Graduate School of Bioscience and Technology of Bioactive Products, Biology Institute, University at Campinas, Campinas, Sao Paulo, Brazil.
School of Pharmacy, Queen's University Belfast, Belfast, United Kingdom.
Biomed Mater. 2021 Oct 4;16(6). doi: 10.1088/1748-605X/ac2885.
Artemether (ART) and lumefantrine (LUM) are the gold standard antimalarial drugs used for the treatment of malaria in children and pregnant women. Typically, ART and LUM are delivered orally in the form of a combined tablet, however, the appropriateness of this route of administration for these drugs is questionable due to the poor absorption and therefore bioavailability observed unless administered alongside lipid-rich foods. Transdermal drug delivery in the form of a patch-type system has been identified as a viable alternative to the conventional tablet-based therapy. A novel, surfactant-based ART-LUM formulation (S3AL), developed for transdermal delivery, may eliminate the shortcomings associated with oral delivery; namely poor drug absorption which is caused by the inherently low solubility of ART and LUM. Moreover, by successfully delivering these antimalarials transdermally, first-pass metabolism will be avoided leading to enhanced drug bioavailability in both cases. The S3AL formulation contained ART and LUM at equal concentrations (2.5% w/w of each) as well as Procetyl® AWS (30% w/w), oleic acid (10% w/w), 1-methyl-2-pyrrolidone (10% w/w), and water (45% w/w). The addition of LUM to the formulation changed the system from a striae structure to a dark field structure when visualized by a polarized light microscope. Additionally, this system possessed higher viscosity and superior skin bioadhesion, as evidenced by mechanical characterization, when compared to a similar formulation containing ART alone. S3AL was also proven to be biocompatible to human keratinocyte cells. Finally,studies demonstrated the propensity of S3AL for successful delivery via the transdermal route, with 2279 ± 295 µg cmof ART and 94 ± 13 µg cmof LUM having permeated across dermatomed porcine skin after 24 h, highlighting its potential as a new candidate for the treatment of malaria.
蒿甲醚(ART)和本芴醇(LUM)是治疗儿童和孕妇疟疾的标准抗疟药物。通常,ART 和 LUM 以联合片剂的形式口服给药,然而,由于观察到吸收不良,因此生物利用度较差,除非与富含脂肪的食物一起服用,否则这种给药途径对这些药物的适用性值得怀疑。以贴片式系统为代表的透皮药物输送已被确定为替代传统基于片剂的治疗方法的可行选择。一种新型的基于表面活性剂的 ART-LUM 制剂(S3AL),专为透皮输送而开发,可能消除与口服输送相关的缺点;即 ART 和 LUM 固有的低溶解度导致的药物吸收不良。此外,通过成功地经皮输送这些抗疟药,可以避免首过代谢,从而在这两种情况下都提高药物的生物利用度。S3AL 制剂包含等浓度的 ART 和 LUM(各 2.5%w/w)以及 Procetyl® AWS(30%w/w)、油酸(10%w/w)、1-甲基-2-吡咯烷酮(10%w/w)和水(45%w/w)。当用偏光显微镜观察时,向制剂中添加 LUM 会使体系从条纹结构转变为暗场结构。此外,与单独含有 ART 的类似制剂相比,该系统具有更高的粘度和优异的皮肤生物黏附性,这一点通过机械特性得到了证明。S3AL 也被证明对人角质形成细胞是生物相容的。最后,研究表明 S3AL 具有经皮输送成功的倾向,在 24 小时后,2279±295µg cm的 ART 和 94±13µg cm的 LUM 渗透过去皮猪皮,突出了其作为治疗疟疾的新候选药物的潜力。