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      Interaction Study of an Amorphous Solid Dispersion of Cyclosporin A in Poly-Alpha-Cyclodextrin with Model Membranes by 1H-, 2H-, 31P-NMR and Electron Spin Resonance

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          Abstract

          The properties of an amorphous solid dispersion of cyclosporine A (ASD) prepared with the copolymer alpha cyclodextrin (POLYA) and cyclosporine A (CYSP) were investigated by 1H-NMR in solution and its membrane interactions were studied by 1H-NMR in small unilamellar vesicles and by 31P 2H NMR in phospholipidic dispersions of DMPC (dimyristoylphosphatidylcholine) in comparison with those of POLYA and CYSP alone. 1H-NMR chemical shift variations showed that CYSP really interacts with POLYA, with possible adduct formation, dispersion in the solid matrix of the POLYA, and also complex formation. A coarse approach to the latter mechanism was tested using the continuous variations method, indicating an apparent 1 : 1 stoichiometry. Calculations gave an apparent association constant of log Ka = 4.5. A study of the interactions with phospholipidic dispersions of DMPC showed that only limited interactions occurred at the polar head group level ( 31P). Conversely, by comparison with the expected chain rigidification induced by CYSP, POLYA induced an increase in the fluidity of the layer while ASD formation led to these effects almost being overcome at 298 K. At higher temperature, while the effect of CYSP seems to vanish, a resulting global increase in chain fluidity was found in the presence of ASD.

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          Lipid conformation in model membranes and biological membranes.

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            On the use of the method of continuous variations

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              Tacrolimus versus cyclosporin for immunosuppression in renal transplantation: meta-analysis of randomised trials.

              To compare tacrolimus with cyclosporin for immunosuppression in renal transplantation. Meta-analysis of randomised trials of two treatments after kidney transplantation. Four studies involving 1037 patients. Trials were included if they were randomised, the intervention group received tacrolimus, the control group received cyclosporin, the patients were followed for a minimum of 12 months, and patient survival, graft survival, incidence of acute rejection, need for antilymphocyte treatment, or the prevalence of diabetes mellitus after transplant was reported. Pooled estimates of patient mortality, allograft loss, and episodes of acute rejection 1 year after transplantation. The odds ratio for loss of allograft with tacrolimus compared with cyclosporin was 0.95 (95% confidence interval 0.65 to 1.40). The odds ratio for mortality with tacrolimus was 1.07 (0.47 to 2.48). Treatment with tacrolimus was associated with a reduction in episodes of acute rejection (0.52; 0.36 to 0.75), a reduction in the use of antilymphocyte antibodies to treat rejection (0.37; 0.25 to 0. 56), and an increased prevalence of diabetes mellitus after transplantation (5.03; 2.04 to 12.36) compared with treatment with cyclosporin. After renal transplantation, immunosuppression with tacrolimus results in a significant reduction in acute rejection compared with cyclosporin. Follow up studies of high methodological quality are needed to determine whether tacrolimus improves long term renal graft survival.
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                Author and article information

                Journal
                J Drug Deliv
                J Drug Deliv
                JDD
                Journal of Drug Delivery
                Hindawi Publishing Corporation
                2090-3014
                2090-3022
                2014
                5 May 2014
                : 2014
                : 575719
                Affiliations
                1IRBA, RNI-Biophysics Laboratory, 24, avenue des Maquis du Grésivaudan, BP 82, 38702 La Tronche Cedex, France
                2Galenic Pharmaceutical Laboratory, LAGEP UMR CNRS 5007, UFR Medicine and Pharmacy, 22 boulevard Gambetta, 76183 Rouen, France
                Author notes
                *Jean-Claude Debouzy: jcddebouzy@ 123456gmail.com

                Academic Editor: Juan M. Irache

                Author information
                http://orcid.org/0000-0002-7051-3966
                Article
                10.1155/2014/575719
                4027026
                c41da919-114f-4f4d-b0da-4c62e87674fb
                Copyright © 2014 Jean-Claude Debouzy et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 December 2013
                : 21 March 2014
                : 31 March 2014
                Categories
                Research Article

                Pharmaceutical chemistry
                Pharmaceutical chemistry

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