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1.
J Pharm Biomed Anal ; 212: 114646, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1699455

ABSTRACT

SBECD (Captisol®) with an average degree of substitution of 6.5 sulfobutylether functional groups (SBE = 6.5), is a solubility enhancer for remdesivir (RDV) and a major component in Veklury, which was approved by FDA for the treatment of patients with COVID-19 over 12 years old and weighing over 40 kg who require hospitalization. SBECD is cleared mainly by renal filtration, thus, potential accumulation of SBECD in the human body is a concern for patients dosed with Veklury with compromised renal function. An LC-MS/MS method was developed and validated for specific, accurate, and precise determination of SBECD concentrations in human plasma. In this method, the hexa-substituted species, SBE6, was selected for SBECD quantification, and the mass transition from its dicharged molecular ion [(M-2H)/2]2-, Molecular (parent) Ion (Q1)/Molecular (parent) Ion (Q3) of m/z 974.7/974.7, was selected for quantitative analysis of SBECD. Captisol-G (SBE-γ-CD, SBE = 3) was chosen as the internal standard. With 25 µL of formic-acid-treated sample and with a calibration range of 10.0-1000 µg/mL, the method was validated with respect to pre-established criteria based on regulatory guidelines and was applied to determine SBECD levels in plasma samples collected from pediatric patients during RDV clinical studies.


Subject(s)
COVID-19 , beta-Cyclodextrins , Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , COVID-19/drug therapy , Child , Chromatography, Liquid , Humans , SARS-CoV-2 , Sodium , Tandem Mass Spectrometry/methods
2.
Am J Health Syst Pharm ; 79(12): 1011-1018, 2022 06 07.
Article in English | MEDLINE | ID: covidwho-1692261

ABSTRACT

PURPOSE: To compare the chemical stability of Captisol-enabled (CE) melphalan ("CE-melphalan"; Evomela, Acrotech Biopharma LLC) and propylene glycol (PG)-based melphalan ("PG-melphalan"; Alkeran, GlaxoSmithKline) admixtures prepared with 0.9% sodium chloride injection in polyvinyl chloride (PVC) bags or reconstituted vials stored at room temperature (RT) and under refrigeration. METHODS: Lyophilized CE-melphalan and generic PG-melphalan were reconstituted to 5 mg/mL with 0.9% sodium chloride injection or manufacturer-supplied diluent, respectively. The reconstituted vials were then diluted to the desired concentrations with 0.9% sodium chloride injection in PVC bags and were stored at RT (23oC) or under refrigeration (4oC). Aliquots were withdrawn from the bags and reconstituted vials of CE-melphalan and PG-melphalan immediately after preparation and at predetermined time intervals. Melphalan concentrations were measured using a validated high-performance liquid chromatography method. RESULTS: CE-melphalan reconstituted in PVC bags at concentrations of 1 and 2 mg/mL was stable for 6 and 24 hours, respectively, at RT and for 8 and 24 hours, respectively, at 4oC. PG-melphalan reconstituted in bags at 1, 1.5, and 2 mg/mL was stable for 1, 2, and 2 hours, respectively, at RT and for 2, 4, and 4 hours, respectively, at 4oC. Reconstituted CE-melphalan vials were stable for 48 hours at both RT and 4oC, whereas PG-melphalan vials were stable for 6 hours at RT but formed precipitate within 2 hours at 4oC. CONCLUSION: CE-melphalan remained stable longer than generic PG-melphalan under the test conditions. CE-melphalan at 2 mg/mL has 24-hour stability at RT and can be used for extended infusion times or may be compounded ahead of time. Reconstituted CE-melphalan vials are stable for 48 hours at both RT and 4oC.


Subject(s)
Melphalan , Refrigeration , Chromatography, High Pressure Liquid , Drug Packaging , Drug Stability , Drug Storage , Humans , Melphalan/chemistry , Polyvinyl Chloride/chemistry , Propylene Glycols , Sodium Chloride/chemistry , Temperature , beta-Cyclodextrins
3.
Front Immunol ; 12: 796855, 2021.
Article in English | MEDLINE | ID: covidwho-1607033

ABSTRACT

Since its appearance, the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), the causal agent of Coronavirus Disease 2019 (COVID-19), represents a global problem for human health that involves the host lipid homeostasis. Regarding, lipid rafts are functional membrane microdomains with highly and tightly packed lipid molecules. These regions enriched in sphingolipids and cholesterol recruit and concentrate several receptors and molecules involved in pathogen recognition and cellular signaling. Cholesterol-rich lipid rafts have multiple functions for viral replication; however, their role in SARS-CoV-2 infection remains unclear. In this review, we discussed the novel evidence on the cholesterol-rich lipid rafts as a platform for SARS-CoV-2 entry, where receptors such as the angiotensin-converting enzyme-2 (ACE-2), heparan sulfate proteoglycans (HSPGs), human Toll-like receptors (TLRs), transmembrane serine proteases (TMPRSS), CD-147 and HDL-scavenger receptor B type 1 (SR-B1) are recruited for their interaction with the viral spike protein. FDA-approved drugs such as statins, metformin, hydroxychloroquine, and cyclodextrins (methyl-ß-cyclodextrin) can disrupt cholesterol-rich lipid rafts to regulate key molecules in the immune signaling pathways triggered by SARS-CoV-2 infection. Taken together, better knowledge on cholesterol-rich lipid rafts in the SARS-CoV-2-host interactions will provide valuable insights into pathogenesis and the identification of novel therapeutic targets.


Subject(s)
COVID-19/metabolism , Cholesterol/metabolism , Membrane Microdomains/metabolism , SARS-CoV-2/metabolism , Spike Glycoprotein, Coronavirus/metabolism , COVID-19/prevention & control , COVID-19/virology , Humans , Hydroxychloroquine/pharmacology , Protein Binding/drug effects , SARS-CoV-2/physiology , Virus Internalization/drug effects , beta-Cyclodextrins/pharmacology
4.
Molecules ; 26(24)2021 Dec 15.
Article in English | MEDLINE | ID: covidwho-1572568

ABSTRACT

The encapsulation mode of dexamethasone (Dex) into the cavity of ß-cyclodextrin (ß-CD), as well as its potential as an inhibitor of the COVID-19 main protease, were investigated using density functional theory with the recent dispersion corrections D4 and molecular docking calculations. Independent gradient model and natural bond orbital approaches allowed for the characterization of the host-guest interactions in the studied systems. Structural and energetic computation results revealed that hydrogen bonds and van der Waals interactions played significant roles in the stabilization of the formed Dex@ß-CD complex. The complexation energy significantly decreased from -179.50 kJ/mol in the gas phase to -74.14 kJ/mol in the aqueous phase. A molecular docking study was performed to investigate the inhibitory activity of dexamethasone against the COVID-19 target protein (PDB ID: 6LU7). The dexamethasone showed potential therapeutic activity as a SARS CoV-2 main protease inhibitor due to its strong binding to the active sites of the protein target, with predicted free energy of binding values of -29.97 and -32.19 kJ/mol as calculated from AutoDock4 and AutoDock Vina, respectively. This study was intended to explore the potential use of the Dex@ß-CD complex in drug delivery to enhance dexamethasone dissolution, thus improving its bioavailability and reducing its side effects.


Subject(s)
COVID-19/drug therapy , Dexamethasone/pharmacology , Protease Inhibitors/pharmacology , SARS-CoV-2/drug effects , beta-Cyclodextrins/pharmacology , Antiviral Agents/pharmacology , Drug Carriers/pharmacology , Humans , Molecular Docking Simulation
5.
Int J Pharm ; 609: 121113, 2021 Nov 20.
Article in English | MEDLINE | ID: covidwho-1473322

ABSTRACT

Depression-the global crisis hastened by the coronavirus outbreak, can be efficaciously treated by the selective serotonin reuptake inhibitors (SSRIs). Cyclodextrin (CD) inclusion complexation is a method of choice for reducing side effects and improving bioavailability of drugs. Here, we investigate in-depth the ß-CD encapsulation of sertraline (STL) HCl (1) and fluoxetine (FXT) HCl (2) by single-crystal X-ray diffraction and DFT complete-geometry optimization, in comparison to the reported complex of paroxetine (PXT) base. X-ray analysis unveiled the 2:2 ß-CD-STL/FXT complexes with two drug molecules inserting their halogen-containing aromatic ring in the ß-CD dimeric cavity, which are stabilized by the interplay of intermolecular O2-H⋯N1-H⋯O3 H-bonds, C3/C5-H⋯π and halogen⋯halogen interactions. Similarly, the 1:1 ß-CD-tricyclic-antidepressant (TCA) complexes have an exclusive inclusion mode of the aromatic ring, which is maintained by C3/C5-H⋯π interactions. By contrast, the 2:1 ß-CD-PXT complex has a total inclusion that is stabilized by host-guest O6-H⋯N1-H⋯O5 H-bonds and C3-H⋯π interactions. The inherent stabilization energies of 1 and 2 evaluated using DFT calculation suggested that the improved thermodynamic stabilities via CD encapsulation facilitates the reduction of drug side effects. Moreover, the SSRI conformational flexibilities are thoroughly discussed for understanding of their pharmacoactivity.


Subject(s)
Serotonin Uptake Inhibitors , beta-Cyclodextrins , Crystallography, X-Ray , Density Functional Theory , X-Ray Diffraction
6.
Clin Microbiol Infect ; 27(10): 1494-1501, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1454090

ABSTRACT

OBJECTIVES: To determine if commercially available mouthwash with ß-cyclodextrin and citrox (bioflavonoids) (CDCM) could decrease the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) salivary viral load. METHODS: In this randomized controlled trial, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR-positive patients aged 18-85 years with asymptomatic to mild coronavirus disease 2019 (COVID-19) symptoms for <8 days were recruited. A total of 176 eligible patients were randomly assigned (1:1) to CDCM or placebo. Three rinses daily were performed for 7 days. Saliva sampling was performed on day 1 at 09.00 (T1), 13.00 (T2) and 18.00 (T3). On the following 6 days, one sample was taken at 15.00. Quantitative RT-PCR was used to detect SARS-CoV-2. RESULTS: The intention-to-treat analysis demonstrated that, over the course of 1 day, CDCM was significantly more effective than placebo 4 hours after the first dose (p 0.036), with a median percentage (log10 copies/mL) decrease T1-T2 of -12.58% (IQR -29.55% to -0.16%). The second dose maintained the low median value for the CDCM (3.08 log10 copies/mL; IQR 0-4.19), compared with placebo (3.31 log10 copies/mL; IQR 1.18-4.75). At day 7, there was still a greater median percentage (log10 copies/mL) decrease in salivary viral load over time in the CDCM group (-58.62%; IQR -100% to -34.36%) compared with the placebo group (-50.62%; IQR -100% to -27.66%). These results were confirmed by the per-protocol analysis. CONCLUSIONS: This trial supports the relevance of using CDCM on day 1 (4 hours after the initial dose) to reduce the SARS-CoV-2 viral load in saliva. For long-term effect (7 days), CDMC appears to provide a modest benefit compared with placebo in reducing viral load in saliva.


Subject(s)
Antiviral Agents/therapeutic use , COVID-19/prevention & control , Mouthwashes/therapeutic use , SARS-CoV-2/drug effects , Adolescent , Adult , Aged , Antiviral Agents/chemistry , Asymptomatic Infections , COVID-19/transmission , Double-Blind Method , Female , Flavonoids/analysis , Flavonoids/therapeutic use , Humans , Intention to Treat Analysis , Male , Middle Aged , Mouthwashes/chemistry , SARS-CoV-2/isolation & purification , Saliva/virology , Viral Load/drug effects , Young Adult , beta-Cyclodextrins/analysis , beta-Cyclodextrins/therapeutic use
7.
Carbohydr Polym ; 264: 118011, 2021 Jul 15.
Article in English | MEDLINE | ID: covidwho-1172080

ABSTRACT

Veklury™ by Gilead Sciences, Inc., containing antiviral drug, remdesivir (REM) has received emergency authorization in the USA and in Europe for COVID-19 therapy. Here, for the first time, we describe details of the non-covalent, host-guest type interaction between REM and the solubilizing excipient, sulfobutylether-beta-cyclodextrin (SBECD) that results in significant solubility enhancement. Complete amorphousness of the cyclodextrin-enabled REM formulation was demonstrated by X-ray diffraction, thermal analysis, Raman chemical mapping and electron microscopy/energy dispersive spectroscopy. The use of solubilizing carbohydrate resulted in a 300-fold improvement of the aqueous solubility of REM, and enhanced dissolution rate of the drug enabling the preparation of stable infusion solutions for therapy. 2D ROESY NMR spectroscopy provided information on the nature of REM-excipient interaction and indicated the presence of inclusion phenomenon and the electrostatic attraction between anionic SBECD and nitrogen-containing REM in aqueous solution.


Subject(s)
Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , Excipients/chemistry , beta-Cyclodextrins/chemistry , Adenosine Monophosphate/chemistry , Alanine/chemistry , Antiviral Agents/chemistry , COVID-19/drug therapy , Calorimetry, Differential Scanning , Freeze Drying/methods , Magnetic Resonance Spectroscopy , Microscopy, Electron, Scanning , Molecular Docking Simulation , Nanofibers/chemistry , Powders , Solubility , Spectrum Analysis, Raman , X-Ray Diffraction
10.
Trials ; 21(1): 906, 2020 Nov 02.
Article in English | MEDLINE | ID: covidwho-901917

ABSTRACT

OBJECTIVES: - To describe the evolution of the SARS-CoV-2 salivary viral load of patients infected with Covid-19, performing 7 days of tri-daily mouthwashes with and without antivirals. - To compare the evolution of the SARS-CoV-2 nasal and salivary viral load according to the presence or absence of antivirals in the mouthwash. TRIAL DESIGN: This is a multi-center, randomised controlled trial (RCT) with two parallel arms (1:1 ratio). PARTICIPANTS: Inclusion criteria - Age: 18-85 years old - Clinical diagnosis of Covid-19 infection - Clinical signs have been present for less than 8 days - Virological confirmation - Understanding and acceptance of the trial - Written agreement to participate in the trial Exclusion criteria - Pregnancy, breastfeeding, inability to comply with protocol, lack of written agreement - Patients using mouthwash on a regular basis (more than once a week) - Patient at risk of infectious endocarditis - Patients unable to answer questions - Uncooperative patient The clinical trial is being conducted with the collaboration of three French hospital centers: Hospital Center Emile Roux (Le Puy en Velay, France), Clinic of the Protestant Infirmary (Lyon, France) and Intercommunal Hospital Center (Mont de Marsan, France). INTERVENTION AND COMPARATOR: Eligible participants will be allocated to one of the two study groups. Intervention group: patients perform a tri-daily mouthwash with mouthwash containing antivirals (ß-cyclodextrin and Citrox®) for a period of 7 days. CONTROL GROUP: patients perform a tri-daily mouthwash with a placebo mouthwash for a period of 7 days. MAIN OUTCOMES: Primary Outcome Measures: Change from Baseline amount of SARS-CoV-2 in salivary samples at 4 and 9 hours, 1, 2, 3, 4, 5 and 6 days. Real-time PCR assays are performed to assess salivary SARS-CoV 2 viral load. SECONDARY OUTCOME MEASURES: Change from Baseline amount of SARS-CoV-2 virus in nasal samples at 6 days. Real-time PCR assays are performed to assess nasal SARS-CoV-2 viral load. RANDOMISATION: Participants meeting all eligibility requirements are allocated to one of the two study arms (mouthwash with ß-cyclodextrin and Citrox® or mouthwash without ß-cyclodextrin and Citrox®) in a 1:1 ratio using simple randomisation with computer generated random numbers. BLINDING (MASKING): Participants, doctors and nurses caring for participants, laboratory technicians and investigators assessing the outcomes will be blinded to group assignment. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): Both the intervention and control groups will be composed of 103 participants, so the study will include a total of 206 participants. TRIAL STATUS: The current protocol version is 6, August 4th, 2020. Recruitment began on April 6, 2020 and is anticipated to be complete by April 5, 2021. As of October 2, 2020, forty-two participants have been included. TRIAL REGISTRATION: This trial was registered on 20 April 2020 at www.clinicaltrials.gov with the number NCT04352959 . FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol." The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2)."


Subject(s)
Betacoronavirus , Clinical Laboratory Techniques/methods , Coronavirus Infections , Mouthwashes , Nasal Cavity/virology , Pandemics , Pneumonia, Viral , Saliva/virology , Adult , Antiviral Agents/administration & dosage , Antiviral Agents/adverse effects , Betacoronavirus/drug effects , Betacoronavirus/isolation & purification , COVID-19 , COVID-19 Testing , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Drug Monitoring/methods , Female , Humans , Male , Mouthwashes/administration & dosage , Mouthwashes/adverse effects , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Randomized Controlled Trials as Topic , SARS-CoV-2 , Treatment Outcome , Viral Load , beta-Cyclodextrins/administration & dosage , beta-Cyclodextrins/adverse effects
11.
J Hazard Mater ; 403: 123841, 2021 02 05.
Article in English | MEDLINE | ID: covidwho-739913

ABSTRACT

Air pollution is a universal concern. The suspended solid/liquid particles in the air and volatile organic compounds (VOCs) are ubiquitous. Synthetic polymer-based air filter media not only has disposal issues but also is a source of air and water pollution at the end of their life cycle. It has been a challenge to filter both particulate matter and VOC pollutants by a common biodegradable filter media having low air resistance. This study reports gelatin/ß-cyclodextrin composite nanofiber mats with dual function air filtration ability at reduced air resistance (148 Pa) and low basis weight (1 g/m²). Gelatin/ß-cyclodextrin nanofibers captured aerosols (0.3-5 µm) with < 95% filtration efficiency at 0.029/Pa quality factor. They adsorbed great amount of xylene (287 mg/g), benzene (242 mg/g), and formaldehyde (0.75 mg/g) VOCs. VOC adsorption of gelatin/ß-cyclodextrin nanofibers is found several times higher than a commercial face mask and pristine powder samples. This study provides a solution for a 'green' dual function respiratory air filtration at low resistance. Gelatin/ß-cyclodextrin nanofibers also have the potential to filter nano-sized viruses.


Subject(s)
Air Pollutants , Nanofibers , Volatile Organic Compounds , beta-Cyclodextrins , Aerosols , Air Pollutants/analysis , Filtration , Gelatin , Volatile Organic Compounds/analysis
12.
Antimicrob Agents Chemother ; 64(11)2020 10 20.
Article in English | MEDLINE | ID: covidwho-738379

ABSTRACT

Remdesivir has reported efficacy against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro and in vivo Drug-drug interactions limit therapeutic options in transplant patients. Remdesivir and its metabolite GS-441524 are excreted principally in urine. In intensive care unit (ICU) settings, in which multiple-organ dysfunctions can occur rapidly, hemodialysis may be a viable option for maintaining remdesivir treatment, while improving tolerance, by removing both remdesivir's metabolite (GS-441524) and sulfobutylether ß-cyclodextrin sodium (SEBCD). Additional studies may prove informative, particularly in the evaluations of therapeutic options for coronavirus disease 2019 (COVID-19).


Subject(s)
Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , Antiviral Agents/administration & dosage , Betacoronavirus/drug effects , Coronavirus Infections/therapy , Furans/urine , Pneumonia, Viral/therapy , Pyrroles/urine , Triazines/urine , beta-Cyclodextrins/urine , Adenosine/analogs & derivatives , Adenosine Monophosphate/administration & dosage , Adenosine Monophosphate/adverse effects , Adenosine Monophosphate/chemistry , Adenosine Monophosphate/metabolism , Alanine/administration & dosage , Alanine/adverse effects , Alanine/chemistry , Alanine/metabolism , Antiviral Agents/adverse effects , Antiviral Agents/chemistry , Antiviral Agents/metabolism , COVID-19 , Coronavirus Infections/drug therapy , Coronavirus Infections/surgery , Coronavirus Infections/virology , Drug Interactions , Furans/adverse effects , Furans/chemistry , Humans , Intensive Care Units , Lung Transplantation , Multiple Organ Failure , Pandemics , Pneumonia, Viral/surgery , Pneumonia, Viral/virology , Pyrroles/adverse effects , Pyrroles/chemistry , Renal Dialysis , SARS-CoV-2 , Transplant Recipients , Triazines/adverse effects , Triazines/chemistry , beta-Cyclodextrins/adverse effects , beta-Cyclodextrins/chemistry
13.
Int J Pharm ; 583: 119396, 2020 Jun 15.
Article in English | MEDLINE | ID: covidwho-165298

ABSTRACT

This review presents the early history, the motivation, the research and some of the backstories behind the discovery and development of sulfobutylether-ß-cyclodextrin as a novel parenterally safe solubilizer and stabilizer. A specific sulfobutylether-ß-cyclodextrin with an average degree of 6.5 sulfobutyl-groups variably substituted on the 2-, 3- and 6-hydroxyls of the seven glucopyranose (dextrose) units of ß-cyclodextrin, is known by its commercial name, Captisol®. Today it is in 13 FDA approved injectables and numerous clinical candidates. It is also an example of a novel product discovered and initially preclinically developed at an academic institution.


Subject(s)
Excipients/chemistry , Pharmaceutical Preparations/chemistry , beta-Cyclodextrins/chemistry , Drug Stability , Excipients/history , History, 20th Century , History, 21st Century , Humans , Injections , Pharmaceutical Preparations/administration & dosage , Pharmaceutical Preparations/history , Solubility , beta-Cyclodextrins/history
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