Lipid Systems for the Delivery of Amphotericin B in Antifungal Therapy

Amphotericin B (AmB), a broad-spectrum polyene antibiotic in the clinic for more than fifty years, remains the gold standard in the treatment of life-threatening invasive fungal infections and visceral leishmaniasis. Due to its poor water solubility and membrane permeability, AmB is conventionally f...

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Main Authors: Célia Faustino, Lídia Pinheiro
Format: Article
Language:English
Published: MDPI AG 2020-01-01
Series:Pharmaceutics
Subjects:
Online Access:https://www.mdpi.com/1999-4923/12/1/29
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author Célia Faustino
Lídia Pinheiro
author_facet Célia Faustino
Lídia Pinheiro
author_sort Célia Faustino
collection DOAJ
description Amphotericin B (AmB), a broad-spectrum polyene antibiotic in the clinic for more than fifty years, remains the gold standard in the treatment of life-threatening invasive fungal infections and visceral leishmaniasis. Due to its poor water solubility and membrane permeability, AmB is conventionally formulated with deoxycholate as a micellar suspension for intravenous administration, but severe infusion-related side effects and nephrotoxicity hamper its therapeutic potential. Lipid-based formulations, such as liposomal AmB, have been developed which significantly reduce the toxic side effects of the drug. However, their high cost and the need for parenteral administration limit their widespread use. Therefore, delivery systems that can retain or even enhance antimicrobial efficacy while simultaneously reducing AmB adverse events are an active area of research. Among those, lipid systems have been extensively investigated due to the high affinity of AmB for binding lipids. The development of a safe and cost-effective oral formulation able to improve drug accessibility would be a major breakthrough, and several lipid systems for the oral delivery of AmB are currently under development. This review summarizes recent advances in lipid-based systems for targeted delivery of AmB focusing on non-parenteral nanoparticulate formulations mainly investigated over the last five years and highlighting those that are currently in clinical trials.
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spelling doaj.art-7ad751a267b44b92ba30bdef97e18c3d2022-12-22T03:18:55ZengMDPI AGPharmaceutics1999-49232020-01-011212910.3390/pharmaceutics12010029pharmaceutics12010029Lipid Systems for the Delivery of Amphotericin B in Antifungal TherapyCélia Faustino0Lídia Pinheiro1Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003 Lisboa, PortugalResearch Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003 Lisboa, PortugalAmphotericin B (AmB), a broad-spectrum polyene antibiotic in the clinic for more than fifty years, remains the gold standard in the treatment of life-threatening invasive fungal infections and visceral leishmaniasis. Due to its poor water solubility and membrane permeability, AmB is conventionally formulated with deoxycholate as a micellar suspension for intravenous administration, but severe infusion-related side effects and nephrotoxicity hamper its therapeutic potential. Lipid-based formulations, such as liposomal AmB, have been developed which significantly reduce the toxic side effects of the drug. However, their high cost and the need for parenteral administration limit their widespread use. Therefore, delivery systems that can retain or even enhance antimicrobial efficacy while simultaneously reducing AmB adverse events are an active area of research. Among those, lipid systems have been extensively investigated due to the high affinity of AmB for binding lipids. The development of a safe and cost-effective oral formulation able to improve drug accessibility would be a major breakthrough, and several lipid systems for the oral delivery of AmB are currently under development. This review summarizes recent advances in lipid-based systems for targeted delivery of AmB focusing on non-parenteral nanoparticulate formulations mainly investigated over the last five years and highlighting those that are currently in clinical trials.https://www.mdpi.com/1999-4923/12/1/29amphotericin bfungal diseasesdrug deliverylipid systemsnanoparticlesinfection
spellingShingle Célia Faustino
Lídia Pinheiro
Lipid Systems for the Delivery of Amphotericin B in Antifungal Therapy
Pharmaceutics
amphotericin b
fungal diseases
drug delivery
lipid systems
nanoparticles
infection
title Lipid Systems for the Delivery of Amphotericin B in Antifungal Therapy
title_full Lipid Systems for the Delivery of Amphotericin B in Antifungal Therapy
title_fullStr Lipid Systems for the Delivery of Amphotericin B in Antifungal Therapy
title_full_unstemmed Lipid Systems for the Delivery of Amphotericin B in Antifungal Therapy
title_short Lipid Systems for the Delivery of Amphotericin B in Antifungal Therapy
title_sort lipid systems for the delivery of amphotericin b in antifungal therapy
topic amphotericin b
fungal diseases
drug delivery
lipid systems
nanoparticles
infection
url https://www.mdpi.com/1999-4923/12/1/29
work_keys_str_mv AT celiafaustino lipidsystemsforthedeliveryofamphotericinbinantifungaltherapy
AT lidiapinheiro lipidsystemsforthedeliveryofamphotericinbinantifungaltherapy