β-cyclodextrin polymer/Soluplus® encapsulated Ebselen ternary complex (EβpolySol) as a potential therapy for vaginal candidiasis and pre-exposure prophylactic for HIV

Abstract

Epidemiological findings have discussed recurrent and persistent vulvovaginal candidiasis to be a major manifestation of HIV infected women. Conversely, women with vulvovaginal candidiasis have higher risk of acquiring HIV transmitted during intercourse. Common treatments for such conditions include combined antiretroviral and antifungal therapy. Drug-Drug interaction is a major problem encountered due to common CYP450 metabolic pathway of azoles and antiretroviral drugs. Ebselen (EB), lipophilic, organo-selenium compound has demonstrated promising anti-HIV and anti-fungal activity. The aim of current research was to develop and characterize a rapidly soluble and non-cytotoxic vaginal film of ebselen which could serve dual purpose of treating vulvovaginal candidiasis and pre-exposure prophylactic (PrEP) against HIV. Ebselen/cyclodextrin polymer/Soluplus® (1:10:10) ternary complex (EβpolySol) showed 200 fold enhancement in aqueous solubility and no degradation of EB in thermogravimetry analysis. EβpolySol film with tensile strength of 33.12 ± 1.98 N/cm² disintegrated within 30 sec, presented instant drug release with no apparent precipitation in simulated vaginal fluid. EβpolySol film showed compatibility with HEC-1A monolayer and HeLa cells compared to VCF®. EβpolySol film showed MIC of 20 μM against Candida species and IC₅₀ of 0.71 μM against HIV.

Keywords: Ebselen; HIV microbicide; Pre-exposure prophylaxis; Ternary inclusion complex; Vaginal candidiasis; β cyclodextrin polymer.