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Phan VHG, Thai NKL, Tran THH, Nguyen TKN, Thambi T, Murgia X, Ho DK, Elmaleh DR. Triple-Hybrid BioScaffold Based on Silk Fibroin, Chitosan, and nano-Biphasic Calcium Phosphates: Preparation, Characterization of Physiochemical and Biopharmaceutical Properties. J Pharm Sci 2024:S0022-3549(24)00099-6. [PMID: 38527617 DOI: 10.1016/j.xphs.2024.03.015] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Abstract
Bioscaffolds, which promote cell regeneration and restore tissues' functions, have emerged as significant need in clinic. The hybrid of several biomaterials in a bioscaffold renders clinically advanced and relevant properties for applications yet add challenges in cost efficiency, production, and clinical investigation. This study proposes a facile and sustainable method to formulate a triple-hybrid bioscaffold based on Vietnamese cocoon origin Silk Fibroin, Chitosan, and nano-Biphasic Calcium Phosphates (nano-BCP) that can be easily molded, has high porosity (55-80%), and swelling capacity that facilitates cell proliferation and nutrient diffusion. Notably, their mechanical properties, in particular compressive strength, can easily be tuned in a range from 50 - 200 kPa by changing the amount of nano-BCP addition, which is comparable to the successful precedents for productive cell regeneration. The latter parts investigate the biopharmaceutical properties of a representative bioscaffold, including drug loading and release studies with two kinds of active compounds, salmon calcitonin and methylprednisolone. Furthermore, the bioscaffold is highly biocompatible as the results of hemocompatibility and hemostasis tests, as well as ovo chick chorioallantoic membrane investigation. The findings of the study suggest the triple-hybrid scaffold as a promising platform for multi-functional drug delivery and bone defect repair.
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Affiliation(s)
- V H Giang Phan
- Biomaterials and Nanotechnology Research Group, Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
| | - Nguyen-Kim-Luong Thai
- Biomaterials and Nanotechnology Research Group, Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Thanh-Han Hoang Tran
- Biomaterials and Nanotechnology Research Group, Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Thien-Kim Ngoc Nguyen
- Biomaterials and Nanotechnology Research Group, Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Thavasyappan Thambi
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Yongin si, Gyeonggi do 17104, Republic of Korea.
| | | | - Duy-Khiet Ho
- Department of Bioengineering, School of Medicine, University of Washington, Seattle, Washington 98195, United States
| | - David R Elmaleh
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02129, USA
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Arrua EC, Hartwig O, Loretz B, Murgia X, Ho DK, Bastiat G, Lehr CM, Salomón CJ. Formulation of benznidazole-lipid nanocapsules: Drug release, permeability, biocompatibility, and stability studies. Int J Pharm 2023:123120. [PMID: 37307960 DOI: 10.1016/j.ijpharm.2023.123120] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/14/2023]
Abstract
Benznidazole, a poorly soluble in water drug, is the first-line medication for the treatment of Chagas disease, but long treatment periods at high dosages cause several adverse effects with insufficient activity in the chronic phase. According to these facts, there is a serious need for novel benznidazole formulations for improving the chemotherapy of Chagas disease. Thus, this work aimed to incorporate benznidazole into lipid nanocapsules for improving its solubility, dissolution rate in different media, and permeability. Lipid nanocapsules were prepared by the phase inversion technique and were fully characterized. Three formulations were obtained with a diameter of 30, 50, and 100 nm and monomodal size distribution with a low polydispersity index and almost neutral zeta potential. Drug encapsulation efficiency was between 83 and 92% and the drug loading was between 0.66 and 1.04%. Loaded formulations were stable under storage for one year at 4 °C. Lipid nanocapsules were found to protect benznidazole in simulated gastric fluid and provide a sustained release platform for the drug in a simulated intestinal fluid containing pancreatic enzymes. The small size and the almost neutral surface charge of these lipid nanocarriers improved their penetration through mucus and such formulations showed a reduced chemical interaction with gastric mucin glycoproteins. LNCs. The incorporation of benznidazole in lipid nanocapsules improved the drug permeability across intestinal epithelium by 10-fold compared with the non-encapsulated drug while the exposure of the cell monolayers to these nanoformulations did not affect the integrity of the epithelium.
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Affiliation(s)
- Eva C Arrua
- Institute of Chemistry, IQUIR-CONICET, National Council Research, Suipacha 531, 2000 Rosario, Argentina
| | - Olga Hartwig
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, 66123 Saarbruecken, Germany; Pharmacy Department, Faculty of Pharmaceutical and Biochemical Sciences, National University of Rosario, Suipacha, 531, 2000 Rosario, Argentina
| | - Brigitta Loretz
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, 66123 Saarbruecken, Germany
| | - Xabier Murgia
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, 66123 Saarbruecken, Germany
| | - Duy-Khiet Ho
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, 66123 Saarbruecken, Germany
| | - Guillaume Bastiat
- LUNAM Université, Micro et Nanomédecines Biomimétiques, F-49933, Angers, France and Inserm, U1066 IBS-CHU, 4 rue Larrey, F-49933 Angers Cédex 9, France
| | - Claus-Michael Lehr
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, 66123 Saarbruecken, Germany; Department of Pharmacy, Saarland University, 66123 Saarbruecken, Germany
| | - Claudio J Salomón
- Institute of Chemistry, IQUIR-CONICET, National Council Research, Suipacha 531, 2000 Rosario, Argentina; Pharmacy Department, Faculty of Pharmaceutical and Biochemical Sciences, National University of Rosario, Suipacha, 531, 2000 Rosario, Argentina.
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Barthold S, Kunschke N, Murgia X, Loretz B, Carvalho-Wodarz CDS, Lehr CM. Overview of Inhaled Nanopharmaceuticals. J Aerosol Med Pulm Drug Deliv 2023; 36:144-151. [PMID: 37310368 DOI: 10.1089/jamp.2023.29089.sb] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
Nanopharmaceuticals represent a group of nanoparticles engineered for medical purposes. Nowadays, nanotechnology offers several possibilities to improve the safety and efficacy of medicines by designing advanced carrier systems which have been found to offer particular advantages when formulated in the nanoscale. Some of the initially marketed nano-formulations already demonstrate advantages over conventional formulations. Innovative delivery systems offer the possibility to not only control drug release but also to overcome biological barriers. For the translation of new drug products from bench to bedside, however, it is pivotal to test and prove their safety. This is of course also true for nanopharmaceuticals, where in particular the biocompatibility and also the clearance/biodegradation of the carrier material after drug delivery has to be demonstrated. The pulmonary route offers some great opportunities for noninvasive drug delivery but also implicates peculiar challenges. Advanced aerosol formulations with innovative drug carriers have already contributed to the significant progress of inhalation therapy. However, in spite of the large alveolar epithelial surface area, the respiratory tract still features diverse efficient biological barriers, primarily designed by nature to protect the human body against inhaled pollutants and pathogens. Only a thorough understanding of particle-lung interactions will allow the rational design of novel nanopharmaceuticals capable of overcoming these barriers, while of course always keeping in mind the strict demands for their safety. While the recent resurrection of inhaled insulin has already confirmed the potential of the pulmonary route for systemic delivery of biopharmaceuticals, inhaled nanopharmaceuticals, currently under investigation, promise to improve also local therapies like anti-infectives.
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Affiliation(s)
- Sarah Barthold
- Helmholtz Centre for Infection Research (HZI), Saarbrucken, Germany
| | - Nicole Kunschke
- Helmholtz Centre for Infection Research (HZI), Saarbrucken, Germany
| | - Xabier Murgia
- Helmholtz Centre for Infection Research (HZI), Saarbrucken, Germany
| | - Brigitta Loretz
- Helmholtz Centre for Infection Research (HZI), Saarbrucken, Germany
| | | | - Claus-Michael Lehr
- Department Drug Delivery and Biological Barriers (DDEL), Helmholtz Centre for Infection Research (HZI), Saarbrucken, Germany
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Storti M, Faietti ML, Murgia X, Catozzi C, Minato I, Tatoni D, Cantarella S, Ravanetti F, Ragionieri L, Ciccimarra R, Zoboli M, Vilanova M, Sánchez-Jiménez E, Gay M, Vilaseca M, Villetti G, Pioselli B, Salomone F, Ottonello S, Montanini B, Ricci F. Time-resolved transcriptomic profiling of the developing rabbit's lungs: impact of premature birth and implications for modelling bronchopulmonary dysplasia. Respir Res 2023; 24:80. [PMID: 36922832 PMCID: PMC10015812 DOI: 10.1186/s12931-023-02380-y] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/03/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Premature birth, perinatal inflammation, and life-saving therapies such as postnatal oxygen and mechanical ventilation are strongly associated with the development of bronchopulmonary dysplasia (BPD); these risk factors, alone or combined, cause lung inflammation and alter programmed molecular patterns of normal lung development. The current knowledge on the molecular regulation of lung development mainly derives from mechanistic studies conducted in newborn rodents exposed to postnatal hyperoxia, which have been proven useful but have some limitations. METHODS Here, we used the rabbit model of BPD as a cost-effective alternative model that mirrors human lung development and, in addition, enables investigating the impact of premature birth per se on the pathophysiology of BPD without further perinatal insults (e.g., hyperoxia, LPS-induced inflammation). First, we characterized the rabbit's normal lung development along the distinct stages (i.e., pseudoglandular, canalicular, saccular, and alveolar phases) using histological, transcriptomic and proteomic analyses. Then, the impact of premature birth was investigated, comparing the sequential transcriptomic profiles of preterm rabbits obtained at different time intervals during their first week of postnatal life with those from age-matched term pups. RESULTS Histological findings showed stage-specific morphological features of the developing rabbit's lung and validated the selected time intervals for the transcriptomic profiling. Cell cycle and embryo development, oxidative phosphorylation, and WNT signaling, among others, showed high gene expression in the pseudoglandular phase. Autophagy, epithelial morphogenesis, response to transforming growth factor β, angiogenesis, epithelium/endothelial cells development, and epithelium/endothelial cells migration pathways appeared upregulated from the 28th day of gestation (early saccular phase), which represents the starting point of the premature rabbit model. Premature birth caused a significant dysregulation of the inflammatory response. TNF-responsive, NF-κB regulated genes were significantly upregulated at premature delivery and triggered downstream inflammatory pathways such as leukocyte activation and cytokine signaling, which persisted upregulated during the first week of life. Preterm birth also dysregulated relevant pathways for normal lung development, such as blood vessel morphogenesis and epithelial-mesenchymal transition. CONCLUSION These findings establish the 28-day gestation premature rabbit as a suitable model for mechanistic and pharmacological studies in the context of BPD.
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Affiliation(s)
- Matteo Storti
- Department of Experimental Pharmacology and Translational Science, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy
| | - Maria Laura Faietti
- Department of Analytic and Early Formulations, Chiesi Farmaceutici S.P.A., R&D, 43122, Parma, Italy
| | | | - Chiara Catozzi
- Department of Experimental Pharmacology and Translational Science, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy
| | - Ilaria Minato
- Laboratory of Biochemistry and Molecular Biology, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, 43124, Parma, Italy.,Interdepartmental Research Centre Biopharmanet-Tec, University of Parma, 43124, Parma, Italy
| | - Danilo Tatoni
- Laboratory of Biochemistry and Molecular Biology, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, 43124, Parma, Italy.,Department of Medical Biotechnologies, University of Siena, 53100, Siena, Italy
| | - Simona Cantarella
- Laboratory of Biochemistry and Molecular Biology, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, 43124, Parma, Italy.,Division of RNA Biology and Cancer, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | | | - Luisa Ragionieri
- Department of Veterinary Sciences, University of Parma, 43124, Parma, Italy
| | - Roberta Ciccimarra
- Department of Veterinary Sciences, University of Parma, 43124, Parma, Italy
| | - Matteo Zoboli
- Department of Veterinary Sciences, University of Parma, 43124, Parma, Italy
| | - Mar Vilanova
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028, Barcelona, Spain
| | - Ester Sánchez-Jiménez
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028, Barcelona, Spain
| | - Marina Gay
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028, Barcelona, Spain
| | - Marta Vilaseca
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028, Barcelona, Spain
| | - Gino Villetti
- Department of Experimental Pharmacology and Translational Science, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy
| | - Barbara Pioselli
- Department of Analytic and Early Formulations, Chiesi Farmaceutici S.P.A., R&D, 43122, Parma, Italy
| | - Fabrizio Salomone
- Department of Experimental Pharmacology and Translational Science, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy
| | - Simone Ottonello
- Laboratory of Biochemistry and Molecular Biology, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, 43124, Parma, Italy.,Interdepartmental Research Centre Biopharmanet-Tec, University of Parma, 43124, Parma, Italy
| | - Barbara Montanini
- Laboratory of Biochemistry and Molecular Biology, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, 43124, Parma, Italy. .,Interdepartmental Research Centre Biopharmanet-Tec, University of Parma, 43124, Parma, Italy.
| | - Francesca Ricci
- Department of Experimental Pharmacology and Translational Science, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy. .,Head of Neonatology and Pulmonary Rare Disease, Preclinical Pharmacology, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy.
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5
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Xu Y, Guo X, Chen M, Ricci F, Salomone F, Murgia X, Sun B. Efficacy of synthetic surfactant (CHF5633) bolus and/or lavage in meconium-induced lung injury in ventilated newborn rabbits. Pediatr Res 2023; 93:541-550. [PMID: 35701606 DOI: 10.1038/s41390-022-02152-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 05/18/2022] [Accepted: 05/26/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The pathogenesis of neonatal meconium aspiration syndrome (MAS) involves meconium-induced lung inflammation and surfactant inactivation. Bronchoalveolar lavage (BAL) with diluted surfactant facilitates the removal of meconium. CHF5633, one of the most promising synthetic surfactants, is effective in neonatal respiratory distress syndrome. Here we investigated its efficacy via BAL in an experimental MAS model. METHODS Experimental MAS was induced at birth in near-term newborn rabbits by intratracheal instillation of reconstituted human meconium. First, undiluted CHF5633 was compared with a porcine-derived surfactant (Poractant alfa) via intratracheal bolus (200 mg/kg). Second, the efficacy of BAL with diluted CHF5633 (5 mg/mL, 20 ml/kg) alone, or followed by undiluted boluses (100 or 300 mg/kg), was investigated. RESULTS Meconium instillation caused severe lung injury, reduced endogenous surfactant pool, and poor survival. CHF5633 had similar benefits in improving survival and alleviating lung injury as Poractant alfa. CHF5633 BAL plus higher boluses exerted better effects than BAL or bolus alone in lung injury alleviation by reversing phospholipid pools and mitigating proinflammatory cytokine mRNA expression, without fluid retention and function deterioration. CONCLUSIONS CHF5633 improved survival and alleviated meconium-induced lung injury, the same as Poractant alfa. CHF5633 BAL plus boluses was the optimal modality, which warrants further clinical investigation. IMPACT To explore the efficacy of a synthetic surfactant, CHF5633, in neonatal lung protection comparing with Poractant alfa in a near-term newborn rabbit model with meconium-induced lung injury. Similar effects on improving survival and alleviating lung injury were found between CHF5633 and Poractant alfa. Optimal therapeutic effects were identified from the diluted CHF5633 bronchoalveolar lavage followed by its undiluted bolus instillation compared to the lavage or bolus alone regimens. Animals with CHF5633 lavage plus bolus regimen exerted neither substantial lung fluid retention nor lung mechanics deterioration but a trend of higher pulmonary surfactant-associated phospholipid pools.
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Affiliation(s)
- Yaling Xu
- The Laboratory of Neonatal Diseases of National Commission of Health; National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Xiaojing Guo
- The Laboratory of Neonatal Diseases of National Commission of Health; National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Meimei Chen
- The Laboratory of Neonatal Diseases of National Commission of Health; National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Francesca Ricci
- Neonatology and Pulmonary Rare Disease Unit, Pharmacology & Toxicology Department, Corporate Preclinical R&D, CHIESI, Parma, Italy
| | - Fabrizio Salomone
- Neonatology and Pulmonary Rare Disease Unit, Pharmacology & Toxicology Department, Corporate Preclinical R&D, CHIESI, Parma, Italy
| | | | - Bo Sun
- The Laboratory of Neonatal Diseases of National Commission of Health; National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China.
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Schwarz C, Procaccianti C, Costa L, Brini R, Friend R, Caivano G, Sadafi H, Mussche C, Schwenck N, Hahn M, Murgia X, Bianco F. Differential Performance and Lung Deposition of Levofloxacin with Different Nebulisers Used in Cystic Fibrosis. Int J Mol Sci 2022; 23:ijms23179597. [PMID: 36076992 PMCID: PMC9455972 DOI: 10.3390/ijms23179597] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/15/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
We compared the performance and levofloxacin (Quinsair) lung deposition of three nebulisers commonly used in CF (I-Neb Advance, eFlow rapid, and LC Plus) with the approved nebuliser Zirela. The delivered dose, delivery rate, and aerosol particle size distribution (APSD) for each device were determined using the methods described in the Pharmacopeia. High-resolution computed tomography scans obtained from seven adult patients with mild CF were used to generate computer-aided, three-dimensional models of their airway tree to assess lung deposition using functional respiratory imaging (FRI). The eFlow rapid and the LC Plus showed poor delivery efficiencies due to their high residual volumes. The I-Neb, which only delivers aerosols during the inspiratory phase, achieved the highest aerosol delivery efficiency. However, the I-Neb showed the largest particle size and lowest delivery rate (2.9 mg/min), which were respectively associated with a high extrathoracic deposition and extremely long nebulisation times (>20 min). Zirela showed the best performance considering delivery efficiency (159.6 mg out of a nominal dose of 240 mg), delivery rate (43.5 mg/min), and lung deposition (20% of the nominal dose), requiring less than 5 min to deliver a full dose of levofloxacin. The present study supports the use of drug-specific nebulisers and discourages the off-label use of general-purpose devices with the present levofloxacin formulation since subtherapeutic lung doses and long nebulisation times may compromise treatment efficacy and adherence.
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Affiliation(s)
- Carsten Schwarz
- Division Cystic Fibrosis, CF Center Westbrandenburg, Campus Potsdam, Clinic Westbrandenburg, 14467 Potsdam, Germany
| | | | - Laura Costa
- Global Medical Affairs, Chiesi Farmaceutici S.p.A., 43122 Parma, Italy
| | - Riccardo Brini
- Global Technical Development, Chiesi Ltd., Chippenham SN14 0AB, UK
| | - Richard Friend
- Global Technical Development, Chiesi Ltd., Chippenham SN14 0AB, UK
| | - Grazia Caivano
- Global Technical Development, Chiesi Farmaceutici S.p.A., 43122 Parma, Italy
| | | | | | | | | | | | - Federico Bianco
- Global Medical Affairs, Chiesi Farmaceutici S.p.A., 43122 Parma, Italy
- Correspondence:
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Arrua EC, Hartwig O, Loretz B, Goicoechea H, Murgia X, Lehr CM, Salomon CJ. Improving the oral delivery of benznidazole nanoparticles by optimizing the formulation parameters through a design of experiment and optimization strategy. Colloids Surf B Biointerfaces 2022; 217:112678. [PMID: 35816885 DOI: 10.1016/j.colsurfb.2022.112678] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/30/2022] [Accepted: 06/28/2022] [Indexed: 10/17/2022]
Abstract
Chagas disease is a neglected tropical disease affecting the American continent and also some regions of Europe. Benznidazole, approved by FDA, is a drug of choice but its poor aqueous solubility may lead to a low bioavailability and efficacy. Therefore, the aim of this study was to formulate nanoparticles of benznidazole for improving its solubility, dissolution and permeability. A Plackett-Burman design was applied to identify the effect of 5 factors over 4 responses. Then, a Central Composite design was applied to estimate the values of the most important factors leading to the best compromise between highest nanoprecipitation efficiency, drug solubility and lower particle size. The optimized nanoparticles were evaluated for in vitro drug release in biorelevant media, stability studies and transmission electron microscopy. Biocompatibility and permeability of nanoparticles were evaluated on the Caco-2 cell line. The findings of the optimization process indicated that concentration of drug and stabilizer influenced significantly the particle size while concentration of stabilizer and organic/water phase volume ratio mainly influenced the drug solubility. Stability studies suggested that benznidazole nanoparticles were stable after 12 months at different temperatures. Minimal interactions of those nanoparticles and mucin glycoproteins suggested favorable properties to address the intestinal mucus barrier. Cell viability studies confirmed the safety profile of the optimized formulation and showed an increased permeation through the Caco-2 cells. Thus, this study confirmed the suitability of the design of experiment and optimization approach to elucidate critical parameters influencing the quality of benznidazole nanoparticles, which could lead to a more efficient management of Chagas disease by oral route.
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Affiliation(s)
- Eva C Arrua
- Instituto de Química de Rosario, Consejo Nacional de Investigaciones Científicas y Tecnológicas, Suipacha 570, 2000 Rosario, Argentina
| | - Olga Hartwig
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, 66123 Saarbrücken, Germany
| | - Brigitta Loretz
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, 66123 Saarbrücken, Germany
| | - Héctor Goicoechea
- Laboratorio de Desarrollo Analítico y Quimiometría (LADAQ), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Ciudad Universitaria, 3000 Santa Fe, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Godoy Cruz 2290, C1425FQB Buenos Aires, Argentina
| | - Xabier Murgia
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, 66123 Saarbrücken, Germany
| | - Claus-Michael Lehr
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, 66123 Saarbrücken, Germany; Department of Pharmacy, Saarland University, 66123 Saarbrücken, Germany
| | - Claudio J Salomon
- Instituto de Química de Rosario, Consejo Nacional de Investigaciones Científicas y Tecnológicas, Suipacha 570, 2000 Rosario, Argentina; Departamento de Farmacia, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Suipacha 531, 2000 Rosario, Argentina.
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8
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Ricci F, Mersanne A, Storti M, Nutini M, Pellicelli G, Carini A, Milesi I, Lombardini M, Dellacà RL, Thomson MA, Murgia X, Lavizzari A, Bianco F, Salomone F. Preclinical Assessment of Nebulized Surfactant Delivered through Neonatal High Flow Nasal Cannula Respiratory Support. Pharmaceutics 2022; 14:pharmaceutics14051093. [PMID: 35631679 PMCID: PMC9146271 DOI: 10.3390/pharmaceutics14051093] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 11/16/2022] Open
Abstract
High-flow nasal cannula (HFNC) is a non-invasive respiratory support (NRS) modality to treat premature infants with respiratory distress syndrome (RDS). The delivery of nebulized surfactant during NRS would represent a truly non-invasive method of surfactant administration and could reduce NRS failure rates. However, the delivery efficiency of nebulized surfactant during HFNC has not been evaluated in vitro or in animal models of respiratory distress. We, therefore, performed first a benchmark study to compare the surfactant lung dose delivered by commercially available neonatal nasal cannulas (NCs) and HFNC circuits commonly used in neonatal intensive care units. Then, the pulmonary effect of nebulized surfactant delivered via HFNC was investigated in spontaneously breathing rabbits with induced respiratory distress. The benchmark study revealed the surfactant lung dose to be relatively low for both types of NCs tested (Westmed NCs 0.5 ± 0.45%; Fisher & Paykel NCs 1.8 ± 1.9% of a nominal dose of 200 mg/kg of Poractant alfa). The modest lung doses achieved in the benchmark study are compatible with the lack of the effect of nebulized surfactant in vivo (400 mg/kg), where arterial oxygenation and lung mechanics did not improve and were significantly worse than the intratracheal instillation of surfactant. The results from the present study indicate a relatively low lung surfactant dose and negligible effect on pulmonary function in terms of arterial oxygenation and lung mechanics. This negligible effect can, for the greater part, be explained by the high impaction of aerosol particles in the ventilation circuit and upper airways due to the high air flows used during HFNC.
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Affiliation(s)
- Francesca Ricci
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 15739 Parma, Italy; (F.R.); (A.M.); (M.S.); (M.N.); (G.P.); (A.C.); (I.M.); (M.L.); (F.B.)
| | - Arianna Mersanne
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 15739 Parma, Italy; (F.R.); (A.M.); (M.S.); (M.N.); (G.P.); (A.C.); (I.M.); (M.L.); (F.B.)
| | - Matteo Storti
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 15739 Parma, Italy; (F.R.); (A.M.); (M.S.); (M.N.); (G.P.); (A.C.); (I.M.); (M.L.); (F.B.)
| | - Marcello Nutini
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 15739 Parma, Italy; (F.R.); (A.M.); (M.S.); (M.N.); (G.P.); (A.C.); (I.M.); (M.L.); (F.B.)
| | - Giulia Pellicelli
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 15739 Parma, Italy; (F.R.); (A.M.); (M.S.); (M.N.); (G.P.); (A.C.); (I.M.); (M.L.); (F.B.)
| | - Angelo Carini
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 15739 Parma, Italy; (F.R.); (A.M.); (M.S.); (M.N.); (G.P.); (A.C.); (I.M.); (M.L.); (F.B.)
| | - Ilaria Milesi
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 15739 Parma, Italy; (F.R.); (A.M.); (M.S.); (M.N.); (G.P.); (A.C.); (I.M.); (M.L.); (F.B.)
| | - Marta Lombardini
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 15739 Parma, Italy; (F.R.); (A.M.); (M.S.); (M.N.); (G.P.); (A.C.); (I.M.); (M.L.); (F.B.)
| | - Raffaele L. Dellacà
- TechRes Lab, Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Politecnico di Milano University, 20133 Milan, Italy;
| | | | | | - Anna Lavizzari
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Federico Bianco
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 15739 Parma, Italy; (F.R.); (A.M.); (M.S.); (M.N.); (G.P.); (A.C.); (I.M.); (M.L.); (F.B.)
| | - Fabrizio Salomone
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 15739 Parma, Italy; (F.R.); (A.M.); (M.S.); (M.N.); (G.P.); (A.C.); (I.M.); (M.L.); (F.B.)
- Correspondence:
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9
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Schwarz C, Procaccianti C, Mignot B, Sadafi H, Schwenck N, Murgia X, Bianco F. Deposition of Inhaled Levofloxacin in Cystic Fibrosis Lungs Assessed by Functional Respiratory Imaging. Pharmaceutics 2021; 13:2051. [PMID: 34959333 PMCID: PMC8708197 DOI: 10.3390/pharmaceutics13122051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 09/24/2021] [Revised: 11/23/2021] [Accepted: 11/26/2021] [Indexed: 11/16/2022] Open
Abstract
Pulmonary infections caused by Pseudomonas aeruginosa (PA) represent the leading cause of pulmonary morbidity in adults with cystic fibrosis (CF). In addition to tobramycin, colistin, and aztreonam, levofloxacin has been approved in Europe to treat PA infections. Nevertheless, no lung deposition data on inhaled levofloxacin are yet available. We conducted a Functional Respiratory Imaging (FRI) study to predict the lung deposition of levofloxacin in the lungs of patients with CF. Three-dimensional airway models were digitally reconstructed from twenty high-resolution computed tomography scans obtained from historical patients' records. Levofloxacin aerosols generated with the corresponding approved nebuliser were characterised according to pharmacopeia. The obtained data were used to inform a computational fluid dynamics simulation of levofloxacin lung deposition using breathing patterns averaged from actual CF patients' spirometry data. Levofloxacin deposition in the lung periphery was significantly reduced by breathing patterns with low inspiratory times and high inspiratory flow rates. The intrathoracic levofloxacin deposition percentages for moderate and mild CF lungs were, respectively, 37.0% ± 13.6 and 39.5% ± 12.9 of the nominal dose. A significant albeit modest correlation was found between the central-to-peripheral deposition (C/P) ratio of levofloxacin and FEV1. FRI analysis also detected structural differences between mild and moderate CF airways. FRI revealed a significant intrathoracic deposition of levofloxacin aerosols, which distributed preferentially to the lower lung lobes, with an influence of the deterioration of FEV1 on the C/P ratio. The three-dimensional rendering of CF airways also detected structural differences between the airways of patients with mild and moderate CF.
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Affiliation(s)
| | | | | | | | | | | | - Federico Bianco
- Global Medical Affairs, Chiesi Farmaceutici S.p.A., 43122 Parma, Italy;
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10
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Huck B, Hidalgo A, Waldow F, Schwudke D, Gaede KI, Feldmann C, Carius P, Autilio C, Pérez-Gil J, Schwarzkopf K, Murgia X, Loretz B, Lehr CM. Systematic Analysis of Composition, Interfacial Performance and Effects of Pulmonary Surfactant Preparations on Cellular Uptake and Cytotoxicity of Aerosolized Nanomaterials. Small Science 2021. [DOI: 10.1002/smsc.202100067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Benedikt Huck
- Helmholtz Center for Infection Research, Helmholtz Institute for Pharmaceutical Research Saarland, Department of Drug Delivery Saarland University Campus E8.1 66123 Saarbrucken Germany
- Department of Pharmacy Saarland University Campus E8 1 66123 Saarbrücken Germany
| | - Alberto Hidalgo
- Helmholtz Center for Infection Research, Helmholtz Institute for Pharmaceutical Research Saarland, Department of Drug Delivery Saarland University Campus E8.1 66123 Saarbrucken Germany
| | - Franziska Waldow
- Research Center Borstel Leibniz Lung Center Parkallee 1-40 23845 Borstel Germany
- German Center for Infection Research Thematic Translational Unit Tuberculosis Site Research Center Borstel Parkallee 1-40 23845 Borstel Germany
| | - Dominik Schwudke
- Research Center Borstel Leibniz Lung Center Parkallee 1-40 23845 Borstel Germany
- German Center for Infection Research Thematic Translational Unit Tuberculosis Site Research Center Borstel Parkallee 1-40 23845 Borstel Germany
- German Center for Lung Research (DZL), Airway Research Center North (ARCN) Research Center Borstel Leibniz Lung Center Site Research Center Borstel Parkallee 1-40 Borstel 23845 Germany
| | - Karoline I. Gaede
- BioMaterialBank Nord, Research Center Borstel Leibniz Lung Center Parkallee 35 23845 Borstel Germany
- German Center for Lung Research (DZL), Airway Research Center North (ARCN) Research Center Borstel Leibniz Lung Center Site Research Center Borstel Parkallee 1-40 Borstel 23845 Germany
| | - Claus Feldmann
- Institute of Inorganic Chemistry Karlsruhe Institute of Technology 76131 Karlsruhe Germany
| | - Patrick Carius
- Helmholtz Center for Infection Research, Helmholtz Institute for Pharmaceutical Research Saarland, Department of Drug Delivery Saarland University Campus E8.1 66123 Saarbrucken Germany
- Department of Pharmacy Saarland University Campus E8 1 66123 Saarbrücken Germany
| | - Chiara Autilio
- Department of Biochemistry and Molecular Biology, Faculty of Biology, and Research Institute “Hospital 12 de Octubre (imas12)” Complutense University 28040 Madrid Spain
| | - Jesus Pérez-Gil
- Department of Biochemistry and Molecular Biology, Faculty of Biology, and Research Institute “Hospital 12 de Octubre (imas12)” Complutense University 28040 Madrid Spain
| | - Konrad Schwarzkopf
- Klinikum Saarbrücken Department of Anaesthesia and Intensive Care 66119 Saarbrücken Germany
| | - Xabier Murgia
- Biotechnology Area GAIKER Technology Centre 48170 Zamudio Spain
| | - Brigitta Loretz
- Helmholtz Center for Infection Research, Helmholtz Institute for Pharmaceutical Research Saarland, Department of Drug Delivery Saarland University Campus E8.1 66123 Saarbrucken Germany
- Department of Pharmacy Saarland University Campus E8 1 66123 Saarbrücken Germany
| | - Claus-Michael Lehr
- Helmholtz Center for Infection Research, Helmholtz Institute for Pharmaceutical Research Saarland, Department of Drug Delivery Saarland University Campus E8.1 66123 Saarbrucken Germany
- Department of Pharmacy Saarland University Campus E8 1 66123 Saarbrücken Germany
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11
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Schütz C, Ho D, Hamed MM, Abdelsamie AS, Röhrig T, Herr C, Kany AM, Rox K, Schmelz S, Siebenbürger L, Wirth M, Börger C, Yahiaoui S, Bals R, Scrima A, Blankenfeldt W, Horstmann JC, Christmann R, Murgia X, Koch M, Berwanger A, Loretz B, Hirsch AKH, Hartmann RW, Lehr C, Empting M. A New PqsR Inverse Agonist Potentiates Tobramycin Efficacy to Eradicate Pseudomonas aeruginosa Biofilms. Adv Sci (Weinh) 2021; 8:e2004369. [PMID: 34165899 PMCID: PMC8224453 DOI: 10.1002/advs.202004369] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/21/2021] [Indexed: 05/21/2023]
Abstract
Pseudomonas aeruginosa (PA) infections can be notoriously difficult to treat and are often accompanied by the development of antimicrobial resistance (AMR). Quorum sensing inhibitors (QSI) acting on PqsR (MvfR) - a crucial transcriptional regulator serving major functions in PA virulence - can enhance antibiotic efficacy and eventually prevent the AMR. An integrated drug discovery campaign including design, medicinal chemistry-driven hit-to-lead optimization and in-depth biological profiling of a new QSI generation is reported. The QSI possess excellent activity in inhibiting pyocyanin production and PqsR reporter-gene with IC50 values as low as 200 and 11 × 10-9 m, respectively. Drug metabolism and pharmacokinetics (DMPK) as well as safety pharmacology studies especially highlight the promising translational properties of the lead QSI for pulmonary applications. Moreover, target engagement of the lead QSI is shown in a PA mucoid lung infection mouse model. Beyond that, a significant synergistic effect of a QSI-tobramycin (Tob) combination against PA biofilms using a tailor-made squalene-derived nanoparticle (NP) formulation, which enhance the minimum biofilm eradicating concentration (MBEC) of Tob more than 32-fold is demonstrated. The novel lead QSI and the accompanying NP formulation highlight the potential of adjunctive pathoblocker-mediated therapy against PA infections opening up avenues for preclinical development.
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12
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Frisch S, Boese A, Huck B, Horstmann JC, Ho DK, Schwarzkopf K, Murgia X, Loretz B, de Souza Carvalho-Wodarz C, Lehr CM. A pulmonary mucus surrogate for investigating antibiotic permeation and activity against Pseudomonas aeruginosa biofilms. J Antimicrob Chemother 2021; 76:1472-1479. [PMID: 33712824 DOI: 10.1093/jac/dkab068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/15/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Pulmonary infections associated with Pseudomonas aeruginosa can be life-threatening for patients suffering from chronic lung diseases such as cystic fibrosis. In this scenario, the formation of biofilms embedded in a mucus layer can limit the permeation and the activity of anti-infectives. OBJECTIVES Native human pulmonary mucus can be isolated from endotracheal tubes, but this source is limited for large-scale testing. This study, therefore, aimed to evaluate a modified artificial sputum medium (ASMmod) with mucus-like viscoelastic properties as a surrogate for testing anti-infectives against P. aeruginosa biofilms. METHODS Bacterial growth in conventional broth cultures was compared with that in ASMmod, and PAO1-GFP biofilms were imaged by confocal microscopy. Transport kinetics of three antibiotics, tobramycin, colistin, and ciprofloxacin, through native mucus and ASMmod were studied, and their activity against PAO1 biofilms grown in different media was assessed by determination of metabolic activity and cfu. RESULTS PAO1(-GFP) cultured in human pulmonary mucus or ASMmod showed similarities in bacterial growth and biofilm morphology. A limited permeation of antibiotics through ASMmod was observed, indicating its strong barrier properties, which are comparable to those of native human mucus. Reduced susceptibility of PAO1 biofilms was observed in ASMmod compared with LB medium for tobramycin and colistin, but less for ciprofloxacin. CONCLUSIONS These findings underline the importance of mucus as a biological barrier to antibiotics. ASMmod appears to be a valuable surrogate for studying mucus permeation of anti-infectives and their efficacy against PAO1 biofilms.
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Affiliation(s)
- Sarah Frisch
- Helmholtz-Institute for Pharmaceutical Research Saarland, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, Saarbrücken, Germany
| | - Annette Boese
- Helmholtz-Institute for Pharmaceutical Research Saarland, Saarbrücken, Germany
| | - Benedikt Huck
- Helmholtz-Institute for Pharmaceutical Research Saarland, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, Saarbrücken, Germany
| | - Justus C Horstmann
- Helmholtz-Institute for Pharmaceutical Research Saarland, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, Saarbrücken, Germany
| | - Duy-Khiet Ho
- Helmholtz-Institute for Pharmaceutical Research Saarland, Saarbrücken, Germany
| | - Konrad Schwarzkopf
- Department of Anaesthesia and Intensive Care, Klinikum Saarbrücken, Germany
| | - Xabier Murgia
- Helmholtz-Institute for Pharmaceutical Research Saarland, Saarbrücken, Germany
| | - Brigitta Loretz
- Helmholtz-Institute for Pharmaceutical Research Saarland, Saarbrücken, Germany
| | | | - Claus-Michael Lehr
- Helmholtz-Institute for Pharmaceutical Research Saarland, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, Saarbrücken, Germany
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13
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Horstmann JC, Thorn CR, Carius P, Graef F, Murgia X, de Souza Carvalho-Wodarz C, Lehr CM. A Custom-Made Device for Reproducibly Depositing Pre-metered Doses of Nebulized Drugs on Pulmonary Cells in vitro. Front Bioeng Biotechnol 2021; 9:643491. [PMID: 33968912 PMCID: PMC8096921 DOI: 10.3389/fbioe.2021.643491] [Citation(s) in RCA: 4] [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: 12/18/2020] [Accepted: 03/16/2021] [Indexed: 12/20/2022] Open
Abstract
The deposition of pre-metered doses (i.e., defined before and not after exposition) at the air-liquid interface of viable pulmonary epithelial cells remains an important but challenging task for developing aerosol medicines. While some devices allow quantification of the deposited dose after or during the experiment, e.g., gravimetrically, there is still no generally accepted way to deposit small pre-metered doses of aerosolized drugs or pharmaceutical formulations, e.g., nanomedicines. Here, we describe a straightforward custom-made device, allowing connection to commercially available nebulizers with standard cell culture plates. Designed to tightly fit into the approximately 12-mm opening of either a 12-well Transwell® insert or a single 24-well plate, a defined dose of an aerosolized liquid can be directly deposited precisely and reproducibly (4.8% deviation) at the air-liquid interface (ALI) of pulmonary cell cultures. The deposited dose can be controlled by the volume of the nebulized solution, which may vary in a range from 20 to 200 μl. The entire nebulization-deposition maneuver is completed after 30 s and is spatially homogenous. After phosphate-buffered saline (PBS) deposition, the viability and barrier properties transepithelial electrical resistance (TEER) of human bronchial epithelial Calu-3 cells were not negatively affected. Straightforward in manufacture and use, the device enables reproducible deposition of metered doses of aerosolized drugs to study the interactions with pulmonary cell cultures grown at ALI conditions.
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Affiliation(s)
- Justus C Horstmann
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Saarbrücken, Germany.,Department of Pharmacy, Saarland University, Saarbrücken, Germany
| | - Chelsea R Thorn
- Clinical and Health Science, University of South Australia, Adelaide, SA, Australia
| | - Patrick Carius
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Saarbrücken, Germany.,Department of Pharmacy, Saarland University, Saarbrücken, Germany
| | - Florian Graef
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Saarbrücken, Germany
| | - Xabier Murgia
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Saarbrücken, Germany
| | | | - Claus-Michael Lehr
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Saarbrücken, Germany.,Department of Pharmacy, Saarland University, Saarbrücken, Germany
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14
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Bianco F, Salomone F, Milesi I, Murgia X, Bonelli S, Pasini E, Dellacà R, Ventura ML, Pillow J. Aerosol drug delivery to spontaneously-breathing preterm neonates: lessons learned. Respir Res 2021; 22:71. [PMID: 33637075 PMCID: PMC7908012 DOI: 10.1186/s12931-020-01585-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 10/06/2020] [Accepted: 11/23/2020] [Indexed: 02/07/2023] Open
Abstract
Delivery of medications to preterm neonates receiving non-invasive ventilation (NIV) represents one of the most challenging scenarios for aerosol medicine. This challenge is highlighted by the undersized anatomy and the complex (patho)physiological characteristics of the lungs in such infants. Key physiological restraints include low lung volumes, low compliance, and irregular respiratory rates, which significantly reduce lung deposition. Such factors are inherent to premature birth and thus can be regarded to as the intrinsic factors that affect lung deposition. However, there are a number of extrinsic factors that also impact lung deposition: such factors include the choice of aerosol generator and its configuration within the ventilation circuit, the drug formulation, the aerosol particle size distribution, the choice of NIV type, and the patient interface between the delivery system and the patient. Together, these extrinsic factors provide an opportunity to optimize the lung deposition of therapeutic aerosols and, ultimately, the efficacy of the therapy. In this review, we first provide a comprehensive characterization of both the intrinsic and extrinsic factors affecting lung deposition in premature infants, followed by a revision of the clinical attempts to deliver therapeutic aerosols to premature neonates during NIV, which are almost exclusively related to the non-invasive delivery of surfactant aerosols. In this review, we provide clues to the interpretation of existing experimental and clinical data on neonatal aerosol delivery and we also describe a frame of measurable variables and available tools, including in vitro and in vivo models, that should be considered when developing a drug for inhalation in this important but under-served patient population.
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Affiliation(s)
- Federico Bianco
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy.
| | - Fabrizio Salomone
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy
| | - Ilaria Milesi
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy
| | | | - Sauro Bonelli
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy
| | - Elena Pasini
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.P.A., 43122, Parma, Italy
| | - Raffaele Dellacà
- TechRes Lab, Dipartimento Di Elettronica, Informazione E Bioingegneria (DEIB), Politecnico Di Milano University, Milano, Italy
| | | | - Jane Pillow
- School of Human Sciences, University of Western Australia, Perth, Australia
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15
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Ricci F, Bresesti I, LaVerde PAM, Salomone F, Casiraghi C, Mersanne A, Storti M, Catozzi C, Tigli L, Zecchi R, Franceschi P, Murgia X, Simonato M, Cogo P, Carnielli V, Lista G. Surfactant lung delivery with LISA and InSurE in adult rabbits with respiratory distress. Pediatr Res 2021; 90:576-583. [PMID: 33452472 PMCID: PMC7809896 DOI: 10.1038/s41390-020-01324-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/02/2020] [Accepted: 11/22/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND In preterm infants, InSurE (Intubation-Surfactant-Extubation) and LISA (less invasive surfactant administration) techniques allow for exogenous surfactant administration while reducing lung injury associated with mechanical ventilation. We compared the acute pulmonary response and lung deposition of surfactant by LISA and InSurE in surfactant-depleted adult rabbits. METHODS Twenty-six spontaneously breathing surfactant-depleted adult rabbits (6-7 weeks old) with moderate RDS and managed with nasal continuous positive airway pressure were randomized to 3 groups: (1) 200 mg/kg of surfactant by InSurE; (2) 200 mg/kg of surfactant by LISA; (3) no surfactant treatment (Control). Gas exchange and lung mechanics were monitored for 180 min. After that, surfactant lung deposition and distribution were evaluated monitoring disaturated-phosphatidylcholine (DSPC) and surfactant protein C (SP-C), respectively. RESULTS No signs of recovery were found in the untreated animals. After InSurE, oxygenation improved more rapidly compared to LISA. However, at 180' LISA and InSurE showed comparable outcomes in terms of gas exchange, ventilation parameters, and lung mechanics. Neither DSPC in the alveolar pool nor SP-C signal distributions in a frontal lung section were significantly different between InSurE and LISA groups. CONCLUSIONS In an acute setting, LISA demonstrated efficacy and surfactant lung delivery similar to that of InSurE in surfactant-depleted adult rabbits. IMPACT Although LISA technique is gaining popularity, there are still several questions to address. This is the first study comparing LISA and InSurE in terms of gas exchange, ventilation parameters, and lung mechanics as well as surfactant deposition and distribution. In our animal study, three hours post-treatment, LISA method seems to be as effective as InSurE and showed similar surfactant lung delivery. Our findings provide some clarifications on a fair comparison between LISA and InSurE techniques, particularly in terms of surfactant delivery. They should reassure some of the concerns raised by the clinical community on LISA adoption in neonatal units.
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Affiliation(s)
- Francesca Ricci
- grid.467287.80000 0004 1761 6733Neonatology and Pulmonary Rare Disease Unit, Pharmacology & Toxicology, Dept. Corporate Preclinical R&D, CHIESI, Parma, Italy
| | - Ilia Bresesti
- Neonatal Intensive Care Unit, “V. Buzzi” Children’s Hospital, ASST-FBF-Sacco, Milan, Italy
| | | | - Fabrizio Salomone
- grid.467287.80000 0004 1761 6733Neonatology and Pulmonary Rare Disease Unit, Pharmacology & Toxicology, Dept. Corporate Preclinical R&D, CHIESI, Parma, Italy
| | - Costanza Casiraghi
- grid.467287.80000 0004 1761 6733Neonatology and Pulmonary Rare Disease Unit, Pharmacology & Toxicology, Dept. Corporate Preclinical R&D, CHIESI, Parma, Italy
| | - Arianna Mersanne
- grid.467287.80000 0004 1761 6733Neonatology and Pulmonary Rare Disease Unit, Pharmacology & Toxicology, Dept. Corporate Preclinical R&D, CHIESI, Parma, Italy
| | - Matteo Storti
- grid.467287.80000 0004 1761 6733Neonatology and Pulmonary Rare Disease Unit, Pharmacology & Toxicology, Dept. Corporate Preclinical R&D, CHIESI, Parma, Italy
| | - Chiara Catozzi
- grid.467287.80000 0004 1761 6733Neonatology and Pulmonary Rare Disease Unit, Pharmacology & Toxicology, Dept. Corporate Preclinical R&D, CHIESI, Parma, Italy
| | - Laura Tigli
- grid.467287.80000 0004 1761 6733Neonatology and Pulmonary Rare Disease Unit, Pharmacology & Toxicology, Dept. Corporate Preclinical R&D, CHIESI, Parma, Italy
| | - Riccardo Zecchi
- grid.8404.80000 0004 1757 2304Mass Spectrometry Service Center (CISM), University of Florence, Florence, Italy
| | - Pietro Franceschi
- grid.424414.30000 0004 1755 6224Unit of Computational Biology, Research and Innovation Centre, Fondazione Edmund Mach, S. Michele all’Adige (TN), Italy
| | | | - Manuela Simonato
- grid.5608.b0000 0004 1757 3470Anesthesiology and Intensive Care Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy ,PCare Laboratory, Fondazione Istituto di Ricerca Pediatrica, “Citta’ della Speranza”, Padova, Italy
| | - Paola Cogo
- grid.5390.f0000 0001 2113 062XDivision of Pediatrics, Department of Medicine, Udine University, Udine, Italy
| | - Virgilio Carnielli
- grid.411490.90000 0004 1759 6306Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Azienda-Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Gianluca Lista
- Neonatal Intensive Care Unit, "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Milan, Italy.
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16
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Phan VHG, Trang Duong HT, Tran PT, Thambi T, Ho DK, Murgia X. Self-Assembled Amphiphilic Starch Based Drug Delivery Platform: Synthesis, Preparation, and Interactions with Biological Barriers. Biomacromolecules 2020; 22:572-585. [PMID: 33346660 DOI: 10.1021/acs.biomac.0c01430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Core-shell structured nanoparticles (NPs) render the simultaneous coloading capacity of both hydrophobic and hydrophilic drugs and may eventually enhance therapeutic efficacy. In this study, we employed a facile squalenoylation technology to synthesize a new amphiphilic starch derivative from partially oxidized starch, which self-assembled into core-shell starch NPs (StNPs) only at a squalenyl degree of substitution (DoS) of ∼1%. The StNPs characteristics could be tuned as the functions of the polymer molecular weight, DoS, and NPs concentration. The biopharmaceutical features of the StNPs, including colloidal stability, carrier properties, and biocompatibility, were carefully investigated. The interaction study between StNPs and mucin glycoproteins, the main organic component of mucus, revealed a moderate mucin interacting profile. Furthermore, the StNPs also showed good penetration through Pseudomonas aeruginosa biofilms. These results nominate StNPs as a versatile drug delivery platform with potential applications for mucosal drug delivery and the treatment of persistent infections.
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Affiliation(s)
- V H Giang Phan
- Biomaterials and Nanotechnology Research Group, Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City 700000, Vietnam
| | - Huu Thuy Trang Duong
- Department of Pharmaceutical Sciences, University of California, Irvine, California 92697, United States
| | - Phu-Tri Tran
- Department of Biochemistry and Cell Biology, Stony Brook University, Stony Brook, New York 11794-5215, United States
| | | | - Duy-Khiet Ho
- Department of Bioengineering, School of Medicine, University of Washington, Seattle, Washington 98195, United States
| | - Xabier Murgia
- Kusudama Therapeutics, Parque Científico y Tecnológico de Gipuzkoa, Donostia-San, Sebastián 20014, Spain
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17
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Ho DK, Christmann R, Murgia X, De Rossi C, Frisch S, Koch M, Schaefer UF, Loretz B, Desmaele D, Couvreur P, Lehr CM. Synthesis and Biopharmaceutical Characterization of Amphiphilic Squalenyl Derivative Based Versatile Drug Delivery Platform. Front Chem 2020; 8:584242. [PMID: 33195079 PMCID: PMC7604382 DOI: 10.3389/fchem.2020.584242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/16/2020] [Accepted: 09/08/2020] [Indexed: 12/15/2022] Open
Abstract
Limited drug loading capacity (LC), mostly below 5% w/w, is a significant drawback of nanoparticulate drug delivery systems (DDS). Squalenoylation technology, which employs bioconjugation of squalenyl moiety and drug, allows self-assemble of nanoparticles (NPs) in aqueous media with significantly high LC (>30% w/w). The synthesis and particle preparation of squalenoylated prodrugs are, however, not facile for molecules with multiple reactive groups. Taking a different approach, we describe the synthesis of amphiphilic squalenyl derivatives (SqDs) as well as the physicochemical and biopharmaceutical characterizations of their self-assembled NPs as DDSs. The SqDs included in this study are (i) cationic squalenyl diethanolamine (ii) PEGylated SqD (PEG 750 Da), (iii) PEGylated SqD (PEG 3,000 Da), and (iv) anionic squalenyl hydrogen sulfate. All four SqDs self-assemble into NPs in a size range from 100 to 200 nm in an aqueous solution. Furthermore, all NP derivatives demonstrate appropriate biocompatibility and adequate colloidal stability in physiological relevant pH environments. The mucoprotein binding of PEGylated NPs is reduced compared to the charged NPs. Most importantly, this technology allows excellent LC (at maximum of 45% w/w) of a wide range of multifunctional compounds, varying in physicochemical properties and molecular weight. Interestingly, the drug release profile can be tuned by different loading methods. In summary, the SqD-based NPs appear as versatile drug delivery platforms.
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Affiliation(s)
- Duy-Khiet Ho
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Centre for Infection Research, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, Saarbrücken, Germany
| | - Rebekka Christmann
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Centre for Infection Research, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, Saarbrücken, Germany
| | - Xabier Murgia
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Centre for Infection Research, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, Saarbrücken, Germany
| | - Chiara De Rossi
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Centre for Infection Research, Saarbrücken, Germany
| | - Sarah Frisch
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Centre for Infection Research, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, Saarbrücken, Germany
| | - Marcus Koch
- INM-Leibniz Institute for New Materials, Saarbrücken, Germany
| | | | - Brigitta Loretz
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Centre for Infection Research, Saarbrücken, Germany
| | - Didier Desmaele
- Faculté de Pharmacie, Institut Galien Paris Sud, Université Paris-Saclay, Chatenay-Malabry, France
| | - Patrick Couvreur
- Faculté de Pharmacie, Institut Galien Paris Sud, Université Paris-Saclay, Chatenay-Malabry, France
| | - Claus-Michael Lehr
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Centre for Infection Research, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, Saarbrücken, Germany
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18
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Ho DK, De Rossi C, Loretz B, Murgia X, Lehr CM. Itaconic Acid Increases the Efficacy of Tobramycin against Pseudomonas aeruginosa Biofilms. Pharmaceutics 2020; 12:pharmaceutics12080691. [PMID: 32707837 PMCID: PMC7463765 DOI: 10.3390/pharmaceutics12080691] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/25/2020] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 01/28/2023] Open
Abstract
The search for novel therapeutics against pulmonary infections, in particular Pseudomonas aeruginosa (PA) biofilm infections, has been intense to deal with the emergent rise of antimicrobial resistance. Despite the numerous achievements in drug discovery and delivery strategies, only a limited number of therapeutics reach the clinic. To allow a timely preclinical development, a formulation should be highly effective, safe, and most importantly facile to produce. Thus, a simple combination of known actives that enhances the therapeutic efficacy would be a preferential choice compared to advanced drug delivery systems. In this study, we propose a novel combination of an anti-inflammatory agent-itaconic acid (itaconate, IA)-and an approved antibiotic-tobramycin (Tob) or ciprofloxacin (Cipro). The combination of Tob and IA at a molar ratio of 1:5 increased the biofilm eradicating efficacy in the strain PA14 wild type (wt) by ~4-fold compared to Tob alone. In contrast, such effect was not observed for the combination of IA with Cipro. Subsequent studies on the influence of IA on bacterial growth, pyocyanin production, and Tob biofilm penetration indicated that complexation with IA enhanced the transport of Tob through the biofilm. We recommend the simple and effective combination of Tob:IA for further testing in advanced preclinical models of PA biofilm infections.
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Affiliation(s)
- Duy-Khiet Ho
- HIPS–Helmholtz Institute for Pharmaceutical Research Saarland, HZI—Helmholtz Center for Infection Research, D-66123 Saarbrücken, Germany; (C.D.R.); (B.L.)
- Correspondence: (D.-K.H.); (X.M.); (C.-M.L.)
| | - Chiara De Rossi
- HIPS–Helmholtz Institute for Pharmaceutical Research Saarland, HZI—Helmholtz Center for Infection Research, D-66123 Saarbrücken, Germany; (C.D.R.); (B.L.)
| | - Brigitta Loretz
- HIPS–Helmholtz Institute for Pharmaceutical Research Saarland, HZI—Helmholtz Center for Infection Research, D-66123 Saarbrücken, Germany; (C.D.R.); (B.L.)
| | - Xabier Murgia
- HIPS–Helmholtz Institute for Pharmaceutical Research Saarland, HZI—Helmholtz Center for Infection Research, D-66123 Saarbrücken, Germany; (C.D.R.); (B.L.)
- Correspondence: (D.-K.H.); (X.M.); (C.-M.L.)
| | - Claus-Michael Lehr
- HIPS–Helmholtz Institute for Pharmaceutical Research Saarland, HZI—Helmholtz Center for Infection Research, D-66123 Saarbrücken, Germany; (C.D.R.); (B.L.)
- Department of Pharmacy, Saarland University, D-66123 Saarbrücken, Germany
- Correspondence: (D.-K.H.); (X.M.); (C.-M.L.)
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19
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Ho D, Murgia X, De Rossi C, Christmann R, Hüfner de Mello Martins AG, Koch M, Andreas A, Herrmann J, Müller R, Empting M, Hartmann RW, Desmaele D, Loretz B, Couvreur P, Lehr C. Cover Picture: Squalenyl Hydrogen Sulfate Nanoparticles for Simultaneous Delivery of Tobramycin and an Alkylquinolone Quorum Sensing Inhibitor Enable the Eradication of
P. aeruginosa
Biofilm Infections (Angew. Chem. Int. Ed. 26/2020). Angew Chem Int Ed Engl 2020. [DOI: 10.1002/anie.202005838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Duy‐Khiet Ho
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
- Current address: Department of Bioengineering School of Medicine University of Washington Seattle WA 98195 USA
| | - Xabier Murgia
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
- Current address: Kusudama Therapeutics Parque Científico y Tecnológico de Gipuzkoa 20014 Donostia-San Sebastián Spain
| | - Chiara De Rossi
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
| | - Rebekka Christmann
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
| | | | - Marcus Koch
- INM—Leibniz Institute for New Materials 66123 Saarbrücken Germany
| | - Anastasia Andreas
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
| | - Jennifer Herrmann
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
| | - Rolf Müller
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
| | - Martin Empting
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
| | - Rolf W. Hartmann
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
| | - Didier Desmaele
- Faculté de Pharmacie Institut Galien Paris Sud Université Paris-Saclay, UMR CNRS 8612 92296 Châtenay-Malabry France
| | - Brigitta Loretz
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
| | - Patrick Couvreur
- Faculté de Pharmacie Institut Galien Paris Sud Université Paris-Saclay, UMR CNRS 8612 92296 Châtenay-Malabry France
| | - Claus‐Michael Lehr
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
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20
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Ho D, Murgia X, De Rossi C, Christmann R, Hüfner de Mello Martins AG, Koch M, Andreas A, Herrmann J, Müller R, Empting M, Hartmann RW, Desmaele D, Loretz B, Couvreur P, Lehr C. Titelbild: Squalenyl Hydrogen Sulfate Nanoparticles for Simultaneous Delivery of Tobramycin and an Alkylquinolone Quorum Sensing Inhibitor Enable the Eradication of
P. aeruginosa
Biofilm Infections (Angew. Chem. 26/2020). Angew Chem Int Ed Engl 2020. [DOI: 10.1002/ange.202005838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Duy‐Khiet Ho
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
- Current address: Department of Bioengineering School of Medicine University of Washington Seattle WA 98195 USA
| | - Xabier Murgia
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
- Current address: Kusudama Therapeutics Parque Científico y Tecnológico de Gipuzkoa 20014 Donostia-San Sebastián Spain
| | - Chiara De Rossi
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
| | - Rebekka Christmann
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
| | | | - Marcus Koch
- INM—Leibniz Institute for New Materials 66123 Saarbrücken Germany
| | - Anastasia Andreas
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
| | - Jennifer Herrmann
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
| | - Rolf Müller
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
| | - Martin Empting
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
| | - Rolf W. Hartmann
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
| | - Didier Desmaele
- Faculté de Pharmacie Institut Galien Paris Sud Université Paris-Saclay, UMR CNRS 8612 92296 Châtenay-Malabry France
| | - Brigitta Loretz
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
| | - Patrick Couvreur
- Faculté de Pharmacie Institut Galien Paris Sud Université Paris-Saclay, UMR CNRS 8612 92296 Châtenay-Malabry France
| | - Claus‐Michael Lehr
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
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21
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Ho D, Murgia X, De Rossi C, Christmann R, Hüfner de Mello Martins AG, Koch M, Andreas A, Herrmann J, Müller R, Empting M, Hartmann RW, Desmaele D, Loretz B, Couvreur P, Lehr C. Squalenyl Hydrogen Sulfate Nanoparticles for Simultaneous Delivery of Tobramycin and an Alkylquinolone Quorum Sensing Inhibitor Enable the Eradication of
P. aeruginosa
Biofilm Infections. Angew Chem Int Ed Engl 2020. [DOI: 10.1002/ange.202001407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Duy‐Khiet Ho
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
- Current address: Department of Bioengineering School of Medicine University of Washington Seattle WA 98195 USA
| | - Xabier Murgia
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
- Current address: Kusudama Therapeutics Parque Científico y Tecnológico de Gipuzkoa 20014 Donostia-San Sebastián Spain
| | - Chiara De Rossi
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
| | - Rebekka Christmann
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
| | | | - Marcus Koch
- INM—Leibniz Institute for New Materials 66123 Saarbrücken Germany
| | - Anastasia Andreas
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
| | - Jennifer Herrmann
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
| | - Rolf Müller
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
| | - Martin Empting
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
| | - Rolf W. Hartmann
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- German Centre for Infection Research (DZIF) Partner Site Hannover-Braunschweig 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
| | - Didier Desmaele
- Faculté de Pharmacie Institut Galien Paris Sud Université Paris-Saclay, UMR CNRS 8612 92296 Châtenay-Malabry France
| | - Brigitta Loretz
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
| | - Patrick Couvreur
- Faculté de Pharmacie Institut Galien Paris Sud Université Paris-Saclay, UMR CNRS 8612 92296 Châtenay-Malabry France
| | - Claus‐Michael Lehr
- Helmholtz Institute for Pharmaceutical Research Saarland Helmholtz Center for Infection Research 66123 Saarbrücken Germany
- Department of Pharmacy Saarland University 66123 Saarbrücken Germany
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22
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Ho DK, Murgia X, De Rossi C, Christmann R, Hüfner de Mello Martins AG, Koch M, Andreas A, Herrmann J, Müller R, Empting M, Hartmann RW, Desmaele D, Loretz B, Couvreur P, Lehr CM. Squalenyl Hydrogen Sulfate Nanoparticles for Simultaneous Delivery of Tobramycin and an Alkylquinolone Quorum Sensing Inhibitor Enable the Eradication of P. aeruginosa Biofilm Infections. Angew Chem Int Ed Engl 2020; 59:10292-10296. [PMID: 32243047 PMCID: PMC7317969 DOI: 10.1002/anie.202001407] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [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: 01/28/2020] [Revised: 03/16/2020] [Indexed: 12/02/2022]
Abstract
Elimination of pulmonary Pseudomonas aeruginosa (PA) infections is challenging to accomplish with antibiotic therapies, mainly due to resistance mechanisms. Quorum sensing inhibitors (QSIs) interfering with biofilm formation can thus complement antibiotics. For simultaneous and improved delivery of both active agents to the infection sites, self‐assembling nanoparticles of a newly synthesized squalenyl hydrogen sulfate (SqNPs) were prepared. These nanocarriers allowed for remarkably high loading capacities of hydrophilic antibiotic tobramycin (Tob) and a novel lipophilic QSI at 30 % and circa 10 %, respectively. The drug‐loaded SqNPs showed improved biofilm penetration and enhanced efficacy in relevant biological barriers (mucin/human tracheal mucus, biofilm), leading to complete eradication of PA biofilms at circa 16‐fold lower Tob concentration than Tob alone. This study offers a viable therapy optimization and invigorates the research and development of QSIs for clinical use.
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Affiliation(s)
- Duy-Khiet Ho
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Center for Infection Research, 66123, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, 66123, Saarbrücken, Germany.,Current address: Department of Bioengineering, School of Medicine, University of Washington, Seattle, WA, 98195, USA
| | - Xabier Murgia
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Center for Infection Research, 66123, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, 66123, Saarbrücken, Germany.,Current address: Kusudama Therapeutics, Parque Científico y Tecnológico de Gipuzkoa, 20014, Donostia-San Sebastián, Spain
| | - Chiara De Rossi
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Center for Infection Research, 66123, Saarbrücken, Germany
| | - Rebekka Christmann
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Center for Infection Research, 66123, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, 66123, Saarbrücken, Germany
| | | | - Marcus Koch
- INM-Leibniz Institute for New Materials, 66123, Saarbrücken, Germany
| | - Anastasia Andreas
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Center for Infection Research, 66123, Saarbrücken, Germany.,German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, 66123, Saarbrücken, Germany
| | - Jennifer Herrmann
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Center for Infection Research, 66123, Saarbrücken, Germany.,German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, 66123, Saarbrücken, Germany
| | - Rolf Müller
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Center for Infection Research, 66123, Saarbrücken, Germany.,German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, 66123, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, 66123, Saarbrücken, Germany
| | - Martin Empting
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Center for Infection Research, 66123, Saarbrücken, Germany.,German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, 66123, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, 66123, Saarbrücken, Germany
| | - Rolf W Hartmann
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Center for Infection Research, 66123, Saarbrücken, Germany.,German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, 66123, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, 66123, Saarbrücken, Germany
| | - Didier Desmaele
- Faculté de Pharmacie, Institut Galien Paris Sud, Université Paris-Saclay, UMR CNRS 8612, 92296, Châtenay-Malabry, France
| | - Brigitta Loretz
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Center for Infection Research, 66123, Saarbrücken, Germany
| | - Patrick Couvreur
- Faculté de Pharmacie, Institut Galien Paris Sud, Université Paris-Saclay, UMR CNRS 8612, 92296, Châtenay-Malabry, France
| | - Claus-Michael Lehr
- Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Center for Infection Research, 66123, Saarbrücken, Germany.,Department of Pharmacy, Saarland University, 66123, Saarbrücken, Germany
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23
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Bianco F, Pasini E, Nutini M, Murgia X, Stoeckl C, Schlun M, Hetzer U, Bonelli S, Lombardini M, Milesi I, Pertile M, Minocchieri S, Salomone F, Bucholski A. Extended Pharmacopeial Characterization of Surfactant Aerosols Generated by a Customized eFlow Neos Nebulizer Delivered through Neonatal Nasal Prongs. Pharmaceutics 2020; 12:pharmaceutics12040319. [PMID: 32252349 PMCID: PMC7238214 DOI: 10.3390/pharmaceutics12040319] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 02/13/2020] [Revised: 03/06/2020] [Accepted: 03/31/2020] [Indexed: 12/17/2022] Open
Abstract
The delivery of nebulized medications to preterm infants during Non-Invasive Ventilation (NIV) remains an unmet clinical need. In this regard, the effective delivery of nebulized surfactant has been particularly investigated in preclinical and clinical studies. In this work, we investigated the feasibility of delivering nebulized surfactant through various commercially available nasal prong types. We first performed a compendial characterization of surfactant aerosols generated by the eFlow Neos nebulizer, customized to be used in neonates, determining the amount of surfactant delivered by the device as well as the aerodynamic characteristics of surfactant aerosols. Additionally, we extended the compendial characterization by testing the effect of different nasal prong types on the estimated lung dose using a realistic Continuous Positive Airway Pressure (CPAP) circuit that included a cast of the upper airways of a preterm neonate. The compendial characterization of surfactant aerosols delivered through different nasal prongs achieved relatively high delivered surfactant doses (in the range 63-74% of the nominal dose), with aerodynamic characteristics displaying mass median aerodynamic diameters ranging between 2.52 and 2.81 µm. Nevertheless, when using a representative in vitro setup mimicking NIV in a clinical setting, significant differences were observed in terms of the estimated lung dose accounting for up to two-fold differences (from 10% to 20% estimated lung deposition of the nominal dose) depending on the chosen nasal prong type. Considering that surfactant lung deposition rates are correlated with therapeutic efficacy, this study points out the relevance of choosing the appropriate NIV interface to maximize the lung dose of nebulized medications.
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Affiliation(s)
- Federico Bianco
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 43122 Parma, Italy; (E.P.); (M.N.); (S.B.); (M.L.); (I.M.); (M.P.); (F.S.)
- Correspondence: ; Tel.: +390521279035
| | - Elena Pasini
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 43122 Parma, Italy; (E.P.); (M.N.); (S.B.); (M.L.); (I.M.); (M.P.); (F.S.)
| | - Marcello Nutini
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 43122 Parma, Italy; (E.P.); (M.N.); (S.B.); (M.L.); (I.M.); (M.P.); (F.S.)
| | | | - Carolin Stoeckl
- PARI Pharma GmbH, 82319 Starnberg, Germany; (C.S.); (M.S.); (U.H.); (A.B.)
| | - Martin Schlun
- PARI Pharma GmbH, 82319 Starnberg, Germany; (C.S.); (M.S.); (U.H.); (A.B.)
| | - Uwe Hetzer
- PARI Pharma GmbH, 82319 Starnberg, Germany; (C.S.); (M.S.); (U.H.); (A.B.)
| | - Sauro Bonelli
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 43122 Parma, Italy; (E.P.); (M.N.); (S.B.); (M.L.); (I.M.); (M.P.); (F.S.)
| | - Marta Lombardini
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 43122 Parma, Italy; (E.P.); (M.N.); (S.B.); (M.L.); (I.M.); (M.P.); (F.S.)
| | - Ilaria Milesi
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 43122 Parma, Italy; (E.P.); (M.N.); (S.B.); (M.L.); (I.M.); (M.P.); (F.S.)
| | - Marisa Pertile
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 43122 Parma, Italy; (E.P.); (M.N.); (S.B.); (M.L.); (I.M.); (M.P.); (F.S.)
| | - Stephan Minocchieri
- Division of Neonatology, Cantonal Hospital Winterthur, 8401 Winterthur, Switzerland;
| | - Fabrizio Salomone
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., 43122 Parma, Italy; (E.P.); (M.N.); (S.B.); (M.L.); (I.M.); (M.P.); (F.S.)
| | - Albert Bucholski
- PARI Pharma GmbH, 82319 Starnberg, Germany; (C.S.); (M.S.); (U.H.); (A.B.)
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Ho DK, Nichols BLB, Edgar KJ, Murgia X, Loretz B, Lehr CM. Challenges and strategies in drug delivery systems for treatment of pulmonary infections. Eur J Pharm Biopharm 2019; 144:110-124. [PMID: 31493510 DOI: 10.1016/j.ejpb.2019.09.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [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: 05/23/2019] [Revised: 08/23/2019] [Accepted: 09/03/2019] [Indexed: 01/08/2023]
Abstract
Inhalation therapy has been reported as the most effective treatment for respiratory bacterial infections due to the increasing relevance of drug bioavailability. Drug delivery systems (DDS) have the capacity to overcome pulmonary biological barriers limiting the bioavailability of inhaled anti-infectives. This is important to eradicate bacterial infections and to prevent the development of bacterial resistance. Despite substantial efforts in the field, the current state-of-the-art often fails to achieve those goals, and we still observe increasing bacterial resistance. We give a brief insight on benefits and challenges in pulmonary delivery of anti-infectives. In the context of drug delivery development for pulmonary infections, particularly focusing on Pseudomonas aeruginosa (PA) infections, this mini review will critically discuss the main requirements, as well as the recent strategies of drug delivery system synthesis and preparation. Finally, interaction of DDS with crucial pulmonary biological barriers will be of great importance for the success of future applications of the developed DDS.
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Affiliation(s)
- Duy-Khiet Ho
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), Saarland University, D-66123 Saarbrücken, Germany
| | - Brittany L B Nichols
- Department of Chemistry, Virginia Tech, Blacksburg, VA 24061, United States; Macromolecules Innovation Institute, Virginia Tech, Blacksburg, VA 24061, United States
| | - Kevin J Edgar
- Macromolecules Innovation Institute, Virginia Tech, Blacksburg, VA 24061, United States; Department of Sustainable Biomaterials, Virginia Tech, Blacksburg, VA 24061, United States
| | - Xabier Murgia
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), Saarland University, D-66123 Saarbrücken, Germany
| | - Brigitta Loretz
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), Saarland University, D-66123 Saarbrücken, Germany.
| | - Claus-Michael Lehr
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), Saarland University, D-66123 Saarbrücken, Germany; Department of Pharmacy, Saarland University, D-66123 Saarbrücken, Germany
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25
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Huck BC, Hartwig O, Biehl A, Schwarzkopf K, Wagner C, Loretz B, Murgia X, Lehr CM. Macro- and Microrheological Properties of Mucus Surrogates in Comparison to Native Intestinal and Pulmonary Mucus. Biomacromolecules 2019; 20:3504-3512. [DOI: 10.1021/acs.biomac.9b00780] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | | | | | - Konrad Schwarzkopf
- Department of Anesthesia and Intensive Care, Klinikum Saarbrücken gGmbH, 66123 Saarbruecken, Germany
| | - Christian Wagner
- Experimental Physics, Saarland University, 66123 Saarbruecken, Germany
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26
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Zecchi R, Franceschi P, Tigli L, Ricci F, Boscaro F, Pioselli B, Mileo V, Murgia X, Bianco F, Salomone F, Schmidt AF, Hillman NH, Kemp MW, Jobe AH. Mass spectrometry imaging as a tool for evaluating the pulmonary distribution of exogenous surfactant in premature lambs. Respir Res 2019; 20:175. [PMID: 31382955 PMCID: PMC6683365 DOI: 10.1186/s12931-019-1144-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 05/07/2019] [Accepted: 07/24/2019] [Indexed: 01/29/2023] Open
Abstract
Background The amount of surfactant deposited in the lungs and its overall pulmonary distribution determine the therapeutic outcome of surfactant replacement therapy. Most of the currently available methods to determine the intrapulmonary distribution of surfactant are time-consuming and require surfactant labelling. Our aim was to assess the potential of Mass Spectrometry Imaging (MSI) as a label-free technique to qualitatively and quantitatively evaluate the distribution of surfactant to the premature lamb. Methods Twelve preterm lambs (gestational age 126-127d, term ~150d) were allocated in two experimental groups. Seven lambs were treated with an intratracheal bolus of the synthetic surfactant CHF5633 (200 mg/kg) and 5 lambs were managed with mechanical ventilation for 120 min, as controls. The right lung lobes of all lambs were gradually frozen while inflated to 20 cmH2O pressure for lung cryo-sections for MSI analysis. The intensity signals of SP-C analog and SP-B analog, the two synthetic peptides contained in the CHF5633 surfactant, were used to locate, map and quantify the intrapulmonary exogenous surfactant. Results Surfactant treatment was associated with a significant improvement of the mean arterial oxygenation and lung compliance (p < 0.05). Nevertheless, the physiological response to surfactant treatment was not uniform across all animals. SP-C analog and SP-B analog were successfully imaged and quantified by means of MSI in the peripheral lungs of all surfactant-treated animals. The intensity of the signal was remarkably low in untreated lambs, corresponding to background noise. The signal intensity of SP-B analog in each surfactant-treated animal, which represents the surfactant distributed to the peripheral right lung, correlated well with the physiologic response as assessed by the area under the curves of the individual arterial partial oxygen pressure and dynamic lung compliance curves of the lambs. Conclusions Applying MSI, we were able to detect, locate and quantify the amount of exogenous surfactant distributed to the lower right lung of surfactant-treated lambs. The distribution pattern of SP-B analog correlated well with the pulmonary physiological outcomes of the animals. MSI is a valuable label-free technique which is able to simultaneously evaluate qualitative and quantitative drug distribution in the lung. Electronic supplementary material The online version of this article (10.1186/s12931-019-1144-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Riccardo Zecchi
- Mass Spectrometry Service Center (CISM), University of Florence, Florence, Italy
| | - Pietro Franceschi
- Computational Biology, Research and Innovation Centre, Fondazione Edmund Mach, S. Michele all'Adige, TN, Italy
| | - Laura Tigli
- Preclinical R&D, Chiesi Farmaceutici, Largo Francesco Belloli, 11/A, 43122, Parma, Italy
| | - Francesca Ricci
- Preclinical R&D, Chiesi Farmaceutici, Largo Francesco Belloli, 11/A, 43122, Parma, Italy
| | - Francesca Boscaro
- Mass Spectrometry Service Center (CISM), University of Florence, Florence, Italy
| | - Barbara Pioselli
- Preclinical R&D, Chiesi Farmaceutici, Largo Francesco Belloli, 11/A, 43122, Parma, Italy
| | - Valentina Mileo
- Preclinical R&D, Chiesi Farmaceutici, Largo Francesco Belloli, 11/A, 43122, Parma, Italy
| | | | - Federico Bianco
- Preclinical R&D, Chiesi Farmaceutici, Largo Francesco Belloli, 11/A, 43122, Parma, Italy
| | - Fabrizio Salomone
- Preclinical R&D, Chiesi Farmaceutici, Largo Francesco Belloli, 11/A, 43122, Parma, Italy.
| | - Augusto F Schmidt
- Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital, Cincinnati, USA
| | - Noah H Hillman
- Division of Neonatology, Cardinal Glennon Children's Hospital, Saint Louis University, Saint Louis, USA
| | - Matthew W Kemp
- Division of Obstetrics and Gynecology, University of Western Australia, Perth, WA, Australia
| | - Alan H Jobe
- Division of Neonatology, Cardinal Glennon Children's Hospital, Saint Louis University, Saint Louis, USA.,Division of Obstetrics and Gynecology, University of Western Australia, Perth, WA, Australia
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27
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Bianco F, Ricci F, Catozzi C, Murgia X, Schlun M, Bucholski A, Hetzer U, Bonelli S, Lombardini M, Pasini E, Nutini M, Pertile M, Minocchieri S, Simonato M, Rosa B, Pieraccini G, Moneti G, Lorenzini L, Catinella S, Villetti G, Civelli M, Pioselli B, Cogo P, Carnielli V, Dani C, Salomone F. From bench to bedside: in vitro and in vivo evaluation of a neonate-focused nebulized surfactant delivery strategy. Respir Res 2019; 20:134. [PMID: 31266508 PMCID: PMC6604359 DOI: 10.1186/s12931-019-1096-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [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: 02/24/2019] [Accepted: 06/12/2019] [Indexed: 01/17/2023] Open
Abstract
Background Non-invasive delivery of nebulized surfactant has been a neonatology long-pursued goal. Nevertheless, the clinical efficacy of nebulized surfactant remains inconclusive, in part, due to the great technical challenges of depositing nebulized drugs in the lungs of preterm infants. The aim of this study was to investigate the feasibility of delivering nebulized surfactant (poractant alfa) in vitro and in vivo with an adapted, neonate-tailored aerosol delivery strategy. Methods Particle size distribution of undiluted poractant alfa aerosols generated by a customized eFlow-Neos nebulizer system was determined by laser diffraction. The theoretical nebulized surfactant lung dose was estimated in vitro in a clinical setting replica including a neonatal continuous positive airway pressure (CPAP) circuit, a cast of the upper airways of a preterm neonate, and a breath simulator programmed with the tidal breathing pattern of an infant with mild respiratory distress syndrome (RDS). A dose-response study with nebulized surfactant covering the 100–600 mg/kg nominal dose-range was conducted in RDS-modelling, lung-lavaged spontaneously-breathing rabbits managed with nasal CPAP. The effects of nebulized poractant alfa on arterial gas exchange and lung mechanics were assessed. Exogenous alveolar disaturated-phosphatidylcholine (DSPC) in the lungs was measured as a proxy of surfactant deposition efficacy. Results Laser diffraction studies demonstrated suitable aerosol characteristics for inhalation (mass median diameter, MMD = 3 μm). The mean surfactant lung dose determined in vitro was 13.7% ± 4.0 of the 200 mg/kg nominal dose. Nebulized surfactant delivered to spontaneously-breathing rabbits during nasal CPAP significantly improved arterial oxygenation compared to animals receiving CPAP only. Particularly, the groups of animals treated with 200 mg/kg and 400 mg/kg of nebulized poractant alfa achieved an equivalent pulmonary response in terms of oxygenation and lung mechanics as the group of animals treated with instilled surfactant (200 mg/kg). Conclusions The customized eFlow-Neos vibrating-membrane nebulizer system efficiently generated respirable aerosols of undiluted poractant alfa. Nebulized surfactant delivered at doses of 200 mg/kg and 400 mg/kg elicited a pulmonary response equivalent to that observed after treatment with an intratracheal surfactant bolus of 200 mg/kg. This bench-characterized nebulized surfactant delivery strategy is now under evaluation in Phase II clinical trial (EUDRACT No.:2016–004547-36). Electronic supplementary material The online version of this article (10.1186/s12931-019-1096-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- F Bianco
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - F Ricci
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - C Catozzi
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - X Murgia
- Scientific Consultancy, Saarbrücken, Germany
| | - M Schlun
- PARI Pharma GmbH, Starnberg, Germany
| | | | - U Hetzer
- PARI Pharma GmbH, Starnberg, Germany
| | - S Bonelli
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - M Lombardini
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - E Pasini
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - M Nutini
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - M Pertile
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - S Minocchieri
- Division of Neonatology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - M Simonato
- Pediatric Research Institute "Città della Speranza", Padova, Italy
| | - B Rosa
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - G Pieraccini
- Mass Spectrometry Center (CISM), Polo Biomedico, Careggi University Hospital of Florence, Florence, Italy
| | - G Moneti
- Mass Spectrometry Center (CISM), Polo Biomedico, Careggi University Hospital of Florence, Florence, Italy
| | - L Lorenzini
- Health Science and Technologies Interdepartmental Center for Industrial Research (HST-ICIR), University of Bologna, Bologna, Italy
| | - S Catinella
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - G Villetti
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - M Civelli
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - B Pioselli
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
| | - P Cogo
- Division of Pediatrics, Department of Medicine, University of Udine, Udine, Italy
| | - V Carnielli
- Polytechnic University of Marche and Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy
| | - C Dani
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence School of Medicine, Careggi University Hospital of Florence, Viale Morgagni, 85, Florence, Italy.
| | - F Salomone
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A, Parma, Italy
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Vukosavljevic B, Hittinger M, Hachmeister H, Pilger C, Murgia X, Gepp MM, Gentile L, Huwer H, Schneider-Daum N, Huser T, Lehr CM, Windbergs M. Vibrational spectroscopic imaging and live cell video microscopy for studying differentiation of primary human alveolar epithelial cells. J Biophotonics 2019; 12:e201800052. [PMID: 30597770 DOI: 10.1002/jbio.201800052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 12/17/2018] [Accepted: 12/28/2018] [Indexed: 06/09/2023]
Abstract
Alveolar type II (ATII) cells in the peripheral human lung spontaneously differentiate toward ATI cells, thus enabling air-blood barrier formation. Here, linear Raman and coherent anti-Stokes Raman scattering (CARS) microscopy are applied to study cell differentiation of freshly isolated ATII cells. The Raman spectra can successfully be correlated with gradual morphological and molecular changes during cell differentiation. Alveolar surfactant rich vesicles in ATII cells are identified based on phospholipid vibrations, while ATI-like cells are characterized by the absence of vesicular structures. Complementary, CARS microscopy allows for three-dimensional visualization of lipid vesicles within ATII cells and their secretion, while hyperspectral CARS enables the distinction between cellular proteins and lipids according to their vibrational signatures. This study paves the path for further label-free investigations of lung cells and the role of the pulmonary surfactant, thus also providing a basis for rational development of future lung therapeutics.
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Affiliation(s)
- Branko Vukosavljevic
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, Saarbrücken, Germany
- PharmBioTec GmbH, Saarbrücken, Germany
| | - Marius Hittinger
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, Saarbrücken, Germany
- PharmBioTec GmbH, Saarbrücken, Germany
| | - Henning Hachmeister
- Biomolecular Photonics, Faculty of Physics, Bielefeld University, Bielefeld, Germany
| | - Christian Pilger
- Biomolecular Photonics, Faculty of Physics, Bielefeld University, Bielefeld, Germany
| | - Xabier Murgia
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, Saarbrücken, Germany
| | - Michael M Gepp
- Fraunhofer Institute for Biomedical Engineering IBMT, Sulzbach, Germany
| | - Luca Gentile
- Fraunhofer Institute for Biomedical Engineering IBMT, Sulzbach, Germany
| | - Hanno Huwer
- Heart and Thoracic Surgery, SHG Kliniken Völklingen, Saarbrücken, Germany
| | - Nicole Schneider-Daum
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, Saarbrücken, Germany
| | - Thomas Huser
- Biomolecular Photonics, Faculty of Physics, Bielefeld University, Bielefeld, Germany
| | - Claus-Michael Lehr
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, Saarbrücken, Germany
- PharmBioTec GmbH, Saarbrücken, Germany
- Department of Pharmacy, Saarland University, Saarbrücken, Germany
| | - Maike Windbergs
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, Saarbrücken, Germany
- PharmBioTec GmbH, Saarbrücken, Germany
- Institute of Pharmaceutical Technology and Buchmann Institute for Molecular Life Sciences, Goethe University Frankfurt, Frankfurt am Main, Germany
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Lehr CM, Hittinger M, Loretz B, Murgia X, Carvalho-Wodarz C, Schneider-Daum N. In vitro models for predictive immunological testing of nanopharmaceuticals targeted to human epithelial barriers. Toxicol Lett 2018. [DOI: 10.1016/j.toxlet.2018.06.1118] [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: 11/25/2022]
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Graef F, Richter R, Fetz V, Murgia X, De Rossi C, Schneider-Daum N, Allegretta G, Elgaher W, Haupenthal J, Empting M, Beckmann F, Brönstrup M, Hartmann R, Gordon S, Lehr CM. In Vitro Model of the Gram-Negative Bacterial Cell Envelope for Investigation of Anti-Infective Permeation Kinetics. ACS Infect Dis 2018; 4:1188-1196. [PMID: 29750862 DOI: 10.1021/acsinfecdis.7b00165] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The cell envelope of Gram-negative bacteria is a formidable biological barrier, inhibiting the action of antibiotics by impeding their permeation into the intracellular environment. In-depth understanding of permeation through this barrier remains a challenge, despite its critical role in antibiotic activity. We therefore designed a divisible in vitro permeation model of the Gram-negative bacterial cell envelope, mimicking its three essential structural elements, the inner membrane and the periplasmic space as well as the outer membrane, on a Transwell setup. The model was characterized by contemporary imaging techniques and employed to generate reproducible quantitative and time-resolved permeation data for various fluorescent probes and anti-infective molecules of different structure and physicochemical properties. For a set of three fluorescent probes, the permeation through the overall membrane model was found to correlate with in bacterio permeation. Even more interestingly, for a set of six Pseudomonas quorum sensing inhibitors, such permeability data were found to be predictive for their corresponding in bacterio activities. Further exploration of the capabilities of the overall model yielded a correlation between the permeability of porin-independent antibiotics and published in bacterio accumulation data; a promising ability to provide structure-permeability information was also demonstrated. Such a model may therefore constitute a valuable tool for the development of novel anti-infective drugs.
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Affiliation(s)
- Florian Graef
- Department of Drug Delivery, Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
- Department of Pharmacy, Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
| | - Robert Richter
- Department of Drug Delivery, Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
- Department of Pharmacy, Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
| | - Verena Fetz
- Department of Chemical Biology, HZI, German Center for Infection Research, Inhoffenstraße 7, 38124 Braunschweig, Germany
- School of Engineering and Science, Jacobs University Bremen, Campus Ring 1, 28759 Bremen, Germany
| | - Xabier Murgia
- Department of Drug Delivery, Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
- Department of Pharmacy, Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
| | - Chiara De Rossi
- Department of Drug Delivery, Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
| | - Nicole Schneider-Daum
- Department of Drug Delivery, Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
| | - Giuseppe Allegretta
- Department of Drug Design and Optimization, HIPS, HZI, Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
| | - Walid Elgaher
- Department of Drug Design and Optimization, HIPS, HZI, Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
| | - Jörg Haupenthal
- Department of Drug Design and Optimization, HIPS, HZI, Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
| | - Martin Empting
- Department of Pharmacy, Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
- Department of Drug Design and Optimization, HIPS, HZI, Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
| | - Felix Beckmann
- Institute of Materials Research, Helmholtz-Zentrum Geesthacht, Max-Planck-Straße 1, 21502 Geesthacht, Germany
| | - Mark Brönstrup
- Department of Chemical Biology, HZI, German Center for Infection Research, Inhoffenstraße 7, 38124 Braunschweig, Germany
| | - Rolf Hartmann
- Department of Pharmacy, Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
- Department of Drug Design and Optimization, HIPS, HZI, Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
| | - Sarah Gordon
- Department of Drug Delivery, Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, James Parsons Building, Byrom Street, L3 3AF Liverpool, United Kingdom
| | - Claus-Michael Lehr
- Department of Drug Delivery, Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
- Department of Pharmacy, Saarland University, Campus Building E8 1, 66123 Saarbrücken, Germany
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31
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Ho DK, Frisch S, Biehl A, Terriac E, De Rossi C, Schwarzkopf K, Lautenschläger F, Loretz B, Murgia X, Lehr CM. Farnesylated Glycol Chitosan as a Platform for Drug Delivery: Synthesis, Characterization, and Investigation of Mucus–Particle Interactions. Biomacromolecules 2018; 19:3489-3501. [DOI: 10.1021/acs.biomac.8b00795] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Duy-Khiet Ho
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), ‡Department of Pharmacy, §INM−Leibniz Institute for New Materials, and ⊥Korea Institute of Science and Technology, KIST Europe, Saarland University, D-66123 Saarbrücken, Germany
| | - Sarah Frisch
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), ‡Department of Pharmacy, §INM−Leibniz Institute for New Materials, and ⊥Korea Institute of Science and Technology, KIST Europe, Saarland University, D-66123 Saarbrücken, Germany
| | - Alexander Biehl
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), ‡Department of Pharmacy, §INM−Leibniz Institute for New Materials, and ⊥Korea Institute of Science and Technology, KIST Europe, Saarland University, D-66123 Saarbrücken, Germany
| | | | - Chiara De Rossi
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), ‡Department of Pharmacy, §INM−Leibniz Institute for New Materials, and ⊥Korea Institute of Science and Technology, KIST Europe, Saarland University, D-66123 Saarbrücken, Germany
| | - Konrad Schwarzkopf
- Department of Anesthesia and Intensive Care, Klinikum Saarbrücken, 66119 Saarbrücken, Germany
| | | | - Brigitta Loretz
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), ‡Department of Pharmacy, §INM−Leibniz Institute for New Materials, and ⊥Korea Institute of Science and Technology, KIST Europe, Saarland University, D-66123 Saarbrücken, Germany
| | - Xabier Murgia
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), ‡Department of Pharmacy, §INM−Leibniz Institute for New Materials, and ⊥Korea Institute of Science and Technology, KIST Europe, Saarland University, D-66123 Saarbrücken, Germany
| | - Claus-Michael Lehr
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Center for Infection Research (HZI), ‡Department of Pharmacy, §INM−Leibniz Institute for New Materials, and ⊥Korea Institute of Science and Technology, KIST Europe, Saarland University, D-66123 Saarbrücken, Germany
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Müller L, Murgia X, Siebenbürger L, Börger C, Schwarzkopf K, Sewald K, Häussler S, Braun A, Lehr CM, Hittinger M, Wronski S. Human airway mucus alters susceptibility of Pseudomonas aeruginosa biofilms to tobramycin, but not colistin. J Antimicrob Chemother 2018; 73:2762-2769. [DOI: 10.1093/jac/dky241] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 05/26/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Laura Müller
- Fraunhofer Institute for Toxicology and Experimental Medicine (Fraunhofer ITEM), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Member of the REBIRTH Cluster of Excellence, Nikolai-Fuchs-Straße 1, Hannover, Germany
| | - Xabier Murgia
- Helmholtz Institute for Pharmaceutical Research (HIPS), Helmholtz Centre for Infection Research, Universitätscampus E8.1, Saarbrücken, Germany
- Korea Institute of Science and Technology, KIST Europe, Campus E7.1, Saarbrücken, Germany
| | | | | | - Konrad Schwarzkopf
- Department of Anaesthesia and Intensive Care, Klinikum Saarbrücken, Winterberg 1, Saarbrücken, Germany
| | - Katherina Sewald
- Fraunhofer Institute for Toxicology and Experimental Medicine (Fraunhofer ITEM), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Member of the REBIRTH Cluster of Excellence, Nikolai-Fuchs-Straße 1, Hannover, Germany
| | - Susanne Häussler
- Helmholtz Institute for Infection Research, Inhoffenstraße 7, Braunschweig, Germany
- TWINCORE, Centre for Experimental and Clinical Infection Research, Feodor-Lynen-Straße 7, Hannover, Germany
| | - Armin Braun
- Fraunhofer Institute for Toxicology and Experimental Medicine (Fraunhofer ITEM), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Member of the REBIRTH Cluster of Excellence, Nikolai-Fuchs-Straße 1, Hannover, Germany
| | - Claus-Michael Lehr
- Helmholtz Institute for Pharmaceutical Research (HIPS), Helmholtz Centre for Infection Research, Universitätscampus E8.1, Saarbrücken, Germany
- PharmBioTec GmbH, Science Park 1, Saarbrücken, Germany
- Department of Pharmacy, Saarland University, Campus, Saarbrücken, Germany
| | | | - Sabine Wronski
- Fraunhofer Institute for Toxicology and Experimental Medicine (Fraunhofer ITEM), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Member of the REBIRTH Cluster of Excellence, Nikolai-Fuchs-Straße 1, Hannover, Germany
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Murgia X, Loretz B, Hartwig O, Hittinger M, Lehr CM. The role of mucus on drug transport and its potential to affect therapeutic outcomes. Adv Drug Deliv Rev 2018; 124:82-97. [PMID: 29106910 DOI: 10.1016/j.addr.2017.10.009] [Citation(s) in RCA: 180] [Impact Index Per Article: 30.0] [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: 07/10/2017] [Revised: 09/29/2017] [Accepted: 10/17/2017] [Indexed: 12/16/2022]
Abstract
A layer of mucus covers the surface of all wet epithelia throughout the human body. Mucus is a hydrogel mainly composed of water, mucins (glycoproteins), DNA, proteins, lipids, and cell debris. This complex composition yields a tenacious viscoelastic hydrogel that lubricates and protects the exposed epithelia from external threats and enzymatic degradation. The natural protective role of mucus is nowadays acknowledged as a major barrier to be overcome in non-invasive drug delivery. The heterogeneity of mucus components offers a wide range of potential chemical interaction sites for macromolecules, while the mesh-like architecture given to mucus by the intermolecular cross-linking of mucin molecules results in a dense network that physically, and in a size-dependent manner, hinders the diffusion of nanoparticles through mucus. Consequently, drug diffusion, epithelial absorption, drug bioavailability, and ultimately therapeutic outcomes of mucosal drug delivery can be attenuated.
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Affiliation(s)
- Xabier Murgia
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, 66123 Saarbrücken, Germany
| | - Brigitta Loretz
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, 66123 Saarbrücken, Germany
| | - Olga Hartwig
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, 66123 Saarbrücken, Germany
| | - Marius Hittinger
- PharmBioTec GmbH, Science Park 1 Campus D 1.1, 66123 Saarbrücken, Germany
| | - Claus-Michael Lehr
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, 66123 Saarbrücken, Germany; PharmBioTec GmbH, Science Park 1 Campus D 1.1, 66123 Saarbrücken, Germany; Department of Pharmacy, Saarland University, 66123 Saarbrücken, Germany.
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Ricci F, Catozzi C, Ravanetti F, Murgia X, D'Aló F, Macchidani N, Sgarbi E, Di Lallo V, Saccani F, Pertile M, Cacchioli A, Catinella S, Villetti G, Civelli M, Amadei F, Stellari FF, Pioselli B, Salomone F. In vitro and in vivo characterization of poractant alfa supplemented with budesonide for safe and effective intratracheal administration. Pediatr Res 2017; 82:1056-1063. [PMID: 28723887 DOI: 10.1038/pr.2017.171] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 06/18/2017] [Indexed: 12/29/2022]
Abstract
BackgroundThe intratracheal (IT) administration of budesonide using surfactant as a vehicle has been shown to reduce the incidence of bronchopulmonary dysplasia (BPD) in preterm infants. The objective of this study was to characterize the in vitro characteristics and in vivo safety and efficacy of the extemporaneous combination of budesonide and poractant alfa.MethodsThe stability, minimum surface tension, and viscosity of the preparation were evaluated by means of high-performance liquid chromatography (HPLC), Wilhelmy balance, and Rheometer, respectively. The safety and efficacy of the IT administration of the mixture were tested in two respiratory distress syndrome (RDS) animal models: twenty-seventh day gestational age premature rabbits and surfactant-depleted adult rabbits.ResultsA pre-formulation trial identified a suitable procedure to ensure the homogeneity and stability of the formulation. Wilhelmy Balance tests clarified that budesonide supplementation has no detrimental effect on poractant alfa surface tension activity. The addition of budesonide to poractant alfa did not affect the physiological response to surfactant treatment in both RDS animal models, and was associated to a significant reduction of lung inflammation in surfactant-depleted rabbits.ConclusionOur in vitro and in vivo analysis suggests that the IT administration of a characterized extemporaneous combination of poractant alfa and budesonide is a safe and efficacious procedure in the context of RDS.
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Affiliation(s)
| | | | | | - Xabier Murgia
- Department of Drug Delivery, Helmholtz Institute for Pharmaceutical Research Saarland, Saarbrücken, Germany
| | | | | | - Elisa Sgarbi
- R&D Department, Chiesi Farmaceutici, Parma, Italy
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Vukosavljevic B, Murgia X, Schwarzkopf K, Schaefer UF, Lehr CM, Windbergs M. Tracing molecular and structural changes upon mucolysis with N-acetyl cysteine in human airway mucus. Int J Pharm 2017; 533:373-376. [DOI: 10.1016/j.ijpharm.2017.07.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 06/14/2017] [Accepted: 07/08/2017] [Indexed: 12/19/2022]
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Rey-Santano C, Mielgo VE, Murgia X, Gomez-Solaetxe MA, Salomone F, Bianco F, Pelizzi N, Loureiro B, López de Heredia Y Goya J. Cerebral and lung effects of a new generation synthetic surfactant with SP-B and SP-C analogs in preterm lambs. Pediatr Pulmonol 2017; 52:929-938. [PMID: 28221717 DOI: 10.1002/ppul.23685] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 01/13/2017] [Accepted: 02/09/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND Though natural surfactants (SF) are clinically superior to protein-free synthetic preparations, CHF-5633, a synthetic SF containing SP-B and SP-C analog peptides is a potential alternative to natural SF for treating neonatal respiratory distress syndrome (RDS). Nevertheless, information is lacking regarding the safety of this new treatment for the neonatal brain. We sought to compare the cerebral and pulmonary effects of this new synthetic surfactant (CHF5633) with those of natural porcine surfactant (Cursosurf) in premature lambs with RDS. METHODS Twenty-one preterm lambs were randomly assigned to receive CHF5633, Curosurf, or no treatment (control). Pulmonary (gas exchange, lung mechanics) and cerebral (carotid artery blood flow, cerebral oxygen metabolism) effects were measured every 30 min for 6 h. Pulmonary and cerebral histological analysis were also performed. RESULTS After delivery, lambs developed severe RDS (FIO2 :1, pH < 7.15, PaCO2 > 70 mmHg, PaO2 < 40 mmHg, Cdyn < 0.1 mL/cmH2 O/kg). By 30 min after treatment, animals in both SF-treated groups had consistently better gas exchange and lung mechanics than controls. After CHF5633 administration, PaCO2 , carotid artery blood flow, and cerebral oxygen delivery tended to slowly decrease compared to other groups. By 2 h, SF-treated groups had similar values of all parameters studied, these remaining steady for the rest of the experiment. Lambs administered CHF5633 obtained better lung and brain injury scores than controls. CONCLUSION Intratracheal administration of a bolus of CHF5633 improves pulmonary status in preterm lambs with severe RDS, obtaining better lung and brain injury scores than controls and favorable cerebral hemodynamics, comparable to those with gold standard Curosurf treatment.
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Affiliation(s)
- Carmen Rey-Santano
- Animal Research Unit, BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Victoria E Mielgo
- Animal Research Unit, BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Xabier Murgia
- Animal Research Unit, BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | | | | | | | | | - Begoña Loureiro
- Neonatal Intensive Care Unit, Cruces University Hospital, Barakaldo, Bizkaia, Spain
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Ricci F, Catozzi C, Murgia X, Rosa B, Amidani D, Lorenzini L, Bianco F, Rivetti C, Catinella S, Villetti G, Civelli M, Pioselli B, Dani C, Salomone F. Physiological, Biochemical, and Biophysical Characterization of the Lung-Lavaged Spontaneously-Breathing Rabbit as a Model for Respiratory Distress Syndrome. PLoS One 2017; 12:e0169190. [PMID: 28060859 PMCID: PMC5217971 DOI: 10.1371/journal.pone.0169190] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 12/13/2016] [Indexed: 12/01/2022] Open
Abstract
Nasal continuous positive airway pressure (nCPAP) is a widely accepted technique of non-invasive respiratory support in spontaneously-breathing premature infants with respiratory distress syndrome (RDS). Surfactant administration techniques compatible with nCPAP ventilation strategy are actively investigated. Our aim is to set up and validate a respiratory distress animal model that can be managed on nCPAP suitable for surfactant administration techniques studies. Surfactant depletion was induced by bronchoalveolar lavages (BALs) on 18 adult rabbits. Full depletion was assessed by surfactant component analysis on the BALs samples. Animals were randomized into two groups: Control group (nCPAP only) and InSurE group, consisting of a bolus of surfactant (Poractant alfa, 200 mg/kg) followed by nCPAP. Arterial blood gases were monitored until animal sacrifice, 3 hours post treatment. Lung mechanics were evaluated just before and after BALs, at the time of treatment, and at the end of the procedure. Surfactant phospholipids and protein analysis as well as surface tension measurements on sequential BALs confirmed the efficacy of the surfactant depletion procedure. The InSurE group showed a significant improvement of blood oxygenation and lung mechanics. On the contrary, no signs of recovery were appreciated in animals treated with just nCPAP. The surfactant-depleted adult rabbit RDS model proved to be a valuable and efficient preclinical tool for mimicking the clinical scenario of preterm infants affected by mild/moderate RDS who spontaneously breathe and do not require mechanical ventilation. This population is of particular interest as potential target for the non-invasive administration of surfactant.
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Affiliation(s)
| | | | - Xabier Murgia
- Department of Drug Delivery, Helmholtz Institute for Pharmaceutical Research Saarland, Saarbrücken, Germany
| | - Brenda Rosa
- Chiesi Farmaceutici, R&D Department, Parma, Italy
| | - Davide Amidani
- Department of Life Sciences, University of Parma, Parma, Italy
| | | | | | - Claudio Rivetti
- Department of Life Sciences, University of Parma, Parma, Italy
| | | | | | | | | | - Carlo Dani
- Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Florence, Italy
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Ricci F, Salomone F, Kuypers E, Ophelders D, Nikiforou M, Willems M, Krieger T, Murgia X, Hütten M, Kramer BW, Bianco F. In Vivo Evaluation of the Acute Pulmonary Response to Poractant Alfa and Bovactant Treatments in Lung-Lavaged Adult Rabbits and in Preterm Lambs with Respiratory Distress Syndrome. Front Pediatr 2017; 5:186. [PMID: 28913327 PMCID: PMC5583171 DOI: 10.3389/fped.2017.00186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 08/15/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Poractant alfa (Curosurf®) and Bovactant (Alveofact®) are two animal-derived pulmonary surfactants preparations approved for the treatment of neonatal respiratory distress syndrome (nRDS). They differ in their source, composition, pharmaceutical form, and clinical dose. How much these differences affect the acute pulmonary response to treatment is unknown. OBJECTIVES Comparing these two surfactant preparations in two different animal models of respiratory distress focusing on the short-term response to treatment. METHODS Poractant alfa and Bovactant were administered in a 50-200 mg/kg dose range to surfactant-depleted adult rabbits with acute respiratory distress syndrome induced by lavage and to preterm lambs (127-129 days gestational age) with nRDS induced by developmental immaturity. The acute impact of surfactant therapy on gas exchange and pulmonary mechanics was assessed for 1 h in surfactant-depleted rabbits and for 3 h in preterm lambs. RESULTS Overall, treatment with Bovactant 50 mg/kg or Poractant alfa 50 mg/kg did not achieve full recovery of the rabbits' respiratory conditions, as indicated by significantly lower arterial oxygenation and carbon dioxide values. By contrast, the two approved doses for clinical use of Poractant alfa (100 and 200 mg/kg) achieved a rapid and sustained recovery in both animal models. The comparison of the ventilation indices of the licensed doses of Bovactant (50 mg/kg) and Poractant alfa (100 mg/kg) showed a superior performance of the latter preparation in both animal models. At equal phospholipid doses, Poractant alfa was superior to Bovactant in terms of arterial oxygenation in both animal models. In preterm lambs, surfactant replacement therapy with Poractant alfa at either 100 or 200 mg/kg was associated with significantly higher lung gas volumes compared to Bovactant treatment with 100 mg/kg. CONCLUSION At the licensed doses, the acute pulmonary response to Poractant alfa was significantly better than the one observed after Bovactant treatment, either at 50 or at 100 mg/kg dose, in two animal models of pulmonary failure.
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Affiliation(s)
- Francesca Ricci
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., Parma, Italy
| | - Fabrizio Salomone
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., Parma, Italy
| | - Elke Kuypers
- Department of Paediatrics, Maastricht University Medical Center, Maastricht, Netherlands
| | - Daan Ophelders
- Department of Paediatrics, Maastricht University Medical Center, Maastricht, Netherlands
| | - Maria Nikiforou
- Department of Paediatrics, Maastricht University Medical Center, Maastricht, Netherlands
| | - Monique Willems
- Department of Paediatrics, Maastricht University Medical Center, Maastricht, Netherlands
| | - Tobias Krieger
- Department of Paediatrics, Maastricht University Medical Center, Maastricht, Netherlands
| | - Xabier Murgia
- Department of Drug Delivery, Helmholtz Institute for Pharmaceutical Research Saarland, Saarbrücken, Germany
| | - Matthias Hütten
- Department of Paediatrics, Maastricht University Medical Center, Maastricht, Netherlands
| | - Boris W Kramer
- Department of Paediatrics, Maastricht University Medical Center, Maastricht, Netherlands
| | - Federico Bianco
- Department of Preclinical Pharmacology, R&D, Chiesi Farmaceutici S.p.A., Parma, Italy
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Murgia X, Pawelzyk P, Schaefer UF, Wagner C, Willenbacher N, Lehr CM. Size-Limited Penetration of Nanoparticles into Porcine Respiratory Mucus after Aerosol Deposition. Biomacromolecules 2016; 17:1536-42. [DOI: 10.1021/acs.biomac.6b00164] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Paul Pawelzyk
- Institute
for Mechanical Process Engineering and Mechanics, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Germany
| | | | | | - Norbert Willenbacher
- Institute
for Mechanical Process Engineering and Mechanics, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Germany
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Goikoetxea E, Murgia X, Serna-Grande P, Valls-i-Soler A, Rey-Santano C, Rivas A, Antón R, Basterretxea FJ, Miñambres L, Méndez E, Lopez-Arraiza A, Larrabe-Barrena JL, Gomez-Solaetxe MA. In vitro surfactant and perfluorocarbon aerosol deposition in a neonatal physical model of the upper conducting airways. PLoS One 2014; 9:e106835. [PMID: 25211475 PMCID: PMC4161382 DOI: 10.1371/journal.pone.0106835] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 08/02/2014] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Aerosol delivery holds potential to release surfactant or perfluorocarbon (PFC) to the lungs of neonates with respiratory distress syndrome with minimal airway manipulation. Nevertheless, lung deposition in neonates tends to be very low due to extremely low lung volumes, narrow airways and high respiratory rates. In the present study, the feasibility of enhancing lung deposition by intracorporeal delivery of aerosols was investigated using a physical model of neonatal conducting airways. METHODS The main characteristics of the surfactant and PFC aerosols produced by a nebulization system, including the distal air pressure and air flow rate, liquid flow rate and mass median aerodynamic diameter (MMAD), were measured at different driving pressures (4-7 bar). Then, a three-dimensional model of the upper conducting airways of a neonate was manufactured by rapid prototyping and a deposition study was conducted. RESULTS The nebulization system produced relatively large amounts of aerosol ranging between 0.3±0.0 ml/min for surfactant at a driving pressure of 4 bar, and 2.0±0.1 ml/min for distilled water (H2Od) at 6 bar, with MMADs between 2.61±0.1 µm for PFD at 7 bar and 10.18±0.4 µm for FC-75 at 6 bar. The deposition study showed that for surfactant and H2Od aerosols, the highest percentage of the aerosolized mass (∼65%) was collected beyond the third generation of branching in the airway model. The use of this delivery system in combination with continuous positive airway pressure set at 5 cmH2O only increased total airway pressure by 1.59 cmH2O at the highest driving pressure (7 bar). CONCLUSION This aerosol generating system has the potential to deliver relatively large amounts of surfactant and PFC beyond the third generation of branching in a neonatal airway model with minimal alteration of pre-set respiratory support.
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Affiliation(s)
- Estibalitz Goikoetxea
- Research Unit for Experimental Neonatal Respiratory Physiology, Cruces University Hospital, Barakaldo, Bizkaia, Spain
- Thermal and Fluids Engineering Division, Mechanical Engineering Department, TECNUN, University of Navarra, San Sebastian, Gipuzkoa, Spain
| | - Xabier Murgia
- Research Unit for Experimental Neonatal Respiratory Physiology, Cruces University Hospital, Barakaldo, Bizkaia, Spain
| | - Pablo Serna-Grande
- Research Unit for Experimental Neonatal Respiratory Physiology, Cruces University Hospital, Barakaldo, Bizkaia, Spain
| | - Adolf Valls-i-Soler
- Neonatal Intensive Care Unit, Cruces University Hospital, Barakaldo, Bizkaia, Spain
| | - Carmen Rey-Santano
- Research Unit for Experimental Neonatal Respiratory Physiology, Cruces University Hospital, Barakaldo, Bizkaia, Spain
| | - Alejandro Rivas
- Thermal and Fluids Engineering Division, Mechanical Engineering Department, TECNUN, University of Navarra, San Sebastian, Gipuzkoa, Spain
| | - Raúl Antón
- Thermal and Fluids Engineering Division, Mechanical Engineering Department, TECNUN, University of Navarra, San Sebastian, Gipuzkoa, Spain
| | - Francisco J. Basterretxea
- Department of Physical Chemistry, Faculty of Science and Technology, University of the Basque Country, Leioa, Bizkaia, Spain
| | - Lorena Miñambres
- Department of Physical Chemistry, Faculty of Science and Technology, University of the Basque Country, Leioa, Bizkaia, Spain
| | - Estíbaliz Méndez
- Department of Physical Chemistry, Faculty of Science and Technology, University of the Basque Country, Leioa, Bizkaia, Spain
| | - Alberto Lopez-Arraiza
- Department of Electronics and Electrotechnics, High Technical School of Maritime Studies, University of the Basque Country, Bilbao, Bizkaia, Spain
| | - Juan Luis Larrabe-Barrena
- Department of Electronics and Electrotechnics, High Technical School of Maritime Studies, University of the Basque Country, Bilbao, Bizkaia, Spain
| | - Miguel Angel Gomez-Solaetxe
- Department of Electronics and Electrotechnics, High Technical School of Maritime Studies, University of the Basque Country, Bilbao, Bizkaia, Spain
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Rey-Santano C, Mielgo VE, Andres L, Ruiz-del-Yerro E, Valls-i-Soler A, Murgia X. Acute and sustained effects of aerosolized vs. bolus surfactant therapy in premature lambs with respiratory distress syndrome. Pediatr Res 2013; 73:639-46. [PMID: 23403804 DOI: 10.1038/pr.2013.24] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Surfactant (SF) instillation may produce acute deleterious effects on gas exchange and both systemic and cerebral hemodynamics. Our aim was to compare the effects of aerosolized SF (SF-aero) with those of bolus SF (SF-bolus) administration on gas exchange, lung mechanics, and cardiovascular function in premature lambs with respiratory distress syndrome (RDS). METHODS Fourteen preterm lambs (85% gestation) were randomly assigned to receive SF-aero or SF-bolus. Oxygenation index (OI), PaCO2, cardiovascular parameters, carotid blood flow (CBF), lung compliance (mean dynamic compliance), and tidal volume (VT) were measured every 30 min for 6 h. Biochemical and histological analyses were performed. RESULTS After delivery, lambs developed severe RDS (inspiratory fraction of oxygen: 1; pH < 7.15; PaCO2 > 80 mm Hg; PaO2 < 30 mm Hg, mean dynamic compliance < 0.08 ml/cm H2O/kg). By 60 min after treatment, both groups showed an improvement in OI, PaCO2, mean dynamic compliance, and VT that was maintained until the end of the experiment. PaCO2 and CBF increased significantly in the SF-bolus group during the first 15-30 min, without concomitant changes in cardiovascular parameters, whereas in the SF-aero group, PaCO2 and CBF decreased gradually. SF-aero induced less alveolar hemorrhage and inflammation. CONCLUSION SF-aero produced improvements in gas exchange and lung mechanics similar to those produced by bolus administration but with less lung injury and fewer cerebral hemodynamic changes.
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Affiliation(s)
- Carmen Rey-Santano
- Research Unit for Experimental Neonatal Respiratory Physiology, Cruces University Hospital, Barakaldo, Spain.
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Rey-Santano C, Mielgo V, Gastiasoro E, Valls-i-Soler A, Murgia X. Effect of surfactant and partial liquid ventilation treatment on gas exchange and lung mechanics in immature lambs: influence of gestational age. PLoS One 2013; 8:e56127. [PMID: 23418521 PMCID: PMC3571983 DOI: 10.1371/journal.pone.0056127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 01/04/2013] [Indexed: 12/05/2022] Open
Abstract
Objectives Surfactant (SF) and partial liquid ventilation (PLV) improve gas exchange and lung mechanics in neonatal RDS. However, variations in the effects of SF and PLV with degree of lung immaturity have not been thoroughly explored. Setting Experimental Neonatal Respiratory Physiology Research Unit, Cruces University Hospital. Design Prospective, randomized study using sealed envelopes. Subjects 36 preterm lambs were exposed (at 125 or 133-days of gestational age) by laparotomy and intubated. Catheters were placed in the jugular vein and carotid artery. Interventions All the lambs were assigned to one of three subgroups given: 20 mL/Kg perfluorocarbon and managed with partial liquid ventilation (PLV), surfactant (Curosurf®, 200 mg/kg) or (3) no pulmonary treatment (Controls) for 3 h. Measurements and Main Results Cardiovascular parameters, blood gases and pulmonary mechanics were measured. In 125-day gestation lambs, SF treatment partially improved gas exchange and lung mechanics, while PLV produced significant rapid improvements in these parameters. In 133-day lambs, treatments with SF or PLV achieved similarly good responses. Neither surfactant nor PLV significantly affected the cardiovascular parameters. Conclusion SF therapy response was more effective in the older gestational age group whereas the effectiveness of PLV therapy was not gestational age dependent.
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Affiliation(s)
- Carmen Rey-Santano
- Research Unit for Experimental Neonatal Respiratory Physiology, Cruces University Hospital, Barakaldo, Bizkaia, Spain.
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Murgia X, Gastiasoro E, Mielgo V, Ruiz-Del-Yerro E, Alvarez-Diaz FJ, Lafuente H, Valls-I-Soler A, Gomez-Solaetxe MA, Rey-Santano C. Surfactant and perfluorocarbon aerosolization during different mechanical ventilation strategies by means of inhalation catheters: an in vitro study. J Aerosol Med Pulm Drug Deliv 2011; 25:23-31. [PMID: 22044251 DOI: 10.1089/jamp.2011.0886] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Aerosol delivery of surfactant and perfluorocarbon (PFC) is a desirable therapeutic approach for the treatment of various lung diseases in patients undergoing mechanical ventilation. However, the behavior of these substances during aerosolization differs significantly from that of aqueous solutions. In particular, the high vapor pressure of many PFCs tends to result in greater evaporation during mechanical ventilation. METHODS Three PFCs and surfactant were aerosolized during mechanical ventilation by means of three intratracheal inhalation catheters (IC) with different air flow rates (IC-1.23, IC-1.1, and IC-1.4), with their aerosol generating tip placed at the distal end of the endotracheal tube (i.d. 4 mm). The influence of four different ventilation strategies on aerosol production rate and PFC and surfactant recovery was studied. The changes in intrapulmonary pressure produced by the air jets of each IC were measured. RESULTS With IC-1.23 and IC-1.1, the highest rates of aerosol production were achieved using FC75 (2.27±0.18 and 0.76±0.01, respectively) followed by PFOB (1.74±0.06 and 0.56±0.04), PFD (0.82±0.01 and 0.21±0.01), and surfactant (0.42±0.05 and 0.092±0.01). With IC-1.4 modest aerosol production was obtained irrespective of the aerosolized compound. Mechanical ventilation influenced aerosol recovery, with the trend being toward recovering higher percentages of the compounds with lower peak inspiratory pressure (PIP) and lower respiratory rate (RR) settings. The highest percentages of the initial volume were recovered with IC-1.23 (between 65.43%±4.2 FC75 and 90.21%±4.71 surfactant) followed by IC-1.1 (between 46.48%±4.46 FC75 and 73.19%±2.82 PFOB) and IC-1.4 (between 4.65%±4.36 FC75 and 63.24%±9.71 surfactant). Each of three of the ICs were found to increase the intrapulmonary pressure by about 2-3 cmH₂O during mechanical ventilation. CONCLUSIONS Despite of mechanical ventilation, IC-1.23 and IC-1.1 were able to deliver significant amounts of surfactant and perfluorocarbon to the lung model. Changes in PIP and RR directly influence the percentage of surfactant and perfluorocarbon recovered.
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Affiliation(s)
- Xabier Murgia
- Experimental Neonatal Respiratory Physiology Research Unit, Hospital de Cruces, Plaza de Cruces, Barakaldo E-48903, Bizkaia, Spain.
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Rey-Santano C, Alvarez-Diaz FJ, Mielgo V, Murgia X, Lafuente H, Ruiz-Del-Yerro E, Valls-I-Soler A, Gastiasoro E. Bronchoalveolar lavage versus bolus administration of lucinactant, a synthetic surfactant in meconium aspiration in newborn lambs. Pediatr Pulmonol 2011; 46:991-9. [PMID: 21520434 DOI: 10.1002/ppul.21460] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 02/28/2011] [Accepted: 02/28/2011] [Indexed: 11/10/2022]
Abstract
This study was designed to study effects of lung lavage versus the classical bolus instillation with a peptide-based synthetic surfactant (lucinactant) in a model of Meconium Aspiration Syndrome (MAS). Eighteen newborn lambs received meconium and were randomized to: the experimental meconium installation (eMAS) group-lambs with eMAS kept on conventional mechanical ventilation (control); the SF-Bolus group-eMAS receiving a lucinactant bolus (30 mg/ml); or the D-SF-Lavage group-eMAS treated with dilute lucinactant bronchoalveolar lavage (10 mg/ml). Systemic and pulmonary arterial pressures, blood gases, and pulmonary mechanics were recorded for 180 min. In addition, the intrapulmonary distribution of the lucinactant was determined using dye-labeled microspheres. Following meconium instillation, severe hypoxia, hypercapnia, acidosis, and pulmonary hypertension developed, and dynamic compliance decreased (50% from baseline). After lung lavage with dilute lucinactant, gas exchange significantly improved versus bolus instillation (P < 0.05). Further, only in the lavage group did pulmonary arterial pressure return to basal values and dynamic compliance significantly increased. Both lung lavage and bolus techniques for the administration of lucinactant resulted in a non-uniform lung distribution. In conclusion, in newborn lambs with respiratory failure and pulmonary hypertension induced by meconium, lung lavage with dilute lucinactant seems to be an effective and safe alternative for treatment for MAS.
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Affiliation(s)
- C Rey-Santano
- Research Unit for Experimental Neonatal Respiratory Physiology, Cruces Hospital, Barakaldo, Bizkaia, Spain.
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Rey-Santano C, Mielgo VE, Gastiasoro E, Murgia X, Lafuente H, Ruiz-Del-Yerro E, Valls-I-Soler A, Hilario E, Alvarez FJ. Early Cerebral Hemodynamic, Metabolic, and Histological Changes in Hypoxic-Ischemic Fetal Lambs during Postnatal Life. Front Neurosci 2011; 5:111. [PMID: 21960958 PMCID: PMC3176408 DOI: 10.3389/fnins.2011.00111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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: 01/25/2011] [Accepted: 08/29/2011] [Indexed: 11/13/2022] Open
Abstract
The hemodynamic, metabolic, and biochemical changes produced during the transition from fetal to neonatal life may be aggravated if an episode of asphyxia occurs during fetal life. The aim of the study was to examine regional cerebral blood flow (RCBF), histological changes, and cerebral brain metabolism in preterm lambs, and to analyze the role of oxidative stress in the first hours of postnatal life following severe fetal asphyxia. Eighteen chronically instrumented newborn lambs were randomly assigned to either a control group or the hypoxic-ischemic (HI) group, in which case fetal asphyxia was induced just before delivery. All the animals were maintained on intermittent positive pressure ventilation for 3 h after delivery. During the HI insult, the injured group developed acidosis, hypoxia, hypercapnia, lactic acidosis, and tachycardia (relative to the control group), without hypotension. The intermittent positive pressure ventilation transiently improved gas exchange and cardiovascular parameters. After HI injury and during ventilatory support, there continued to be an increased RCBF in inner regions among the HI group, but no significant differences were detected in cortical flow compared to the control group. Also, the magnitude of the increase in TUNEL positive cells (apoptosis) and antioxidant enzymes, and decrease of ATP reserves was significantly greater in the brain regions where the RCBF was not higher. In conclusion, our findings identify early metabolic, histological, and hemodynamic changes involved in brain damage in premature asphyxiated lambs. Such changes have been described in human neonates, so our model could be useful to test the safety and the effectiveness of different neuroprotective or ventilation strategies applied in the first hours after fetal HI injury.
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Affiliation(s)
- Carmen Rey-Santano
- Research Unit on Experimental Respiratory Physiology, Cruces Hospital Bizkaia, Spain
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Murgia X, Gastiasoro E, Mielgo V, Alvarez-Diaz F, Lafuente H, Valls-i-Soler A, Gomez-Solaetxe MA, Larrabe JL, Rey-Santano C. Surfactant and perfluorocarbon aerosolization by means of inhalation catheters for the treatment of respiratory distress syndrome: an in vitro study. J Aerosol Med Pulm Drug Deliv 2011; 24:81-7. [PMID: 21410324 DOI: 10.1089/jamp.2010.0831] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aerosolization of perfluorocarbons or surfactant has emerged as a feasible alternative to instillation, for the treatment of experimental respiratory distress syndrome. However, the biophysical properties that make these compounds useful in such therapies, significantly affect the performance of nebulizers. Therefore, in vitro studies are required to assess the suitability of new aerosolization technologies for use with these compounds. METHODS The aim of the present in vitro study was to investigate the influence of the biophysical properties of perfluorocarbons (PFD, FC75, and PFOB) and a natural porcine surfactant, Curosurf®; on aerosolization and to assess the suitability of three intratracheal inhalation catheters (IC) with different air flow rates (IC-1.23, IC-1.1, IC-1.4) coupled to a jet nebulizer, for aerosol delivery of these compounds. RESULTS With IC-1.23 significantly higher aerosol production rates were achieved (p < 0.0001), ranging between 6.05 ± 0.17 mL/min (FC75) and 1.94 ± 0.09 mL/min (Curosurf®), and lower percentage losses of the compound (5-21%), compared to IC-1.1 and IC-1.4 catheters. The lowest aerosolization rates were produced with IC-1.4 ranging from 0.58 ± 0.02 mL/min (FC75) to 0.14 ± 0.01 mL/min (Curosurf®), and this catheter also resulted in the highest percentage losses (25-60%). The mass median aerodynamic diameter (MMAD) ranged between 0.77 μm (PFD) and 8.29 μm (Curosurf®) with IC-1.1, whereas higher MMAD values, of between 4.84 μm (FC75) and 13.42 μm (PFOB), were observed with IC-1.23. Regardless of the catheter used during aerosolization, the perfluorocarbon with the highest kinematic viscosity showed the lowest aerosolization and emission rates and vice versa, which reveals the substantial contribution of this parameter that should accordingly be considered in the design of perfluorocarbon aerosol drug delivery systems. CONCLUSIONS Jet aerosolization of perfluorocarbons or surfactant with the intratracheal inhalation catheters seems to be a suitable method for treating experimental respiratory distress syndrome, because it delivers relatively high doses of perfluorocarbons and surfactant to the lungs in a respirable size droplets.
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Affiliation(s)
- Xabier Murgia
- Research Unit for Experimental Neonatal Respiratory Physiology, Cruces Hospital, Plaza de Cruces, Barakaldo, Bizkaia, Spain.
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