Mesilato de desferroxamina como candidato a adjuvante farmacêutico e cosmético / Desferroxamine mesylate as a candidate for pharmaceutical and cosmetic adjuvant

Este trabalho propôs o uso do fármaco quelante mesilato de desferroxamina (DFO) como agente adjuvante para estabilização química e microbiológica de formulações. Soluções de ácido ascórbico (AA) 5,0% (p/v) foram preparadas com sistemas antioxidantes constituídos por diferentes combinações de DFO, ácido etilenodiamino tetra-acético (EDTA) e metabissulfito de sódio, cada adjuvante na concentração máxima de 0,1% (p/v). Os sistemas foram testados previamente quanto à atividade antioxidante, mediante adição de um complexo de ferro (III) redox-ativo e ensaio baseado em fluorescência. Os sistemas também foram associados ao metilparabeno e avaliados quanto à atividade antimicrobiana pelo método turbidimétrico, utilizando-se a técnica de microdiluição em meios líquidos e cepas padrão de bactérias e fungos, incluindo S. aureus (ATCC 6538), E. coli (ATCC 8739), P. aeruginosa (ATCC 9027), C. albicans (ATCC 10231) e A. brasiliensis (ATCC 16404). As soluções de AA foram expostas a condições de teste de estabilidade acelerada e avaliadas quanto à estabilidade química, empregando-se método volumétrico validado para quantificar AA. Verificou-se que o EDTA foi o agente quelante que melhor contribuiu na estabilidade química da solução de AA, entretanto, o DFO apresentou desempenho muito superior ao EDTA para bloquear a atividade pró-oxidante do ferro. Além disso, o DFO foi fator relevante na inibição do crescimento microbiano e demonstrou sinergia com o metilparabeno. A otimização estatística dos resultados indicou que o uso do DFO nos sistemas antioxidante e conservante pode reduzir consideravelmente a concentração dos adjuvantes convencionais, EDTA, metabissulfito e metilparabeno, os quais são muitas vezes associados a reações de hipersensibilidade ou a danos ao meio ambiente

In this work it was proposed the use of the chelating drug desferroxamine mesylate (DFO) as adjuvant for chemical and microbiological stabilization of formulations. Ascorbic acid (AA) solutions 5.0% (w/v) were prepared with antioxidant systems containing different combinations of DFO, ethylenediaminetetraacetic acid (EDTA) and sodium metabisulphite, using a maximum concentration of 0.1% (w/v) for each adjuvant. Previously, the systems were spiked with a redox-active iron (III) complex and tested for antioxidant activity by fluorescence-based assay. The systems also were associated with methylparaben and evaluated for antimicrobial activity by turbidimetric method, using the microdilution technique and standard strains of bacteria and fungi, including S. aureus (ATCC 6538), E. coli (ATCC 8739), P. aeruginosa (ATCC 9027), C. albicans (ATCC 10231) and A. brasiliensis (ATCC 16404). The AA solutions were exposed to accelerated stability test conditions and evaluated for chemical stability, using a volumetric method that was validated to quantify AA. It was found that EDTA was the chelating agent that most contributed to the chemical stability of AA solution, however, DFO demonstrated a much higher performance to EDTA to block the pro-oxidant activity of iron. In addition, DFO was a relevant factor in the inhibition of microbial growth and showed synergy with methylparaben. The statistical optimization of the results indicated that the use of DFO in the antioxidant and preservative systems might considerably reduce the concentration of the conventional adjuvants, EDTA, metabisulphite and methylparaben, which are often associated with hypersensitivity reactions or environmental damage

Evaluación piloto de la reducción de niveles séricos de productos de glicación avanzada (AGEs) sobre la electrofisiología de la visión, en pacientes con diabetes mellitus tipo 2 / Pilot evaluation of the serum levels reduction of advanced glication products (AGEs) on the vision electrophysiology in type 2 diabetic patients

BACKGROUND: Diabetic vascular complications are associated with elevated concentrations of advanced glycation end-products (AGEs). These substances can be originated endogenously by hyperglycaemia and oxidative stress, but also by dietary intake. There is indirect evidence suggesting that these complications can be prevented by lowering AGEs levels by dietary or pharmacological interventions, however its clinical benefits are still not clear enough because this would require long periods of treatment. Specific neuro-ophthalmologic tests like Multifocal Electroretinogram (MFERG) and visual evoked potentials (VEP) can detect retinal and myelinic nerve early changes, and thus could represent good methods to study the results of certain interventions in shorter lapses. The aim of this preliminary study was to evaluate the effects of a pharmacological intervention designed to lower AGEs levels, on these variables. PATIENTS AND METHODS: We included 7 patients with type 2 diabetes (DM2), with more than 5 and less than 10 years of disease, without clinically evident micro and macrovascular disease, without renal failure, hypothyroidism nor vitamin B12 deficiency, whose AGEs dietary intake was moderately elevated or high (according to dietary recalls). Upon admission, a clinical evaluation, urine and blood samples were obtained for routine labs, plus ultrasensitive C Reactive Protein (usCRP) as an inflammatory marker, and carboxymethyl-lysine (CML) as representative of AGEs. Then a complete ophthalmologic evaluation was performed, including fundus, MFERG and VEP. After the initial evaluation, placebo capsules were prescribed (12 daily capsules, 4 with each main meal) during 3 months, repeating the same initial evaluation at completion of this period. Then the active treatment followed, with capsules containing cholestyramine (4 capsules containing 500 mg each, totaling 6 g per day). Patients were cited each month, to register adverse events and repeating the same evaluation after this second 3 months period. RESULTS: The sample was composed of 2 male patients, mean age was 55.1 ± 3.8 years, and diabetes was managed with metformin plus other oral agents or o insulin (4 cases). In addition, 4 patients received lipid lowering and 4 antihypertensive drugs. Metabolic control and lipid levels were variable (ranges of HbA1c 6.2-8.4%, LDL cholesterol 45-141 mg/dL, triglycerides 70-220 mg/dL). AGEs levels represented by CML were highly variable (median 31.7, range min-max 3.4-58.9 ug/uL). Basal usCRP was also variable (median 405.9, range min-max 265.6-490.7 mg/L). The treatment was well tolerated, except for mild constipation associated with cholestiramine intake. No significant changes in electroretinography or evoked potentials were observed when comparing the initial placebo period with cholestyramine treatment. A significant increase in triglyceride levels and decrease of vitamin D levels after cholestyramine treatment was observed. No changes were detected in serum concentrations of CML, usCRP or glycemic control, after treatment. The latter variables were not correlated with neurophthalmologic studies. DISCUSSION: In this preliminary study we did not observe changes in MFERG nor VEP after 6 g/day cholestyramine treatment, which did not induce lowering of CML levels. This could be attributed to the many limitations of a pilot study, such as a small sample size, short duration of treatment, reduced doses. However this design allowed to evaluate the patients´ tolerance to the drug and rule out adverse effects, in order to plan further studies using the necessary doses to obtain lowering of AGEs