Bioassay for total serum bioactivity of Atractylodes lancea.

The study aimed to establish a bioassay for total bioactivity of Atractylodes lancea (AL) in human serum samples. Inhibition of bacterial growth (Staphylococcus aureus ATCC 25923) was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The calibration curve (0, 0.39, 0.78, 1.56, 3.13, 2.56, and 50 ng/µl) was linear with correlation coefficients >0.990. The limit of quantification (LOQ) was 1.66 mg/ml using 20-ml serum sample. The developed bioassay method meets the standard of the bioanalytical method for determination of serum bioactivity of AL.

Association between ABCB1 Polymorphisms and Artesunate-Mefloquine Treatment Responses of Patients with Falciparum Malaria on the Thailand-Myanmar Border.

A decrease in the clinical efficacy of a 3-day artesunate-mefloquine combination treatment was reported in the areas of multidrug-resistant Plasmodium falciparum along the Thailand-Myanmar border. The current study investigated the possible contribution of genetic polymorphisms of the three major genes encoding drug efflux transporters, ABCB1, ABCG2, and ABCC1, to responses to the aforementioned treatment in 91 patients with acute uncomplicated falciparum malaria residing along the Thailand-Myanmar border. Patients carrying homozygous mutant genotype ABCB1 c.1236C>T (TT) were found to have a three-times higher chance of successful treatment with this combination compared with other genotypes (CC and CT). Furthermore, whole blood mefloquine concentrations in these patients with the TT genotype were significantly lower than those of patients carrying the CC genotype. Patients with heterozygous mutant genotype (CT), however, were three-times more likely to experience treatment failure. No significant association was found with the ABCG2 and ABCC1 gene polymorphisms. The results suggest that ABCB1 c.1236C>T polymorphisms could be useful genetic markers for predicting responses to the 3-day artesunate-mefloquine treatment; however, studies using larger sample sizes in different malaria-endemic areas are necessary to confirm this finding. This study highlights the impact of pharmacogenetic factors on antimalarial treatment responses and the basis for the application of control policies in various malaria-endemic areas.

Patients' adherence and clinical effectiveness of a 14-day course of primaquine when given with a 3-day chloroquine in patients with Plasmodium vivax at the Thai-Myanmar border.

Primaquine is the only antimalarial drug available for eradicating the hypnozoite stage of Plasmodium vivax to prevent the disease from recurring. However, one limitation of its clinical use is the long treatment course of 14 days, which may result in poor patients' adherence and low treatment efficacy. The aim of the current study was to assess patients' adherence and the clinical effectiveness of the unsupervised standard 14-day primaquine regimen (daily dose of 15mg base/kg body weight daily for 14 days) when given together with 3-day chloroquine (25mg base/kg body weight over 3 days). The study was conducted in 85 patients with P. vivax malaria in a malaria endemic area along the Thai-Myanmar border. Patients' adherence to primaquine therapy was assessed based on primaquine concentrations in finger-prick dried blood spot (DBS) samples alongside patients' self-reporting on drug administration and pill counting methods. Results suggest high rate of patients' adherence to this 14-day primaquine regimen (95-98% based on primaquine concentrations in DBS on days 3, 7, and 14 of treatment, and 100% based on patients' self-reporting and pill counting methods. Clinical effectiveness was 100% during the 42-day follow-up.

Preliminary investigation of the contribution of CYP2A6, CYP2B6, and UGT1A9 polymorphisms on artesunate-mefloquine treatment response in Burmese patients with Plasmodium falciparum malaria.

CYP2A6, CYP2B6, and UGT1A9 genetic polymorphisms and treatment response after a three-day course of artesunate-mefloquine was investigated in 71 Burmese patients with uncomplicated Plasmodium falciparum malaria. Results provide evidence for the possible link between CYP2A6 and CYP2B6 polymorphisms and plasma concentrations of artesunate/dihydroartemisinin and treatment response. In one patient who had the CYP2A6*1A/*4C genotype (decreased enzyme activity), plasma concentration of artesunate at one hour appeared to be higher, and the concentration of dihydroartemisinin was lower than for those carrying other genotypes (415 versus 320 ng/mL). The proportion of patients with adequate clinical and parasitologic response who had the CYP2B6*9/*9 genotype (mutant genotype) was significantly lower compared with those with late parasitologic failure (14.0% versus 19.0%). Confirmation through a larger study in various malaria-endemic areas is required before a definite conclusion on the role of genetic polymorphisms of these drug-metabolizing enzymes on treatment response after artesunate-based combination therapy can be made.

A high-throughput colorimetric-based bioassay method for determination of fosmidomycin in plasma and urine and application for pharmacokinetic study.

INTRODUCTION: Fosmidomycin is a phosphonic acid derivative originally isolated as a natural antibiotic from Streptomyces lavendulae. It was originally used as an antibiotic, and later on as an antimalarial drug. A simple, sensitive, selective and reproducible bioassay based on colorimetric method was developed for the determination of fosmidomycin in human plasma and urine. METHODS AND RESULTS: Enterobacter cloacae ATCC 23355 strain was used as a test organism. Inhibition of bacterial growth was assessed using MTT assay. Calibration curves were prepared from concentration response curves in plasma (0, 0.5, 1, 2.5, 5, 12.5, 25, 50 ng/microl) and urine (0, 0.5, 1, 2.5, 5, 12.5, 25, 50 and 100 ng/microl) and were all linear with correlation coefficients better than 0.990. The precision of the method based on within-day repeatability and reproducibility (day-to-day variation) was below 10% (% coefficient of variations: % C.V.) Good accuracy was observed for both the intra-day and inter-day assays, as indicated by the minimal deviation of mean values found between the measured samples and the theoretical values (below +/-10%). Limit of quantification (L.O.Q.) was accepted as 0.5 ng using 20 microl plasma or 10 microl urine sample. The mean recovery for fosmidomycin was greater than 99%. The method was free from interference from other commonly used antibiotics. DISCUSSION: The analytical method established in this study meets the criteria of high sensitivity, accuracy and reproducibility for routine use in pharmacokinetic studies. The method has advantages over the recently developed bioassay in its simplicity, accuracy, short analysis time, good sensitivity, and the requirement for smaller volumes of samples. The method appears to be robust and has been applied to a pharmacokinetic study to determine the plasma and urinary excretion of fosmidomycin in a total of 24 Thai patients with acute uncomplicated falciparum malaria following oral doses of 1800 fosmidomycin given every 10 h for 3 days.

Bioassay for determination of fosmidomycin in plasma and urine: application for pharmacokinetic dose optimisation.

A simple, sensitive, selective and reproducible method based on agar diffusion disk assay was developed for the determination of fosmidomycin and clindamycin in human plasma and urine. A disk diffusion technique was used, essentially as previously described but utilising the assay organism Enterobacter cloacae ATCC 23355 strain to seed the agar assay plates. Calibration curves were prepared from concentration response curves in plasma (0, 1, 2.5, 5, 7.5, 10, 25, 50 ng/microl) and urine (0, 10, 25, 50, 75, 100, 250 and 500 microg/microl) were all linear with correlation coefficients better than 0.990. The precision of the method based on within-day repeatability and reproducibility (day-to-day variation) was below 5% (% coefficient of variations: %C.V.). Good accuracy was observed for both the intra-day or inter-day assays, as indicated by the minimal deviation of mean values found with measured samples from that of the theoretical values (below +/-5%). Limit of quantification (L.O.Q.) was accepted as 1 ng using 40-microl plasma or 7.5-microl urine sample. The mean recovery for fosmidomycin was greater than 99%. The method was free from interference from other commonly used antibiotics including clindamycin, carbenicillin, cephalothin, chloramphenicol, kanamycin, methicillin, penicillin, erythromycin, lincomycin, tetracycline and paromomycin. The method appears to be robust and has been applied to a pharmacokinetic study in plasma and urinary excretion of fosmidomycin in a patient with malaria following oral doses of clindamycin at 1200 mg given every 8 h for 7 days.