Microbicide Containing Ellagic Acid Can Inhibit HIV-1 Infection.

OBJECTIVES: Ellagic acid (EA) has a wide range of biological effects. The purpose of this study was to investigate the in vitro effects of EA on HIV-1 replication, viral enzyme activity and cytokine secretion by infected cells. METHODS: The anti-HIV-1 activity of EA in solution was determined in vitro using the infection of TZM-bl cells by the nano luciferase-secreting R5-tropic JRCSF strain of HIV-1, which allows for the quantification of viral growth by measuring nano luciferase in the culture supernatants. The effect of EA on the cytokine secretion of TZM-bl cells was determined by a multiplexed bead array after 48 h of HIV-1 exposure. The antiviral effect of EA in the gel formulation (Ellagel), as would be used for vaginal application, was investigated by the inhibition of infection of UC87.CD4.CCR5 cells with R5-tropic pBaLEnv-recombinant HIV-1. RESULTS: EA in solutions of up to 100 µM was not toxic to TZM-bl cells. EA added either 1 h before or 4 h after HIV-1 exposure suppressed the replication of R5-tropic HIV-1 in TZM-bl cells in a dose-dependent manner, with up to 69% inhibition at 50 µM. EA-containing solutions also exhibited a dose-dependent inhibitory effect on HIV-1 replication in U87 cells. When EA was formulated as a gel, Ellagel containing 25 µM and 50 µM EA inhibited HIV-1 replication in U87 cells by 56% and 84%, respectively. In assays of specific HIV-1 enzyme activity, Ellagel inhibited HIV-1 integrase but not protease. EA did not significantly modulate cytokine secretion. CONCLUSIONS: We conclude that EA either in solution or in a gel form inhibits HIV infection without adverse effects on target cells. Thus, gel containing EA can be tested as a new microbicide against HIV infection.

In vitro elution characteristics of gentamicin-impregnated Polymethylmethacrylate: premixed with a second powder vs. liquid Lyophilization.

BACKGROUND: Antibiotic-loaded bone cement, or antibiotic-impregnated polymethylmethacrylate (PMMA), were developed to prevent and treat bone and joint infections. Gentamicin is an antibiotic that is commonly used in combination with PMMA; however, gentamicin powder is hard to obtain in many countries. This study aimed to evaluate the elution characteristics of gentamicin-impregnated PMMA made with lyophilized liquid gentamicin, compared with PMMA; which is made from commercial gentamicin powder. METHODS: The experimental sample was divided into 2 groups: the gentamicin power group (PG-PMMA) and the lyophilized liquid gentamicin group (LG-PMMA). Ten cement spacers were prepared in each group. These were produced by mixing gentamicin powder, or lyophilized liquid gentamicin, with a powder polymer before adding the liquid monomer (2 g of gentamicin and 40 g of PMMA). The volume and surface area of the antibiotic-impregnated cement spacers were 50 cm3 and 110 cm2, respectively. Each spacer was immersed in phosphate-buffered saline, which was changed daily under sterile conditions. The solutions were collected to measure the level of gentamicin using the enzyme multiplied immunoassay technique (EMIT), at days 1, 2, 3, 4, 5, 6, 7, 14, 21, 28, 35 and 42. RESULTS: The collections from both groups had high concentrations of gentamicin on day 1 (113.63 ± 23.42 mg/dL in LG-PMMA and 61.7 ±8.37 mg/dL in PG-PMMA), but experienced a continuous decrease over time. The PMMA spacers from both groups could release gentamicin for up to 6 weeks (3.28 ± 1.17 mg/dL in LG-PMMA and 1.21 ± 0.28 mg/dL in PG-PMMA). However, there were significantly higher levels of gentamicin concentrations in the LG-PMMA group compared to the PG-PMMA group at all time points (P< 0.05). CONCLUSION: Gentamicin-impregnated PMMA made with lyophilized liquid gentamicin had approximately a two times higher rate of antibiotic elution in preliminary in vitro studies, as compared with PMMA made with premixed gentamicin powder.

Efficacy of a Chitosan-curcumin Mixture in Treating Indomethacininduced Acute Gastric Ulcer in Rats.

BACKGROUND: Curcumin is claimed as a potent protectant against Gastric Ulcer (GU) induced by strong necrotizing agents, including NSAIDs through its antioxidant, anti-inflammatory and gastroprotective activities. However, it was found to exert opposite effects to either delay ulcer healing or exacerbate ulcer inflammation through some curative mechanisms differently modified by curcumin dosage. Its ability to inhibit the expression of COX-2 may also delay the healing of NSAIDs-induced GU. Recently, a topical chitosan-curcumin solution has been found to be a safe and potential alternative agent in treating oral ulcer. Therefore, an oral chitosan-curcumin mixture was developed and determined for its efficacy in treating NSAIDs-induced GU in the rat. METHODS: A chitosan (150 mg)-curcumin (20 mg) mixture with optimal gastric pH was developed. Indomethacin (30 mg/kg) was given orally to the rat and test preparations were administered orally at 5 h later and then every 24 h for two consecutive days. The sum of all gastric ulcerated areas (mm2) for each stomach was used as ulcer index. Gastric pro-inflammatory mediators and cytoprotective factors were determined. RESULTS: An oral administration of a chitosan-curcumin mixture exerted a superior efficacy than curcumin, chitosan or lansoprazole (a standard antiulcer agent) in healing indomethacin-induced GU. It was revealed that the mixture exhibited the highest anti-oxidant, anti-inflammatory and gastric mucus producing activities including the high potency in down-regulating pro-inflammatory COX-2 and iNOS expression but up-regulating cytoprotective COX-1, nNOS and eNOS expression. CONCLUSION: The present findings indicated the benefit of a chitosan-curcumin mixture as a potential alternative agent in treating NSAIDs-induced gastric ulcers.

Efficacy of An Aqueous Morinda citrifolia Fruit Extract-Phytosome Gel in Treating Oral Inflammatory Ulcer in Rabbit Model.

BACKGROUND: Oral inflammatory ulcers are one of the common complaints of patients attending out-patient clinics. Previous in vivo studies had shown that an Aqueous M. citrifolia Fruit Extract (AMFE) possessed anti-inflammatory and ulcer healing activities. Therefore, a standardized topical bioadhesive gel containing AMFE-phytosome was developed and determined for its oral ulcer healing efficacy in a rabbit model. METHODS: The AMFE phytosome (AMFE-P) was prepared by a complexation method with the required amount of AMFE: Phosphatidylcholine: Tween 80 to weigh ratio of 2:1:0.2. Poloxamer 407 was used as a gelling agent. The oral ulcer was induced in male New Zealand white rabbits by topical application of acetic acid. Each test compound was applied to the ulcer for 10 days beginning on the second day after the ulcer induction. Complete ulcer healing on the specimen obtained on day 12 was observed histologically using the histological scoring protocol. RESULTS: The optimized gel containing AMFE-P equivalent to AMFE 10%w/w (10%AMFE-P gel) showed the best bioadhesive gel quality, a smooth and homogeneous texture with an optimum viscosity and pH range used in human oral cavity, a good physical and chemical stability and the highest percentage cumulative release of total phenolic and scopoletin content. It was found that a daily application of 10% AMFE-P gel exerted a superior ulcer healing efficacy and a significantly rapid ulcer healing process than a twice daily application of topical gel containing AMFE 10%w/w or chlorhexidine 0.2%. CONCLUSION: These findings demonstrated that 10% AMFE-P gel has potential as a safe and effective alternative therapeutic agent for oral ulcers.

Effectiveness of an Alcohol-Free Chitosan-Curcuminoid Mouthwash Compared with Chlorhexidine Mouthwash in Denture Stomatitis Treatment: A Randomized Trial.

Objective: An alcohol-free mouthwash of curcuminoids purified from the turmeric (Curcuma longa Linn.) rhizome was formulated using a cosolvent system, comprising chitosan and polyethylene glycol (PEG) 400, and determined for its efficacy and safety in management of denture stomatitis (DS) in comparison with a chlorhexidine (CHX) mouthwash. Design: A single-center, randomized, controlled parallel-arm trial was conducted. Setting: The study took place at the Faculty of Dentistry, Prince of Songkla University, Hat-Yai, Thailand, between June 2016 and June 2017. Subjects: Participants were 20 years old or older adults of both genders, using removable dentures, and with a confirmed diagnosis of DS from an oral medicine specialist. Interventions: A total of 30 patients were randomly assigned to 3 different interventions, including the chitosan-curcuminoid (CHI-CUR) mouthwash, CHX mouthwash, and a vehicle formulation comprising chitosan and PEG 400. Ten milliliters of each intervention was given to the patient to be used for 30 sec, three times a day at 8 am, 12 pm, and 4 pm, for 2 weeks. Outcome measures: Outcome measures included complete relief of erythematous lesions under the denture and reduction in the number of candida colonies present in the denture-fitting surface. Results: Eight of 10 patients (80%) using the CHI-CUR mouthwash had a complete response after the 2-week treatment course compared with 30% of patients using the CHX mouthwash (p < 0.05). Both interventions exerted comparable anticandida efficacy. No oral or systemic adverse events that could possibly be related to the use of mouthwash were documented. Conclusions: The finding indicated that an alcohol-free CHI-CUR mouthwash may serve as a safe and potential topical therapeutic alternative in treating generalized or candida-associated DS.

The development of dimple-shaped chitosan carrier for ethambutol dihydrochloride dry powder inhaler.

OBJECTIVE: In this study, a dimple-shaped chitosan carrier was developed for delivering the antituberculosis drug ethambutol dihydrochloride (EDH) from a dry powder inhaler (DPI) to the lungs. MATERIALS AND METHODS: Nanosized drug particles were prepared using nanospray drying. The microsized carrier was developed from a chitosan solution by spray drying. Five formulations were prepared by physically mixing the drug and carrier in different ratios. The physico-chemical properties of the formulations were analyzed using scanning electron microscopy, differential scanning calorimetry, Fourier transform infrared spectroscopy, ultracentrifugation and a cascade impactor. RESULT AND DISCUSSION: The EDH size was 222 nm and the chitosan carrier size was 1.2 µm. Five formulations, i.e. 1:2, 1:2.5, 1:3.3, 1:5 and 1:10 w/w of the EDH to chitosan carrier were prepared by physical mixing. The chitosan carrier was spherical in shape with a dimpled surface and this provided shallow cavities to which the drug was bound, both within its grooves as well as on its surface. The median adhesion force (50% of drug detachment) for formulations #1 to #5 was between 122 and 993 µN. The mass median aerodynamic diameter of the EDH was between 2.3 and 2.7 µm, with the fine particle fractions (aerosolized particles less than 4.4 µm) of 32-42% of the nominal dose. CONCLUSION: We suggest that ethambutol dihydrochloride mixed with a chitosan carrier was suitable for use in a dry powder inhaler for controlling tuberculosis especially in minimizing the risk of multidrug resistant tuberculosis and the possible side effects from EDH.

Liposome-containing Hibiscus sabdariffa calyx extract formulations with increased antioxidant activity, improved dermal penetration and reduced dermal toxicity.

Hibiscus sabdariffa Linn, or Roselle, is a medicinal plant used extensively in traditional Thai medicine since ancient times. The extracts of Roselle calyces possess antioxidant activity and have potential for development as active ingredients in cosmetic products. However the limitations of using Roselle extracts in cosmetics are its low skin permeation and dermal irritation. Liposome technology is an obvious approach that might overcome these problems. Liposome formulations of standardized Roselle extracts were developed with various lipid components. The formulation showing the highest entrapment efficiency was selected for stability, skin permeation and dermal irritability studies. The liposome formulation with the highest entrapment efficiency (83%) and smalôlest particle size (332 mm) was formulated with phosphatidylcholine from soybean (SPC): Tween 80: deoxycholic acid (DA); 84:16:2.5 weight ratio, total lipid of 200 g/mL and 10% w/v Roselle extract in final liposomal preparation. This liposome formulation was found to be stable after storage at 4 degrees C, protected from light, for 2 months. The in vitro skin permeation studies, using freshly excised pig skin and modified Franz-diffusion cells, showed that the liposome formulation was able to considerably increased the rate of permeation of active compounds in Roselle extracts compared to the Roselle extract solution. The in vivo dermal irritability testing on rabbit skin showed that the liposome formulation dramatically decreased skin irritability compared to the unformulated extract. These results showed that the liposomes containing Roselle extracts had good stability, high entrapment efficacy, increased skin permeation and low skin irritation.

Chitosan/TPP and chitosan/TPP-hyaluronic acid nanoparticles: systematic optimisation of the preparative process and preliminary biological evaluation.

PURPOSE: Chitosan is one of the most sought-after components for designing nanoparticles for drug delivery applications. However, despite the large number of studies, reproducibility is often an issue; generally more attention should be focused on purity and precise characterization of the starting material, as well as on the development of robust preparative procedures. METHODS: Using a rational experimental design, we have studied the influence of a number of orthogonal factors (pH, concentrations, ratios of components, different methods of mixing) in the preparation of chitosan/triphosphate (TPP) nanoparticles and in their coating with hyaluronic acid (HA), aiming at the minimisation of size polydispersity, the maximisation of zeta potential and long-term stability, and at the control over average nanoparticle size. RESULTS AND CONCLUSION: Three optimised nanoparticles have been developed (two uncoated and one HA-coated) and their toxicity on fibroblasts and macrophages has been evaluated: experiments showed the beneficial character of HA-coating in the reduction of toxicity (IC50 raised from 0.7-0.8 mg/mL to 1.8 mg/mL) and suggested that the uncoated chitosan/TPP nanoparticles had toxic effects following internalisation rather than membrane disruption.

Formulation and efficacy of triamcinolone acetonide mouthwash for treating oral lichen planus.

PURPOSE: The stability of a triamcinolone acetonide mouthwash and its efficacy in treating oral lichen planus are described. METHODS: The solubility of triamcinolone acetonide in ethanol, propylene glycol, and glycerin was determined by shaking and equilibrating an excess of triamcinolone acetonide with the solvents for 72 hours. All three solvents were used in formulating a mouthwash. A stock solution of triamcinolone acetonide standard was prepared in ethanol and diluted to yield concentrations of 2, 4, 8, 12, and 16 microg/mL. Analytical sample solutions were prepared by pipetting 0.1 mL of triamcinolone acetonide mouthwash into 10-mL volumetric flasks and diluting to volume with the mobile phase. Accelerated stability studies were conducted by storing the samples in 60-mL amber glass bottles at 45, 60, 70, and 80 degrees C and 75% relative humidity until the triamcinolone concentration decreased markedly. Efficacy was tested by 20 subjects with a clinical diagnosis of and histologically confirmed symptomatic oral lichen planus who were randomized to use the mouthwash (n = 11) or the commercially available triamcinolone acetonide paste (n = 9). RESULTS: The mouthwash had a satisfactory shelf life and was well accepted by patients. Ten of 11 patients treated with the mouthwash for four weeks reported a positive response, and a complete response in signs and symptoms occurred in 4 and 5 of 11 patients, respectively. No significant difference in clinical improvement was observed between groups. CONCLUSION: A triamcinolone acetonide mouthwash had a satisfactory shelf life and was well accepted by patients. It did not have a significantly different therapeutic efficacy from the commercial paste dosage form in the treatment of oral lichen planus.