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      Lipid Formulations of Polyene Antifungal Drugs and Attenuation of Associated Nephrotoxicity

      a,b , c , d , b

      Nephron

      S. Karger AG

      Lipid formulations, Nephrotoxicity, Amphotericin B

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          Abstract

          Amphotericin B is an effective broad-spectrum antifungal agent, but various side effects, especially nephrotoxicity, have restricted its use. Recently, lipid formulations of amphotericin B have been developed in order to reduce its toxic side effects. Clinical trials, although in the early stages, suggest promising results, and that some of these lipid formulations are potent and less toxic, even at higher doses. We summarize herein the existing information about newer lipid formulations of polyene antifungal drugs, which could attenuate associated nephrotoxicity.

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          Most cited references 1

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          Antifungal activity of amphotericin B cochleates against Candida albicans infection in a mouse model.

           L Zarif,  D Perlin,  R Mannino (2000)
          Cochleates are lipid-based supramolecular assemblies composed of natural products, negatively charged phospholipid, and a divalent cation. Cochleates can encapsulate amphotericin B (AmB), an important antifungal drug. AmB cochleates (CAMB) have a unique shape and the ability to target AmB to fungi. The minimal inhibitory concentration and the minimum lethal concentration against Candida albicans are similar to that for desoxycholate AmB (DAMB; Fungizone). In vitro, CAMB induced no hemolysis of human red blood cells at concentrations of as high as 500 microg of AmB/ml, and DAMB was highly hemolytic at 10 microg of AmB/ml. CAMB protect ICR mice infected with C. albicans when the agent is administered intraperitoneally at doses of as low as 0.1 mg/kg/day. In a tissue burden study, CAMB, DAMB, and AmBisome (liposomal AmB; LAMB) were effective in the kidneys, but in the spleen CAMB was more potent than DAMB at 1 mg/kg/day and was equivalent to LAMB at 10 mg/kg/day. In summary, CAMB are highly effective in treating murine candidiasis and compare well with AmBisome and AmB.
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            Author and article information

            Journal
            NEF
            Nephron
            10.1159/issn.1660-8151
            Nephron
            S. Karger AG
            1660-8151
            2235-3186
            2001
            2001
            10 October 2001
            : 89
            : 3
            : 251-254
            Affiliations
            aDepartment of Oral Medicine and Diagnostic Sciences, Harvard School of Dental Medicine, Boston, Mass., USA; bSecond Department of Pathology, Nagasaki University School of Medicine, Nagasaki, Japan; cCenter for Medical Mycology, Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA and dDepartment of Medicine, Penn State College of Medicine, Hershey, Pa., USA
            Article
            46081 Nephron 2001;89:251–254
            10.1159/000046081
            11598385
            © 2001 S. Karger AG, Basel

            Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            Page count
            References: 21, Pages: 4
            Product
            Self URI (application/pdf): https://www.karger.com/Article/Pdf/46081
            Categories
            Short Review

            Cardiovascular Medicine, Nephrology

            Amphotericin B, Lipid formulations, Nephrotoxicity

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