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Rapidly dissolving microneedle patch of amphotericin B for intracorneal fungal infections. Drug Deliv Transl Res 2022; 12:931-943. [PMID: 34302273 PMCID: PMC8888497 DOI: 10.1007/s13346-021-01032-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 12/29/2022]
Abstract
Chronic fungal infection of the cornea could lead to blindness if not treated properly. Topical amphotericin B (AMP-B) is considered the first treatment of choice for ocular fungal infection. However, factors related to its poor solubility and penetration through intact cornea lead to poor bioavailability. Microneedles (MNs) are emerging as a minimally invasive method to enhance ocular drug delivery. This study aims to investigate the potential use of biodegradable poly(vinylpyrrolidone) (PVP) and hyaluronic acid (HA)-based rapidly dissolving MNs for delivery of AMP-B to treat fungal infection. The data obtained illustrates PVP/HA MN arrays' reproducibility, good mechanical strength, and faster dissolution with 100% drug recovery. Multiphoton microscopic results revealed that MNs successfully penetrate the corneal tissue and enhance AMP-B permeation through corneal layers. Furthermore, PVP/HA MN arrays showed high solubility. Both PVP and HA successfully decreased AMP-B cytotoxicity when compared to free drug. More interestingly, the biocompatible MN formulations preserved the antifungal activity of AMP-B, as demonstrated by significant inhibition of fungal growth. Therefore, this study shows the feasibility of ocular delivery of the poorly soluble AMP-B using a fast-dissolving MN patch.
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2
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Preclinical Pharmacokinetics Study of Amphamide: a New Semisynthetic Antifungal Antibiotic. Pharm Chem J 2020. [DOI: 10.1007/s11094-020-02165-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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3
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Tan JSL, Roberts C, Billa N. Pharmacokinetics and tissue distribution of an orally administered mucoadhesive chitosan-coated amphotericin B-Loaded nanostructured lipid carrier (NLC) in rats. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2019; 31:141-154. [DOI: 10.1080/09205063.2019.1680926] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Janet Sui Ling Tan
- School of Pharmacy, The University of Nottingham, Malaysia, Semenyih, Selangor, Malaysia
| | - Clive Roberts
- School of Pharmacy, The University of Nottingham, Nottingham, UK
| | - Nashiru Billa
- School of Pharmacy, The University of Nottingham, Malaysia, Semenyih, Selangor, Malaysia
- College of Pharmacy, Qatar University, Doha, Qatar
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Ghorbani M, Farhoudi R. Leishmaniasis in humans: drug or vaccine therapy? DRUG DESIGN DEVELOPMENT AND THERAPY 2017; 12:25-40. [PMID: 29317800 PMCID: PMC5743117 DOI: 10.2147/dddt.s146521] [Citation(s) in RCA: 198] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Leishmania is an obligate intracellular pathogen that invades phagocytic host cells. Approximately 30 different species of Phlebotomine sand flies can transmit this parasite either anthroponotically or zoonotically through their bites. Leishmaniasis affects poor people living around the Mediterranean Basin, East Africa, the Americas, and Southeast Asia. Affected regions are often remote and unstable, with limited resources for treating this disease. Leishmaniasis has been reported as one of the most dangerous neglected tropical diseases, second only to malaria in parasitic causes of death. People can carry some species of Leishmania for long periods without becoming ill, and symptoms depend on the form of the disease. There are many drugs and candidate vaccines available to treat leishmaniasis. For instance, antiparasitic drugs, such as amphotericin B (AmBisome), are a treatment of choice for leishmaniasis depending on the type of the disease. Despite the availability of different treatment approaches to treat leishmaniasis, therapeutic tools are not adequate to eradicate this infection. In the meantime, drug therapy has been limited because of adverse side effects and unsuccessful vaccine preparation. However, it can immediately make infections inactive. According to other studies, vaccination cannot eradicate leishmaniasis. There is no perfect vaccine or suitable drug to eradicate leishmaniasis completely. So far, no vaccine or drug has been provided to induce long-term protection and ensure effective immunity against leishmaniasis. Therefore, it is necessary that intensive research should be performed in drug and vaccine fields to achieve certain results.
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Affiliation(s)
- Masoud Ghorbani
- Department of Viral Vaccine Production, Pasteur Institute of Iran, Research and Production Complex, Karaj, Iran
| | - Ramin Farhoudi
- Department of Viral Vaccine Production, Pasteur Institute of Iran, Research and Production Complex, Karaj, Iran
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5
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Patere SN, Pathak PO, Kumar Shukla A, Singh RK, Kumar Dubey V, Mehta MJ, Patil AG, Gota V, Nagarsenker MS. Surface-Modified Liposomal Formulation of Amphotericin B: In vitro Evaluation of Potential Against Visceral Leishmaniasis. AAPS PharmSciTech 2017; 18:710-720. [PMID: 27222025 DOI: 10.1208/s12249-016-0553-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 05/12/2016] [Indexed: 11/30/2022] Open
Abstract
Surface modification of liposomes with targeting ligands is known to improve the efficacy with reduced untoward effects in treating infective diseases like visceral leishmaniasis (VL). In the present study, modified ligand (ML), designed by modifying polysaccharide with a long chain lipid was incorporated in liposomes with the objective to target amphotericin B (Amp B) to reticuloendothelial system and macrophages. Conventional liposomes (CL) and surface modified liposomes (SML) were characterized for size, shape, and entrapment efficiency (E.E.). Amp B SML with 3% w/w of ML retained the vesicular nature with particle size of ∼205 nm, E.E. of ∼95% and good stability. SML showed increased cellular uptake in RAW 264.7 cells which could be attributed to receptor-mediated endocytosis. Compared to Amp B solution, Amp B liposomes exhibited tenfold increased safety in vitro in RAW 264.7 and J774A.1 cell lines. Pharmacokinetics and biodistribution studies revealed high t 1/2, area under the curve (AUC)0-24, reduced clearance and prolonged retention in liver and spleen with Amp B SML compared to other formulations. In promastigote and amastigote models, Amp B SML showed enhanced performance with low 50% inhibitory concentration (IC50) compared to Amp B solution and Amp B CL. Thus, due to the targeting ability of ML, SML has the potential to achieve enhanced efficacy in treating VL.
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6
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Gupta PK, Jaiswal AK, Asthana S, Teja B V, Shukla P, Shukla M, Sagar N, Dube A, Rath SK, Mishra PR. Synergistic enhancement of parasiticidal activity of amphotericin B using copaiba oil in nanoemulsified carrier for oral delivery: an approach for non-toxic chemotherapy. Br J Pharmacol 2015; 172:3596-610. [PMID: 25825339 DOI: 10.1111/bph.13149] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 03/19/2015] [Accepted: 03/25/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND PURPOSE The aim of this study was to devise a nanoemulsified carrier system (CopNEC) to improve the oral delivery of amphotericin B (AmB) by increasing its oral bioavailability and synergistically enhance its antileishmanial activity with copaiba oil (Cop). EXPERIMENTAL APPROACH The AmB encapsulated NEC (CopNEC-AmB) comprised of Cop, d-α-tocopheryl polyethylene glycol 1000 succinate and phosphatidylcholine was prepared by high-pressure homogenization method. Stability study of CopNEC-AmB was carried out in simulated gastric fluid and simulated intestinal fluid. The CopNEC-AmB and plain AmB were compared as regards their in vitro antileishmanial activity, pharmacokinetics, organ distribution and toxicity. KEY RESULTS The optimal CopNEC-AmB had a small globule size, low polydispersity index, high ζ potential and encapsulation efficiency. The high resolution transmission electron microscopy illustrated spherical particle geometry with homogeny in their sizes. The optimal CopNEC-AmB was found to be stable in gastrointestinal fluids showing insignificant changes in globule size and encapsulation efficiency. The AUC0-48 value of CopNEC-AmB in rats was significantly improved showing 7.2-fold higher oral bioavailability than free drug. The in vitro antileishmanial activity of CopNEC-AmB was significantly higher than that of the free drug as Cop synergistically enhanced the antileishmanial effect of AmB by causing drastic changes in the morphology of Leishmania parasite and rupturing its plasma membrane. The CopNEC-AmB showed significantly less haemolytic toxicity and cytotoxicity and did not change the histopathology of kidney tissues as compared with AmB alone. CONCLUSIONS AND IMPLICATIONS This prototype CopNEC formulation showed improved bioavailability and had a non-toxic synergistic effect on the antileishmanial activity of AmB.
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Affiliation(s)
- Pramod K Gupta
- Pharmaceutics Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow, India
| | - Anil K Jaiswal
- Parasitology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow, India
| | - Shalini Asthana
- Pharmaceutics Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow, India
| | - Venkatesh Teja B
- Pharmaceutics Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow, India
| | - Prashant Shukla
- Pharmaceutics Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow, India
| | - Minakshi Shukla
- Parasitology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow, India
| | - Neeti Sagar
- Toxicology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow, India
| | - Anuradha Dube
- Parasitology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow, India
| | - Srikanta K Rath
- Toxicology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow, India
| | - Prabhat R Mishra
- Pharmaceutics Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow, India
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7
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Souza ACO, Nascimento AL, de Vasconcelos NM, Jerônimo MS, Siqueira IM, R-Santos L, Cintra DOS, Fuscaldi LL, Pires Júnior OR, Titze-de-Almeida R, Borin MF, Báo SN, Martins OP, Cardoso VN, Fernandes SO, Mortari MR, Tedesco AC, Amaral AC, Felipe MSS, Bocca AL. Activity and in vivo tracking of Amphotericin B loaded PLGA nanoparticles. Eur J Med Chem 2015; 95:267-76. [PMID: 25827397 DOI: 10.1016/j.ejmech.2015.03.022] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 03/11/2015] [Accepted: 03/12/2015] [Indexed: 10/23/2022]
Abstract
The development of biocompatible polymeric nanoparticles has become an important strategy for optimizing the therapeutic efficacy of many classical drugs, as it may expand their activities, reduce their toxicity, increase their bioactivity and improve biodistribution. In this study, nanoparticles of Amphotericin B entrapped within poly (lactic-co-glycolic) acid and incorporated with dimercaptosuccinic acid (NANO-D-AMB) as a target molecule were evaluated for their physic-chemical characteristics, pharmacokinetics, biocompatibility and antifungal activity. We found high plasma concentrations of Amphotericin B upon treatment with NANO-D-AMB and a high uptake of nanoparticles in the lungs, liver and spleen. NANO-D-AMB exhibited antifungal efficacy against Paracoccidioides brasiliensis and induced much lower cytotoxicity levels compared to D-AMB formulation in vivo and in vitro. Together, these results confirm that NANO-D-AMB improves Amphotericin B delivery and suggest this delivery system as a potential alternative to the use of Amphotericin B sodium deoxycholate.
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Affiliation(s)
- A C O Souza
- Biology Institute, University of Brasília, DF, Brazil
| | | | | | - M S Jerônimo
- Biology Institute, University of Brasília, DF, Brazil
| | - I M Siqueira
- Biology Institute, University of Brasília, DF, Brazil
| | - L R-Santos
- Faculty of Agronomy and Veterinary Medicine, University of Brasília, DF, Brazil
| | - D O S Cintra
- Biology Institute, University of Brasília, DF, Brazil
| | - L L Fuscaldi
- Biotechnology Department, Health Sciences Faculty, University of Brasília, DF, Brazil
| | | | - R Titze-de-Almeida
- Faculty of Agronomy and Veterinary Medicine, University of Brasília, DF, Brazil
| | - M F Borin
- Biotechnology Department, Health Sciences Faculty, University of Brasília, DF, Brazil
| | - S N Báo
- Biology Institute, University of Brasília, DF, Brazil
| | - O P Martins
- Chemistry Department of FFCLRP, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - V N Cardoso
- Pharmacy Department, Federal University of Minas Gerais, MG, Brazil
| | - S O Fernandes
- Pharmacy Department, Federal University of Minas Gerais, MG, Brazil
| | - M R Mortari
- Biology Institute, University of Brasília, DF, Brazil
| | - A C Tedesco
- Chemistry Department of FFCLRP, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - A C Amaral
- Biotechnology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, GO, Brazil.
| | - M S S Felipe
- Biology Institute, University of Brasília, DF, Brazil; Genomic Science and Biotechnology Post-Graduate Program, Catholic University of Brasília, DF, Brazil
| | - A L Bocca
- Biology Institute, University of Brasília, DF, Brazil
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8
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Gupta PK, Jaiswal AK, Asthana S, Verma A, Kumar V, Shukla P, Dwivedi P, Dube A, Mishra PR. Self Assembled Ionically Sodium Alginate Cross-Linked Amphotericin B Encapsulated Glycol Chitosan Stearate Nanoparticles: Applicability in Better Chemotherapy and Non-Toxic Delivery in Visceral Leishmaniasis. Pharm Res 2014; 32:1727-40. [DOI: 10.1007/s11095-014-1571-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 11/10/2014] [Indexed: 01/09/2023]
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9
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Gupta PK, Asthana S, Jaiswal AK, Kumar V, Verma AK, Shukla P, Dwivedi P, Dube A, Mishra PR. Exploitation of Lectinized Lipo-Polymerosome Encapsulated Amphotericin B to Target Macrophages for Effective Chemotherapy of Visceral Leishmaniasis. Bioconjug Chem 2014; 25:1091-102. [DOI: 10.1021/bc500087h] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Pramod K. Gupta
- Pharmaceutics and ‡Parasitology
Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector 10, Jankipuram Extension,
Sitapur Road, Lucknow, India 226031
| | - Shalini Asthana
- Pharmaceutics and ‡Parasitology
Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector 10, Jankipuram Extension,
Sitapur Road, Lucknow, India 226031
| | - Anil K. Jaiswal
- Pharmaceutics and ‡Parasitology
Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector 10, Jankipuram Extension,
Sitapur Road, Lucknow, India 226031
| | - Vivek Kumar
- Pharmaceutics and ‡Parasitology
Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector 10, Jankipuram Extension,
Sitapur Road, Lucknow, India 226031
| | - Ashwni K. Verma
- Pharmaceutics and ‡Parasitology
Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector 10, Jankipuram Extension,
Sitapur Road, Lucknow, India 226031
| | - Prashant Shukla
- Pharmaceutics and ‡Parasitology
Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector 10, Jankipuram Extension,
Sitapur Road, Lucknow, India 226031
| | - Pankaj Dwivedi
- Pharmaceutics and ‡Parasitology
Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector 10, Jankipuram Extension,
Sitapur Road, Lucknow, India 226031
| | - Anuradha Dube
- Pharmaceutics and ‡Parasitology
Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector 10, Jankipuram Extension,
Sitapur Road, Lucknow, India 226031
| | - Prabhat R. Mishra
- Pharmaceutics and ‡Parasitology
Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector 10, Jankipuram Extension,
Sitapur Road, Lucknow, India 226031
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10
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Mohamed-Ahmed AHA, Seifert K, Yardley V, Burrell-Saward H, Brocchini S, Croft SL. Antileishmanial activity, uptake, and biodistribution of an amphotericin B and poly(α-Glutamic Acid) complex. Antimicrob Agents Chemother 2013; 57:4608-14. [PMID: 23796924 PMCID: PMC3811429 DOI: 10.1128/aac.02343-12] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 06/09/2013] [Indexed: 11/20/2022] Open
Abstract
A noncovalent, water-soluble complex of amphotericin B (AMB) and poly(α-glutamic acid) (PGA), with AMB loadings ranging from 25 to 55% (wt/wt) using PGA with a molecular weight range of 50,000 to 70,000, was prepared as a potential new treatment for visceral leishmaniasis (VL). The AMB-PGA complex was shown to be as active as Fungizone (AMB deoxycholate) against intracellular Leishmania donovani amastigotes in differentiated THP-1 cells. The in vitro uptake of the AMB-PGA complex by differentiated THP-1 cells was similar to that of Fungizone and higher than that of AmBisome (liposomal AMB). The AMB-PGA complex also displayed a dose-response profile similar to that of AmBisome in vivo in BALB/c mice against L. donovani, with 50% effective doses (ED50s) of 0.24 ± 0.03 mg/kg of body weight for the AMB-PGA complex and 0.24 ± 0.06 mg/kg for AmBisome. A biodistribution study with mice indicated that the AMB-PGA complex cleared more rapidly from plasma than AmBisome, with a comparable low level of distribution to the kidneys.
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Affiliation(s)
- Abeer H. A. Mohamed-Ahmed
- Department of Pharmaceutics, UCL School of Pharmacy, London, United Kingdom
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Karin Seifert
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Vanessa Yardley
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Hollie Burrell-Saward
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Stephen Brocchini
- Department of Pharmaceutics, UCL School of Pharmacy, London, United Kingdom
| | - Simon L. Croft
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
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11
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Hong Y, Ramzan I, McLachlan AJ. Disposition of amphotericin B in the isolated perfused rat liver. J Pharm Pharmacol 2010; 56:35-41. [PMID: 14979999 DOI: 10.1211/0022357022502] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Abstract
The hepatic disposition and biliary excretion of amphotericin B were investigated in the isolated perfused rat liver (IPRL). Bolus dose of 50 μg, 99 μg and 198 μg amphotericin B in lipoprotein-free perfusate and 198 μg amphotericin B in perfusate with 1 μM high-density lipoprotein (HDL) or 1 μM low-density lipoprotein (LDL) were examined in the IPRL. Amphotericin B concentration in perfusate was measured using a validated HPLC assay. Amphotericin B was eliminated from the perfusate in a biexponential manner. The hepatic clearance (CLH) increased in proportion to the dose administered (0.27±0.05 mL min−1 at low dose, 0.54±0.23 mL min−1 at medium dose and 1.06±0.24 mL min−1 at high dose), indicating non-linear hepatic disposition of amphotericin B. The hepatic extraction ratio of amphotericin B was very low (0.066±0.015). Tissue-to-perfusion partition coefficient, calculated at 120 min, increased 1.5 fold from 9.8±1.7 at low dose to 15.9±6.4 at high dose, suggesting the significant uptake and extensive retention of amphotericin B in the liver. Biliary excretion made only minor contribution to amphotericin B elimination in the IPRL, representing around 1–3% of the dose administered. No metabolites were detected in perfusate, bile and liver samples. The hepatic disposition of amphotericin B was not affected by the presence of HDL and LDL in the perfusate. In conclusion, the hepatic disposition of amphotericin B demonstrates restrictive elimination and is concentration-dependent, consistent with carrier-mediated uptake, and lipoproteins do not influence amphotericin B hepatobiliary disposition.
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Affiliation(s)
- Ying Hong
- Faculty of Pharmacy, University of Sydney, NSW 2006, Australia
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12
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Gershkovich P, Wasan EK, Lin M, Sivak O, Leon CG, Clement JG, Wasan KM. Pharmacokinetics and biodistribution of amphotericin B in rats following oral administration in a novel lipid-based formulation. J Antimicrob Chemother 2009; 64:101-8. [PMID: 19398459 DOI: 10.1093/jac/dkp140] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To assess the pharmacokinetics and biodistribution of amphotericin B (AmB) following oral administration in a novel mono/diglyceride-phospholipid formulation and to compare with intravenous (iv) administrations using commercial formulations. METHODS Rats were allocated into the following treatment groups: oral gavage of AmB dispersed in mono/diglyceride-phospholipid formulation at doses of 4.5 and 10 mg/kg; iv bolus administration of 0.8 mg/kg Fungizone; iv bolus of 5 mg/kg Abelcet and iv bolus of 5 mg/kg AmBisome. Blood was sampled from jugular vein cannula at certain time points. The animals were sacrificed 72 h following administration of AmB and multiple tissues were harvested. The concentration of AmB in plasma and tissues was determined by means of HPLC. The plasma creatinine concentrations were determined using an enzymatic kit. RESULTS The pharmacokinetics and tissue distribution of AmB following iv administrations of the commercial formulations were found to be highly formulation dependent. The terminal half-life and biodistribution of orally administered AmB in a mono/diglyceride-phospholipid formulation resembled those of Fungizone. The larger volume of the co-administered lipid-based formulation in the case of the higher dose of orally administered AmB resulted in flip-flop kinetics and in preferential distribution into the kidneys. No nephrotoxicity was detected for any formulation and route of administration. CONCLUSIONS Oral administration of AmB in a mono/diglyceride-phospholipid formulation to rats resulted in significant intestinal absorption into the systemic circulation with pharmacokinetic and biodistribution properties similar to a micellar iv preparation.
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Affiliation(s)
- Pavel Gershkovich
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC, Canada.
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Espada R, Valdespina S, Dea MA, Molero G, Ballesteros MP, Bolás F, Torrado JJ. In vivo distribution and therapeutic efficacy of a novel amphotericin B poly-aggregated formulation. J Antimicrob Chemother 2008; 61:1125-31. [DOI: 10.1093/jac/dkn048] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Briones E, Colino CI, Lanao JM. Delivery systems to increase the selectivity of antibiotics in phagocytic cells. J Control Release 2007; 125:210-27. [PMID: 18077047 DOI: 10.1016/j.jconrel.2007.10.027] [Citation(s) in RCA: 136] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2007] [Accepted: 10/29/2007] [Indexed: 11/25/2022]
Abstract
Many infectious diseases are caused by facultative organisms that are able to survive in phagocytic cells. The intracellular location of these microorganisms protects them from the host defence systems and from some antibiotics with poor penetration into phagocytic cells. One strategy used to improve the penetration of antibiotics into phagocytic cells is the use of carrier systems that deliver these drugs directly to the target cell. Delivery systems such as liposomes, micro/nanoparticles, lipid systems, conjugates, and biological carriers such as erythrocyte ghosts may contribute to increasing the therapeutic efficacy of antibiotics and antifungal agents in the treatment of infections caused by intracellular microorganisms. The main objective of this review is to analyze recent advances and current perspectives in the use of antibiotic delivery systems in the treatment of intracellular infections such as mycobacterial infections, brucellosis, salmonellosis, listeriosis, fungal infections, visceral leishmaniasis, and HIV.
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Affiliation(s)
- Elsa Briones
- Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain
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15
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Gupta S, Dube A, Vyas SP. Antileishmanial efficacy of amphotericin B bearing emulsomes against experimental visceral leishmaniasis. J Drug Target 2007; 15:437-44. [PMID: 17613662 DOI: 10.1080/10611860701453836] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Amphotericin B (AmB) was formulated in trilaurin-based emulsomes (nanosize lipid particles) stabilized by soya phosphatidylcholine (PC), as a new delivery system for macrophage targeting for the treatment of visceral leishmaniasis (VL). Emulsomes were modified by coating them with macrophage-specific ligand (O-palmitoyl mannan, OPM). The antileishmanial activity of AmB-deoxycholate (AmB-Doc) and emulsome entrapped AmB was tested in vitro in Leishmania donovani infected macrophage-amastigote system (J774A.1 cells), which showed higher efficacy of OPM grafted AmB emulsomes (TLEs-OPM) over plain AmB emulsomes (TLEs) and AmB-Doc. The in vivo antileishmanial activity of the AmB (0.5 mg/kg) was tested in AmB-Doc, TLEs and TLEs-OPM forms against VL in L. donovani infected hamsters. Formulation TLEs-OPM eliminated intracellular amastigotes of L. donovani within splenic macrophages more efficiently (73.7 +/- 6.7% parasite inhibition) than the formulation TLEs (51.7 +/- 5.4% parasite inhibition) (P < 0.01) or AmB-Doc (30.4 +/- 4.8% parasite inhibition) (P < 0.001). Our results suggest that these newer formulations (plain and ligand appended emulsomes) are a promising alternative to the conventional AmB-Doc formulation for the treatment of VL.
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Affiliation(s)
- Swati Gupta
- Drug Delivery Research Laboratory, Department of Pharmaceutical Sciences, Dr Hari Singh Gour Vishwavidyalaya, Sagar, MP, India
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Trocóniz IF, Zsolt I, Garrido MJ, Valle M, Antonijoan RM, Barbanoj MJ. Dealing with time-dependent pharmacokinetics during the early clinical development of a new leukotriene B4 synthesis inhibitor. Pharm Res 2006; 23:1533-42. [PMID: 16783479 DOI: 10.1007/s11095-006-0254-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2005] [Accepted: 02/16/2006] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to explore the possibility of achieving a practical dosing regimen for 2,4,6-triiodophenol (AM-24), a new leukotriene B4 (LTB4) synthesis inhibitor. First, a model capable of dealing with the nonlinearity in its pharmacokinetic profile was built, and then it was combined with a pharmacodynamic model previously established with data from earlier phase I trials. METHODS One week after the first 240-, 350-, or 500-mg oral dose of AM-24, six additional doses were given to 24 healthy volunteers once daily. A total of 33 blood samples were obtained from each individual. Different models, including enzyme turnover models, were fitted to the data by using the software NONMEM. RESULTS Drug absorption was modeled with a first-order process. Drug disposition was described with a one-compartment model, and elimination with an (auto)inhibited and a noninhibited clearance. AM-24 inhibited the enzyme production rate to a maximum of 98%. Relative bioavailability was independent of the decrease in the amount of enzyme. The estimate of the enzyme turnover half-life was 8.5 h. CONCLUSIONS Simulations have shown that steady-state conditions eliciting 90% of maximal LTB4 synthesis inhibition can be reached after 3 weeks during an oral treatment with AM-24 administered at the dosage of 500 mg once daily.
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Affiliation(s)
- Iñaki F Trocóniz
- Departmento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de Navarra, Pamplona, Spain
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17
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Yang YL, Cheng HH, Lo HJ. In vitro activity of voriconazole against Candida species isolated in Taiwan. Int J Antimicrob Agents 2005; 24:294-6. [PMID: 15325436 DOI: 10.1016/j.ijantimicag.2004.01.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2003] [Accepted: 01/09/2004] [Indexed: 11/21/2022]
Abstract
The activity of voriconazole was determined against 285 Candida species consisting of 53 resistant isolates, 43 susceptible-dose dependent and 189 isolates susceptible to fluconazole. The MIC(50) and MIC(90) to fluconazole were 8 and 64 mg/l, respectively. The range of minimum inhibitory concentrations (MICs) to voriconazole was from 0.0325 to 2 mg/l and the MIC(50) and MIC(90) were 0.125 and 0.5 mg/l, respectively. Only 3 of 285 tested isolates had MICs to voriconazole equal to 2 mg/l. A total of 38 isolates, consisted of 3 Candida albicans, 5 Candida krusei, 7 Candida tropicalis and 21 Candida glabrata, had >/= 0.5 mg/l to voriconazole. There was correlation between the susceptibility to fluconazole and voriconazole.
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Affiliation(s)
- Yun-Liang Yang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan, ROC
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18
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Doubek M, Mayer J, Lauschova I, Scheer P, Krejcirova L, Horky D, Doubek J. Comparison of the effect of amphotericin B desoxycholate and amphotericin B colloidal dispersion on renal functions and renal morphology in rats. Nephrology (Carlton) 2005; 10:57-62. [PMID: 15705183 DOI: 10.1111/j.1440-1797.2005.00339.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM Amphotericin B (AmB) desoxycholate remains as one of the most efficacious agents currently available for the treatment of systemic fungal infections; however, amphotericin B colloidal dispersion (ABCD) has been developed because of AmB desoxycholate nephrotoxicity. The goal of our study was to compare the effect of administration of AmB desoxycholate and ABCD on renal functions and renal morphology in rats. RESULTS Amophotericin B desoxycholate as well as ABCD causes damage to renal tubuli and polyuria. Amophotericin desoxycholate causes considerably more severe damage to tubuli than ABCD, but the morphological damage to renal glomeruli is minimal in both formulas. In tubular cells, AmB desoxycholate causes severe damage to mitochondria, vacuolation of cytoplasm, and increased values of volume density of peroxisomes. CONCLUSION None of these formulas causes a decrease in glomerular filtration in rats when animals are properly hydrated.
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Affiliation(s)
- Michael Doubek
- Department of Internal Medicine - Haematology/Oncology, University Hospital, 62500 Brno, Czech Republic.
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19
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Dea-Ayuela MA, Rama-Iñiguez S, Sánchez-Brunete JA, Torrado JJ, Alunda JM, Bolás-Fernández F. Anti-leishmanial activity of a new formulation of amphotericin B. Trop Med Int Health 2004; 9:981-90. [PMID: 15361111 DOI: 10.1111/j.1365-3156.2004.01296.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The effectiveness of albumin microspheres loaded with amphotericin B was tested in an in vivo model of visceral leishmaniasis using the golden hamster. Free and encapsulated amphotericin B was tested at the dose of 1 mg/kg given by the intracardiac route on days 25, 26 and 27 post-infection (p.i.) to treat animals previously infected with 10(7) stationary promastigotes by the intracardiac route. Encapsulated amphotericin was highly effective against infection causing a reduction of 88.8% and 87.2% in the early stage of infection (day 32 p.i.) and of 66.7% and 54% in a later stage of infection (day 135 p.i.) in liver and spleen parasite load respectively, compared with untreated animals, whereas free amphotericin was inactive. Lymphocyte proliferation was restored together with an increase in CD4(+) subsets in animals treated with encapsulated amphotericin B, but not in those treated with the non-encapsulated compound. Antibody responses did not increase after treatment with encapsulated amphotericin B with antibody levels remaining at base levels for most animals in contrast to those of untreated or treated with free amphotericin, where in most animals the antibody levels sharply increased. This new formulation could be a more economical alternative to liposomes for the treatment of visceral leishmaniasis with amphotericin B.
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Affiliation(s)
- M A Dea-Ayuela
- Departamento de Parasitología, Universidad Complutense, Madrid, Spain.
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20
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Sánchez-Brunete JA, Dea MA, Rama S, Bolás F, Alunda JM, Raposo R, Méndez MT, Torrado-Santiago S, Torrado JJ. Treatment of experimental visceral leishmaniasis with amphotericin B in stable albumin microspheres. Antimicrob Agents Chemother 2004; 48:3246-52. [PMID: 15328080 PMCID: PMC514726 DOI: 10.1128/aac.48.9.3246-3252.2004] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2004] [Revised: 04/26/2004] [Accepted: 05/24/2004] [Indexed: 11/20/2022] Open
Abstract
Hydrophilic albumin microspheres are proposed as a new delivery system for amphotericin B (AMB; AMB microspheres). The acute toxicity of AMB microspheres was lower than that of the AMB-deoxycholate (AMB-Doc) reference formulation in hamsters. Lethal doses in healthy and infected animals were improved at least eight times. Intravenous bolus administration of doses of AMB microspheres up to 40 mg/kg of body weight did not produce acute symptoms of toxicity. The efficacy of this new formulation was tested against Leishmania infantum-infected hamsters at doses of 2, 10, 20, and 40 mg/kg. With the 2-mg/kg dose, the activity of AMB, as assessed through the parasite load reductions in the liver and spleen and the evolution of antibody levels, was also improved (P < 0.05) by use of the AMB microsphere system. At the higher doses of 10, 20, and 40 mg/kg, reductions in parasite levels of more than 99% were achieved in the liver and spleen after the administration of AMB microspheres. A pharmacokinetic study was performed to study the serum, liver, and spleen AMB concentrations after administration of AMB microspheres and the reference formulation. Interestingly, a significant accumulation of AMB in the spleen and liver was observed after AMB microsphere administration. Our results suggest that this new formulation is a promising alternative to the conventional AMB-Doc formulation for the treatment of visceral leishmaniasis.
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Affiliation(s)
- J A Sánchez-Brunete
- Department of Pharmacy and Pharmaceutical Technology, Universidad Complutense, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
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Segarra I, Movshin DA, Zarif L. Pharmacokinetics and tissue distribution after intravenous administration of a single dose of amphotericin B cochleates, a new lipid-based delivery system. J Pharm Sci 2002; 91:1827-37. [PMID: 12115810 DOI: 10.1002/jps.10173] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Model independent pharmacokinetic analysis of intravenous (iv) amphotericin B cochleates (CAMB), a new lipid-based drug delivery system, in mice (0.625 mg/kg) shows a two-phase disposition profile in blood [area under the curve of concentration versus time from time zero to infinity (AUC(0-infinity)) = 1.01 microg. h/mL, half-life (t((1/2))) = 11.68 h, volume of distribution at steady state (V(ss)) = 9.59 L/kg, clearance (CL) = 10.36 mL/min/kg and mean residence time from time 0 to infinity (MRT(0-infinity)) = 15.41 h). In target tissues, maximum time (t(max)) ranged from 2 min (spleen and lung) to 10 min (liver) and lungs presented the highest AMB concentration (16.4 microg. h/g) followed by liver (8.56 microg/g), and spleen (6.63 microg/g). In addition, liver and spleen presented the longest elution half-life (75.03 and 66.71 h, respectively), MRT(0-infinity) (98.4 and 86.3 h, respectively), and AMB exposure:liver AUC(0-infinity) = 474 and 116.4 microg. h/g for the spleen. The large V(ss) and the extensive tissue AUC indicate large and efficient ability of cochleates to penetrate and deliver AMB. Differences in tissue uptake mechanism and pharmacokinetic data suggest a crucial role of macrophages in CAMB clearance from blood as well as an essential role of the liver and the spleen in AMB distribution to target tissues.
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Affiliation(s)
- Ignacio Segarra
- BioDelivery Sciences International, Department of Biopharmacy and Pharmacokinetics, UMDNJ, New Jersey Medical School, 185 South Orange Avenue, Building 4, Newark 07103, USA
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Abstract
Amphotericin B (AmB) is considered the drug of choice for the treatment of systemic fungal infections. Nephrotoxicity is a major complication associated with its use, and appears to be related to higher cumulative doses, diuretic use, abnormal serum creatinine at baseline, and the use of concomitant nephrotoxic drugs. The two major hypotheses for the pathogenesis of AmB-related nephrotoxicity are direct effects of the drug on epithelial cell membranes and vasoconstriction. During the last few years, some randomized trials have tested different strategies to reduce AmB-induced renal toxicity. These strategies include sodium supplementation, low-dose dopamine, slower infusion rates, the administration of AmB in lipid emulsions, and in lipid formulations. The results of these trials showed that the lipid formulations of AmB significantly reduce nephrotoxicity. Unfortunately, these agents are costly, restricting their use to patients with a high risk of developing renal failure.
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Affiliation(s)
- S Costa
- Grupo de Controle de Infecção Hospitalar, Departamento de Doenças Infecciosas e Parasitárias, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
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Abstract
The relentless increase of invasive fungal infections and poor outcomes associated with available antifungal agents prompted the search for better therapeutic strategies. Combining antifungal drugs was recommended as a means to enhance efficacy in a variety of invasive infections including cryptococcosis, candidiasis, and aspergillosis. With the exception of cryptococcal meningitis, data from controlled clinical trials supporting such combinations are sparse. Moreover, little consensus exists regarding which combinations are synergistic or antagonistic in vitro and in vivo. Based on available data, several principles underlie these combinations.
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Affiliation(s)
- R E Lewis
- Department of Clinical Sciences and Administration, University of Houston College of Pharmacy Texas Medical Center, 77030-4095, USA
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