Document Detail


Development of a novel self-microemulsifying drug delivery system for reducing HIV protease inhibitor-induced intestinal epithelial barrier dysfunction.
MedLine Citation:
PMID:  20349948     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The development of HIV protease inhibitors (PIs) has been one of the most significant advances of the past decade in controlling HIV infection. Unfortunately, the benefits of HIV PIs are compromised by serious side effects. One of the most frequent and deleterious side effects of HIV PIs is severe gastrointestinal (GI) disorders including mucosal erosions, epithelial barrier dysfunction, and leak-flux diarrhea, which occurs in 16-62% of patients on HIV PIs. Although the underlying mechanisms behind HIV PI-associated serious adverse side effects remain to be identified, our recent studies have shown that activation of endoplasmic reticulum (ER) stress response plays a critical role in HIV PI-induced GI complications. The objective of this study was to develop a novel self-microemulsifying drug delivery system (SMEDDS) using various antioxidants as surfactants and cosurfactants to reduce the GI side effects of the most commonly used HIV PI, ritonavir. The biological activities of this SMSDDS of ritonavir were compared with that of Norvir, which is currently used in the clinic. Rat normal intestinal epithelial cells (IEC-6) and mouse Raw 264.7 macrophages were used to examine the effect of new SMEDDS of ritonavir on activation of ER stress and oxidative stress. Sprague-Dawley rats and C57/BL6 mice were used for pharmacokinetic studies and in vivo studies. The intracellular and plasma drug concentrations were determined by HPLC analysis. Activation of ER stress was detected by Western blot analysis and secreted alkaline phosphatase (SEAP) reporter assay. Reactive oxygen species (ROS) was measured using dichlorodihydrofluorescein diacetate as a probe. Cell viability was determined by Roche's cell proliferation reagent WST-1. Protein levels of inflammatory cytokines (TNF-alpha and IL-6) were determined by enzyme-linked immunosorbent assays (ELISA). The intestinal permeability was assessed by luminal enteral administration of fluorescein isothiocyanate conjugated dextran (FITC-dextran, 4 kDa). The pathologic changes in intestine were determined by histological examination. The results indicated that incorporation of antioxidants in this new SMEDDS not only significantly reduced ritonavir-induced ER stress activation, ROS production and apoptosis in intestinal epithelial cells and macrophages, but also improved the solubility, stability and bioavailability of ritonavir, and significantly reduced ritonavir-induced disruption of intestinal barrier function in vivo. In conclusion, this new SMEDDS of ritonavir has less GI side effects compared to Norvir. This new SMEDDS can be used for other HIV PIs and any insoluble antiviral drug with serious GI side effects.
Authors:
Bokai Lei; Weibin Zha; Yun Wang; Cong Wen; Elaine J Studer; Xuan Wang; Fang Jin; Guangji Wang; Luyong Zhang; Huiping Zhou
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Molecular pharmaceutics     Volume:  7     ISSN:  1543-8392     ISO Abbreviation:  Mol. Pharm.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-07     Completed Date:  2010-09-07     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  101197791     Medline TA:  Mol Pharm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  844-53     Citation Subset:  IM    
Affiliation:
Department of Microbiology and Immunology, Virginia Commonwealth University, Richmond, Virginia 23298, USA.
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MeSH Terms
Descriptor/Qualifier:
Alkaline Phosphatase / metabolism
Animals
Ascorbic Acid / administration & dosage,  chemistry,  therapeutic use
Blotting, Western
Cell Line
Cell Survival / drug effects
Chromatography, High Pressure Liquid
Drug Delivery Systems*
Enzyme-Linked Immunosorbent Assay
HIV Protease Inhibitors / administration & dosage*,  adverse effects*,  chemistry
Interleukin-6 / metabolism
Intestinal Mucosa / drug effects*,  metabolism,  pathology
Linoleic Acids / administration & dosage,  chemistry,  therapeutic use
Male
Mice
Mice, Inbred C57BL
Oleic Acid / administration & dosage,  chemistry,  therapeutic use
Rats
Rats, Sprague-Dawley
Reactive Oxygen Species / metabolism
Ritonavir / administration & dosage*,  adverse effects*,  chemistry
Tumor Necrosis Factor-alpha / metabolism
Grant Support
ID/Acronym/Agency:
R01 AT004148-01/AT/NCCAM NIH HHS; R01AI057189/AI/NIAID NIH HHS; R01AT004148/AT/NCCAM NIH HHS; R21 AI068432-01A1/AI/NIAID NIH HHS; R21AI068432/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/HIV Protease Inhibitors; 0/Interleukin-6; 0/Linoleic Acids; 0/Reactive Oxygen Species; 0/Ritonavir; 0/Tumor Necrosis Factor-alpha; 112-80-1/Oleic Acid; 50-81-7/Ascorbic Acid; 544-35-4/ethyl linoleate; EC 3.1.3.1/Alkaline Phosphatase
Comments/Corrections

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