Prodrug Approaches for Enhancing the Bioavailability of Drugs with Low Solubility

Low water solubility and low bioavailability are frequent problems in drug development, particularly in the area of central nervous system (CNS) drugs. This short review describes selected prodrug approaches which have been developed to enhance the bioavailability of drugs, especially that of poorly soluble drugs. Some of the most successful drugs on the market are prodrugs. With a better understanding of active‐transport processes at cell membranes in the gut as well as at the blood–brain barrier, the importance of prodrug approaches will further increase in the future. Prodrug approaches will already be considered in the early phase of drug discovery.     

New Ideas about the Solubility of Drugs

Methods are described for detecting precipitation of ionisable drugs under conditions of changing pH, estimating kinetic solubility from the onset of precipitation, and measuring solubility by chasing equilibrium. Definitions are presented for kinetic, equilibrium, and intrinsic solubility of ionisable drugs, supersaturation and subsaturation, and for chasers and non‐chasers, which are two classes of ionisable drug with significantly different solubility properties. The use of Bjerrum Curves and Neutral‐Species Concentration Profiles to depict solubility properties are described and illustrated with case studies showing super‐dissolving behaviour, conversion between crystalline forms and enhancement of solubility through supersaturation, and the use of additives and simulated gastrointestinal fluids.     

On the Modeling of Some Anti-inflammatory and Anti-thrombotic Drugs by AM1

Two families of autacoids from cell membrane phospholipids have been identified. The first, the icosanoids, which are formed from arachidonic acid, include prostaglandins and leukotrienes. The other includes modified phospholipids, as the platelet aggregating factor (PAF). These compounds are related to inflammatory and cardiovascular diseases. We review in this paper some of the work that has been done in our laboratories in the last few years relating to the modeling of new potential thromboxane synthase (TXS) and 5-lipoxygenase (5-LO) and cyclooxygenase (COX) inhibitors, and TXA₂ receptor antagonists derived from nitrogenated heterocycles. We include the results of the modeling of a group of proposed PAF antagonists, and compare their structures with PAF itself and with a recently proposed PAF antagonist model. This revised version was published online in June 2006 with corrections to the Cover Date.     

Some Properties of Plackett and Hewlett's Model for the Joint Action of Drugs

The model of PLACKETT and HEWLETT (1963) for the joint action of mixtures of drugs in the case of quantal response is discussed in terms of isobols. The model is shown to be able to fit quite different types of joint actions.     

Efficacy and Safety of Oral Antidiabetic Drugs in Comparison to Insulin in Treating Gestational Diabetes Mellitus: A Meta-Analysis

Objective

To assess the efficacy and safety of oral antidiabetic drugs (OADs) in gestational diabetes mellitus (GDM) in comparison to insulin.

Methods

A meta-analysis of randomized controlled trials was conducted. The efficacy and safety of OADs in comparison to insulin in GDM patients were explored. Studies were identified by conducting a literature search using the electronic databases of Medline, CENTRAL, CINAHL, LILACS, Scopus and Web of Science in addition to conducting hand search of relevant journals from inception until October 2013.

Results

Thirteen studies involving 2,151 patients met the inclusion criteria. These studies were randomized controlled trials of metformin and glyburide in comparison to insulin therapy. Our results indicated a significant increase in the risk for preterm births (RR, 1.51; 95% CI, 1.04–2.19, p = 0.03) with metformin compared to insulin. However, a significant decrease in the risk for gestational hypertension (RR, 0.54; 95% CI, 0.31–0.91, p = 0.02) was found. Postprandial glucose levels also decreased significantly in patients receiving metformin (MD, −2.47 mg/dL; 95% CI, −4.00, −0.94, p = 0.002). There was no significant difference between the two groups for the remaining outcomes. There were significant increases in the risks of macrosomia (RR, 2.34; 95% CI, 1.18–4.63, p = 0.03) and neonatal hypoglycemia (RR, 2.06; 95% CI, 1.27–3.34, p = 0.005) in the glyburide group compared to insulin whereas results for the other analyzed outcomes remained non-significant.

Conclusion

The available evidence suggests favorable effects of metformin in treating GDM patients. Metformin seems to be an efficacious alternative to insulin and a better choice than glyburide especially those with mild form of disease.     

Nanocapsules: A Novel Lipid Formulation Platform for Platinum-based Anti-cancer Drugs

Platinum-based anti-cancer agents have been used for many years to treat many different types of cancer. However, the efficacy of these drugs is limited by serious side effects. One of the strategies to reduce the side effects is encapsulation of the drug in a lipid formulation. Recently, we discovered a novel method for the efficient encapsulation of cisplatin in a lipid formulation. The method is unique in that it does not generate conventional liposomes but nanocapsules: small aggregates of solid cisplatin covered by a lipid bilayer. Also carboplatin, a cisplatin-derived anti-cancer drug with different chemical properties, can be efficiently encapsulated by a similar method. The encapsulation in nanocapsules dramatically improves the in vitro cytotoxicity of the platinum drugs. Our results hold the promise that the nanocapsule technology could prove successful in the efficient encapsulation of many other (platinum-based) drugs, and thereby improve their therapeutic index and profile in vivo.     

Study of Polymorphs of Progesterone by Novel Melt Sonocrystallization Technique: A Technical Note

A large number of pharmaceuticals exhibit polymorphism; 23% steroids, 60% sulfonamides, and 70% of barbiturates have shown this property. In this study, we have investigated and compared a new technique termed as melt sonocrystallization (MSC) with melt and sonocrystallization (SC) for induction of polymorphism in progesterone (PRG). Polymorphs were characterized by DSC, XRD, FT-IR, and FT Raman spectroscopy. Melt sonocrystallized progesterone (MSC-PRG) contained both the polymorphs, more soluble form II along with less soluble form I, whereas melt progesterone (M-PRG) and sonocrystallized progesterone (SC-PRG) contained only form I. Improvement in dissolution characteristics of both the polymorphs were compared and form II was found to be more readily soluble than form I in deionized water. Reduction in mean particle size of PRG during SC was also determined using laser diffractometer. During stability testing (40°C/75% RH) for 1 month, metastable form II of MSC-PRG was found to be transformed into its more stable state. MSC technique was thus found as a useful tool for induction of polymorphism.     

Technical Note: Modelling Soft Tissue Using Biphasic Theory - A Word of Caution

In recent years the biphasic approach initiated by Mow and coworkers, has been very popular in modelling soft, hydrated, cartilage tissues as well as other soft tissues, such as the brain. This work points out that due to the inherent inability of biphasic models in their present form to account for stress-strain rate dependence resulting from the viscoelasticity of the solid phase, the applicability of these models is limited to the loading conditions producing large relative velocities of phases.     

Efficacy of different antidiabetic drugs based on metformin in the treatment of type 2 diabetes mellitus: A network meta-analysis involving eight eligible randomized-controlled trials

Diabetes mellitus is one of the most prevalent metabolic diseases globally and it is increasing in prevalence. It is one of the most expensive diseases with respect to total health care costs per patient as a result of its chronic nature and its severe complications. To provide a more effective treatment of type 2 diabetes mellitus (T2DM), this study aims to compare different efficacies of six kinds of hypoglycemic drugs based on metformin, including glimepiride, pioglitazone, exenatide, glibenclamide, rosiglitazone, and vildagliptin, in T2DM by a network meta-analysis that were verified by randomized-controlled trials (RCTs). Eight eligible RCT in consistency with the aforementioned six hypoglycemic drugs for T2DM were included. The results of network meta-analysis demonstrated that the exenatide + metformin and vildagliptin + metformin regimens presented with better efficacy. Patients with T2DM with unsatisfactory blood glucose control based on diet control, proper exercise, and metformin treatment were included. The original regimen and dose of medication were unchanged, followed by the addition of glimepiride, pioglitazone, exenatide, glibenclamide, rosiglitazone, and vildagliptin. The results of RCTs showed that all these six kinds of drugs reduced the HbA1c level. Compared with other regimens, exenatide + metformin reduced fasting plasma glucose (FPG), fasting plasma insulin (FPI), total cholesterol (TC), and homeostasis model assessment insulin resistance index (HOMA-IR) levels, but increased the high-density lipoprotein (HDL) level; vildagliptin + metformin decreased FPI and low-density lipoprotein (LDL) levels; glibenclamide + metformin decreased the FPG level, but promoted HDL; and glimepiride + metformin decreased the TC level and rosiglitazone + metformin reduced the LDL level. Our findings indicated that exenatide + metformin and vildagliptin + metformin have better efficacy in T2DM since they can improve insulin sensitivity.     

A Specific Effect of Antipsychotic Drugs on Protein Synthesis in Human Lymphomononuclear Cells

We have studied the effects of psychotropic drugs on patterns of protein synthesis in human lymphomononuclear cells by two-dimensional gel electrophoretic analysis. Drugs effective in treatment of schizophrenia specifically increased the relative synthesis of a 30-kDa polypeptide in cultured human lymphomononuclear cells whereas dopamine (DA) or psychoactive drugs lacking antipsychotic properties did not. The effect was stereospecific with respect to the clinically active and inactive isomers of flupenthixol. Synthesis of the 30-kDa polypeptide appears therefore to be correlated with antipsychotic properties but not with DA receptor binding. It is possible that such effects may be associated with the clinically beneficial effect of antipsychotic drugs in the brain.     

双刃剑:自噬与肿瘤发生发展的关系及相关靶点小分子药物研究进展

自噬是哺乳动物细胞内重要且复杂的生理活动,同样影响着肿瘤的发生与进展.随着抗肿瘤药物的广泛使用,肿瘤耐药问题日益突出,影响患者预后.多年研究显示,肿瘤自噬与耐药密切相关.目前,已有越来越多的自噬相关小分子药物被用来调节肿瘤自噬活动,以求其能被广泛运用于抗癌方案之中.该文将针对自噬在癌症发生发展过程中的分子机制及相关小分...