Characterization and pharmacokinetic analysis of aerosolized aqueous voriconazole solution

Invasive fungal infections in immunocompromised patients have high mortality rates despite current treatment modalities. This study was designed to evaluate the suitability of an aqueous solution of voriconazole solubilized with sulfobutyl ether-β-cyclodextrin for targeted drug delivery to the lungs via nebulization. A solution was prepared such that the inspired aerosol dose was isotonic with an acceptable mass median aerodynamic diameter of 2.98 μm and a fine particle fraction of 71.7%. Following single and multiple inhaled doses, high voriconazole concentrations were observed within 30 min in the lung tissue and plasma. Drug solubilization with sulfobutyl ether-β-cyclodextrin contributed to the rapid and high drug concentrations in plasma following inhalation. Maximal concentrations in the lung and plasma were 11.0 ± 1.6 μg/g wet lung weight and 7.9 ± 0.68 μg/mL, respectively, following a single inhaled dose with a corresponding tissue/plasma concentration ratio of 1.4 to 1. Following multiple inhaled doses, peak concentrations in lung tissue and plasma were 6.73 ± 3.64 μg/g wet lung weight and 2.32 ± 1.52 μg/mL, respectively. AUC values in lung tissue and plasma were also high. The clinically relevant observed pharmacokinetic parameters of inhaled aqueous solutions of voriconazole suggest that therapeutic outcomes could be benefitted through the use of inhaled voriconazole.     

Absorption of andrographolides from Andrographis paniculata and its effect on CCl4-induced oxidative stress in rats

A simple and validated high-performance liquid chromatography (HPLC) method with UV detection has been used to determine the content of andrographolide (AP) and 14-deoxy-11,12-didehydroandrographolide (DIAP) in rat plasma after oral dose of methanol extract (1 g/kg body weight) of Andrographis paniculata leaf. An increase in plasma concentration of AP and DIAP was observed from 30 min to 3 h after oral administration of the extract. The maximum plasma concentrations of AP and DIAP were 1.42 ± 0.09 μg/ml and 1.31 ± 0.04 μg/ml, respectively. Fourteen days oral treatment of rats with the methanol extract (1 g/kg body weight) followed by CCl₄ administration preserved catalase (CAT), and superoxide dismutase (SOD) activities in erythrocytes, whereas plasma lipid peroxidation, alanine transaminase (ALT) and aspartate transaminase (AST) activities were restored to values comparable with control values. Treatment of rats with CCl₄ did not showed significant alteration (p > 0.05) in plasma total antioxidant status (TAS) as compare to values of control group.     

Biopharmaceutical characterisation of insulin and recombinant human growth hormone loaded lipid submicron particles produced by supercritical gas micro-atomisation

Homogeneous dispersions of insulin and recombinant human growth hormone (rh-GH) in tristearin/phosphatidylcholine/PEG mixtures (1.3:1.3:0.25:0.15 w/w ratio) were processed by supercritical carbon dioxide gas micro-atomisation to produce protein-loaded lipid particles. The process yielded spherical particles, with a 197 ± 94 nm mean diameter, and the insulin and rh-GH recovery in the final product was 57 ± 8% and 48 ± 5%, respectively. In vitro, the proteins were slowly released for about 70–80 h according to a diffusive mechanism. In vivo, the insulin and glucose profiles in plasma obtained by subcutaneous administration of a dose of particles containing 2 μg insulin to diabetic mice overlapped that obtained with 2 μg of insulin in solution. Administration of a dose of particles containing 5 μg insulin resulted in faster and longer glycaemia reduction. Oral administration of 20 and 50 μg insulin equivalent particles produced a significant hypoglycaemic effect. The glucose levels decreased since 2 h after administration, reaching about 50% and 70% glucose reduction in 1–2 h with the lower and higher dose, respectively. As compared to subcutaneous administration, the relative pharmacological bioavailability obtained with 20 and 50 μg equivalent insulin particles was 7.7% and 6.7%, respectively. Daily subcutaneous administration of 40 μg of rh-GH-loaded particles to hypophysectomised rats induced similar body weight increase as 40 μg rh-GH in solution. The daily oral administration of 400 μg rh-GH equivalent particles elicited a slight body weight increase, which corresponded to a relative pharmacological bioavailability of 3.4% compared to subcutaneous administration.     

Pharmacological properties of ATP-sensitive purinergic receptors expressed in human G292 osteoblastic cells

We characterized the pharmacological properties of P2 receptors expressed in G292 osteoblastic cells by studying the responses or changes in intracellular Ca²⁺ level to P2 receptor agonists, antagonists and modulators. ATP induced robust responses in a concentration-dependent manner with EC₅₀ of 0.5 ± 0.07 μM. While α,β-methylene-ATP (αβmeATP) and 2',3'-O-(4-benzoylbenzoyl)-ATP (BzATP) were ineffective, ADP mimicked the action of ATP with EC₅₀ of 0.7 ± 0.2 μM. UTP and UDP also evoked responses with EC₅₀ of 2.0 ± 0.4 μM and 0.5 ± 0.1 μM respectively, but their responses were much smaller, resulting in an order of the response magnitude: ATP ~ ADP >> UTP ~ UDP. The responses evoked by ATP and ADP were blocked by pyridoxal-5'-phosphate-6-azophenyl-2,4,-disulfonate (PPADS) with IC₅₀ of 3.0 ± 0.05 μM and 5.0 ± 0.4 μM respectively, but not by suramin up to 30 μM. ATP-evoked responses were insensitive to inhibition by trinitrophenyl-ATP (TNP-ATP) and brilliant blue G. ADP-evoked responses were significantly inhibited by 2'-deoxy-N⁶-methyladenosine-3',5'-biphosphate (MRS2179) and 2-chloro-N⁶-methyl-(N)-methanocarba-2'-deoxyadenosine-3',5'-bisphosphate (MRS2279) with IC₅₀ of 48 ± 1.9 μM and 7.7 ± 0.9 μM respectively. Taken together, these results provide strong evidence for functional expression of ATP-sensitive P2Y receptors and particularly P2Y₁-like receptor in G292 cells.     

Cationic liposomes as carriers for aerosolized formulations of an anionic drug: Safety and efficacy study

This study tests the hypothesis that pegylated cationic liposomes are a viable carrier for inhalable formulations of low molecular weight heparin, an anionic drug. Cationic liposomal formulations of low molecular weight heparin were prepared by the hydration method using 1,2-dioleoyl-3-trimethylammonium-propane (chloride salt), cholesterol and 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[methoxy(polyethyleneglycol)-2000]. The formulations were characterized for particle size, entrapment efficiency, pulmonary absorption and pharmacological efficacy. For absorption studies, the formulations were administered to anesthetized male Sprague–Dawley rats via the pulmonary route and drug absorption was monitored by measuring plasma anti-factor Xa activity. The pharmacological efficacy of the formulations was studied in rodent models of pulmonary embolism and deep vein thrombosis. The mean particle size of the liposomes was 104.8 ± 20.7 nm and the drug entrapment efficiency was 90.3 ± 0.1%. The half-life of the cationic liposomal formulation was 10.6 ± 0.2 h, a 2.2-fold increase compared to low molecular weight heparin formulated in saline, and the relative bioavailability was 73.4 ± 19.1% when compared to subcutaneously administered drug. A once-every-other-day inhaled dose of the formulation showed similar efficacy in reducing thrombus weight as a once-daily dose of subcutaneously administered drug. Likewise, cationic liposomal formulations administered via the pulmonary route 6 h prior to embolization in the lungs showed a thrombolytic effect comparable to that of low molecular weight heparin administered subcutaneously 2 h before embolization. Histological examination of lung tissue and measurement of injury markers in bronchoalveolar lavage fluid suggest that the formulations did not produce extensive damage. The results demonstrate that pegylated cationic liposomes could be a viable carrier for an inhalable formulation of low molecular weight heparin.     

Steady-state pharmacokinetics and pharmacodynamics of piperacillin/tazobactam administered by prolonged infusion in hospitalised patients

The objective of this study was to evaluate the steady-state pharmacokinetics and pharmacodynamics of piperacillin/tazobactam, administered by prolonged infusion, in hospitalised patients requiring antimicrobial therapy. Thirteen patients received 4.5 g every 8 h (q8h), infused over 4 h, and pharmacokinetic parameters were determined by non-compartmental methods. Monte Carlo simulations (10 000 patients) were performed to calculate the cumulative fraction of response (CFR) for seven Gram-negative pathogens using minimum inhibitory concentration (MIC) data from the Meropenem Yearly Susceptibility Test Information Collection (2004–2007, USA) as well as the probability of target attainment (PTA) at MICs ranging from 1 μg/mL to 64 μg/mL. The pharmacodynamic target was free piperacillin concentration remaining above the MIC for 50% of the dosing interval. Mean ± standard deviation maximum and minimum serum concentrations, half-life, volume of distribution at steady-state and systemic clearance of piperacillin were 108.2 ± 31.7 μg/mL, 27.6 ± 26.3 μg/mL, 2.1 ± 1.2 h, 22.1 ± 4.0 L and 8.6 ± 3.0 L/h, respectively. The CFR was >90% for Escherichia coli, Serratia marcescens and Citrobacter spp., 88.6% for Enterobacter spp., 87% for Klebsiella pneumoniae, 85.5% for Pseudomonas aeruginosa and 52.8% for Acinetobacter spp. The PTA was 100%, 81.1% and 12.3% at MICs of ≤16 μg/mL, 32 μg/mL and 64 μg/mL, respectively. Piperacillin/tazobactam 4.5 g q8h infused over 4 h provides excellent target attainment for bacterial pathogens with MICs ≤ 16 μg/mL. However, the CFR was <90% for four of the seven Gram-negative pathogens evaluated.     

Plasma concentrations and electrocardiographic alterations after repetitive administration of propoxyphene to dogs

Propoxyphene hydrochloride was administered orally to four dogs every 8 hr for 19 days. Initial doses of 20 mg/kg were increased to 60 mg/kg in 5 to 15 mg/kg increments every 3 to 4 days. At the conclusion of the experiments animals were ambulatory although signs of toxicity including anorexia, sedation, tremors, and emesis were noted periodically throughout the study. Slight elevations in alkaline phosphatase and serum glutamate pyruvate transaminase values were also observed. Plasma concentrations of propoxyphene (P) (2.3±0.5 μg/ml) and norpropoxyphene (NP) (18.4±4.7 μg/ml), its major metabolite, were markedly elevated over those observed with a single near-lethal dose administered to naive dogs (P, 0.83 μg/ml; NP, 2.56 μg/ml). Tissue concentrations of P and NP were in excess of plasma concentrations showing marked tissue accumulation of both compounds. Electrocardiograms (ECG) showed an increase in PR interval after the first dose of propoxyphene. Doses from 20 to 45 mg/kg produced no further lengthening of the PR interval. Only when dogs were receiving 60 mg/kg (three times daily) were further changes in this interval observed, along with alterations in the QRS complex and T wave portions of the ECG. The average heart rate of these dogs was not significantly altered during the course of the study. At necropsy, mild superficial focal erosions in the mucosa of the stomach and upper small intestine were noted. No other histological changes were observed. These results demonstrated that in the dog, high plasma and tissue concentrations of P and NP can occur without causing significant toxic or lethal effects.     

Effect of P-glycoprotein inhibitor, verapamil, on oral bioavailability and pharmacokinetics of irinotecan in rats

The objective of present investigation was to study the effect of verapamil on the pharmacokinetics of irinotecan in order to evaluate the role of P-glycoprotein (P-gp) in irinotecan disposition. An in vitro study using Caco-2 intestinal cell monolayer was first carried out to determine the effect of verapamil on the function of intestinal P-gp. Verapamil (25 mg/kg) was administered orally 2 h before irinotecan oral (80 mg/kg) or intravenous (20 mg/kg) dosing in female Wistar rats. Plasma and biliary samples were collected at specified time points from control and treated animals to determine irinotecan and its metabolite, SN-38 concentrations. Bi-directional transport and inhibition studies in Caco-2 cells indicated irinotecan to be a P-gp substrate and the function of intestinal P-gp was significantly inhibited in presence of verapamil. After oral irinotecan dosing, the mean area under the plasma concentration–time curve (AUC) was found to be 14.03 ± 2.18 μg h/ml which was increased significantly, i.e. 61.71 ± 15.0 μg h/ml when verapamil was co-administered (P < 0.05). Similarly, the mean maximum plasma concentration of irinotecan increased from 2.93 ± 0.37 μg/ml (without verapamil) to 10.75 ± 1.0 μg/ml (with verapamil) (P < 0.05). There was approximately 4–5-folds increase in apparent bioavailability. On the other hand, the intravenous irinotecan administration with verapamil resulted in small but statistically significant effect on AUC (10.76 ± 2.0 to 23.3 ± 3.8 μg h/ml; P < 0.05) and systemic clearance (1206.4 ± 159.7 to 713.5 ± 78.2 ml/(h kg)). In addition, SN-38 showed significant change in oral pharmacokinetic parameters and minor changes in intravenous pharmacokinetic profile. Biliary excretion curves of both irinotecan and SN-38 were lowered by verapamil. The mean percent of irinotecan excreted into bile over 5 h following intravenous and oral administration was found to be 8% and 1%, respectively, which was further reduced to half when treated with verapamil. These results are quite stimulating for further development of a clinically useful oral formulation of irinotecan based on P-gp inhibition.     

Acute and chronic effects of neonatal lead exposure on development of the visual evoked response in rats

Developmental electrophysiologic studies of the visual evoked response (VER) provided a means for evaluating the effects of lead on central nervous system (CNS) ontogeny. Newborn rats exposed to Pb via dams' milk (dams' consuming 0.2% lead acetate solution) on Days 1 through 21 exhibited no changes in growth rate, age of eye opening, or brain weights (wet and dry). At 21 days of age, the lead concentrations in blood and brain of controls were 6 ± 1 and 7 ± 1 μg/100 ml, respectively while rats treated with lead had 65 ± 9 and 53 ± 4 μg/100 ml, respectively. VERs were recorded on Days 9–13, 16, 20, and 100. Lead exposure produced a significant increase in the latency of the primary (P₁N₁) and the secondary (P₂N₂) components of the VER throughout the neonatal period. Significantly longer latencies were also seen in adult rats (Day 90) exposed to Pb only during suckling. Lead concentrations in blood and brain of adult controls were 5 ± 1 and 11 ± 1 μg/100 ml, respectively. Adult lead-treated rats had 7 ± 1 and 13 ± 2 μg/100 ml, respectively. Exposed adults also exhibited a significantly decreased CNS recoverability function, as indicated by an increased latency to paired flashes, and a significantly decreased ability to follow repetitive light flashes compared to controls.     

Impurity profile study of lopinavir and validation of HPLC method for the determination of related substances in lopinavir drug substance

Several related substances (RS4–RS10) were detected in lopinavir drug substance at levels ranging from 0.03% to 0.1% by employing gradient RP-HPLC. The related substances were identified by LC–MS analysis. These related substances were isolated and characterized by Mass, ¹H NMR and FT-IR spectral data. The separation was achieved on a YMC Pack ODS-AQ (250 mm × 4.6 mm, 5 μm) column thermostated at 45 °C using 0.02 M KH₂PO₄ (pH 2.5): acetonitrile as a mobile phase in gradient elution mode. A PDA detector set at 210 nm was used for detection. The investigated validation elements showed the method has acceptable specificity, accuracy, linearity, precision, robustness and high sensitivity with detection limits and quantitation limits ranging from 0.028 μg/ml to 0.063 μg/ml and 0.084 μg/ml to 0.192 μg/ml respectively. The method can be used for routine quality control analysis and stability testing of lopinavir drug substance.     

Pharmacokinetics of thrombin-like enzyme from venom of Agkistrodon halys ussuriensis Emelianov determined by ELISA in the rat

A thrombin-like enzyme (TLE) was separated and purified from the venom of a northeast Chinese snake Agkistrodon halys ussuriensis Emelianov. Experiments were performed in rats to determine the pharmacokinetic parameters following an intravenous (i.v.) or a subcutaneous (s.c.) injection of the thrombin-like enzyme. The plasma levels of TLE were estimated by enzyme-linked immunosorbent assay. The method exhibited high reproducibility and accuracy in correlating optical densities with TLE concentrations (0.2–30 ng ml⁻¹, r=0.99). The plasma concentration-time course after i.v. administration of 50 μg kg⁻¹ TLE was well fitted by a two-compartment open model. The half-life of the α-phase was 18.0±3.2 min, and that of the β-phase 3.9±0.7 h. The apparent volume of distribution was 1.8±0.5 l kg⁻¹, and clearance was 5.4±0.5 ml min⁻¹ kg⁻¹. When the TLE was injected s.c. at a dose of 0.75 mg kg⁻¹, the changes in plasma concentration were best described by a two-compartment model with a first-order absorption. The maximal plasma level of 51±2.7 ng ml⁻¹ was reached at 5.2±0.5 h. The absorption rate constant was 0.3±0.03 h⁻¹. The area under the plasma concentration-time curve (AUC) was 2.8±0.8 μg h⁻¹ ml⁻¹.     

The fate of3H-terbutaline sulphate administered to man as an aerosol

Summary Six asthmatic patients and two healthy volunteers inhaled tritiated terbutaline sulphate delivered by a pressurized aerosol inhaler. Spirometric measurements were performed and the amounts of total radioactivity in plasma, urine and faeces were determined. The analysis of urine included determination of radioactivity due to metabolized drug. Depending on the amount of drug inhaled the peak plasma level varied from undetectable to 3.8 ng/ml. An early plasma peak was found in 7 out of 8 subjects. The main plasma peaks were observed 1 – 6 hours after administration. The results of urinalysis showed a metabolic profile similar to that after parenteral administration. Disregarding the amount of inhaled drug and sampling time, 3 – 35% of the delivered drug was recovered in the urine and 2 – 37% in the faeces. Immediately after treatment 4 subjects rinsed their mouths with water and it was found to contain 14.5 – 50% of the delivered dose. The adapters from the aerosol canisters contained 14 – 27.5% of the delivered dose of drug.Subsidiary to AB Astra, Sweden     

Simultaneous determination of five systemic azoles in plasma by high-performance liquid chromatography with ultraviolet detection

A simple, specific and automatable HPLC assay was developed for a simultaneous determination of systemic azoles (fluconazole, posaconazole, voriconazole, itraconazole and its metabolite hydroxyl-itraconazole, and ketoconazole) in plasma. The major advantage of this assay was sample preparation by a fully automatable solid phase extraction with Varian Plexa cartridges. C6-phenyl column was used for chromatographic separation, and UV detection was set at a wavelength of 260 nm. Linezolid was used as an internal standard. The assay was specific and linear over the concentration range of 0.05 to 40 μg/ml excepted for fluconazole which was between 0.05 and 100 μg/ml, and itraconazole between 0.1 and 40 μg/ml. Validation data for accuracy and precision for intra- and inter-day were good and satisfied FDA's guidance: CV between 0.24% and 11.66% and accuracy between 93.8% and 108.7% for all molecules. This assay was applied to therapeutic drug monitoring on patients hospitalized in intensive care and onco-hematologic units.     

Monitoring plasma voriconazole levels following intravenous administration in critically ill patients: an observational study

Data relating to the pharmacokinetics of voriconazole in critically ill patients are lacking. A prospective observational study was conducted on 18 non-consecutive critically ill patients aged 24–97 years, comprising 12 patients with normal renal function (NRF) [creatinine clearance (CL_Cr) ≥60 mL/min] and 6 patients with moderate renal impairment (MRI) (CL_Cr 40–55 mL/min), administered voriconazole intravenously (6 mg/kg loading dose and 3–4 mg/kg twice daily thereafter) in order to determine the suitability of these doses in this patient population. Steady-state blood levels were monitored and liver and renal function were recorded throughout treatment. Large variability in patient plasma levels was observed, ranging from 37% at ≤1 mg/L (minimum inhibitory concentration at which, for most fungal pathogens, 90% of isolates are susceptible) to 19% at >5.5 mg/L. Moreover, maintaining trough concentrations above clinical breakpoints was not consistently achieved because 16/30 (53%) were ≤1 mg/L. In a few MRI patients, average concentrations were found to be significantly different compared with those of NRF patients administered the same dose, however this difference was not noted in pharmacokinetic parameters following dose normalisation. None of the patients experienced deterioration in renal or liver function. Recommended voriconazole doses are inadequate to achieve drug concentrations >1 μg/mL over the entire dosing interval in some critically ill patients.     

Pharmacokinetics and pharmacodynamics of intravenous and inhaled fluticasone furoate in healthy Caucasian and East Asian subjects

AIM

The aim of the study was to evaluate the pharmacokinetics (PK) of inhaled and intravenous (i.v.) fluticasone furoate (FF) in healthy Caucasian, Chinese, Japanese and Korean subjects.

METHOD

This was an open label, randomized, two way crossover study in healthy Caucasian, Chinese, Japanese and Korean subjects (n = 20 per group). Inhaled FF (200 μg for 7 days, then 800 μg for 7 days from a dry powder inhaler [DPI]) was administered in one treatment period and i.v.FF (250 μg infusion) in the other. FF PK and serum cortisol (inhaled 200 μg only) were compared between the ethnic groups using analysis of variance. P450 CYP3A4 activity and safety were also assessed.

RESULTS

Ethnic differences in i.v. FF PK were accounted for by body weight differences. CYP3A4 activity was similar across the groups. Higher FF systemic exposure was seen following inhaled dosing in Chinese, Japanese and Korean subjects compared with Caucasian subjects. Absolute bioavailability was greater (36%–55%) in all East Asian groups than for Caucasian subjects following inhaled FF 800 μg. Deconvolution analysis suggested inhaled FF resided in the lung of East Asian subjects longer than for Caucasians (time for 90% to be absorbed [t90]: 29.1–30.8 h vs. 21.4 h). In vitro simulation method predicted comparable delivered lung dose across ethnic groups. Serum cortisol weighted mean was similar between Caucasians and Chinese or Koreans, while in Japanese was on average 22% lower than in Caucasians. All FF treatments were safe and well tolerated.

CONCLUSION

Modestly higher (<50%) FF systemic exposure seen in East Asian subjects following inhaled dosing was not associated with a clinically significant effect on serum cortisol, suggesting that a clinical dose adjustment in East Asian subjects is not required.     

A comparison of the pharmacokinetics of metronidazole in man after oral administration of single doses of benzoylmetronidazole and metronidazole

1 Three healthy male volunteers were treated with benzoylmetronidazole suspension (3.2 g equivalent to 2 g metronidazole) in a pilot study to investigate the absorption of benzoylmetronidazole into the systemic circulation. A further ten healthy male volunteers took part in a crossover study to compare the pharmacokinetics of metronidazole and its principal oxidative metabolites after administration of benzoylmetronidazole (equivalent to 2 g or 400 mg of metronidazole) or metronidazole (400 mg).

2 The plasma pharmacokinetics of metronidazole and metabolite I[1-(2-hydroxyethyl)-2-methyl-5-nitroimidazole] and plasma and urinary concentrations of these, plus benzoylmetronidazole and metabolite II [2-methyl-5-nitroimidazole-1-acetic acid], were determined using specific and sensitive high performance liquid chromatographic assay procedures.

3 No benzoylmetronidazole was observed in any plasma or urine sample assayed. The values for and times of the highest observed plasma metronidazole concentrations after a single oral dose of benzoylmetronidazole, equivalent to 2 g and 400 mg metronidazole, were 17 μg/ml at 5.1 h after dosing and 4.6 μg/ml at 3.2 h after dosing, respectively. Following oral administration of metronidazole (400 mg), the comparable values were 8.5 μg/ml at 0.8 h after dosing. Peak plasma concentrations of metabolite I after each dose were comparable with each other when corrected for the amount of metronidazole reaching the systemic circulation. The peak concentrations of this metabolite were markedly lower than the peak metronidazole concentrations in the same volunteer. Metabolite II was observed in low concentrations (0.8 μg/ml or less) in plasma at a few time intervals after administration of the higher dose of benzoylmetrinidazole and was not detected at any time interval after administration of benzoylmetronidazole (640 mg, equivalent to 400 mg metronidazole) or metronidazole (400 mg).

4 Pharmacokinetic parameters of metronidazole absorption are markedly different after administration of benzoylmetronidazole than after dosing with metronidazole, but the pharmacokinetic parameters of metronidazole and metabolite I elimination are essentially identical after equimolar doses of each form of the drug. The systemic availability of metronidazole derived from benzoylmetronidazole is approximately 80% of that from metronidazole and is independent of dose over the range studied.

5 The mean value for minimum plasma metronidazole concentration at steady-state during the o.d. administration of benzoylmetronidazole (3.2 g equivalent to 2 g metronidazole) was predicted (from these single dose data) to be 6.2 μg/ml. Thus, these predictions suggest that the majority of patients will maintain therapeutic plasma metronidazole concentrations for the whole of the dosing interval during a once-daily dosing regimen. This oral liquid formulation of metronidazole may thus be regarded as a suitable alternative to other presentations of the drug.

     

Trophic transfer of Cd from larval chironomids (Chironomus riparius) exposed via sediment or waterborne routes, to zebrafish (Danio rerio): tissue-specific and subcellular comparisons

Zebrafish were fed chironomid larvae (8% wet weight daily ration) for 7 days, followed by 3 days of gut clearance in a static-renewal system. Regardless of whether the chironomids had been loaded with Cd via a waterborne exposure or sediment exposure, they had similar subcellular distributions of Cd, with the largest areas of storage being metal rich granules (MRG) > organelles (ORG) > enzymes (ENZ) except that sediment-exposed chironomids had significantly more Cd in the metallothionein-like protein (MTLP) fraction, and significantly less Cd in the cellular debris (CD) fraction. When zebrafish fed sediment-exposed chironomids (153 ± 11 μg Cd/g dry weight) were compared directly to zebrafish fed waterborne exposed chironomids (288 ± 12 μg Cd/g dry weight), identical whole-body Cd levels were observed, despite the difference in the concentration in the food source. Thus trophic transfer efficiency (TTE) of Cd was significantly greater from sediment-exposed chironomids (2.0 ± 0.5%) than from waterborne-exposed chironomids (0.7 ± 0.2%). Subsequent tests with waterborne exposed chironomids loaded to comparable Cd concentrations, as well as with Cd-spiked manufactured pellets, demonstrated that TTEs were concentration-independent. In all treatments, zebrafish exhibited similar subcellular storage of Cd, with the greatest uptake occurring in the ORG fraction followed by the ENZ fraction. However, neither trophically available metal (TAM) nor metabolically available fractions (MAF) were good predictors for the TTEs found in this study. Tissue Cd concentrations were highest in the kidney and gut tissue, then liver, but lower in the gill, and carcass. Overall, the gut and carcass contributed ≥71% to total body burdens on a mass-weighted basis. This study presents evidence that Cd may be acquired by fish from natural diets at levels of environmental relevance for contaminated sites, and that the exposure route of the prey influences the TTE.     

Inhalation delivery dramatically improves the efficacy of topotecan for the treatment of local and distant lung cancer

Topotecan is potent anti-cancer drug approved for various malignancies but hematopoietic toxicities undermine its wider application and use of its most effective dose. This study aims to improve these limitations through inhalation-delivery. The pharmacokinetics, efficacy, and toxicity of 2–5 times lower inhalation doses of topotecan dry-powder were compared with the standard intravenous (IV) delivery once/twice-a-week. Human-derived EGFR-mutant (H1975), KRAS-mutant (A549), and EGFR/KRAS wild-type (H358) orthotopic and distant lung tumors were evaluated in murine models. Inhalation of 1 mg/kg topotecan significantly improved the half-life and drug exposure (area under the curve, AUC) compared to 5 mg/kg via IV-delivery. AUCs (h*ng/mL) for inhaled/IV topotecan in plasma, lung, liver, and brain were, 831/888, 60,000/1080, 8380/4000, and 297/15, respectively; while the half-life was also greatly increased in these tissues. The average lung tumor burden of H358-derived tumors was reduced from 15.0 g to 8.4 g (44%) in rats treated once-a-week with 2 mg/kg IV and 1.8 g (88%) with 1 mg/kg inhaled topotecan, corroborating previous findings using A549- and H1975-derived orthotopic lung tumors. Importantly, inhaled topotecan showed superior efficacy in suppressing lung tumors at distant sites. The growth of H1975- and H358-derived subcutaneous xenografts were completely arrested and A549-derived tumors were significantly reduced in mice treated twice-a-week with 1 mg/kg inhaled topotecan compared to a minor (H1975 and H358) or no reduction (A549) with twice-a-week 5 mg/kg IV topotecan.     

Cognitive impairment in an adult Mexican population non-occupationally exposed to manganese

We examined the association between non-occupational exposure to Mn and cognitive functions. The study was carried out in a mining district located in Hidalgo State, Mexico, with 288 adults. Air and blood Mn concentrations were determined, and neuropsychological tests were administered to explore cognitive functions and depression. Blood Mn mean was 9.5 ± 4.14 μg/L. A total of 73% of the study group were in contact with air Mn levels that surpassed the EPA recommended guideline level for non-occupational environments (0.05 μg/m³). Air Mn concentration was associated as a risk factor for attention impairment (OR = 1.75, 95% CI: 1.01–3.06). Blood Mn levels were not associated to any of the measured outcomes. The main finding of this study is the presence of attention impairments associated to high levels of air Mn exposure. These results confirm previous studies, in which cognitive impairment is reported for exposed population.     

Lipid nanocapsules: Ready-to-use nanovectors for the aerosol delivery of paclitaxel

Aerosol drug delivery permits the development of dose-intensification strategies in severe, malignant lung diseases. The aim of the study was to demonstrate that the encapsulation of paclitaxel in lipid nanocapsules (LNCs), a novel drug nanocarrier for lipophilic components, allows one to provide pulmonary drug delivery of paclitaxel by nebulisation, thereby allowing preclinical and clinical studies. LNC dispersions are made into aerosols with commercial nebulisers. The structure, drug payload and cytotoxicity of nebulised LNCs were compared to fresh LNCs. The results demonstrated that LNC dispersions could be made into aerosols by using mesh nebulisers without altering the LNC structure. Only eFlow^® rapid-produced aerosols are compatible with human use: the mean duration to nebulise 3 ml of LNC dispersion is less than 9 min, with an aerosol mass median aerodynamic diameter equal to 2.7 ± 0.1 μm and a fine-particle fraction (between 1.0 and 5.0 μm) of 81.5 ± 3.1%. No modifications of drug payload or cytotoxicity effects of paclitaxel-loaded LNC (PTX–LNC) were observed. In order to carry out preclinical studies, a scaled-up LNC formulation protocol was used. Chemical parameters, such as acidity and osmolarity, were optimised, and a storage procedure for PTX–LNC batches was set-up. Animal studies are now needed to determine the tolerance and therapeutic potential of LNC dispersion aerosols.