Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark.
Bioneer:FARMA, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark.
Int J Pharm. 2023 Feb 25;633:122601. doi: 10.1016/j.ijpharm.2023.122601. Epub 2023 Jan 9.
Amphotericin B (AmB) is a "life-saving" medicine for the treatment of invasive fungal infections and visceral leishmaniasis. To date, all marketed AmB formulations require parenteral administration, which causes high rates of acute infusion-related side effects and dose-dependent nephrotoxicity. The development of an oral AmB formulation will entail numerous advantages including increased patient compliance, eliminated infusion-related toxicities and reduced nephrotoxicity. Unfortunately, the gastrointestinal absorption of AmB is negligible due to its extremely low solubility in both aqueous and lipid solvents, and its poor gastrointestinal permeability. Drug-phospholipid complexation is an emerging strategy for oral delivery of poorly soluble drugs. In this study, monoacyl-phosphatidylcholine (MAPC) was complexed with AmB forming an AmB-MAPC complex (APC), to enhance the dissolution rate and aqueous solubility of AmB, in order to enable oral delivery of AmB. X-ray powder diffraction demonstrated that AmB was transformed to its amorphous form following complexation with MAPC, i.e. in the APC. Fourier-transform infrared spectroscopy suggested molecular interactions between AmB and MAPC. Dynamic light scattering indicated formation of colloidal structures after aqueous dispersion of APC; Cryogenic transmission electron microscopy showed that APC formed small round, "rod-like" and "worm-like" micellar structures and Small-angle neutron scattering provided three-dimensional micellar structures formed by APC upon aqueous dispersion, which indicated that AmB was inserted into the micellar mono-layer membrane formed by MAPC. Additionally, APC showed an increased dissolution rate and a higher amount of AmB solubilized in fasted state simulated intestinal fluid, compared to AmB/MAPC physical mixtures and crystalline AmB. In conclusion, an APC exhibiting amorphous properties was developed, the APC showed improved dissolution rate and increased apparent aqueous solubility compared to AmB, indicating that the application of APC could be a promising strategy to enable the oral delivery of AmB.
两性霉素 B(AmB)是治疗侵袭性真菌感染和内脏利什曼病的“救命药”。迄今为止,所有市售的 AmB 制剂都需要通过注射给药,这会导致很高的急性输注相关副作用发生率和剂量依赖性肾毒性。开发一种口服 AmB 制剂将带来许多优势,包括提高患者的顺应性、消除输注相关毒性和降低肾毒性。不幸的是,由于两性霉素 B 在水相和脂相溶剂中的溶解度极低,以及其在胃肠道中的渗透性差,两性霉素 B 的胃肠道吸收可以忽略不计。药物-磷脂复合物化是一种用于口服递送难溶性药物的新兴策略。在这项研究中,单酰基磷脂酰胆碱(MAPC)与 AmB 复合形成 AmB-MAPC 复合物(APC),以提高 AmB 的溶解速率和水溶解度,从而实现 AmB 的口服递送。X 射线粉末衍射表明,AmB 在与 MAPC 复合后转变为无定形形式,即在 APC 中。傅里叶变换红外光谱表明 AmB 与 MAPC 之间存在分子相互作用。动态光散射表明 APC 在水分散后形成胶体结构;低温透射电子显微镜显示 APC 形成小的圆形、“棒状”和“蠕虫状”胶束结构,小角中子散射提供了 APC 在水分散时形成的三维胶束结构,这表明 AmB 插入了由 MAPC 形成的胶束单层膜中。此外,与 AmB/MAPC 物理混合物和结晶 AmB 相比,APC 显示出更高的溶解速率和更多的 AmB 在禁食状态模拟肠液中溶解。总之,开发了一种具有无定形性质的 APC,与 AmB 相比,APC 显示出改善的溶解速率和增加的表观水溶解度,表明 APC 的应用可能是实现 AmB 口服递送的有前途的策略。
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