Drug Delivery System Excellence Centre, Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, 90112, Thailand.
Department of Anatomy, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla, 90112, Thailand.
Drug Deliv Transl Res. 2020 Feb;10(1):59-69. doi: 10.1007/s13346-019-00662-x.
Aerosol inhalation of amphotericin B (AmB) can be a clinically compliant way to administer the drug directly to the pulmonary route for treatment as well as prophylaxis of invasive pulmonary aspergillosis (IPA). We report aerosol formulation of AmB using sodium deoxycholate sulfate (SDCS), a lipid carrier synthesized in-house using natural precursor deoxycholic acid. In vitro toxicity was determined by MTT assay. Biodistribution and histopathology in rats were evaluated in targeted organs including the lungs, kidneys, spleen, and liver. No toxicity was observed when lung and kidney cells treated with AmB-SDCS formulations up to 8 μg/mL and minimal toxicity at higher concentration 16 μg/mL, while the Fungizone®-like formulation induced toxicity to lung and kidney cells with viability decreasing from 86 to 41% and 100 to 49%, respectively, when compared with an equivalent concentration of AmB-SDCS. Renal and hepatic markers were raised for Fungizone®-like formulation-treated rats but not for AmB-SDCS formulations following 7 days of regular dosing by intratracheal instillation. AmB concentrations were highest in the lungs (5.4-8.3 μg/g) which were well above minimum inhibitory concentration (MIC) of all Aspergillus species. Plasma concentration was also above MIC (> 2 μg/mL) for all AmB-SDCS formulations in comparison with Fungizone®-like formulation. No evidence of abnormal histopathology was observed in the lungs, liver, spleen, and kidneys for all AmB-SDCS formulations but was observed for the group treated with Fungizone®-like formulation. It is concluded that AmB-SDCS formulations can be efficiently administered via intratracheal instillation with no evidence of toxicity and may find great value in the treatment as well as prophylaxis of IPA through inhalation route.
两性霉素 B(AmB)的雾化吸入是一种临床可行的方法,可将药物直接通过肺部给药,用于治疗和预防侵袭性肺曲霉病(IPA)。我们报告了一种使用硫酸去氧胆酸钠(SDCS)制成的 AmB 雾化制剂,SDCS 是一种使用天然前体去氧胆酸合成的脂质载体。通过 MTT 测定法确定了体外毒性。在靶向器官(包括肺、肾、脾和肝)中评估了 AmB-SDCS 制剂在大鼠中的体内分布和组织病理学。当用 AmB-SDCS 制剂处理肺和肾细胞时,最高浓度达 8μg/mL 时未观察到毒性,而在更高浓度 16μg/mL 时观察到最小毒性,而 Fungizone®样制剂则使肺和肾细胞毒性,与等效浓度的 AmB-SDCS 相比,细胞活力分别从 86%降至 41%和从 100%降至 49%。肾和肝标志物在 Fungizone®样制剂处理的大鼠中升高,但在用 AmB-SDCS 制剂经气管内滴注 7 天后则没有升高。AmB 在肺部的浓度最高(5.4-8.3μg/g),远高于所有曲霉属物种的最低抑菌浓度(MIC)。与 Fungizone®样制剂相比,所有 AmB-SDCS 制剂的血浆浓度也高于 MIC(>2μg/mL)。所有 AmB-SDCS 制剂在肺部、肝脏、脾脏和肾脏中均未观察到异常组织病理学,但用 Fungizone®样制剂处理的组观察到。结果表明,AmB-SDCS 制剂可通过气管内滴注有效给药,且无毒性证据,可能通过吸入途径在 IPA 的治疗和预防方面具有很高的价值。