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胡椒堿前体纳米脂质体作为大麻素的新型口服递药系统:与口腔喷雾给药相比在健康志愿者中的药代动力学评价。

Piperine-pro-nanolipospheres as a novel oral delivery system of cannabinoids: Pharmacokinetic evaluation in healthy volunteers in comparison to buccal spray administration.

机构信息

Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, P.O. Box 12065, Jerusalem 91120, Israel.

Department of Anesthesiology and Critical Care Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

出版信息

J Control Release. 2017 Nov 28;266:1-7. doi: 10.1016/j.jconrel.2017.09.011. Epub 2017 Sep 8.

Abstract

Nowadays, therapeutic indications for cannabinoids, specifically Δ-tetrahydrocannabinol (THC) and Cannabidiol (CBD) are widening. However, the oral consumption of the molecules is very limited due to their highly lipophilic nature that leads to poor solubility at the aqueous environment. Additionally, THC and CBD are prone to extensive first pass mechanisms. These absorption obstacles render the molecules with low and variable oral bioavailability. To overcome these limitations we designed and developed the advanced pro-nanolipospheres (PNL) formulation. The PNL delivery system is comprised of a medium chain triglyceride, surfactants, a co-solvent and the unique addition of a natural absorption enhancer: piperine. Piperine was selected due to its distinctive inhibitory properties affecting both Phase I and Phase II metabolism. This constellation self emulsifies into nano particles that entrap the cannabinoids and the piperine in their core and thus improve their solubility while piperine and the other PNL excipients inhibit their intestinal metabolism. Another clear advantage of the formulation is that its composition of materials is approved for human consumption. The safe nature of the excipients enabled their direct evaluation in humans. In order to evaluate the pharmacokinetic profile of the THC-CBD-piperine-PNL formulation, a two-way crossover, single administration clinical study was conducted. The trial comprised of 9 healthy volunteers under fasted conditions. Each subject received a THC-CBD (10.8mg, 10mg respectively) piperine (20mg)-PNL filled capsule and an equivalent dose of the oromucosal spray Sativex® with a washout period in between treatments. Single oral administration of the piperine-PNL formulation resulted in a 3-fold increase in Cmax and a 1.5-fold increase in AUC for THC when compared to Sativex®. For CBD, a 4-fold increase in Cmax and a 2.2-fold increase in AUC was observed. These findings demonstrate the potential this formulation has in serving as a standardized oral cannabinoid formulation. Moreover, the concept of improving oral bioavailability described here, can pave the way for other potential lipophilic active compounds requiring enhancement of their oral bioavailability.

摘要

如今,大麻素(尤其是Δ-四氢大麻酚(THC)和大麻二酚(CBD))的治疗适应症正在扩大。然而,由于其高度亲脂性,导致在水性环境中溶解度差,这些分子的口服消耗非常有限。此外,THC 和 CBD 容易受到广泛的首过机制的影响。这些吸收障碍使这些分子具有低且可变的口服生物利用度。为了克服这些限制,我们设计并开发了先进的前纳米脂质体(PNL)制剂。PNL 给药系统由中链甘油三酯、表面活性剂、共溶剂和独特的天然吸收增强剂胡椒碱组成。胡椒碱因其独特的抑制特性而被选中,这种特性影响了 I 相和 II 相代谢。这种组合自乳化成纳米颗粒,将大麻素和胡椒碱困在其核心内,从而提高它们的溶解度,同时胡椒碱和 PNL 的其他赋形剂抑制它们的肠道代谢。该制剂的另一个明显优势是其组成材料可被批准用于人类食用。赋形剂的安全性质使其能够直接在人体中进行评估。为了评估 THC-CBD-胡椒碱-PNL 制剂的药代动力学特征,进行了一项两向交叉、单次给药的临床研究。该试验包括 9 名在禁食条件下的健康志愿者。每个受试者接受一个 THC-CBD(分别为 10.8mg 和 10mg)、胡椒碱(20mg)-PNL 填充胶囊和 Sativex®的等效剂量的口腔黏膜喷雾,两种治疗之间有一个洗脱期。与 Sativex®相比,胡椒碱-PNL 制剂的单次口服给药使 THC 的 Cmax 增加了 3 倍,AUC 增加了 1.5 倍。对于 CBD,观察到 Cmax 增加了 4 倍,AUC 增加了 2.2 倍。这些发现表明,该制剂有可能成为一种标准化的口服大麻素制剂。此外,这里描述的提高口服生物利用度的概念可以为其他需要增强其口服生物利用度的潜在亲脂性活性化合物铺平道路。

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