Murashov Mikhail D, Diaz-Espinosa Jennifer, LaLone Vernon, Tan Joel W Y, Laza Raluca, Wang Xueding, Stringer Kathleen A, Rosania Gus R
Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, MI 48109, USA.
Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA.
Pharmaceutics. 2018 Nov 17;10(4):238. doi: 10.3390/pharmaceutics10040238.
Clofazimine (CFZ) is a broad spectrum antimycobacterial agent recommended by the World Health Organization as a first line treatment for leprosy and second line treatment for multidrug resistant tuberculosis. Oral administration of CFZ leads to a red skin pigmentation side effect. Since CFZ is a weakly basic, red phenazine dye, the skin pigmentation side effect results from lipophilic partitioning of the circulating, free base (neutral) form of CFZ into the skin. Here, we developed a stable and biocompatible formulation of CFZ-HCl microcrystals that mimics the predominant form of the drug that bioaccumulates in macrophages, following long term oral CFZ administration. In mice, intravenous injection of these biomimetic CFZ-HCl microcrystals led to visible drug accumulation in macrophages of the reticuloendothelial system with minimal skin accumulation or pigmentation. In fact, no skin pigmentation was observed when the total amount of CFZ-HCl administered was equivalent to the total oral dose leading to maximal skin pigmentation. Thus, parenteral (injected or inhaled) biomimetic formulations of CFZ-HCl could be instrumental to avoid the pigmentation side effect of oral CFZ therapy.
氯法齐明(CFZ)是一种广谱抗分枝杆菌药物,被世界卫生组织推荐作为麻风病的一线治疗药物和耐多药结核病的二线治疗药物。口服CFZ会导致皮肤色素沉着的副作用。由于CFZ是一种弱碱性的红色吩嗪染料,皮肤色素沉着副作用是由循环中的游离碱(中性)形式的CFZ亲脂性分配到皮肤中引起的。在此,我们开发了一种稳定且生物相容的CFZ-HCl微晶制剂,它模拟了长期口服CFZ后在巨噬细胞中生物蓄积的主要药物形式。在小鼠中,静脉注射这些仿生CFZ-HCl微晶导致药物在网状内皮系统的巨噬细胞中明显蓄积,而皮肤蓄积或色素沉着最少。事实上,当给予的CFZ-HCl总量相当于导致最大皮肤色素沉着的口服总剂量时,未观察到皮肤色素沉着。因此,CFZ-HCl的肠胃外(注射或吸入)仿生制剂可能有助于避免口服CFZ治疗的色素沉着副作用。