Evaluation of in vitro penetration of fluticasone propionate from MP-AzeFlu and fluticasone propionate nasal spray through EpiAirway (TM) 606 tissues using vertical diffusion cells

Purpose: Most patients with allergic rhinitis (AR) have moderate-to-severe disease, requiring complete and prompt relief when symptoms occur. The time course of fluticasone propionate (FP) penetration into nasal tissues after intranasal administration is not well characterized. The goal of this proof-of-concept study was to evaluate the mucosal penetration of FP from fixed-combination FP-azelastine nasal spray (MP-AzeFlu) compared with an FP-only nasal spray in an in vitro, 3-dimensional human bronchial tissue model. Materials and Methods: Absorption of FP from MP-AzeFlu and FP nasal spray was modeled using EpiAirway (TM) 606 (MatTek Corporation; Ashland, MA, USA) tissue cultured in vertical diffusion cells. The dosing amount of MP-AzeFlu was optimized in a pilot study. Based on the results of the pilot study, 10 mu L of MP-AzeFlu (3.65 mu g; n = 8) and 10 mu L of FP nasal spray (5.00 mu g; n = 8) were evaluated for penetration of tissue. Tissue integrity was monitored with Lucifer yellow. FP in the receiving media was quantified for each sample using liquid chromatography with tandem mass spectrometry. Results: MP-AzeFlu and FP nasal spray were associated with similar FP accumulation profiles in the receiving media, but the permeability of FP was greater for MP-AzeFlu during hours 0 to 6, suggesting faster absorption for MP-AzeFlu. No indications of compromised tissue integrity were found in any of the tested cells. Conclusion: The higher and more rapid penetration of FP from MP-AzeFlu supports the use of MP-AzeFlu for patients with AR, particularly when prioritizing fast and pronounced symptom relief

Allergic Rhinitis and Asthma Symptoms in a Real-Life Study of MP-AzeFlu to Treat Multimorbid Allergic Rhinitis and Asthma

Acknowledgements We would like to thank the subjects who participated in the trial. Funding This study was supported by MEDA Pharma GmbH & Co. KG (A Mylan Company), Bad Homburg, Germany. Technical, editorial, and medical writing assistance was provided under the direction of the authors by Strategix, an affiliate of The Lynx Group, LLC. Funding for this support was provided by Mylan Inc.Peer reviewedPublisher PD

MP-AzeFlu Improves the Quality-of-Life of Patients with Allergic Rhinitis

Acknowledgments: We would like to thank the subjects who participated in the trial. The abstract of this paper was presented at the EAACI Congress 2020 as an oral presentation. The presentation’s abstract was published in Allergy: Van Weissenbruch R, Klimek L, Galffy G, et al. MP-Azeflu improves quality of life of patients with allergic rhinitis: a real-world study Funding: Technical, editorial, and medical writing assistance were provided under the direction of the authors by Erin Burns, PhD, and Strategix, an affiliate of The Lynx Group, LLC. Funding for this support was provided by Mylan Inc.Peer reviewedPublisher PD

Klonierung eines HIV-1-abgeleiteten Virus zur Infektion von simianen Zellen sowie Analyse der Regulation von Vif HIV-1 und Proteinen der APOBEC3-Familie durch Phosphorylierung

Die Etablierung eines HIV-1 Tiermodells ist ein großes Ziel auf dem Weg zur Entwicklung antiretroviraler Medikamente und Impfstoffe gegen HIV-1. Speziesspezifische Restriktionsfaktoren und fehlende Kofaktoren verhindern jedoch die Replikation von HIV-1 in Tieren. Restriktionsfaktoren sind Bestandteil der intrinsischen Immunität und entwickelten sich im Laufe der Evolution als Abwehrmechanismus gegen diverse Pathogene. Dazu gehören die Proteine der APOBEC3-Familie, TRIM5􀀁 und Tetherin, welche die Virusreplikation von HIV-1 an verschiedenen Punkten seines Lebenszyklus inhibieren. Koevolutionär entwickelten Retroviren Antagonisten, um die restriktive Funktion ihrer Wirtsproteine zu umgehen. Um ein replikationskompetentes, simiantropes HIV zu generieren, wurden im Rahmen dieser Arbeit die Sequenzen vifHIV-1 und vpuHIV-1 gegen vifagm.tan aus SIVagm.tan und vpugsn/den aus den Immundefizienzviren SIVgsn und SIVden substituiert, um die Restriktion gegen A3G und Tetherin in Zellen der Afrikanischen Grünen Meerkatze zu umgehen. Die TRIM5 vermittelte Restriktion wurde über eine Mutation in der Cyclophilin A Bindedomäne des Kapsids verhindert. Die Analyse der Vifagm.tan Funktion bestätigte den geänderten Tropismus des chimären HIV-1 bezüglich der APOBEC3G vermittelten Restriktion. Denn nach Austausch des vifHIV-1 Gens war das Virus nicht mehr in der Lage, die Aktivität des humanen APOBEC3G zu unterbinden und initiierte stattdessen die Degradation des Analogons aus der Afrikanischen Grünen Meerkatze. Weiterhin konnte die erfolgreiche Klonierung des vpugsn/den Gens in HIV-1 die Aktivität der SHIV-Konstrukte gegen Tetherin der Afrikanischen Grünen Meerkatze und der Rhesusaffen ändern, wohingegen humanes Tetherin nicht mehr abgebaut werden konnte. Trotz der erfolgreichen Aktivität der konstruierten SHIVs gegen die zellulären Restriktionsfaktoren der Afrikanischen Grünen Meerkatze, replizierten die generierten chimären Viren in einer AGM Zelllinie, nicht aber in periphären mononuklearen Blutzellen der Afrikanischen Grünen Meerkatze. Ein Indiz, das für weitere strukturelle Anpassungen der Viren gegenüber ihren Wirten spricht, die zur Bildung der Spezies-Barriere beitragen und Zoonosen erschweren. Im zweiten Teil der Dissertation wurden die Aktivitäten der Proteine der APOBEC3-Familie und VifHIV-1 auf ihre Regulation durch Phosphorylierung untersucht. Proteinphosphorylierungen gehören zu den wichtigsten posttranslationalen Proteinmodifikationen, um diverse Funktionen wie die Enzymaktivität, Proteininteraktionen und die zelluläre Lokalisation zu steuern. Dabei konnte die durch Yang et al. postulierte Phosphorylierung von VifHIV-1 nicht bestätigt werden. Analysen der mutmaßlichen VifHIV-1 Phosphomutanten enthüllten, dass die Funktion von VifHIV-1, die Infektiosität von HIV-1 zu gewährleisten, durch Substitution der mutmaßlichen Phosphoaminosäuren nicht beeinträchtigt wird und ebenso sämtliche Phosphomutanten die Degradation von A3G initiierten, wenn auch in unterschiedlichem Maße. Weiterhin wurde im Rahmen dieser Arbeit gezeigt, dass A3C entweder in einem phosphorylierten Protein-Komplex vorliegt oder ein phosphoryliertes Protein bindet. Zudem konnte ermittelt werden, dass APOBEC3A als einziges Protein der APOBEC3-Familie nach TPA- und cAMP-Stimulation phosphoryliert wird. In vitro Kinase Studien konnten zeigen, dass die Phosphorylierung unter anderem durch ERK2 erfolgt. Es konnte jedoch kein Zusammenhang zwischen der Phosphorylierung von A3A und dessen zellulärer Lokalisation, Aktivität gegen HIV-1 als auch gegen die Retrotranspositionselemente IAP und LINE-1 hergestellt werden. Dies lässt den Schluss zu, dass die Phosphorylierung die untersuchten Aktivitäten von APOBEC3A nicht beeinflusst oder APOBEC3A eine bisher unbekannte durch Phosphorylierung regulierte Funktion besitzt

Deposition characteristics of a novel intranasal formulation of azelastine hydrochloride plus fluticasone propionate in an anatomic model of the human nasal cavity

Background: Intranasal antihistamines and steroids should be delivered in a volume and with a technique that allow for optimal drug retention within the entire nasal cavity, maximize local absorption by the nasal mucosa, and, subsequently, increase the potential for the most desirable local availability and therapeutic effect. Objective: This in vitro evaluation simulated nasal medication deposition and evaluated the extent of runoff. MP-AzeFlu, a novel intranasal formulation of azelastine hydrochloride (AZE) plus fluticasone propionate (FP), was compared with sequential sprays of available commercial products with the individual medication components. Methods: A model of a normal adult human nasal cavity was used to visualize deposition of nasal spray products. A single spray of MP-AzeFlu (0.137 mL [137 mg of AZE/50 mg of FP]) or single sequential sprays of AZE nasal spray (0.137 mL [137 mg]) followed by brand name or generic FP nasal spray (0.100 mL [50 mg]) were manually actuated into the model. The interior was coated with a water-sensitive dye that changes to magenta when exposed to aqueous-based formulations. A slight vacuum was applied during spray delivery to simulate sniffing. The results were photographed by using anterior and lateral views. Results: Three replicates of MP-AzeFlu showed no dripping from the front of the nostril or backflow from the nasal cavity. However, three replicates of AZE nasal spray, followed by a brand name or generic FP nasal spray, showed significant dripping from the front of the nostril and backflow from the nasal cavity. Conclusion: A single spray of MP-AzeFlu resulted in no runoff compared with sequential dosing of the two other therapeutic products. Product runoff is likely due to the volume exceeding the capacity of the nasal cavity model. Furthermore, the common clinical dosing regimen of two sprays per nostril of each of the individual components would promote even greater increased undesirable flooding and leakage

Effect of MP‐AzeFlu compared to monotherapy on COX‐2, PGE2, and EP2 gene expression in upper airway mucosa

Abstract MP‐AzeFlu (intranasal fluticasone and azelastine) has been widely studied and has demonstrated efficacy in Allergic rhinitis with a superior effect compared to these drugs administered individually; however, the mechanism by which MP‐AzeFlu produces this improved clinical effect has not yet been fully explained. In this study, we investigated the effect of MP‐AzeFlu and fluticasone propionate (FP) on arachidonic acid metabolism as measured by changes in regulation of cyclooxygenase (COX) isoforms, prostaglandin (PG) D2, PGE2, PGE2 receptor (EP) 2, and EP3. Expression of these key inflammation markers was assessed through an in vitro model of upper airway inflammation using fibroblasts derived from both healthy and inflamed upper airway mucosa. Both MP‐AzeFlu and FP inhibited interleukin‐1β‐induced COX‐2 messenger RNA (mRNA) and protein expression and PGE2 secretion in vitro. MP‐AzeFlu and FP both upregulated EP2 mRNA expression, though neither upregulated EP2 protein expression. This downregulation of COX‐2 and PGE2 coupled with upregulation of EP2 receptor expression reinforces the anti‐inflammatory effect of MP‐AzeFlu in upper airway inflammation

Onset of Action of the Fixed Combination Intranasal Azelastine-Fluticasone Propionate in an Allergen Exposure Chamber.

International audienceBACKGROUND:A fixed-dose combination of intranasal azelastine hydrochloride and fluticasone propionate (MP-AzeFlu) is the most effective treatment of allergic rhinitis, but its onset of action requires further investigation.OBJECTIVE:To compare the onset of action of MP-AzeFlu with the free combination of oral loratadine (LORA) and intranasal fluticasone propionate (INFP).METHODS:In this single-center, randomized, placebo-controlled, double-blind, double-dummy, 3-period crossover trial, allergic rhinitis symptoms were induced in asymptomatic patients by ragweed pollen challenge in an allergen environmental exposure chamber. Patients received single-dose MP-AzeFlu, LORA/INFP, or placebo and were monitored for 4 hours. The primary outcome was onset of action measured by total nasal symptom score (TNSS). Secondary measures were total ocular symptom score (TOSS), total score of the 7 nasal and ocular symptoms (T7SS), and the global visual analog scale (VAS).RESULTS:The full analysis set included 82 patients, of which 78 completed all treatments. TNSS was significantly reduced versus placebo from 5 minutes for MP-AzeFlu and 150 minutes for LORA/INFP onward (both P < .05) till the end of assessment (0-4 hours). MP-AzeFlu reduced TNSS to a greater extent at each time point from 5 to 90 minutes (P < .05) and over the entire assessment interval (P ≤ .005) versus LORA/INFP or placebo. No statistically significant difference between LORA/INFP and placebo was observed over the assessment interval (P = .182). The onset of action of MP-AzeFlu assessed by TOSS, T7SS, and VAS was 10 minutes, 2 hours earlier than with LORA/INFP.CONCLUSION:MP-AzeFlu had a more rapid onset of action (5 minutes) and was more effective than LORA/INFP