DRUG METABOLISM AND TRANSPORT DURING REJECTION OF TRANSPLANTED LIVER

Organ transplantation is an accepted therapy for diseases that result in chronic irreversible failure of various organs. During transplantation, the transplanted organ is subjected to two inflammatory processes, alloantigen-independent (ischemia/reperfusion injury) and alloantigen-dependent (rejection), both of which involve release of cytokines. The objectives of this dissertation were to evaluate the effect of acute rejection of liver in rats on hepatic and extra-hepatic drug metabolizing capacity for phase I and II enzymes, to evaluate the effect of chronic rejection of liver in humans on hepatic metabolizing capacity of phase I and II enzymes, to evaluate the effect of acute and chronic rejection of liver on hepatic and extra-hepatic protein and mRNA expression of P-glycoprotein and to evaluate the effect of different cytokines on the constitutive and inducible hepatic CYP3A4 activity and protein expression in human hepatocytes. Alloantigen-independent inflammation and altered blood flow caused a reduction in hepatic mRNA of different phase I and II enzymes. However, this reduction did not significantly alter protein levels of all CYP450 enzymes studied. Occurrence of rejection resulted in further reduction in mRNA, protein levels and activity of all CYP450s studied. Syngeneic and allogeneic transplantation caused reduction in the metabolic capacity of extra-hepatic tissues and increased expression of P-gp in the liver. Chronic rejection of the liver in humans selectively altered the activity and protein expression of different phase I and II enzymes and increased P-gp protein expression. In human hepatocyte cultures, IL-1â, IL-6 and TNF-á decreased the activity and protein expression of both constitutive and induced forms of CYP3A4 enzyme. Pre-exposing or co-exposing the hepatocytes to cytokines reduced the ability of rifampicin to induce CYP3A4.In conclusion, acute and chronic rejection of liver significantly altered the expression and activity of several drug metabolizing enzymes and transporters. The magnitude of these alterations was higher in acute rejection. Acute rejection also caused alterations in the metabolizing ability and transporters expression in renal and pulmonary tissues. Cytokines play a major role in modulating the activity of drug metabolizing enzymes and transporters and may contribute to the large inter-individual variation in the pharmacokinetics of drugs in transplant patients

Influence of intestinal efflux pumps on the absorption and transport of furosemide

AbstractPurposeFurosemide is a commonly used diuretic which is used in the treatment of edema, congestive heart failure, hypertension and renal failure. Its absorption exhibits inter- and intra-subject variability that can be attributed to many factors including the intestinal efflux pumps such as the P-glycoprotein (P-gp). This study was done due to the great disagreement between what is published in the literature regarding the influence of P-gp on furosemide and at the same time due to the importance of this drug in the treatment of different conditions as described above. In addition, an investigation of the effect of two of the commonly used pharmaceutical excipients (hydroxypropyl β-cyclodextrin [HPβCD] and Tween 80) and also a P-gp inhibitor (verapamil hydrochloride) on the intestinal absorption of this drug were also done.MethodsThe study utilized the everted intestinal sacs technique to investigate both the effect of the efflux transporter (P-gp) on furosemide absorption and also the effect of the chosen excipients.ResultsThe absorption of furosemide was significantly influenced by the P-gp as confirmed by the everted vis the non-everted sacs together with the verapamil study in which the transport of furosemide was inhibited by verapamil. In addition, Tween 80 was also shown to inhibit the P-gp pump whereas the HPβCD did not significantly influence the efflux of furosemide in this study.ConclusionsP-glycoprotein and some of the used excipients in the formulation play a very important role in the transport of furosemide and other drugs. Thus excipients that affect the activity of P-gp should be avoided when formulating drugs that are substrate for the P-gp or other efflux pumps

Effect of Garden Cress Seeds Powder and Its Alcoholic Extract on the Metabolic Activity of CYP2D6 and CYP3A4

The powder and alcoholic extract of dried seeds of garden cress were investigated for their effect on metabolic activity of CYP2D6 and CYP3A4 enzymes. In vitro and clinical studies were conducted on human liver microsomes and healthy human subjects, respectively. Dextromethorphan was used as a common marker for measuring metabolic activity of CYP2D6 and CYP3A4 enzymes. In in vitro studies, microsomes were incubated with NADPH in presence and absence of different concentrations of seeds extract. Clinical investigations were performed in two phases. In phase I, six healthy female volunteers were administered a single dose of dextromethorphan and in phase II volunteers were treated with seeds powder for seven days and dextromethorphan was administered with last dose. The O-demethylated and N-demethylated metabolites of dextromethorphan were measured as dextrorphan (DOR) and 3-methoxymorphinan (3-MM), respectively. Observations suggested that garden cress inhibits the formation of DOR and 3-MM metabolites. This inhibition of metabolite level was attributed to the inhibition of CYP2D6 and CYP3A4 activity. Garden cress decreases the level of DOR and 3-MM in urine and significantly increases the urinary metabolic ratio of DEX/DOR and DEX/3-MM. The findings suggested that garden cress seeds powder and ethanolic extract have the potential to interact with CYP2D6 and CYP3A4 substrates

Effects of Nigella sativa and Lepidium sativum on Cyclosporine Pharmacokinetics

The present study was conducted to investigate the effects of Nigella sativa and Lepidium sativum on the pharmacokinetics of cyclosporine in rabbits. Two groups of animals were treated separately with Nigella sativa (200 mg/kg p.o.) or Lepidium sativum (150 mg/kg p.o.) for eight consecutive days. On the 8th day, cyclosporine (30 mg/kg p.o.) was administered to each group one hour after herbal treatment. Blood samples were withdrawn at different time intervals (0.0, 0.5, 1.0, 1.5, 2.0, 3.0, 4.0, 6.0, 8.0, 12, and 24 hrs) from marginal ear vein. Cyclosporine was analyzed using UPLC/MS method. The coadministration of Nigella sativa significantly decreased the max and AUC 0−∞ of cyclosporine; the change was observed by 35.5% and 55.9%, respectively ( ≤ 0.05). Lepidium sativum did not produce any significant change in max of cyclosporine, although its absorption was significantly delayed compared with control group. A remarkable change was observed in max and AUC 0− of Lepidium sativum treated group. Our findings suggest that concurrent consumption of Nigella sativa and Lepidium sativum could alter the pharmacokinetics of cyclosporine at various levels

Modulatinn Intestinal Uptake of Atenolol Usinn Niosomes as Drun Permeation Enhancers

It is well established through the last decade that niosomes have potential applications as drug carriers either to improve drug permeation across membranes or targeting to specific tissues. Having a considerable ability to improve the permeability of drugs through lipoid membranes, niosomes have been utilized as carriers to enhance atenolol absorption from the gastrointestinal tract. Two methods have been adopted to prepare niosomes, the proniosome-derived method (A) and the conventional film hydration method (B). The products from the two methods were compared in terms of their morphology, vesicle size, drug encapsulation efficiency, in vitro drug release and enhancement effect on drug permeation across the intestinal membrane using an everted sac technique. Proniosome-derived niosomes were smoother and exhibited a smaller (5 μm) vesicle size compared to those prepared by conventional methods (12 μm). High encapsulation efficiencies of 98.6% and 93.4% were achieved by methods A and B, respectively. In vitro drug release has been significantly retarded from both types of niosomes. Comparing to pure drug, which dissolved completely in 15 min, only 8.9% and 9.9% of the entrapped drug was released in the same time period. The drug release kinetics showed non-Fickian (anomalous) behavior. Permeation through an everted intestinal sac showed a significant enhancement effect (more than 4 fold) for both types of niosomes compared to untrapped drug; however, the difference between the two types of niosomes was not significan

Hydroxypropyl-β-Cyclodextrin for Delivery of Sinapic Acid via Inclusion Complex Prepared by Solvent Evaporation Method

The goal of this study was to increase the aqueous solubility and dissolution rate of sinapic acid (SA) by formulating binary inclusion complex (BIC) of SA with hydroxypropyl-β-cyclodextrin (HPβCD) using solvent evaporation (SE) technology. The phase solubility and dissolution studies were conducted to determine the solubility and in vitro release rate of SA. In addition, the prepared inclusion complex was characterized for solid state characterization using techniques such as DSC, PXRD, SEM, and FTIR. Moreover, the prepared SA-BIC was evaluated for its antioxidant activity. Results revealed that the SA solubility can be shown to improve with a change in HPβCD concentration. About 2.59 times higher solubility of SA in water was noticed in the presence of HPβCD (10 mM). Dissolution study demonstrated that the 34.11 ± 4.51% of SA was released from binary physical mixture (BPM), while the maximum release of 46.27 ± 2.79% of SA was observed for SA-BIC prepared by SE method. The prepared SA-BIC demonstrated distinctive properties when compared to pure SA, which was demonstrated by different analytical methods, such as DSC, PXRD, SEM, and FTIR, as evidence of SA inclusion into HPβCD cavity. Further, it was observed that SA-BIC displayed stronger DPPH radical scavenging activity than SA. In conclusion, SE technology considerably enhanced the complexity of SA with HPβCD, and these observations could help to heighten the SA solubility, which may lead to a better bioavailability

Prevalence of \u3ci\u3eEscherichia coli\u3c/i\u3e O157:H7 and \u3ci\u3eSalmonella\u3c/i\u3e in Camels, Cattle, Goats, and Sheep Harvested for Meat in Riyadh

Escherichia coli O157:H7 and Salmonella are significant foodborne pathogens that can be found in the feces and on the hides of meat animals. When hides are removed during the harvest process, the carcass and subsequent meat products can become contaminated. Camels, cattle, sheep, and goats are harvested for meat in Riyadh, Saudi Arabia. The prevalence of E. coli O157:H7 and Salmonella are unknown in these animals, and it is assumed that if the animals carry the pathogens in their feces or on their hides, meat products are likely to become contaminated. To this end, a minimum of 206 samples each from hides and feces of camels, cattle, goats, and sheep were collected over the course of 8 months and tested for E. coli O157:H7 and Salmonella. It was found that E. coli O157:H7 was present in feces (10.7, 1.4, 2.4, and 2.4%) and on hides (17.9, 8.2, 2.9, and 9.2%) of cattle, goats, camels, and sheep, respectively. The prevalence of Salmonella was 11.2, 13.5, 23.2, and 18.8% in feces and 80.2, 51.2 67.6, and 60.2% on hides of cattle, goats, camels, and sheep, respectively. The prevalence of E coli O157:H7 was nearly zero in all samples collected in June and July, while Salmonella did not exhibit any seasonal variation. These results constitute the first comprehensive study of E. coli O157:H7 and Salmonella prevalence in Saudi Arabian meat animals at harvest

Delivery of Insulin via Skin Route for the Management of Diabetes Mellitus: Approaches for Breaching the Obstacles

Insulin is used for the treatment of diabetes mellitus, which is characterized by hyperglycemia. Subcutaneous injections are the standard mode of delivery for insulin therapy; however, this procedure is very often invasive, which hinders patient compliance, particularly for individuals requiring insulin doses four times a day. Furthermore, cases have been reported of sudden hypoglycemia occurrences following multidose insulin injections. Such an invasive and intensive approach motivates the quest for alternative, more user-friendly insulin administration approaches. For example, transdermal delivery has numerous advantages, such as prolonged drug release, low variability in the drug plasma level, and improved patient compliance. In this paper, the authors summarize different approaches used in transdermal insulin delivery, including microneedles, chemical permeation enhancers, sonophoresis, patches, electroporation, iontophoresis, vesicular formulations, microemulsions, nanoparticles, and microdermabrasion. Transdermal systems for insulin delivery are still being widely researched. The conclusions presented in this paper are extracted from the literature, notably, that the transdermal route could effectively and reliably deliver insulin into the circulatory system. Consistent progress in this area will ensure that some of the aforementioned transdermal insulin delivery systems will be introduced in clinical practice and commercially available in the near future

Thermodynamic Solubility Profile of Temozolomide in Different Commonly Used Pharmaceutical Solvents

The solubility parameters, and solution thermodynamics of temozolomide (TMZ) in 10 frequently used solvents were examined at five different temperatures. The maximum mole fraction solubility of TMZ was ascertained in dimethyl sulfoxide (1.35 × 10−2), followed by that in polyethylene glycol-400 (3.32 × 10−3) > Transcutol® (2.89 × 10−3) > ethylene glycol (1.64 × 10−3) > propylene glycol (1.47 × 10−3) > H2O (7.70 × 10−4) > ethyl acetate (5.44 × 10−4) > ethanol (1.80 × 10−4) > isopropyl alcohol (1.32 × 10−4) > 1-butanol (1.07 × 10−4) at 323.2 K. An analogous pattern was also observed for the other investigated temperatures. The quantitated TMZ solubility values were regressed using Apelblat and Van’t Hoff models and showed overall deviances of 0.96% and 1.33%, respectively. Apparent thermodynamic analysis indicated endothermic, spontaneous, and entropy-driven dissolution of TMZ in all solvents. TMZ solubility data may help to formulate dosage forms, recrystallize, purify, and extract/separate TMZ