Interaction Between drug loaded Polyaspartamide-polylactide-polisorbate based micelles and cell membrane models: a calorimetric study

Amphiphilic biodegradable copolymers, for their ability to self-assemble into micelle-like aggregates, with a suitable loading capacity, are of emerging interest for the delivery of water-insoluble drugs. α,β-Poly[(N-hydroxyethyl)-dl-aspartamide] (PHEA) is suitable to obtain amphiphilic graft copolymers. These copolymers can be obtained starting from PHEA-ethylenediamine (PHEA-EDA) which is functionalized with polysorbate 80 (PS₈₀, like targeting residues to the brain) and polylactide (PLA, like hydrophobic chains) in order to obtain polymeric micelles of PHEA-EDA-PS₈₀-PLA potentially useful to release drugs to the central nervous system. In this paper, the interaction and absorption of PHE…

Safety and efficacy of ombitasvir/paritaprevir/ritonavir/dasabuvir plus ribavirin in patients over 65 years with HCV genotype 1 cirrhosis

Purpose: To analyse safety and efficacy of treatment based on ombitasvir/paritaprevir/ritonavir/dasabuvir plus ribavirin in the sub-group of GT1 patients older than 65 years. Methods: We collected data extracted from the ABACUS compassionate-use nationwide Italian programme, in patients with cirrhosis due to hepatitis C virus (HCV) Genotype-1 (GT1) or 4 and at high risk of decompensation. GT1-HCV-infected patients received once-daily ombitasvir/paritaprevir, with the pharmacokinetic enhancer ritonavir (25/150/100 mg) and twice-daily dasabuvir (250 mg) plus Ribavirin (RBV) (OBV/PTV/r + DSV + RBV) for 12 (GT1b) or 24 (GT1a) weeks. Endpoints were to evaluate safety and efficacy, the latter def…

Effect of pH on the transfer kinetics of an anti-inflammatory drug from polyaspartamide hydrogels to a lipid model membrane

Abstract The release of a nonsteroidal anti-inflammatory drug (NSAID), 4-biphenylacetic acid (BPAA), from α,β-poly( N -hydroxyethyl)- dl -aspartamide (PHEA) hydrogels was tested at different pHs (4 and 7.4) by measuring the drug transfer from loaded hydrogel to dimyristoylphosphatidylcholine (DMPC) liposomes (multilamellar vesicles, MLV), chosen as a biomembrane model. This drug transfer was compared with the transfer from powdered drug and with drug classical. The perturbing effect of pure BPAA on the thermotropic behaviour of DMPC liposomes, in terms of transition temperature shift (Δ T m ) and enthalpy changes (Δ H ), was analysed at different pHs (4 and 7.4) by differential scanning cal…

Temperature and pressure dependence of quercetin-3-O-palmitate interaction with a model phospholipid membrane: film balance and scanning probe microscopy study

The molecular interaction of quercetin-3-O-palmitate (QP) with dimyristoylphosphatidylcholine (DMPC) has been studied. Film balance measurements of the average molecular area vs QP molar fraction in DMPC/QP mixed monolayers showed that relevant positive deviations from ideality, i.e., a less dense monolayer packing, occurred for a temperature of 10 degrees C, below the critical melting transition temperature of DMPC monolayers T c m approximately equal 20 degrees C), while ideal behavior was observed at 37 degrees C, above this phase transition temperature. The positive deviation observed at low temperatures in the average molecular area increased with the surface pressure. Scanning probe m…

DRUG RELEASE FROM alpha,beta-POLYASPARTYLHYDRAZIDE DERIVATIVES POLYMERS AND INTERACTION WITH A BIOMEMBRANE MODEL

Influence of functionalization on interaction and drug release from α,β-polyaspartylhydrazide derivatives to a biomembrane model: evaluation by differential scanning calorimetry technique

Abstract A comparative study on the ability of various polymers to interact with a biomembrane model was carried out by differential scanning calorimetry (DSC). The investigated samples were a water soluble polymer, the α,β-polyaspartylhydrazide (PAHy) and its derivatives containing polyethylene glycol (PEG2000) (sample PAHy–PEG2000), or hexadecylamine (C16) (sample PAHy–C16) or both compounds (sample PAHy–PEG2000–C16). Some samples are able to arrange themselves as micellar structures and to interact potentially with the membrane surface so as to favor the release of the drug near the target membrane and consequently to improve drug adsorption processes. First, the interaction of all polym…

Evaluation of the interaction and drug release from alpha,beta-polyaspartamide derivatives to a biomembrane model

This article reports on a comparative study on the ability of various polymers, containing hydrophilic and/or hydrophobic groups, to interact with a biomembrane model using the differential scanning calorimetry (DSC) technique. Multilamellar vesicles of mixed dimyristoylphosphatidylcholine (DMPC) and dimyristoylphosphatidic acid (DMPA) were chosen as a model of cell membranes. The investigated samples were a water soluble polymer, the alpha,beta-poly(N-2-hydroxyethyl)-DL-aspartamide (PHEA) and its derivatives partially functionalized with polyethylene glycol (PEG2000) to obtain PHEA-PEG2000, with hexadecylamine (C16) to obtain PHEA-C16, and with both compounds to obtain PHEA-PEG2000-C16. Th…

Estimating minimum adult HIV prevalence: A cross-sectional study to assess the characteristics of people living with HIV in Italy

In 2012, we conducted a retrospective cross-sectional study to assess the number of people living with HIV linked to care and, among these, the number of people on antiretroviral therapy. The health authority in each of the 20 Italian Regions provided the list of Public Infectious Diseases Clinics providing antiretroviral therapy and monitoring people with HIV infection. We asked every Public Infectious Diseases Clinic to report the number of HIV-positive people diagnosed and linked to care and the number of those on antiretroviral therapy during 2012. In 2012, 94,146 people diagnosed with HIV and linked to care were reported. The majority were males (70.1%), Italians (84.4%), and aged betw…

Efficacy and safety of dalbavancin in the treatment of acute bacterial skin and skin structure infections (ABSSSIs) and other infections in a real-life setting: data from an Italian observational multicentric study (DALBITA study)

Objectives: We evaluated the efficacy and safety of dalbavancin in ABSSSI and ‘other sites’ infections’ (OTA). Methods: Observational study involving 11 Italian hospitals including patients that received ≥1 dose of dalbavancin in 2016–2019. The outcome was end-of-treatment efficacy and safety in ABSSSI and OTA in a real-life setting. Results: 206 patients enrolled (males 50%, median age 62 [IQR 50–76] years), 60.2% ABSSSI, 39.8% OTA. 69.7% ABSSSI vs 90.7% OTA (p = 0.003) and 46.3% ABSSSI vs 37.2% OTA (p = 0.786) received previous and concomitant antibiotics, respectively. 82.5% reached clinical cure. Eleven (5.4%) patients had non-serious adverse events (AE). OTA patients showed longer hosp…

Kinetics of Molecule Transfer between Lipid Vesicles and β-Cyclodextrins

Abstract We propose a calorimetric method based on the van't Hoff model of depression of the freezing temperature to investigate slow kinetics involving lipid vesicles (liposomes) and drug–β-cyclodextrin (Cyd) complexes. Some nonsteroidal antiinflammatory drugs (NSAIDs) were examined and standard phospholipid liposomes were used in our experiments. Three different kinetic processes were investigated: (a)9Transfer of drugs from water-soluble Cyd-complexes to void liposomes. (b)9Uptake of drugs from the surface of liposomes by free Cyd dissolved in the aqueous phase. (c)9Exchange of drugs from loaded to void vesicles, and the effect of free Cyd in enhancing such a transfer. Most experiments w…

DIFFERENTIAL SCANNING CALORIMETRY STUDY ON DRUG RELEASE FROM AN INULIN-BASED HYDROGEL AND ITS INTERACTION WITH A BIOMEMBRANE MODEL:pH AND LOADING EFFECT

Inulin has been derivatized with methacrylic anhydride (MA) and succinic anhydride (SA) to obtain a methacrylated/succinilated derivative (INU-MA-SA) able to produce a pH sensitive hydrogel after UV irradiation. The hydrogel was characterized and loaded with diflunisal (10.4, 17 and 24%, w/w) chosen as a model drug. The drug release from INU-MA-SA-based hydrogel to a biomembrane model made by unilamellar vesicles of dimyristoylphosphatidyl-choline (DMPC) was investigated at pH 4.0 and 7.4 by differential scanning calorimetry (DSC) that appears to be a suitable technique to follow the transfer kinetics of a drug from a controlled release system to a biomembrane model. The drug release from t…

DRUG RELEASE FROM INULIN DERIVATIVE HYDROGEL: EFFECT OF DRUG LOADING AND pH

Drug Prescription and Delirium in Older Inpatients: Results From the Nationwide Multicenter Italian Delirium Day 2015-2016

Objective This study aimed to evaluate the association between polypharmacy and delirium, the association of specific drug categories with delirium, and the differences in drug-delirium association between medical and surgical units and according to dementia diagnosis. Methods Data were collected during 2 waves of Delirium Day, a multicenter delirium prevalence study including patients (aged 65 years or older) admitted to acute and long-term care wards in Italy (2015-2016); in this study, only patients enrolled in acute hospital wards were selected (n = 4,133). Delirium was assessed according to score on the 4 "A's" Test. Prescriptions were classified by main drug categories; polypharmacy w…

STIMA DEI PROFILI DI VELOCITA’ DEI FLUSSI IPERCONCENTRATI: analisi di sensitività sui parametri dell’equazione di Bagnold.

Nel presente lavoro l'attenzione è focalizzata sulla dinamica di propagazione delle colate detritiche, fenomeni naturali di elevata pericolosità e forza distruttiva. Com’è noto, una colata detritica si verifica quando il materiale solido (sedimenti e materiale sciolto) di versanti caratterizzati da elevate pendenze viene destabilizzato dal deflusso di ingente volume d’acqua. Durante la propagazione della miscela acqua-sedimento, elementi anche di elevata dimensione (massi, alberi,..) possono essere mobilitati aumentando la forza distruttiva della colata con conseguenti possibili ingenti danni a edifici e infrastrutture, perdita di vite umane e ostruzioni (parziali o totali) dei corsi d’acqu…

Influence of different parameters on drug release from hydrogel systems to a biomembrane model. Evaluation by differential scanning calorimetry technique

A comparative study on the drug release capacity of four water swellable polymeric systems was carried out by differential scanning calorimetry (DSC). The polymeric systems chosen were alpha,beta-polyaspartahydrazide (PAHy) crosslinked by glutaraldehyde (GLU) (PAHy-GLU) or by ethyleneglycoldiglycidylether (EGDGE), (PAHy-EGDGE), polyvinylalcohol (PVA) crosslinked by glutaraldehyde (PVA-GLU) and alpha,beta-poly(N-hydroxyethyl)-DL-aspartamide (PHEA) by gamma irradiation (PHEA-gamma matrices). The degree of crosslinking for PAHy-GLU, PAHy-EGDGE and PVA-GLU samples was about 0.4 and 0.8. These hydrogels were characterized as free of drugs and were loaded with diflunisal (DFN) (approximately 2.5%…

Antiretroviral genotypic resistance in plasma RNA and whole blood DNA in HIV-1 infected patients failing HAART

The extent to which HIV-1 proviral DNA mutations cause clinically relevant antiretroviral resistance is still controversial. Paired plasma HIV-1 RNA and whole blood DNA were compared in patients failing HAART to investigate if the additional knowledge of archived mutations could improve the selection of potentially active drugs. Seventy-three HIV-1-infected patients with first/second HAART failure were studied before starting a new regimen based on RNA genotyping. Follow-up data after a 12-week therapy were available. DNA genotyping was retrospectively performed on stored whole blood samples and mutational profiles were compared to those from RNA. The mean number of IAS pol mutations was si…

Clinical features and comorbidity pattern of HCV infected migrants compared to native patients in care in Italy: A real-life evaluation of the PITER cohort

Background: Direct-acting antivirals are highly effective for the treatment of hepatitis C virus (HCV) infection, regardless race/ethnicity. We aimed to evaluate demographic, virological and clinical data of HCV-infected migrants vs. natives consecutively enrolled in the PITER cohort. Methods: Migrants were defined by country of birth and nationality that was different from Italy. Mann-Whitney U test, Chi-squared test and multiple logistic regression were used. Results: Of 10,669 enrolled patients, 301 (2.8%) were migrants: median age 47 vs. 62 years, (p < 0.001), females 56.5% vs. 45.3%, (p < 0.001), HBsAg positivity 3.8% vs. 1.4%, (p < 0.05). Genotype 1b was prevalent in both gro…

Temperature and polymer crosslinking degree influence on drug transfer from alpha,beta-polyasparthydrazide hydrogel to model membranes. A calorimetric study

Abstract A non-steroidal anti-inflammatory drug, diflunisal, has been chosen as drug model to be incorporated in α , β -polyasparthydrazide (PAHy) matrices to study the effect of polymer crosslinking degrees on the release processes from hydrogel ( X =0.4 and X =0.8) to a model membrane represented by unilamellar vesicles of dipalmitoylphosphatidylcholine. The technique employed to monitor these processes was differential scanning calorimetry that appears to be particularly suitable to follow the transfer kinetics of a drug from a controlled release system to void biomembrane model. The drug release from the two PAHy hydrogels differently crosslinked by glutaraldehyde to the lipidic model w…

INTERACTION OF MACROMOLECULAR PRO-DRUGS WITH LIPID MODEL MEMBRANE - CALORIMETRIC STUDY OF 4-BIPHENYLACETIC ACID LINKED TO ALPHA,BETA-POLY(N-HYDROXYETHYL)-DL-ASPARTAMIDE INTERACTING WITH PHOSPHATIDYLCHOLINE VESICLES

The effect of 4-biphenylacetic acid (BPAA) covalently linked to α,β-poly(N-hydroxyethyl)-dl-aspartamide (PHEA) on the thermotropic properties of dipalmitoylphosphatidylcholine (DPPC) liposomes was investigated by differential scanning calorimetry (DSC). Addition of increasing amounts of PHEA-BPAA adduct to a suspension of phospholipid vesicles modified the thermotropic gel-to-liquid crystalline phase transition by decreasing the enthalpy changes ΔH with concomitant broadening of the peak without variations in the transition temperature (Tm). These effects are interpreted in terms of a deep interaction of BPAA bound to the polymer with the apolar moiety of the lipid bilayer. The amount of dr…

α,β-Poly(N-Hydroxyethyl)-DL-Aspartamide Hydrogels as Drug Delivery Devices

α,β-poly(N-hydroxyethyl)-DL-aspartamide (PHEA) was exposed to gamma radiation to obtain micromatrices able to swell in an aqueous medium. Crosslinked PHEA was loaded with an anti-inflammatory drug, 4-biphenylacetic acid (BPAA) and the drug dispersion in the network was investigated by X-ray analysis. The BPAA loaded PHEA microparticles were also characterized by dimensional analysis, which showed the presence of quasispherical shapes. The drug release from PHEA hydrogel was studied in vitro in a pH 1.1 (simulated gastric juice) and in a pH 7.4 buffer solution, respectively. The experimental data indicate that an anomalous delivery occurs, but Fickian diffusion through swollen PHEA hydrogel…

Effectiveness and safety of switching to entecavir hepatitis B patients developing kidney dysfunction during tenofovir

Background and Aims: Tenofovir disoproxil fumarate (TDF) is recommended for chronic hepatitis B (CHB) treatment, but it may induce kidney dysfunction whose management is not yet known. This Italian, multicentre, retrospective study aimed to assess the efficacy and safety of switching to entecavir (ETV) patients who developed TDF-associated glomerular and/or tubular dysfunction. Methods: A total of 103 TDF-treated patients were included as follows: age 64 years, 83% male, 49% cirrhotics, 98% with undetectable HBV DNA, 47% with previous lamivudine resistance (LMV-R) and 71% previously treated with adefovir. Twenty-nine (28%) were switched to ETV because estimated glomerular filtration rate (e…

Ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir, plus ribavirin for patients with hepatitis C virus genotype 1 or 4 infection with cirrhosis (ABACUS): a prospective observational study

Summary Background We ran a compassionate use nationwide programme (ABACUS) to provide access to ombitasvir, paritaprevir, and ritonavir, with dasabuvir, plus ribavirin for hepatitis C virus (HCV) genotype 1 infection and ombitasvir, paritaprevir, and ritonavir, plus ribavirin for HCV genotype 4 infection in patients with cirrhosis at high risk of decompensation while approval of these regimens was pending in Italy. Methods In this prospective observational study, we collected data from a compassionate use nationwide programme from March 17, 2014, to May 28, 2015. Patients with HCV genotype 1 infection and cirrhosis at high risk of decompensation were given coformulated ombitasvir (25 mg), …

Efficacy and safety of dalbavancin in the treatment of acute bacterial skin and skin structure infections (ABSSSIs) and other infections in a real-life setting: data from an Italian observational multicentric study (DALBITA study)

We evaluated the efficacy and safety of dalbavancin in ABSSSI and ‘other sites’ infections’ (OTA). Observational study involving 11 Italian hospitals including patients that received ≥1 dose of dalbavancin in 2016–2019. The outcome was end-of-treatment efficacy and safety in ABSSSI and OTA in a real-life setting. 206 patients enrolled (males 50%, median age 62 [IQR 50–76] years), 60.2% ABSSSI, 39.8% OTA. 69.7% ABSSSI vs 90.7% OTA (p = 0.003) and 46.3% ABSSSI vs 37.2% OTA (p = 0.786) received previous and concomitant antibiotics, respectively. 82.5% reached clinical cure . Eleven (5.4%) patients had non-serious adverse events (AE). OTA patients showed longer hospitalization (13.5 days, 5.5–2…