Development of an amphotericin B micellar formulation using cholesterol-conjugated styrene-maleic acid copolymer for enhancement of blood circulation and antifungal selectivity.

Amphotericin B (AmB) is an effective antifungal agent for life-threatening systemic fungal infections. However, its poor solubility in water and organic solvents makes it difficult to formulate. We previously reported AmB-encapsulated micellar formations using styrene-maleic acid copolymer (SMA) and butylated SMA. These micelles make AmB water-soluble; however, the blood circulation of AmB by these intravenous administrations was as low as that of Fungizone®, a conventional micellar formulation of AmB. The destabilization of SMA micelles by salt in the blood has been suggested to be a cause of low blood circulation. Therefore, in this study, to reduce salt-induced instability and increase blood circulation of the micelles, we covalently attached cholesterol molecules to the SMA backbone because AmB interacts with sterols. This AmB nanoparticle micellar formulation (Cho-SMA/AmB micelles) was water-soluble, stable in the presence of salts, and formed a complex with albumin. Compared with Fungizone®, this formulation had equal antifungal activity and markedly improved blood circulation and lower toxicity. Its toxicity was further reduced in the presence of albumin. Taken together, our results indicate that Cho-SMA/AmB micelles could be an intravenous formulation with high antifungal selectivity, and drug interactants-conjugated SMA system could be applied to a variety of drug-loaded nanomicellar systems.

Synthesis and evaluation of styrene-maleic acid copolymer conjugated amphotericin B.

Amphotericin B (AmB), which plays a central role in the treatment of systemic fungal infections, is difficult to formulate because it's sparingly soluble in water and organic solvents. We previously prepared AmB-loaded micelles using styrene-maleic acid copolymer (SMA). Although solubilization was achieved by this formulation, stability in the blood circulation was as insufficient as that of Fungizone®, which is a conventional formulation of AmB. Meanwhile, it is well known that polymer-drug conjugates are more stable in circulation than drug-loaded micelles. Therefore, in this study, we developed covalently conjugated SMA-AmB (SMA-AmB conjugate). The SMA-AmB conjugate was found to be soluble and present as micelles in aqueous solution. Furthermore, it was revealed that this micelle behaves as a larger molecule by forming a complex with albumin. The circulation in the blood increased significantly compared to that of Fungizone®, which was suggested to be due to this complex-forming ability. Although in vitro and in vivo antifungal activity of the SMA-AmB conjugate against Saccharomyces cerevisiae was reduced by 1/3 compared to that of Fungizone®, hemolysis decreased to 1/40 or less, and the LD50 decreased to 1/10. In conclusion, it is expected that the SMA-AmB conjugate can be a polymer-therapeutic agent with high antifungal selectivity.