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      Enhanced Delivery of 4-Thioureidoiminomethylpyridinium Perchlorate in Tuberculosis Models with IgG Functionalized Poly(Lactic Acid)-Based Particles

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          Abstract

          The compound 4-thioureidoiminomethylpyridinium perchlorate (perchlozone ©) is a novel anti-tuberculosis drug that is active in multiple drug resistance cases, but the compound is hepatotoxic. To decrease the systemic load and to achieve targeting, we encapsulated the drug into poly(lactic acid)-based micro- (1100 nm) and nanoparticles (170 nm) that were modified with single-chain camel immunoglobulin G (IgG) for targeting. Both micro- and nanoparticles formed stable suspensions in saline solution at particle concentrations of 10–50 mg/mL. The formulations were injected intraperitoneally and intravenously into the mice with experimental tuberculosis. The survival of control animals was compared to that of mice which were treated with daily oral drug solution, single intraperitoneal administration of drug-loaded particles, and those treated both intravenously and intraperitoneally by drug-loaded particles modified with polyclonal camel IgGs. The distribution of particles in the organs of mice was analyzed with immunofluorescence and liquid chromatography/mass spectrometry. Morphological changes related to tuberculosis and drug toxicity were registered. Phagocytic macrophages internalized particles and transported them to the foci of tuberculosis in inner organs. Nanoparticle-based drug formulations, especially those with IgG, resulted in better survival and lower degree of lung manifestations than the other modes of treatment.

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          Effect of the size and surface charge of polymer microspheres on their phagocytosis by macrophage.

          Polystyrene and phenylated polyacrolein microspheres of different diameters, as well as modified cellulose microspheres with different surface charges, were prepared in order to study the size and surface charge effect on their phagocytosis by mouse peritoneal macrophages. It was found that the maximal phagocytosis of polystyrene and phenylated polyacrolein microspheres took place when their size was in the range 1.0-2.0 microns. Microspheres with hydrophobic surfaces were more readily phagocytosed than those with hydrophilic surfaces. There was no significant difference in phagocytosis between cationic and the anionic surfaces when compared at a zeta potential of the same absolute value. The least phagocytosis was observed for cellulose microspheres with non-ionic hydrophilic surfaces. Addition of fetal calf serum to the culture medium resulted in decrease in phagocytosis for all microspheres.
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            Poly (DL-lactide-co-glycolide) nanoparticle-based inhalable sustained drug delivery system for experimental tuberculosis.

            To improve the bioavailability of antitubercular drugs (ATDs) as well as to assess the feasibility of administering ATDs via the respiratory route, this study reports the formulation of three frontline ATDs, i.e. rifampicin, isoniazid and pyrazinamide encapsulated in poly (DL-lactide-co-glycolide) nanoparticles suitable for nebulization. Drug-loaded nanoparticles were prepared by the multiple emulsion technique, vacuum-dried and nebulized to guinea pigs. The formulation was evaluated with respect to the pharmacokinetics of each drug and its chemotherapeutic potential in Mycobacterium tuberculosis infected guinea pigs. The aerosolized particles exhibited a mass median aerodynamic diameter of 1.88 +/- 0.11 microm, favourable for bronchoalveolar lung delivery. A single nebulization to guinea pigs resulted in sustained therapeutic drug levels in the plasma for 6-8 days and in the lungs for up to 11 days. The elimination half-life and mean residence time of the drugs were significantly prolonged compared to when the parent drugs were administered orally, resulting in an enhanced relative bioavailability (compared to oral administration) for encapsulated drugs (12.7-, 32.8- and 14.7-fold for rifampicin, isoniazid and pyrazinamide, respectively). The absolute bioavailability [compared to intravenous (i.v.) administration] was also increased by 6.5-, 19.1- and 13.4-fold for rifampicin, isoniazid and pyrazinamide, respectively. On nebulization of nanoparticles containing drugs to M. tuberculosis infected guinea pigs at every 10th day, no tubercle bacilli could be detected in the lung after five doses of treatment whereas 46 daily doses of orally administered drug were required to obtain an equivalent therapeutic benefit. Nebulization of nanoparticles-based ATDs forms a sound basis for improving drug bioavailability and reducing the dosing frequency for better management of pulmonary tuberculosis.
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              New drugs for the treatment of tuberculosis: needs, challenges, promise, and prospects for the future.

              For the first time in 40 years, a portfolio of promising new compounds for the treatment of tuberculosis is on the horizon. The introduction of new drugs in combination treatment for all forms of tuberculosis raises several issues related to patients' access to novel treatments, programmatic feasibility, cost effectiveness, and implications for monitoring and surveillance, particularly with regard to the development of drug resistance. Particular attention should be given to the identification of optimal drug combination(s) for the treatment of all forms of tuberculosis, particularly in high-risk and vulnerable groups, such as human immunodeficiency virus-coinfected persons and children, and to the rational use of new drugs. Addressing these issues adequately requires the establishment of clear guidelines to assist countries in the development of policies for the proper use of tuberculosis drugs in a way that guarantees access to best treatments for all those in need and avoids inappropriate use of new drugs. After a description of these various challenges, we present activities that will be carried out by the World Health Organization in collaboration with key stakeholders for the development of policy guidelines for optimal treatment of tuberculosis.
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                Author and article information

                Journal
                Pharmaceutics
                Pharmaceutics
                pharmaceutics
                Pharmaceutics
                MDPI
                1999-4923
                21 December 2018
                January 2019
                : 11
                : 1
                : 2
                Affiliations
                [1 ]Faculty of Medicine, Saint Petersburg State University, 7/9 Universitetskaya Embankment, 199034 St. Petersburg, Russia; elpach@ 123456mail.ru (L.C.); poidan@ 123456mail.ru (M.P.); utekhin44@ 123456mail.ru (V.U.); v.zinserling@ 123456spbu.ru (V.Z.); glhirurgb2@ 123456mail.ru (P.Y.)
                [2 ]Institute of Chemistry, Saint Petersburg State University, 7/9 Universitetskaya Embankment, 199034 St. Petersburg, Russia; v.korzhikov-vlakh@ 123456spbu.ru (V.K.-V.); kat_sinitsyna@ 123456mail.ru (E.S.); ravendoctor@ 123456mail.ru (D.P.); arto.urtti@ 123456helsinki.fi (A.U.)
                [3 ]Institute of Macromolecular Compounds, Russian Academy of Sciences, Bolshoi pr. V.O. 31, 199004 St. Petersburg, Russia; gplaton@ 123456mail.ru
                [4 ]Republican Center for Innovative and Technical Creativity, Slavinskogo str. 12, 220086 Minsk, Belarus; centre@ 123456rcitt.by
                [5 ]St. Petersburg Research Institute of Phthisiopulmonology, Polytechnical str. 32, 194064, St. Petersburg, Russia; vinogradova@ 123456spbniif.ru (T.V.); zabol-natal@ 123456yandex.ru (N.Z.)
                Author notes
                [* ]Correspondence: tennikova@ 123456mail.ru ; Tel.: +7-921-969-1060; Fax: +7-812-363-6722
                Author information
                https://orcid.org/0000-0001-6359-0026
                https://orcid.org/0000-0002-1095-3484
                https://orcid.org/0000-0001-5867-230X
                https://orcid.org/0000-0001-9690-0043
                Article
                pharmaceutics-11-00002
                10.3390/pharmaceutics11010002
                6359407
                30577686
                5ac2b9ab-0355-409e-b040-8d37728a7e92
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 08 November 2018
                : 18 December 2018
                Categories
                Article

                tuberculosis,polymeric nanoparticles,poly(lactide),4-thioureidoiminomethylpyridinium perchlorate (perchlozone),macrophage,camel mini-antibodies,opsonization,drug delivery

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