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伏立康唑治疗侵袭性曲霉病的药代动力学/药效学关系的改善。通过新型快速释放制剂降低药物毒性。

Improvement of the pharmacokinetic/pharmacodynamic relationship in the treatment of invasive aspergillosis with voriconazole. Reduced drug toxicity through novel rapid release formulations.

机构信息

Department of Pharmaceutical Technology, Faculty of Pharmacy, Complutense University, Plaza Ramón y Cajal s/n, Madrid 28040, Spain.

Unit of Microbiology, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili and Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.

出版信息

Colloids Surf B Biointerfaces. 2020 Sep;193:111119. doi: 10.1016/j.colsurfb.2020.111119. Epub 2020 May 11.

Abstract

Voriconazole (VCZ) is currently the first-line treatment for invasive aspergillosis, although the doses are limited by its poor solubility and high hepatic toxicity. The aim of this study was to develop a solid self-dispersing micellar system of VCZ to improve the pharmacokinetic/pharmacodynamic (PK/PD) relationship and reduce hepatotoxicity. In this work, solid micellar systems of VCZ are formulated with different polysorbate 80 ratios using mannitol as a hydrophilic carrier. The novel micellar systems were characterized by scanning electron microscopy (SEM), powder X-ray diffraction (PXRD), differential scanning calorimetry (DSC) and dissolution studies. Self-dispersing micellar systems reduced VCZ crystallinity, leading to an improvement in its dissolution rate. The in vitro susceptibility test also revealed that the most common microorganisms in invasive aspergillosis exhibited low minimum inhibitory concentration (MIC) values for micellar systems. Pharmacokinetic studies indicated an improvement in bioavailability for MS-1:3:0.05, and changes in its biodistribution to different organs. MS-1:3:0.05 showed an increased concentration in lungs and a significant decrease in VCZ accumulated in the liver.

摘要

伏立康唑(VCZ)目前是治疗侵袭性曲霉病的一线药物,但其溶解度差和肝毒性高,限制了其使用剂量。本研究旨在开发 VCZ 的固体自分散胶束系统,以改善药代动力学/药效学(PK/PD)关系并降低肝毒性。在这项工作中,使用甘露醇作为亲水性载体,用不同聚山梨酯 80 比例制备 VCZ 的固体胶束系统。新型胶束系统通过扫描电子显微镜(SEM)、粉末 X 射线衍射(PXRD)、差示扫描量热法(DSC)和溶解研究进行了表征。自分散胶束系统降低了 VCZ 的结晶度,从而提高了其溶解速率。体外药敏试验还表明,侵袭性曲霉病中最常见的微生物对胶束系统表现出较低的最低抑菌浓度(MIC)值。药代动力学研究表明 MS-1:3:0.05 的生物利用度得到了改善,其在不同器官中的分布也发生了变化。MS-1:3:0.05 在肺部的浓度增加,而 VCZ 在肝脏中的积累显著减少。

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