Dextran Microparticulate Inhalable Dry Powder for the Treatment of Cystic Fibrosis and Mucopolysaccharidosis

Background: Cystic Fibrosis (CF) is a genetic disease which affects the patient’s lungs, pancreas, liver, kidney and intestine and lacks sulfatase enzyme, leading to mucopolysaccharidosis. Colistin sulfate acts by interacting with phospholipids of bacterial cell membranes. Sulfatase enzyme reduces the high levels of sulfated glycosaminoglycans and glycolipids by the hydrolysis of sulfate esters in lysosome. Objective: The aim of the present investigation was to prepare and evaluate dextran microparticulate inhalable dry powder for the efficient targeting of colistin sulfate at affected area of lung without causing the side effects in the treatment of CF and mucopolysaccharidosis. Methods: Microparticulate dry powder was prepared by the lyophilization method and evaluated for particle size, % yield, % drug content, solid state characterization, in-vitro lung deposition study, and in-vitro drug release study. Results: Particle size, % yield and % drug content were found to be 4.03 ± 0.196 µm, 94.02 % and 99.45 ± 0.015% respectively. Bulk density, tapped density, hausner’s ratio, carr’s index and angle of repose of optimized batch were found to be 0.216 ± 0.025 g/cm3, 0.236 ± 0.035 g/cm3, 1.09 ± 0.026, 8.47 ± 0.025 % and 26.10 ± 0.029˚ respectively. A fine particle fraction, fine particle dose, mass median aerodynamic diameter, geometric standard deviation and emitted dose were found to be 66.78%, 16.45 mg, 4.89 µm, 1.32 and 246.33 mg respectively. The % CDR of optimized batch was found to be 96.12 ± 0.049 % at 24 h. Conclusion: Based on the obtained results, we conclude that dextran microparticulate inhalable dry powder might be suitable carrier for the delivery of colistin sulfate and sulfatase in combination via pulmonary route for the treatment of cystic fibrosis and mucopolysaccharidosis.

Inhalable Dry Powder of Bedaquiline for Pulmonary Tuberculosis: In Vitro Physicochemical Characterization, Antimicrobial Activity and Safety Studies

Bedaquiline is a newly developed anti-tuberculosis drug, conditionally approved by the United States Food and Drug Administration (USFDA) for treating drug-resistant tuberculosis in adults. Oral delivery of bedaquiline causes severe side effects such as increased hepatic aminotransferase levels and cardiac arrhythmias (prolongation of QT-interval). This study aimed to develop inhalable dry powder particles of bedaquiline with high aerosolization efficiency to reduce the side-effects of oral bedaquiline. Bedaquiline (with or without l-leucine) powders were prepared using a Buchi Mini Spray-dryer. The powders were characterized for physicochemical properties and for their in vitro aerosolization efficiency using a next-generation impactor (NGI). The formulation with maximum aerosolization efficiency was investigated for physicochemical and aerosolization stability after one-month storage at 20 ± 2 °C/30 ± 2% relative humidity (RH) and 25 ± 2 °C/75% RH in an open Petri dish. The cytotoxicity of the powders on A549 and Calu-3 cell-lines was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The powders were also evaluated for antimicrobial activity against Mycobacterium tuberculosis. The aerodynamic diameter of the l-leucine-containing powder was 2.4 µm, and the powder was amorphous in nature. The aerosolization efficiency (fine-particle fraction) of l-leucine-containing powder (fine-particle fraction (FPF): 74.4%) was higher than the bedaquiline-only powder (FPF: 31.3%). l-leucine containing powder particles were plate-shaped with rough surfaces, but the bedaquiline-only powder was spherical and smooth. The optimized powder was stable at both storage conditions during one-month storage and non-toxic (up to 50 µg/mL) to the respiratory cell-lines. Bedaquiline powders were effective against Mycobacterium tuberculosis and had a minimal inhibitory concentration (MIC) value of 0.1 µg/mL. Improved aerosolization may help to combat pulmonary tuberculosis by potentially reducing the side-effects of oral bedaquiline. Further research is required to understand the safety of the optimized inhalable powder in animal models.