通过脂肪酸结合方法提高两性霉素 B 的口服生物利用度和胃肠道稳定性。

Improved Oral Bioavailability and Gastrointestinal Stability of Amphotericin B through Fatty Acid Conjugation Approach.

机构信息

Centre for Pharmaceutical Nanotechnology, Department of Pharmaceutics , National Institute of Pharmaceutical Education and Research (NIPER) , Sector 67, Phase X , SAS Nagar (Mohali), Punjab 160062 , India.

出版信息

Mol Pharm. 2019 Nov 4;16(11):4519-4529. doi: 10.1021/acs.molpharmaceut.9b00662. Epub 2019 Sep 30.

Abstract

Amphotericin B (AmB) is one of the most effective drugs used in the treatment of leishmaniasis and systemic fungal infections. Considering the global burden of leishmaniasis, ∼90% of disease cases occur in developing countries, suggestive of the need for an affordable AmB therapy. However, owing to the physicochemical properties of AmB, all the clinically available formulations must be administered by intravenous route, thereby creating a significant hurdle in patients' access to AmB due to pharmacoeconomic considerations. We have previously demonstrated that lipid conjugation (e.g., fatty acids) to AmB significantly decreases the toxicity of resulting prodrug by a favorable alteration in the aggregation pattern. The hypothesis of the present work was to investigate the potential of the previously established AmB-lipid conjugate [AmB-oleyl conjugate (AmB-OA)] in improving the physicochemical properties such as gastric instability and lower intestinal permeability that otherwise limits the oral delivery of AmB. The synthesized AmB-OA conjugate was remarkably stable at gastric pH in contrast to AmB and exhibited significantly higher permeation across the Caco-2 monolayer (indicative of intestinal permeability). Mechanistic studies revealed that AmB-OA retained an equivalent antifungal activity. Also, AmB-OA was found to interact preferentially with intracellular membranes of , while AmB interacted with the plasma membrane. The results of Caco-2 monolayer permeation experiments were further confirmed by in vivo pharmacokinetics, which showed that AmB-OA exhibited a 3.13-fold increase in the and a 4.88-fold increase in AUC as compared to AmB. In conclusion, the lipid conjugation approach may provide an effective solution for current challenges in designing drug delivery systems intended for oral AmB therapy.

摘要

两性霉素 B(AmB)是治疗利什曼病和系统性真菌感染最有效的药物之一。考虑到利什曼病的全球负担,约 90%的病例发生在发展中国家,这表明需要一种负担得起的两性霉素 B 治疗方法。然而,由于两性霉素 B 的物理化学性质,所有临床可用的制剂都必须通过静脉途径给药,这使得患者获得两性霉素 B 的机会因药物经济学考虑而受到显著阻碍。我们之前已经证明,两性霉素 B 的脂质结合(例如脂肪酸)通过对聚集模式的有利改变,显著降低了前药的毒性。本工作的假设是研究先前建立的两性霉素 B-脂质缀合物[两性霉素 B-油酰基缀合物(AmB-OA)]在改善物理化学性质方面的潜力,例如胃不稳定性和较低的肠道通透性,否则会限制两性霉素 B 的口服递送。与两性霉素 B 相比,合成的两性霉素 B-OA 缀合物在胃 pH 下非常稳定,并表现出明显更高的穿过 Caco-2 单层的渗透性(表示肠道通透性)。机制研究表明两性霉素 B-OA 保留了等效的抗真菌活性。此外,发现两性霉素 B-OA 优先与 的细胞内膜相互作用,而两性霉素 B 与质膜相互作用。Caco-2 单层渗透实验的结果进一步通过体内药代动力学得到证实,结果表明两性霉素 B-OA 的 AUC 增加了 3.13 倍,而两性霉素 B 的 AUC 增加了 4.88 倍。总之,脂质缀合方法可能为设计用于口服两性霉素 B 治疗的药物递送系统提供有效的解决方案。

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