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2017 ; 250
(ä): 96-106
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Inhaled sildenafil as an alternative to oral sildenafil in the treatment of
pulmonary arterial hypertension (PAH)
#MMPMID28185800
Rashid J
; Patel B
; Nozik-Grayck E
; McMurtry IF
; Stenmark KR
; Ahsan F
J Control Release
2017[Mar]; 250
(ä): 96-106
PMID28185800
show ga
The practice of treating PAH patients with oral or intravenous sildenafil suffers
from the limitations of short dosing intervals, peripheral vasodilation, unwanted
side effects, and restricted use in pediatric patients. In this study, we sought
to test the hypothesis that inhalable poly(lactic-co-glycolic acid) (PLGA)
particles of sildenafil prolong the release of the drug, produce pulmonary
specific vasodilation, reduce the systemic exposure of the drug, and may be used
as an alternative to oral sildenafil in the treatment of PAH. Thus, we prepared
porous PLGA particles of sildenafil using a water-in-oil-in-water double emulsion
solvent evaporation method with polyethyleneimine (PEI) as a porosigen and
characterized the formulations for surface morphology, respirability, in-vitro
drug release, and evaluated for in vivo absorption, alveolar macrophage uptake,
and safety. PEI increased the particle porosity, drug entrapment, and produced
drug release for 36h. Fluorescent particles showed reduced uptake by alveolar
macrophages. The polymeric particles were safe to rat pulmonary arterial smooth
muscle cell and to the lungs, as evidenced by the cytotoxicity assay and analyses
of the injury markers in the bronchoalveolar lavage fluid, respectively.
Intratracheally administered sildenafil particles elicited more pulmonary
specific and sustained vasodilation in SUGEN-5416/hypoxia-induced PAH rats than
oral, intravenous, or intratracheal plain sildenafil did, when administered at
the same dose. Overall, true to the hypothesis, this study shows that inhaled
PLGA particles of sildenafil can be administered, as a substitute for oral form
of sildenafil, at a reduced dose and longer dosing interval.