Cyclosporine Amicellar delivery system for dry eyes

Background The objectives of this study were to develop stable cyclosporine A (CsA) ophthalmic micelle solutions for dry-eye syndrome and evaluate their physicochemical properties and therapeutic efficacy. Materials and methods CsA-micelle solutions (MS-CsA) were created by a simple method with Cremophor EL, ethanol, and phosphate buffer. We investigated the particle size, pH, and osmolarity. In addition, long-term physical and chemical stability for MS-CsA was observed. To confirm the therapeutic efficacy, tear production in dry eye-induced rabbits was evaluated using the Schirmer tear test (STT). When compared to a commercial product, Restasis, MS-CsA demonstrated improvement in goblet-cell density and conjunctival epithelial morphology, as demonstrated in histological hematoxylin and eosin staining. Results MS-CsA had a smaller particle size (average diameter 14–18 nm) and a narrow size distribution. Physicochemical parameters, such as particle size, pH, osmolarity, and remaining CsA concentration were all within the expected range of 60 days. STT scores significantly improved in MS-CsA treated groups (P<0.05) in comparison to those of the Restasis-treated group. The number of goblet cells for rabbit conjunctivas after the administration of MS-CsA was 94.83±8.38, a significantly higher result than the 65.17±11.51 seen with Restasis. The conjunctival epithelial morphology of dry eye-induced rabbits thinned with loss of goblet cells. However, after 5 days of treatment with drug formulations, rabbit conjunctivas recovered epithelia and showed a relative increase in the number of goblet cells. Conclusion The results of this study indicate the potential use of a novel MS for the ophthalmic delivery of CsA in treating dry eyes.

[1]  D. Rodeheaver,et al.  Design and Evaluation of Ophthalmic Pharmaceutical Products , 2016 .

[2]  A. Mitra,et al.  Topical, Aqueous, Clear Cyclosporine Formulation Design for Anterior and Posterior Ocular Delivery. , 2015, Translational vision science & technology.

[3]  Su-Eon Jin,et al.  Supercritical fluid-mediated liposomes containing cyclosporin A for the treatment of dry eye syndrome in a rabbit model: comparative study with the conventional cyclosporin A emulsion , 2014, International journal of nanomedicine.

[4]  A. Goepferich,et al.  Self-Assembling Colloidal System for the Ocular Administration of Cyclosporine A , 2014, Cornea.

[5]  Soumen Ghosh,et al.  Physicochemical Studies on the Micellization of Cationic, Anionic, and Nonionic Surfactants in Water–Polar Organic Solvent Mixtures , 2013 .

[6]  Jeong-Sook Park,et al.  Characterization and stability studies of a novel liposomal cyclosporin A prepared using the supercritical fluid method: comparison with the modified conventional Bangham method , 2013, International journal of nanomedicine.

[7]  A. Domb,et al.  Cyclosporin nanosphere formulation for ophthalmic administration. , 2012, International journal of pharmaceutics.

[8]  R. Gurny,et al.  Novel micelle carriers for cyclosporin A topical ocular delivery: in vivo cornea penetration, ocular distribution and efficacy studies. , 2012, European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V.

[9]  J. Veuthey,et al.  In vivo characterisation of a novel water-soluble Cyclosporine A prodrug for the treatment of dry eye disease. , 2012, European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V.

[10]  A. Bhattarai,et al.  A comparative study of Critical Micelle Concentration (CMC) and Free Energy of Micellization of cationic surfactant and anionic surfactant in different composition of methanol-water mixed solvent media by conductometric method at 308.15 K , 2012 .

[11]  A. Chauhan,et al.  Ophthalmic delivery of cyclosporine A by punctal plugs. , 2011, Journal of controlled release : official journal of the Controlled Release Society.

[12]  Fen Ye,et al.  Tear osmolarity as a biomarker for dry eye disease severity. , 2010, Investigative ophthalmology & visual science.

[13]  A. Mahmoud,et al.  Nanoemulsion as a Potential Ophthalmic Delivery System for Dorzolamide Hydrochloride , 2009, AAPS PharmSciTech.

[14]  L. Gan,et al.  Novel microemulsion in situ electrolyte-triggered gelling system for ophthalmic delivery of lipophilic cyclosporine A: in vitro and in vivo results. , 2009, International journal of pharmaceutics.

[15]  Jim Jiao Polyoxyethylated nonionic surfactants and their applications in topical ocular drug delivery. , 2008, Advanced drug delivery reviews.

[16]  Jian Ge,et al.  A rabbit dry eye model induced by topical medication of a preservative benzalkonium chloride. , 2008, Investigative ophthalmology & visual science.

[17]  S. Krishnakumar,et al.  Nanotechnology in ocular drug delivery. , 2008, Drug discovery today.

[18]  S. Pflugfelder,et al.  Effects of Sequential Artificial Tear and Cyclosporine Emulsion Therapy on Conjunctival Goblet Cell Density and Transforming Growth Factor-β2 Production , 2008, Cornea.

[19]  Jiasheng Tu,et al.  Preparation and ocular pharmacokinetics of ganciclovir liposomes , 2007, The AAPS Journal.

[20]  K. Wasan,et al.  Cyclosporine A: A Review of Current Oral and Intravenous Delivery Systems , 2007, Drug development and industrial pharmacy.

[21]  V. Torchilin,et al.  Micellar Nanocarriers: Pharmaceutical Perspectives , 2006, Pharmaceutical Research.

[22]  R. Gurny,et al.  Intraocular implants for extended drug delivery: therapeutic applications. , 2006, Advanced drug delivery reviews.

[23]  D. Brocks,et al.  Polymeric micelles for the solubilization and delivery of cyclosporine A: pharmacokinetics and biodistribution. , 2005, Biomaterials.

[24]  J. Wojciechowska,et al.  Microemulsions as potential ocular drug delivery systems: phase diagrams and physical properties depending on ingredients. , 2005, Acta poloniae pharmaceutica.

[25]  G. Kwon,et al.  Polysorbate 80 and Cremophor EL micelles deaggregate and solubilize nystatin at the core-corona interface. , 2005, Journal of pharmaceutical sciences.

[26]  M. Dana,et al.  The controlled-environment chamber: a new mouse model of dry eye. , 2005, Investigative ophthalmology & visual science.

[27]  S. Fialho,et al.  New vehicle based on a microemulsion for topical ocular administration of dexamethasone , 2004, Clinical & experimental ophthalmology.

[28]  S. Pflugfelder Antiinflammatory therapy for dry eye. , 2004, American journal of ophthalmology.

[29]  R. Strickley Solubilizing Excipients in Oral and Injectable Formulations , 2004, Pharmaceutical Research.

[30]  R. Gurny,et al.  Cyclosporine A delivery to the eye: a pharmaceutical challenge. , 2003, European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V.

[31]  Ruxandra Gref,et al.  The effect of a PEG versus a chitosan coating on the interaction of drug colloidal carriers with the ocular mucosa. , 2003, European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences.

[32]  J. Buring,et al.  Prevalence of dry eye syndrome among US women. , 2003, American journal of ophthalmology.

[33]  R. Hodges,et al.  Isolation and characterization of cultured human conjunctival goblet cells. , 2003, Investigative ophthalmology & visual science.

[34]  P. van der Bijl,et al.  Comparative permeability of human and rabbit corneas to cyclosporin and tritiated water. , 2002, Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics.

[35]  G. Spedalieri,et al.  Flurbiprofen-loaded acrylate polymer nanosuspensions for ophthalmic application. , 2002, Biomaterials.

[36]  Hitoshi Watanabe Significance of Mucin on the Ocular Surface , 2002, Cornea.

[37]  De-Quan Li,et al.  A mouse model of keratoconjunctivitis sicca. , 2002, Investigative ophthalmology & visual science.

[38]  I. Gipson,et al.  Goblet cell numbers and epithelial proliferation in the conjunctiva of patients with dry eye syndrome treated with cyclosporine. , 2002, Archives of ophthalmology.

[39]  P. van der Bijl,et al.  Effects of Three Penetration Enhancers on Transcorneal Permeation of Cyclosporine , 2001, Cornea.

[40]  R Roggeband,et al.  Eye irritation responses in rabbit and man after single applications of equal volumes of undiluted model liquid detergent products. , 2000, Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association.

[41]  B. Reis,et al.  Efficacy and safety of cyclosporin a ophthalmic emulsion in the treatment of moderate-to-severe dry eye disease: A dose-ranging, randomized trial☆ , 2000 .

[42]  Lawrence X. Yu,et al.  Vitamin E-TPGS Increases Absorption Flux of an HIV Protease Inhibitor by Enhancing Its Solubility and Permeability1 , 1999, Pharmaceutical Research.

[43]  J. Beijnen,et al.  Cremophor EL causes (pseudo-) non-linear pharmacokinetics of paclitaxel in patients , 1999, British Journal of Cancer.

[44]  S. Burgalassi,et al.  Development of a Simple Dry Eye Model in the Albino Rabbit and Evaluation of Some Tear Substitutes , 1999, Ophthalmic Research.

[45]  S. Ding,et al.  Distribution of cyclosporin A in ocular tissues after topical administration to albino rabbits and beagle dogs. , 1999, Current eye research.

[46]  Y. Lo,et al.  Comparison of effects of surfactants with other MDR reversing agents on intracellular uptake of epirubicin in Caco-2 cell line. , 1998, Anticancer research.

[47]  A. Kanai,et al.  Effect of cyclosporin A eyedrops on tear secretion in rabbit. , 1998, Japanese journal of ophthalmology.

[48]  R. Borchardt,et al.  The Use of Surfactants to Enhance the Permeability of Peptides Through Caco-2 Cells by Inhibition of an Apically Polarized Efflux System , 1996, Pharmaceutical Research.

[49]  P. Constantinides,et al.  Lipid Microemulsions for Improving Drug Dissolution and Oral Absorption: Physical and Biopharmaceutical Aspects , 1995, Pharmaceutical Research.

[50]  A. Markham,et al.  Cyclosporin. A review of the pharmacokinetic properties, clinical efficacy and tolerability of a microemulsion-based formulation (Neoral). , 1995, Drugs.

[51]  P. Artursson,et al.  Mechanisms of absorption enhancement by medium chain fatty acids in intestinal epithelial Caco-2 cell monolayers. , 1995, The Journal of pharmacology and experimental therapeutics.

[52]  K. Gündüz,et al.  Topical cyclosporin treatment of keratoconjunctivitis sicca in secondary Sjögren's syndrome , 1994, Acta ophthalmologica.

[53]  N el Tayar,et al.  Solvent-dependent conformation and hydrogen-bonding capacity of cyclosporin A: evidence from partition coefficients and molecular dynamics simulations. , 1993, Journal of medicinal chemistry.

[54]  M. O’connell,et al.  Pilot Trial of Cyclosporine 1% Ophthalmic Ointment in the Treatment of Keratoconjunctivitis Sicca , 1993, Cornea.

[55]  D. Ward,et al.  Spontaneous canine keratoconjunctivitis sicca. A useful model for human keratoconjunctivitis sicca: treatment with cyclosporine eye drops. , 1989, Archives of ophthalmology.

[56]  Susi Burgalassi,et al.  Evaluation of muco-adhesive properties and in vivo activity of ophthalmic vehicles based on hyaluronic acid , 1989 .

[57]  A. Herp,et al.  Studies on the isolation and composition of human ocular mucin. , 1988, Experimental eye research.

[58]  K. Polse,et al.  Measurement of in vivo human corneal stromal pH: open and closed eyes. , 1987, Investigative ophthalmology & visual science.

[59]  W. Coles,et al.  Dynamics of ocular surface pH. , 1984, The British journal of ophthalmology.

[60]  J. Friend,et al.  Goblet cell density in ocular surface disease. A better indicator than tear mucin. , 1983, Archives of ophthalmology.

[61]  M. Lemp,et al.  Wettability and wetting of corneal epithelium. , 1971, Experimental eye research.

[62]  R. Gurny,et al.  Novel cyclosporin A formulations using MPEG-hexyl-substituted polylactide micelles: a suitability study. , 2011, European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V.

[63]  A. Mearza,et al.  Uses and safety profile of ciclosporin in ophthalmology. , 2008, Expert opinion on drug safety.

[64]  Y. Kawashima,et al.  Cyclosporine A Formulation Affects Its Ocular Distribution in Rabbits , 2004, Pharmaceutical Research.

[65]  J. Dressman,et al.  Estimation of the Increase in Solubility of Drugs as a Function of Bile Salt Concentration , 2004, Pharmaceutical Research.

[66]  S. Benita,et al.  Evaluation of a positively charged submicron emulsion of piroxicam on the rabbit corneum healing process following alkali burn. , 1999, Journal of controlled release : official journal of the Controlled Release Society.

[67]  W. Curatolo,et al.  C) Means to enhance penetration , 1992 .

[68]  D. Pang,et al.  International Journal of Nanomedicine , 2022 .