Lymphatic targeting of anti-HIV nucleosides: distribution of 2',3'-dideoxyinosine after intravenous and oral administration of dipalmitoylphosphatidyl prodrug in mice

Self-assembled drug delivery systems: Part 3. In vitro/in vivo studies of the self-assembled nanoparticulates of cholesteryl acyl didanosine

Self-assembled drug delivery systems (SADDS) are defined as the self-assemblies of amphiphilic prodrugs, integrating prodrugs, molecular self-assembly and nanotechnology for drug targeting and controlled release. Cholesteryl-succinyl didanosine (CSD) and cholesteryl-adipoyl didanosine (CAD) nanoparticulate systems in water were previously prepared and optimized. In this paper, the in vitro and in vivo behavior of them was investigated. Precipitation occurred when they were mixed with acid solutions due to rapid production of hypoxanthine and subsequent disruption of supramolecular structures. They showed pH-dependent degradation and kept relatively stable in the neutral pH range. CSD is more stable than CAD due to the shorter spacer and poloxamer protection. CSD showed different degradation rates in various plasma with the descending order of rat, mouse, rabbit, dog and human. The half-life (t(1/2)) of CSD is 9 days in rat plasma, and 5.9 days in rat liver homogenates. CAD has a faster degradation than CSD though the t(1/2) in rat liver homogenates is long to 23 h. CSD nanoparticulates showed no significant anti-HIV effect in MT4 cell model because of very slow degradation. CSD nanoparticulates showed the distribution t(1/2) of 7.6 min after bolus intravenous (i.v.) administration to rats, and the site-specific distribution in liver, lung and spleen with the high t(1/2) of 10 days in liver. The factors affecting achievement of successful SADDS are discussed.

Prodrug and antedrug: two diametrical approaches in designing safer drugs

The prodrug and antedrug concepts, which were developed to overcome the physical and pharmacological shortcomings of various therapeutic classes of agents, employ diametrically different metabolic transformations. The prodrug undergoes a predictable metabolic activation prior to exhibiting its pharmacological effects in a target tissue while the antedrug undergoes metabolic deactivation in the systemic circulation upon leaving a target tissue. An increased therapeutic index is the aspiration for both approaches in designing as well as evaluation criteria. The recent research endeavors of prodrugs include the gene-directed and antibody-directed enzymatic activation of a molecule in a targeted tissue, organ specific delivery, improved bioavailabilities of nucleosides and cellular penetration of nucleotides. As for antedrugs, emphasis in research has been based upon the design and synthesis of systemically inactive molecule by incorporating a metabolically labile functional group into an active molecule.

Improved uptake and retention of lipophilic prodrug to improve treatment of HIV

Dideoxynucleosides currently in use for anti-HIV therapy have been found to be inefficient in passing through the blood-brain barrier to enter and maintain therapeutic drug levels in brain, a very significant reservoir of HIV. The low bioavailability of these drugs combined with the bone marrow toxicity of AZT (3'-azido, 3'-deoxythymidine, Zidovudine), resulting in anemia and leukopenia, pancreatitis with ddI (2',3'-dideoxyinosine, Didanosine) and painful peripheral neuropathy in case of ddC (2',3-dideoxycytosine, Zalcitabine) are the limiting factors in their use. In addition, the emergence of strains of HIV resistant to AZT, the most commonly used drug, further restricts its use. Thus the control of AIDS and its complications, needs special therapeutic approaches to combat the disease. In order to overcome these limitations, AZT and ddI have been synthesized as ester-linked ceramide- and phosphatidylcholine-linked prodrugs possessing therapeutic attributes lacking in the parent compounds. There is greater uptake and longer retention of these prodrugs in NIH/3T3 cells in vitro. Pretreatment with our prodrugs blocked infection of these cells by Moloney murine leukemia virus (M-MuLV) for an extended period, which the parent drugs failed to do. When human CD4+ HeLa cells were continuously exposed to the AZT prodrug, subsequent infection of these cells by HIV was blocked. Similar results were obtained with NIH/3T3 cells exposed to M-MuLV. AE(6)C, a prodrug of AZT linked to ceramide via a cleavable ester bond and a six carbon linker, was less toxic to both mouse and human bone marrow progenitor cells than free AZT. Most significantly, the prodrugs concentration was greater and the retention longer, in well known sanctuaries for HIV, such as the brain, testes and thymus.

Development and optimization of anti-HIV nucleoside analogs and prodrugs: A review of their cellular pharmacology, structure-activity relationships and pharmacokinetics

Significant improvements in antiviral therapy have been realized over the past 10 years. Numerous nucleoside analogs, as well as prodrugs of active compounds, have been synthesized and tested for anti-HIV activity. In addition to the five nucleoside analogs currently used clinically for the treatment of HIV infection, a broad spectrum of anti-HIV nucleoside analogs (including 2',3'-dideoxynucleoside analogs, oxathiolanyl 2',3'-dideoxynucleoside analogs, dioxolanyl 2',3'-dideoxynucleoside analogs, carbocyclic 2',3'-dideoxynucleoside analogs and acyclic nucleoside analogs) and their prodrugs (including ester prodrugs, phospholipid prodrugs, dihydropyridine prodrugs, pronucleotides and dinucleotide analogs), targeted at HIV reverse transcriptase, are reviewed with focus on structure-activity relationships, cellular pharmacology and pharmacokinetics. Several of these anti-viral agents show promise in the treatment of AIDS.