Showing posts with label Drug Designing Journal. Show all posts
Showing posts with label Drug Designing Journal. Show all posts

Tuesday, 28 February 2023

Lupine Publishers| Affordability Issues of Biotech Drugs in Low- and Middle-Income Countries (LMICs)

  Lupine Publishers| Journal of Drug Designing & Intellectual Properties




Abstract

According to World Bank publication Disease Control Priorities: Improving Health and Reducing Poverty (3rd edition, 2017), nearly 20% total health expenditure globally came from out-of-pocket payments in 2014. The same was nearly 40% total health expenditure for low-income countries, 56% for lower-middle-income countries, and 30% for upper-middle-income countries (WHO, 2016). One third of the world’s population lacks timely access to quality-assured medicines while estimates indicate that at least 10% of medicine in low- and middle-income countries (LMICs) are substandard or falsified, costing approximately US$ 31 billion annually (Global Health, 2018). Surprisingly, 80% of global cardiovascular deaths occur in LMICs which is (partly) due to the lack of access to healthcare including skilled human resources, equipped facilities and medicines (Global status report on noncommunicable diseases, WHO, 2010). Price of drugs, vaccines, and diagnostics is a major burden in LMICs round the globe. Cost of biotech drugs are even higher due to high cost incurred by the pharmaceutical companies for clinical trial. Biotech drugs have completely changed the management of several diseases, including cancer and autoimmune diseases. Although essential but their affordability is still a burning issue, especially in LMICs.

Keywords: LMICs; Out-of-pocket expenditure; Cancer treatments; Biotech drugs; Pharmaceutical patents; Biosimilars

Abbreviations: PIVI: Partnership for Influenza Vaccine Introduction; NITAGs: National Immunization Technical Advisory Groups; OOP: Out-of-pocket; LMICs: Low-and Middle-Income Countries; RCT: Randomized Control Trial; HPV: Human Papillomavirus; GDP: Gross Domestic Product; EML: Essential Medicine List; R&D: Research and Development; BRICS countries: Brazil, Russia, India, China and South Africa; NCDs: Non-communicable diseases; CVDs: Cardiovascular Diseases

Mini Review

(Figure 1) Pharmaceutical companies invest in the development and testing of their drugs including by funding clinical trials. Furthermore, pharmaceutical companies also spend a large amount of money on advertising. For instance, in 2016 US$6.7 billion was spent on direct-to-consumer pharmaceutical advertising alone in the USA [1]. Worldwide spending on medicines reached $1.2 trillion in 2018 and will exceed $1.5 trillion by 2023, according to “The Global Use of Medicine in 2019 and Outlook to 2023” [2,3]. Although, access to essential medicines is problematic for one third of all persons worldwide [4]. Limited access to essential medicines (EMs) for treating chronic diseases is a major challenge in low- and middle-income countries (LMICs) [4,5]. Average public sector availability of even low-cost generic medicines ranges from 30% to 55% across 36 LMICs [6]. Price of drugs, vaccines, and diagnostics is a major burden in 105 middle income countries round the globe, comprising of 70% of the world population, 75% of the poor [7]. While public hospitals offer free or subsidized treatment including essential medicines, the high patient caseloads, underfunding and inefficient medicine distribution systems are barriers to consistent service provision [8]. Moreover, 90% of the population in developing countries purchase medicines through out-of-pocket (OOP) payments [7]. Poor availability of medicines in the public sector has pushed up household OOP expenditure, making them the largest household expenditure item after food [9]. Non-communicable diseases (NCDs) which, according to WHO are now the world’s biggest killers. Over 36 million people die annually (63% of global deaths) from NCDs, mainly CVDs, cancer, chronic respiratory diseases and diabetes. Of these, 80% occur in LMICs [10]. So, The WHO has set a minimum of 80% as target availability of medicines for both communicable and non-communicable diseases in all countries [11]. But Pharmaceutical companies have a substantial desire in developing drugs for chronic diseases and cancer treatments, not only because of high prevalence, but also because these drugs are often used in long term [12]. Pharmaceutical patents maintain drug prices well above the cost of production and can restrict access to needed medicines [13]. Biotech drugs have completely changed the management of several diseases, including cancer and autoimmune diseases such as, psoriasis, rheumatoid arthritis, multiple sclerosis, and inflammatory bowel disease [14]. The high cost of biotech medications (target a gene or protein and typically are injected or infused, associated with treating a chronic condition) often requires significant OOP expenditures [15,16]. Some studies say that pharmaceutical companies price drugs monopolistically, protected by patent rights, while others believe that the high prices for orphan drugs simply allow drug R&D and production costs. However, the global orphan drug market is estimated to reach US $209 billion by 2022 accounting for 21.4% of total branded prescription drug sales [17]. According to the Tufts Center for Drug Development, it costs, on average, $100 million in 1975, around $900 million before 2004 and 1.3 billion after 2005 to develop a new drug and bring it to market [18,19]. While, Scavone et.al, 2019 reported that entire time that passes from the R&D phase until the drug’s marketing approval can last up to 15 years, and it is characterized by extremely high costs, usually exceeding $1.2 billion [20]. Gouglas et.al, 2018 estimated a minimum of $2·8– 3·7 billion ($1·2 billion–$8·4 billion range) for one vaccine through to the end of phase 2a among 11 epidemic infectious diseases [21]. Apart from the traditional design of RCT, in recent years further study designs, including umbrella, basket and platform trials, were developed and applied to new therapies, especially in the area of oncology research [22]. Tay-Teo et.al, 2019 stated the most commonly accepted estimates of R&D costs, including cancer drugs, are between $200 million and $2.9 billion, after adjustments for the probability of failure and opportunity costs [23]. Genomic studies conducted in the past two decades identified the molecular drivers of certain cancers and led to the advent of targeted therapies as an important additional pillar of the cancer therapy armamentarium [24]. According to the Global Oncology Trend Report, global spending on cancer medications rose from $75 billion in 2010 to $100 billion in 2014, 10.3% rise in spending. Asia accounts for 60% of the world population and 50% of the global burden of cancer [25]. There are over 100 types of cancers, located in different organs and sub-tissues and originating from different cell types. Some cancer types (e.g., colon, breast, and non-Hodgkin’s lymphoma) contain even more specific classifications based on their molecular subtypes. Despite this complexity and variability, most types of cancer are treated with the same generic therapies [26]. Critics claim that prices of innovative drugs are excessive and argue that lowering prices will not harm the flourishing innovation. On the opposite end, the pharmaceutical industry insists that restrictive pricing policies will have a detrimental impact on their ability to generate innovation [27]. During 2017, PIVI worked with its country partners and the WHO regional and local offices to assess NITAGs strengthening needs and to provide technical assistance in 7 LMICs (Laos Peoples Democratic Republic, Mongolia, Vietnam, Armenia, Côte d’Ivoire; Moldova and the Republic of Georgia) [28]. In Europe, total cancer drug sales more than doubled between 2005 and 2014, increasing from €8.0 billion to €19.8 billion [29]. Biologics were estimated to account for US$289 billion pharmaceutical sales in 2014 and are projected to reach US$445 billion in 2019. It is also anticipated that biologics’ share of global prescription and OTC pharmaceutical sales will rise to 26% by 2019 [30]. It is projected that new cases of cancer will increase from about 14 million in 2012 to 22 million in 2030, with most cases in LMICs located in Africa, Asia and Latin America [31]. The projected increase in cancer incidence is predicted to be most significant in LMICs in Asia. In these countries, over 60% of the total healthcare expenditure comes from private resources, of which more than 80% is direct OOP payments, with catastrophic results for most families in these countries [25]. In India alone, as many as 63 million people are forced into poverty every year, owing to catastrophic health expenses, the majority of which are OOP payments for medicines [32]. Genetic predisposition, increasing life expectancy, urbanization, mechanization, inadequate health services and rapid economic development fueling sedentariness and changing dietary patterns are contributing to rising chronic disease burden in the South Asian region [33]. Rijal et.al, 2018 reported that Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, India, Pakistan and Sri Lanka, which are mostly LMICs with regional GDP per capita 1640 USD and home to a quarter of world population [34]. According to Giri et.al, 2018 breast cancer was the most prevalent cancer and fourth leading cause of cancer-related mortality among women in Asia [35]. Siegel et.al, 2019 states mortality rates in the poorest counties were 2-fold higher than most affluent counties for cervical cancer and 40% higher for male lung and liver cancers during 2012-2016 [36]. One-third of the world cervical cancer burden is endured in India, Bangladesh, Nepal and Sri Lanka. High-risk HPV types were found in 97% of cervical cancers, and HPV-16 and 18 were found in 80% of cancers in India [37]. Stomach cancer (9·0%), breast cancer (8·2%), lung cancer (7·5%), lip and oral cavity cancer (7·2%), pharynx cancer other than nasopharynx (6·8%), colon and rectum cancer (5·8%), leukemia (5·2%), and cervical cancer (5·2%) are the leading types of cancer in India in 2016 [38]. India has been well known in the global oncology community as the country where cancer drug prices are cheaper compared to other countries. For instance, the 4-weekly cost of trastuzumab was $2761 in India versus $6849 in the US [39]. It was indeed heartening to see that India paid $19000 for a 4-week course of bevacizumab (based on purchasing power parity) while Australia paid only $543 [40]. In the US, individuals diagnosed with cancer are 2.7 times more likely to declare bankruptcy, than individuals without cancer [41]. Saqib et.al, 2018 stated that patients in LMICs find it difficult to afford non-biologics and their treatment with new therapeutic agents like biologic is almost impossible. Therefore, the management of cancer is seriously affected by the availability and affordability of anticancer agents [42]. Due to lack of information on comparative drug prices and quality, it is difficult for physicians to prescribe the most economical treatment. Lack of information on quality, nonavailability and conflicts of interest are also responsible for physicians not prescribing the least expensive medication. The difference in cost between the various brands of the same drug varies from 2- fold to more than 100-fold in India [43]. Bhutan (13%), Maldives (5%) and Timor-Leste (5%) – are small countries with challenging geographies that lack the capacity for local pharmaceutical production. They may also use alternative strategies, such as sending patients with cancer for treatment abroad [26]. Many examples of high drug prices exist and are frequently discussed in the media. One often mentioned example is imatinib (brand name Gleevec®), a drug for chronic myeloid leukemia, which tripled in cost after the US FDA allowed for a new indication. Novartis raised its price from $31,930 in 2005 to $118,000 per year in 2015 despite a huge increase in the volumes sold [44]. The 19th revision of the WHO EML in 2015 added 16 essential cancer drugs, including three high-cost medicines, imatinib, rituximab and trastuzumab, and therefore improving equitable access to innovative treatments for cancer that are widely unavailable in low-resource settings [45]. India is one of the top global funders of R&D into neglected diseases, according to Thomas et.al, 2019. Nearly 12% of drug, diagnostic, and vaccine candidates for neglected diseases in the R&D pipeline are from India [46]. Most South Asian countries have well laid out regulatory pathways for biosimilar approval. While no biosimilar insulin is approved in USA as of date August 2015, the European Medicines Agency and Japanese drug regulatory authorities have given approval to only one insulin-a biosimilar insulin glargine produced by Eli Lilly [47]. One of the most significant safety concerns with biosimilars is the potential risk of immune-based adverse reactions. Because of their molecular size, biologics can directly induce anti-drug antibodies which may have significant consequences for both safety and efficacy [48]. As manufacturers of biosimilar products do not have access to the cell line and technique of reference product, the manufacturing process may change slightly, but this may have tremendous impact on the biological function of the product, including immunogenicity, potentially affecting the safety and efficacy profile [49]. Also, the costs of drug distribution in India are 2 to 3 times greater than in the United States or the European Union, despite vastly lower labor costs. Their staff are not required to show skills in pharmaceutical warehousing and management, often with disastrous consequences [50]. The monthly drug prices were the highest in the U.S and lowest in India. However, despite having the lowest drug prices, drugs were the least affordable (affordability estimated as drug prices divided by GDP per capita or average salary) in India [39,40]. Those drugs that ensure cure should be given the first priority. The governments and policy makers in LMICs should prioritize access to highly effective biotech drugs used in curative setting and limit spending on costly but ineffective or minimally effective drugs used in palliative setting. Inter collaborations between the BRICS countries like Brazil, China and India need to set the pace and create more incentives to increase local production of drugs with LMICs [51]. There are various interventions or changes in policies advised that can help in lowering the cost of biotech drugs like breaking the monopoly in drug manufacturers, changing the regulatory guidelines by government agencies in favor of those companies which manufacture cheaper drugs and making the new drug approvals faster, increasing the cost effectiveness ratio of drugs, achieving a balance between physician autonomy in prescribing biotech drugs and costs incurred by patients, encouraging non-profit generic companies which manufacture biotech drugs by giving them tax incentives and other measures, value based reimbursement by medical insurance companies.

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Monday, 23 January 2023

Lupine Publishers| The Synthesis of Alginate Microparticles and Nanoparticles

 Lupine Publishers| Journal of Drug Designing & Intellectual Properties



Abstract

Alginate is a natural polysaccharide that is widely used as a component of pharmaceuticals and in food industry. Alginate particles can be used for encapsulation of substances with the necessity of prolonged release. They can also provide appropriate microenvironment for cells. Here the methods of the synthesis of alginate beads, micro- and nanoparticles are reviewed with special attention to the calcium alginate ones. The results from publications that did not deal with alginate particles but, to our opinion, could be applied in this field are also included in order to give an outline for possible future research. The suggested applications of the particles are mentioned as well. The two main methods for the synthesis of calcium alginate particles are internal and external gelation, but the external gelation techniques can be themselves subdivided into several subtypes. Currently, a technique being able to produce alginate nanoparticles with any desirable size does not exist. We analyze the possibilities of employing aerosolization method for this purpose. The potentials to overcome the problem of burst release of the encapsulated substances by means of cyclodextrin inclusion complexes and employing additional crosslinking agents are also discussed. The clinical application of alginate nanoparticles is still limited because of the burst release of encapsulated drugs and the poor size control of the particles formed. Further research must concentrate on overcoming these problems and on topical application of alginate particles without entering bloodstream rather than on investigation of model drug release in vitro without taking the above-mentioned problems into account.

Keywords: Calcium alginate; Alginate beads; Alginate microparticles; Alginate nanoparticles; Drug encapsulation; Particle size control; Aerosol

Introduction

Alginates are polysaccharides. The commercially available ones come from brown algae. They are linear copolymers of (1→4)-linked units of β-D-mannuronic acid and α-L-guluronic acid. The molar ratio between them and their distribution along the commercial polymer depend on the algal source, its location, age, collection season and extraction technique. Guluronic acid residues can form so-called egg-box complexes with calcium ions or some other divalent metal cations leading to gel formation (Figure 1). The name ‘egg-box’ is used because, if depicted schematically, the cations look like eggs situated inside puckered boxes formed by four guluronic acid residues of two superimposed chains. Mannuronic acid residues have much less affinity to metal ions [1]. Barium ions have more affinity to alginate than the calcium ones. If reacted with calcium alginate at lower concentrations, they create new gelling junctions. At higher concentrations, barium ions also displace calcium ions from existing junctions [2].

Figure 1: The egg-box model.

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To extract alginate, algae are usually washed with organic solvents and water, dried and milled. After acid pretreatment, alginate is solubilized with Na2CO3 . The crude extract is concentrated, dialyzed against water and then freeze-dried or precipitated with ethanol. Acidification or treatment with Ca2+ can be used instead. Brown algae are abundant in nature; however, the possibility of cultivating them exists as well [1]. The viscosity of aqueous sodium alginate solution rapidly increases with its concentration. For example, the addition of 10% of alginate to water leads to a ~100-fold increase in viscosity. But the poly electrolyte nature of alginate has little effect on its hydration, and in the above example less than 3.7% of the water molecules present in solution is involved in alginate hydration. Such a large viscosity increase is determined by the polysaccharide network, with large bulk-like water pools present between the polysaccharide chains [3].

Sodium alginate may act as a mucoadhesive polymer. A comparative study of adhesion between buccoadhesive compacts and pig buccal mucosa or sodium alginate solution revealed that the results were of similar performance [4]. Sodium alginate was proposed as a mucoadhesive component of a nasal gel [5] or in buccal patches containing salbutamol sulfate [6]. Sodium alginate conferred in situ gelling mucoadhesive properties and retarded drug release from liquid rectal suppositories. These suppositories were successfully tested on Guinea pigs to alleviate symptoms of histamine-induced bronchospasm [7]. Sodium alginate was also evaluated as an excipient in salbutamol sulfate sublingual films [8] and tablets [9]. However, drug release was found to be too slow in the films [8] or too rapid in tablets [9]. Only salbutamol sulfate tablets formulated from granules containing mastic and sodium alginate excelled commercial tablets in the terms of drug release when tested on rabbits [10]. In combination with hydroxy propyl methyl cellulose and propylene glycol sodium alginate was used in the formulation of terbutaline sulfate sublingual films [11]. Sodium alginate could be also used as a component of plugs for water-soluble parts of crosslinked gelatin capsules containing pellets with encapsulated salbutamol sulfate. The plug absorbed the surrounding fluid, and began to release the drug through the swollen matrix and was finally ejected out of the capsule by erosion of the material. The usability of the system was shown on rabbits [12].

Chitosan-alginate complex was proposed as an excipient for orodispersible tablets, and their disintegration time was so short that it was even referred to as a ‘super dis-integrant’ [13]. One optimized formulation containing the excipient for 5-fluorouracil tablets, suitable for trans buccal and rectal drug delivery, contained this chitosan-alginate complex along with the same components un-complexed in order to avoid burst release and to improve the mucoadhesive properties [14].

Sodium alginate itself also has a therapeutic effect. When admixed to foods for diabetic human patients, it decreased gastric emptying rate and rises glucose in blood, serum insulin and plasma C-peptide levels [15]. Orally administered, sodium alginate significantly alleviated small intestinal enteritis in rats, caused by treatment with the anti-inflammatory drug indomethacin, and this relief seemed to be independent of the sodium alginate viscosity administered [16]. Oral disposal of sodium alginate to rats with colitis led to a significant reduction of colonic damage, decreased lesion formation [17,18] and inhibited mucosal injury [17]. Orally administered alginate oligosaccharide obtained from hydrolysis of sodium alginate by Bacillus subtilis improved histopathological and biochemical parameters of mice having ovalbumin-induced asthma in a dose-dependent manner [19]. Rats fed with sodium alginate drank more water, and their urine volume and pH rose sharply. In contrast, calcium alginate caused very little changes in the same parameters [20].

Commercially available calcium alginate swabs were used for sampling nasal flora for subsequent DNA extraction [21]. The mucoid exopolysaccharide produced by the pathogenic bacterium Pseudomonas aeruginosa is alginate, but it has low immunogenicity if it is not conjugated with a carrier protein. Even in the form of conjugate it is non-toxic if administered intraperitoneally to mice or guinea pigs and non-pyrogenic if administered intravenously to rabbits [22]. When alginate beads with encapsulated tumor cells were implanted to mice, a process of angiogenesis was observed in the implants zone. The beads were prepared from commercially available alginate [23]. It may be considered as a further proof of alginate biocompatibility.

Sodium alginate was also shown to be beneficial for agriculture. Being administered as dietary supplement to the white shrimp Litopenaeus vannamei, it acted as an immunostimulant and improved its resistance against the attack of Vibrio alginolyticus bacterium [24]. Sodium alginate digested with alginate lyase promoted root elongation of rice, carrot [25], lettuce [26] and barley plants [27,28] even under hypoxic conditions [28]. It was hypothesized that digested alginate might initiate some signal transduction pathway [27,28]. Under hypoxic conditions digested alginate also caused enhancement of the activity of the enzymes regenerating NAD+ [28].

Alginate oligomers promoted the germination of unhulled rice and Komatsuna seeds as well as tobacco callus differentiation. The mixture of oligomers was assumed to contain so-called oligosaccharine, an oligosaccharide inducing unusual proliferation and/or differentiation of plant cells. There are several kinds of oligosaccharines. They act as a chemical signal for the stimulation of hormone synthesis [29]. The promoting effect of alginate oligosaccharides on root formation and growth in rice was mediated by endogenous indole-3-acetic acid [30]. But proliferation of the microalga Chlamidononas reinhardtii was repressed by the same oligomers [29]. It should be noted that only digested sodium alginate shows this effect. And the possibility of alginate degradation by the lyases of soil bacteria is assumed [28]. Therefore, it is speculated that these active substances can be formed from alginate under natural conditions. Another notable advantage of alginate is its ability to bind micronutrients. Some important Mn, Cu, Zn and Mo fertilizers are MnCl2 , CuSO4 ·5H2O, ZnCO3 and Na2 MoO4 ·2H2O, respectively [31]. Manganese can be complexed with alginate by addition of MnCl2 to the gelling solution of CaCl2 or BaCl2 , and slow release of manganese ions from the beads into physiological saline has been reported [32] because the affinity of alginate to Ca2+ is higher than to Mn2+ [33]. The beads containing Ba and Mn could be used for manganeseenhanced magnetic resonance imaging and were tested on rats [32]. The use of CuSO4 [34] or CuCl2 [35] as a gelling solution led to copper alginate hydrogel being able to release copper ions into simulated body fluid [34] or into phosphate buffer (pH 6) [35] in a prolonged manner. The use of basic zinc carbonate for zinc alginate hydrogel formation using internal gelation method has also been reported. The hydrogel was active against E. coli [36]. Molybdenum can be adsorbed by preformed calcium alginate beads preferably in the form of H2[MoO4] or [Mo(H2O)6]3+ at pH 2 and released back up to 50% into 0.1M HCl. If radioactive molybdenum is used, the method is suitable for radiotherapy [37]. Copper ions from CuCl2 may also be adsorbed onto preformed calcium alginate beads [38]. Copper alginate shows activity against Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus pyogenes and E. coli [34].

The biodegradability of unmodified alginate particles, their ability to bind micronutrients and the beneficial effect of alginate make them promising carriers of agrochemicals. This is especially important because in a recent review [39] the authors expressed great concerns regarding the use of nanoparticles in agriculture because of the negative impact of metal and oxide nanoparticles on soil microorganisms, earthworms and even on cultivated plants.

Alginate beads can also have industrial applications:

• Wastewater treatment. The beads with encapsulated horseradish peroxidase could be reused up to 3 times, although the encapsulation decreased enzyme activity in comparison with the free enzyme [40]. In another report, the efficiency of phenol removal by encapsulated horseradish peroxidase was demonstrated by reducing to half the initial phenol quantity after only 5 reaction cycles [41].

• Food industry. Xylanase immobilized in alginate beads may be used for fruit juice clarification [42]. Lactobacillus helveticus and Streptococcus thermophilus immobilized in alginate beads were intended for use as lactic starters in milk fermentation [43]. Alginate particles with encapsulated healthy nutrients can also be used as components of functional foods.

• Enzyme production by cells immobilized in alginate beads. A good example is glucoamylase [44]. In this case fungus Thermomucor indicae-seudaticae was immobilized in alginate beads, and cane molasses was used as a cheap medium [44]. In all these applications alginate is exploited because of its natural origin, i.e. it cannot be a harmful admixture if separated incompletely. Beads (and not nanoparticles) are chosen because they can be easily separated by sedimentation. As could be seen above, not only enzymes themselves but also enzyme-producing bacteria can be immobilized in alginate beads.

In contrast to metal nanoparticles, alginate particles can be modified either before or after their synthesis. In the former case, bulk alginate is modified and then used to prepare the particles. This way is usually preferable from the two options because it avoids the leak or destruction of encapsulated substance during the modification. The chemical modification of alginate is reviewed widely in [45].

Alginate microparticles and nanoparticles are usually used to encapsulate and carry various substances, and the goal of many studies is to achieve sustained release of them. It should be noted, however, that the results of experiments dealing with the release of poorly water-soluble drugs might often be misinterpreted, because the drug not found in the solution is assumed to remain encapsulated in the particles. However, it may decompose after the release or simply precipitate out. Supersaturated solutions with varying extent of supersaturation can also be formed, making the results irreproducible. Special care must be taken in the case of putting the particles into a dialysis bag, because the films act as an additional diffusion barrier. If centrifugation is used for separation of the medium with the released substance from the nanoparticles, the pressure generated during the process can disturb the equilibrium. It can also make difficult resuspending the nanoparticles in the fresh portion of medium for further incubation [46].

For consistency, throughout this review we will use the following terms (even if different names for them were used in the respective publications):

• Encapsulation efficiency: the percentage of the substance that was encapsulated (i.e. not lost).

• Loading efficiency (expressed in percent): the ratio of the weight of the successfully encapsulated substance regarding to the total weight of the particle. Some authors calculate loading efficiency using different formulae, but we will give their values without a special discussion. We have rounded encapsulation and loading efficiencies as well as zeta potentials to the nearest integer values.

• Nanoparticles are considered smaller than 1µm. Microparticles have size from 1 to 1000µm. Beads have size in a millimeter range. We have rounded bead size to the first decimal place.

Also, some authors term their particles ‘microcapsules’. However, we will use this term only if they have demonstrated or at least assumed the presence of a liquid core in their particles. In other cases, we will refer them to as microparticles.

Alginate-chitosan particles

Since alginate is a polyanion and chitosan is a polycation, they can form a polyelectrolyte complex upon mixing, provided both of them are charged, i.e. at suitable pH. This mixture can spontaneously form particles. The pKa of alginate carboxyl group is close to 5, and that of the ammonium group of chitosan is about 6.2 [1].

Alginate-chitosan nanoparticles were prepared by dropwise addition of a chitosan solution containing glutathione into an alginate solution at pH 4, under stirring. If prepared at 0.75 alginate: chitosan ratio, the formed nanoparticles with encapsulated glutathione had the following characteristics: size 361nm, polydispersity index 0.33, zeta potential 27mV [47,48]. At 1.5 alginate: chitosan ratio, the values were 212nm, 0.4 and 23mV, respectively, although the storage stability decreased, making these nanoparticles less suitable for application. In the same way, the pH increase from 5.0 to 6.5 and further caused aggregation [48]. The encapsulation efficiency was 27% [47] or 80% at ratio 0.75 and fell to 1% at ratio 1.5 [48]. The respective investigations were aimed to achieve the synthesis of mucoadhesive nanoparticles with an encapsulated NO donor needed for treat important diseases because of the multifaceted role of NO in vivo. Therefore, encapsulated glutathione was nitrosated inside the nanoparticles by adding sodium nitrite to the solution. S-nitrosoglutathione decomposition at 400µM was delayed by its encapsulation in the nanoparticles. At 18µM encapsulated S-nitroso glutathione was not cytotoxic to cultured Chinese hamster lung fibroblast cells (V79), whereas free S-nitroso glutathione was slightly cytotoxic at the same concentration. This assay could enable the use of these anti microbial nanoparticles in pharmaceutical applications such as wound healing without severe side effects [47,48].

Later, the same technique was used by the same group to encapsulate mercaptosuccinic acid and nitrosate it inside the particles. In this case, the hydrodynamic size of the nanoparticles was ~750nm. The encapsulation efficiency was 89%. Burst release of NO in aqueous solution was followed for 4 hours, although the release in the normal mode continued for 6 hours more. These nanoparticles were assayed for topical application for bovine mastitis. The minimal inhibitory concentration of the nanoparticles for Staphylococcus aureus determined in vitro was 125-250µg/ml. The number of colony forming units was 10-fold and 1000-fold lower after bacteria were incubated with nitrosated nanoparticles at 500µg/ml for 4 and 7 hours, respectively, compared with bacteria growth in the presence of empty nanoparticles at the same concentration and time. The CFU drastically decreased further upon the addition of a second dose of nitrosated nanoparticles. For E. coli the minimal inhibitory concentration exceeded 2000µg/ml, i.e. these nanoparticles were inefficient against this bacterium. The 50% cytotoxicity concentration of the nanoparticles for cultured HEp-2 cells was 640µg/ml. Chitosan nanoparticles without alginate at the same concentrations of the acid released more NO at higher rates. Nevertheless, it was concluded that NO-releasing nanoparticles might be used to combat bacteria for treating and preventing bovine mastitis [49].

Spherical alginate-chitosan beads with encapsulated lemongrass oil having size of 1.8-2.1mm displayed significant antibacterial and antioxidant activity. For unencapsulated oil the same activity was observed only at higher concentration. This beneficial action was attributed to the strong interaction between chitosan and the oil. This kind of beads has potential applications as a greener agent for medical purposes [50].

The following advantages of alginate-chitosan particles can be underlined:

• Chitosan can enhance drug bioavailability by its capacity of infiltration into the mucus layer of the small intestine with subsequent opening of tight junctions of epithelial cells [51].

• Unlike calcium alginate, alginate-chitosan polyelectrolyte complex cannot be disintegrated by chelatoring agents. Their main disadvantage could be the necessity to use an acidic solution of chitosan because of its insolubility at neutral pH.

Preparation of alginate particles without employing gelation

Now we describe the techniques for preparation of particles from bulk sodium alginate or its solution as well as spontaneous formation of particles of modified alginic acid in water. The resultant particles are usually intended to be ready to use. However, dry sodium alginate particles can be later treated with CaCl2 solution in order to convert them to calcium alginate particles.

There exists a patented technique for producing alginate, cellulose, starch or collagen particles from bulk substances by ball milling with the possibility to control particle size from 100nm to 50µm. The resultant nanoparticles containing therapeutic proteins have shown efficacy in treating solid tumors, single dose vaccination, and oral delivery. For instance, tumor-bearing mice that received these nanoparticles containing Texas red and cisplatin showed significant tumor size diminishing. If the same nanoparticles were coupled to dendritic cell-binding peptide and contained encapsulated pneumococcal surface protein A, together with an adjuvant, they were effective to combat the bacterial load of the mice that was reduced (in the terms of infected tissue volume) after exposition to nanoparticles. The nanoparticles produced by the same milling technique were also used to induce passive immunity against anthrax toxin in mice by means of oral delivery of monoclonal antibodies developed versus anthrax toxin [52].

Another technique consists in dropwise addition of pure ethanol or acetone to 1% sodium alginate in water containing drug solution in dimethyl formamide. Mixing [53] and cooling down to 3-5 °C is needed during the process. At low mixing speed aggregation was observed [54]. These microparticles can be separated by filtration, washed with the same solvent and dried on air, in a heating oven [53] or in a desiccator [54]. Using nitrofurazone as an example of an encapsulated drug, the loading efficiency and yield of microparticles decreased as the particle size increased from 5 to 30μm with ethanol dripping rate increasing. The presence of 0.1% ammonia [54] (pH 8-9) and of a surfactant was needed in order to avoid particle aggregation in the case of nitrofurazone. Other drugs, viz. acridone, tetracycline, dibazole and metronidazole were encapsulated in the same way (but without ammonia), although the encapsulation conditions needed to be optimized for every drug separately. The yield varied from 31% for metronidazole to 77.5% for tetracycline, and the loading efficiency varied from 2% for metronidazole to 43% for nitrofurazone [53]. In a later publication, the same group reported that in the case of nitrofurazone the yield of microparticles was 81% with a loading efficiency of 34%. Spray drying instead of filtration was recommended to increase the yield [54]. The stability of nitrofurazone-loaded microparticles resuspended in water was reported to increase with pH [53]. At 1% and 2% of particles (nitrofurazone concentration was 0.34% and 0.68%, respectively) these solutions were more active against E. coli, P. aeruginosa, P. vulgaris, S. aureus and B. subtilis than aqueous nitrofurazone solution having drug concentration less than 0.02% because of its insolubility. In the case of Candida albicans the same solutions of microparticles excelled in antifungal activity nitrofurazone solutions in DMSO with the concentrations of 1% and 2% [54]. The ability of the particles to form stable suspensions and to enhance drug solubility in water broadens the field of drug application [53,54]. The encapsulated drugs are expected to be more stable under ambient conditions [53].

Spray drying the sodium alginate solution containing the payload (caffeine-loaded peptidic nanoparticles) yielded microparticles having size of about 4μm. The crosslinking with CaCl2 solution increased their mean size to 7.4µm but decreased their shrinkage and slowed down the release of caffeine into simulated gastric fluids. The particles are potentially bioactive because of the presence of antioxidant peptides [55]. Spray drying the solution containing sodium alginate, pectin and gentamicin sulfate at inlet temperature of 90 ºC was used for wound dressing preparation. The volume diameter at the 50th percentile (spanning from 310 to 1003nm for various samples), the width of particle size distribution, water content and drug release rate increased with nozzle spray mesh diameter and with feed solution concentration at constant ratio of the components. Flowability of the powders, the adhesive strength of the gel formed from them in contact with simulated wound fluid as well as its activity at 0.25mg/ml of gentamicin sulfate against Staphylococcus aureus and Pseudomonas aeruginosa showed the opposite tendency. Antimicrobial activity was expressed as the diameter of the zones of clearance around the two samples spotted on agar plates with the spread bacterial culture after incubation for 24 hours. For Staphylococcus aureus the activity of two samples was also tested in culture medium after 3, 6, 9 and 12 days of incubation. The particles were mainly spherical, but other shapes appeared when either feed concentration or mesh nozzle increased, and further increase led to large collapsed particles. All the particles were composed of smaller aggregated particles. The encapsulated drug was being released in simulated wound fluid in Franz-type diffusion cells for up to 5 days. Loading efficiency was around 24-27% with an encapsulation efficiency between 70 and 83%, and for all the samples initial burst release was observed. At 40 °C and 75% relative humidity drug content was preserved for 6 months with only slight increase in water content. Swelling rate in contact with simulated wound fluid depended on particle size. The yield increased with feed solution concentration but decreased with nozzle spray mesh diameter. The nanoparticulate powder may be used as a self-consistent formulation having great potential application in the treatment of both acute and chronic infected wounds [56].

Low molecular weight alginic acid prepared by acid hydrolysis of sodium alginate formed nanoparticles itself (without calcium ions) when its hydroxyl groups were functionalized with oleoyl residues. The nanoparticles were loaded with vitamin D3 by addition of its solution to the reconstituted solution of vacuumdried nanoparticles. Loading efficiency increased with the vitamin concentration from 0.3 to 0.9%, but the encapsulation efficiency also decreased from 68% to 46%. Mean nanoparticle hydrodynamic diameter also decreased from 559nm to 305nm, and particle formation rate was sped up when substitution degree increased. An unimodal particle size distribution was revealed. In simulated gastric fluid they retained spherical shape and released ~40% of the encapsulated vitamin for 3 hours. But in simulated intestinal fluid they became irregularly shaped, their hydrodynamic diameter was 757nm and burst release of 40% of the vitamin occurred, with 60% of the vitamin released after 7 hours. The nanoparticles can be used as oral carriers for liposoluble nutraceuticals [57]. The great disadvantage of sodium alginate particles is the very limited possibility of prolonged drug release because of sodium alginate solubility leading to fast disintegration of the particles. The particles of modified alginic acid offer convenient manipulation, but the need of its prior chemical functionalization limits the applicability of the technique for non-specialized, e.g. biomedical laboratories.

Production of Alginate Particles Using Other Particles as Cores

In this method, sodium alginate is physically adsorbed or covalently linked to the surface of other particles. The particles can also be formed already capped with alginate. In some cases subsequent gelation with CaCl2 is carried out. For CaCO3 particles there is a possibility of their generation simultaneously with alginate gelation.

Dropwise addition of chitosan nanoparticles with encapsulated bovine serum albumin modified with rhodamine isothiocyanate to sodium alginate solution at controlled pH yielded negatively charged nanoparticles having hydrodynamic diameter of several hundred nanometers depending on the solution composition. The highest diameters were registered in water. The nanoparticles successfully delivered the protein into cultured cells, with the localization depending on cell type. Significant increase in peroxide production by HCEC cells was observed at 300 and 600µg/ml of empty nanoparticles after exposure for 4 hours. However, there was almost no superoxide production after either 4 or 24 hours of exposure. The metabolic activity of LN229 and MCF-7 cells remained unchanged for up to 72 hours of incubation with the empty nanoparticles. But MDA-MB-231 and HCEC cells displayed significantly decreased metabolic activity at nanoparticle concentration above 180µg/ml after 72 hours of exposure, but not after 24 hours. Similar survival decrease at these concentrations of nanoparticles was observed for A549 cells. Dose dependencies acquired after 24 or 72 hours of exposure were almost the same. Survival of HT29 and CaCO2 cells was significantly increased only after exposure to 600µg/ml of the nanoparticles for 72 hours. The nanoparticles have potential applicability as nanocarriers in cancer therapy [58]. A similar technique was used for enoxaparin encapsulation. The proposal was to evaluate nanoparticles loaded with this low molecular weight heparin for its oral delivery, controlled and prolonged release in order to improve patient compliance. In this, chitosan nanoparticles were covered with sodium alginate (applied in phosphate buffer) and treated with CaCl2 . Parameters of the optimized formulation were as follows: average size 335nm, spherical, polydispersity index 0.37, zeta potential –31mV, encapsulation efficiency >70%, drug release in simulated gastric fluid for 2 hours 2%, in simulated intestinal fluid for 14 hours ~60%. Degradation and erosion of nanoparticles was identified as a possible drug release mechanism. The pharmacokinetic parameters of the drug given orally to fasted rats through cannula in a dose of 50mg/kg body weight were improved. Nevertheless, those of intravenously administered free enoxaparin at 1mg/kg were better. 75% of the encapsulated drug applied at 2mg/ml reached across the intestine to the serosal fluid for 90 minutes, as shown in vitro by means of everted intestinal sac model. 900 IU of orally administered encapsulated drug reduced thrombus formation by 59% compared with buffer. Significant uptake of the nanoparticles by the intestinal mucosa for 1 hour was shown by administration of nanoparticles loaded with fluorescein isothiocyanate instead of the drug through gastric cannula to fasted rats. Therefore, the nanoparticles proved their utility as oral delivery vehicle for enoxaparin. Such a vehicle is a foremost requirement for non-invasive and non-hospitalized treatment of vascular disorders (deep vein thrombosis, pulmonary embolism and venous thromboembolism). But subcutaneously injected free drug was even better [51].

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Tuesday, 6 December 2022

Lupine Publishers| QSAR and Molecular Docking Studies of Serotonin Derivatives

 Lupine Publishers| Journal of Drug Designing & Intellectual Properties


Abstract

Serotonin, 5-hydroxytryptamine, represents a class of monoamine neurontransmitters, all of which having a chemical template comprised of a basic amino group separated from an aromatic nucleus by a two-carbon aliphatic chain. In this paper we present a docking study on serotonin targeting the proteins 3ADX and 2YX8, respectively, performed by AutoDock Vina. A set of thirtyfive serotonins, downloaded from PubChem, was modeled, within the hypermolecule strategy; the predicted activity was LD50 and prediction was done on similarity clusters with the leaders chosen as the best docked ligands on the Peroxisome proliferatoractivated receptor gamma. It was concluded that LD50 of the studied serotonins is not directly influenced by their binding energies to the target proteins.

Keywords: Serotonin; Docking; Binding affinity; 3ADX; 2YX8; Hypermolecule; LD50; QSAR

Introduction

Serotonin is a neurotransmitter involved in a wide variety of behaviors, including feeding and body-weight regulation, social hierarchies, aggression and suicidality, obsessive compulsive disorder, alcoholism, anxiety, and affective disorders [1-3]. Peroxisome proliferator-activated receptors are ligandactivated transcription factors that regulate genes important in cell differentiation and various metabolic processes, especially lipid and glucose homeostasis [4].

Receptor activity-modifying proteins (RAMPs) are a class of proteins that interact with and modulate the activities of several Class B G Protein-Coupled Receptors including the receptors for secretin, calcitonin (CT) and glucagon, RAMPs complex with Sumatriptan molecule [5].

A method is described to dock a serotonin into a binding site in a peroxisome proliferator-activated receptor gamma on the basis of the complementarity of the inter-molecular atomic contacts. Docking is performed by maximization of a complementarity function that is dependent on atomic contact surface area and the chemical properties of the contacting atoms [6].

Serotonin is metabolized in cells of the brain, gastrointestinal tract, liver, lungs and platelets; it exerts its effect on endothelial cells through multiple receptors [7].

A pharmacophore model can be established either in a ligand based manner, by superposing a set of active molecules with low binding energy [8] and extracting common chemical features that are essential for their bioactivity, or in a structure-based manner, by probing possible interaction points between the protein target and serotonins [9,10].

In our previous work [11], we performed a QSAR study on a set of serotonins, by the similarity cluster prediction approach, proposed by TOPO Group Cluj. In this paper, a docking study, performed to identify the geometric description of the pharmacophore in the interaction of this class of ligands with the peroxisome proliferatoractivated receptor gamma, is reported. We developed a new approach by creating similarity clusters using as leaders those ligands showing the best scores in the docking test.

Docking Study

A set of 35 derivatives of serotonin were taken from PubChem Database [12] and were divided into a training set (25 molecules) and a test set (10 molecules, in Italics), taken with the lowest docking energy (Table 1). The property chosen for modeling was LD50 (on rat, intraperitoneal route administered).

The molecular docking study was carried out to explore the binding mode of serotonin derivatives (Table 2) within the binding energy of peroxisome proliferator-activated receptor gamma 3ADX and Receptor activity-modifying protein 1 2YX8.

Table 1: Serotonin molecular structures (in SMILES code) and LD50 (taken from PubChem).

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Table 2: List of Molar Mass, Molecular Formulas and Torsions of the Ligands.

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Figure 1:The proteins (Peroxisome proliferator-activated receptor gamma left, Receptor activity-modifying protein 1 right) (RCSB PDB CODE: 3ADX, 2YX8).

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Molecular graphics laboratory (MGL) tools and AutoDock4.2 was downloaded from www.scripps.edu [14]. We employed the Lamarckian genetic algorithm (LGA) for ligand conformational searching [15]. AutoDock Tools was used for creating PDBQT files from traditional PDB files. The grid menu is toggled [16]; after loading protein. pdbqt the map files were selected directly with setting up the grid points appropriate for the searching of ligand within the active site of the protein molecule. This way the grid parameter files are created with setting up the map files directly. The docking parameter files were completed by using the Lamarckian genetic algorithm [17].

(Figure 2) illustrates the final Lamarckian genetic algorithm docked state: binding energy of ligands with the active site of Peroxisome proliferator-activated receptor gamma (3ADX). Docking energies lie in the range: -7.0 and -5.1kcal/mol. It seems that the higher the number of rotatable bonds, the higher the ligand–enzyme affinity is.

The distribution of the docking energy (Figure 2) may be attributed to the differences in position of the functional groups within the studied compounds. Interaction of the ligand with the protein can be seen in (Figure 3).

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Wednesday, 7 September 2022

Lupine Publishers| Antidiabetic Plant Extracts

 Lupine Publishers| Journal of Drug Designing & Intellectual Properties


Abstract

Diabetes mellitus is a chronic health problem with long term consequences that are potentially preventable. It is a heterogeneous group of disease, characterized by high blood glucose levels resulting from impaired insulin secretion, impaired insulin action, or both. There are several synthetic antidiabetic drugs. These include Insulin Secretagogues (Sulfonylureas), biguanides, Thiazolidinediones, α- Glucosidase, Glucagon. Although, antidiabetic agents such as insulin, biguanides, thiazolidinediones and α glucosidase inhibitors are available in Guyana to treat diabetes, a safe and effective treatment paradigm is yet to be achieved. This is due to that fact that these drugs fail to significantly reduce the course of diabetic complications and have limited use because of their undesirable pathological conditions and high secondary failure rates. Therefore, it is essential to discover more effective antidiabetic agents with few adverse effects, low costs and ease of accessibility. In recent years, there has been a resurgence of interest in medicinal plants for the treatment of diseases. A World Health Organization (WHO) study shows that 80% of the world’s population solely relies on medicinal plants for their primary health care needs. Medicinal plant extracts, having antidiabetic properties can be a useful source for the development of oral hypoglycemic agents in both animal models and human subjects. Over 350 plants are used in the treatment of diabetes mellitus, but only a small number of these plants had gained scientific and medical evaluation to assess their effectiveness and efficacy

Keywords: Diabetes; Chronic; Synthetic antidiabetic drugs; World Health Organisation; WHO

Introduction

Diabetes mellitus is a chronic health problem with long term consequences that are potentially preventable. It is a heterogeneous group of disease, characterized by high blood glucose levels resulting from impaired insulin secretion, impaired insulin action, or both [1-4]. In a hyperglycemic state, the body tries to remove excess glucose by excreting in the urine. This increases urine output, causing glycosuria and result in frequent thirst. In addition, the body is deprived of glucose energy and seeks alternative energy sources such as fats and muscle tissues, leading to weight loss [5]. A diminishing growth effect and increased predisposition to certain infections, may also be present with chronic hyperglycemia [1]. These combinations along with polyuria, polydipsia, polyphagia, and blurry vision produces the common symptoms of diabetes [6]. As this disease progresses, vascular damage ensues leading to severe diabetic microvascular and macrovascular complications [7]. Therefore, diabetes covers a wide range of diseases which are the major causes of chronic morbidity and death in diabetic subjects [8].

Being described as the “the perfect epidemic” this condition affects an estimated 387 million people worldwide. According to the WHO [9], the incidence of diabetes has risen dramatically over the past years with a current prevalence of 9% and it is expected to affect more than 500 million adults by 2030. North America and the Caribbean are the regions with a higher prevalence of 11%, having 37 million people affected. In 2012, an estimated 1.5 million deaths were directly caused by diabetes, with 80% deaths occurring in low and middle-income countries [9-11].

Table 1: IUPAC name for several synthetic antidiabetic drugs.

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There are several synthetic antidiabetic drugs. These include Insulin Secretagogues (Sulfonylureas), biguanides, Thiazolidinediones, α- Glucosidase, Glucagon [12] etc. The structure of some of these drugs are shown in Figure 1. The scientific name is given in Table 1. Interestingly, most of these drugs seem to incorporate the urea linkage.

Figure 1:Antidiabetic drugs.

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Although, antidiabetic agents such as insulin, biguanides, thiazolidinediones and α glucosidase inhibitors are available in Guyana to treat diabetes, a safe and effective treatment paradigm is yet to be achieved. This is due to that fact that these drugs fail to significantly reduce the course of diabetic complications and have limited use because of their undesirable pathological conditions and high secondary failure rates. Therefore, it is essential to discover more effective antidiabetic agents with few adverse effects, low costs and ease of accessibility [12]. Synthetic drugs currently in use for diabetic treatment have undesirable side effects, including weight gain, hypoglycemia, nausea and diarrhea. These contributes a great deal to non-compliance in patients which can lead to further deleterious progression of their condition and result inevitably, in the increased mortality rate of the disease. For this reason, natural hypoglycemic compounds found in plant extracts present an attractive alternative to synthetic drugs or as reinforcements for currently used treatments.

In recent years, there has been a resurgence of interest in medicinal plants for the treatment of diseases [12]. A World Health Organization (WHO) study shows that 80% of the world’s population solely relies on medicinal plants for their primary health care needs [13]. Medicinal plant extracts, having antidiabetic properties can be a useful source for the development of oral hypoglycemic agents in both animal models and human subjects [1]. Over 350 plants are used in the treatment of diabetes mellitus, but only a small number of these plants had gained scientific and medical evaluation to assess their effectiveness and efficacy [5]. For the management of diabetes, the World Health Organization (WHO) has recommended the evaluation of traditional plant treatments as they are effective, non-toxic, with little or no side effects and are considered to be excellent candidates for oral therapy [6].

The anti-diabetic activity of Psidium guajava have been reported [7,9]. For example, a study to evaluate the hypoglycemic potential of the aqueous extract of Psidium guajava unripe fruit peel on blood glucose level (BGL) of normal and streptozotocin induced mild and severely diabetic rats has been undertaken. This study revealed that the fruit peel of P. guajava had marked hypoglycemic effect [7].

A study to test for the hypoglycemic potential of the ethanolic extract of Psidium guajava leaves on normal and alloxan induced diabetic rats have been reported[8]. After 21 days of administering the ethanolic leaf extracts, blood glucose was found to attain normal levels in the plasma of the Psidium guajava treated rats. However, in this study, adequate results were not obtained to indicate sufficient evidence of anti-hyperglycemic activity of Psidium guajava . Nevertheless, the study confirmed that P. guajava has some form of hypoglycemic action, as is evident in prior research carried out on the species [9,10].

The antidiabetic activity of T. indica extract (100mg/kg and 200mg/kg) and standard compound glibenclamide were investigated [11]. A significant decrease of blood glucose level in treated diabetic rats compared to untreated diabetic rats (227.10mg/dL), p < 0.01 was observed. The glibenclamide produced a reduction in blood glucose to 127.32mg/dL which was lower than the 100mg/kg dose, resulting in a decrease in blood glucose to 133.27mg/dL [13].

The hypoglycemic and hypolipidemic activities of an ethanolic extract of Averrhoa bilimbi Linn. leaves Italised Oxalidaceae in streptozotocin (STZ)-diabetic rats have been reported. The beneficial effects of the ethyl acetate fraction of A. bilimbi fruit (ABAEE) on the antioxidant/oxidant status in diabetes mellitus rats have also been reported [14,15].

Antidiabetic effect of the ethanolic extract of Phyllanthus emblica fruits in evan rats has been reported and is dose dependent [16]. The anti-hyperglycemic effect of Quercetin, a major constituent of the methanolic extracts of Phyllanthus emblica fruit in Streptozotocin (STZ) induced diabetic rats were determined[17].

The hypoglycemic effect of the aqueous extract of the fruits of Psidium guajava, Averrhoa bilimbi and the peel of Tamarindus indica on normoglycemic guinea pigs have been reported by us [18]. The guinea pigs were divided into three groups of three: control group, aqueous fruit extract treatment group at a dose of 6ml/kg) and glibenclamide treatment group (with the dose 2.5mg/ kg). Guinea pigs received treatment twice daily for 12 days for each fruit and peel. Blood glucose and body weight were measured before treatment and between three days interval. Additionally, each plant extract at the dose of 6ml/kg was orally administered for glucose tolerance test during 120 minutes study in comparison to glibenclamide at the dose of 2.5mg/kg. Administration of extracts of Psidium guajava, Tamarindus indica and Averrhoa bilimbi resulted in a marked hypoglycemic (reduction) activity in blood glucose levels when compared to the control and Glibenclamide treated group on the 12th day: Psidium guajava (90±3.0 to 75.7±3.5mg/ dL), Tamarindus indica (89.0±5.6 to 70.7±2.1mg/dL) and Averrhoa bilimbi (110.0±9.2 to 86.7±10.0mg/dL). Glibenclamide also resulted in a reduction (88.0±2.0 to 67.3±3.5mg/dL) as compared to the control.

There are several herbs that are used to treat diabetes locally and internationally [19-23]. Locally Momordica charantia [19], an herbaceous, tendril-bearing vine contains a compound called charantin, which have hypoglycaemic effect. It has been found to increase insulin sensitivity. A daily dose of 100mg per kilogram of body weight is comparable to 2.5mg/kg of the anti-diabetes drug glibenclamide taken twice per day. Other compounds in M.charantia have been found to activate the AMPK, the protein that regulates glucose uptake. The whole plant is used as a decoction for diabetes. The dry leaf and stem are boiled and the water drunk as an anti diabetic. The fruit is cooked and eaten as an anti diabetic. Use with almond oil for a vulnerary. Tablets of M.charantia extract are sold in the United Kingdom.

Phyllanthus niruri [19] contains alkaloids, flavonoids and triterpenes. The whole plant is used as a blood purifier (bitter tonic) to reduce blood sugar level. It’s available as capsules. Cajanus cajan [19], Pigeon peas contain high levels of protein and the important amino acids methionine, lysine, and tryptophan. Leaves and flowers are boiled for a diuretic and diabetes remedy. The whole plant of Desmodium barbatum [19] is use to reduced blood sugar level. The wood of the plant, Telitoxium [19] is used for diabetes. The active adaptogenic constituents of Tinospora cordifolia [19] are diterpenoid compounds: polyphenols, and polysaccharides, including arabinogalactan polysaccharide. T. crispa and T. rumphii are used in Thailand and Philippines for treatment of diabetes. A decoction of the leaves of Azadirachta indica [19], Neem is used as a bitter tonic for treating diabetes and jaundice [20]. Internationally, the juice of the leaves of Abrus precatorius are given to diabetic patients. Achyranthes aspera [21-23] is used as a decoction in the treatment of diabetes mellitus. Likewise, the roots of Catharanthus roseus is used as decoction in the treatment of diabetes mellitus. The entire plant of Centella asiatica [21-23], is also used as a decoction in the treatment of diabetes mellitus [18- 23]. Curcuma longa is a rhizomatous herbaceous perennial plant which is used in the treatment of diabetes mellitus. Phyllanthus emblica [21-23], edible fruits are antidiabetic in nature. Piper bettle [21-23] leaf extract is used in the treatment for diabetes mellitus. Sphaeranthus indicus [21-23].

Conclusion

Diabetes mellitus is a serious disease worldwide and results in a wide range of ailments in humans. Synthetic treatments include the use of Insulin Secretagogues (Sulfonylureas), biguanides, Thiazolidinediones, α- Glucosidase, Glucagon etc. However, there is a need to continue with herbal treatments. Herbal treatments include plant parts from Momordica charantia , Phyllanthus niruri, Cajanus cajan, Desmodium barbatum , Tinospora cordifolia, Azadirachta indica, Abrus precatorius, Catharanthus roseus, Centella asiatica, Curcuma longa, Phyllanthus emblica , Piper betle and Sphaeranthus indicus. Type II diabetes is most likely to be developed in regions where there sedentary mode of life and lack of physical exercise and the diet is mainly of the Fast Food type. Stress is another factor that contributes to diabetes. Unless effective prevention strategies are implemented, the incidence of diabetes in the world will continue to rise, increasing the already high socioeconomic burden on families and the National Health Care System.

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Tuesday, 26 July 2022

Lupine Publishers| Person’s Foresight about Cause and Tackling of Catastrophe of Dengue Fever

 Lupine Publishers| Journal of Drug Designing & Intellectual Properties



Abstract

Dengue fever is a mosquito born disease. Biting of female mosquito transfer virus in to host through its tentacles and then it multiply, first when host defense mechanism strong it fights with phages after time they become resistant multiply and cause infection that cause dengue fever. Biology students gave their contribution in evaluation of understanding and their views relate to dengue fever. In Pakistan, upper Punjab suffered catastrophe of dengue fever. It was concluded that most subjects claimed mosquito infection was viral, also people claimed it never treated with surgery. Some people understood it can be treated by specific type of medicine, it also not metabolic disease.

Keywords: Phages; Resistant; Catastrophe

Introduction

Dengue fever is commonly cause by the dengue virus that cause infection. This virus spread in the tropical or sub-tropical areas. It is also called mosquito borne illness. Mosquitoes spread diseases without affective themselves. Dengue Virus is a mosquito borne positive single stranded RNA virus. Sudden high fever, severe headaches, eyes pain, fatigue, nausea skin rashes are the symptoms of dengue fever. Bleeding gums, blood vomiting, rapid breathing are the warning signs that can cause severe dengue fever. When mosquito bites symptoms start to show after five to seven days. Sometimes symptoms show after two weeks from biting. Liver, heart, lungs can damage by the dengue fever [1-2]. Objective of the present study was, person’s foresight about cause and tackling of catastrophe of dengue fever.

Materials and Methods

In recent study the subject were hundred students, from the Bahauddin Zakariya University Multan, Pakistan

Project Designing

The topic, for we got views of subjects was person’s foresight about cause and tackling of catastrophe of dengue fever. A questionnaire helped about the visions of the subjects, about dengue fever, the subjects were biology students. In this way subjects visualized their information and knowledge about dengue fever.

Statistical Analysis

MS excel was used to perform the statistical analysis (Table 1-4).

Table 1: Questionnaire to evaluate awareness about etiology of dengue fever.

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Table 2: Questionnaire to evaluate views about prevalence of dengue fever.

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Table 3: Questionnaire to evaluate views about transmission of dengue fever.

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Table 4: Questionnaire to evaluate views about Hope for dengue fever.

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Results

Figure 1: Is dengue infection viral or not?

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Figure 2:Is dengue infection bacterial or not?

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Is dengue infection viral or not? The results are given in (Figure 1). 69% female said it is viral, 25% males said viral, remained claimed no it was not viral. Is dengue infection bacterial or not? The results in (Figure 2). 42% and 45% males and females respectively claimed, no it was not bacterial. Is it being fungal disease? The results in (Figure 3). 42% and 58% males and females understood not fungal infection it was Is Dengue fever, genetic disease? 31% and 69% disease males and females said it is not genetic infection. Results explained in (Figure 4). Is dengue infection metabolic? Results explained in (Figure 5). It observed that 39% and 35% females and males claimed not metabolic infection. Person’s views about prevalence and tackling from catastrophe of dengue fever are given in (Table 5). 100% males and females both claimed that they never effected by the disaster of dengue fever. 22% males subject said that any family member never effected. 49% males said neighbor never effected by such type of infection. 1% female claimed, her fellow suffered from it. 45% males said such type of infection spread from transmission of lymph. 63% males said it is no need of any treatment. Both100% men and women subjects claimed that it never be remedy by surgery

Figure 3:Is it is fungal disease? or not.

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Figure 4: Is dengue fever genetic disease?

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Figure 5:Is dengue infection metabolic?

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Table 5:Prevalence and management of dengue fever.

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Discussion

Questionnaire based study had an important [3-6]. Jahan Asia Public Family Medicine published the paper of Jamal et. al., who discussed the dengue fever in Pakistan, it leads to death in sever condition. International journal of mosquito research published another paper in which it is reported that 71649 people suffered from this disease with 757 deaths. Multiple dengue virus serotypes also affected the persons in India and Srilanka. Uncovered and pure water first habitat of dengue fever, cover self-first also your family it is the foremost tackling of about dengue virus that cause dengue fever.

Conclusion

It was concluded that most subjects claimed mosquito infection was viral, also people claimed it never treated with surgery. Some people understood it can be treated by specific type of medicine, it also not metabolic disease.

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Monday, 28 February 2022

Lupine Publishers| Regulatory Inflation in Pharmaceutical Drug Development?

 Lupine Publishers| Journal of Drug Designing & Intellectual Properties


Opinion

During the last decade, and exponentially over the last three years, numerous pharmaceutical manufacturing plants have closed their doors following current Good Manufacturing Practices (cGMP) audits from various agencies, such as FDA, EMA and Health Canada. Regulatory affairs have been evolving and so should be the audits, auditors and regulations. However, the density and interpretations of regulatory requirements have become increasingly stringent, especially with respect to sterile products, making them more difficult to develop and manufacture within reasonable time and cost. A quick search on Google shows numerous press releases from various pharmaceutical organizations reporting critical/ major deficiencies, leading to temporary or permanent closures of manufacturing plants. Furthermore, it seems that this evolving situation has not only impacted drug shortage, but these events have placed the pharmaceutical industry under a permanent state of siege. The negative impacts of regulatory inflation are a center of attention among pharmaceutical professionals.

This article explores three interrelated components of this regulatory inflation phenomenon.

Regulatory Narrative Leading to Global Inadequacy

The Health Canada (HC) website, more precisely the Drug &Health product inspections section [1] is listing 802 pages of cGMP audit results from virtually all Canadian establishment license holders. Even though compliant, the vast majority of them were listed as having inadequate quality systems. Comments such as: The handling of standard operating procedures for good manufacturing practices was inadequate, the written procedures for recalls were inadequate, the education, experience, and/ or oversight of the individual in charge of the quality control department was inadequate, to name but a few, can be read everywhere across the site. Compliant CMOs complain privately that labeling them as inadequate on the public domain, resulted in drops of direct business revenues and a weakening of their competitiveness. Indeed, foreign clients that would like to export their business in Canada are misinformed through HC website and get the impression that Canadian CMOs are problematic. In contrast FDA and EMA do not publish the same kind of data, through detailed documents and audit reports from compliant organizations. At the FDA cGMP audit reports exist and are on the public domain but recently both EMA and FDA have published the first report from the FDA-EMA pilot program for the parallel assessment of qualityby- design elements of marketing applications [2].

Regulatory Inflation: The Emergence and Growth

Originally, regulatory compliance was an integral part of the pharmaceutical industry. Over the last 20 years compliance has evolved to a separate industry, generating multi-billion dollars of revenues. By definition this new autonomous industry must continue to grow, and this growth is mediated via the creation of new, increasingly sophisticated requirements and guidelines. More over, the costs of compliance audits have all been transferred, directly or indirectly, to the industry. Twenty years ago, regulatory auditors were essentially testing and measuring compliance to operating procedures. Today it is the manufacturers who are paying very competent specialists from the compliance industry to piously prepare risk analysis, gap analysis, trending analysis, CAPA etc., on all aspects of operations, and present them to public or private regulatory agencies (e.g. ISO system) as proof of compliance. In parallel with this regulatory requirement inflation, there was an emerging of regulatory consulting firms [3]. In an ideal world, the compliance industry must help the manufacturers it regulates because they generate the economy, the profitability, and the taxes that drive the country. Nowadays, it looks like the compliance industry has developed in less than 25 years everything but a symbiotic relationship. And let.com be clear, there are no villains or conspiracy here: it is a systemic social problem caused by out-ofcontrol human factors: a form of conflict of interest between two groups that should work together.

Generational Turnover of Inspectors and Auditors

As a professor of drug development, I have been training graduate students in scientific and regulatory affairs for two decades. This training attempts to bridge the gap between the theory of a basic research undergraduate training and the reality that will be faced in the industry. Over the years I have noticed that most of the conformity auditors were people with hands-on experience in the past in their field of expertise, meaning that they had the necessary experience to bridge the gap between theory and reality. During the last decade, a younger and ambitious auditor profile, showing a lower hands-on experience level, a more reactive than proactive behavior, and an apparent a lack of sustainability taught by seasoned colleagues, has become the conformity auditing landscape. This new generation of regulatory enforcers are highly knowledgeable in regulatory requirements. However, the lack of “hands-on” expertise makes more difficult for them to bridge the gap between theory and practice. Most of my ex-students work in the industry and all their testimonies are pointing in that sense, even though, as described in Costanza et al. [4] Meta-analysis showed that “generational differences do exist on work-related outcomes, they are relatively small and the inconsistent pat-tern of results does not support the hypothesis of systematic difference.

The gravity of regulatory inflation is only beginning to be measured. It used to be relatively easy for a group of young and ambitious entrepreneurs to build, with a reasonable amount of money, a pharmaceutical CMO. The density of regulations was lower, and the way these regulations were managed were based on audits, or inspections from regulatory agencies sustained by the states. These entrepreneurs form that generation has been raised with these inflationist regulatory constraints.Today, the cost of managing compliance has become so disproportionate that there is no young company pushing behind: No succession. Our opinions on this problem are very visceral: the fact that young graduates cannot practically do the same thing as we are doing because of regulatory inflation should be deeply studies, dug and understood. As a professor andconsultant in product development, I do think that the primary duty of parents is to keep the context of opportunities they have had and transfer it to their children. The Canadian federal government has passed the law that recognizes the problem and provides solutions, “the Red Tape Reduction Act” but this law is not retroactive to heal the harm already done [5]. At the light of these comments, it is difficult to see how the wave can be modified, since it has already started to be painful, by looking at all the companies that have already closed. However, it should be extremely clear that the definition of the word “culture” is the following: Culture is the body of knowledge, know-how, traditions, customs, specific to a human group, to a civilization. It is transmitted socially, from generation to generation and not by genetic inheritance, and largely conditions individual behavior. It means that people, firms and agencies working directly or indirectly in conformity should be advertised in that regards in order to start a paradigm shift and to make the pharmaceutical industry evolving under a progressive way, where all the actors could benefit of it. It is interesting to note that this regulatory inflation does not only affect the pharmaceutical industry, but several other industries, such as the aviation [6] and as the article is mentioning: As the second most geographically vast nation in the world and with a small, open economy, Canada is dependent on air transportation like almost no other country [7].

Conclusion

The author of this article had the chance to be part of the tail of the “golden age” of the pharmaceutical industry. Indeed, I had the chance, regardless of my “specialty” to share, discuss and see how the development was going, from basic research through all the steps that were needed to develop a drug, making myself “hands on” on all the steps that were, and are still needed to file a new drug product successfully. For that reason, I have been raised “holistically” under a “regulated” way of thinking in non-clinical, clinical, CMC, and regulatory affairs so that it was possible for me to understand, to share the same languages than the auditors, whether they were coming from private firms or government agencies. Things have changed (and not evolved) in that regards. For example, if current auditors have never had the chance of being part of a blending operation, it will be very difficult for them to realize if a speed of 10,000rpm would be realistic for a blender impeller. On the other side, they will know better than all of.com the guidelines saying that this or that should be done according to this or that, as written in the page 5 of the FDA/EMA/EP/JP…. Guidelines.

The cost of managing compliance has become such that it has become virtually impossible to start a business without having a lot of money to build large “quality systems” from scratch.

Of course, we do not have proximity expertise in all the other highly regulated field such as commercial aviation to assert anything, but according to what we have seen over the past ten years, the trend is similar, as in other regulated businesses.

As a professor teaching drug development, the next steps could be:

a) To conduct a confidential survey in the industry on the effect of this HC website that is showing relatively clearly this regulatory inflation on the Canadian exportation potential of pharmaceutical product and services.

b) To monitor if there is a correlation between company closures and regulatory affairs and conformity consulting service companies.

Please note that this article strictly represents the point of view of the author based on his expertise and experience.

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