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Lackovic M, Nikolic D, Milicic B, Dimitrijevic D, Jovanovic I, Radosavljevic S, Mihajlovic S. Pre-Pregnancy Obesity and Infants' Motor Development within the First Twelve Months of Life: Who Is Expected to Be the Ultimate Carrier of the Obesity Burden? Nutrients 2024; 16:1260. [PMID: 38732507 PMCID: PMC11085635 DOI: 10.3390/nu16091260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/28/2024] [Accepted: 04/11/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION Pre-pregnancy obesity is a significant public health concern with profound implications for maternal and child health. The burgeoning evidence suggests that maternal obesity prior to conception is intricately linked with an increased risk of gestational complications, as well as with adverse neonatal outcomes. Furthermore, the long and short-term health of offspring, including the risk of early motor development impairment, obesity, and metabolic syndrome in childhood and adulthood, may be adversely affected as well. Addressing pre-pregnancy obesity is critical for improving overall maternal and child health outcomes, and therefore, the aim of this study was to evaluate the connections linking pre-pregnancy obesity with infants' motor development within the first twelve months of infants' lives. MATERIAL AND METHODS This study included 200 mother-infant pairs divided into two groups based on their pre-pregnancy body mass index values. To assess infants' early motor development, we used the Alberta Infant Motor Scale (AIMS) and evaluated the parameters of infants' early motor development at the ages of three, six, nine, and twelve months. RESULTS Pre-pregnancy overweight/obesity was significantly associated with excessive gestational weight gain (p < 0.001), fetal macrosomia (p = 0.022), and a family history of diabetes and cardiovascular diseases (p = 0.048 and p = 0.041, respectively), as well as with all observed parameters of early motor development at the ages of three, six, nine, and twelve months: AIMS 3 months total (p < 0.001), AIMS 6 months total (p < 0.001), AIMS 9 months total (p < 0.001), and AIMS 12 months total (p < 0.001). Furthermore, pre-pregnancy overweight/obesity was a significant predictor for AIMS 6 months total (p = 0.043) and AIMS 6 months supination (p = 0.017). CONCLUSIONS Pre-pregnancy obesity is a critical determinant of pregnancy outcomes and offspring early motor development, with possible far-reaching implications for children's long-term well-being. Addressing this issue requires a comprehensive approach that includes preconception weight management, targeted interventions during the pregnancy and postpartum periods, and ongoing research to better understand the underlying mechanisms and develop effective strategies for prevention and management.
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Affiliation(s)
- Milan Lackovic
- Department of Obstetrics and Gynecology, University Hospital “Dragisa Misovic”, Heroja Milana Tepica 1, 11000 Belgrade, Serbia;
| | - Dejan Nikolic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (D.D.)
- Department of Physical Medicine and Rehabilitation, University Children’s Hospital, 11000 Belgrade, Serbia
| | - Biljana Milicic
- Department of Medical Statistics, Faculty of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Dejan Dimitrijevic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (D.D.)
- Clinic for Gynecology and Obstetrics “Narodni Front”, 11000 Belgrade, Serbia;
| | - Ivona Jovanovic
- Clinic for Gynecology and Obstetrics “Narodni Front”, 11000 Belgrade, Serbia;
| | - Sofija Radosavljevic
- Department of Radiology, University Hospital “Dragisa Misovic”, Heroja Milana Tepica 1, 11000 Belgrade, Serbia
| | - Sladjana Mihajlovic
- Department of Obstetrics and Gynecology, University Hospital “Dragisa Misovic”, Heroja Milana Tepica 1, 11000 Belgrade, Serbia;
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (D.D.)
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Rovcanin M, Jankovic S, Mikovic Z, Sipetic Grujicic S, Ersk IRB, Lackovic M, Dimitrijevic D, Simanic S, Vujcic I. The Translation and Cross-Cultural Adaptation of the Pregnancy Physical Activity Questionnaire: Validity and Reliability of a Serbian Version (PPAQ-SRB). Healthcare (Basel) 2022; 10:healthcare10081482. [PMID: 36011143 PMCID: PMC9408768 DOI: 10.3390/healthcare10081482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/25/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
Exercise during pregnancy has a positive effect on the health of both pregnant women and their fetuses. This study aimed to translate the Pregnancy Physical Activity Questionnaire (PPAQ) into the Serbian language and assess its validity and reliability among Serbian pregnant women. The study was conducted between October 2020 and March 2021 at the Obstetrics and Gynecology Clinic (Narodni Front), in Belgrade, Serbia. The PPAQ was translated according to a standardized methodology, and its internal consistency and construct and concurrent validity were assessed. The mean PPAQ score for the total amount of physical activity was 37.72 MET-h/week−1. Exploratory factor analysis of the Serbian PPAQ identified six factors similar to the original questionnaire that explained 70.26% of the data variance. The Cronbach’s alpha coefficient of the Serbian version of the PPAQ was 0.69. The two-week intraclass correlation coefficient (ICC) scores ranged from 0.768 to 0.930. We tested the evidence to assess the concurrent validity of the Serbian version of PPAQ (PPAQ-SRB) correlations with the International Physical Activity Questionnaire-long form (IPAQ-LF), and all domains of the PPAQ were significantly correlated with domains of the IPAQ-LF. The findings of our reliability and validity evaluation are consistent with those of prior studies, indicating that the PPAQ was successfully translated and implemented in the Serbian population and that its reliability was acceptable.
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Affiliation(s)
- Marija Rovcanin
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Svetlana Jankovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Zeljko Mikovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Sandra Sipetic Grujicic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26, 11000 Belgrade, Serbia
| | - Ivana Rudic Biljic Ersk
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Milan Lackovic
- Clinical Hospital Center, Dr Dragiša Mišović, Heroja MilanaTepica 1, 11000 Belgrade, Serbia
| | - Dejan Dimitrijevic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Sara Simanic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Isidora Vujcic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26, 11000 Belgrade, Serbia
- Correspondence: ; Tel.: +381-11-3607-061
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Dimitrijevic D. Sentinel surveillance of Severe Acute Respiratory Infections in Serbia in 2018–2019 influenza season. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Lackovic M, Filimonovic D, Mihajlovic S, Milicic B, Filipovic I, Rovcanin M, Dimitrijevic D, Nikolic D. The Influence of Increased Prepregnancy Body Mass Index and Excessive Gestational Weight Gain on Pregnancy Course and Fetal and Maternal Perinatal Outcomes. Healthcare (Basel) 2020; 8:healthcare8040362. [PMID: 32987862 PMCID: PMC7711986 DOI: 10.3390/healthcare8040362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 11/29/2022] Open
Abstract
Background: The aim of our study was to assess the influence of prepregnancy Body Mass Index (BMI) changes as well as excessive gestational weight gain (GWG) on maternal and fetal perinatal parameters. Furthermore, we aimed to analyze the influence of increased prepregnancy BMI values and excessive GWG on neonatal early motoric development. Methods: The 203 eligible female participants were evaluated. Prepregnancy Body Mass Index (BMI) and excessive gestational weight gain (GWG) defined according to Institute of Medicine 2009 guidelines in the USA were assessed with tested maternal and fetal perinatal parameters and infants early motoric development (Alberta Infant Motor Scale—AIMS). Results: Significant predictors of increased prepregnancy BMI in perinatal period include: weight at delivery (p = 0.001), GWG (p = 0.002) and BMI at delivery (p < 0.001), while significant predictors of excessive GWG in perinatal period are: prepregnancy BMI (p = 0.029) and BMI at delivery (p < 0.001). In the group of participants with both increased prepregnancy BMI and excessive GWG versus others, significant predictors were: hypertension (HTA) (p = 0.019), amniotic fluid index (AFI) (p = 0.047), Pronation (AIMS) (p = 0.028) and Supination (AIMS) (p = 0.029). Conclusion: Increased prepregnancy BMI and excessive GWG are significantly associated with numerous perinatal factors that could alter the pregnancy course, pregnancy outcome and early motoric development of newborn. Moreover, increased prepregnancy BMI is shown to be a significant predictor of excessive GWG; thus, early selection of pregnant women for close monitoring of weight gain during pregnancy will have positive effects on reducing the risk of less favorable pregnancy course and early motoric development of newborn.
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Affiliation(s)
- Milan Lackovic
- Clinical Hospital Center “Dr. Dragiša Mišović”, 11000 Belgrade, Serbia; (M.L.); (S.M.); (I.F.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.F.); (M.R.); (D.D.)
| | - Dejan Filimonovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.F.); (M.R.); (D.D.)
- Obstetrics/Gynecology Clinic “Narodni front”, 11000 Belgrade, Serbia
| | - Sladjana Mihajlovic
- Clinical Hospital Center “Dr. Dragiša Mišović”, 11000 Belgrade, Serbia; (M.L.); (S.M.); (I.F.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.F.); (M.R.); (D.D.)
| | - Biljana Milicic
- Faculty of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Ivana Filipovic
- Clinical Hospital Center “Dr. Dragiša Mišović”, 11000 Belgrade, Serbia; (M.L.); (S.M.); (I.F.)
| | - Marija Rovcanin
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.F.); (M.R.); (D.D.)
- Obstetrics/Gynecology Clinic “Narodni front”, 11000 Belgrade, Serbia
| | - Dejan Dimitrijevic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.F.); (M.R.); (D.D.)
- Obstetrics/Gynecology Clinic “Narodni front”, 11000 Belgrade, Serbia
| | - Dejan Nikolic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.F.); (M.R.); (D.D.)
- Physical Medicine and Rehabilitation Department, University Children’s Hospital, Tirsova 10, 11000 Belgrade, Serbia
- Correspondence:
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Mihajlovic S, Vasiljevic M, Jurisic A, Kisic-Tepavcevic D, Dimitrijevic D, Nejkovic L. Predictive value of transvaginal ultrasound score for detection of endometrial malignancy. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog3068.2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Dimitrijevic D, Vasiljevic M, Anicic R, Brankovic S, Ristic A, Devic A. Recurrence rate of ovarian endometriosis in patients treated with laparoscopic surgery and postoperative suppressive therapy. CLIN EXP OBSTET GYN 2015. [DOI: 10.12891/ceog1946.2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Dimitrijevic D, Vasiljevic M, Anicic R, Brankovic S, Ristic A, Devic A. Recurrence rate of ovarian endometriosis in patients treated with laparoscopic surgery and postoperative suppressive therapy. CLIN EXP OBSTET GYN 2015; 42:339-343. [PMID: 26152006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION The testing represented a prospective study that was performed at the Gynaecology and Obstetrics Clinic "Narodni Front" in Belgrade during a two-year period. The study encompassed female patients with ovarian endometrioma operated with laparoscopic surgery. The research objective was to determine the percentage of occurrence of relapses in patients operated for endometriosis of the ovary in relation to the stage of the disease and the type of performed operation, and which were receiving suppressive therapy with gonadotropin-releasing hormone (GnRH) analogues after the surgery compared to those who were not receiving suppressive therapy after the operation. MATERIALS AND METHODS The recurrence of endometriosis on the ovary of the test and control groups was monitored during the first year after surgery. In all patients ultrasound checks were done every month during the first six months after surgery, and then every three months for the next six months. In all patients in whom the recurrence, i.e. endometrioma on the ovary larger than three cm was revealed postoperatively by ultrasound, the laparoscopic removal of the endometrioma was performed again as well as the histopathological examination of the material. RESULTS AND CONCLUSION There was no statistically significant difference in the distribution of recurrence of endometriosis between the groups formed according to the type of surgical technique (cystectomy or cystotomy). The recurrence of endometriosis occurred later in the group of patients in which the treatment GnRH analogues was applied after the surgical treatment. The recurrence of endometriosis in more severe stages (Stage III and IV) occurs later in the group of patients in which the treatment GnRH analogues is applied after the surgical treatment.
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Dimitrijevic D, Vasiljevic M, Anicic R, Brankovic S. Comparison of hysterosonography and hysteroscopy for diagnosing perimenopausal bleeding. CLIN EXP OBSTET GYN 2013; 40:246-249. [PMID: 23971251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This investigation was a prospective study performed at the Gynecological Clinic "Narodni Front" in Belgrade. In the investigated group, endometrial hyperplasia, endometrial polyp, and myoma were diagnosed as the most frequent causes of bleeding during perimenopause. The test group of patients was then subjected to hysterosonography in order to diagnose bleeding etiology, followed by hysteroscopy to confirm its etiology based on hysterosonography. Material was sent for histopathological analysis to definitely confirm the diagnosis. The aim of this study was to the compare the findings of hysterosonography and hysteroscopy to evaluate the sensitivity and efficacy of hysterosonography for diagnosing the etiology of uterine bleeding in perimenopausal women. In the diagnostics of submucosal myoma, endometrial hyperplasia, and endometrial polyps, hysterosonography has proven to be a good screening method. By its use for diagnosing intracavitary uterine pathology, and thus also the pathology of bleeding in perimenopausal women, in many cases hysteroscopy can be avoided. This is a method that is easy to perform, less invasive, less costly to perform, and is well-tolerated.
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Affiliation(s)
- D Dimitrijevic
- Clinic of Gynecology and Obstetrics "Narodni Front", Belgrade, Serbia.
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Anicic R, Djukic M, Rakic S, Vasiljevic M, Dimitrijevic D, Milicevic S. Evaluation of utero-ovarian hemodynamics in relation to fertility and stage of endometriosis. CLIN EXP OBSTET GYN 2012; 39:526-528. [PMID: 23444760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The aim of this study was to compare hemodynamic changes in the uterine and ovarian arteries between infertile women with moderate and/or severe endometriosis and healthy women. In this prospective study, 99 women in their generative age were subjected to color Doppler ultrasonography to measure hemodynamic parameters from July 2010 to January 2011. The examination was performed during the proliferative or ovulatory phase of the natural menstrual cycle in a random sample of 54 women treated for endometriosis-induced infertility and 45 healthy women were included in control examination procedure. Irrespective of considered stage, endometriosis was most often found in the ovaries, in the sacro-uterine ligaments, peritoneum, and rectovaginally. Resistance to blood flow expressed as the resistance index (RI) in the measured arteries, was significantly higher in severe endometriosis compared to moderate form. Average values of pulsation index (PI) and RI are significantly higher, in both endometriosis stages, compared to measured values in healthy women.
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Affiliation(s)
- R Anicic
- Narodni Front Clinic of Gynaecology and Obstetrics, University of Belgrade, School of Medicine, Belgrade, Serbia.
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Maglic R, Maglic D, Dimitrijevic D, Ristic A, Jovanovic D, Stojanovic D. 27 Grade IV endometriosis surgical treatment and outcome – a case report. Reprod Biomed Online 2011. [DOI: 10.1016/s1472-6483(11)60044-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Loncarevic G, Payne L, Kon P, Petrovic V, Dimitrijevic D, Knezevic T, Medić S, Milic N, Nedelijković J, Seke K, Coulombier D. Public health preparedness for two mass gathering events in the context of pandemic influenza (H1N1) 2009--Serbia, July 2009. ACTA ACUST UNITED AC 2009; 14. [PMID: 19660246 DOI: 10.2807/ese.14.31.19296-en] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Preparedness planning for two large mass gatherings events were considered in Serbia in the context of pandemic influenza (H1N1) 2009. Planning included approaches to prevention, detection and response in order to mitigate the situation at this early stage of the epidemic in Serbia. Cases of influenza A(H1N1)v were identified nationally immediately prior to the mass gatherings but also identified in association with both events, as expected in the context of the pandemic situation. This article describes the experiences of planning and the epidemiological situation during the period of the mass gathering events.
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Affiliation(s)
- G Loncarevic
- Institute of Public Health of Serbia Dr Milan Jovanović Batut, Belgrade, Serbia
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Abstract
The effects of a non-ionic surfactant, polysorbate 80, and the sodium salt of the saturated fatty acid, sodium caprate (C10), as potential brain absorption enhancers for vigabatrin were studied. Vigabatrin is an enzyme-activated irreversible inhibitor of gamma-aminobutyric acid (GABA) transaminase that increases brain and cerebrospinal GABA concentrations in animals and man. Before intravenous administration, a range of concentrations of the surfactants were tested using erythrocyte lysis or the red blood cell lysis test to establish the non-toxic concentration range. Vigabatrin was dissolved in 0.1% polysorbate 80 and 0.1% sodium caprate and administered intravenously in doses of 4 mL kg(-1) to male Wistar rats (230-250 g; n = 3). Rats were killed 2 h after drug and surfactant administration and the brains were immediately removed and homogenized in 0.4 M perchloric acid. Selected ion monitoring electrospray mass spectrometry was used to determine the concentration of vigabatrin and GABA directly from the perchloric acid extract of the rat brain. This method was developed to increase the speed and efficiency of the analysis by removing the need for complex extraction and derivatization procedures while retaining the specificity of the mass spectrometer as a detector. The stability of both vigabatrin and GABA in perchloric acid was established by monitoring their pseudo molecular ions in standard solutions at timed intervals over 24 h. Although the detection level for vigabatrin and GABA was at least 50 pg, only GABA was detected in rat brain. Vigabatrin caused a small increase in whole brain GABA. However, GABA levels were higher in the samples with vigabatrin + enhancer than in the samples where vigabatrin alone was administered. One-way analysis of variance indicated a significant effect of the surfactants on GABA levels (F (5,17) = 11.86, P < 0.01) and vigabatrin absorption was presumed. The rectal temperature of the rats is lowered by the presence of vigabatrin in the brain. Vigabatrin alone decreased rectal temperature by 6%. When given with either polysorbate 80 or sodium caprate, the extent of temperature lowering was significantly greater (P < 0.001). There was no significant difference after 2 h between polysorbate 80 + vigabatrin, and sodium caprate + vigabatrin.
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Affiliation(s)
- D Dimitrijevic
- Centre for Drug Delivery Research, The School of Pharmacy, University of London, UK
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Abstract
The effects of the non-ionic surfactants polysorbate 20, polysorbate 60, polysorbate 85, cholesteryl poly (24) oxyethylene ether (Solulan C24) and the lanolin-based poly (16) oxyethylene ether (Solulan 16) on the epithelial integrity of monolayers of human intestinal epithelial (Caco-2) cells has been studied using metformin as a model drug. The aim was to identify the surfactants and their optimal concentrations capable of enhancing drug transport while causing no, or only minor, cellular damage. Effects on cell permeability were assessed by measurements of the transport of metformin, a hydrophilic drug, by monitoring transepithelial electrical resistance. Cell viability was determined by the diphenyltetrazolium bromide test (the MTT test). All the surfactants studied demonstrated concentration-dependent effects on cell permeability and cell viability. The effects on transepithelial electrical resistance correlated with cell viability, i.e. increased transepithelial electrical resistance and increased cell-monolayer permeability for metformin corresponded to decreased cell viability. The results indicate that the Solulan and polysorbate surfactants were active as absorption enhancers, Solulan C24 and 16 being more effective than polysorbates 20, 60 or 85, causing an increase in metformin transport at lower concentrations than the polysorbates. Polysorbate 20 exerted its greatest effect at a concentration of 5%-increasing the flux of metformin after 3 h by a factor of around 20 over the control. Large increases in the transport of metformin, especially at surfactant levels of 0.05%, 0.1% and 0.5%, were related to the effect of Solulan C24 and Solulan 16 on the cell permeability. The Caco-2 cell monolayer experiments confirmed the ability, especially of polysorbate 20, Solulan C24 and Solulan 16, to increase the absorption of metformin. The polysorbates increased permeability as a result of solubilisation of membrane components, while Solulans did so by penetrating and solubilising the membrane. Correlation between increase in membrane permeability and the toxicity of the surfactants towards the cell membrane has been established.
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Affiliation(s)
- D Dimitrijevic
- Centre for Drug Delivery Research, The School of Pharmacy, University of London, UK
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Dimitrijevic D, Lamandin C, Uchegbu IF, Shaw AJ, Florence AT. The effect of monomers and of micellar and vesicular forms of non-ionic surfactants (Solulan C24 and Solulan 16) on Caco-2 cell monolayers. J Pharm Pharmacol 1997; 49:611-6. [PMID: 9330201 DOI: 10.1111/j.2042-7158.1997.tb06854.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Measurements of transepithelial electrical resistance (TEER), the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide) test and monitoring of poly(ethylene glycol) (PEG) transport have been used to study the effects of the non-ionic surfactants Solulan C24 and Solulan 16, either free in solution or as an integral part of niosome bi-layers, on intestinal epithelial cells from man (Caco-2 cell monolayers). The effects on epithelial integrity and on the transport of the hydrophilic drug metformin depend on the concentration of the surfactants. At concentrations above 1% the effect on TEER of the surfactant in niosomal form and free in solution were equivalent whereas cell viability was preserved to a higher concentration of Solulans when the Solulans were present in the niosomal form. It was concluded that the toxic effect of niosomes arises from free surfactant present in the niosome suspension.
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Affiliation(s)
- D Dimitrijevic
- Centre for Drug Delivery Research, School of Pharmacy, University of London, UK
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Vyas SP, Singh R, Dimitrijevic D. Development and characterization of nifedipine lipospheres. Pharmazie 1997; 52:403-4. [PMID: 9183794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- S P Vyas
- Department of Pharmaceutical Sciences, Dr. H. S. Gour University, Sagar, India
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