Mechanistic enhancement of the intestinal absorption of drugs containing the polar guanidino functionality.

INTRODUCTION: Guanidino-containing compounds are well-known for their important biological roles in vivo. In a rational drug design process, the guanidino group is frequently adopted to mimic the arginine residue of the endogenous substrate and secure the affinity of the drug to the target. However, due to their inherent polarity and positive charge in the gastrointestinal tract, it is difficult for guanidino-containing compounds to be orally absorbed by passive diffusion. Hence, guanidino-containing compounds are frequently associated with low oral bioavailability. AREAS COVERED: In this review, we present the barriers and challenges toward the oral absorption of guanidino-containing compounds, provide an overview of the research that has been done so far in the area, and summarize recent advances and future directions in the mechanistic enhancement of the intestinal absorption of drugs containing the polar guanidino functionality. For instance, application of several different prodrug approaches, a novel recently developed ion-pairing strategy and the utilization of advanced formulations are discussed. EXPERT OPINION: While additional research is required to allow efficient and facile solutions to low oral bioavailability of guanidino-containing compounds, novel and exciting strategies have been developed in recent years. Although challenging, the development of a potent guanidino-containing compound into an orally administered drug is becoming an achievable target.

Ex vivo activated human macrophages improve healing, remodeling, and function of the infarcted heart.

BACKGROUND: Activated macrophages have a significant role in wound healing and damaged tissue repair. We sought to explore the ability of ex vivo activated macrophages to promote healing and repair of the infarcted myocardium. METHODS AND RESULTS: Human activated macrophage suspension (AMS) was prepared from a whole blood unit obtained from young donors in a closed sterile system and was activated by a novel method of hypo-osmotic shock. The AMS (approximately 4 x 10(5) cells) included up to 43% CD14-positive cells and was injected into the ischemic myocardium of rats (n=8) immediately after coronary artery ligation. The control group (n=9) was treated with saline injection. The human cells existed in the infarcted heart 4 to 7 days after injection, as indicated by histology, human growth hormone-specific polymerase chain reaction, and magnetic resonance imaging (MRI) tracking of iron oxide-nanoparticle-labeled cells. After 5 weeks, scar vessel density (+/-SE) (25+/-4 versus 10+/-1 per mm2; P<0.05), myofibroblast accumulation, and recruitment of resident monocytes and macrophages were greater in AMS-treated hearts compared with controls. Serial echocardiography studies, before and 5 weeks after injection, showed that AMS improved scar thickening (0.15+/-0.01 versus 0.11+/-0.01 cm; P<0.05), reduced left ventricular (LV) diastolic dilatation (0.87+/-0.02 versus 0.99+/-0.04 cm; P<0.05), and improved LV fractional shortening (31+/-2 versus 20+/-4%; P<0.05), compared with controls. CONCLUSIONS: Early after myocardial infarction, injection of AMS accelerates vascularization, tissue repair, and improves cardiac remodeling and function. Our work suggests a novel clinically relevant option to promote the repair of ischemic tissue.