Efficacy, Biodistribution, and Nephrotoxicity of Experimental Amphotericin B-Deoxycholate Formulations for Pulmonary Aspergillosis

Antimicrob Agents Chemother. 2018 Jun 26;62(7):e00489-18. doi: 10.1128/AAC.00489-18. Print 2018 Jul.

Abstract

An experimental micellar formulation of 1:1.5 amphotericin B-sodium deoxycholate (AMB:DCH 1:1.5) was obtained and characterized to determine its aggregation state and particle size. The biodistribution, nephrotoxicity, and efficacy against pulmonary aspergillosis in a murine model were studied and compared to the liposomal commercial formulation of amphotericin B after intravenous administration. The administration of 5 mg/kg AMB:DCH 1:1.5 presented 2.8-fold-higher lung concentrations (18.125 ± 3.985 μg/g after 6 daily doses) and lower kidney exposure (0.391 ± 0.167 μg/g) than liposomal commercial amphotericin B (6.567 ± 1.536 and 5.374 ± 1.157 μg/g in lungs and kidneys, respectively). The different biodistribution of AMB:DCH micelle systems compared to liposomal commercial amphotericin B was attributed to their different morphologies and particle sizes. The efficacy study has shown that both drugs administered at 5 mg/kg produced similar survival percentages and reductions of fungal burden. A slightly lower nephrotoxicity, associated with amphotericin B, was observed with AMB:DCH 1:1.5 than the one induced by the liposomal commercial formulation. However, AMB:DCH 1:1.5 reached higher AMB concentrations in lungs, which could represent a therapeutic advantage over liposomal commercial amphotericin B-based treatment of pulmonary aspergillosis. These results are encouraging to explore the usefulness of AMB:DCH 1:1.5 against this disease.

Keywords: amphotericin B; aspergillosis; deoxycholate; efficacy; nephrotoxicity; pulmonary concentrations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amphotericin B / pharmacology*
  • Amphotericin B / therapeutic use*
  • Animals
  • Antifungal Agents / pharmacology*
  • Antifungal Agents / therapeutic use*
  • Deoxycholic Acid / pharmacology*
  • Deoxycholic Acid / therapeutic use*
  • Drug Combinations
  • Kidney / drug effects*
  • Kidney / metabolism*
  • Lung / drug effects
  • Lung / metabolism
  • Male
  • Mice
  • Pulmonary Aspergillosis / drug therapy*
  • Pulmonary Aspergillosis / metabolism*

Substances

  • Antifungal Agents
  • Drug Combinations
  • Deoxycholic Acid
  • Amphotericin B
  • amphotericin B, deoxycholate drug combination