the principle of gelation is so attractive, key issues remain to be solved which include (i) variability of the drug release, (ii) avoidance of burst release in case of depot formulation, and (iii) issues related to toxicity. Unfortunately, till now area concerning the detailed processes of the gelling formation is still not much explored. Despite this proclamation, many efforts are made in industry and institutions to improve concerned approaches. New materials and approaches enter the preclinical and clinical phases and one can be sure that this strategy will gain further clinical importance within the next years. Thus, this review article will assuredly serve as an informative tool for the innovators working in the concern area.

Prospects of pharmaceuticals and biopharmaceuticals loaded microparticles prepared by double emulsion technique for controlled delivery

Several methods and techniques are potentially useful for the preparation of microparticles in the field of controlled drug delivery. The type and the size of the microparticles, the entrapment, release characteristics and stability of drug in microparticles in the formulations are dependent on the method used. One of the most common methods of preparing microparticles is the single emulsion technique. Poorly soluble, lipophilic drugs are successfully retained within the microparticles prepared by this method. However, the encapsulation of highly water soluble compounds including protein and peptides presents formidable challenges to the researchers. The successful encapsulation of such compounds requires high drug loading in the microparticles, prevention of protein and peptide degradation by the encapsulation method involved and predictable release, both rate and extent, of the drug compound from the microparticles. The above mentioned problems can be overcome by using the double emulsion technique, alternatively called as multiple emulsion technique. Aiming to achieve this various techniques have been examined to prepare stable formulations utilizing w/o/w, s/o/w, w/o/o, and s/o/o type double emulsion methods. This article reviews the current state of the art in double emulsion based technologies for the preparation of microparticles including the investigation of various classes of substances that are pharmaceutically and biopharmaceutically active.

Protein S Thr103Asn mutation associated with type II deficiency reproduced in vitro and functionally characterised

Protein S functions as a cofactor to activated protein C (APC) in the degradation of FVa and FVIIIa. In protein S, the thrombin sensitive region (TSR) and the first EGF-like domain are important for expression of the APC cofactor activity. A naturally occurring Thr103Asn (T103N) mutation in the first EGF-like domain of protein S has been associated with functional (type II) protein S deficiency. To elucidate the functional consequences of the T103N mutation, recombinant protein S mutant was expressed in mammalian cells and functionally characterised. The expression level of protein S T103N from transiently transfected COS 1 cells was equal to that of wild type protein S. The mutant protein S and wild type protein S were also expressed in 293 cells after stable transfection, and the recombinant proteins purified. In APTT- and PT-based coagulation assays, the mutant protein demonstrated approximately 50% lower anticoagulant activity as compared to wild type protein S. The functional defect was further investigated in FVa- and FVIIIa-degradation assays. The functional defect of mutant protein S was attenuated at increasing concentrations of APC. The results demonstrate the region around residue 103 of protein S to be of functional importance, possibly through a direct interaction with APC.

Deficient APC-cofactor activity of protein S Heerlen in degradation of factor Va Leiden: a possible mechanism of synergism between thrombophilic risk factors

In protein S Heerlen, an S-to-P (single-letter amino acid codes) mutation at position 460 results in the loss of glycosylation of N458. This polymorphism has been found to be slightly more prevalent in thrombophilic populations than in normal controls, particularly in cohorts of patients having free protein S deficiency. This suggests that carriers of the Heerlen allele may have an increased risk of thrombosis. We have now characterized the expression in cell cultures of recombinant protein S Heerlen and investigated the anticoagulant functions of the purified recombinant protein in vitro. Protein S Heerlen was synthesized and secreted equally well as wild-type protein S by transiently transfected COS-1 cells. The recombinant protein S Heerlen interacted with conformation-dependent monoclonal antibodies and bound C4b-binding protein to the same extent as wild-type protein S. Protein S Heerlen displayed reduced anticoagulant activity as cofactor to activated protein C (APC) in plasma-based assays, as well as in a factor VIIIa-degradation system. In contrast, protein S Heerlen functioned equally well as an APC cofactor in the degradation of factor Va as wild-type protein S did. However, when recombinant activated factor V Leiden (FVa:Q506) was used as APC substrate, protein S Heerlen was found to be a poor APC cofactor as compared with wild-type protein S. These in vitro results suggest a possible mechanism of synergy between protein S Heerlen and factor V Leiden that might be involved in the pathogenesis of thrombosis in individuals carrying both genetic traits. (Blood. 2000;96:523-531)

In vitro characterisation of two naturally occurring mutations in the thrombin-sensitive region of anticoagulant protein S

The molecular consequences of two naturally occurring mutations in the thrombin-sensitive region of protein S were investigated using a combination of recombinant protein expression, functional analysis and molecular modelling. Both mutations (R49H and R70S) have been found in thrombosis patients diagnosed as having type I protein S deficiency. Molecular modelling analysis suggested the R49H substitution not to disrupt the structure of thrombin-sensitive region, whereas the R70S substitution could affect the 3D structure mildly. To elucidate the molecular consequences of these substitutions experimentally, site directed mutagenesis of protein S cDNA and expression in mammalian cells created the two mutants. The secretion profiles and functional anticoagulant activities of the protein S mutants were characterised. Secretion of the R49H mutant was similar to that of wild type protein S, whereas the R70S mutant showed moderately decreased expression. Neither of the mutants showed any major functional defects as cofactors to activated protein C (APC) in an APTT-based assay or in degradation of factor Va. However, both mutants demonstrated decreased activity in a factor VIIIa degradation assay, which in addition to APC and protein S also included factor V as synergistic APC cofactor. In conclusion, the R49H substitution did not produce a quantitative abnormality in vitro, raising doubts as to whether it caused the type I deficiency. In contrast, the experimental data obtained for the R70S mutant agrees well with the observed type I deficiency. Our study illustrates that in vitro experimental characterisation together with computer-based structural analysis are useful tools in the analysis of the relationship between naturally occurring mutations and clinical phenotypes.

Topological studies of the amino terminal modules of vitamin K-dependent protein S using monoclonal antibody epitope mapping and molecular modeling

Protein S is an important anticoagulant protein acting as cofactor to activated protein C (APC) in the degradation of membrane-bound factors Va and VIIIa. Binding of protein S to the membrane depends on the Gla-domain, whereas sites for APC-interaction are located in the thrombin-sensitive region (TSR) and the first EGF domain. The aims of the present investigation were to localize the sites on protein S which are involved in APC-cofactor function and to elucidate possible orientations of the TSR in relation to the membrane. For these purposes, we determined the epitope for a calcium-dependent monoclonal antibody (HPS67) against the TSR, which inhibits APC cofactor activity even though it does not impede protein S binding to the membrane. HPS67 did not recognize wild-type mouse protein S but gained reactivity against a recombinant mouse protein in which G49 and R52 were mutated to R and Q (found in human protein S), respectively, suggesting these two residues to be part of a surface exposed epitope for HPS67. This information helped in the validation and refinement of the structural model for the Gla-TSR-EGF1-modules of protein S. The X-ray structure of a Fab-fragment mimicking HPS67 was docked onto the protein S model. The observation that HPS67 did not inhibit phospholipid binding of protein S has implications for the possible orientation of protein S on the membrane surface. In the proposed model for membrane-bound protein S, there is no contact between the TSR and the membrane. Rather, the TSR is free to interact with membrane-bound APC.

A new direct, fast and quantitative enzyme-linked ligandsorbent assay for measurement of free protein S antigen

A new method to determine the concentration of free protein S in plasma is described. It is an enzyme-linked ligandsorbent assay (ELSA) which utilises the protein S binding capacity of the natural ligand C4b-binding protein (C4BP) to capture the free protein S from plasma samples. The use of C4BP as ligand in the assay is possible due to the high affinity (Kd = 0.1 nM) of the interaction between protein S and C4BP and to a slow rate of complex dissociation. A monoclonal antibody (HPS 54) was conjugated with horseradish peroxidase and used as target antibody. This antibody recognises a Ca2+ dependent epitope in the first EGF-like domain of protein S and does not interfere with C4BP binding sites of protein S. Addition of calcium in the assay helped prevent dissociation of the C4BP-protein S-HPS 54 complex. Three different experiments demonstrated the assay to be specific for free protein S. First, near-identical dose response curves were obtained with protein S in plasma and with purified protein S. Second, addition of purified C4BP to normal plasma resulted in loss of free protein S. Third, protein S depleted plasma gave zero values and around 80% of purified protein S added to protein S depleted plasma, and approximately 70% of protein S added to protein S deficient plasma samples, was recovered with the assay. The assay is fast (involves only a single incubation step of 30 min), sensitive and the range of measurement is 3% to 200% of free protein S when plasma dilution 1:20 represents 100%. Intra- and inter-assay coefficients of variation at two levels were 2.3-4.3% and 5.1-7.4%, respectively. In a large protein S deficient family, the assay showed 100% sensitivity and specificity for the causative mutation. Moreover, free protein S levels in anticoagulated protein S deficient patients were completely separated from those obtained in non-anticoagulated controls. The new assay for free protein S is suitable for automation and it provides a useful means for routine clinical purposes to detect protein S deficiencies.

Spectrum of clinical and laboratory characteristics of HIV infection in northern India

To define the impact of HIV infection in India, the clinical and laboratory profile and the correlation of CD4 count to the likely opportunistic infection in a cohort of 134 HIV positive patients in Northern India was analysed. Majority of the patients, 72% and 67.8% (children and adults respectively) were asymptomatic, having been detected during routine screening and maintained that status for a median follow-up period of 3 years. Among the symptomatic patients, oropharyngeal candidiasis was the most common opportunistic infection followed closely by tuberculosis (both pulmonary and extra pulmonary) around 3.6-4.0 years from probable HIV infection with a median CD4 of 420-578 per cmm. Infection with Cryptococcosis, Cryptosporidiosis and cytomegalovirus occurred only after a significant fall in CD4 to < 100/cmm usually around 8-10 years from probable HIV infection. Pneumocystis carinii pneumonia was the terminal event among the 12 deaths at a mean CD4 count of 6/cmm. Non specific constitutional symptoms like fever, prolonged diarrhoea and significant weight loss were frequent. In general, the clinical profile of Indian patients with HIV bears much resemblance to African countries owing perhaps to the similar background of poverty, malnutrition and endemic infection.

Sociodemographic characteristics of HIV infection in northern India

134 patients testing positive for HIV antibody during the period 1986-1993 were included in the present study. An in-depth analysis of the subjects revealed that the adult males seemed to have the highest propensity for HIV infection in this part of the country. Marital status had no bearing on incidence and route of seropositivity. This was not so in females. Extramarital heterosexual contact was the mode of HIV acquisition in adults in contrast to blood transfusion in children. Clinically, most of these patients were still asymptomatic. At presentation, oral Candidiasis was common. Pneumocystis carinii pneumonia (PCP) was the leading cause of death.

Profile of HLA-B27-related 'unclassifiable' seronegative spondyloarthropathy in females and its comparison with the profile in males

Unclassifiable seronegative spondyloarthropathy (SSA) syndrome is primarily considered to be an affliction of males. In this report from northern India, 25 HLA-B27 antigen positive females with this condition are described and compared with 39 HLA-B27-positive males with the same disease. All these patients presented with typical features of spondyloarthropathy such as predominantly lower limb synovitis, enthesopathy and inflammatory spinal pain. The onset was insidious in 56% of the females and in 64% of the males. The mean age of onset as also the mean duration of symptoms prior to diagnosis were significantly higher in females (26.2 vs 19.4 yr and 8 vs 2 yr, respectively). A mono- or oligo-arthritis was seen in 52% of the females and in 53% of the males, but the average number of joints involved was less in females (4.8 vs 7.7). Lower limb joints alone were involved in 56% of the females and 49% of the males, with the knees, ankles and hips being most commonly involved, often asymmetrically. The mean degree of symmetry was significantly lower in females (62 vs 76). Ninety-two per cent of females and 74% of males had inflammatory spinal pain. Radiographic sacroiliitis was demonstrable in 56% females and 74% males. It is concluded that 'unclassifiable' SSA syndrome is not infrequent in females but is diagnosed late. Fewer joints tend to be involved and there is greater tendency towards asymmetry in females.